scholarly journals Inter-observer agreement on the evaluation of automated breast volume scanner for breast masses

2022 ◽  
pp. 1-11
Author(s):  
Yingchun Liu ◽  
Lin Chen ◽  
Jia Zhan ◽  
Xuehong Diao ◽  
Yun Pang ◽  
...  
Keyword(s):  
Imaging Modality ◽  
Observer Agreement ◽  
Breast Volume ◽  
Imaging Data ◽  
Predictive Values ◽  
Breast Masses ◽  
Cutoff Value ◽  
Automated Breast Volume Scanner ◽  
The Masses ◽  
Sensitivity Specificity

Objective: To explore inter-observer agreement on the evaluation of automated breast volume scanner (ABVS) for breast masses. Methods: A total of 846 breast masses in 630 patients underwent ABVS examinations. The imaging data were independently interpreted by senior and junior radiologists regarding the mass size ([Formula: see text][Formula: see text]cm, [Formula: see text][Formula: see text]cm and total). We assessed inter-observer agreement of BI-RADS lexicons, unique descriptors of ABVS coronal planes. Using BI-RADS 3 or 4a as a cutoff value, the diagnostic performances for 331 masses with pathological results in 253 patients were assessed. Results: The overall agreements were substantial for BI-RADS lexicons ([Formula: see text]–0.779) and the characteristics on the coronal plane of ABVS ([Formula: see text]), except for associated features ([Formula: see text]). However, the overall agreement was moderate for orientation ([Formula: see text]) for the masses [Formula: see text][Formula: see text]cm. The agreements were substantial to be perfect for categories 2, 3, 4, 5 and overall ([Formula: see text]–0.918). However, the agreements were moderate to substantial for categories 4a ([Formula: see text]), 4b ([Formula: see text]), and 4c ([Formula: see text]), except for category 4b of the masses [Formula: see text][Formula: see text]cm ([Formula: see text]). Moreover, for radiologists 1 and 2, there were no significant differences in sensitivity, specificity, accuracy, positive and negative predictive values with BI-RADS 3 or 4a as a cutoff value ([Formula: see text] for all). Conclusion: ABVS is a reliable imaging modality for the assessment of breast masses with good inter-observer agreement.

Multi-Slice Computed Tomographic Angiography for Stenosis Detection in Forearm Hemodialysis Arteriovenous Fistulas

2008 ◽  
Vol 9 (4) ◽  
pp. 278-284 ◽  
Author(s):  
P.P.G.M. Rooijens ◽  
G.P Serafino ◽  
D. Vroegindeweij ◽  
R. Dammers ◽  
T.I. Yo ◽  
...  
Keyword(s):  
High Specificity ◽  
Computed Tomographic Angiography ◽  
Observer Agreement ◽  
Predictive Values ◽  
Computed Tomographic ◽  
Arteriovenous Fistulas ◽  
Blinded Manner ◽  
Sensitivity Specificity ◽  
Tomographic Angiography ◽  
Diameter Reduction

Purpose A method of diagnosing the extent and severity of arteriovenous fistula (AVF) stenoses is multi-slice computed tomographic angiography (MS-CTA). The aim of this prospective study was to assess the accuracy of MS-CTA for the detection and grading of stenoses in AVF in comparison to digital subtraction angiography (DSA), which was used as the gold standard of reference. Methods Fifteen hemodialysis (HD) patients with dysfunctioning forearm AVF were included. These AVFs were evaluated by both DSA and MS-CTA and were read in a prospective, blinded manner by two radiologists experienced in vascular imaging. Results ROC analysis revealed areas under the curve of 0.90 ± 0.07 for observer I and 0.87 ± 0.08 for observer II at a stenosis cut-off level of ≥50% diameter reduction. The combined results for MS-CTA showed sensitivity, specificity and positive and negative predictive values of 82%, 98%, 82% and 98% for stenoses ≥50% and 71%, 99%, 77% and 98% for stenoses ≥75%. Inter-observer agreement for the detection of stenoses ≥50% diameter reduction was 0.70 and 1.0, for MS-CTA and DSA, respectively. Conclusion MS-CTA can provide good visualization of forearm HD access AVF and has moderate sensitivity, but high specificity for the detection of flow-limiting stenoses.

Radiographically negative stress-related bone injury

1998 ◽  
Vol 39 (4) ◽  
pp. 416-420 ◽  
Author(s):  
J. Hodler ◽  
H. Steinert ◽  
M. Zanetti ◽  
U. Frölicher ◽  
J. Rogala ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Bone Scintigraphy ◽  
Imaging Modality ◽  
Diagnostic Value ◽  
Bone Diseases ◽  
Two Phase ◽  
Predictive Values ◽  
Bone Injury ◽  
Initial Imaging ◽  
Sensitivity Specificity

Purpose: To assess the diagnostic value of MR imaging relative to two-phase bone scintigraphy in radiographically negative stress-related injuries. Material and Methods: Sixteen consecutive patients presenting with stressrelated bone injuries and normal standard radiographs were examined with two-phase bone scans and MR imaging. MR imaging protocols varied according to the region to be examined. The MR and scintigraphic images were evaluated blindly and separately by respectively two radiologists and two nuclear medicine physicians. The standard of reference was represented by a combination of clinical and scintigraphic findings as well as clinical follow-up. Results: For MR imaging, sensitivity, specificity, and positive and negative predictive values for the presence of stress-related injuries for the two readers were 69/63%, 100/80%, 100/91%, and 50/40%, respectively. Interobserver agreement was good (kappa=0.62). For scintigraphy, all abnormal and normal findings were correctly identified. Conclusion: For patients with clinically suspected stress-related injuries and a low probability of other active bone diseases (such as infection or neoplasm), bone scintigraphy should be the initial imaging modality.

scholarly journals Performance of RIPASA and AIR Scores in a Middle-Eastern Subset of Patients with Suspected Diagnosis of Acute Appendicitis

2020 ◽  
Author(s):  
Mohammed Faisal ◽  
Ahmed Bayoumi ◽  
Ahmed Abo Bakr ◽  
Marcus Edlehamre ◽  
Islam Khaled
Keyword(s):  
Acute Appendicitis ◽  
Low Income ◽  
Low Income Countries ◽  
Risk Scores ◽  
Predictive Values ◽  
Cutoff Value ◽  
Egyptian Population ◽  
Cutoff Values ◽  
Sensitivity Specificity ◽  
Ripasa Score

Abstract Background: Early and definitive acute appendicitis (AA) diagnosis remains a great challenge in clinical practice worldwide. Currently, several risk scores are available for the clinical assessment of AA, although there are differences in their accuracy rates. The aim of the study was to assess and analyze the accuracy of the acute inflammatory response (AIR) and Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scores in an Egyptian population. Methods: A series of 310 patients, 61% male with a median age of 18 years, with Rt. Iliac fossa pain were clinically evaluated for suspicion of AA. All patients were assessed using both the AIR and RIPASA scores. Following evaluation, all patients underwent appendectomy. A final diagnosis of AA was based on histopathology. Two predetermined cutoff values for the AIR score and one cutoff value for the RIPASA score was evaluated for sensitivity, specificity, and accuracy. Statistical analysis was performed using SPSS version 22. Cross tabulation was performed to assess sensitivity, specificity, positive and negative predictive values along with other tests for parametric and non-parametric variables.Results: The sensitivities of the RIPASA score cutoff value of ≥7.5 and AIR score cutoff values of >4 and >8 were 83.8%, 92.2%, and 33.1%, accordingly, while the specificities were 69.2%, 76.7%, and 84.6%, respectively. AIR score of >4 (91%) was more accurate compared to AIR score of >8 (37.4%) and RIPASA score of ≥7.5 (82.5%). Conclusion: An AIR score of >4 had better sensitivity, specificity, and accuracy compared to a RIPASA score of ≥7.5 for the Egyptian population. However, an AIR score of >8 was more specific. Therefore, an evaluation of patients in low-income countries using one of these scoring systems is highly recommended to avoids unnecessary hospitalization along in negative individuals, in addition to preventing complications in positive cases.

Usefulness of Grey Scale and Doppler transvaginal sonography in diagnosis of ovarian torsion

2020 ◽  
Vol 14 (2) ◽  
pp. 97-102
Author(s):  
Khalid Rehman `Yousaf ◽  
Shahzad Saeed ◽  
Saman Chaudhry ◽  
Rabia Bashrat ◽  
Abadullah Khalid ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Ovarian Function ◽  
Imaging Modality ◽  
Ovarian Torsion ◽  
Transvaginal Sonography ◽  
Predictive Values ◽  
Grey Scale ◽  
Sensitivity Specificity

Background: Ovarian torsion diagnosis is a great challenge as delay in diagnosis can cause severe morbidity. Early accurate diagnosis is crucial to preserve ovarian function. Ultrasonography being the primary imaging modality plays a vital role in the evaluation of suspected ovarian torsion by helping surgeons reach the correct diagnosis, thus avoiding unnecessary intervention. This study aims to determine the diagnostic accuracy of isolated and combined sonographic features of ovarian torsion on grey scale and Doppler transvaginal ultrasonography. Patients and methods: From radiology database, from January 2016 till December 2019, sonographic signs of ovarian torsion in 113 women with suspected ovarian torsion on ultrasonography and subsequent surgical diagnosis were evaluated. Ultrasound findings were compared with surgical findings to determine the accuracy, sensitivity, specificity, and positive and negative predictive values of individual and combined ultrasound signs. Results: Diagnostic accuracy of ultrasound for ovarian torsion was 85.8%. Abnormal ovarian Doppler flow was the most accurate individual sonographic sign with accuracy, sensitivity, specificity and positive predictive value of 85.8%, 83.5%, 100% and 100% respectively followed by ovarian enlargement and ovarian edema. Combined ultrasound signs resulted in higher sensitivity and positive predictive values, and lower specificity and negative predictive values for ovarian torsion. Increasing the number of sonographic parameters increased the specificity but decreased sensitivity. High accuracy, sensitivity, positive predictive value, specificity and negative predictive value was seen when combination of three or two sonographic parameters was used as diagnostic criteria. Conclusion: Transvaginal sonography is a convenient, reliable and extremely useful imaging modality for preoperative diagnosis of ovarian torsion with high specificity, sensitivity, positive predictive value and diagnostic accuracy helping treating physicians to take prompt decisions regarding timely surgical intervention. However, due to low negative predictive values, absence of sonographic signs does not rule out ovarian torsion and high index of clinical suspicion remains of utmost importance.

scholarly journals Differentiation of the right versus left outflow tract ventricular arrhythmias using local activation time at the His bundle electrogram

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Won-Seok Choe ◽  
So-Ryoung Lee ◽  
Myung-Jin Cha ◽  
Eue-Keun Choi ◽  
Seil Oh
Keyword(s):  
Diagnostic Accuracy ◽  
Outflow Tract ◽  
Activation Time ◽  
Characteristic Analysis ◽  
Predictive Values ◽  
Cutoff Value ◽  
Local Activation ◽  
His Bundle ◽  
Sensitivity Specificity ◽  
Local Activation Time

Abstract Background Although multiple algorithms based on surface electrocardiographic criteria have been introduced to localize idiopathic ventricular arrhythmia (VA) origins from the outflow tract (OT), their diagnostic accuracy and clinical usefulness remain limited. We evaluated whether local activation time of the His bundle region could differentiate left and right ventricular OT VA origins in the early stage of electrophysiology study. Methods We studied 30 patients who underwent catheter ablation for OT VAs with a left bundle branch block pattern and inferior axis QRS morphology. The interval between the local V signal on the mapping catheter placed in the RVOT and His bundle region (V(RVOT)-V(HB) interval) and the interval from QRS complex onset to the local V signal on the His bundle region (QRS-V(HB) interval) were measured during VAs. Results The V(RVOT)-V(HB) and QRS-V(HB) intervals were significantly shorter in patients with LVOT VAs. The area under the curve (AUC) for the V(RVOT)-V(HB) interval by receiver operating characteristic analysis was 0.865. A cutoff value of ≤ 50 ms predicted an LVOT origin of VA with sensitivity, specificity, and positive and negative predictive values of 100%, 62.5%, 40%, and 100%, respectively. The QRS-V(HB) interval showed similar diagnostic accuracy (AUC, 0.840), and a cutoff value of ≤ 15 ms predicted an LVOT origin of VA with a sensitivity, specificity, and positive and negative predictive values of 100%, 70.8%, 45.2%, and 100%, respectively. Conclusion The V(RVOT)-V(HB) and QRS-V(HB) intervals could differentiate left from right OT origins of VA with high sensitivity and negative predictive values.

scholarly journals Accuracy of fine needle aspiration compared to core needle biopsy in breast masses

2019 ◽  
Vol 21 (2) ◽  
pp. 75-79
Author(s):  
Mohammad Moazeni Bistgani ◽  
Monem Basravi ◽  
Abdolmajid Taheri ◽  
Shahla Taheri ◽  
Soleyman Kheiri
Keyword(s):  
Fine Needle Aspiration ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
High Sensitivity ◽  
Needle Aspiration ◽  
Predictive Values ◽  
Breast Masses ◽  
Core Needle ◽  
Fine Needle ◽  
Sensitivity Specificity

Background and aims: Breast cancer is one of the main causes of death in women, the early diagnosis of which is made by physical examination, mammography, ultrasound, and biopsy of breast masses. The aim of this study was to assess the diagnostic accuracy of fine needle aspiration (FNA) compared to core needle biopsy (CNB) in breast masses. Methods: The current descriptive study was conducted in Kashani and Hajar hospitals in 2015. And a total of 200 patients diagnosed with breast masses participated in this study. First, patients referred to the clinic, received local anesthesia in the area, and then underwent FNA using 10 cc syringes and 23G needles, and simultaneously CNB specimens were taken by a special needle for diagnosis. FNA and CNB specimens were transferred to the Pathology Department with a few day interval for cytological interpretation. Results: The sensitivity and specificity of FNA compared to CNB in the diagnosis of malignant breast masses were 83.9% and 89.9%, respectively. Moreover, the positive and negative predictive values of FNA for breast masses were 78.8% and 92.5%, respectively. The accuracy of FNA test for breast masses was also 0.88%. Conclusion: According to the results of this study, FNA test had a high sensitivity, specificity, and predictive value in the diagnosis of breast masses. Therefore, it could be used as an appropriate diagnostic tool, and could obviously save many costs as well.

scholarly journals The Diagnostic Value of Serum Gastrin-17 and Pepsinogen for Gastric Cancer Screening in Eastern China

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Hongzhang Shen ◽  
Kangwei Xiong ◽  
Xiangyu Wu ◽  
Sile Cheng ◽  
Qifeng Lou ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Eastern China ◽  
Intraepithelial Neoplasia ◽  
Diagnostic Value ◽  
Diagnostic Efficiency ◽  
Predictive Values ◽  
Cutoff Value ◽  
Cutoff Values ◽  
Significant Difference ◽  
Sensitivity Specificity

Objective. To evaluate the diagnostic value of gastrin-17 (G-17) and pepsinogen (PG) in gastric cancer (GC) screening in China, especially eastern China, and to determine the best diagnostic combination and threshold (cutoff values) to screen out patients who need gastroscopy. Methods. The serum concentrations of G-17 and pepsinogen I and II (PGI and PGII) in 834 patients were analyzed, and the PGI/PGII ratio (PGR) was calculated. According to pathological results, patients can be divided into chronic nonatrophic gastritis (NAG)/chronic atrophic gastritis (CAG)/intraepithelial neoplasia (IN)/GC groups. The differences in G-17, PG, and PGR in each group were analyzed, and their values in GC diagnosis were evaluated separately and in combination. Results. There were differences in serum G-17, PGII, and PGR among the four groups (NAG/CAG/IN/GC) ( P ≤ 0.001 ). In total, 54 GC cases were diagnosed, of which 50% were early GC. There was no significant difference in the PGI levels among the four groups ( P = 0.377 ). NAG and CAG composed the chronic gastritis (CG) group. The G-17 and PGII levels in the IN and GC groups were higher than those in the CG group (both P ≤ oth   C ), while the PGR levels were lower ( P ≤ lower ). When distinguishing NAG from CAG, the best cutoff value for G-17 was 9.25 pmol/L, PGII was 7.06 μg/L, and PGR was 12.07. When distinguishing CG from IN, the best cutoff value for G-17 was 3.86 pmol/L, PGII was 11.92 μg/L, and PGR was 8.26. When distinguishing CG from GC, the best cutoff value for G-17 was 3.89 pmol/L, PGII was 9.16 μg/L, and PGR was 14.14. The sensitivity, specificity, accuracy, and positive and negative predictive values of G-17/PGII/PGR for GC diagnosis were 83.3%/70.4%/79.6%, 51.8%/56.3%/47.8%, 53.8%/57.2%/49.9%, 10.7%/10.9%/9.6%, and 97.8%/96.5%/97.1%, respectively. The sensitivity, specificity, accuracy, and positive predictive and negative predictive values of PGII/G-17 vs. PGR/G-17 vs. PGR/PGII in the diagnosis of GC were 63.0% vs. 70.4% vs. 64.8%, 70.5% vs. 70.1% vs. 60.4%, 70.0% vs. 70.1% vs. 60.7%, 12.9% vs. 14.0% vs. 10.2%, and 96.5% vs. 97.2% vs. 96.1%, respectively. Conclusion. The PGII and G-17 levels in patients with gastric IN and GC were significantly increased, while the serum PGR level was significantly decreased. Serological detection is effective for screening GC. The combination of different markers can improve the diagnostic efficiency. The highest diagnostic accuracy was G-17 combined with PGR, and the best cutoff values were G − 17 > 3.89   pmol / L and PGR < 14.14 .

scholarly journals CORRELATION OF SERUM CRP & LACTATE AS AN EARLY PREDICTOR OF STRANGULATION IN ACUTE ABDOMEN

2020 ◽  
Vol 7 (2) ◽  
pp. 181-188
Author(s):  
Saleem Tahir ◽  
Samaksh Giri ◽  
Shadab Asif ◽  
Brijesh Rathore
Keyword(s):  
Acute Abdomen ◽  
Diagnostic Value ◽  
Serum Lactate ◽  
C Reactive Protein ◽  
Predictive Values ◽  
Cutoff Value ◽  
Reactive Protein ◽  
Sensitivity Specificity ◽  
Serum Crp ◽  
Early Predictor

Strangulation in acute abdomen is one of the dangerous complication in patients of acute abdomen and early diagnosis is necessary for prevention of mortality. Present study was aimed to find whether serum C-Reactive Protein (CRP) and Serum Lactate can be used as early predictor for strangulation in cases of acute abdomen. A total of 75 patients with acute abdomen were included in the study. The serum CRP and Lactate values were measured preoperatively and correlated with intraop findings postoperatively. ROC curve was drawn and cutoff value for prediction of strangulation and mortality based on which diagnostic value was calculated. At cutoff level of 45.5 mg/L, CRP was 85.0% sensitive and 85.7% specific with positive and negative predictive values of 87.2% & 83.3% for prediction of strangulation in acute abdomen while sensitivity, specificity, PPV and NPV of Serum lactate was 100.0%, 91.4% 93.0% & 100.0% respectively using cutoff value ≥23.5mg/dl. Serum CRPand Lactate could be useful markers in predicting strangulation in cases of acute abdomen.

scholarly journals Role of Computed Tomography Perfusion in Identification of Acute Lacunar Stroke Syndromes

Stroke ◽  
2021 ◽  
Vol 52 (1) ◽  
pp. 339-343
Author(s):  
Carlos Garcia-Esperon ◽  
Milanka Visser ◽  
Leonid Churilov ◽  
Ferdinand Miteff ◽  
Andrew Bivard ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Posterior Fossa ◽  
Delay Time ◽  
Imaging Modality ◽  
Lacunar Stroke ◽  
Transient Time ◽  
Predictive Values ◽  
Computed Tomography Perfusion ◽  
Noncontrast Computed Tomography ◽  
Sensitivity Specificity

Background and Purpose: Lacunar syndromes correlate with a lacunar stroke on imaging in 50% to 60% of cases. Computed tomography perfusion (CTP) is becoming the preferred imaging modality for acute stroke triage. We aimed to estimate the sensitivity, specificity, and predictive values for noncontrast computed tomography and CTP in lacunar syndromes, and for cortical, subcortical, and posterior fossa regions. Methods: A retrospective analysis of confirmed ischemic stroke patients who underwent acute CTP and follow-up magnetic resonance imaging between 2010 and 2018 was performed. Brain noncontrast computed tomography and CTP were assessed independently by 2 stroke neurologists. Receiver operating characteristic curve analysis was performed to estimate sensitivity, specificity, and area under the curve (AUC) for the detection of strokes in patients with lacunar syndromes using different CTP maps. Results: We found 106 clinical lacunar syndromes, but on diffusion-weighted imaging, these consisted of 59 lacunar, 33 cortical, and 14 posterior fossa strokes. The discrimination of ischemia identification was very poor using noncontrast computed tomography in all 3 regions, but good for cortical (AUC, 0.82) and poor for subcortical and posterior regions (AUCs, 0.55 and 0.66) using automated core-penumbra maps. The addition of delay time and mean transient time maps substantially increased subcortical (AUC, 0.80) and slightly posterior stroke detection (AUC, 0.69). Conclusions: Analysis of mean transient time and delay time maps in combination with core-penumbra maps improves detection of subcortical and posterior strokes.

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