scholarly journals Role of MRI in the Diagnosis of Injury to the Lisfranc Ligament Complex

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0029
Author(s):  
Christopher Kreulen ◽  
Eric Giza ◽  
Eva Escobedo ◽  
Cyrus Bateni ◽  
Michael Doherty
Keyword(s):  
Magnetic Resonance ◽  
Mr Imaging ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
High Sensitivity ◽  
Lisfranc Injury ◽  
Radiology Reports ◽  
Lisfranc Ligament ◽  
Sensitivity Specificity

Category: Sports Introduction/Purpose: Subtle Lisfranc ligamentous injuries are difficult to diagnose and magnetic resonance is becoming a useful tool. The purpose of this study is to evaluate the efficacy of magnetic resonance (MR) imaging for the diagnosis of injuries of the Lisfranc ligament complex. Methods: The radiology database was searched between Jan 1, 2010 and Mar 10, 2015 to identify patients over the age of 18 years who had MR imaging of the foot for suspected injury of the Lisfranc ligament complex. MR images were reviewed by 2 fellowship trained musculoskeletal radiologists, whom were blinded to the original radiology reports. Findings were categorized as: no injury or injury present. Injury was deemed to be present if 2 of the 3 components of C1-M2 ligament showed disruption or signal alterations on T1 and T2 weighted images. Disagreements were resolved by consensus. Correlation was made with surgical findings whenever performed. In patients not undergoing surgery, the presence or absence of injury was determined by clinical examination performed by an orthopedic surgeon and follow-up. Sensitivity, specificity, positive predictive value(PPV), and negative predictive value (NPV) of MR for diagnosis of Lisfranc ligament complex injury was determined. Results: Of 60 patients, 9 were excluded due to a lack of follow-up. Lisfranc injury was determined to be present on MR in 26 patients and 18 underwent surgery. Injury was confirmed in 16, and 2 were intact. 2 patients underwent closed reduction and were clinically determined to be injured. 6 of the injured 26 patients were sprained and not injured/torn on clinical evaluation. Of the 25 patients determined to have no injury on MR, 24 were intact clinically. 1 patient had a Lisfranc injury on follow-up. Sensitivity, specificity, PPV and NPV of MR for detection of significant Lisfranc injury were 94.7% (CI: 73.9% to 99.9%), 75% (CI: 56.6% to 88.5%), 69.2% (CI: 55% to 80.5%) and 96% (CI: 77.9% to 99.4%) respectively. Conclusion: MR has a high sensitivity and negative predictive value for diagnosis of injury to the Lisfranc ligament complex. MR of the foot should be considered in patients with clinical suspicion of injury to the Lisfranc ligament complex, and it is highly accurate in excluding such injuries.

Isolated demyelinating syndromes: comparison of CSF oligoclonal bands and different MR imaging criteria to predict conversion to CDMS

2001 ◽  
Vol 7 (6) ◽  
pp. 359-363 ◽  
Author(s):  
M Tintoré ◽  
A Rovira ◽  
L Brieva ◽  
E Grivé ◽  
R Jardí ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
High Sensitivity ◽  
Oligoclonal Bands ◽  
High Negative Predictive Value ◽  
Csf Oligoclonal Bands ◽  
Sensitivity Specificity

Aim of the study: To evaluate and compare the capacity of oligoclonal bands (OB) and three sets of MR imaging criteria to predict the conversion of clinically isolated syndromes (CIS) to clinically definite multiple sclerosis (CDMS). Patients and methods: One hundred and twelve patients with CIS were prospectively studied with MR imaging and determination of OB. Based on the clinical follow-up (conversion or not conversion to CDMS), we calculated the sensitivity, specificity accuracy, positive and negative predictive value of the OB, and MR imaging criteria proposed by Paty et al, Fazekas et al and Barkhof et al. Results: CDMS developed in 26 (23.2%) patients after a mean follow-up of 31 months (range 12-62). OB were positive in 70 (62.5%) patients and were associated with a higher risk of developing CDMS. OB showed a sensitivity of 81%, specificity of 43%, accuracy of 52%, positive predictive value (PPV) of 30% and negative predictive value (NPV) of 88%. Paty and Fazekas criteria showed the same results with a sensitivity of 77%, specificity of 51%, accuracy of 57%, positive predictive value of 32% and negative predictive value of 88%. Barkhof criteria showed a sensitivity of 65%, specificity of 70%, accuracy of 69%, PPV of 40% and NPV of 87%. The greatest accuracy was achieved when patients with positive OB and three or four Barkhof's criteria were selected. Conclusions: We observed a high prevalence of OB in CIS. OB and MR imaging (Paty's and Fazekas' criteria) have high sensitivity. Barkhof's criteria have a higher specificity. Both OB and MR imaging criteria have a high negative predictive value.

scholarly journals High Sensitivity of PD-L1 analysis from pleural effusion in non-small cell lung cancer

2020 ◽  
pp. 00787-2020
Author(s):  
Lars Hagmeyer ◽  
Stephan Schäfer ◽  
Marianne Engels ◽  
Anja Pietzke-Calcagnile ◽  
Marcel Treml ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Pleural Effusion ◽  
Small Cell Lung Cancer ◽  
Negative Predictive Value ◽  
Cell Lung Cancer ◽  
Predictive Value ◽  
High Sensitivity ◽  
Small Cell ◽  
Small Cell Lung ◽  
Sensitivity Specificity

BackgroundPD-1/PD-L1 immune checkpoint inhibitors have been approved for monotherapy of metastatic non-small cell lung cancer (mNSCLC) depending on tumor cells' PD-L1 expression. Pleural effusion (PE) is common in mNSCLC. The significance of immunocytochemistry PD-L1 analysis from PE samples is unclear.Aim of the studyTo analyse the sensitivity regarding immunocytochemistry PD-L1 analysis of PE in NSCLC as compared to immunohistochemistry of pleural biopsies.Patients and Methods50 consecutive subjects (17 female, median age 72.5, 7 never-smokers) were enrolled in this prospective controlled two-center study. Inclusion criteria were PE, suspected or known lung cancer, indication for pleural puncture and thoracoscopy, written informed consent. Immunocytochemistry and immunohistochemistry PD-L1 analyses were performed with the Dako-PDL1-IHC-22C3pharmDx assay. Analysis for sensitivity, specificity, positive (PPV) and negative predictive value (NPV) was performed for PD-L1 detection from PE.Results50 subjects underwent pleural puncture and thoracoscopy. Pathologic diagnoses were lung cancer (48), lymphoma (1), mesothelioma (1). Sensitivity, specificity, positive-predictive-value and negative-predictive-value of PD-L1-testing with expression ≥50% defined as positive were 100% (95% confidence interval 46–100%), 63%(36–84%), 45%(18–75%), 100%(66–100%), and with expression ≥1% defined as positive 86%(56–97%), 43%(12–80%), 75%(47–92%), 60%(17–93%).ConclusionPD-L1 analysis in tumor-positive PE samples shows a very high sensitivity and negative-predictive-value, especially regarding PD-L1 expression levels ≥50% (European Medicines Agency approval). Negative results are reliable and help in the decision against a first-line checkpoint inhibitor monotherapy. However, a 1% cut-off level (United States Food and Drug Administration approval) leads to a markedly lower negatve-predictive-value, making other invasive procedures necessary. (NCT02855281)

scholarly journals Missed Abstracts

2016 ◽  
Keyword(s):  
Ct Scan ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
False Negative ◽  
High Sensitivity ◽  
Carcinoma Cervix ◽  
Figo Staging ◽  
Guided Biopsy ◽  
Pre Treatment ◽  
Sensitivity Specificity

Aim: To compare the findings of CT scan pelvis and cystoscopy findings of bladder involvement in carcinoma cervix in VIEW of revised FIGO staging and to demonstrate the accuracy of CT scan for pretreatment diagnosis of bladder involvement. Methods: A prospective and comparative study was conducted in the department of Obstetrics and Gynaecology, Rajindra hospital Patiala on a number of 100 patients of carcinoma cervix who underwent both cystoscopy and CT scan pelvis to ascertain bladder involvement. Cystoscopy guided biopsy proven cases of bladder involvement were taken as true cases of bladder involvement in the study and the results of both modalities were analysed and compared. Results: Out of 100 patients of carcinoma cervix, 28 patients showed bladder involvement on CT scan pelvis and 6 patients were proven as positive cases on cystoscopic guided bladder biopsy. The true positives in the study were 6 cases. True negatives were 94 cases. 22 patients were false positive on CT scan findings and there were no false negative patients for bladder involvement on CT scan pelvis findings in the study. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT scan pelvis for bladder involvement were 100%, 76.60%, 21.43%, 100% and 78% respectively. CT scan pelvis was able to detect all cases of bladder involvement which came positive cystoscopy guided biopsy as well. Conclusions: With the revised FIGO staging which has given optional status to both CT scan and cystoscopy for bladder involvement in patients of carcinoma cervix, CT scan can be used as the preliminary modality for detective bladder involvement in patients of carcinoma cervix. The high sensitivity and negative predictive value of CT scan helps choose which patients should undergo cystoscopy and helps in better and more efficient pre-treatment evaluation of patients with carcinoma cervix for bladder involvement.

scholarly journals Role of imprint cytology in thoracic endoscopy suite

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Mohammed Elsaid Hantera ◽  
Salwa Atef Ganna ◽  
Ayman Mohamed Elsaka ◽  
Walaa Mowafy El-Lawaty
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Fiberoptic Bronchoscopy ◽  
High Sensitivity ◽  
Added Value ◽  
Imprint Cytology ◽  
Medical Thoracoscopy ◽  
Multiple Biopsies ◽  
Sensitivity Specificity

Abstract Background Fiberoptic bronchoscopy and medical thoracoscopy are basic interventional modalities for the diagnosis of a wide variety of pleuropulmonary diseases. In some cases, we need fast and accurate results for decision-making. We aimed to evaluate the diagnostic accuracy of imprint cytology and its added value to the pulmonologist. Results Multiple biopsies were taken from 54 patients included 31 patients with lung masses subjected to fiberoptic bronchoscopy and 23 patients with undiagnosed exudative pleural effusion subjected to medical thoracoscopy. Imprint cytology was done to all biopsies which are later examined histopathologically. Regarding fiberoptic bronchoscopy biopsies, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of imprint cytology were 93.33, 100, 100, 33.33, and 93.55%, respectively. While in medical thoracoscopy biopsies, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of imprint cytology were 94.74, 100, 100, 80, and 95.65%, respectively. Conclusion Imprint cytology is an easy, rapid, and reliable method that has a high sensitivity and specificity in the diagnosis of lung and pleural malignancies compared with histopathology.

scholarly journals 1.5-Tesla Multiparametric-Magnetic Resonance Imaging for the detection of clinically significant prostate cancer

2017 ◽  
Vol 90 (1) ◽  
pp. 40-48
Author(s):  
Cristian Popita ◽  
Anca Raluca Popita ◽  
Adela Sitar-Taut ◽  
Bogdan Petrut ◽  
Bogdan Fetica ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Imaging Modality ◽  
High Sensitivity ◽  
Resonance Imaging ◽  
Multiparametric Magnetic Resonance Imaging ◽  
Clinically Significant

Background and aims. Multiparametric-magnetic resonance imaging (mp-MRI) is the main imaging modality used for prostate cancer detection. The aim of this study is to evaluate the diagnostic performance of mp-MRI at 1.5-Tesla (1.5-T) for the detection of clinically significant prostate cancer.Methods. In this ethical board approved prospective study, 39 patients with suspected prostate cancer were included. Patients with a history of positive prostate biopsy and patients treated for prostate cancer were excluded. All patients were examined at 1.5-T MRI, before standard transrectal ultrasonography–guided biopsy.Results. The overall sensitivity, specificity, positive predictive value and negative predictive value for mp-MRI were 100%, 73.68%, 80% and 100%, respectively.Conclusion. Our results showed that 1.5 T mp-MRI has a high sensitivity for detection of clinically significant prostate cancer and high negative predictive value in order to rule out significant disease.

Diagnosis of hyperfunctional thyroidn odules

2014 ◽  
Vol 53 (05) ◽  
pp. 173-177 ◽  
Author(s):  
V. Stebner ◽  
R. Görges ◽  
J. Farahati ◽  
D. Simon ◽  
A. Bockisch ◽  
...  
Keyword(s):  
Real Time ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
High Sensitivity ◽  
Scoring Systems ◽  
Benign Nodules ◽  
Sensitivity Specificity ◽  
Hot Thyroid Nodules

SummaryAim: Several studies described the ultrasound based real-time elastography (USE) having a high sensitivity, specificity and negative predictive value in the diagnosis of suspicious thyroid nodules. Recently published studies called these results into question. Until now the usefulness of USE in the diagnosis of scintigraphically hyperfunctional thyroid nodules is not examined. Patients, methods: This study included 135 hyperfunctional thyroid nodules of 102 consecutive patients. The following attributes of the nodules were analyzed: stiffness with the USE using scores of Rago or Asteria and ultrasound criteria using TIRADS. Results: 94 of the examined thyroid nodules (70%) were rated as hard (suspicious for malignancy) and 41 nodules (30%) as soft (not suspicious) with a specificity of 30%. The scoring systems of Rago and Asteria showed no sigificant difference. Applying the TIRADS criteria 44 nodules (33%) have a higher risk for malignancy (33 nodules TIRADS 4a, 11 nodules TIRADS 4b). Combining USE and TIRADS 32 nodules (24%) are categorized as suspicious (intersection of hard nodules that are categorized as TIRADS 4a or 4b). Conclusion: Ultrasound based real-time elastography cannot identify scintigraphically hyperfunctional thyroid nodules as benign nodules reliably. Its accuracy in the assessment of at least “hot” thyroid nodules is to be questioned.

scholarly journals Comparison between cystoscopy and CT scan findings of bladder involvement in carcinoma cervix in view of revised FIGO staging

2016 ◽  
Keyword(s):  
Ct Scan ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
False Negative ◽  
High Sensitivity ◽  
Carcinoma Cervix ◽  
Figo Staging ◽  
Guided Biopsy ◽  
Pre Treatment ◽  
Sensitivity Specificity

Aim: To compare the findings of CT scan pelvis and cystoscopy findings of bladder involvement in carcinoma cervix in VIEW of revised FIGO staging and to demonstrate the accuracy of CT scan for pretreatment diagnosis of bladder involvement. Methods: A prospective and comparative study was conducted in the department of Obstetrics and Gynaecology, Rajindra hospital Patiala on a number of 100 patients of carcinoma cervix who underwent both cystoscopy and CT scan pelvis to ascertain bladder involvement. Cystoscopy guided biopsy proven cases of bladder involvement were taken as true cases of bladder involvement in the study and the results of both modalities were analysed and compared. Results: Out of 100 patients of carcinoma cervix, 28 patients showed bladder involvement on CT scan pelvis and 6 patients were proven as positive cases on cystoscopic guided bladder biopsy. The true positives in the study were 6 cases. True negatives were 94 cases. 22 patients were false positive on CT scan findings and there were no false negative patients for bladder involvement on CT scan pelvis findings in the study. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT scan pelvis for bladder involvement were 100%, 76.60%, 21.43%, 100% and 78% respectively. CT scan pelvis was able to detect all cases of bladder involvement which came positive cystoscopy guided biopsy as well. Conclusions: With the revised FIGO staging which has given optional status to both CT scan and cystoscopy for bladder involvement in patients of carcinoma cervix, CT scan can be used as the preliminary modality for detective bladder involvement in patients of carcinoma cervix. The high sensitivity and negative predictive value of CT scan helps choose which patients should undergo cystoscopy and helps in better and more efficient pre-treatment evaluation of patients with carcinoma cervix for bladder involvement.

Role of Magnetic Resonance Imaging in Predicting Residual Breast Cancer After Vacuum-Assisted Breast Biopsy

2020 ◽  
pp. 000313482095243
Author(s):  
Sun Zheng ◽  
Liu Qi ◽  
Zhang Guang-Qiang ◽  
Shi Ming-Ming ◽  
Xu Chun-Hong
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Breast Biopsy ◽  
Breast Mri ◽  
High Sensitivity ◽  
Resonance Imaging ◽  
Residual Cancer ◽  
Sensitivity Specificity

Purpose This study aims to evaluate the effectiveness of breast magnetic resonance imaging (MRI) in detecting residual breast cancer in patients after vacuum-assisted breast biopsy (VABB). Methods Between 2012 and 2019, 26 patients with breast cancer who underwent VABB were enrolled. Breast MRI was conducted after VABB. Imaging findings were then compared with the histopathological results. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. Results Residual cancer was confirmed histologically in 8 of the 26 patients after VABB. The overall sensitivity, specificity, PPV, NPV, and accuracy of MRI for diagnosing residual cancer were 79.9%, 73.0%, 87.1%, 61.3%, and 77.8%, respectively. The sensitivity and NPV improved to 100%, when the number of biopsy specimens was larger than five. Conclusion Breast MRI showed high sensitivity and NPV in detecting residual breast tumor after VABB.

Urinary Met level as a novel biomarker for urothelial carcinoma of the bladder.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 257-257
Author(s):  
M. Sorbellini ◽  
B. McNeil ◽  
B. Cohen ◽  
G. Athauda ◽  
A. Giubellino ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Trial Design ◽  
Transitional Cell ◽  
Clinical Trial Design ◽  
Carcinoma Of The Bladder ◽  
Muscle Invasive ◽  
Sensitivity Specificity

257 Background: To determine whether urinary soluble Met (sMet) can differentiate between benign conditions and bladder cancer (CaB), and in cases of bladder cancer, between different stages of transitional cell carcinoma (TCC). Methods: Urinary samples from patients with (Total: 63, pTa: 12, pTis: 22, pT1: 13, ≥ pT2: 16) and without (Total: 27) CaB from three different institutions were prospectively collected prior to cystosopy, TURBT or cystectomy. sMet levels were determined by electrochemiluminescence immunoassay and normalized to urinary creatinine values. Normalized sMet values were compared to final pathologic stage. AUC values were obtained comparing patients with and without TCC. Results: Urinary sMet levels accurately differentiated between patients with and without CaB (AUC: 78%, sensitivity, specificity and negative predictive value were: 68%, 78% and 95%, respectively), patients with no CaB and those with lamina propria invasion (AUC: 79%, sensitivity, specificity and negative predictive value were: 65%, 81% and 95%, respectively) and patients with no CaB and those with muscle invasive CaB (AUC: 85%, sensitivity, specificity and negative predictive value were: 75%, 83% and 97%, respectively). Conclusions: Urinary sMet levels accurately distinguish patients with CaB from those without, and between patients with different CaB stages. These results suggest that urinary sMet may have utility as a bladder cancer marker for screening, treatment follow-up and clinical trial design. No significant financial relationships to disclose.

scholarly journals A direct comparison of decision rules for early discharge of suspected acute coronary syndromes in the era of high sensitivity troponin

2018 ◽  
Vol 8 (5) ◽  
pp. 421-431 ◽  
Author(s):  
Pei Gee Chew ◽  
Fredrick Frost ◽  
Liam Mullen ◽  
Michael Fisher ◽  
Heidar Zadeh ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
High Sensitivity ◽  
Early Discharge ◽  
Coronary Syndrome ◽  
One Year

Background: We tested the hypothesis that a single high sensitivity troponin at limits of detection (LOD HSTnT) (<5 ng/l) combined with a presentation non-ischaemic electrocardiogram is superior to low-risk Global Registry of Acute Coronary Events (GRACE) (<75), Thrombolysis in Myocardial Infarction (TIMI) (≤1) and History, ECG, Age, Risk factors and Troponin (HEART) score (≤3) as an aid to early, safe discharge for suspected acute coronary syndrome. Methods: In a prospective cohort study, risk scores were computed in consecutive patients with suspected acute coronary syndrome presenting to the Emergency Room of a large English hospital. Adjudication of myocardial infarction, as per third universal definition, involved a two-physician, blinded, independent review of all biomarker positive chest pain re-presentations to any national hospital. The primary and secondary outcome was a composite of type 1 myocardial infarction, unplanned coronary revascularisation and all cause death (MACE) at six weeks and one year. Results: Of 3054 consecutive presentations with chest pain 1642 had suspected acute coronary syndrome (52% male, median age 59 years, 14% diabetic, 20% previous myocardial infarction). Median time from chest pain to presentation was 9.7 h. Re-presentations occurred in eight hospitals with 100% follow-up achieved. Two hundred and eleven (12.9%) and 279 (17%) were adjudicated to suffer MACE at six weeks and one year respectively. Only HEART ≤3 (negative predictive value MACE 99.4%, sensitivity 97.6%, %discharge 53.4) and LOD HSTnT strategy (negative predictive value MACE 99.8%, sensitivity 99.5%, %discharge 36.9) achieved pre-specified negative predictive value of >99% for MACE at six weeks. For type 1 myocardial infarction alone the negative predictive values at six weeks and one year were identical, for both HEART ≤3 and LOD HSTnT at 99.8% and 99.5% respectively. Conclusion: HEART ≤3 or LOD HSTnT strategy rules out short and medium term myocardial infarction with ≥99.5% certainty, and short-term MACE with >99% certainty, allowing for early discharge of 53.4% and 36.9% respectively of suspected acute coronary syndrome. Adoption of either strategy has the potential to greatly reduce Emergency Room pressures and minimise follow-up investigations. Very early presenters (<3 h), due to limited numbers, are excluded from these conclusions.

Sign in / Sign up

Export Citation Format

Share Document