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.

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 Evaluation of the Rapidec Carba NP Test for Detection of Carbapenemases in Enterobacteriaceae

2015 ◽  
Vol 53 (12) ◽  
pp. 3828-3833 ◽  
Author(s):  
Michael Hombach ◽  
Barbara von Gunten ◽  
Claudio Castelberg ◽  
Guido V. Bloemberg
Keyword(s):  
Positive Predictive Value ◽  
Broad Spectrum ◽  
Incubation Time ◽  
Predictive Value ◽  
False Negative ◽  
Content Type ◽  
Negative Results ◽  
False Negative Results ◽  
Bacterial Inoculum ◽  
Sensitivity Specificity

This study evaluated the performance of the Rapidec Carba NP test, which was introduced recently into the market for the detection of carbapenemase production in a broad spectrum of β-lactamase-producingEnterobacteriaceaeclinical isolates. In total, 252 clinicalEnterobacteriaceaeisolates that had been genetically characterized with respect to carbapenemase, extended-spectrum β-lactamase (ESBL), and AmpC genes were analyzed; 51/252 isolates (20.2%) were genetically confirmed to be carbapenemase producers, whereas 201/252 isolates (79.8%) were genetically negative for the presence of carbapenemase genes. The Rapidec Carba NP test was applied according to the manufacturer's instructions, and results were read after 30 and 120 min of incubation. The overall sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the Rapidec Carba NP test were 90.2%, 100%, 100%, and 97.6%, respectively, when the manufacturer's instructions were followed. Four of 5 false-negative results occurred with OXA-48-like enzymes. After an incubation time of 30 min, the sensitivity was 49%. The sensitivity increased to 100% when the recommended bacterial inoculum was doubled and the test was read strictly after 120 min of incubation. The Rapidec Carba NP test is a useful tool for the reliable confirmation of carbapenemase-producingEnterobacteriaceaeisolates. The test should be read strictly after 120 min of incubation and the inoculum should be larger than recommended by the manufacturer.

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 An assessment of chromosomal alterations detected by fluorescence in situ hybridisation in pancreatobiliary tract malignancy

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xiaohong Pu ◽  
Hongwei Zheng ◽  
Xin Yang ◽  
Qing Ye ◽  
Zhiwen Fan ◽  
...  
Keyword(s):  
Predictive Value ◽  
In Situ Hybridisation ◽  
False Negative ◽  
Chinese Patients ◽  
Fluorescence In Situ Hybridisation ◽  
Predictive Values ◽  
Formalin Fixed Paraffin Embedded ◽  
9P21 Locus ◽  
Sensitivity Specificity

Abstract Background Using fluorescence in situ hybridisation (FISH) to detect any gain of chromosomes 3, 7, or 17 and loss of the 9p21 locus has been proven to be sensitive in the diagnosis of pancreatobiliary tumors. However, both genetic and environmental factors contribute to the pathogenesis of pancreatobiliary tumors. Therefore, it is unknown whether this method is suitable for Chinese patients with pancreatobiliary tumors. This study aims to compare the sensitivity, specificity, predictive values and accuracy of cytology, ERCP/MRCP and FISH based on Chinese patients with pancreatobiliary tumors,and to analyze differences between brushing-based and formalin-fixed paraffin-embedded (FFPE)-based FISH. Methods A total of 66 brush cytology specimens obtained during ERCP were detected by FISH and cytology test respectively to compare the sensitivity, specificity, predictive values and accuracy. Besides, FFPE-based FISH was performed on 46 corresponding paraffin sections of pancreatobiliary tumors obtained by surgical resection. Results Our findings demonstrate that FISH greatly improves diagnostic sensitivity and negative predictive value compared to ERCP/MRCP and cytology without much reduction in specificity and positive predictive value. However, our results also indicate that FFPE-based FISH could not effectively identify the false-negative of brushing-based FISH. Conclusions We believe that FISH can effectively distinguish true positive and false positive results of cytological or radiological suspicions of malignancy. However, FFPE-based FISH still does not precisely recognize the false-negative of brushing-based FISH. Both cytology-based and PPFE-based FISH had limitation in some specimens.

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.

The role of ultrasonography in the diagnosis of talocalcaneal coalitions

2020 ◽  
pp. 028418512094491
Author(s):  
Tiezheng Wang ◽  
Hengtao Qi ◽  
Kai Rong ◽  
Shuqian Zhang ◽  
Shougang Bao ◽  
...  
Keyword(s):  
False Negative ◽  
Fibrous Tissue ◽  
Joint Space ◽  
Clinical Suspicion ◽  
Youden Index ◽  
Imaging Method ◽  
Predictive Values ◽  
Negative Results ◽  
Reduced Space ◽  
Sensitivity Specificity

Background Patients with talocalcaneal coalitions (TCC) often undergo computed tomography (CT). However, ultrasonography diagnosis of TCC has been seldom done according to the literature. Purpose To investigate the accuracy of ultrasonography in diagnosing TCC compared to CT. Material and Methods Ninety-seven consecutive patients with a clinical suspicion of TCC were included. Ultrasonography was used to assess the classification and complication of TCC. The main sonographic criteria for a positive diagnosis in cases of osseous coalition were the joint space between the medial surface of talar head and the underlying sustentaculum tali of calcaneus disappearing and being replaced by a continuous hyperechoic bony structure. In cases of fibrous coalition, ultrasonography revealed a reduced space of the joint associated with an irregular, angular appearance of its outline and hypoechoic fibrous tissue inside. These data were compared with CT findings. κ statistic was applied to determine the level of agreement. The sensitivity, specificity, positive and negative predictive values, accuracy, and Youden index of ultrasonography as a diagnostic method were assessed. Results Ultrasonography findings were positive in 20 of 97 patients with a clinical suspicion of TCC. The diagnosis was confirmed by CT in 21 patients. There were one false-positive result and two false-negative results by ultrasonography. The κ value was 0.907. The sensitivity, specificity, positive and negative predictive values, accuracy, and Youden index of ultrasonography were 90.5%, 98.7%, 95.0%, 97.4%, 96.9%, and 0.892, respectively. Conclusion Ultrasonography could be a reliable, accurate, and non-radioactive diagnostic imaging method in diagnosis of patients with suspected TCC.

scholarly journals Screening of Extended-Spectrum β-Lactamases (ESBL)-producing Klebsiella pneumoniae with ChromID ESBL Media

2018 ◽  
Vol 10 (3) ◽  
pp. 217-21
Author(s):  
Emy Noerwidayati ◽  
Andaru Dahesihdewi ◽  
Osman Sianipar
Keyword(s):  
Likelihood Ratio ◽  
Predictive Value ◽  
Clinical Laboratory ◽  
False Negative ◽  
Clinical Isolates ◽  
True Negative ◽  
Nasal Sinus ◽  
Negative Results ◽  
Extended Spectrum ◽  
Sensitivity Specificity

BACKGROUND: Klepsiella pneumoniae, one of clinical isolates, is frequently found causative agent of hospital acquired infection. Currently, K. pneumoniae is found as extended-Spectrum β-lactamases (ESBL) producer, allowing it to become multidrugresistant. A clinical laboratory with limited facility needs a valid, reliable, inexpensive and simple laboratory test to control its infection and antimicrobial-resistancy. The aim of this study is to evaluate the diagnostic performance of a ESBL media to detect ESBL-producing K. pneumoniae.METHODS: An independent and blind comparative study of ChromID ESBL media and Double Disc Synergy Test (DDST) was conducted for detecting the clinical isolate of ESBL-producing K. pneumoniae. Clinical isolates of K. pneumoniae collected from the Clinical Laboratory of Dr. Sardjito Hospital were isolated.RESULTS: There were 103 clinical isolates of K. pneumoniae, which were isolated from urine, pus, blood, stool, cerebrospinal fluid, sputum, drain liquid, nasal sinus liquid, gastric wash, bronchi liquid, injury liquid and nasal swab. The number of true positive, true negative, false positive and false negative results were 74, 18, 9 and 2, respectively. Meanwhile, the sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio for positive result and likelihood ratio for negative result of the new ESBL media were 97.4%, 66.7%, 89.2%, 90%, 2.9 and 0.03, respectively.CONCLUSION: Since the new ESBL media and DDST results were similar, so the new ESBL media could be used for screening patients with clinical presentation that indicating a high suspicious of ESBL-producing bacteria.KEYWORDS: K. pneumoniae, ChromID ESBL, DDST, ESBL, sensitivity

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.

scholarly journals Clinical Performance of Two SARS-CoV-2 Serologic Assays

2020 ◽  
Vol 66 (8) ◽  
pp. 1055-1062 ◽  
Author(s):  
Mei San Tang ◽  
Karl G Hock ◽  
Nicole M Logsdon ◽  
Jennifer E Hayes ◽  
Ann M Gronowski ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Clinical Performance ◽  
False Negative ◽  
Diagnostic Sensitivity ◽  
Diagnostic Specificity ◽  
Negative Results ◽  
False Negative Results ◽  
Recent Emergence ◽  
Sensitivity Specificity ◽  
Record Review

Abstract Background The recent emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a rapid proliferation of serologic assays. However, little is known about their clinical performance. Here, we compared two commercial SARS-CoV-2 IgG assays. Methods 103 specimens from 48 patients with PCR-confirmed SARS-CoV-2 infections and 153 control specimens were analyzed using SARS-CoV-2 serologic assays by Abbott and EUROIMMUN (EI). Duration from symptom onset was determined by medical record review. Diagnostic sensitivity, specificity, and concordance were calculated. Results The Abbott SARS-CoV-2 assay had a diagnostic specificity of 99.4% (95% CI; 96.41–99.98%), and sensitivity of 0.0% (95% CI; 0.00–26.47%) at &lt;3 days post symptom onset, 30.0% (95% CI; 11.89–54.28) at 3–7d, 47.8% (95% CI; 26.82–69.41) at 8–13d and 93.8% (95% CI; 82.80–98.69) at ≥14d. Diagnostic specificity on the EI assay was 94.8% (95% CI; 89.96–97.72) if borderline results were considered positive and 96.7% (95% CI; 92.54–98.93) if borderline results were considered negative. The diagnostic sensitivity was 0.0% (95% CI; 0.00–26.47%) at &lt;3d, 25.0% (95% CI; 8.66–49.10) at 3–7d, 56.5% (95% CI; 34.49–76.81) at 3–7d and 85.4% (95% CI; 72.24–93.93) at ≥14d if borderline results were considered positive. The qualitative concordance between the assays was 0.83 (95% CI; 0.75–0.91). Conclusion The Abbott SARS-CoV-2 assay had fewer false positive and false negative results than the EI assay. However, diagnostic sensitivity was poor in both assays during the first 14 days of symptoms.

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