scholarly journals Optimization of Classification Strategies of Acetowhite Temporal Patterns towards Improving Diagnostic Performance of Colposcopy

2017 ◽  
Vol 2017 ◽  
pp. 1-10
Author(s):  
Karina Gutiérrez-Fragoso ◽  
Héctor Gabriel Acosta-Mesa ◽  
Nicandro Cruz-Ramírez ◽  
Rodolfo Hernández-Jiménez
Keyword(s):  
Cervical Cancer ◽  
Diagnostic Performance ◽  
Precancerous Lesions ◽  
Temporal Patterns ◽  
Nearest Neighbors ◽  
High Grade ◽  
Classification Methods ◽  
Computing Systems ◽  
Sensitivity Specificity ◽  
Better Than

Efforts have been being made to improve the diagnostic performance of colposcopy, trying to help better diagnose cervical cancer, particularly in developing countries. However, improvements in a number of areas are still necessary, such as the time it takes to process the full digital image of the cervix, the performance of the computing systems used to identify different kinds of tissues, and biopsy sampling. In this paper, we explore three different, well-known automatic classification methods (k-Nearest Neighbors, Naïve Bayes, and C4.5), in addition to different data models that take full advantage of this information and improve the diagnostic performance of colposcopy based on acetowhite temporal patterns. Based on the ROC and PRC area scores, thek-Nearest Neighbors and discrete PLA representation performed better than other methods. The values of sensitivity, specificity, and accuracy reached using this method were 60% (95% CI 50–70), 79% (95% CI 71–86), and 70% (95% CI 60–80), respectively. The acetowhitening phenomenon is not exclusive to high-grade lesions, and we have found acetowhite temporal patterns of epithelial changes that are not precancerous lesions but that are similar to positive ones. These findings need to be considered when developing more robust computing systems in the future.

scholarly journals Epidemiological Approach and Precocious Diagnosis of Precancerous Cervical Lesion in Sidi Bel Abbes Region (North-West of Algeria)

2020 ◽  
Vol 10 (1-s) ◽  
pp. 72-78
Author(s):  
Samira Meziani ◽  
Khadidja Haoud ◽  
Hayet Mehida ◽  
Norddine Menadi ◽  
Fatima Zohra Chenni ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Precancerous Lesions ◽  
Precancerous Lesion ◽  
Public Health Problem ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesions ◽  
Pathology Laboratory ◽  
Intraepithelial Lesions

Object: Cervical cancer of the uterine (CCU) is the first cancer of the genital tract. In Algeria, this cancer remains a real public health problem. The diagnosis is still done often with advanced stages which makes the therapeutic results modest and the cost of the high care. Methodology: Our study aims to elucidate the reality of this type of pathology in the region of Sidi Bel Abbes, northwestern Algeria. This retrospective and descriptive study was devoted to the epidemiological and clinical analysis of cervical cancer cases over a period of 3 years. Results: This study shows that out of a total of 500 smears recorded between (2014-2016) at the Ana-pathology laboratory level in Sidi Bel Abbes, we found that 230 smears presented precancerous lesions according to a cytological study, atypical squamous cells of undetermined significance (ASC-US: were 18%; low-grade squamous intraepithelial lesions (LSIL) were 20%, while high-grade squamous intraepithelial lesions (HSIL) were 8%. The results obtained according to the distribution of the patients in relation to the various factors: the most affected age group is late 46-55 years with a total of 40%; precocious age of 1st report 18-20 years is (38.2%); gestation 4-5 pregnancies and parities 4-5 children with a rate of (38.70% and 32.6%) respectively ; the hormonal state in genital activity is estimated at 62.2%; patients on oral contraception (OC) have a rate of 48.9%. Finally, more than half of the patients (57.8%), were able to have a biopsy within three to four months of the last smear. In histology, the presence of a HPV (Human Papilloma Virus) low grade lesion does not predict the evolution of this lesion. Conclusion: HPV can be oncogenic or non-oncogenic. it is the oncogenic HPV infection that is the main risk factor for developing a high grade lesion  and cervical cancers outside the associated cofactors. Keywords: Pap Smear, Precancerous lesion, Cancer, Cervix, Screening

scholarly journals Safety and Efficacy of the New CryoPop® Cryotherapy Device for Cervical Dysplasia in Low- and Middle-income Countries: Study Protocol for a Multicentre Open-label Non-inferiority Clinical Trial With Historical Controls

2021 ◽  
Author(s):  
S YogeshKumar ◽  
Jean Anderson ◽  
Enrique Lu ◽  
Edward Kenyi ◽  
Margaret Mensa ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Trial ◽  
Cervical Cancer ◽  
Precancerous Lesions ◽  
Cervical Dysplasia ◽  
High Grade ◽  
Care Providers ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Background: Cervical cancer is the fourth most common cancer in the world, affecting mainly women residing in low- and middle-income countries. Progression from a pre-invasive phase to that of an invasive phase generally takes years and provides a window of opportunity to screen for and treat precancerous lesions. Methods: This study is being conducted at four sites in north Karnataka, India. Community sensitization activities have been organized in the study areas to create awareness among stakeholders, including elected representatives, physicians, health care workers and potential participants. Organized community based as well as hospital-based screening is being conducted using Visual Inspection with Acetic acid (VIA). Screen positive women are referred to respective study hospitals for colposcopy and directed biopsy. Participants with confirmed high-grade cervical dysplasia (high grade squamous intraepithelial lesions or HSIL) who fit all other eligibility criteria will be recruited to the study and will receive cryotherapy using CryoPop®, an innovative new cryotherapy device.Discussion: There is a need to develop an inexpensive, simple and effective cryotherapy device for use by frontline health care providers at locations where screening and timely treatment can be given, accelerating access to cervical cancer prevention services and minimizing loss to follow-up of women with precancerous lesions who need treatment.Trial Registration: Clinical Trial Registry - India CTRI/2019/01/017289 ClinicalTrials.Gov number NCT04154644 on November 6, 2019. https://bit.ly/3yRQWC4

scholarly journals Deep Learning With Data Enhancement for the Differentiation of Solitary and Multiple Cerebral Glioblastoma, Lymphoma, and Tumefactive Demyelinating Lesion

2021 ◽  
Vol 11 ◽  
Author(s):  
Yu Zhang ◽  
Kewei Liang ◽  
Jiaqi He ◽  
He Ma ◽  
Hongyan Chen ◽  
...  
Keyword(s):  
Deep Learning ◽  
Diagnostic Performance ◽  
Area Under The Curve ◽  
Discrimination Performance ◽  
Central Nervous System Lymphoma ◽  
3D Segmentation ◽  
Accurate Identification ◽  
Tumefactive Demyelinating Lesion ◽  
Sensitivity Specificity ◽  
Better Than

ObjectivesTo explore the MRI-based differential diagnosis of deep learning with data enhancement for cerebral glioblastoma (GBM), primary central nervous system lymphoma (PCNSL), and tumefactive demyelinating lesion (TDL).Materials and MethodsThis retrospective study analyzed the MRI data of 261 patients with pathologically diagnosed solitary and multiple cerebral GBM (n = 97), PCNSL (n = 92), and TDL (n = 72). The 3D segmentation model was trained to capture the lesion. Different enhancement data were generated by changing the pixel ratio of the lesion and non-lesion areas. The 3D classification network was trained by using the enhancement data. The accuracy, sensitivity, specificity, and area under the curve (AUC) were used to assess the value of different enhancement data on the discrimination performance. These results were then compared with the neuroradiologists’ diagnoses.ResultsThe diagnostic performance fluctuated with the ratio of lesion to non-lesion area changed. The diagnostic performance was best when the ratio was 1.5. The AUCs of GBM, PCNSL, and TDL were 1.00 (95% confidence interval [CI]: 1.000–1.000), 0.96 (95% CI: 0.923–1.000), and 0.954 (95% CI: 0.904–1.000), respectively.ConclusionsDeep learning with data enhancement is useful for the accurate identification of GBM, PCNSL, and TDL, and its diagnostic performance is better than that of the neuroradiologists.

scholarly journals Safety and efficacy of the new CryoPop® cryotherapy device for cervical dysplasia in low- and middle-income countries: study protocol for a multicenter open-label non-inferiority clinical trial with historical controls

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
S. Yogeshkumar ◽  
Jean Anderson ◽  
Enriquito Lu ◽  
Edward Kenyi ◽  
Margaret Mensa ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Trial ◽  
Cervical Cancer ◽  
Precancerous Lesions ◽  
Cervical Dysplasia ◽  
High Grade ◽  
Care Providers ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

Abstract Background Cervical cancer is the fourth most common cancer in the world, affecting mainly women residing in low- and middle-income countries. Progression from a pre-invasive phase to that of an invasive phase generally takes years and provides a window of opportunity to screen for and treat precancerous lesions. Methods This study is being conducted at four sites in north Karnataka, India. Community sensitization activities have been organized in the study areas to create awareness among stakeholders, including elected representatives, physicians, health care workers, and potential participants. Organized community based as well as hospital-based screening is being conducted using visual inspection with acetic acid (VIA). Screen positive women are referred to respective study hospitals for colposcopy and directed biopsy. Participants with confirmed high-grade cervical dysplasia (high-grade squamous intraepithelial lesions or HSIL) who fit all other eligibility criteria will be recruited to the study and will receive cryotherapy using CryoPop®, an innovative new cryotherapy device. Discussion There is a need to develop an inexpensive, simple, and effective cryotherapy device for use by frontline health care providers at locations where screening and timely treatment can be given, accelerating access to cervical cancer prevention services and minimizing loss to follow-up of women with precancerous lesions who need treatment. Trial registration Clinical Trial Registry - India CTRI/2019/01/017289 ClinicalTrials.Gov number NCT04154644. Registered on November 6, 2019.

scholarly journals The Performance of Artificial Intelligence in Cervical Colposcopy: A Retrospective Data Analysis

2022 ◽  
Vol 2022 ◽  
pp. 1-6
Author(s):  
Yuqian Zhao ◽  
Yucong Li ◽  
Lu Xing ◽  
Haike Lei ◽  
Duke Chen ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Medical Records ◽  
Precancerous Lesions ◽  
Diagnostic Study ◽  
Retrospective Data ◽  
High Grade ◽  
Hpv Testing ◽  
Retrospective Data Analysis ◽  
Sensitivity Specificity ◽  
Histopathological Results

Objective. We aimed to evaluate the performance of artificial intelligence (AI) system in detecting high-grade precancerous lesions. Methods. A retrospective and diagnostic study was conducted in Chongqing Cancer Hospital. Anonymized medical records with cytology, HPV testing, colposcopy findings with images, and the histopathological results were selected. The sensitivity, specificity, and areas under the curve (AUC) in detecting CIN2+ and CIN3+ were evaluated for the AI system, the AI-assisted colposcopy, and the human colposcopists, respectively. Results. Anonymized medical records from 346 women were obtained. The images captured under colposcopy of 194 women were found positive by the AI system; 245 women were found positive either by human colposcopists or the AI system. In detecting CIN2+, the AI-assisted colposcopy significantly increased the sensitivity (96.6% vs. 88.8%, p = 0.016 ). The specificity was significantly lower for AI-assisted colposcopy (38.1%), compared with human colposcopists (59.5%, p < 0.001 ) or the AI system (57.6%, p < 0.001 ). The AUCs for the human colposcopists, AI system, and AI-assisted colposcopy were 0.741, 0.765, and 0.674, respectively. In detecting CIN3+, the sensitivities of the AI system and AI-assisted colposcopy were not significantly higher than human colposcopists (97.5% vs. 92.6%, p = 0.13 ). The specificity was significantly lower for AI-assisted colposcopy (37.4%) compared with human colposcopists (59.2%, p < 0.001 ) or compared with the AI system (56.6%, p < 0.001 ). The AUCs for the human colposcopists, AI system, and AI-assisted colposcopy were 0.759, 0.674, and 0.771, respectively. Conclusions. The AI system provided equally matched sensitivity to human colposcopists in detecting CIN2+ and CIN3+. The AI-assisted colposcopy significantly improved the sensitivity in detecting CIN2+.

scholarly journals Fibrinogen performs better than D-dimer for the diagnosis of periprosthetic joint infection: a meta-analysis of diagnostic trials

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Liping Pan ◽  
Hao Wu ◽  
Heng Liu ◽  
Xin Yang ◽  
Zhichao Meng ◽  
...  
Keyword(s):  
Likelihood Ratio ◽  
Periprosthetic Joint Infection ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Joint Infection ◽  
Negative Likelihood Ratio ◽  
Cochrane Library ◽  
Sensitivity Specificity ◽  
D Dimer ◽  
Better Than

Abstract Purpose D-dimer and fibrinogen, both belonging to coagulation parameters, are controversial for the diagnosis of periprosthetic joint infection (PJI). This meta-analysis was conducted to compare their diagnostic accuracies for PJI by synthesizing currently available evidence. Methods Cochrane Library, MEDLINE, Web of Science, and Embase up to March 1, 2020, and other relevant articles were searched. Five hundred and eighty-one articles were identified after initial research, and 11 studies were included finally. No threshold effects were found between studies. The pooled sensitivity, specificity, and positive and negative likelihood ratio were reported to evaluate the diagnostic performance with heterogeneity analysis. Z test statistics was used to analyze the difference of diagnostic performance between D-dimer and fibrinogen. Results The pooled sensitivity, specificity, and positive and negative likelihood ratio of D-dimer for PJI were 0.79 (95% [CI], 0.72–0.85), 0.77 (0.67–0.84), 3.38 (2.21–5.18), and 0.27 (0.18–0.41), respectively. As for fibrinogen, the pooled sensitivity, specificity, and positive and negative likelihood ratio for PJI were 0.75 (0.68–0.80), 0.85 (0.82–0.88), 5.12 (4.22–6.22), and 0.30 (0.23–0.37), respectively. Great heterogeneity was found in studies for D-dimer, and univariate meta-regression analysis revealed that number of involved joints, disease spectrum, comorbidities influencing D-dimer, and sample sources were the source of heterogeneity. Z test found that the pooled specificity of fibrinogen was significantly higher than D-dimer (0.85 ± 0.01 versus 0.77 ± 0.04, p = 0.03). The pooled positive likelihood ratio of fibrinogen was significantly higher than D-dimer (5.12 ± 0.51 versus 3.38 ± 0.74, p = 0.03). Conclusion Based on currently available evidence, the meta-analysis suggests that fibrinogen performs better than D-dimer as a rule-in diagnostic tool for its higher specificity. However, more prospective trials with larger size are still needed to provide further confirmation. Trial registration This meta-analysis was prospectively registered on PROSPERO (International prospective register of systematic reviews), and the registering number was CRD42020177176.

Comparison Between 18F-Dopa and 18F-Fet PET/CT in Patients with Suspicious Recurrent High Grade Glioma: A Literature Review and Our Experience

2019 ◽  
Vol 12 (3) ◽  
pp. 220-228 ◽  
Author(s):  
Laura Evangelista ◽  
Lea Cuppari ◽  
Luisa Bellu ◽  
Daniele Bertin ◽  
Mario Caccese ◽  
...  
Keyword(s):  
Case Series ◽  
High Grade Glioma ◽  
High Grade ◽  
True Negative ◽  
Fet Pet ◽  
Positron Emission ◽  
Pet Ct ◽  
Magnetic Resonance Imaging Mri ◽  
Definition Of ◽  
Sensitivity Specificity

Purpose: The aims of the present study were to: 1- critically assess the utility of L-3,4- dihydroxy-6-18Ffluoro-phenyl-alanine (18F-DOPA) and O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) Positron Emission Tomography (PET)/Computed Tomography (CT) in patients with high grade glioma (HGG) and 2- describe the results of 18F-DOPA and 18F-FET PET/CT in a case series of patients with recurrent HGG. Methods: We searched for studies using the following databases: PubMed, Web of Science and Scopus. The search terms were: glioma OR brain neoplasm and DOPA OR DOPA PET OR DOPA PET/CT and FET OR FET PET OR FET PET/CT. From a mono-institutional database, we retrospectively analyzed the 18F-DOPA and 18F-FET PET/CT of 29 patients (age: 56 ± 12 years) with suspicious for recurrent HGG. All patients underwent 18F-DOPA or 18F-FET PET/CT for a multidisciplinary decision. The final definition of recurrence was made by magnetic resonance imaging (MRI) and/or multidisciplinary decision, mainly based on the clinical data. Results: Fifty-one articles were found, of which 49 were discarded, therefore 2 studies were finally selected. In both the studies, 18F-DOPA and 18F-FET as exchangeable in clinical practice particularly for HGG patients. From our institutional experience, in 29 patients, we found that sensitivity, specificity and accuracy of 18F-DOPA PET/CT in HGG were 100% (95% confidence interval- 95%CI - 81-100%), 63% (95%CI: 39-82%) and 62% (95%CI: 39-81%), respectively. 18F-FET PET/CT was true positive in 4 and true negative in 4 patients. Sensitivity, specificity and accuracy for 18F-FET PET/CT in HGG were 100%. Conclusion: 18F-DOPA and 18F-FET PET/CT have a similar diagnostic accuracy in patients with recurrent HGG. However, 18F-DOPA PET/CT could be affected by inflammation conditions (false positive) that can alter the final results. Large comparative trials are warranted in order to better understand the utility of 18F-DOPA or 18F-FET PET/CT in patients with HGG.

scholarly journals Predictive Evaluation on Cytological Sample of Metastatic Melanoma: The Role of BRAF Immunocytochemistry in the Molecular Era

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1110
Author(s):  
Andrea Ronchi ◽  
Marco Montella ◽  
Federica Zito Marino ◽  
Michele Caraglia ◽  
Anna Grimaldi ◽  
...  
Keyword(s):  
Metastatic Melanoma ◽  
Molecular Analysis ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Cost Effective ◽  
Needle Aspiration ◽  
Braf V600e ◽  
Mutational Status ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity

Background: Cutaneous malignant melanoma is an aggressive neoplasm. In advanced cases, the therapeutic choice depends on the mutational status of BRAF. Fine needle aspiration cytology (FNA) is often applied to the management of patients affected by melanoma, mainly for the diagnosis of metastases. The evaluation of BRAF mutational status by sequencing technique on cytological samples may be inconvenient, as it is a time and biomaterial-consuming technique. Recently, BRAF immunocytochemistry (ICC) was applied for the evaluation of BRAF V600E mutational status. Although it may be useful mainly in cytological samples, data about BRAF ICC on cytological samples are missing. Methods: We performed BRAF ICC on a series of 50 FNA samples of metastatic melanoma. BRAF molecular analysis was performed on the same cytological samples or on the corresponding histological samples. Molecular analysis was considered the gold standard. Results: BRAF ICC results were adequate in 49 out of 50 (98%) cases, positive in 15 out of 50 (30%) cases and negative in 34 out of 50 (68%) of cases. Overall, BRAF ICC sensitivity, specificity, positive predictive value and negative predictive value results were 88.2%, 100%, 100% and 94.1%, respectively. The diagnostic performance of BRAF ICC results was perfect when molecular evaluation was performed on the same cytological samples. Hyperpigmentation represents the main limitation of the technique. Conclusions: BRAF ICC is a rapid, cost-effective method for detecting BRAF V600E mutation in melanoma metastases, applicable with high diagnostic performance to cytological samples. It could represent the first step to evaluate BRAF mutational status in cytological samples, mainly in poorly cellular cases.

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