HIGH DIAGNOSTIC ACCURACY OF ENDOSCOPIC ULTRASONOGRAPHY IN PATIENTS WITH SUSPECTED CHOLEDOCHOLITHIASIS

2019 ◽  
Author(s):  
B Keczer ◽  
Z Dubravcsik ◽  
A Szepes ◽  
L Madácsy ◽  
L Harsányi ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Endoscopic Ultrasonography ◽  
High Diagnostic Accuracy

scholarly journals Detection of Degenerative Changes on MR Images of the Lumbar Spine with a Convolutional Neural Network: A Feasibility Study

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 902
Author(s):  
Nils Christian Lehnen ◽  
Robert Haase ◽  
Jennifer Faber ◽  
Theodor Rüber ◽  
Hartmut Vatter ◽  
...  
Keyword(s):  
Neural Network ◽  
Lumbar Spine ◽  
Diagnostic Accuracy ◽  
Nerve Root ◽  
Spinal Canal ◽  
Spinal Canal Stenosis ◽  
Degenerative Changes ◽  
High Diagnostic Accuracy ◽  
Canal Stenosis ◽  
Disc Herniations

Our objective was to evaluate the diagnostic performance of a convolutional neural network (CNN) trained on multiple MR imaging features of the lumbar spine, to detect a variety of different degenerative changes of the lumbar spine. One hundred and forty-six consecutive patients underwent routine clinical MRI of the lumbar spine including T2-weighted imaging and were retrospectively analyzed using a CNN for detection and labeling of vertebrae, disc segments, as well as presence of disc herniation, disc bulging, spinal canal stenosis, nerve root compression, and spondylolisthesis. The assessment of a radiologist served as the diagnostic reference standard. We assessed the CNN’s diagnostic accuracy and consistency using confusion matrices and McNemar’s test. In our data, 77 disc herniations (thereof 46 further classified as extrusions), 133 disc bulgings, 35 spinal canal stenoses, 59 nerve root compressions, and 20 segments with spondylolisthesis were present in a total of 888 lumbar spine segments. The CNN yielded a perfect accuracy score for intervertebral disc detection and labeling (100%), and moderate to high diagnostic accuracy for the detection of disc herniations (87%; 95% CI: 0.84, 0.89), extrusions (86%; 95% CI: 0.84, 0.89), bulgings (76%; 95% CI: 0.73, 0.78), spinal canal stenoses (98%; 95% CI: 0.97, 0.99), nerve root compressions (91%; 95% CI: 0.89, 0.92), and spondylolisthesis (87.61%; 95% CI: 85.26, 89.21), respectively. Our data suggest that automatic diagnosis of multiple different degenerative changes of the lumbar spine is feasible using a single comprehensive CNN. The CNN provides high diagnostic accuracy for intervertebral disc labeling and detection of clinically relevant degenerative changes such as spinal canal stenosis and disc extrusion of the lumbar spine.

scholarly journals Validity of different copeptin assays in the differential diagnosis of the polyuria-polydipsia syndrome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Clara Odilia Sailer ◽  
Julie Refardt ◽  
Claudine Angela Blum ◽  
Ingeborg Schnyder ◽  
Jose Alberto Molina-Tijeras ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Diagnostic Accuracy ◽  
Healthy Volunteers ◽  
Primary Outcome ◽  
The Other ◽  
Poor Correlation ◽  
Elisa Assay ◽  
Moderate Correlation ◽  
High Diagnostic Accuracy ◽  
Osmotic Stimulation

AbstractThe aim of this study was to correlate three commercially available copeptin assays and their diagnostic accuracy in the differential diagnosis of the polyuria-polydipsia syndrome. Analyzed data include repeated copeptin measures of 8 healthy volunteers and 40 patients with polyuria-polydipsia syndrome undergoing osmotic stimulation and of 40 patients hospitalized with pneumonia. Copeptin was measured using the automated Brahms KRYPTOR, the manual Brahms LIA and the manual Cloud Clone ELISA assay. Primary outcome was the interrater correlation coefficient (ICC) and diagnostic accuracy in the polyuria-polydipsia syndrome of the three assays. In healthy volunteers, there was a moderate correlation for the KRYPTOR and LIA (ICC 0.74; 95% CI 0.07 to 0.91), and a poor correlation for the KRYPTOR and ELISA (ICC 0.07; 95% CI − 0.06 to 0.29), as for the LIA and ELISA (ICC 0.04; 95% CI − 0.04 to 0.17). The KRYPTOR had the highest diagnostic accuracy (98% (95% CI 83 to100)), comparable to the LIA (88% (95% CI 74 to 100)), while the ELISA had a poor diagnostic accuracy (55% (95% CI 34 to 68)) in the differential diagnosis of the polyuria-polydipsia syndrome. The KRYPTOR and LIA yield comparable copeptin concentrations and high diagnostic accuracy, while the ELISA correlates poorly with the other two assays and shows a poor diagnostic accuracy for polyuria-polydipsia patients. The current copeptin cut-off is valid for the KRYPTOR and LIA assay. Our results indicate that interpretation with other assays should be performed with caution and separate validation studies are required before their use in differentiating patients with polyuria-polydipsia syndrome.Trial registration: NCT02647736 January 6, 2016/NCT01940614 September 12, 2013/NCT00973154 September 9, 2009.

scholarly journals Image-guided Biopsy of Mesenteric, Omental, and Peritoneal Disease

2018 ◽  
Vol 02 (02) ◽  
pp. 106-115
Author(s):  
Joshua Cornman-Homonoff ◽  
David Madoff
Keyword(s):  
Diagnostic Accuracy ◽  
Patient Care ◽  
Clinical History ◽  
Peritoneal Disease ◽  
Image Guided ◽  
High Diagnostic Accuracy ◽  
Guided Biopsy ◽  
Imaging Characteristics ◽  
Procedural Evaluation ◽  
Technical Considerations

AbstractThe peritoneum, omenta, and mesenteries can be affected by a myriad of disease processes, but many common pathologies cannot be definitively distinguished based on clinical history and imaging characteristics alone. Percutaneous image-guided biopsy is a safe, well-tolerated procedure with high diagnostic accuracy, which has supplanted more invasive means of obtaining tissue and is increasingly essential in directing patient care. An understanding of the indications, pre-procedural evaluation, technical considerations, and potential complications is essential for the radiologist who performs these procedures, and more broadly for any clinician who may request them.

Robotic Colonoscopy: Comparative Analysis of Costs Compared to Painless Conventional Colonoscopy

2020 ◽  
Author(s):  
Rosi Sicuro ◽  
Emanuele Tumino ◽  
Christian Lambiase ◽  
Domenica Mamone
Keyword(s):  
Colorectal Cancer ◽  
Diagnostic Accuracy ◽  
Impact Analysis ◽  
Early Stage ◽  
Health Technology ◽  
University Hospital ◽  
Time Interval ◽  
Diagnostic Colonoscopy ◽  
High Diagnostic Accuracy ◽  
The University

Abstract BackgroundAmong the various causes of death, colorectal carcinoma represents the second highest cause in frequency both in men and in women. A colorectal cancer is diagnosed every 3.5 minutes and a person dies of colorectal cancer every 9 minutes. In 2018, in Italy were recorded around 51.000 new cases, with a mortality rate of over 18.000 deaths. There is clear evidence demonstrating that the identification and treatment of cancer at an early stage positively influence the reduction in mortality. Colonoscopy is the most effective technique used to identify and remove polyps, thus avoiding the costs related to surgical treatment and hospitalization.The purpose of this study is to evaluate the costs of the system Endotics for robotic colonoscopy as an alternative to conventional diagnostic colonoscopy performed under anaesthesia at the University Hospital of Pisa.MethodsThe cost analysis was developed according to the Budget Impact Analysis method application, an essential and complementary part of the Health Technology Assessment evaluation, which has the main purpose of assessing the financial sustainability of new health technology, estimating the consequences of its use and diffusion in a specific context characterized by the limited availability of resources. The observation period covered a time interval of 3 months, during which an average of 43 colonoscopic procedures per day was performed and mapped and a total of 23 colonoscopes were used. ResultsOverall, the work done has allowed identifying the cost of a conventional painless diagnostic colonoscopy performed in our institution which amounts to € 426.25. The valuation of the costs of the robotic colonoscopy amounted overall to € 441.25.ConclusionsThe ideal procedure to diagnose a colon disease should be safe, well-tolerated, possibly non-invasive, with high diagnostic accuracy and, not least, cost-effectiveness. The results of this study suggest that in the University Hospital of Pisa the costs related to robotic colonoscopy performed with the Endotics system are superimposable to those of conventional painless colonoscopy, reducing the overall risk associated with the colonoscopic procedure maintaining a high diagnostic accuracy with a greater tolerability by the patient, thus pushing the colonoscopy towards “the ideal procedure”.

scholarly journals Diagnostic accuracy of deep-learning with anomaly detection for a small amount of imbalanced data: discriminating malignant parotid tumors in MRI

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hidetoshi Matsuo ◽  
Mizuho Nishio ◽  
Tomonori Kanda ◽  
Yasuyuki Kojita ◽  
Atsushi K. Kono ◽  
...  
Keyword(s):  
Anomaly Detection ◽  
Diagnostic Accuracy ◽  
Area Under The Curve ◽  
Imbalanced Data ◽  
Classification Models ◽  
Mr Images ◽  
High Diagnostic Accuracy ◽  
Parotid Tumors ◽  
Malignant Parotid Tumors ◽  
Local Outlier

Abstract We hypothesized that, in discrimination between benign and malignant parotid gland tumors, high diagnostic accuracy could be obtained with a small amount of imbalanced data when anomaly detection (AD) was combined with deep leaning (DL) model and the L2-constrained softmax loss. The purpose of this study was to evaluate whether the proposed method was more accurate than other commonly used DL or AD methods. Magnetic resonance (MR) images of 245 parotid tumors (22.5% malignant) were retrospectively collected. We evaluated the diagnostic accuracy of the proposed method (VGG16-based DL and AD) and that of classification models using conventional DL and AD methods. A radiologist also evaluated the MR images. ROC and precision-recall (PR) analyses were performed, and the area under the curve (AUC) was calculated. In terms of diagnostic performance, the VGG16-based model with the L2-constrained softmax loss and AD (local outlier factor) outperformed conventional DL and AD methods and a radiologist (ROC-AUC = 0.86 and PR-ROC = 0.77). The proposed method could discriminate between benign and malignant parotid tumors in MR images even when only a small amount of data with imbalanced distribution is available.

L-DOPA decarboxylase mRNA levels provide high diagnostic accuracy and discrimination between clear cell and non-clear cell subtypes in renal cell carcinoma

2015 ◽  
Vol 48 (9) ◽  
pp. 590-595 ◽  
Author(s):  
Emmanuel I. Papadopoulos ◽  
Constantina Petraki ◽  
Alkiviadis Gregorakis ◽  
Eleni Chra ◽  
Emmanuel G. Fragoulis ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Diagnostic Accuracy ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Clear Cell ◽  
Dopa Decarboxylase ◽  
Mrna Levels ◽  
High Diagnostic Accuracy

scholarly journals Detecting delirium superimposed on dementia: diagnostic accuracy of a simple combined arousal and attention testing procedure

2017 ◽  
Vol 29 (10) ◽  
pp. 1585-1593 ◽  
Author(s):  
Sarah J. Richardson ◽  
Daniel H. J. Davis ◽  
Giuseppe Bellelli ◽  
Wolfgang Hasemann ◽  
David Meagher ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Medical Records ◽  
Clinical Utility ◽  
The Elderly ◽  
Testing Procedure ◽  
Cognitive Tests ◽  
Attention Task ◽  
High Diagnostic Accuracy ◽  
Eye Opening ◽  
Delirium Superimposed On Dementia

ABSTRACTBackground:Detecting delirium superimposed on dementia (DSD) can be challenging because assessment partly relies on cognitive tests that may be abnormal in both conditions. We hypothesized that a combined arousal and attention testing procedure would accurately detect DSD.Methods:Patients aged ≥70 years were recruited from five hospitals across Europe. Delirium was diagnosed by physicians using DSM-5 criteria using information from nurses, carers, and medical records. Dementia was ascertained by the Informant Questionnaire on Cognitive Decline in the Elderly. Arousal was measured using the Observational Scale of Level of Arousal (OSLA), which assesses eye opening, eye contact, posture, movement, and communication. Attention was measured by participants signaling each time an “A” was heard when “S-A-V-E-A-H-A-A-R-T” was read out.Results:The sample included 114 persons (mean age 82 years (SD 7); 54% women). Dementia alone was present in 25% (n = 28), delirium alone in 18% (n = 21), DSD in 27% (n = 31), and neither in 30% (n = 34). Arousal and attention was assessed in n = 109 (96%). Using OSLA, 83% participants were correctly identified as having delirium (sensitivity 85%, specificity 82%, AUROC 0.92). The attention task correctly classified 76% of participants with delirium (sensitivity 90%, specificity 64%, AUROC 0.80). Combining scores correctly classified 91% of participants with delirium (sensitivity 84%, specificity 92%, AUROC 0.94). Diagnostic accuracy remained high in the subgroup with dementia (93% correctly classified, sensitivity 94%, specificity 92%, AUROC 0.98).Conclusions:This combined arousal–attention assessment to detect DSD was brief yet had high diagnostic accuracy. Such an approach could have clinical utility for diagnosing DSD.

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