The Inter- and Intra- Observer Agreement in Confocal Endomicroscopy Guided Diagnosis Of Pancreatic Cysts and Evaluation of Diagnostic Accuracy Compared to Histopathology

2021 ◽  
Author(s):  
J Machicado ◽  
B Napoleon ◽  
AM Lennon ◽  
D Tan Meng Yew ◽  
S Pereira ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Observer Agreement ◽  
Pancreatic Cysts ◽  
Confocal Endomicroscopy

scholarly journals In vivo optical cellular diagnosis for uterine cervical or vaginal intraepithelial neoplasia using flexible gastrointestinal endocytoscopy -a prospective pilot study-

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shoko Ono ◽  
Ayako Nozaki ◽  
Kana Matsuda ◽  
Emi Takakuwa ◽  
Naoya Sakamoto ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Intraepithelial Neoplasia ◽  
Observer Agreement ◽  
Optical Biopsy ◽  
Link Type ◽  
Guided Biopsy ◽  
Vaginal Intraepithelial Neoplasia ◽  
High Level

Abstract Backgrouund For patients with any kind of atypical squamous intraepithelial lesion of the uterine cervix or vagina, colposcopy and punch biopsy are common procedures for histological determination following cytology. However, colposcopy-guided biopsy does not provide a high level of diagnostic accuracy. The aim of this study was to determine the usefulness of optical biopsy in vivo using endocytoscopy compared with conventional procedures using colposcopy. Methods Between May 2018 and March 2019, patients who were scheduled for cervical conization or mapping biopsies of the vagina were prospectively enrolled. Endocytoscopy was performed by senior endoscopists prior to scheduled procedures, and endocytoscopic images and biopsy samples were taken from the most prominent site and surrounding area of the cervical or vaginal lesions. The collection process of images was randomized and anonymous, and three doctors separately evaluated the images according to the ECA classification. ECA 4 and 5 are indicative of endoscopic malignancy. The primary endpoint was diagnostic accuracy (benign or malignant: cervical intraepithelial neoplasia (CIN) 3 or vaginal intraepithelial neoplasia (VAIN) 3 or worse) of cell images at the most prominent site in each patient. Results A total of 28 consecutive patients were enrolled. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of endocytoscopic images were 95.0% (84.8–98.6%), 87.5% (61.9–96.5%), 95.0% (84.8–98.6%), 87.5% (61.9–96.5%) and 92.9% (78.2–98.0%), respectively. Inter-observer agreement among three reviewers was 0.78 (0.08–9.88, P < 0.01). On the other hand, the accuracy of colposcopy-guided biopsy was 74.1% (64.0–84.0%). Conclusions Optical cell diagnosis of cervical or vaginal intraepithelial neoplasia using endocytoscopy provides a high level of diagnostic accuracy. Trial registration The study was registered with the UMIN database (ID: 000031712). UMIN000031712. Registered 16 March 2017,

Tu1409 INTER-OBSERVER AGREEMENT BETWEEN ENDOSONOGRAPHERS FOR THE CLASSIFICATION OF PANCREATIC CYSTS WITHIN A PROSPECTIVE RANDOMIZED CLINICAL TRIAL

2019 ◽  
Vol 89 (6) ◽  
pp. AB613-AB614
Author(s):  
Harsh K. Patel ◽  
Michael B. Wallace ◽  
Amrita Sethi ◽  
Douglas O. Faigel ◽  
William R. Brugge ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Observer Agreement ◽  
Pancreatic Cysts ◽  
Prospective Randomized Clinical Trial

scholarly journals Comparison of diagnostic accuracy of computed tomography virtual endoscopy and flexible fibre-optic laryngoscopy in the evaluation of neck anatomic structures and neoplasms

2020 ◽  
pp. 197140092095723
Author(s):  
Angela Guarnizo ◽  
Rafael Glikstein ◽  
Vered Tsehmaister-Abitbul ◽  
Ionut Busca ◽  
Samy El-Sayed ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Diagnostic Accuracy ◽  
Virtual Endoscopy ◽  
Observer Agreement ◽  
Invasive Technique ◽  
Fibre Optic ◽  
Vocal Cords ◽  
Non Invasive ◽  
Laryngeal Lesions ◽  
Mcnemar’S Test

Background and purpose Computed tomography virtual endoscopy (CT-VE) is a non-invasive technique which allows visualisation of intraluminal surfaces by tridimensional reconstruction of air/soft tissues. The aim of this study was to compare the diagnostic accuracy of CT-VE and flexible fibre-optic laryngoscopy (FFL) in identifying normal neck anatomic structures and pharyngeal and laryngeal lesions. Methods Forty-two patients with a history of neck cancer were assessed by two ENT surgeons using FFL and by one neuroradiologist using CT-VE in order to evaluate the visualisation of the epiglottis, vallecula, glossoepiglottic folds, pyriform sinuses, vocal cords and mass pathology. The visualisation of the structures in both modalities was assessed according to the following score: 0 = not visualised, 1 = partial visualisation, 2 = complete and clear visualisation. A weighted kappa coefficient was used to evaluate the inter-observer agreement. McNemar’s test was performed to compare the two diagnostic tests. Results The inter-observer agreement between FFL and CT-VE was fair in the assessment of the vocal cords ( k = 0.341); moderate in the assessment of the glossoepiglottic folds ( k = 0.418), epiglottis ( k = 0.513) and pyriform sinuses ( k = 0.477); and substantial in the assessment of the vallecula ( k = 0.618) and the tumour (0.740). McNemar’s test showed no significant difference between the two tests ( p<0.05). Conclusion CT-VE is a non-invasive technique with a diagnostic accuracy comparable to FFL in terms of visualisation of anatomical structures and pharyngeal and laryngeal lesions.

Incidental pancreatic cysts: natural history and diagnostic accuracy of a limited serial pancreatic cyst MRI protocol

2014 ◽  
Vol 24 (5) ◽  
pp. 1020-1029 ◽  
Author(s):  
Stephanie Nougaret ◽  
Caroline Reinhold ◽  
Jaron Chong ◽  
Laure Escal ◽  
Gregoire Mercier ◽  
...  
Keyword(s):  
Natural History ◽  
Diagnostic Accuracy ◽  
Pancreatic Cyst ◽  
Pancreatic Cysts ◽  
Mri Protocol ◽  
Incidental Pancreatic Cysts

Needle-based confocal endomicroscopy for pancreatic cysts: the current agreement in interpretation

2016 ◽  
Vol 83 (5) ◽  
pp. 924-927 ◽  
Author(s):  
Kunal Karia ◽  
Irving Waxman ◽  
Vani J. Konda ◽  
Frank G. Gress ◽  
Amrita Sethi ◽  
...  
Keyword(s):  
Pancreatic Cysts ◽  
Confocal Endomicroscopy

scholarly journals Low diagnostic accuracy and inter-observer agreement on CT and MRI in diagnosis of spinal fractures in multiple myeloma

2021 ◽  
Vol 13 (3) ◽  
Author(s):  
Viktor Dalen ◽  
Anne-Sofie Vegsgaard Olsen ◽  
Claude-Pierre Jerome ◽  
Jonn-Terje Geitung ◽  
Anders E.A. Dahm
Keyword(s):  
Multiple Myeloma ◽  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Osteoporotic Fractures ◽  
Spinal Fractures ◽  
Observer Agreement ◽  
Cohen’S Kappa ◽  
Cohen's Kappa ◽  
Magnetic Resonance Imaging Mri ◽  
Ct And Mri

Skeletal disease is common in multiple myeloma. We investigated the inter-observer agreement and diagnostic accuracy of spinal fractures diagnosed by computer tomography (CT) and magnetic resonance imaging (MRI) from 12 myeloma patients. Two radiologists independently assessed the images. CT, MRI, and other images were combined to a gold standard. The inter-observer agreement was assessed with Cohen’s kappa. Radiologist 1 diagnosed 20 malignant spinal fractures on CT and 26 on MRI, while radiologist 2 diagnosed 12 malignant spinal fractures on CT and 22 on MRI. In comparison the gold standard diagnosed 10 malignant spinal fractures. The sensitivity for malignant fractures varied from 0.5 to 1 for CT and MRI, and the specificity varied from 0.17 to 0.67. On MRI, the specificity for malignant spinal fractures was 0.17 for both radiologists. The inter-observer agreement for malignant spinal fractures on CT was -0.42 (Cohen’s kappa) and -0.13 for MRI, while for osteoporotic fractures it was -0.24 for CT and 0.53 for MRI. We conclude that malignant spinal fractures were over-diagnosed on CT and MRI. The inter-observer agreement was extremely poor.

scholarly journals The Role of Confocal Endomicroscopy in the Diagnosis and Management of Pancreatic Cysts

2021 ◽  
pp. 41-49
Author(s):  
Margaret G Keane ◽  
Stephen P Pereira
Keyword(s):  
Diagnostic Accuracy ◽  
Needle Aspiration ◽  
Diagnostic Techniques ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Pancreatic Cysts ◽  
Cystic Lesions ◽  
Cystic Neoplasms ◽  
Common Clinical Finding

Pancreatic cystic lesions are an increasingly common clinical finding. Current diagnostic techniques cannot reliably differentiate patients with high-risk lesions requiring surgical resection from those that can be safely surveyed or discharged. As a result, some patients may undergo unnecessary surgery with associated morbidity while others enter long-term surveillance with associated healthcare costs. Needle-based confocal laser endomicroscopy enables real time microscopic examination of the epithelial lining of a cyst wall at the time of a standard endoscopic ultrasound examination. The procedure is associated with low rates of adverse events, especially when the probe is loaded into the fine-needle aspiration needle before the procedure and examination times are limited. Needle-based confocal laser endomicroscopy has consistently been shown to have better diagnostic accuracy than cytology, which is often paucicellular and non-diagnostic in pancreatic cystic lesions. Studies have shown that diagnostic accuracy in needle-based confocal laser endomicroscopy is 84–95% in mucinous lesions and 39–99% in serous lesions. However, this technology is expensive and its place in diagnostic algorithms remains uncertain. Despite this, health economic analyses in certain health systems have been favourable, largely because of its potential to be able to discharge patients with benign lesions, such as serous cystic neoplasms, from long-term surveillance. Widespread adoption of this technology is unlikely but it has the potential to have an important role in indeterminate pancreatic cystic lesions.

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