scholarly journals Solid Indeterminate Nodules with a Radiological Stability Suggesting Benignity: A Texture Analysis of Computed Tomography Images Based on the Kurtosis and Skewness of the Nodule Volume Density Histogram

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Bruno Max Borguezan ◽  
Agnaldo José Lopes ◽  
Eduardo Haruo Saito ◽  
Claudio Higa ◽  
Aristófanes Corrêa Silva ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Texture Analysis ◽  
Sensitivity And Specificity ◽  
Roc Curve ◽  
Area Under The Curve ◽  
Pulmonary Nodules ◽  
Volume Density ◽  
Ct Scans ◽  
Computed Tomography Images ◽  
Indeterminate Nodules

Background. The number of incidental findings of pulmonary nodules using imaging methods to diagnose other thoracic or extrathoracic conditions has increased, suggesting the need for in-depth radiological image analyses to identify nodule type and avoid unnecessary invasive procedures. Objectives. The present study evaluated solid indeterminate nodules with a radiological stability suggesting benignity (SINRSBs) through a texture analysis of computed tomography (CT) images. Methods. A total of 100 chest CT scans were evaluated, including 50 cases of SINRSBs and 50 cases of malignant nodules. SINRSB CT scans were performed using the same noncontrast enhanced CT protocol and equipment; the malignant nodule data were acquired from several databases. The kurtosis (KUR) and skewness (SKW) values of these tests were determined for the whole volume of each nodule, and the histograms were classified into two basic patterns: peaks or plateaus. Results. The mean (MEN) KUR values of the SINRSBs and malignant nodules were 3.37 ± 3.88 and 5.88 ± 5.11, respectively. The receiver operating characteristic (ROC) curve showed that the sensitivity and specificity for distinguishing SINRSBs from malignant nodules were 65% and 66% for KUR values >6, respectively, with an area under the curve (AUC) of 0.709 (p<0.0001). The MEN SKW values of the SINRSBs and malignant nodules were 1.73 ± 0.94 and 2.07 ± 1.01, respectively. The ROC curve showed that the sensitivity and specificity for distinguishing malignant nodules from SINRSBs were 65% and 66% for SKW values >3.1, respectively, with an AUC of 0.709 (p<0.0001). An analysis of the peak and plateau histograms revealed sensitivity, specificity, and accuracy values of 84%, 74%, and 79%, respectively. Conclusions. KUR, SKW, and histogram shape can help to noninvasively diagnose SINRSBs but should not be used alone or without considering clinical data.

scholarly journals Conditional CT Strategy—An Effective Tool to Reduce Negative Appendectomy Rate and the Overuse of the CT

2021 ◽  
Vol 10 (11) ◽  
pp. 2456
Author(s):  
Raminta Luksaite-Lukste ◽  
Ruta Kliokyte ◽  
Arturas Samuilis ◽  
Eugenijus Jasiunas ◽  
Martynas Luksta ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Sensitivity And Specificity ◽  
Surgical Outcomes ◽  
Imaging Modality ◽  
Ct Scans ◽  
Negative Appendectomy ◽  
Transabdominal Ultrasound ◽  
First Choice ◽  
Negative Appendectomy Rate

(1) Background: Diagnosis of acute appendicitis (AA) remains challenging; either computed tomography (CT) is universally used or negative appendectomy rates of up to 30% are reported. Transabdominal ultrasound (TUS) as the first-choice imaging modality might be useful in adult patients to reduce the need for CT scans while maintaining low negative appendectomy (NA) rates. The aim of this study was to report the results of the conditional CT strategy for the diagnosis of acute appendicitis. (2) Methods: All patients suspected of acute appendicitis were prospectively registered from 1 January 2016 to 31 December 2018. Data on their clinical, radiological and surgical outcomes are presented. (3) Results: A total of 1855 patients were enrolled in our study: 1206 (65.0%) were women, 649 (35.0%) were men, and the median age was 34 years (IQR, 24.5–51). TUS was performed in 1851 (99.8%) patients, and CT in 463 (25.0%) patients. Appendices were not visualized on TUS in 1320 patients (71.3%). Furthermore, 172 (37.1%) of 463 CTs were diagnosed with AA, 42 (9.1%) CTs revealed alternative emergency diagnosis and 249 (53.8%) CTs were normal. Overall, 519 (28.0%) patients were diagnosed with AA: 464 appendectomies and 27 diagnostic laparoscopies were performed. The NA rate was 4.2%. The sensitivity and specificity for TUS and CT are as follows: 71.4% and 96.2%; 93.8% and 93.6%. (4) Conclusion: A conditional CT strategy is effective in reducing NA rates and avoids unnecessary CT in a large proportion of patients. Observation and repeated TUS might be useful in unclear cases.

Pulmonary Infiltrates in a Patient With Advanced Melanoma

2017 ◽  
Vol 35 (7) ◽  
pp. 705-708 ◽  
Author(s):  
Charles A. Powell
Keyword(s):  
Computed Tomography ◽  
Subcutaneous Tissue ◽  
Relevant Literature ◽  
Pulmonary Nodules ◽  
Advanced Melanoma ◽  
Resection Margins ◽  
Left Chest ◽  
Pulmonary Infiltrates ◽  
Computed Tomography Images ◽  
History Of

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice. A 60-year-old former smoker with metastatic melanoma presented with the chief complaint of pulmonary infiltrates. Five years ago, he was diagnosed with a left chest wall melanoma. He underwent surgery but received no additional therapy for an American Joint Committee on Cancer stage T3a N0 M0 tumor that was 2.7 mm in depth with no ulceration of the epidermal surface. Resection margins were free of tumor. Four years later, he underwent excision of a raised pigmented skin lesion on his left calf that proved to be melanoma with positive margins. He underwent re-excision of melanoma but 2 months later developed a new left hip soft tissue nodule. Positron emission tomography (PET) –computed tomography showed multiple hypermetabolic lesions involving subcutaneous tissue, muscle osseous structures, and bone marrow, consistent with advanced melanoma. He began systemic therapy with ipilimumab and nivolumab. After four cycles of immunotherapy, he developed a nonproductive cough and mild dyspnea on exertion (Modified Medical Research Council dyspnea scale score of 2 [ie, he had to stop for breath when walking at his own pace on level ground]). A chest x-ray showed bilateral hilar enlargement, thickening of the right paratracheal stripe, and scattered patchy increased interstitial markings bilaterally. PET and chest computed tomography images showed enlarged mediastinal adenopathy with increased [18F]fluorodeoxyglucose uptake on PET and scattered diffuse 1- to 2-mm pulmonary nodules with ground-glass opacities ( Fig 1 ). The patient was referred for pulmonary input. The patient had smoked one pack of cigarettes per day for 35 years; he quit 6 years ago. He had no history of pneumonia, childhood asthma, or tuberculosis. His mother had asthma, but there was no other family history of asthma or other lung disease.

The greater tuberosity radius ratio: maybe a new predictor in diagnosis of rotator cuff tear

2020 ◽  
Author(s):  
Qi Ma ◽  
Changjiao Sun ◽  
Pu Liu ◽  
Sha Wu ◽  
Xu Cai
Keyword(s):  
Computed Tomography ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Roc Curve ◽  
Radius Ratio ◽  
Rotator Cuff Tears ◽  
Cutoff Value ◽  
Greater Tuberosity ◽  
Cuff Tear ◽  
Computed Tomography Images

Abstract Background The role of the greater tuberosity of humerus in subacromial impingement should be of equal important as the acromion. In this study we concerned on the morphological characteristics of the greater tuberosity of humerus and proposed the greater tuberosity radius ratio (GTRR) as a new predictor for the diagnosis of rotator cuff tear. We hypothesized that a larger value of the GTRR could increase the risk of developing rotator cuff tear. Methods This was a retrospective study and clinical data and preoperative computed tomography images of the patients with rotator cuff tears (defined as the RCT group, simple size: 61) or without rotator cuff tears (defined as the control group, simple size: 56) were collected. Three-dimensional models of shoulders were established by multiplanar reconstruction of computed tomography scans. In a standard anteroposterior view, the radius of the best-fit circle of the humeral head (the r) and the radius of the concentric circle passing through the most superolateral edge of the greater tuberosity (the R) were measured for each shoulder. The ratio of R and r (R/r) was defined as the greater tuberosity radius ratio (GTRR). Independent samples t tests were used to find significant differences within the r, the R and the GTRR between groups. Receiver operating characteristic (ROC) curve based on the values of GTRR was performed to determine an applied cutoff value which may be useful in clinical practice. Results There was no significant difference in the values of r or R. However, the mean values of GTRR were 1.339 ± 0.143 (range, 1.087–1.684) and 1.244 ± 0.172 (range, 1.040–1.706) in the two groups respectively (p = 0.002). According to the ROC curve, an optimized cutoff value of GTRR was determined as 1.262, whose sensitivity was 72% and specificity was 65% for diagnosis of rotator cuff tear. Conclusion The greater tuberosity of humerus contributes to the mechanisms of rotator cuff tear. The greater tuberosity radius ratio is recommended as a new predictor for diagnosis of rotator cuff tear, with an optimized cutoff value set as 1.262.

Bag-of-Frequencies: A Descriptor of Pulmonary Nodules in Computed Tomography Images

2015 ◽  
Vol 34 (4) ◽  
pp. 962-973 ◽  
Author(s):  
Francesco Ciompi ◽  
Colin Jacobs ◽  
Ernst Th. Scholten ◽  
Mathilde M. W. Wille ◽  
Pim A. de Jong ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Nodules ◽  
Computed Tomography Images

scholarly journals The combination of CTCs and CEA can help guide the management of patients with SPNs suspected of being lung cancer

2019 ◽  
Author(s):  
Jian Zheng ◽  
Xiong Ye ◽  
Yuxia Zhao ◽  
Mudan He ◽  
Hui Xiao
Keyword(s):  
Lung Cancer ◽  
Sensitivity And Specificity ◽  
Radiographic Finding ◽  
Gene Copy Number ◽  
Area Under The Curve ◽  
Pulmonary Nodules ◽  
Gene Copy ◽  
Solitary Pulmonary Nodules ◽  
Diagnostic Efficacy ◽  
Diagnostic Biomarkers

Abstract Objective: Solitary pulmonary nodules (SPNs) is a common radiographic finding and require further evaluation because of the possibility of lung cancer. This study aimed to determine the sensitivity and specificity of circulating tumour cells (CTCs) as a marker for the diagnosis of SPNs and the integration of CTCs, carcinoembryonic antigen (CEA) and imaging findings to improve the sensitivity and specificity of diagnosis in patients with SPNs suspected of being lung cancer.Method: For the serum biomarker assay, the concentration of CEA was measured by an automated electrochemiluminescence analyzer. CTCs were collected from 6 ml of blood by i-FISH method, which detects the gene copy number in eight chromosomes and the tumour-associated antigen CK18.Results: With a threshold of 6 CTC units, the method showed a sensitivity of 67.1% and a specificity of 56.5% in the diagnosis of NSCLC, especially in the upper lobe, in which the diagnostic strength was the highest (P < 0.01). CTCs, CEA and nodule type had the highest diagnostic efficacy (area under the curve, 0.827; 95% confidence interval, 0.752-0.901) in patients with SPNs being suspected lung cancer. Combining CTCs (cut-off value 12 units) with CEA (1.78 ng/ml), the method showed a sensitivity of 77.8% and a specificity of 90% in the diagnosis of NSCLC, especially in the upper lobe, sub solid nodules and nodules ≥8 mm.Conclusion: Our results demonstrated that CTCs are feasible diagnostic biomarkers in patients with SPNs, especially in the upper lobe. Furthermore, CTCs combined with CEA showed higher diagnostic efficacy in the upper lobe, sub solid nodules and nodules ≥8 mm.

scholarly journals Comparison of the diagnostic accuracy of cone beam computed tomography and three intraoral radiographic systems in the diagnosis of carious lesions in vitro.

2020 ◽  
Vol 9 (6) ◽  
pp. 466-473
Author(s):  
Jorge A. Beltrán ◽  
◽  
Roberto A. León-Manco ◽  
Maria Eugenia Guerrero ◽  
◽  
...  
Keyword(s):  
Computed Tomography ◽  
Dental Caries ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Cone Beam Computed Tomography ◽  
Area Under The Curve ◽  
Cone Beam ◽  
Occlusal Surfaces ◽  
Caries Lesions

Objective: The objective of the study was to compare the diagnostic accuracy of cone beam computed tomography and three intraoral radiographic systems in the detection of in vitro caries lesions. Material and Methods: One hundred teeth (46 molars and 54 premolars) were evaluated, including 176 proximal surfaces and 90 occlusal surfaces, with or without dental caries lesions. Digital images of all teeth were obtained using specific intraoral radiographs, VistaScan DürrDental®phosphor-plate radiography, XIOS XG Sirona® digital sensor radiography, and CBCT I-CATTM. Observers evaluated the images for the detection of caries lesions. The teeth were clinically sectioned and stereomicroscopy served as a validation tool. The relationship of sensitivity and specificity between all systems was determined through the ROC curve using Az values. Results: The values of the area under the curve (Az) selected for the CBCT I-CATTM system were 0.89 (0.84-0.93), for conventional radiography 0.71 (0.66-0.76), digital sensor radiography 0.74 (0.70-0.78) and digital radiography with phosphor-plates 0.73 (0.69-0.77). Statistically significant differences were found between the CBCT I-CATTM system and intraoral radiographic systems (p<0.01). The sensitivity and specificity values for the CBCT I-CATTM were 0.84 and 0.93 respectively. Conclusion: CBCT has a high sensitivity and specificity compared to intraoral radiographic systems for the diagnosis of dental caries lesions in vitro.

scholarly journals Evaluation of prediction score of contrast-induced nephropathy in inpatients undergone to digital or CT angiography

2020 ◽  
Vol 10 (3) ◽  
pp. 78-84
Author(s):  
Seleno Glauber de Jesus-Silva ◽  
Ana Elisa Chaves ◽  
Caio Augusto Alves Maciel ◽  
Edson Eziel Ferreira Scotini ◽  
Pablo Girardelli Mendonça Mesquita ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Roc Curve ◽  
Computed Tomography Angiography ◽  
Score Test ◽  
Area Under The Curve ◽  
Roc Curve Analysis ◽  
Contrast Induced Nephropathy ◽  
Mean Values ◽  
Iodinated Contrast ◽  
The Mean

Objectives: To assess the incidence of contrast-induced nephropathy (CIN) and determine the Mehran Score's (MS) ability to predict CIN in patients undergoing digital angiography or computed tomography angiography. Methods: 252 medical records of inpatients who underwent DA or CTA over 28 months in a quaternary hospital were reviewed. CIN was defined as serum creatinine> 0.5 mg / dL or > 25% increase in baseline creatinine, 48 h after administration of iodinated contrast. The ROC curve and the area under the curve (AUC) were used as a score test. Results: The majority (159; 63.1%) were male, and the average age was 60.4 years. Anemia, diabetes mellitus, and age > 75 years were the most prevalent factors. The incidence of CIN was 17.8% (n = 45). There was a decrease in the mean values ​​of creatinine pre and post among patients who did not suffer CIN (1.38 ± 1.22 vs 1.19 ± 0.89; t = 3.433; p = 0.0007), while among patients who suffering CIN, the mean increase was 1.03 mg / dL (1.43 ± 1.48 vs 2.46 ± 2.35 mg / dL; t = 5.44; p = 0.117). The ROC curve analysis identified a low correlation between MS and the occurrence of CIN (AUC = 0.506). Conclusion: The incidence of CIN in hospitalized patients undergoing angiography or computed tomography angiography was high. The EM did not allow the prediction of NIC.

Sign in / Sign up

Export Citation Format

Share Document