scholarly journals Diagnostic Accuracy of NICE Classification System for Optical Recognition of Predictive Morphology of Colorectal Polyps

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Josipa Patrun ◽  
Lucija Okreša ◽  
Hrvoje Iveković ◽  
Nadan Rustemović
Keyword(s):  
Diagnostic Accuracy ◽  
Classification System ◽  
Colorectal Neoplasia ◽  
Colorectal Polyps ◽  
Histopathological Analysis ◽  
Histopathological Diagnosis ◽  
Proper Training ◽  
The Moment ◽  
Type 3 ◽  
Optical Recognition

The NICE classification is an international endoscopic classification of colorectal neoplasia through a narrowband spectrum that on the basis of lesion colors, vascular pattern, and structure of the surface of the mucous membrane classifies colorectal neoplasms in three categories: type 1 as hyperplastic lesions, type 2 as adenomas, and type 3 as invasive tumors. The aim of this study was to verify diagnostic accuracy of the NICE classification system compared to the reference standard: histopathological analysis. This retrospective study was conducted by ten physicians on a sequential sample of 418 patients and 735 polyps. The total diagnostic accuracy of the NICE classification system is found to be 76.7%. Optical recognition is significantly better with larger polyps, high-risk lesions (HGIEN), and neoplastic lesions. This research has shown that the NICE classification system is at the moment inferior to histopathological analysis. However, it is noticed that some physicians achieve significantly better results, with the accuracy of diagnosis ranging from 59.5% to 84.2%. These results show that with proper training of physicians and the use of endoscope enhancements to improve image quality, the NICE classification system could in the future potentially replace the histopathological diagnosis process.

scholarly journals The value of three narrow-band imaging model in the diagnosis of small colorectal polyps

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jie Sha ◽  
Pin Wang ◽  
Nan Sang ◽  
Huiai Zhang ◽  
Aiping Yang ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Colorectal Polyps ◽  
Histopathological Analysis ◽  
Clinical Value ◽  
Promising Tool ◽  
Imaging Model ◽  
Magnification Endoscopy ◽  
Image Definition

AbstractThis prospective study was aimed to evaluate the clinical value of narrow-band imaging (NBI), magnification endoscopy with narrow-band imaging (NBIME) and magnification endoscopy with acetic acid enhancement and narrow-band imaging (AA-NBIME) in the diagnosis of small colorectal polyps. We studied 261 small colorectal polyps from 122 patients with the use of above three techniques. Lesions were resected for histopathological analysis. The endoscopic images were independently reviewed by three experts and three non-experts and the diagnostic accuracy and image definition were compared among the modalities. The “experts-agreed” diagnostic accuracy was 87.7% for NBI versus 91.6% for NBIME versus 94.6% for AA-NBIME. The “non-experts-agreed” diagnostic accuracy was 80.1% for NBI versus 84.3% for NBIME versus 89.3% for AA-NBIME. All experts and non-experts diagnosed the small colorectal polyps statistically more accurately with AA-NBIME than NBI (P < 0.05). In all three modalities, the expert group’s diagnostic accuracies were statistically significantly higher compared with the non-expert group. For experts, the Kappa values for AA-NBIME, NBIME and NBI diagnosis were 0.962 (0.892–1.032), 0.577 (0.507–0.647) and 0.567 (0.497–0.637), respectively; while for nonexperts, 0.818 (0.748–0.888), 0.532 (0.462–0.602) and 0.530 (0.460–0.600). This demonstrated a good reproducibility of AA-NBIME diagnosis. The average scores (experts and non-experts) of images acquired using AA-NBIME were significantly higher than those acquired using NBIME and ME (P < 0.05). AA-NBIME is a promising tool to clearly visualize the mucosal pit pattern (PP) of colorectal polyps for better differentiating neoplastic polyps from non-neoplastic ones.

scholarly journals The Histopathological Analysis of 122 Cases of Ovarian Lesions

2021 ◽  
Vol 15 (6) ◽  
pp. 1397-1399
Author(s):  
Z. Kashif ◽  
S. Z. Warriach ◽  
M. B. Pasha ◽  
S. S. Ali ◽  
A. U Rehman ◽  
...  
Keyword(s):  
Marital Status ◽  
Retrospective Review ◽  
Malignant Neoplasm ◽  
Ovarian Cysts ◽  
Histopathological Analysis ◽  
Histopathological Diagnosis ◽  
The Mean ◽  
Final Histological Diagnosis ◽  
Bilateral Lesions ◽  
Ovarian Involvement

Aim: To outline various histopathological types of ovarian cysts received in our teaching hospital along with their prevalence and mode of presentation and to assess the proportion of physiologic versus pathological cysts and benign versus malignant ovarian cysts. Duration of study: From Jan 2019 to March 2021. Methods: Histopathology Department of Bakhtawar Amin Medical & Dental College & Hospital, Multan. A retrospective review of 122 ovarian lesions including physiological/functional cysts, pathological non neoplastic cysts as well as benign, borderline and malignant neoplasm. Histopathology reports of all ovarian specimens were reviewed and counted. Details like age, marital status, parity, presenting complaints, procedure opted, laterality, size, gross and microscopic details and final histological diagnosis etc were recorded. H&E stained slides of all cases were reviewed. In difficult suspicious cases, immunohistochemistry was also carried out. Percentage and proportions were calculated for all the variables. Relevant tables and charts were computed. Results: A total of 122 ovarian specimens with some lesion were segregated in histopathology department of Bakhtawar Amin Hospital from 117 patients with 5 patients having bilateral lesions. The mean age was 33.2 years (ranging from 13-71 years). Most ladies presented between 25-45 years of age. Out of these 117 patients, 18 ladies were unmarried. Out of the 99 married, 12 were nulliparous. Sixty four ladies (54.7%) found to have cysts/neoplasm in right sided ovary, forty eight (41%) presented with left sided ovarian involvement and 5 (4.3 %) presented with bilateral ovarian lesions. Conclusion: Non neoplastic ovarian cysts are more frequent as compared to neoplastic masses. Histopathological diagnosis is mandatory for final confirmatory diagnosis. Keywords: Ovarian lesions, reproductive cells, cyst

scholarly journals A Novel Country Classification System for Choosing International Business Locations

2019 ◽  
Vol 13 (1) ◽  
pp. 29
Author(s):  
Mikidadu Mohammed ◽  
Jean Marie Luundo
Keyword(s):  
Political Economy ◽  
International Business ◽  
Classification System ◽  
New Classification ◽  
International Investments ◽  
Doing Business ◽  
Legal Risks ◽  
Political Economic ◽  
Type 3

This paper introduces a novel country classification system that rates the political economy risks of countries for the purpose of conducting international business. It is intended to provide investors, multinational companies, and business researchers a quick and efficient way of gauging the extent of political, economic, and legal risks associated with doing business in different countries. The study covers over 170 countries and identifies 24 country types. At the extremes are Type 1 countries (least risky) and Type 24 countries (most risky). Overall, the new classification system suggests that political economy risks associated with doing international business are relatively mild in Type 1, Type 3, and Type 4 countries. However, international businesses should temper their investment decisions with caution in Type 19, Type 20, Type 22, Type 23, and Type 24 countries due to high political, economic, and legal risks, especially Types 23 and 24 where these risks are excessive. At the same time, international businesses may want to refocus their attention to Type 11 countries who are now havens for international investments due to drastic reduction in political, economic, and legal risks associated with doing business. The twenty-four country types identified in this new classification system are time-invariant. Thus, countries may move up or down due to improvements or deteriorations in certain aspects of their political economy.

Ultrasound-Guided Biopsies of Neuroendocrine Metastases

1993 ◽  
Vol 34 (5) ◽  
pp. 474-477 ◽  
Author(s):  
A. Elvin ◽  
E. Wilander ◽  
K. Öberg ◽  
B. Eriksson ◽  
P. G. Lindgren
Keyword(s):  
Diagnostic Accuracy ◽  
Neuroendocrine Tumour ◽  
Fibrous Tissue ◽  
Histopathological Diagnosis ◽  
Interferon Treatment ◽  
Ultrasound Guided

Twenty-five patients with known neuroendocrine tumour disease were biopsied with 1.2 mm and 0.9 mm biopsy-gun needles to evaluate the respective diagnostic accuracy of the 2 needle sizes. The influence of treatment-related fibrosis on the histopathological diagnosis was also evaluated. The overall diagnostic accuracy with the 0.9 mm needle was 69% as compared to 92% with the 1.2 mm needle. This difference, however, seems more related to needle guiding difficulties with the 0.9 mm needle than to insufficient tissue yield. When the tumour was hit with both the 0.9 and the 1.2 mm needle the tissue yield was inferior with the 0.9 mm needle in only one of 16 cases. The increased amount of fibrous tissue due to interferon treatment did not seem to negatively influence the diagnostic accuracy.

scholarly journals Jugular bulb and skull base pathologies: proposal for a novel classification system for jugular bulb positions and microsurgical implications

2018 ◽  
Vol 45 (1) ◽  
pp. E5 ◽  
Author(s):  
Sunil Manjila ◽  
Timothy Bazil ◽  
Matthew Kay ◽  
Unni K. Udayasankar ◽  
Maroun Semaan
Keyword(s):  
Skull Base ◽  
Middle Ear ◽  
Classification System ◽  
Internal Auditory Canal ◽  
Imaging Study ◽  
Jugular Bulb ◽  
Anatomical Location ◽  
Inferior Margin ◽  
Consensus Classification ◽  
Type 3

OBJECTIVEThere is no definitive or consensus classification system for the jugular bulb position that can be uniformly communicated between a radiologist, neurootologist, and neurosurgeon. A high-riding jugular bulb (HRJB) has been variably defined as a jugular bulb that rises to or above the level of the basal turn of the cochlea, within 2 mm of the internal auditory canal (IAC), or to the level of the superior tympanic annulus. Overall, there is a seeming lack of consensus, especially when MRI and/or CT are used for jugular bulb evaluation without a dedicated imaging study of the venous anatomy such as digital subtraction angiography or CT or MR venography.METHODSA PubMed analysis of “jugular bulb” comprised of 1264 relevant articles were selected and analyzed specifically for an HRJB. A novel classification system based on preliminary skull base imaging using CT is proposed by the authors for conveying the anatomical location of the jugular bulb. This new classification includes the following types: type 1, no bulb; type 2, below the inferior margin of the posterior semicircular canal (SCC), subclassified as type 2a (without dehiscence into the middle ear) or type 2b (with dehiscence into the middle ear); type 3, between the inferior margin of the posterior SCC and the inferior margin of the IAC, subclassified as type 3a (without dehiscence into the middle ear) and type 3b (with dehiscence into the middle ear); type 4, above the inferior margin of the IAC, subclassified as type 4a (without dehiscence into the IAC) and type 4b (with dehiscence into the IAC); and type 5, combination of dehiscences. Appropriate CT and MR images of the skull base were selected to validate the criteria and further demonstrated using 3D reconstruction of DICOM files. The microsurgical significance of the proposed classification is evaluated with reference to specific skull base/posterior fossa pathologies.RESULTSThe authors validated the role of a novel classification of jugular bulb location that can help effective communication between providers treating skull base lesions. Effective utilization of the above grading system can help plan surgical procedures and anticipate complications.CONCLUSIONSThe authors have proposed a novel anatomical/radiological classification system for jugular bulb location with respect to surgical implications. This classification can help surgeons in complication avoidance and management when addressing HRJBs.

Detection of Helicobacter pylori in virtual slides requires high resolution digitalisation

2021 ◽  
pp. jclinpath-2020-207378
Author(s):  
Arnaud Uguen
Keyword(s):  
Helicobacter Pylori ◽  
High Resolution ◽  
Digital Pathology ◽  
Histopathological Analysis ◽  
Histopathological Diagnosis ◽  
Low Resolution ◽  
Glass Slides ◽  
Sydney System ◽  
Kappa Value ◽  
Gastric Biopsies

To diagnose Helicobacter pylori (HP) infection and its related mucosal injuries requires the histopathological analysis of gastric biopsies. The move from glass slides interpretation towards digital pathology implies technical choices to maintain the performances of histopathological diagnosis. The intra-rater agreement in assessing gastritis diagnostic criteria between glass slides, low resolution and high resolution digital slides in the subject of the present study. One hundred gastric biopsies were re-assessed by a single digestive pathologist on glass slides and digitalised slides at low resolution (ie, x20 magnification and single focus without z-stack) and high resolution (ie, x40 magnification with seven focus levels and z-stack) about the criteria of the updated Sydney system and the detection of HP. Inter-analyses agreement were very good (Kappa values>0.81) for every criteria but slightly inferior (ie, Kappa values<0.9) comparing glass slides interpretations with low resolution digital slides-based ones. Indeed, some HP infections were misdiagnosed using x20 magnification histochemical stained digitalised slides (p<0.05). At the opposite, anti-HP immunohistochemistry slides and/or x40 magnification digitalisation permitted to maintain almost perfect concordance in diagnosis (Kappa value>0.9). As mentioned in current guidelines, a high resolution x40 magnification digitalisation must be favoured in order to avoid some misdetection of microorganisms as HP.

5-Aminolevulinic acid for enhanced surgical visualization of high-grade gliomas: a prospective, multicenter study

2021 ◽  
pp. 1-10
Author(s):  
Alexander J. Schupper ◽  
Rebecca B. Baron ◽  
William Cheung ◽  
Jessica Rodriguez ◽  
Steven N. Kalkanis ◽  
...  
Keyword(s):  
Adverse Events ◽  
Diagnostic Accuracy ◽  
Tumor Volume ◽  
Aminolevulinic Acid ◽  
Intraoperative Imaging ◽  
The United States ◽  
Histopathological Analysis ◽  
High Grade ◽  
Neurological Morbidity ◽  
High Grade Gliomas

OBJECTIVE Greater extent of resection (EOR) is associated with longer overall survival in patients with high-grade gliomas (HGGs). 5-Aminolevulinic acid (5-ALA) can increase EOR by improving intraoperative visualization of contrast-enhancing tumor during fluorescence-guided surgery (FGS). When administered orally, 5-ALA is converted by glioma cells into protoporphyrin IX (PPIX), which fluoresces under blue 400-nm light. 5-ALA has been available for use in Europe since 2010, but only recently gained FDA approval as an intraoperative imaging agent for HGG tissue. In this first-ever, to the authors’ knowledge, multicenter 5-ALA FGS study conducted in the United States, the primary objectives were the following: 1) assess the diagnostic accuracy of 5-ALA–induced PPIX fluorescence for HGG histopathology across diverse centers and surgeons; and 2) assess the safety profile of 5-ALA FGS, with particular attention to neurological morbidity. METHODS This single-arm, multicenter, prospective study included adults aged 18–80 years with Karnofsky Performance Status (KPS) score > 60 and an MRI diagnosis of suspected new or recurrent resectable HGG. Intraoperatively, 3–5 samples per tumor were taken and their fluorescence status was recorded by the surgeon. Specimens were submitted for histopathological analysis. Patients were followed for 6 weeks postoperatively for adverse events, changes in the neurological exam, and KPS score. Multivariate analyses were performed of the outcomes of KPS decline, EOR, and residual enhancing tumor volume to identify predictive patient and intraoperative variables. RESULTS Sixty-nine patients underwent 5-ALA FGS, providing 275 tumor samples for analysis. PPIX fluorescence had a sensitivity of 96.5%, specificity of 29.4%, positive predictive value (PPV) for HGG histopathology of 95.4%, and diagnostic accuracy of 92.4%. Drug-related adverse events occurred at a rate of 22%. Serious adverse events due to intraoperative neurological injury, which may have resulted from FGS, occurred at a rate of 4.3%. There were 2 deaths unrelated to FGS. Compared to preoperative KPS scores, postoperative KPS scores were significantly lower at 48 hours and 2 weeks but were not different at 6 weeks postoperatively. Complete resection of enhancing tumor occurred in 51.9% of patients. Smaller preoperative tumor volume and use of intraoperative MRI predicted lower residual tumor volume. CONCLUSIONS PPIX fluorescence, as judged by the surgeon, has a high sensitivity and PPV for HGG. 5-ALA was well tolerated in terms of drug-related adverse events, and its application by trained surgeons in FGS for HGGs was not associated with any excess neurological morbidity.

Cheek Dimpleplasty: A New Classification of Described Procedures

2020 ◽  
Vol 37 (3) ◽  
pp. 131-137
Author(s):  
Jude L. Opoku-Agyeman ◽  
Jamee E. Simone
Keyword(s):  
Classification System ◽  
Cosmetic Surgery ◽  
English Language ◽  
Cochrane Library ◽  
New Classification ◽  
Systematic Classification ◽  
Advantages And Disadvantages ◽  
Buccinator Muscle ◽  
Type 3

Cheek dimpleplasty has become a popular request amongst patients requesting cosmetic surgery. Since the first reported dimpleplasty in 1962, there have been many reported procedures in the literature for cheek dimple creation. Some of the procedures described by various authors as “novel” are actually similar if not identical to existing procedures. This study reviews the different procedures of cheek dimple creation and provides the first ever systematic classification for these techniques. EMBASE, Cochrane library, Ovid medicine, and PubMed databases were searched from its inception to June of 2019. We included all studies describing the surgical creation of cheek dimples. The studies were reviewed, and the different procedures were cataloged. We then proposed a new classification system for these procedures based on their common characteristics. The study included 12 articles published in the English language that provided a descriptive procedure for cheek dimple creation. We classified the procedures into 3 broad categories and subcategories. Type 1 procedures are nonexcisional myocutaneous dimpleplasties. In these procedures, the buccinator muscle is not excised. In type 1A, the suture used to create the adhesion traverses the epidermis. In type 1B, the suture does not traverse the epidermis, rather, the suture travels up into the dermis and returned back to the mucosa. Type 2 procedures are excisional dimpleplasties. In these procedures, the buccinator muscle is excised with (open) or without (closed) the excision of the mucosa. Type 3 procedures are incisional dimpleplasty. In these procedures, the muscle is incised and fixed to the dermis. Each of these groups of procedures has potential unique advantages and disadvantages. There are multiple procedures reported in the English language literature for the creation of cheek dimples. Most of the procedures are based on similar concept with minor variations. Our classification system, the Opoku-Simone Classification, will help facilitate communication when describing the different configurations of these procedures. Procedure within each group has similar potential advantages and disadvantages.

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