The accuracy of diagnostic Imaging techniques in patients with a suspected Fracture-related Infection (IFI) trial: study protocol for a prospective multicenter cohort study.

IntroductionThe optimal diagnostic imaging strategy for fracture-related infection (FRI) remains to be established. In this prospective study, the three commonly used advanced imaging techniques for diagnosing FRI will be compared. Primary endpoints are (1) determining the overall diagnostic performances of white blood cell (WBC) scintigraphy, fluorodeoxyglucose positron emission tomography (FDG-PET) and magnetic resonance imaging (MRI) in patients with suspected FRI and (2) establishing the most accurate imaging strategy for diagnosing FRI.Methods and analysisThis study is a non-randomised, partially blinded, prospective cohort study involving two level 1 trauma centres in The Netherlands. All adult patients who require advanced medical imaging for suspected FRI are eligible for inclusion. Patients will undergo all three investigational imaging procedures (WBC scintigraphy, FDG-PET and MRI) within a time frame of 14 days after inclusion. The reference standard will be the result of at least five intraoperative sampled microbiology cultures, or, in case of no surgery, the clinical presence or absence of infection at 1 year follow-up. Initially, the results of all three imaging modalities will be available to the treating team as per local protocol. At a later time point, all scans will be centrally reassessed by nuclear medicine physicians and radiologists who are blinded for the identity of the patients and their clinical outcome. The discriminative ability of the imaging modalities will be quantified by several measures of diagnostic accuracy.Ethics and disseminationApproval of the study by the Institutional Review Board has been obtained prior to the start of this study. The results of this trial will be disseminated by publication of peer-reviewed manuscripts, presentation in abstract form at scientific meetings and data sharing with other investigators through academically established means.Trial registration numberThe IFI trial is registered in the Netherlands Trial Register (NTR7490).

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Investigating the performance and cost-effectiveness of the simple ultrasound-based rules compared to the risk of malignancy index in the diagnosis of ovarian cancer (SUBSONiC-study): protocol of a prospective multicenter cohort study in the Netherlands

BMC Cancer ◽

10.1186/s12885-015-1319-5 ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 8

Author(s):

Evelyne MJ Meys ◽

Iris JG Rutten ◽

Roy FPM Kruitwagen ◽

Brigitte F Slangen ◽

Martin GM Bergmans ◽

...

Keyword(s):

Ovarian Cancer ◽

Cohort Study ◽

Cost Effectiveness ◽

The Netherlands ◽

Study Protocol ◽

Multicenter Cohort Study ◽

Multicenter Cohort ◽

Risk Of Malignancy ◽

Risk Of Malignancy Index

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The usefulness of repeated CMR and FDG PET/CT in the diagnosis of patients with initial possible cardiac sarcoidosis

EJNMMI Research ◽

10.1186/s13550-021-00870-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

H. Mathijssen ◽

T. W. H. Tjoeng ◽

R. G. M. Keijsers ◽

A. L. M. Bakker ◽

F. Akdim ◽

...

Keyword(s):

Fdg Pet ◽

Cardiac Sarcoidosis ◽

Imaging Techniques ◽

Immunosuppressive Treatment ◽

Imaging Modalities ◽

Fdg Uptake ◽

Positron Emission ◽

Pet Ct ◽

Fdg Pet Ct ◽

Lge Cmr

Abstract Background Cardiac sarcoidosis (CS) diagnosis is usually based on advanced imaging techniques and multidisciplinary evaluation. Diagnosis is classified as definite, probable, possible or unlikely. If diagnostic confidence remains uncertain, cardiac imaging can be repeated. The objective is to evaluate the usefulness of repeated cardiac magnetic resonance imaging (CMR) and fluorodeoxyglucose positron emission tomography (FDG PET/CT) for CS diagnosis in patients with an initial “possible” CS diagnosis. Methods We performed a retrospective cohort study in 35 patients diagnosed with possible CS by our multidisciplinary team (MDT), who received repeated CMR and FDG PET/CT within 12 months after diagnosis. Imaging modalities were scored on abnormalities suggestive for CS and classified as CMR+/PET+, CMR+/PET−, CMR−/PET+ and CMR−/PET−. Primary endpoint was final MDT diagnosis of CS. Results After re-evaluation, nine patients (25.7%) were reclassified as probable CS and 16 patients (45.7%) as unlikely CS. Two patients started immunosuppressive treatment after re-evaluation. At baseline, eleven patients (31.4%) showed late gadolinium enhancement (LGE) on CMR (CMR+) and 26 (74.3%) patients showed myocardial FDG-uptake (PET+). At re-evaluation, nine patients (25.7%) showed LGE (CMR+), while 16 patients (45.7%) showed myocardial FDG-uptake (PET+). When considering both imaging modalities together, 82.6% of patients with CMR−/PET+ at baseline were reclassified as possible or unlikely CS, while 36.4% of patients with CMR+ at baseline were reclassified as probable CS. Three patients with initial CMR−/PET+ showed LGE at re-evaluation. Conclusion Repeated CMR and FDG PET/CT may be useful in establishing or rejecting CS diagnosis, when initial diagnosis is uncertain. However, clinical relevance has to be further determined.

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Multimodality Imaging in the Evaluation of Cardiovascular Manifestations of Malignancy

Cardiology Research and Practice ◽

10.4061/2011/378041 ◽

2011 ◽

Vol 2011 ◽

pp. 1-11

Author(s):

Laura Jiménez-Juan ◽

Jessica Leen ◽

Rachel M. Wald ◽

Elsie T. Nguyen ◽

Andrew T. Yan ◽

...

Keyword(s):

Multimodality Imaging ◽

Imaging Techniques ◽

Cardiovascular Imaging ◽

Imaging Modalities ◽

Direct Result ◽

Cancer Therapies ◽

Appropriate Use ◽

Anti Cancer ◽

Imaging Strategy ◽

Optimum Imaging

Up to one third of the population will die as a direct result of cancer. Accurate and timely diagnosis of disease often requires multiple different approaches including the use of modern imaging techniques. Prompt recognition of adverse consequences of some anti-cancer therapies also requires a knowledge of the optimum imaging strategy for the problem at hand. The purpose of this article is to review not only some of the commoner cardiovascular manifestations of malignancy but also to discuss the strengths, weaknesses and appropriate use of cardiovascular imaging modalities.

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MODERN IMAGING TECHNIQUES FOR EVALUATION OF DISTRACTIONAL REGENERATE BONE

Diagnostic radiology and radiotherapy ◽

10.22328/2079-5343-2019-10-3-14-21 ◽

2019 ◽

pp. 14-21

Author(s):

K. A. Diachkov ◽

A. V. Gubin ◽

A. Yu. Vasiliev ◽

G. V. Diachkova ◽

A. M. Aranovich

Keyword(s):

Magnetic Resonance Imaging ◽

Diagnostic Imaging ◽

Imaging Techniques ◽

Limb Lengthening ◽

Imaging Modalities ◽

Resonance Imaging ◽

Effective Evaluation ◽

Modern Imaging ◽

Medical Institutions ◽

Diagnostic Imaging Techniques

The review presents the results of diagnostic imaging techniques for evaluation of distractional regenerate bone starting from classical polypositional radiography to modern imaging modalities such as magnetic resonance imaging and computed tomography. There are described the modifications of the known techniques for evaluation of regeneration bone with quantitative and qualitative analysis, the opinions of different authors about possibilities and problems of imaging practices. There are presented the problems and goals for more effective evaluation of new bone at different stages of limb lengthening with the focus on a wider application of modern imaging modalities at medical institutions. The review is based on dissertation work of K. A. Diachkov «Diagnostic imaging for detection of the rules of distractional regenerate bone formation and bone quality during limb lengthening». Literature review was performed using database of PubMed, Medline, Embase 12 Russian journals on traumatology and orthopaedics, diagnostic imaging 2007–2016. All articles on evaluation of distractional bone regeneration were reviewed.

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What determines a successful tension-free vaginal tape? A prospective multicenter cohort study: Results from The Netherlands TVT database

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2005.06.021 ◽

2006 ◽

Vol 194 (1) ◽

pp. 65-74 ◽

Cited By ~ 38

Author(s):

Steven E. Schraffordt Koops ◽

Tanya M. Bisseling ◽

H. Jorien van Brummen ◽

A. Peter M. Heintz ◽

Harry A.M. Vervest

Keyword(s):

Cohort Study ◽

The Netherlands ◽

Multicenter Cohort Study ◽

Tension Free ◽

Tension Free Vaginal Tape ◽

Multicenter Cohort ◽

Study Results

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Survey of Physical Therapists’ Attitudes, Knowledge, and Behaviors Regarding Diagnostic Imaging

Physical Therapy ◽

10.1093/ptj/pzaa187 ◽

2020 ◽

Vol 101 (1) ◽

Author(s):

Sean D Rundell ◽

Murray E Maitland ◽

Robert C Manske ◽

George J Beneck

Keyword(s):

Diagnostic Imaging ◽

Knowledge Base ◽

Professional Education ◽

Research Policy ◽

Physical Therapists ◽

Imaging Techniques ◽

The United States ◽

Imaging Modalities ◽

Plain Radiographs ◽

And Behaviors

Abstract Objective The purpose of this study was to describe physical therapists’ attitudes, knowledge, and behaviors regarding the use of diagnostic imaging. Methods Physical therapists in the United States were recruited from July 2018 through May 2019 to complete a web-based, cross-sectional survey. Participants were asked about demographics, their perceived knowledge base and skills for recommending or ordering different imaging modalities, and their behaviors regarding diagnostic imaging. Descriptive statistics were used to characterize the participants’ demographics and responses to all questions. Chi-square tests were performed to compare responses by characteristics of survey participants and Wilcoxon signed-rank tests to compare levels of agreement. Results The mean age was 43 years, and of the 739 respondents, 58% (n = 417) were female. Ninety-two percent of respondents (n = 595) reported having recommended diagnostic imaging to another provider at least once. Only 11.6% (n = 75) reported having ever directly ordered diagnostic imaging. Participants’ attitudes about their knowledge base and skills for recommending or ordering plain radiographs were stronger compared with any other imaging modalities followed by magnetic resonance imaging (MRI) over other imaging techniques. Participants’ attitudes on recommending plain radiographs or MRI differed by professional education level, board-certification status, fellowship completion, and years since graduation. Conclusion It is common for physical therapists to recommend imaging, but few have directly ordered imaging. Most survey participants believed that they have an adequate knowledge base and skills for recommending and ordering plain radiographs and MRI. Impact These results can serve as a benchmark for future comparison as policies and educations evolve. Understanding physical therapists’ attitudes, knowledge, and use of diagnostic imaging is important to inform research, policy, and education.

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Imaging in Suspected Cardiac Sarcoidosis: A Diagnostic Challenge

Current Cardiology Reviews ◽

10.2174/1573403x15666190725121246 ◽

2020 ◽

Vol 16 (2) ◽

pp. 90-97 ◽

Cited By ~ 1

Author(s):

Francis J. Ha ◽

Sharad Agarwal ◽

Katharine Tweed ◽

Sonny C. Palmer ◽

Heath S. Adams ◽

...

Keyword(s):

Cardiac Imaging ◽

Fdg Pet ◽

Cardiac Sarcoidosis ◽

Imaging Techniques ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

Imaging Modalities ◽

Cardiac Imaging Techniques ◽

Diagnostic Dilemma

Cardiac Sarcoidosis (CS) represents a unique diagnostic dilemma. Guidelines have been recently revised to reflect the established role of sophisticated imaging techniques. Trans-thoracic Echocardiography (TTE) is widely adopted for initial screening of CS. Contemporary TTE techniques could enhance detection of subclinical Left Ventricular (LV) dysfunction, particularly LV global longitudinal strain assessment which predicts event-free survival (meta-analysis of 5 studies, hazard ratio 1.28, 95% confidence interval 1.18-1.37, p < 0.0001). However, despite the wide availability of TTE, it has limited sensitivity and specificity for CS diagnosis. Cardiac Magnetic resonance Imaging (CMR) is a crucial diagnostic modality for suspected CS. Presence of late gadolinium enhancement signifies myocardial scar and enables risk stratification. Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) coupled with myocardial perfusion imaging can identify active CS and guide immunosuppressant therapy. Gallium scintigraphy may be considered although FDG-PET is often preferred. While CMR and FDG-PET provide complementary information in CS evaluation, current guidelines do not recommend which imaging modalities are essential in suspected CS and if so, which modality should be performed first. The utility of hybrid imaging combining both advanced imaging modalities in a single scan is currently being explored, although not yet widely available. In view of recent, significant advances in cardiac imaging techniques, this review aims to discuss changes in guidelines for CS diagnosis, the role of various cardiac imaging modalities and the future direction in CS.

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Individual risk calculator to predict lymph node metastases in patients with submucosal (T1b) esophageal adenocarcinoma: a multicenter cohort study

Endoscopy ◽

10.1055/a-1399-4989 ◽

2021 ◽

Author(s):

Annieke W. Gotink ◽

Steffi Elisabeth Maria van de Ven ◽

Fiebo JW ten Kate ◽

Daan Nieboer ◽

Lucia Suzuki ◽

...

Keyword(s):

Cohort Study ◽

Lymph Node ◽

Lymphovascular Invasion ◽

Invasion Depth ◽

Multicenter Cohort Study ◽

Discriminative Ability ◽

Subdistribution Hazard ◽

Multicenter Cohort ◽

C Statistic ◽

Node Metastases

Background and study aims: There is a risk for lymph node metastases (LNM) after endoscopic resection of early esophageal adenocarcinoma (EAC). The aim of this study was to develop and internally validate a prediction model that estimates the individual metastases risk in patients with pT1b EAC. Patients and methods: This is a nationwide, retrospective, multicenter cohort study. Patients with pT1b EAC and treated with endoscopic resection and/or surgery between 1989 and 2016 were included. Primary endpoint was the presence of LNM in surgical resection specimen or the detection of metastases during follow-up. All resection specimens were histologically reassessed by specialized gastrointestinal pathologists. Subdistribution hazard regression analysis was used to develop a prediction model. The discriminative ability of this model was assessed using the c-statistic. Results: 248 patients with pT1b EAC were included. Metastases were seen in 78 patients, and the 5-year cumulative incidence was 30.9% (95% CI 25.1%-36.8%). The risk for metastases increased with submucosal invasion depth (subdistribution hazard ratio [SHR] 1.08, 95% CI 1.02-1.14, for every increase of 500 μm), for tumors with lymphovascular invasion (SHR 2.95, 95% CI 1.95-4.45) and for larger tumors (SHR 1.23, 95% CI 1.10-1.37, for every increase of 10 mm). The model demonstrated a good discriminative ability (c-statistic 0.81, 95% CI 0.75-0.86). Conclusions: One third of patients with pT1b EAC experienced metastases within 5 years. The probability for developing post resection metastases can be estimated with a personalized predicted risk score incorporating tumor invasion depth, tumor size and lymphovascular invasion. This model needs to be externally validated before implementation into clinical practice.

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Clinical applications of imaging modalities of the carpal joint in dogs with particular reference to the carpal canal

Journal of Veterinary Research ◽

10.2478/jvetres-2020-0006 ◽

2020 ◽

Vol 64 (1) ◽

pp. 169-174

Author(s):

Angelika Tobolska ◽

Zbigniew Adamiak ◽

Joanna Głodek

Keyword(s):

Diagnostic Imaging ◽

Soft Tissues ◽

Current Knowledge ◽

Wrist Joint ◽

Imaging Techniques ◽

Imaging Modalities ◽

Imaging Method ◽

Joint Surfaces ◽

Small Joint ◽

Carpal Joint

AbstractThe structure of the canine carpal joint is complex. This small joint consists of articulations that include the antebrachiocarpal, middle, carpometacarpal, and intercarpal joint surfaces. A large number of ligaments and tendons support and stabilise the carpus in dogs. Many injuries of this joint in dogs are not correctly recognised, diagnosed, or treated due to the limited use of diagnostic imaging methods. Radiography, the most common of them, has extensive application in diagnosing the causes of lameness in small animals. Other techniques, such as ultrasonography, computed tomography, and magnetic resonance imaging visualise other joint structures and surrounding soft tissues. However, these imaging modalities are rarely used to diagnose diseases and injuries of the canine carpus at present. The main reason for this is the small amount of research carried out and the lack of a properly described methodology for the use of imaging techniques. The wide use of all diagnostic imaging tools in the diagnosis of diseases and injuries of the wrist joint in humans shows that conducting studies on dogs could expand current knowledge. The use of these techniques in veterinary medicine could facilitate diagnosis and subsequent therapy of carpal disorders in dogs. MRI is the most frequently used imaging method in human medicine for visualisation of abnormalities of joints. This method could become a valuable part of the detection of inflammatory, traumatic, and degenerative diseases of the carpal joint in dogs.

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