Comparative Analysis of Diagnostic Value for Shear Wave Elastography and Real-Time Elastographic Imaging for Thyroid Nodules

2019 ◽  
Vol 9 (2) ◽  
pp. 334-338
Author(s):  
Qing Yang ◽  
Wenhong Zhou ◽  
Jiyu Li ◽  
Guojun Wu ◽  
Feng Ding ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Shear Wave ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Roc Curves ◽  
Diagnostic Value ◽  
Sensitivity Specificity

Objective: To compare the diagnostic value of shear wave elastography (SWE) and real-time elastography (RTE) in the diagnosis of benign and malignant thyroid nodules. Methods: A total of 34 patients who ever received thyroidectomy in our hospital from January 2016 to January 2018 were identified. Meanwhile, all the patients received SWE and RTE before surgery, and all the diagnoses were confirmed by pathological examinations. With respect to SWE technique, the Subject Operating Characteristics (ROC) curves were drawn, in order to obtain the optimal threshold and then make differential diagnoses of benign and malignant thyroid nodules. In terms of RTE, the Rago 5 scoring method was utilized to make differential diagnoses of benign and malignant thyroid nodules. Besides, the pathological examinations after surgery could be considered as the golden standard. At last, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of SWE and RTE were calculated, respectively. Results: A total of 51 thyroid nodules were identified, and 41 nodules were benign, 10 nodules were malignant. On the basis of ROC curves, with respect to SWE, the best threshold for differential diagnosis of benign and malignant thyroid nodules is 38.3 kPa. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of SWE were 72.7% (8/11), 85% (34/40), 82.4% (42/51), 68.4% (13/19), and 87.5% (35/40), respectively. And the diagnostic indicators of RTE were 81.8% (9/11), 87.5% (35/40), 84.3% (43/51), 73.7% (14/19), and 90.0% (36/40). The sensitivity of quasi-static elastography in differential diagnosis of benign and malignant thyroid nodules with diameter ≤1 cm was 87.5% (7/8), and the sensitivity of SWE was 50.0% (5/10). In addition, the accuracy of SWE in differential diagnosis of benign and malignant thyroid nodules with diameter ≥3 cm was 100% (6/6), and the accuracy of RTE for this kind of thyroid nodules was 66.7% (4/6). Conclusion: Both SWE and RTE technology have good application value in differential diagnosis of benign and malignant thyroid nodules. But, SWE is preferable when making diagnosis of benign and malignant thyroid nodules with diameter ≥3 cm, and RTE was superior in detecting benign and malignant thyroid nodules with diameter ≤1 cm.

scholarly journals A Control Study on the Value of the Ultrasound Grayscale Ratio for the Differential Diagnosis of Thyroid Micropapillary Carcinoma and Micronodular Goiter in Two Medical Centers

2021 ◽  
Vol 10 ◽  
Author(s):  
Zhijiang Han ◽  
Na Feng ◽  
Yidan Lu ◽  
Mingkui Li ◽  
Peiying Wei ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Medical Center ◽  
Threshold Sensitivity ◽  
Ultrasound Images ◽  
Diagnostic Efficacy ◽  
Medical Centers ◽  
Sensitivity Specificity

ObjectiveTo investigate the value of ultrasound gray-scale ratio (UGSR) for the differential diagnosis of papillary thyroid microcarcinoma (PTMC) and micronodular goiter (MNG) in two medical centers.MethodsUltrasound images of 881 PTMCs from 785 patients and 744 MNGs from 687 patients in center A were retrospectively analyzed and compared with 243 PTMCs from 203 patients and 251 MNGs from 198 patients in center B. All cases were confirmed by surgery and histology. The grayscale values of thyroid lesions and surrounding normal tissues were measured, and the UGSR was calculated. The optimal UGSR threshold for identifying PTMCs and MNGs in two medical centers was determined by receiver operating characteristic (ROC) curve, and the area under the curve (AUC), optimal UGSR threshold, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were compared between the two medical centers.ResultsThe UGSR values of PTMCs and MNGs in medical center A were 0.5537 (0.4699, 0.6515) and 0.8708 (0.7616, 1.0123) (Z = -27.691, P = 0), respectively, whereas those in medical center B were 0.5517 (0.4698, 0.6377) and 0.8539 (0.7366, 0.9929) (Z = -16.057, P = 0), respectively. The UGSR of PTMCs and MNGs did not differ significantly between the two medical centers (Z = -0.609, P = 0.543 and Z = -1.394, P = 0.163, respectively). The AUC, optimal UGSR threshold, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the two medical centers were 0.898 vs. 0.918, 0.7214 vs. 0.6911, 0.881 vs. 0.868, 0.817 vs. 0.833, 0.851 vs. 0.834, 0.853 vs. 0.867, and 0.852 vs. 0.850, respectively.ConclusionsUGSR can quantify the echo intensity of PTMCs and MNGs and is therefore valuable for the differential diagnosis of the two diseases. The diagnostic efficacy was consistent between the two medical centers. This method should be widely promoted and applied.

scholarly journals AIBx, artificial intelligence model to risk stratify thyroid nodules

2021 ◽  
Author(s):  
Johnson Thomas ◽  
Tracy Haertling
Keyword(s):  
Artificial Intelligence ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Classification Systems ◽  
Image Similarity ◽  
Ultrasound Images ◽  
Similarity Model ◽  
Sensitivity Specificity

AbstractBackgroundCurrent classification systems for thyroid nodules are very subjective. Artificial intelligence (AI) algorithms have been used to decrease subjectivity in medical image interpretation. 1 out of 2 women over the age of 50 may have a thyroid nodule and at present the only way to exclude malignancy is through invasive procedures. Hence, there exists a need for noninvasive objective classification of thyroid nodules. Some cancers have benign appearance on ultrasonogram. Hence, we decided to create an image similarity algorithm rather than image classification algorithm.MethodsUltrasound images of thyroid nodules from patients who underwent either biopsy or thyroid surgery from February of 2012 through February of 2017 in our institution were used to create AI models. Nodules were excluded if there was no definitive diagnosis of benignity or malignancy. 482 nodules met the inclusion criteria and all available images from these nodules were used to create the AI models. Later, these AI models were used to test 103 thyroid nodules which underwent biopsy or surgery from March of 2017 through July of 2018.ResultsNegative predictive value of the image similarity model was 93.2%. Sensitivity, specificity, positive predictive value and accuracy of the model was 87.8%, 78.5%, 65.9% and 81.5% respectively.ConclusionWhen compared to published results of ACR TIRADS and ATA classification system, our image similarity model had comparable negative predictive value with better sensitivity specificity and positive predictive value. By using image similarity AI models, we can eliminate subjectivity and decrease the number of unnecessary biopsies. Using image similarity AI model, we were able to create an explainable AI model which increases physician’s confidence in the predictions.

scholarly journals NILAI DIAGNOSTIK MALARIA ANTIGEN CASSETTE PENYAKIT MALARIA

2018 ◽  
Vol 16 (1) ◽  
pp. 7
Author(s):  
Binawati . ◽  
Prihatini . ◽  
M.Y Probohoesodo
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Cross Sectional ◽  
Clinical Criteria ◽  
Malaria Antigen ◽  
Peripheral Areas ◽  
Sensitivity Specificity ◽  
Death Cases

Malaria is an endemic disease in many countries. In 103 endemic countries with around 2.5 billion population, 1−3 million death cases were reported every year. Clinical criteria and blood smear established the diagnosis of malaria. ICT (imuno chromatographytest) is needed in peripheral areas where there are no experienced laboratory technicians. The procedure is simple, practical, easy, aswell as quicker than the conventional method, and no experienced technicians are needed this ICT advantages. The aim of this study isto know the diagnostic value of Malaria Antigen Cassette with microscopic examination as the gold standard examination of malaria.This research used observational cross-sectional method This study was done in Nusa Tenggara Barat during May−June 2008. Bloodsamples were taken by finger prick in patients with Malaria symptoms: fever, chill and sweating, followed by examining the blood smearby Malaria Antigen Cassette from Focus Diagnostic. The diagnostic value was then evaluated by calculating the sensitivity, specificity,positive predictive value as well as the negative predictive value. The diagnostic value of Malaria Antigen Cassette in patients withmalaria falciparum was found as follows: sensitivity 95.2%, specificity 100%, positive predictive value 100%, and negative predictivevalue 97.6%. The diagnostic value of Malaria Antigen Cassette in patients other types than malaria falciparum was as follows: sensitivity94.8%, specificity 100%, positive predictive value 100%, and negative predictive value 95.3%. The diagnostic value of Malaria AntigenCassette was very high in diagnosing malaria falciparum compared to other types than malaria falciparum.

scholarly journals Qualitative analysis of contrast-enhanced ultrasound in the diagnosis of small, TR3–5 benign and malignant thyroid nodules measuring ≤1 cm

2020 ◽  
Vol 93 (1111) ◽  
pp. 20190923
Author(s):  
Xin Li ◽  
Feng Gao ◽  
Fan Li ◽  
Xiao-xia Han ◽  
Si-hui Shao ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Qualitative Analysis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Thyroid Nodules ◽  
Area Under The Curve ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Sensitivity Specificity

Objective: To evaluate the performance of contrast-enhanced ultrasound in the diagnosis of small, solid, TR3–5 benign and malignant thyroid nodules (≤1 cm). Methods: From January 2016 to March 2018, 185 thyroid nodules from 154 patients who underwent contrast enhanced ultrasound (CEUS) and fine-needle aspiration or thyroidectomy in Shanghai General Hospital were included. The χ2 test was used to compare the CEUS characteristics of benign and malignant thyroid nodules, and the CEUS features of malignant nodules assigned scores. The total score of the CEUS features and the scores of the above nodules were evaluated according to the latest 2017 version of the Thyroid Imaging Reporting and Data System (TI-RADS). The diagnostic performance of the two were compared based on the receiver operating characteristic curves generated for benign and malignant thyroid nodules. Results: The degree, enhancement patterns, boundary, shape, and homogeneity of enhancement in thyroid small solid nodules were significantly different (p＜0.05). No significant differences were seen between benign and malignant thyroid nodules regarding completeness of enhancement and size of enhanced lesions (p＞0.05). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the TI-RADS classification TR5 in diagnosis of malignant nodules were 90.10%, 55.95%, 74.59%, 72.22%, and 82.46%, respectively (area under the curve [AUC]=0.738; 95% confidence interval[CI], 0.663–0.813). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the total score of CEUS qualitative analysis indicators were 86.13%, 89.29%, 87.57%, 90.63%, and 84.27% respectively (AUC = 0.916; 95% CI, 0.871–0.961). Conclusion: CEUS qualitative analysis is superior to TI-RADS in evaluating the diagnostic performance of small, solid thyroid nodules. Qualitative analysis of CEUS has a significantly higher specificity for diagnosis of malignant thyroid nodules than TI-RADS. Advances in knowledge: The 2017 version of TI-RADS has recently suggested the malignant stratification of thyroid nodules by ultrasound. In this paper we applied this system and CEUS to evaluate 185 nodules and compare the results with pathological findings to access the diagnostic performance.

scholarly journals BCL-xL is Correlated With Disease Severity in Neonatal Infants With Sepsis

2021 ◽  
Author(s):  
Wenshen Wu ◽  
Qi Peng ◽  
Tianli Huang ◽  
Jinfen Liao ◽  
Ning Li
Keyword(s):  
Septic Shock ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Disease Severity ◽  
Predictive Value ◽  
B Cell Lymphoma ◽  
Diagnostic Value ◽  
Operating Characteristics ◽  
Tnf Α ◽  
Sensitivity Specificity

Abstract Objective: to investigate the association between disease severity in patients with sepsis and TNF-a, B cell lymphoma-extra-large (BCL-xL), and serum Mitochondrial membrane potential (MMP). Methods: we investigated the correlation between SNAP-II score and levels of TNF-α, BCL-xL, and MMP-index, respectively. The receiver-operating characteristics (ROC) was to assess the diagnostic value of the the Bcl - xL in the diagnosis of the of septic shock. Results: A total of 37 children were diagnosed with sepsis. SNAP-II was positively correlated with the level of BCL-xL (r=0.450, P =0.006). The area under the BCL-xL curve was 83.0%, and the 95% CI was 67.1–93.3%. The septic shock threshold was >3.022 ng/mL, and the sensitivity and specificity were 75.0% and 95.2%, respectively. The positive predictive value was 92.3%, and the negative predictive value was 83.3%. Furthermore, the level of SNAP-II was >10, and BCL-xL was >3.022 ng/mL as the threshold, and the sensitivity, specificity, positive predictive value, and negative predictive value of septic shock were 93.8%, 95.2%, 93.8%, and 95.2%, respectively. Conclusion: A correlation has been established between SNAP II and neonatal prognosis. The combination of BCL-xL and SNAP-II was more sensitive and specific than the BCL-xL to predict neonatal sepsis outcomes.

SWE combined with ACR TI-RADS categories for malignancy risk stratification of thyroid nodules with indeterminate FNA cytology

2020 ◽  
Vol 76 (3) ◽  
pp. 381-390 ◽  
Author(s):  
Wei-Bing Zhang ◽  
Jing-Jing Li ◽  
Xiang-Yong Chen ◽  
Bei-Li He ◽  
Rong-Hua Shen ◽  
...  
Keyword(s):  
Risk Stratification ◽  
Shear Wave ◽  
Gold Standard ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Roc Curves ◽  
Diagnostic Sensitivity ◽  
Diagnostic Efficacy ◽  
Malignancy Risk ◽  
Sensitivity Specificity

OBJECTIVES: To compare the diagnostic efficacy of shear wave elastography (SWE) comnined with ACR TI-RADS categories for malignancy risk stratification of thyroid nodules with interminate FNA cytology. METHODS: The clinical data, sonographic features, ACR TI-RADS grading and shear wave elastography images of 193 patients of surgical pathologically proven thyroid nodules with interminate FNA cytology were retrospectively analyzed. The diagnostic efficacy of ACR TI-RADS categories, the maximum Young’s modulus (Emax) of SWE and the combination of the two were calculated respectively. RESULTS: The ROC curves were drawn using surgical pathology results as the gold standard. The ROC curves indicated that the cut-off value of ACR TI-RADS and Emax of SWE was TR5 and 41.2 kPa respectively, and the area under the ROC curve (AUC) was 0.864 (95% CI: 0.879–0.934) and 0.858 (95% CI: 0.796–0.920) respectively. The diagnostic sensitivity, specificity and accuracy of ACR TI-RADS was 81.4% (127/156), 84.8% (31/37), and 81.9% (158/193), respectively. That of SWE Emax was 80.8% (126/156), 78.4% (29/37), and 80.3% (155/193), respectively. After SWE combined with ACR TI-RADS, the sensitivity, specificity and accuracy was 94.2% (147/156), 75.7% (28/37), and 90.7% (175/193), respectively. CONCLUSIONS: ACR TI-RADS classification system and shear wave elastography had high diagnostic efficacy for thyroid nodules with interminate FNA cytology. The combination of the two could improve diagnostic sensitivity and accuracy, and could help to differentiate benign and malignant thyroid nodules with interminate FNA cytology.

scholarly journals Diagnostic value of transabdominal hydrosonography in gastric carcinoma

1970 ◽  
Vol 10 (3) ◽  
pp. 170-176
Author(s):  
AF Rabbi ◽  
RN Sarker ◽  
A Hossain
Keyword(s):  
Gastric Carcinoma ◽  
Positive Predictive Value ◽  
Key Words ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Clinical Suspicion ◽  
Diagnostic Modality ◽  
Key Words Gastric Carcinoma ◽  
Sensitivity Specificity

Aim: To evaluate the efficacy of transabdominal hydrosonography in the diagnosis of gastric carcinoma. Materials and Methods: Transabdominal hydrosonography of the stomach was carried out on fifty patients with clinical suspicion of gastric carcinoma. Endoscopic or peroperative biopsy was taken from pathological sites in all cases. The validity of transabdominal hydrosonography of the stomach was evaluated as compared to histopathological diagnoses. Results: The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of transabdominal hydrosonography in the diagnosis of gastric carcinoma were 81.82%, 96.43%, 90.00%, 94.74% & 87.10% respectively. Conclusion: Transabdominal hydrosonography is a useful diagnostic modality for the diagnosis of gastric carcinoma. Key words: Gastric carcinoma, transabdominal hydrosonography. DOI: http://dx.doi.org/ 10.3329/bjms.v10i3.8360 BJMS 2011; 10(3): 170-176

Diagnostic Value of Real-Time Shear Wave Elastography in Diagnosing Thyroid Cancer

2018 ◽  
Vol 68 (12) ◽  
pp. 2818-2822
Author(s):  
Maria Cristina Oprea ◽  
Mihaela Vlad ◽  
Ioana Golu ◽  
Ioan Sporea ◽  
Lazar Fulger
Keyword(s):  
Shear Wave ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Imaging Techniques ◽  
Area Under The Curve ◽  
Thyroid Volume ◽  
Shear Wave Elastography ◽  
Maximum Diameter ◽  
Diagnostic Tools ◽  
Tissue Elasticity

Thyroid nodules are a common pathology found in 50 to 60% of otherwise healthy people. Diagnostic imaging techniques are help discriminating between benign and malignant nodules, while fine needle aspiration is still a gold standard. Shear wave elastography, a recent imaging technique, holds the promise to become reliable diagnostic tools and is currently used in combination with ultrasound. We here report data obtained in a series of 52 thyroid nodules analysed by means of elastography, as well as conventional and Doppler ultrasound. We found no differences in age, nodule and thyroid volume, length, width, thickness and maximum diameter between benign and malignant lesions. Several sonographic patterns are considered to be predictive of malignancy, out of which we only found the intranodular blood flow to be statistically significant. By the means of shear wave elastography we have first assessed tissue elasticities, which are shown in a range of colours, depending on tissue elasticity/stiffness. Then, we have measured and recorded four parameters automatically displayed by the system, namely SWE-mean, SWE-max, SWE-SD and SWE-ratio. Data analysis showed all these quantitative parameters had good sensitivity, specificity, positive predictive value, negative predictive value and area under the curve, as calculated by the ROC curve. As with these parameters, the cut-off points were lower than in literature, still able to indicate reliable diagnoses, which were confirmed by histopathological exam. Our conclusion is that shear wave elastography has great potential for reliably and accurately diagnosing thyroid malignancies.

scholarly journals Added value of diffusion-weighted MRI in assessment of pleural lesions

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Youssriah Yahia Sabri ◽  
Ikram Hamed Mahmoud ◽  
Lamis Tarek El-Gendy ◽  
Mohamed Raafat Abd El-Mageed ◽  
Sally Fouad Tadros
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Added Value ◽  
Adc Value ◽  
Pleural Diseases ◽  
Conventional Mri ◽  
Malignant Lesions

Abstract Background There are many causes of pleural disease including variable benign and malignant etiologies. DWI is a non-enhanced functional MRI technique that allows qualitative and quantitative characterization of tissues based on their water molecules diffusivity. The aim of this study was to evaluate the diagnostic value of DWI-MRI in detection and characterization of pleural diseases and its capability in differentiating benign from malignant pleural lesions. Results Conventional MRI was able to discriminate benign from malignant lesions by using morphological features (contour and thickness) with sensitivity 89.29%, specificity 76%, positive predictive value 89%, negative predictive value 76.92%, and accuracy 85.37%. ADC value as a quantitative parameter of DWI found that ADC values of malignant pleural diseases were significantly lower than that of benign lesions (P < 0.001). Hence, we discovered that using ADC mean value of 1.68 × 10-3 mm2/s as a cutoff value can differentiate malignant from benign pleural diseases with sensitivity 89.3%, specificity 100%, positive predictive value 100%, negative predictive value 81.2%, and accuracy 92.68% (P < 0.001). Conclusion Although DWI-MRI is unable to differentiate between malignant and benign pleural effusion, its combined morphological and functional information provide valid non-invasive method to accurately characterize pleural soft tissue diseases differentiating benign from malignant lesions with higher specificity and accuracy than conventional MRI.

scholarly journals Foundational Statistical Principles in Medical Research: Sensitivity, Specificity, Positive Predictive Value, and Negative Predictive Value

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 503
Author(s):  
Thomas F. Monaghan ◽  
Syed N. Rahman ◽  
Christina W. Agudelo ◽  
Alan J. Wein ◽  
Jason M. Lazar ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Medical Literature ◽  
Disease Prevalence ◽  
Positive Test Result ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Test Result ◽  
Test Probability

Sensitivity, which denotes the proportion of subjects correctly given a positive assignment out of all subjects who are actually positive for the outcome, indicates how well a test can classify subjects who truly have the outcome of interest. Specificity, which denotes the proportion of subjects correctly given a negative assignment out of all subjects who are actually negative for the outcome, indicates how well a test can classify subjects who truly do not have the outcome of interest. Positive predictive value reflects the proportion of subjects with a positive test result who truly have the outcome of interest. Negative predictive value reflects the proportion of subjects with a negative test result who truly do not have the outcome of interest. Sensitivity and specificity are inversely related, wherein one increases as the other decreases, but are generally considered stable for a given test, whereas positive and negative predictive values do inherently vary with pre-test probability (e.g., changes in population disease prevalence). This article will further detail the concepts of sensitivity, specificity, and predictive values using a recent real-world example from the medical literature.

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