Transhepatic forceps biopsy after PTCD for histological assessment of bile duct stenoses or occlusions

2019 ◽  
Vol 57 (02) ◽  
pp. 133-138
Author(s):  
Eva-Marie Warnken ◽  
Michael Uder ◽  
Hubert Stein ◽  
Michael Wucherer ◽  
Michael Lell ◽  
...  
Keyword(s):  
Predictive Value ◽  
False Negative ◽  
Short Term ◽  
Microsoft Excel ◽  
Ct Guided ◽  
Forceps Biopsy ◽  
Negative Results ◽  
False Negative Results ◽  
Pet Ct ◽  
Ct Guided Biopsy

Abstract Purpose The goal of this study was to evaluate the experience of 11 years of wire-guided forceps biopsy via PTCD in patients with obstructive jaundice. Materials and methods In a retrospective approach, 56 biopsies in 51 patients were analyzed (22 female, 29 male). Data was collected from 2006 to 2016. Mean age was 71 years (range: 34 – 86 years). Data was extracted from dig. Patients’ records (KIS, PACS, RIS) to be analyzed in Microsoft Excel. Results All 56 procedures were technically successful. Stenosis in anastomoses were benign due to scarring in 7 patients and in 9 due to papillitis or others. In 4 patients, results in anastomosis were malignant. In 19 patients without anastomosis, CCC was the diagnosis, thereof 10 klatskin, 9 stenosis in other locations, followed by gastric, pancreatic, and colon carcinoma in 5, 3, and 2 patients. Three patients had a CUP (multimetering in case of more than 1 related category). Overall results were 35 mal. and 16 benign, 76.8 % of all proc. had a correct histopathologic result, and 23.2 % were false negative. Sensitivity was 65.8 %, which results in negative predictive value of 58.1 %. There was no false positive and so specificity was 100 %, as was the positive predictive value. False negative results (no malignancy but clinically and imaging suspect) were corrected by rerunning the procedure, by CT-guided biopsy or by 1 PET-CT. In 1 case the surg. sample brought the result. Minor complications occurred in 8 patients: shivering in 1 case, distinct but hemodynamically not relevant hemobilia in 5 cases, 2 portovenal bleedings. All bleedings were short-term and self-limiting. Conclusion Despite good feasibility, low peri- and post-interv. risk and high validity the forceps biopsy via PTCD is not widely used. For experienced interventionalists, it is an effective method for obtaining histology.

scholarly journals Evaluation of the Carba NP Test for Rapid Detection of Carbapenemase-Producing Enterobacteriaceae and Pseudomonas aeruginosa

2013 ◽  
Vol 57 (9) ◽  
pp. 4578-4580 ◽  
Author(s):  
Nathalie Tijet ◽  
David Boyd ◽  
Samir N. Patel ◽  
Michael R. Mulvey ◽  
Roberto G. Melano
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Rapid Detection ◽  
False Negative ◽  
Bacterial Extract ◽  
Content Type ◽  
Negative Results ◽  
False Negative Results

ABSTRACTThe Carba NP test was evaluated against a panel of 244 carbapenemase- and non-carbapenemase-producingEnterobacteriaceaeandPseudomonas aeruginosaisolates. We confirmed the 100% specificity and positive predictive value of the test, but the sensitivity and negative predictive value were 72.5% and 69.2%, respectively, and increased to 80% and 77.3%, respectively, using a more concentrated bacterial extract. False-negative results were associated with mucoid strains or linked to enzymes with low carbapenemase activity, particularly OXA-48-like, which has emerged globally in enterobacteria.

scholarly journals Study of the Efficacy of PET/CT in Lung Aspiration Biopsy and Factors Associated with False-Negative Results

2018 ◽  
Vol 79 (3) ◽  
pp. 129
Author(s):  
Il Wan Son ◽  
Ji Won Lee ◽  
Yeon Joo Jeong ◽  
Ahrong Kim ◽  
Hie Bum Suh ◽  
...  
Keyword(s):  
False Negative ◽  
Aspiration Biopsy ◽  
Factors Associated ◽  
Negative Results ◽  
False Negative Results ◽  
Pet Ct

scholarly journals Combined CTP- IGF-1 Score: A New Score for Assessment of Disease Severity in HCV Related Liver Cirrhosis

2022 ◽  
Author(s):  
Elsayed Ghannam ◽  
Salah Rozaik ◽  
Ramy Hasan Agwa ◽  
Ahmed Marwan ◽  
Mervat El-Sayed Mashaly ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
False Negative ◽  
The Body ◽  
P Value ◽  
Study Group ◽  
Negative Results ◽  
False Negative Results ◽  
Ctp Score

Abstract Background: Liver is the largest endocrine organ in the body. It is a key organ in insulin mediated metabolism, growth hormone and insulin like growth factors (IGF) pathway. Liver cirrhosis is the end result of many chronic diseases including hepatitis C virus infection. Child-Turcotte-Pugh (CTP) score is the standard used in assessment of hepatic reserve but it has its drawbacks in the form of subjective variables, hepatic encephalopathy and ascites. The aim of this work is to assess IGF-1 in patients with liver cirrhosis, correlate it with CTP score and assess value of modified combined CTP-IGF-1 score. Patients and Methods: 170 patients with CLD (liver cirrhosis) and 72 healthy controls in the study groups were enrolled in the study. All patients were subjected to thorough history, clinical examination and laboratory assessment. IGF-1 was measured and all patients were evaluated using CTP and CTP-IGF-1 scores. Results: IGF1 showed highly significant low values in the study group in comparison to controls (42.15 ± 27.976 and 66.31 ± 33.084 ng/ml respectively, p <0.001). It showed also highly significant negative correlation to CTP score in the study group (p < 0.001) with progressive decrements with CTP score stage progression where IGF1 levels were 48.32 ± 28.611, 40.28 ± 25.869 and 18.80 ± 15.953 ng/ml (mean ± standard deviation) in relation to CTP score groups A, B and C respectively (p value < 0.001). The combined CTP-IGF-1 score in comparison to the classic CTP score showed improved area under curve (0.848 and 0.854), sensitivity (71.2% and 88%), negative predictive value (41.7% and 53.7%), false negative results (49 and 19) and accuracy (75.73% and 83.98%) but decreased specificity (97.22% and 61.1%), positive predictive value (99.2% and 91.5%) and higher false positive results (1 and 14) respectively. Conclusion: IGF-1 show progressive decrements with progression of liver cirrhosis and is negatively correlated with CTP score. Addition of IGF-1 to CTP score to formulate combined score improves the AUC, sensitivity, negative predictive value and the accuracy of CTP score and decreases the false negative results.

FDG PET/CT and N0 mediastinal nodal status in early stage non-small cell lung cancer: A single institution retrospective experience.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 11570-11570
Author(s):  
Shashank Reddy Cingam ◽  
Sean Connor ◽  
Abhishek Harshad Patel ◽  
Samip R. Master ◽  
Amol Takalkar
Keyword(s):  
Fdg Pet ◽  
Early Stage ◽  
False Negative ◽  
Nodal Involvement ◽  
True Negative ◽  
Negative Results ◽  
Early Stage Nsclc ◽  
False Negative Results ◽  
Pet Ct ◽  
Fdg Pet Ct

11570 Background: The increasing use of CT and now low-dose screening CT scans for at-risk patients have led to increasing detection of lung cancer at early stages. FDG PET/CT is used as an adjunct to conventional imaging to assess loco-regional lymph node spread. However, there is a potential for false-negative results, especially in smaller lesions or early nodal involvement. The main objective of this study was to study the value of PET/CT scan to evaluate for true negative mediastinal nodes in patients with early stage NSCLC. Accurate determination of N0 status can have a significant impact on the cost-effectiveness and timely management of early stage NSCLC. Methods: Of a total of 404 patients with NSCLC managed at our facility between 2008 to 2015, 29 adult patients whose PET scan showed no or equivocal mediastinal nodal involvement and subsequently underwent surgical exploration of mediastinal lymph nodes were included in the study. Data variables that were collected included the cancer site, date of PET, node status on PET, type and date of surgery, cancer histology, and the tissue diagnosis of the sampled nodes. SAS software was used for the analysis of the data. Results: Of the 29 patients with N0 or equivocal nodes on FDG PET/CT, 7 (24.13%) had evidence of malignancy on biopsy of the surgically resected lymph nodes. No statistically significant differences were noted between the site of the neoplastic lesion, cancer histology, duration between the date of PET and the date of surgery in the true negative (TN) and false negative (FN) groups. The recurrence rate was higher in the FN group 60 % (3/5) compared to 21 % (4/19) in the TN group who had follow up for atleast 2 years. Conclusions: Our findings suggest incidence of false negative results of FDG PET/CT for evaluation of N0 nodes in early stage NSCLC is 24.13%. This is comparatively higher than false negatives rates with mediastinoscopy (5-10%) reported in other studies. Although our sample size is small, if confirmed, such a relatively high incidence of false negative results on FDG PET/CT for N0 disease supports the current recommendations for exploratory mediastinoscopy and/or surgery for definitive staging in early stage NSCLC.

scholarly journals Study of ascitic fluid cytology in ovarian tumors

2017 ◽  
Vol 5 (12) ◽  
pp. 5227 ◽  
Author(s):  
Chandralekha Janagam ◽  
Bhagyalakshmi Atla
Keyword(s):  
Ascitic Fluid ◽  
Predictive Value ◽  
False Positive ◽  
False Negative ◽  
Ovarian Tumors ◽  
Peritoneal Cytology ◽  
Negative Results ◽  
Benign Ovarian Tumours ◽  
False Negative Results ◽  
Fluid Cytology

Background: The objectives of this study were to examine the validity of ascitic fluid cytology in the detection of pathological findings, to examine the percentage of false positive and false negative results in the cytology of ascitic fluid and to determine the validity of peritoneal cytology in relation to the histopathological type of the ovarian tumour.Methods: This retrospective study, over a period of 6 months, included 106 peritoneal cytology findings. The experimental group included 106 cytology findings obtained from patients who presented with an abdominal lump/mass with ascites and diagnosed with ovarian tumors clinically. They included 88 benign ovarian tumours (83%) and 18 malignant ovarian tumors (17%). Patients with other causes of ascites were excluded from the study.Results: The sensitivity of peritoneal cytology is 90%, specificity is 96.5%, positive predictive value is 85.7%, and negative predictive value is 97.6%. In 1.8% of patients, the peritoneal cytology showed false negative results, while in 2.8%, the results were false positive. False negative results were found in one case of teratoma with squamous cell carcinoma and one case of yolk sac tumor. False positive results were found in 2 cases of tuberculous-salpingo- oophoritis and one case of chronic salpingo-oophoritis due to reactive mesothelial proliferation, mistaken for adenocarcinoma.Conclusions: Peritoneal cytology of ascitic fluid is highly specific and sensitive for detection of ovarian malignancies, particularly in grade 3 and grade 4 disease, since most of the patients with ovarian malignancies present to us at advanced stage of the disease.

scholarly journals 18F-FDG-PET/CT Evaluation of Indeterminate Adrenal Masses in Noncancer Patients

2021 ◽  
Author(s):  
Xin He ◽  
Elaine M Caoili ◽  
Anca M Avram ◽  
Barbra S Miller ◽  
Tobias Else
Keyword(s):  
Fdg Pet ◽  
False Negative ◽  
Blood Pool ◽  
Adrenal Tumors ◽  
Negative Results ◽  
False Negative Results ◽  
Pet Ct ◽  
Adrenal Masses ◽  
18F Fdg ◽  
Fdg Pet Ct

Abstract Context Adrenal tumors in noncancer patients are common. Objective Evaluate performance of 18F-fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG-PET/CT) in distinguishing between benign and malignant adrenal tumors. Design Retrospective chart review 2010-2019. Setting Academic institution. Patients One hundred and seventeen noncancer patients, defined as having no history of cancer or with cancer in remission for ≥5 years, completed 18F-FDG-PET/CT to evaluate adrenal masses, with pathologic diagnoses or imaging follow-up (≥12 months). Intervention 18F-FDG-PET/CT of 117 indeterminate adrenal masses. Main Outcome Measures Receiver operator characteristic curve of the ratios of adrenal lesion standardized uptake value (SUV)max to liver SUVmean and of adrenal lesion SUVmax to aortic arch blood pool SUVmean were constructed. Results Seventy benign and 47 malignant masses (35 adrenocortical carcinomas [ACCs], 12 adrenal metastases) were identified. Malignant masses had higher median liver SUV and blood pool SUV ratios than benign masses (6.2 and 7.4 vs 1.4 and 2.0, P &lt; .001). Median liver and blood pool SUV ratios of ACC (6.1 and 7.3, respectively) and metastases (6.7 and 7.7, respectively) were higher than those of than adenomas (1.4 and 2.2, P &lt; .05 for all comparisons). Optimal liver SUV ratio to discern between benign and malignant masses was 2.5, yielding 85% sensitivity, 90% specificity, and 7 false negative results (including 3 ACCs). Optimal blood pool SUV ratio was 3.4, yielding 83% sensitivity, 90% specificity, and 8 false negative results (including 4 ACCs). Conclusion When used in conjunction with other clinical assessments, 18F-FDG-PET/CT can be a valuable tool in evaluating adrenal masses in noncancer patients.

scholarly journals Soft Salt-Mannitol Agar–Cloxacillin Test: a Highly Specific Bedside Screening Test for Detection of Colonization with Methicillin-Resistant Staphylococcus aureus

1998 ◽  
Vol 36 (4) ◽  
pp. 986-989 ◽  
Author(s):  
Nuria Mir ◽  
Miguel Sánchez ◽  
Fernando Baquero ◽  
Blanca López ◽  
Celia Calderón ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Staphylococcus Aureus ◽  
Intensive Care ◽  
Predictive Value ◽  
Color Change ◽  
False Negative ◽  
Clinical Samples ◽  
Methicillin Resistant ◽  
Negative Results ◽  
False Negative Results

The early detection of colonization with methicillin-resistantStaphylococcus aureus (MRSA) of patients in intensive-care units is an essential step in the strategy for preventing MRSA epidemics. In this study, tubes containing soft salt-mannitol agar with cloxacillin (6 μg/ml) (SSMAC) were prepared for inoculation of clinical samples at patients’ bedsides by personnel of an intensive-care unit. A total of 1,914 swabs from different sample sites of 81 patients were dipped into SSMAC tubes, and after 24 h of incubation (in an incubator located near the intensive-care unit), an evident color change was considered by the intensive-care-unit personnel to be an MRSA alarm. Sixty-three (3.3%) SSMAC tubes were considered positive for MRSA, 1,827 (95.4%) were considered negative, and 24 (1.2%) were considered intermediate. Compared with values for parallel conventional surveillance cultures for MRSA, excluding tubes with intermediate results, the SSMAC test had a sensitivity of 72.7%, a specificity of 99.2%, a positive predictive value of 76.2%, and a negative predictive value of 99.0%. When intermediate tubes were considered positive, the corresponding values were 75.3, 98.2, 63.2, and 99.0%, respectively. The sensitivity and specificity values of the test to identify MRSA-colonized patients were 89.4 and 100%, respectively. Oropharyngeal and naris specimens were the most reliable samples for MRSA detection. False-negative results were frequent in bronchial aspirates with low (<103 to 106CFU/ml) MRSA counts. False-positive results were mainly due to methicillin-resistant Staphylococcus haemolyticus. The SSMAC tube is a useful, rapid, and inexpensive tool for the early identification of MRSA-colonized patients and, consequently, for the implementation of measures to prevent the spread of MRSA.

scholarly journals Validity of protein-creatinine and protein-osmolality ratios in the estimation of massive proteinuria in children with nephrotic syndrome

2007 ◽  
Vol 47 (4) ◽  
pp. 139
Author(s):  
M. Sukmawati ◽  
K. Suarta
Keyword(s):  
Nephrotic Syndrome ◽  
Predictive Value ◽  
Diagnostic Tests ◽  
Quantitative Methods ◽  
False Negative ◽  
Creatinine Ratio ◽  
Negative Results ◽  
False Negative Results ◽  
Sensitivity Specificity ◽  
Posttest Probability

Background Children with nephrotic syndrome have massiveproteinuria, a rate of excretion equal to or greater than 40 mg/hour/m 2 body surface. The ability to quantitate massive urinaryprotein excretion is very important for both diagnostic andprognostic purposes. Quantification of proteinuria using 24-hoururine collection (Esbach) is difficult to do especially in children;moreover, many false-positive and false-negative results arereported for any semi-quantitative methods such as dipstick andsulfosalicylic acid measurement.Objective To determine the accuracy of protein-creatinine ratio(PCR) and protein-osmolality ratio (POR) in quantification ofmassive proteinuria in children with nephrotic syndrome.Methods Diagnostic tests were conducted on children withnephrotic syndrome aged 2-12 years with Esbach as a referencestandard. Sensitivity, specificity, positive predictive value (PPV),negative predictive value, (NPV), pre and posttest probabilitywere compared between PCR and POR.Results Study patients consisted of 47 children, 38 (81%) withmassive proteinuria. PCR has sensitivity of 92%, specificity of78%, PPV of 95%, NPV of 70% and posttest probability of 95%.POR has sensitivity of 76%, specificity of 78%, PPV of 94%, NPVof 44% and posttest probability of 94%.Conclusion Both PCR and POR are accurate to determine massiveproteinuria in children with nephrotic syndrome.

scholarly journals Characterization of Focal Liver Lesions using CEUS and MRI with Liver-Specific Contrast Media: Experience of a Single Radiologic Center

2017 ◽  
Vol 38 (06) ◽  
pp. 619-625 ◽  
Author(s):  
Lukas Beyer ◽  
Florian Wassermann ◽  
Benedikt Pregler ◽  
Katharina Michalik ◽  
Janine Rennert ◽  
...  
Keyword(s):  
Contrast Media ◽  
Predictive Value ◽  
False Negative ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Predictive Values ◽  
Negative Results ◽  
False Negative Results ◽  
Sensitivity Specificity

Abstract Aim The purpose of this study was to compare contrast-enhanced ultrasound (CEUS), magnetic resonance imaging (MRI) using liver-specific contrast agent and a combination of both for the characterization of focal liver lesions (FLL). Methods 83 patients with both benign and malignant liver lesions were examined using CEUS and MRI after the intravenous administration of liver-specific contrast media. All patients had inconclusive results from prior imaging examinations. Histopathological specimens could be obtained in 53 patients. Ultrasound was performed using a multi-frequency curved probe (1 – 6 MHz) after the injection of 1 – 2.4 ml ultrasound contrast media. The sensitivity, specificity, positive predictive value and negative predictive value of CEUS, MRI and a combination of both (CEUS + MRI) were compared. Results The sensitivity, specificity, positive and negative predictive values regarding lesion classification were 90.9 %, 70.6 %, 92.3 % and 66.6 %, respectively, for CEUS; 90.9 %, 82.4 %, 95.2 % and 70.0 %, respectively, for MRI; and 96.9 %, 70.6 %, 92.7 % and 85.7 % respectively, for CEUS + MRI. There were no statistically significant differences. 6 malignant lesions were missed using CEUS or MRI alone (false negatives). The use of both modalities combined reduced the false-negative results to 2. Conclusion CEUS and MRI with liver-specific contrast media are very reliable and of equal informative value in the characterization of focal liver lesions. The number of false-negative results can be decreased using a combination of the two methods.

Sign in / Sign up

Export Citation Format

Share Document