The Role of Elastography in Fibroadenoma of the Breast and Differentiating it from its Mimics

Abstract Background Fibroadenomas are one of the most common benign diseases of the breast varying in number and size in all quadrants of the breast. Less than 2% of lesions with the typical ultrasound features of a fibroadenoma, are found to be malignant on biopsy. Aim of the Work To evaluate the diagnostic performance of combined ultrasonography and strain elastography and to compare the imaging characteristics of fibroadenomas with other benign and malignant mimics and assess the results by histopathological characteristics. Patients and Methods Type of Study: Cross-sectional study. Study Setting: The study was conducted at Ain Shams University Hospitals, Radiodiagnosis department. Study Period: 6 months (From March 2020 till September 2020). Study Population: Female Patients with breast lumps. Results Ultrasound elastography combined with B-mode ultrasonography had shown variable degrees of sensitivity and specificity. However, in our study it showed high sensitivity and specificity as compared to other studies. The most reliable tool in our study was the strain ratio having the highest sensitivity and specificity. Conclusion Strain elastography combined to B-mode sonography improves the diagnostic performance of differentiating benign from malignant well circumscribed breast lesions with an additional benefit of preventing unnecessary biopsies and speeding up the diagnosis of malignant lesions instead of follow up of the patient for early diagnosis of malignancies.

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Simple, Mobile-based Artificial Intelligence Algorithm in the detection of Diabetic Retinopathy (SMART) study

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2019-000892 ◽

2020 ◽

Vol 8 (1) ◽

pp. e000892 ◽

Cited By ~ 3

Author(s):

Bhavana Sosale ◽

Sosale Ramachandra Aravind ◽

Hemanth Murthy ◽

Srikanth Narayana ◽

Usha Sharma ◽

...

Keyword(s):

Artificial Intelligence ◽

Diabetic Retinopathy ◽

Sensitivity And Specificity ◽

Smart Phone ◽

High Sensitivity ◽

Ground Truth ◽

Cross Sectional Study ◽

Retinal Images ◽

Cross Sectional ◽

Smart Study

IntroductionThe aim of this study is to evaluate the performance of the offline smart phone-based Medios artificial intelligence (AI) algorithm in the diagnosis of diabetic retinopathy (DR) using non-mydriatic (NM) retinal images.MethodsThis cross-sectional study prospectively enrolled 922 individuals with diabetes mellitus. NM retinal images (disc and macula centered) from each eye were captured using the Remidio NM fundus-on-phone (FOP) camera. The images were run offline and the diagnosis of the AI was recorded (DR present or absent). The diagnosis of the AI was compared with the image diagnosis of five retina specialists (majority diagnosis considered as ground truth).ResultsAnalysis included images from 900 individuals (252 had DR). For any DR, the sensitivity and specificity of the AI algorithm was found to be 83.3% (95% CI 80.9% to 85.7%) and 95.5% (95% CI 94.1% to 96.8%). The sensitivity and specificity of the AI algorithm in detecting referable DR (RDR) was 93% (95% CI 91.3% to 94.7%) and 92.5% (95% CI 90.8% to 94.2%).ConclusionThe Medios AI has a high sensitivity and specificity in the detection of RDR using NM retinal images.

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Detecting proteinuria: A comparison of diagnostic tests

Paediatrica Indonesiana ◽

10.14238/pi51.1.2011.17-21 ◽

2011 ◽

Vol 51 (1) ◽

pp. 17

Author(s):

Jeanida Mauliddina ◽

Rosmayanti Siregar ◽

Oke Rina Ramayani ◽

Rafita Ramayati ◽

Rusdidjas Rusdidjas

Keyword(s):

Sensitivity And Specificity ◽

Predictive Value ◽

High Sensitivity ◽

Cross Sectional Study ◽

Common Symptom ◽

Sulfosalicylic Acid ◽

Cross Sectional ◽

Renal Disorders ◽

Acid Test ◽

Urine Specimens

Background Proteinuria is a condition when protein is found in urine, a common symptom in children with renal disorders. Proteinuria can also be found in nonnal children and in those with non-renal disorders. A high sensitivity test is needed to detect proteinuria. Spectrophotometry has been used as a standard to detect proteinuria, however, it is expensive and not readily available in health clinics. We tested the use of20% sulfosalicylic add to detect proteinuria, and compared it to spectrophotometry. The sulfosalicylic add test is inexpensive, rapid, and easily performed in primary community health centers.Objective To compare 2 0 % sulfosalicylic acid test t o spectrophotometry as a diagnostic test for proteinuria.Methods We conducted a cross-sectional study in Adam Malik Hospital from September 2009 until December 2009. Inclusion criteria were children aged 3 to 18 years who experienced kidney disease. We collected 24 hour urine specimens from 55 children by consecutive sampling. Urine specimens were tested for proteinuria by 20% sulfosalicylic acid test and spectrophotometry.Results Sensitivity and specificity of 20% sulfosalicylic acid test compared to spectrophotometry were 88.1 % and 69.2%, respectively, with a positive predictive value and a negative predictive value of 90.2% and 64.3%, respectively.Conclusion The sulfosalicylic acid test had low sensitivity and specificity for detecting proteinuria, but it was more practical and less expensive compared to spectrophotometry.

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Abstract 25: Carotid Plaque Thickness, Stenosis, Ulceration, Age And Male Sex Optimally Predict Carotid Intraplaque Hemorrhage

Stroke ◽

10.1161/str.46.suppl_1.25 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Joseph S McNally ◽

Michael McLaughlin ◽

Peter Hinckley ◽

Scott Treiman ◽

Gerald Treiman ◽

...

Keyword(s):

Area Under The Curve ◽

High Sensitivity ◽

Cross Sectional Study ◽

Discriminatory Power ◽

Intraplaque Hemorrhage ◽

Multivariable Logistic Regression Model ◽

Cross Sectional ◽

Rapid Acquisition ◽

Imaging Characteristics ◽

Male Sex

Background and Purpose: MRI-detected intraplaque hemorrhage (IPH) is associated with acute and future stroke. IPH can be detected with a high sensitivity, specificity and accuracy using heavily T1-weighted sequences such as the magnetization-prepared rapid acquisition gradient echo (MPRAGE) sequence. This sequence is not always available in screening of potential carotid sources of stroke. The purpose of this study was to determine the discriminatory power of clinical and imaging markers in predicting carotid IPH. Methods: In this retrospective cross sectional study, patients undergoing stroke workup were imaged with magnetic resonance imaging (MRI) and IPH detection. A total of 726 carotid plaques were imaged. Carotid imaging characteristics were recorded, including percent diameter and mm stenosis, plaque thickness, ulceration, intraluminal thrombus and IPH. Clinical confounders were recorded and a multivariable logistic regression model was fitted. Backward-elimination was used to determine essential predictors of IPH with a threshold two-sided p<.10. Receiver operating characteristic (ROC) analysis was performed to determine discriminatory value. Results: Significant predictors of carotid IPH included plaque thickness (Odds ratio, OR=2.20, p<.001), mm stenosis (OR=0.46, p<.001), ulceration (OR=4.25, p=.020), age (OR=1.11, p=.001) and male sex (OR=3.23, p=.077). Percent diameter stenosis (OR=31.0, p=.001) could be used nearly interchangeably with mm stenosis. The final model discriminatory value was excellent (Area under the curve, AUC=0.932). This was significantly higher than models using only plaque thickness (AUC=0.881), only mm stenosis (AUC=0.830) or only ulceration (AUC=0.715) p<.001. Conclusions: Optimal discrimination of carotid IPH required information on plaque thickness, mm stenosis, ulceration, age and male sex. When these factors are recorded, IPH can be predicted with a high discriminatory power.

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Penggunaan ROC pada Skrining Pre-Eklampsia dengan Metode USG DVAUT pada Ibu Hamil di Puskesmas Mulyorejo Surabaya

Jurnal Biometrika dan Kependudukan ◽

10.20473/jbk.v8i2.2019.126-133 ◽

2019 ◽

Vol 8 (2) ◽

pp. 129

Author(s):

Intan Laraswati ◽

Diah Indriani

Keyword(s):

Pregnant Women ◽

Sensitivity And Specificity ◽

Screening Method ◽

Sampling Technique ◽

High Sensitivity ◽

Cross Sectional Study ◽

Observational Research ◽

Operating Characteristics ◽

Cross Sectional ◽

Uterine Artery Doppler

Pre-eclampsia is the third highest cause of death in pregnant women. Symptoms of pre-eclampsia can be identified by the presence of hypertension, proteinuria and edema during pregnancy until postpartum. Pre-eclampsia cannot be identified with certain risk factors, and cannot be prevented. Pre-eclampsia can be detected early using the pre-eclampsia screening method with sonography. The sonographic device used is referred to as DVAUt ultrasound (Uterine Artery Doppler Velocimetry Ultrasonography). This studying an analytic observational research with a cross sectional study design. The population was all pregnant women who examined at the Mulyorejo primary health center in 2013 until the first quarter of 2018. The sampling technique was consecutive sampling with inclusion and exclusion criteria. The number of samples obtained is 496 data. The study aimed to determine the sensitivity and specificity of the pre-eclampsia screening method using DVAUt ultrasound in detecting the tendency of pregnant women to experience pre-eclampsia. The data were analyzed of sensitivity and specificity and the Receiver Operating Characteristics (ROC) curve with p <0.001. P1GF / sFlt-1 (Gold standard) biomaker test sensitivity of 89% and specificity of 90%. The results of this study were the sensitivity of pre-eclampsia screening at 99.7% and specificity of 81.9%. The ROC method obtained the results of pre-eclampsia screening using DVAUt ultrasound has a high sensitivity and specificity in detecting the tendency of pregnant women to experience pre-eclampsia. Suggestions for research to refresh knowledge and procedures for conducting pre-eclampsia screening checks.

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The Alpha-fetoprotein Serum is still Reliable as a Biomarker for the Surveillance of Hepatocellular Carcinoma in Indonesia

10.21203/rs.2.24011/v1 ◽

2020 ◽

Author(s):

Chyntia Olivia Maurine Jasirwan ◽

Alessa - Fahira ◽

Lianda - Siregar ◽

Imelda - Loho

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Cancer ◽

Hepatitis B ◽

Sensitivity And Specificity ◽

High Sensitivity ◽

Cross Sectional Study ◽

Surveillance Program ◽

Average Life Expectancy ◽

Cross Sectional ◽

Patients At Risk

Abstract Background and Aims: Hepatocellular carcinoma (HCC), the most common type of liver cancer, is one of the leading causes of cancer-related death worldwide with an inferior prognosis. In Indonesia, the average life expectancy is less than 3 months, with most patients being in an advanced stage where in the survival rate is very low. Early detection through surveillance program is very crucial. HCC guidelines worldwide have provided surveillance recommendation through the examination of α-fetoprotein (AFP) and ultrasound for patients at risk in developing HCC. However, there have been some controversies regarding the usage of AFP concerning its low sensitivity and specificity in detecting HCC. Therefore, the effectiveness of AFP in the surveillance of HCC patients and identifying the parameters most associated with the increase of AFP≥10 ng/ml in Indonesia should be evaluated.Methods: We analysed medical records of HCC patients and those at high-risk of developing HCC through cross-sectional study, including patients with cirrhosis and hepatitis B and C, from 2015 to 2017 who underwent treatment at the Cipto Mangunkusumo National Hospital and Dharmais National Cancer Hospital, Indonesia.Results: The sensitivity and specificity of AFP in the surveillance of HCC in Indonesia with a cut-off of 10 ng/ml were 82.6% and 68.9%, respectively. The parameters most associated with the increase of AFP ≥10 ng/ml according to multivariate analysis were the etiology of hepatitis B, the stage of Barcelona Clinic Liver Cancer B and C, and the presence of cirrhosis, respectively.Conclusion: AFP can still be used in the surveillance of HCC in Indonesia for its high sensitivity value.

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Xpert Ultra Assay on Stool to Diagnose Pulmonary Tuberculosis in Children

Clinical Infectious Diseases ◽

10.1093/cid/ciaa583 ◽

2020 ◽

Cited By ~ 3

Author(s):

Senjuti Kabir ◽

S M Mazidur Rahman ◽

Shakil Ahmed ◽

Md Shamiul Islam ◽

Rupali Sisir Banu ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Sensitivity And Specificity ◽

Diagnostic Performance ◽

Tertiary Care ◽

Cross Sectional Study ◽

Induced Sputum ◽

World Health ◽

Cross Sectional ◽

Health Organization ◽

Tuberculosis In Children

Abstract Background The World Health Organization recommends the Xpert MTB/RIF Ultra assay for diagnosing pulmonary tuberculosis (PTB) in children. Though stool is a potential alternative to respiratory specimens among children, the diagnostic performance of Xpert Ultra on stool is unknown. Thus, we assessed the diagnostic performance of Xpert Ultra on stool to diagnose PTB in children. Methods We conducted a cross-sectional study among consecutively recruited children (< 15 years of age) with presumptive PTB admitted in 4 tertiary care hospitals in Dhaka, Bangladesh, between January 2018 and April 2019. Single induced sputum and stool specimens were subjected to culture, Xpert, and Xpert Ultra. We considered children as bacteriologically confirmed on induced sputum if any test performed on induced sputum was positive for Mycobacterium tuberculosis and bacteriologically confirmed if M. tuberculosis was detected on either induced sputum or stool. Results Of 447 children, 29 (6.5%) were bacteriologically confirmed on induced sputum and 72 (16.1%) were bacteriologically confirmed. With “bacteriologically confirmed on induced sputum” as a reference, the sensitivity and specificity of Xpert Ultra on stool were 58.6% and 88.1%, respectively. Xpert on stool had sensitivity and specificity of 37.9% and 100.0%, respectively. Among bacteriologically confirmed children, Xpert Ultra on stool was positive in 60 (83.3%), of whom 48 (80.0%) had “trace call.” Conclusions In children, Xpert Ultra on stool has better sensitivity but lesser specificity than Xpert. A high proportion of Xpert Ultra assays positive on stool had trace call. Future longitudinal studies on clinical evolution are required to provide insight on the management of children with trace call.

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Ultrasound Elastography and TI- Rads (Thyroid Imaging Reporting and Data System) in the Diagnostic Evaluation of Thyroid Nodules

QJM ◽

10.1093/qjmed/hcaa068.010a ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

M A Ali ◽

A S Abdelrahman ◽

A M Khalaf

Keyword(s):

Thyroid Nodules ◽

Scoring Systems ◽

Cross Sectional Study ◽

Ultrasound Elastography ◽

P Value ◽

University Hospitals ◽

Cross Sectional ◽

Thyroid Cells ◽

Abnormal Growth ◽

Significant Difference

Abstract Background Thyroid nodules refers to an abnormal growth of thyroid cells that forms a lump within the thyroid gland. Although the vast majority of thyroid nodules are benign , a small percent is presenting as a thyroid cancer. Objective To quantify the sensitivity & the specifity of ultrasound elastography and TI-RAADS in evaluation of thyroid nodules among study population in Ain Shams university hospitals. Patients and Methods Type of study: cross sectional study. Study setting: it was conducted at Ain Shams University hospitals. Study period: March2018 to September 2018. Sample size: 41 patients were included in this study. Results There is a significant increase in the hyperechoic and isoechoic echogenicity in benign groups while no significant difference in hypoechogenicity and a significant difference in very hypoechogenicity in malignant group P- value=0.002. Conclusion Finally both the use of TI- RADS and elastography are methods to evaluate thyroids nodules according to US features and scoring systems that they are easy to perform, not invasive, informative, not costy and can be combined together to increase the accuracy of evaluation.

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The Alpha-fetoprotein Serum is still Reliable as a Biomarker for the Surveillance of Hepatocellular Carcinoma in Indonesia

10.21203/rs.2.24011/v2 ◽

2020 ◽

Author(s):

Chyntia Olivia Maurine Jasirwan ◽

Alessa - Fahira ◽

Lianda - Siregar ◽

Imelda - Loho

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Cancer ◽

Hepatitis B ◽

Sensitivity And Specificity ◽

High Sensitivity ◽

Cross Sectional Study ◽

Surveillance Program ◽

Average Life Expectancy ◽

Cross Sectional ◽

Patients At Risk

Abstract Background and Aims Hepatocellular carcinoma (HCC), the most common type of liver cancer, is one of the leading causes of cancer-related death worldwide with an inferior prognosis. In Indonesia, the average life expectancy is less than 5 months, with most patients being in an advanced stage wherein the survival rate is very low. Early detection through surveillance program is very crucial. HCC guidelines worldwide have provided surveillance recommendation through the examination of α-fetoprotein (AFP) and ultrasound for patients at risk in developing HCC. However, there have been some controversies regarding the usage of AFP concerning its low sensitivity and specificity in detecting HCC. Therefore, the effectiveness of AFP in the surveillance of HCC patients and identifying the parameters most associated with the increase of AFP≥10 ng/ml in Indonesia should be evaluated. Methods We analyzed medical records of HCC patients and those at high risk of developing HCC through cross-sectional study, including patients with cirrhosis and hepatitis B and C, from 2015 to 2017 who underwent treatment at the Cipto Mangunkusumo National Hospital and Dharmais National Cancer Hospital, Indonesia. Results The sensitivity and specificity of AFP in the surveillance of HCC in Indonesia with a cut-off of 10 ng/ml were 82.6% and 71.2%, respectively. The parameters most associated with the increase of AFP ≥10 ng/ml according to multivariate analysis were the etiology of hepatitis B, the stage of Barcelona Clinic Liver Cancer B and C, and the presence of cirrhosis, respectively. Conclusion AFP can still be used in the surveillance of HCC in Indonesia for its high sensitivity value.

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Penggunaan ROC pada Skrining Pre-Eklampsia dengan Metode USG DVAUT pada Ibu Hamil di Puskesmas Mulyorejo Surabaya

Jurnal Biometrika dan Kependudukan ◽

10.20473/jbk.v8i2.2019.129-137 ◽

2019 ◽

Vol 8 (2) ◽

pp. 129

Author(s):

Intan Laraswati ◽

Diah Indriani

Keyword(s):

Pregnant Women ◽

Sensitivity And Specificity ◽

Screening Method ◽

Sampling Technique ◽

High Sensitivity ◽

Cross Sectional Study ◽

Observational Research ◽

Operating Characteristics ◽

Cross Sectional ◽

Uterine Artery Doppler

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Screening of Primary School Children for Amblyopia and Amblyogenic Factors in Central Cairo, Egypt

Journal of Ophthalmology ◽

10.1155/2018/8425319 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Mohammad A. Rashad ◽

Khaled M. Abd Elaziz ◽

Samah Mahmoud Fawzy ◽

Ahmed Abdel Meguid Abdel latif ◽

Mahmoud Abdel Meguid Abdel latif

Keyword(s):

Visual Acuity ◽

Primary School ◽

School Children ◽

High Sensitivity ◽

Cross Sectional Study ◽

Primary School Children ◽

University Hospitals ◽

Cross Sectional ◽

Cutoff Value ◽

Ophthalmologic Examination

Objective. To measure the prevalence of amblyopia and amblyogenic factors among primary school children and to evaluate distance visual acuity (VA) as a screening test to detect amblyopia and define its cutoff value. Subjects and Methods. A cross-sectional study was conducted on primary school children in two schools in Central Cairo. Children underwent assessment of visual acuity using Landolt broken ring. Comprehensive ophthalmologic examination was performed for amblyopia suspects at the Ophthalmology Department of Ain Shams University Hospitals, including reassessment of best-corrected visual acuity (BCVA) using the same chart. Results. A total of 352 children were examined. Reduced screening VA (amblyopia suspect) was detected in 47 subjects (13.35%) proved amblyopia after comprehensive examination was 1.98% (7 cases). Refractive errors (REs) were present in all suspected and proved amblyopia cases (100%) but was only present in 11.6% of nonamblyopic students (P<0.05). The prevalence of hyperopia in the whole sample was 3.6%, and was 27.6% in subjects with RE. Thirty percent of hyperopic eyes were amblyopic. The prevalence of myopia was 9.3% of the whole sample and 70% of students with RE. Only 9% of myopic eyes were amblyopic. Mild to moderate amblyopia (VA better than 0.2log MAR) was 42.9%, while severe amblyopia represented 57.1%. Conclusion. This study emphasizes the importance of school-based eye care system targeting the detection of amblyopia by application of a fast screening distance VA test with a cutoff value of high sensitivity at log MAR 0.539 (Snellen′s VA equivalent 6/18).

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