Routine non-thyroid head and neck cytology in a large UK centre: clinical utility and pitfalls

2015 ◽  
Vol 129 (7) ◽  
pp. 682-687
Author(s):  
P V Kaye ◽  
M Pigera ◽  
M M Khan ◽  
P Hollows ◽  
N Beasley
Keyword(s):  
Diagnostic Accuracy ◽  
Head And Neck ◽  
Reporting System ◽  
Needle Aspiration ◽  
High Rate ◽  
University Hospitals ◽  
Predictive Values ◽  
The Absolute ◽  
Sensitivity Specificity

AbstractObjective:This study aimed to examine the performance of head and neck cytology at Nottingham University Hospitals between 2009 and 2010.Methods:Cases were extracted from the Winpath pathology reporting system and correlations were investigated between results and the histological and clinical outcomes. Specimen adequacy and the sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of the cytology tests were calculated.Results:In all, 19.7 per cent of aspirates were judged to be inadequate. The absolute and relative sensitivities of head and neck cytology were 87.0 per cent and 89.0 per cent, respectively, and the absolute and relative specificities were 99.0 per cent and 97.0 per cent, respectively. The positive predictive values were 99.0 per cent and 96.0 per cent and the negative predictive values were 92.0 per cent and 92.0 per cent for a diagnostic accuracy of 94.5 per cent and 93.0 per cent. The performance was consistent with previous reports and superior to that of a recent UK series. The high rate of inadequate samples is, however, a concern.Conclusion:Head and neck cytology is a robust technique at our institution, although there are certain problem areas. There is room for improvement in the technical quality of fine needle aspiration.

scholarly journals Diagnostic Accuracy of Magnetic Resonance Imaging in Infective Vertebral Lesions

2021 ◽  
Vol 46 (3) ◽  
pp. 233-239
Author(s):  
Nusrat Ghafoor ◽  
Syeeda Showkat ◽  
Bishwajit Bhowmik ◽  
Shahryar Nabi ◽  
Mahmood uz Jahan ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Fine Needle Aspiration ◽  
Soft Tissues ◽  
Needle Aspiration ◽  
Ct Guided ◽  
Predictive Values ◽  
Fine Needle ◽  
Imaging Characteristics ◽  
Mri Diagnosis ◽  
Sensitivity Specificity

Background: Infective vertebral lesions usually involve the vertebral column, including the bone, intervertebral disk and paravertebral soft tissues. Variable imaging characteristics in conjunction with clinical findings can facilitate early diagnosis and treatment. MRI is a powerful imaging tool that can be help to evaluate spinal pathology specially infection. Typical MRI findings of infective vertebral disease are vertebral endplate destruction, bone marrow and intervertebral disc signal intensity changes and para vertebral soft tissue involvement. Objective: This study was aimed to assess whether the MRI can different the in differentiate the invective vertebral lesions from benign or malignant Tumors. Methods: This cross-sectional study was conducted on a total of 52 clinically suspected patients of infective vertebral lesions to establish diagnostic accuracy of MRI. The validity of MRI diagnosis for infective vertebral lesion was compared against CT-guided fine needle aspiration cytological (FNAC) diagnosis. Results: The sensitivity, specificity, positive and negative predictive values (PPVs and NPVs) and finally diagnostic accuracy of MRI were calculated by comparing the MRI diagnoses with those of fine needle aspiration cytological diagnosis of vertebral lesions. Finally the sensitivity, specificity, PPV and NPV of MRI diagnosis for infective vertebral lesion were 95.6%, 85.7%, 97.7% and 75.0% respectively. The overall diagnostic accuracy was 94.2%. Conclusion: Finding of this study suggested that MRI should be considered as the imaging modality of choice for patients with suspected infective vertebral lesions. Bangladesh Med Res Counc Bull 2020; 46(3): 233-239

scholarly journals Comparison of Immunocytochemistry and Immunohistochemistry on Breast Carcinoma: A Boon or a Bane?

2017 ◽  
Vol 9 (01) ◽  
pp. 005-010
Author(s):  
Kempula Geethamala ◽  
Venkataramappa Srinivasa Murthy ◽  
Bangalore Ramalingiah Vani ◽  
Madireddi Sudha Rao ◽  
Malugnalli Uddappa Thejaswini ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Hormone Receptor ◽  
Growth Factor Receptor ◽  
Needle Aspiration ◽  
Hormone Receptor Status ◽  
Kappa Statistics ◽  
Diagnostic Reliability ◽  
Predictive Values ◽  
Receptor Status ◽  
Sensitivity Specificity

ABSTRACT Introduction: Breast carcinoma is the most common cancer among women in the urban Indian population. Conventionally, immunohistochemistry (IHC) is done to determine the hormone receptor status of the tumor. Immunocytochemistry (ICC) on fine‑needle aspiration cytology (FNAC) was carried out to determine the same hormone receptor status of the tumor. Objective: The study was undertaken to evaluate the diagnostic reliability of performing estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (Her2/neu) receptor status on FNAC by ICC and to compare the results with IHC. Materials and Methods: A 2 years 6 months prospective study conducted in the Department of Pathology, ESIC Medical College and PGIMSR and ESIC Model Hospital, Rajajinagar, Bengaluru, wherein 100 breast carcinoma patients’ samples both cytology and histology were collected. IHC and ICC were done by peroxidase antiperoxidase technique. Validations of the receptor status were analyzed using sensitivity, specificity, positive and negative predictive values (PPV and NPV), and kappa statistics for agreements between ICC and IHC. Results: ICC was positive for ER, PR, and Her2/neu in 53, 50, and 22 cases, respectively. For ER, a cytohistologic correlation of 98%, with a sensitivity of 96.3%, specificity of 100%, and PPV and NPV being 100% and 95.7%. For PR, concordance of 97%, with a sensitivity of 94.3%, specificity of 100%, and PPV and NPV being 100% and 94%. Her2/neu had an agreement of 89%, with a sensitivity of 72%, specificity of 95.5%, and PPV and NPV being 85.7% and 90.1%. Conclusion: ICC has been a boon and can be a paramount diagnostic adjunct to the routine investigations.

scholarly journals A comparative study of fine-needle aspiration cytology and histopathology in salivary gland lesions

1970 ◽  
Vol 1 (2) ◽  
pp. 108-113 ◽  
Author(s):  
S Vaidya ◽  
A Sinha ◽  
S Narayan ◽  
S Adhikari ◽  
KC Sabira
Keyword(s):  
Salivary Gland ◽  
Diagnostic Accuracy ◽  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Neoplastic Lesions ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity

Background: A wide variety of benign and malignant tumours originate in the salivary glands and insufficient tumour cells make their diagnosis difficult in some patients. The aim of this study was to evaluate the efficacy of fine-needle aspiration cytology in the diagnosis of salivary gland lesions and to correlate cytological findings with histopathology. Materials and Methods: This was a prospective study done from September 2002 to May 2004. Fine needle aspiration cytology was performed in 58 patients with clinically significant salivary gland masses. Results: Fine needle aspiration cytology categorized 67.24% of the salivary gland lesions as neoplastic and 32.76% as non-neoplastic lesions. Amongst the neoplastic lesions, 76.9% were benign and 23.1% were malignant cases. Histopathological examination revealed that 81.05% of the cases were benign and 18.95% were malignant. Fine needle aspiration cytology had a sensitivity, specificity and diagnostic accuracy of 81.82%, 100% and 96.55%, respectively. The positive predictive value and negative predictive value was 100% and 95.9%, respectively. Conclusion: Fine needle aspiration of the salivary gland is a safe and reliable technique in the primary diagnosis of salivary gland lesions. Although, limitations are encountered while predicting specific lesions on cytology, especially when dealing with cystic and some malignant lesions, this study has shown that fine needle aspiration cytology has a high sensitivity, specificity and diagnostic accuracy in diagnosing salivary gland lesions. Keywords: Salivary glands; Fine needle aspiration cytology; Histopathology DOI: http://dx.doi.org/10.3126/jpn.v1i2.5403 JPN 2011; 1(2): 108-113

scholarly journals A Study of the Diagnostic Accuracy of an Existing Multivariable Test to Predict Shoulder Dystocia

2019 ◽  
Vol 09 (03) ◽  
pp. e262-e267
Author(s):  
Henry Alexander Easley ◽  
Todd Michael Beste
Keyword(s):  
Diagnostic Accuracy ◽  
Prediction Model ◽  
Study Design ◽  
False Positive ◽  
False Positive Rate ◽  
Shoulder Dystocia ◽  
The Other ◽  
Predictive Values ◽  
Positive Rate ◽  
Sensitivity Specificity

Objectives To evaluate the diagnostic accuracy of a multivariable prediction model, the Shoulder Screen (Perigen, Inc.), and compare it with the American College of Obstetricians and Gynecologists (ACOG) guidelines to prevent harm from shoulder dystocia. Study Design The model was applied to two groups of 199 patients each who delivered during a 4-year period. One group experienced shoulder dystocia and the other group delivered without shoulder dystocia. The model's accuracy was analyzed. The performance of the model was compared with the ACOG guideline. Results The sensitivity, specificity, positive, and negative predictive values of the model were 23.1, 99.5, 97.9, and 56.4%, respectively. The sensitivity of the ACOG guideline was 10.1%. The false-positive rate of the model was 0.5%. The accuracy of the model was 61.3%. Conclusion A multivariable prediction model can predict shoulder dystocia and is more accurate than ACOG guidelines.

scholarly journals Feasibility and Validity of Computed Tomography-Derived Fractional Flow Reserve in Patients With Severe Aortic Stenosis

2020 ◽  
Author(s):  
Michael Michail ◽  
Abdul-Rahman Ihdayhid ◽  
Andrea Comella ◽  
Udit Thakur ◽  
James D. Cameron ◽  
...  
Keyword(s):  
Aortic Stenosis ◽  
Diagnostic Accuracy ◽  
Operating Characteristic ◽  
Severe Aortic Stenosis ◽  
Characteristic Curve ◽  
Fractional Flow ◽  
Predictive Values ◽  
Flow Reserve ◽  
Artery Disease ◽  
Sensitivity Specificity

Background: Coronary artery disease is common in patients with severe aortic stenosis. Computed tomography-derived fractional flow reserve (CT-FFR) is a clinically used modality for assessing coronary artery disease, however, its use has not been validated in patients with severe aortic stenosis. This study assesses the safety, feasibility, and validity of CT-FFR in patients with severe aortic stenosis. Methods: Prospectively recruited patients underwent standard-protocol invasive FFR and coronary CT angiography (CTA). CTA images were analyzed by central core laboratory (HeartFlow, Inc) for independent evaluation of CT-FFR. CT-FFR data were compared with FFR (ischemia defined as FFR ≤0.80). Results: Forty-two patients (68 vessels) underwent FFR and CTA; 39 patients (92.3%) and 60 vessels (88.2%) had interpretable CTA enabling CT-FFR computation. Mean age was 76.2±6.7 years (71.8% male). No patients incurred complications relating to premedication, CTA, or FFR protocol. Mean FFR and CT-FFR were 0.83±0.10 and 0.77±0.14, respectively. CT calcium score was 1373.3±1392.9 Agatston units. On per vessel analysis, there was positive correlation between FFR and CT-FFR (Pearson correlation coefficient, R =0.64, P <0.0001). Sensitivity, specificity, positive predictive value, and negative predictive values were 73.9%, 78.4%, 68.0%, and 82.9%, respectively, with 76.7% diagnostic accuracy. The area under the receiver-operating characteristic curve for CT-FFR was 0.83 (0.72–0.93, P <0.0001), which was higher than that of CTA and quantitative coronary angiography ( P =0.01 and P <0.001, respectively). Bland-Altman plot showed mean bias between FFR and CT-FFR as 0.059±0.110. On per patient analysis, the sensitivity, specificity, positive predictive, and negative predictive values were 76.5%, 77.3%, 72.2%, and 81.0% with 76.9% diagnostic accuracy. The per patient area under the receiver-operating characteristic curve analysis was 0.81 (0.67–0.95, P <0.0001). Conclusions: CT-FFR is safe and feasible in patients with severe aortic stenosis. Our data suggests that the diagnostic accuracy of CT-FFR in this cohort potentially enables its use in clinical practice and provides the foundation for future research into the use of CT-FFR for coronary evaluation pre-aortic valve replacement.

scholarly journals Role of fine needle aspiration cytology (FNAC) in head and neck neoplasms with histopathological correlation

2015 ◽  
Vol 04 (02) ◽  
pp. 80-85
Author(s):  
Junu Devi ◽  
Kunja Lal Talukdar
Keyword(s):  
Lymph Node ◽  
Head And Neck ◽  
Fine Needle Aspiration ◽  
Head And Neck Neoplasms ◽  
Fine Needle Aspiration Cytology ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity

Abstract Background : Fine needle aspiration cytology is a simple, quick,inexpensive and minimally invasive technique used to diagnose head and neck neoplasms commonly originated from cervical lymph node, thyroid, parotid and other salivary glands. In this study a correlation was done between cytology and histopathology whenever surgical specimens were available. Aim : To assess the frequency of various benign and malignant neoplasms in different age groups and to evaluate the sensitivity, specificity of fine needle aspiration cytology(FNAC) in head and neck neoplasms. Materials and method : The study was conducted between September 2011 to August 2013 and total 249 cases of head and neck neoplasms were analysed. Patients between 1 to 80 years were included in the study. Fine needle aspiration cytology (FNAC) diagnosis was correlated with histopathology whenever possible. Results: Out of 249 head and neck neoplasms 55.42% were from lymph node, 19.28% were from salivary gland, 14.86% were from thyroid gland, 1.20% were nasal mass, 9.24% from other sites (skin and soft tissue). M:F was 1.4:1. Most commonly affected age group was 51-60 years. Metastatic squamous cell carcinoma was most commonly encountered neoplastic lesion. Overall sensitivity, specificity oflme needle aspiration cytology(FNAC) were 97.92% and 91.67% respectively. Conclusion : Fine needle aspiration cytology is a highly sensitive, specific and has a definite role in diagnosing most of the head and neck neoplasms.

Angio-CT

1995 ◽  
Vol 1 (1) ◽  
pp. 43-57 ◽  
Author(s):  
G. Grossi ◽  
F. Romanzi ◽  
G. MacChia ◽  
U. Ruffinengo ◽  
S. Calia
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Diagnostic Accuracy ◽  
Helical Ct ◽  
Diagnostic Information ◽  
Digital Angiography ◽  
Angio Ct ◽  
Associated Malformations ◽  
Sensitivity Specificity ◽  
Short Time

After nine months' experience with helical CT (Elscint Twin), we describe an epicrisis in 13 patients with intracranial aneurysms, 12 of whom were referred to us by the emergency room for suspect subarachnoid hemorrhage. After standard CT scan confirming subarachnoid hemorrhage, patients underwent angio-CT with display of the sac responsible for bleeding in all cases. All patients subsequently underwent digital angiography which confirmed the angio-CT findings and in three cases disclosed associated malformations. The sensitivity, specificity and diagnostic accuracy of the technique are assessed in relation to the quality of the images obtained (MIP) in such a short time (15 min on average). The diagnostic information is comparable to that offered by angio-MR with the obvious positive and negative aspects linked to each method. Digital angiography remains the technique of choice in terms of diagnostic accuracy, but carries some risk to the patient.

Interpretations of the dial test should be reconsidered. A diagnostic accuracy study reporting sensitivity, specificity, predictive values and likelihood ratios

2018 ◽  
Vol 3 (4) ◽  
pp. 198-204
Author(s):  
Richard Norris ◽  
Christian Kopkow ◽  
Michael James McNicholas
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Knee Ligament ◽  
Predictive Values ◽  
Medial Knee ◽  
Sensitivity Specificity ◽  
Dial Test

ObjectivesTo determine the accuracy of the dial test, used alone and in combination with additional clinical tests, in the diagnosis of an isolated posterolateral corner (PLC) injury, combined PLC-posterior cruciate ligament (PCL) injury or medial knee injury.MethodsA retrospective analysis of consecutive patients who underwent arthroscopic and/or open knee ligament reconstruction surgery was conducted. The dial test was performed in an outpatient’s clinic as part of a routine knee examination. Examination under anaesthetic and intraoperative findings were used as the reference standard test to determine the diagnostic accuracy of the dial test used alone and in combination with other PCL and medial knee tests. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+) and negative likelihood ratio (LR−) were calculated with corresponding 95% CI.ResultsData from 87 patients were available and included in the data analysis. For an isolated PLC injury, the dial test sensitivity and specificity were 0.20 (95% CI 0.08 to 0.39) and 1.00 (95% CI 0.92 to 1.00). The PPV and NPV were 1.00 (95% CI 0.52 to 1.00) and 0.70 (95% CI 0.59 to 0.80). LR+ and LR− of the dial test detecting isolated PLC injury were infinity (95% CI calculation not possible, infinity) and 0.80 (95% CI 0.41 to 1.57). The diagnostic accuracy of the dial test, when used alone and in combination with other PCL and medial knee tests, was also calculated for combined PLC-PCL and medial knee injuries.ConclusionA negative dial test at 30° of knee flexion can rule out a PLC injury, while a test that is positive at 30° and negative at 90° indicates a PLC injury, without concomitant injury to the PCL or medial knee ligaments. A positive test at both 30° and 90° can indicate isolated PLC, combined PLC-PCL or medial ligament injuries, and other knee examination findings are required to differentially diagnose these injury patterns.Level of evidenceII.

scholarly journals Nuclear imaging does not have clear added value in patients with low a priori chance of periprosthetic joint infection. A retrospective single-center experience

2022 ◽  
Vol 7 (1) ◽  
pp. 1-9
Author(s):  
Karsten D. Ottink ◽  
Stefan J. Gelderman ◽  
Marjan Wouthuyzen-Bakker ◽  
Joris J. W. Ploegmakers ◽  
Andor W. J. M. Glaudemans ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Revision Surgery ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
A Priori ◽  
Nuclear Imaging ◽  
Added Value ◽  
Low Grade ◽  
Predictive Values ◽  
Sensitivity Specificity

Abstract. Background: A low-grade periprosthetic joint infection (PJI) may present without specific symptoms, and its diagnosis remains a challenge. Three-phase bone scintigraphy (TPBS) and white blood cell (WBC) scintigraphy are incorporated into recently introduced diagnostic criteria for PJI, but their exact value in diagnosing low-grade PJI in patients with nonspecific symptoms remains unclear. Methods: In this retrospective study, we evaluated patients with a prosthetic joint of the hip or knee who underwent TPBS and/or WBC scintigraphy between 2009 and 2016 because of nonspecific symptoms. We reviewed and calculated diagnostic accuracy of the TPBS and/or WBC scintigraphy to diagnose or exclude PJI. PJI was defined based on multiple cultures obtained during revision surgery. In patients who did not undergo revision surgery, PJI was ruled out by clinical follow-up of at least 2 years absent of clinical signs of infection based on MSIS 2011 criteria. Results: A total of 373 patients were evaluated, including 340 TPBSs and 142 WBC scintigraphies. Thirteen patients (3.5 %) were diagnosed with a PJI. TPBS sensitivity, specificity, and positive and negative predictive values (PPV, NPV) were 71 %, 65 %, 8 % and 98 %, respectively. Thirty-five percent of TPBS showed increased uptake. Stratification for time intervals between the index arthroplasty and the onset of symptoms did not alter its diagnostic accuracy. WBC scintigraphy sensitivity, specificity, PPV and NPV were 30 %, 90 %, 25 % and 94 %, respectively. Conclusion: Nuclear imaging does not have clear added value in patients with low a priori chance of periprosthetic joint infection.

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