scholarly journals Recognition Accuracy Using 3D Endoscopic Images for Superficial Gastrointestinal Cancer: A Crossover Study

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Kosuke Nomura ◽  
Mitsuru Kaise ◽  
Daisuke Kikuchi ◽  
Toshiro Iizuka ◽  
Yumiko Fukuma ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Gastrointestinal Cancer ◽  
Recognition Accuracy ◽  
3D Images ◽  
Confidence Levels ◽  
Endoscopic Images ◽  
Group 2 ◽  
Tumor Extent ◽  
2D Images ◽  
Group 1

Aim. To determine whether 3D endoscopic images improved recognition accuracy for superficial gastrointestinal cancer compared with 2D images.Methods. We created an image catalog using 2D and 3D images of 20 specimens resected by endoscopic submucosal dissection. The twelve participants were allocated into two groups. Group 1 evaluated only 2D images at first, group 2 evaluated 3D images, and, after an interval of 2 weeks, group 1 next evaluated 3D and group 2 evaluated 2D images. The evaluation items were as follows: (1) diagnostic accuracy of the tumor extent and (2) confidence levels in assessing (a) tumor extent, (b) morphology, (c) microsurface structure, and (d) comprehensive recognition.Results. The use of 3D images resulted in an improvement in diagnostic accuracy in both group 1 (2D: 76.9%, 3D: 78.6%) and group 2 (2D: 79.9%, 3D: 83.6%), with no statistically significant difference. The confidence levels were higher for all items ((a) to (d)) when 3D images were used. With respect to experience, the degree of the improvement showed the following trend: novices > trainees > experts.Conclusions. By conversion into 3D images, there was a significant improvement in the diagnostic confidence level for superficial tumors, and the improvement was greater in individuals with lower endoscopic expertise.

scholarly journals Contrast-Enhanced Harmonic Endoscopic Ultrasound-Guided Fine-Needle Aspiration versus Standard Fine-Needle Aspiration in Pancreatic Masses: A Propensity Score Analysis

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 792
Author(s):  
Antonio Facciorusso ◽  
Christian Cotsoglou ◽  
Andrea Chierici ◽  
Ruxandra Mare ◽  
Stefano Francesco Crinò ◽  
...  
Keyword(s):  
Propensity Score ◽  
Diagnostic Accuracy ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Contrast Enhanced ◽  
Pancreatic Masses ◽  
Group 2 ◽  
Group 1

Background: Whether endoscopic ultrasound (EUS) contrast-enhanced fine-needle aspiration (CH-EUS-FNA) determines superior results in comparison to standard EUS-FNA in tissue acquisition of pancreatic masses remains unclear. The aim of this study was to compare these two techniques on a series of patients with solid pancreatic lesions. Methods: 362 patients underwent EUS-FNA (2008–2019), after the propensity score matching of two groups were compared; 103 treated with CH-EUS-FNA (group 1) and 103 with standard EUS-FNA (group 2). The primary outcome was the diagnostic accuracy. Secondary outcomes were sensitivity, specificity, and sample adequacy. Results: Diagnostic sensitivity was 87.6% in group 1 and 80% in group 2 (p = 0.18). The negative predictive value was 56% in group 1 and 41.5% in group 2 (p = 0.06). The specificity and positive predictive values were 100% for both groups. Diagnostic accuracy was 89.3% and 82.5%, respectively (p = 0.40). Sample adequacy was 94.1% in group 1 and 91.2% in group 2 (p = 0.42). The rate of adequate core histologic samples was 33% and 28.1%, respectively (p = 0.44), and the number of needle passes to obtain adequate samples were 2.4 ± 0.6 and 2.7 ± 0.8, respectively (p = 0.76). These findings were confirmed in subgroup analyses, conducted according to lesion size and contrast enhancement pattern. Conclusions: CH-EUS-FNA does not appear to be superior to standard EUS-FNA in patients with pancreatic masses.

Parathyrin measured concurrently with free or total calcium in the differential diagnosis of hypercalcemia.

1981 ◽  
Vol 27 (4) ◽  
pp. 574-579 ◽  
Author(s):  
J C Boyd ◽  
J W Lewis ◽  
E Slatopolsky ◽  
J H Ladenson
Keyword(s):  
Primary Hyperparathyroidism ◽  
Diagnostic Accuracy ◽  
Diagnostic Utility ◽  
Antibody Specificity ◽  
Total Calcium ◽  
Histological Evidence ◽  
Group 3 ◽  
Group 2 ◽  
Calcium Measurement ◽  
Group 1

Abstract We assessed the diagnostic utility of measuring C-terminal immunoreactive parathyrin (i-PTH) concurrently with free (CaF) or total (CaT) calcium in four groups of patients: (1) 91 patients with histologically proven primary hyperparathyroidism; (2) seven patients without histological evidence of hyperparathyroidism; (3) 70 patients with non-parathyroid malignancies with hypercalcemia; and (4) 28 similar patients without hypercalcemia. In patients in Group 1, the use of either calcium measurement along with i-PTH increased diagnostic accuracy from 95 to 99%. In Group 2, values consistent with primary hyperparathyroidism were obtained for 21% of samples with i-PTH assay alone, 29% with i-PTH and CaT, and 12% with i-PTH and CaF. Surprisingly, 36% of samples from both malignancy groups (3 and 4) had above-normal i-PTH values. In patients with malignancy and hypercalcemia (Group 3) the following percentages were classified as possibly being hyperparathyroid: 26% with i-PTH assay alone; 31% with i-PTH and CaT, and 24% with i-PTH and CaF. Our data indicate that (a) about a fourth of patients with nonparathyroid malignancies also have evidence of hyperparathyroidism as judged by this (and probably all other) i-PTH methods based on C-terminal antibody specificity and that (b) measuring CaF and i-PTH rather than CaT and i-PTH gives a small increase in diagnostic accuracy.

scholarly journals Evaluating the effectiveness of a lower extremity venous phantom on developing ultrasound examination skills and confidence

Ultrasound ◽  
2020 ◽  
pp. 1742271X2095077
Author(s):  
Carol Mitchell ◽  
Pazee L Xiong ◽  
Benjamin L Cox ◽  
Maame A Adoe ◽  
Michelle M Cordio ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Teaching Methods ◽  
Ultrasound Examination ◽  
Human Volunteer ◽  
Confidence Levels ◽  
Significant Difference ◽  
Ultrasound Phantom ◽  
Group 2 ◽  
Didactic Lecture ◽  
Group 1

Introduction The aims of this study were: (1) Determine the effect on student ultrasound scanning skills using a lower extremity venous ultrasound phantom in addition to standard teaching methods of didactic lecture and scanning live volunteers and (2) Determine the effect of using a lower extremity venous ultrasound phantom in addition to standard teaching methods of didactic lecture and scanning live volunteers on student confidence levels in performing the lower extremity venous ultrasound examination. Methods Participants were first year diagnostic medical sonography students with minimal scanning experience ( n = 11), which were randomized into two groups. Group 1 ( n = 5) received the standard didactic lecture and attended a scan lab assessment where they performed a lower extremity venous examination on a human volunteer. Group 2 ( n = 6) received the standard didactic lecture, performed three scheduled scanning sessions on an anatomic lower extremity venous phantom with flow and then attended the same scan lab assessment as Group 1, where they performed a lower extremity venous examination on a human volunteer. Results Scan lab assessments on day 4 of the study demonstrated a significant difference in scanning performance ( p = 0.019) between the two groups. Post scan lab assessment confidence scores also demonstrated a significant difference between how participants in each group scored their confidence levels ( p = 0.0260), especially in the ability to image calf veins. Conclusions This study suggests anatomical phantoms can be used to develop scanning skills and build confidence in ultrasound imaging of the lower extremity venous structures.

A 3‐DIMENSIONAL COMPUTED TOMOGRAPHIC PROCEDURE FOR PLANNING RETROSIGMOID CRANIOTOMY

2009 ◽  
Vol 64 (suppl_5) ◽  
pp. ons241-ons246 ◽  
Author(s):  
Tadashi Hamasaki ◽  
Motohiro Morioka ◽  
Hideo Nakamura ◽  
Shigetoshi Yano ◽  
Toshinori Hirai ◽  
...  
Keyword(s):  
External Surface ◽  
Tomographic Imaging ◽  
Sigmoid Sinus ◽  
Anatomic Landmarks ◽  
3D Images ◽  
3 Dimensional ◽  
Computed Tomographic ◽  
Group 2 ◽  
Group 1 ◽  
Computed Tomographic Imaging

Abstract OBJECTIVE The planning of retrosigmoid craniotomies often relies on anatomic landmarks on the posterolateral surface of the cranium, such as the asterion. However, the location of the asterion is not fixed with respect to the underlying transverse-sigmoid sinus complex. We introduce a simple procedure that uses 3-dimensional (3D) computed tomographic imaging to project the transverse-sigmoid sinus complex onto the external surface of the cranium. METHODS We enrolled 8 patients scheduled for retrosigmoid craniotomy (Group 1) and 30 patients without posterior fossa lesions (Group 2). The procedure consists of 3 steps: 1) marking the sinus on the internal surface on 3D images of the cranium, 2) transferring the marks to the external surface on axial images, and 3) checking the transferred marks on the external surface of the cranium on 3D images. RESULTS In Group 1, the craniotomies planned with the aid of our procedure coincided with findings made at surgery, indicating the accuracy of our procedure. When we applied it in morphometric studies in Group 2, we found that the relative location of the transverse-sigmoid sinus junction to the asterion, the superior nuchal line, and the posterior edge of the mastoid process exhibited a high degree of individual variation. CONCLUSION Retrosigmoid craniotomy standardized according to anatomic landmarks raises the risk for sinus injury because of variations in their location. We offer our 3D computed tomographic imaging-based procedure as a useful device for the planning of safer retrosigmoid craniotomies.

scholarly journals High Rate of False Negative Diagnosis of Silent Patent Ductus Arteriosus on the Chest CT with 3 mm Slice-Thickness, Suggesting the Need for Analysis with Thinner Slice Thickness

Tomography ◽  
2021 ◽  
Vol 7 (3) ◽  
pp. 278-285
Author(s):  
Dongjun Lee ◽  
Minji Son ◽  
Seungmin Yoo ◽  
Sanghoon Jung ◽  
Eunju Chun ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Ductus Arteriosus ◽  
Correct Diagnosis ◽  
False Negative ◽  
Chest Ct ◽  
High Rate ◽  
Slice Thickness ◽  
Axial Ct ◽  
Group 2 ◽  
Group 1

The purpose of this study was to evaluate the diagnostic accuracy of patent with ductus arteriosus (PDA) based on the availability of pretest information on routine chest CT with 3 mm slice-thickness. We retrospectively evaluated CT of 64 patients with PDA. The enrolled patients were categorized as group 1 (presence of pretest information) and 2 (absence of pretest information, silent PDA). CTs were read by eleven board-certified radiologists, and subsequently by two blind readers. We investigated whether a PDA was mentioned on the initial CT reading. Correct diagnosis of PDA was made in all patients with group 1 (n = 42). In contrast, only 13.7% were correctly diagnosed in group 2. All cases of missed PDA in group 2 were also missed by two blind readers. It is important to realize that the diagnostic accuracy of silent PDA is poor on the chest CT with 3 mm slice-thickness. Thus, use of axial CT images with the thinnest slice-thickness and multi-planar reformatted images (i.e., sagittal and coronal images) may be one way to reduce the number of missed PDA.

P6182Combination of a new iterative reconstruction technique with low tube voltage and high tube current has important role of detection of late enhancement on 320 slice CT

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Goto ◽  
H Takaoka ◽  
T Sakai ◽  
S Ochi ◽  
S Wakabayashi ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Iterative Reconstruction ◽  
Late Enhancement ◽  
Left Ventricular ◽  
Tube Voltage ◽  
Low Tube Voltage ◽  
Tube Current ◽  
Group 2 ◽  
New Generation ◽  
Group 1

Abstract Background New iterative reconstruction tecniques, including Adaptive Iterative Dose Reduction 3D (AIDR 3D) and Forward Projected Model-based Iterative Reconstruction SoluTion (FIRST), have been recently available on new generation 320 slice CT, and they can provide high-quality CT images. Purpose The aim of this study was to evaluate the diagnostic performance of detection of abnormal late enhancement (LE) in left ventricular (LV) myocardium (LVM) using 320-slice CT with new iterative reconstruction techiniques, AIDR 3D (Figure A) and FIRST (Figure B). Methods A total of 100 patients who were suspected of having various myocardial diseases and underwent late phase acquisition both on cardiac CT and CMR within 3 months were analyzed. The first 50 consecutive patients (Group 1) underwent 320-slice CT with AIDR 3D, 120 Kv tube voltage, 519±71 mA tube current. The next 50 consecutive patients (Group 2) underwent 320-slice CT with FIRST, 80 or 100Kv tube voltage, 803±20 mA tube current. We compared diagnostic accuracy of CT for detection of LE in LVM against that of CMR (the gold standard) in between the 2 groups. Results On patient-by-patient analysis, sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and overall accuracy for detection of LE on CT vs CMR were 87, 95, 96, 82, and 90% in Group 1, and 97, 83, 91, 88, and 90% in Group 2. There were no significant difference of diagnostic accuracy on patient-by-patient analysis in between the 2 groups (Figure C). However, on a segment-by-segment analysis (using 17 American Heart Association LV segment model), these values for detection of LE on CT vs CMR were 60, 95, 73, 91, and 88% in Group 1, and 85, 95, 86, 95, and 93% in Group 2. Sensitivity, PPV, NPV and overall accuracy were significantly higher in Group 2 than in Group 1 (all P<0.01) (Figure D). Conclusions Diagnostic accuracy of detection of LE in LVM on CT combining low tube voltage and high tube current acquisition on a new generation 320-slice CT with FIRST was superior to 320-slice CT with AIDR 3D. Acknowledgement/Funding TSUCHIYA MEMORIAL MEDICAL FOUNDATION

scholarly journals CovidNudge: diagnostic accuracy of a novel lab-free point-of-care diagnostic for SARS-CoV-2

2020 ◽  
Author(s):  
Malick M Gibani ◽  
Christofer Toumazou ◽  
Mohammadreza Sohbati ◽  
Rashmita Sahoo ◽  
Maria Karvela ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Point Of Care ◽  
N Gene ◽  
Hospital Inpatient ◽  
Standard Laboratory ◽  
Rt Pcr ◽  
Viral Transport Medium ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background Access to rapid diagnosis is key to the control and management of SARS-CoV-2. Reverse Transcriptase- Polymerase Chain Reaction (RT-PCR) testing usually requires a centralised laboratory and significant infrastructure. We describe the development and diagnostic accuracy assessment of a novel, rapid point-of-care RT-PCR test, the DnaNudge platform CovidNudge test, which requires no laboratory handling or sample pre-processing. Methods Nasopharyngeal swabs are inserted directly into a cartridge which contains all reagents and components required for RT-PCR reactions, including multiple technical replicates of seven SARS-CoV-2 gene targets (rdrp1, rdrp2, e-gene, n-gene, n1, n2 and n3) and human ribonuclease P (RNaseP) as a positive control. Between April and May 2020, swab samples were tested in parallel using the CovidNudge direct-to-cartridge platform and standard laboratory RT-PCR using swabs in viral transport medium. Samples were collected from three groups: self-referred healthcare workers with suspected COVID-19 (Group 1, n=280/386; 73%); patients attending the emergency department with suspected COVID-19 (Group 2, n=15/386; 4%) and hospital inpatient admissions with or without suspected COVID-19 (Group 3, n=91/386; 23%). Results Of 386 paired samples tested across all groups, 67 tested positive on the CovidNudge platform and 71 with standard laboratory RT-PCR. The sensitivity of the test varied by group (Group 1 93% [84-98%], Group 2 100% [48-100%] and Group 3 100% [29-100%], giving an average sensitivity of 94.4% (95% confidence interval 86-98%) and an overall specificity of 100% (95%CI 99-100%; Group 1 100% [98-100%]; Group 2 100% [69-100%] and Group 3 100% [96-100%]). Point of care testing performance was comparable during a period of high (25%) and low (3%) background prevalence. Amplification of the viral nucleocapsid (n1, n2, n3) targets were most sensitive for detection of SARS-CoV2, with the assay able to detect 1x104 viral particles in a single swab. Conclusions The CovidNudge platform offers a sensitive, specific and rapid point of care test for the presence of SARS-CoV-2 without laboratory handling or sample pre-processing. The implementation of such a device could be used to enable rapid decisions for clinical care and testing programs.

Role of omega-3 fatty acids in parenteral nutrition of cancer patients

2021 ◽  
pp. 64-72
Author(s):  
E. V. Gameeva ◽  
A. E. Shestopalov
Keyword(s):  
Fatty Acids ◽  
Parenteral Nutrition ◽  
Gastrointestinal Cancer ◽  
Metabolic Disorders ◽  
Cancer Surgery ◽  
Omega 3 Fatty Acids ◽  
Omega 3 ◽  
Early Management ◽  
Group 2 ◽  
Group 1

Relevance. When selecting the components of parenteral nutrition (PN) for oncology patients, it is necessary to take into account not only the composition optimization but also its potential positive effect on the surgical treatment outcome. Therefore, the use of pharmaconutrients in PN, in particular, omega-3 fatty acids, is of great theoretical and practical interest and has determined the aim of this study.The aim. To assess the effiacy of postoperative PN using the 3-in-1 system with omega-3 fatty acids (FA) (SMOFKabiven central and peripheral) in the treatment of metabolic disorders in patients undergoing gastrointestinal cancer surgery.Materials and methods. A prospective, randomized, controlled, comparative study included the patients undergoing gastrointestinal cancer surgery. Group 1 (comparison group) consisted of 29 patients, postoperative PN was performed using a 3-in-1 system without omega-3 fatty acids.Group 2 (main group) consisted of 20 patients treated with 3-in-1 system with omega-3 FA (SMOFKabiven central) and 9 patients recieved PN with omega-3 FA through peripheral vein access FA (SMOFKabiven peripheral).Main results. A complete range of amino acids in SMOFKabiven (50 g/L) and an increased content of nitrogen (8 g/L) have a pronounced effect on protein metabolism and anabolic processes. The long-term PN showed that the liver enzyme (alanine transaminase [ALT], aspartate transaminase [AST], and total bilirubin) levels were signifiantly lower compared to the patients who received traditional lipid emulsions without fih oil. The analysis of the corrective effect of PN containing omega-3 fatty acids showed that at day 6–7 after surgery the group 2 patients had a signifiant decrease in the concentration of pro-inflmmatory cytokines: IL-6 down to 79.5±19.2 pg/mL, TNF-α down to 12.9±3.3 pg/mL (p < 0.05) compared to group 1. Clinical signs of gastrointestinal dysfunction were mainly resolved at day 4–5. Full recovery of the GIT functions was seen in more than 80 % of patients. The anti-inflmmatory properties of omega-3 fatty acids, as well as their effect on the cytokine balance recovery, have been confimed in our studies by signifiant reductions in the synthesis of IL-6, TNF.Conclusion. The high content of omega-3 fatty acids in PN promotes early management of metabolic disorders after surgery, can have a signifiant effect on the ability to adequately tolerate the maintenance chemotherapy and radiation therapy, and can signifiantly improve the quality of life under the conditions of progressive disease.

In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Prosthetic Vascular Graft Infection ◽  
Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

The influence of continuous local wound infusion on postoperative pain in patients undergoing transfemoral amputation

VASA ◽  
2015 ◽  
Vol 44 (5) ◽  
pp. 381-386 ◽  
Author(s):  
Christian Uhl ◽  
Thomas Betz ◽  
Andrea Rupp ◽  
Markus Steinbauer ◽  
Ingolf Töpel
Keyword(s):  
Pain Management ◽  
Pilot Study ◽  
Local Anaesthetic ◽  
Phantom Pain ◽  
Transfemoral Amputation ◽  
Postoperative Wound ◽  
Stump Pain ◽  
Management Protocol ◽  
Group 2 ◽  
Group 1

Abstract. Summary: Background: This pilot study was set up to examine the effects of a continuous postoperative wound infusion system with a local anaesthetic on perioperative pain and the consumption of analgesics. Patients and methods: We included 42 patients in this prospective observational pilot study. Patients were divided into two groups. One group was treated in accordance with the WHO standard pain management protocol and in addition to that received a continuous local wound infusion treatment (Group 1). Group 2 was treated with analgesics in accordance with the WHO standard pain management protocol, exclusively. Results: The study demonstrated a significantly reduced postoperative VAS score for stump pain in Group 1 for the first 5 days. Furthermore, the intake of opiates was significantly reduced in Group 1 (day 1, Group 1: 42.1 vs. Group 2: 73.5, p = 0.010; day 2, Group 1: 27.7 vs. Group 2: 52.5, p = 0.012; day 3, Group 1: 23.9 vs. Group 2: 53.5, p = 0.002; day 4, Group 1: 15.7 vs. Group 2: 48.3, p = 0.003; day 5, Group 1 13.3 vs. Group 2: 49.9, p = 0.001). There were no significant differences between the two groups, neither in phantom pain intensity at discharge nor postoperative complications and death. Conclusions: Continuous postoperative wound infusion with a local anaesthetic in combination with a standard pain management protocol can reduce both stump pain and opiate intake in patients who have undergone transfemoral amputation. Phantom pain was not significantly affected.

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