Comparison of 2D Fat Suppressed Proton Density (FS-PD) and 3D (WATS-c) MRI pulse sequences in evaluation of chondromalacia patellae

Abstract Background Comparing the diagnostic performance of widely used 2D FSE technique (fat-suppressed proton density; FS-PD) and the 3D technique (water-selective cartilage scan; WATS-c) in evaluation of the chondromalacia patella by using arthroscopy as reference standard Results Seventy-five adult patients were enrolled in this study. They underwent MRI examinations then arthroscopy done in 2–4 days after it. MRI was done using 2D (FS-PD) and 3D (WATS-c) sequences and MR images were compared by two radiologists separately, then grading of the cartilage lesions was performed according to modified Noyes grading system and comparison between grade 0–1, 2, and 3 lesions was done using arthroscopic findings as a reference. A false-negative result is considered if there was undergrading of chondromalacia and false-positive result if chondromalacia was overgraded. Each sequence sensitivity, specificity, and accuracy was calculated by both readers. For reader 1, the sensitivity is 69% for WATS-c and 80% for FS-PD and the accuracy is 90% for WATS-c and 92% for FS-PD and for reader 2, the sensitivity is 56% for WATS-c and 84% for FS-PD and the accuracy is 88% for WATS-c and 94% for FS-PD. Conclusion 2D FS-PD images showed better diagnostic performance than 3D WATS-c images for evaluating chondromalacia patella.

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Scanned versus Fused-Reconstructed Oblique MR-Images for Assessment of the Tibiofibular Syndesmosis—Diagnostic PerFormance and Reader Agreement

Diagnostics ◽

10.3390/diagnostics11020197 ◽

2021 ◽

Vol 11 (2) ◽

pp. 197

Author(s):

Hannes Seuss ◽

Matthias Hammon ◽

Frank Roemer ◽

Rafael Heiss ◽

Rolf Janka ◽

...

Keyword(s):

Diagnostic Performance ◽

False Negative ◽

Ankle Sprains ◽

Tibiofibular Syndesmosis ◽

Mr Images ◽

Predictive Values ◽

Tibiofibular Ligament ◽

Ligament Rupture ◽

Sensitivity Specificity ◽

Oblique Images

To evaluate the diagnostic performance and reader agreement of a novel MRI image fusion method enabling the reconstruction of oblique images for the assessment of the tibiofibular syndesmosis. We evaluated 40 magnetic resonance imaging examinations of patients with ankle sprains (16 with ruptures and 24 without) for the presence of anteroinferior tibiofibular ligament rupture. For all patients, we performed a fusion of standard two-dimensional transversal and coronal 3 mm PDw TSE images into an oblique-fusion reconstruction (OFR) and compared these against conventionally scanned oblique sequence for the evaluation of the tibiofibular syndesmosis. To evaluate diagnostic performance, two expert readers independently read the OFR images twice. We analyzed sensitivity, specificity, negative and positive predictive values, accuracy, and agreement. Reader 1 misinterpreted one OFR as a false negative, demonstrating a sensitivity of 0.94 and specificity of 1.00, reader 2 demonstrated perfect accuracy. Intrareader agreement was almost perfect for reader 1 (α = 0.95) and was perfect for reader 2 (α = 1.00). Additionally, interreader agreement between all fusion sequence reads was almost perfect (α = 0.97). The proposed OFR enables reliable detection of anteroinferior tibiofibular ligament rupture with excellent inter- and intrareader agreement, making conventional scanning of oblique images redundant and supplies a method to retroactively create oblique images, e.g., from external examinations.

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Mr Evaluation of Mediopatellar Plica

Acta Radiologica ◽

10.1177/02841851960373p228 ◽

1996 ◽

Vol 37 (3P2) ◽

pp. 567-571 ◽

Cited By ~ 9

Author(s):

K. Nakanishi ◽

M. Inoue ◽

T. Ishida ◽

T. Murakami ◽

K. Tsuda ◽

...

Keyword(s):

Mr Imaging ◽

Pulse Sequences ◽

Screening Method ◽

Flip Angle ◽

Knee Joints ◽

Mr Images ◽

Medial Condyle ◽

Low Intensity ◽

Arthroscopic Findings

Purpose: Evaluation of the usefulness of MR imaging for diagnosing mediopatellar plica (MP) of the knee joint. Material and Methods: We prospectively examined MR images of 40 knee joints in 30 patients with symptoms. The pulse sequences were SE T1-weighted images (600/26 ms), T2-weighted images (1800/70), and FLASH images (320/15/flip angle 90°). When a low-intensity band was found above the medial condyle of the femur on T1-weighted and T2-weighted MR images, we defined it as MP. We compared these MR findings with arthroscopic findings, including the Sakakibara classification of MP. Results: In 29 of the 40 knee joints in which MP was arthroscopically found, 27 were correctly diagnosed as having MP on MR. In the remaining 11 without MP, 9 were correctly diagnosed by MR. Conclusion: MR images are useful not only for detecting MP but also for evaluating its extension. Our results suggest that MR imaging is useful as a screening method for detecting MP before arthroscopy.

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Asbestos-related diseases in mineworkers: a clinicopathological study

ERJ Open Research ◽

10.1183/23120541.00022-2017 ◽

2017 ◽

Vol 3 (3) ◽

pp. 00022-2017 ◽

Cited By ~ 2

Author(s):

Ntombizodwa Ndlovu ◽

David Rees ◽

Jill Murray ◽

Naseema Vorajee ◽

Guy Richards ◽

...

Keyword(s):

Lung Cancer ◽

Predictive Value ◽

Imaging Techniques ◽

False Negative ◽

Accurate Diagnosis ◽

Reference Standard ◽

Disease Manifestation ◽

Clinical Diagnoses ◽

Low Sensitivity ◽

Sensitivity Specificity

The accurate diagnosis of asbestos-related diseases is important because of past and current asbestos exposures. This study evaluated the reliability of clinical diagnoses of asbestos-related diseases in former mineworkers using autopsies as the reference standard.Sensitivity, specificity, positive predictive value and negative predictive value were calculated.The 149 cases identified had clinical examinations 0.3–7.4 years before death. More asbestos-related diseases were diagnosed at autopsy rather than clinically: 77 versus 52 for asbestosis, 27 versus 14 for mesothelioma and 22 versus 3 for lung cancer. Sensitivity and specificity values for clinical diagnoses were 50.6% and 81.9% for asbestosis, 40.7% and 97.5% for mesothelioma, and 13.6% and 100.0% for lung cancer. False-negative diagnoses of asbestosis were more likely using radiographs of acceptable (versus good) quality and in cases with pulmonary tuberculosis at autopsy.The low sensitivity values are indicative of the high proportion of false-negative diagnoses. It is unlikely that these were the result of disease manifestation between the last clinical assessment and autopsy. Where clinical features suggest asbestos-related diseases but the chest radiograph is negative, more sophisticated imaging techniques or immunohistochemistry for asbestos-related cancers should be used. Autopsies are useful for the detection of previously undiagnosed and misdiagnosed asbestos-related diseases, and for monitoring clinical practice and delivery of compensation.

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Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis

10.21203/rs.2.15646/v3 ◽

2020 ◽

Author(s):

Auttakiat Karnjanapiboonwong ◽

Thunyarat Anothaisintawee ◽

Usa Chaikledkaew ◽

Charungthai Dejthevaporn ◽

John Attia ◽

...

Keyword(s):

Systematic Review ◽

Blood Pressure ◽

Ambulatory Blood Pressure ◽

Pressure Measurement ◽

Diagnostic Performance ◽

Blood Pressure Measurement ◽

Home Blood Pressure ◽

Reference Standard ◽

Sensitivity Specificity ◽

Pool Prevalence

Abstract Background: Clinic blood pressure measurement (CBPM) is currently the most commonly used form of screening for hypertension, however it might have a problem of white coat hypertension (WCHT) and masked hypertension (MHT). Home blood pressure measurement (HBPM) may be an alternative, but its diagnostic performance is inconclusive relative to CBPM. Therefore, this systematic review aimed to estimate the performance of CBPM and HBPM compared with ambulatory blood pressure measurement(ABPM) and to pool prevalence of WCHT and MHT. Methods: Medline, Scopus, Cochrane Central Register of Controlled Trials and WHO's International Clinical Trials Registry Platform databases were searched up to 23rd January 2020. Studies having diagnostic tests as CBPM or HBPM with reference standard as ABPM which reported sensitivity and specificity of both tests and/or proportion of WCHT or MHT were eligible. Diagnostic performance of CBPM and HBPM were pooled using bivariate mixed-effect regression model. Random effect model was applied to pool prevalence of WCHT and MHT. Results: Fifty-eight studies were eligible. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of CBPM, when using 24-hour ABPM as the reference standard, were 74%(95%CI:65%-82%), 79%(95%CI:61%-87%), and 11.11(95%CI:6.82-14.20), respectively. Pooled prevalence of WCHT and MHT were 0.24 (95% CI: 0.19, 0.29) and 0.29 (95% CI: 0.20, 0.38). Pooled sensitivity, specificity, and DOR of HBPM were 71%(95%CI:61%-80%), 82%(95%CI:77%-87%), and 11.60(95%CI:8.55.0-22.03), respectively. Conclusions: Diagnostic performances of HBPM were slightly higher than CBPM. However, the prevalence of MHT was high in negative CBPM and some persons with normal HBPM had elevated BP from 24-hour ABPM. Therefore, ABPM is still necessary for confirming the diagnosis of HT.

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Performance Evaluation of Standard Health System Microscopy and Rapid Diagnostic Test for the Focused Screening and Treatment of Malaria in South-eastern Tanzania

10.21203/rs.3.rs-299414/v1 ◽

2021 ◽

Author(s):

lin kangming ◽

Duoquan Wang ◽

Prosper Chaki ◽

Michael Mihayo ◽

Fei Luo ◽

...

Keyword(s):

Health System ◽

Gold Standard ◽

Diagnostic Tests ◽

Diagnostic Performance ◽

False Negative ◽

Rapid Diagnostic Tests ◽

Malaria Burden ◽

South Eastern ◽

Local Standard ◽

Sensitivity Specificity

Abstract Background: The Focused screening and treatment (FSAT) has been identified as one of the key approaches for reducing the malaria burden in Tanzania. However, the diagnostic performance of the local standard health system microscopy and rapid diagnostic tests (RDT) for the malaria infections is yet to be established. Thus, we aimed to evaluate the performance of the local standard health system microscopy and RDTs in comparison to that of the gold standard modality through the re-examination of blood slide microscopy findings. Methods: We used the paired RDTs and standard health system microscopy results from the participants screened in the FSAT during 2015–2016. With the gold standard modality as reference, the results of local standard health system microscopy and RDTs were evaluated according to their sensitivity, specificity and reliability.Results: A total of 1,497 paired standard health system microscopy and RDTs results were analysed. Of these, 679 (45.4%) samples and 818 (54.6%) samples were from the high transmission areas (HTA) and low transmission areas (LTA) in the Rufiji District of south eastern Tanzania, respectively. With the gold standard as the reference, the sensitivity of RDTs were higher than those of standard health system microscopy (87.10% vs 76.88%) and (86.99% vs 65.04%) in the HTA and LTA, respectively. Further, the false-negative rates of RDTs were lower than those of standard microscopy in both HTA (12.90% vs 13.01%) and LTA (23.12% vs 34.96%). Conclusions: RDTs have better performance than the standard health system microscopy in terms of sensitivity and specificity for FSAT in study areas in Tanzania.

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Evaluation of Serum Cryptococcal Antigen Testing Using Two Novel Semiquantitative Lateral Flow Assays in Persons with Cryptococcal Antigenemia

Journal of Clinical Microbiology ◽

10.1128/jcm.02046-19 ◽

2020 ◽

Vol 58 (4) ◽

Cited By ~ 1

Author(s):

Caleb Skipper ◽

Kiiza Tadeo ◽

Emily Martyn ◽

Elizabeth Nalintya ◽

Radha Rajasingham ◽

...

Keyword(s):

False Positive ◽

Diagnostic Performance ◽

False Negative ◽

Lateral Flow ◽

Reference Standard ◽

Serum Samples ◽

Cryptococcal Antigen ◽

Negative Results ◽

Lateral Flow Assays ◽

Positive Results

ABSTRACT Early cryptococcal disease can be detected via circulating antigen in blood before fulminant meningitis develops, when early antifungal therapy improves survival. Two semiquantitative cryptococcal antigen (CrAg) lateral flow assays (LFAs) have been developed, but their diagnostic performance has not been defined. Cryopreserved serum samples from HIV-infected Ugandans obtained as part of a prospective CrAg-screening cohort were tested in duplicate for CrAg by the CrAgSQ (IMMY) and CryptoPS (Biosynex) lateral flow assays. Case-controlled diagnostic performance was measured using the FDA-approved CrAg LFA (IMMY) as a reference standard via McNemar’s test. Of 99 serum samples tested, 57 were CrAg positive (CrAg+) by the CrAg LFA reference standard. By CrAgSQ, 57 were read as positive, with 98% sensitivity (56/57; 95% confidence interval [CI], 0.91 to 0.99) and 98% specificity (41/42; 95% CI, 0.88 to 0.99) (McNemar’s, P = 0.99). The sample with a false-negative result by CrAgSQ (n = 1) had a titer of <1:5, while the sample with a false-positive result (n = 1) yielded a 1+ result. By CryptoPS, 52 samples were read as positive, with 88% sensitivity (50/57; 95% CI, 0.76 to 0.95) and 95% specificity (40/42; 95% CI, 0.84 to 0.99) (McNemar’s, P = 0.18). The CryptoPS false-negative results included samples with titers of <1:5 (n = 1), 1:5 (n = 5), and 1:20 (n = 1), while samples with false-positive results by CryptoPS (n = 2) yielded Positive results. The CryptoPS assay missed 35% (7/20) of samples with CrAg LFA titers of ≤1:20. The new semiquantitative CrAg LFAs allow rapid estimation of titer levels in easy-to-perform platforms. The CrAgSQ demonstrated better qualitative sensitivity and specificity than the CryptoPS compared to the reference standard. The exact grading of the CrAgSQ results has some subjectivity, with interreader variability; however, qualitative reads were generally concordant for both assays.

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Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis

10.21203/rs.2.15646/v4 ◽

2020 ◽

Author(s):

Auttakiat Karnjanapiboonwong ◽

Thunyarat Anothaisintawee ◽

Usa Chaikledkaew ◽

Charungthai Dejthevaporn ◽

John Attia ◽

...

Keyword(s):

Systematic Review ◽

Blood Pressure ◽

Ambulatory Blood Pressure ◽

Pressure Measurement ◽

Diagnostic Performance ◽

Blood Pressure Measurement ◽

Home Blood Pressure ◽

Reference Standard ◽

Sensitivity Specificity ◽

Pool Prevalence

Abstract Background: Clinic blood pressure measurement (CBPM) is currently the most commonly used form of screening for hypertension, however it might have a problem detecting white coat hypertension (WCHT) and masked hypertension (MHT). Home blood pressure measurement (HBPM) may be an alternative, but its diagnostic performance is inconclusive relative to CBPM. Therefore, this systematic review aimed to estimate the performance of CBPM and HBPM compared with ambulatory blood pressure measurement(ABPM) and to pool prevalence of WCHT and MHT. Methods: Medline, Scopus, Cochrane Central Register of Controlled Trials and WHO's International Clinical Trials Registry Platform databases were searched up to 23rd January 2020. Studies having diagnostic tests as CBPM or HBPM with reference standard as ABPM which reported sensitivity and specificity of both tests and/or proportion of WCHT or MHT were eligible. Diagnostic performance of CBPM and HBPM were pooled using bivariate mixed-effect regression model. Random effect model was applied to pool prevalence of WCHT and MHT. Results: Fifty-eight studies were eligible. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of CBPM, when using 24-hour ABPM as the reference standard, were 74%(95%CI:65%-82%), 79%(95%CI:69%, 87%), and 11.11(95%CI:6.82, 14.20), respectively. Pooled prevalence of WCHT and MHT were 0.24 (95% CI: 0.19, 0.29) and 0.29 (95% CI: 0.20, 0.38). Pooled sensitivity, specificity, and DOR of HBPM were 71%(95%CI:61%, 80%), 82%(95%CI:77%, 87%), and 11.60(95% CI: 8.98, 15.13), respectively. Conclusions: Diagnostic performances of HBPM were slightly higher than CBPM. However, the prevalence of MHT was high in negative CBPM and some persons with normal HBPM had elevated BP from 24-hour ABPM. Therefore, ABPM is still necessary for confirming the diagnosis of HT.

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Diagnostic performance of clinic and home blood pressure measurements compared with ambulatory blood pressure: a systematic review and meta-analysis

BMC Cardiovascular Disorders ◽

10.1186/s12872-020-01736-2 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Auttakiat Karnjanapiboonwong ◽

Thunyarat Anothaisintawee ◽

Usa Chaikledkaew ◽

Charungthai Dejthevaporn ◽

John Attia ◽

...

Keyword(s):

Systematic Review ◽

Blood Pressure ◽

Ambulatory Blood Pressure ◽

Pressure Measurement ◽

Diagnostic Performance ◽

Blood Pressure Measurement ◽

Home Blood Pressure ◽

Reference Standard ◽

Sensitivity Specificity ◽

Pool Prevalence

Abstract Background Clinic blood pressure measurement (CBPM) is currently the most commonly used form of screening for hypertension, however it might have a problem detecting white coat hypertension (WCHT) and masked hypertension (MHT). Home blood pressure measurement (HBPM) may be an alternative, but its diagnostic performance is inconclusive relative to CBPM. Therefore, this systematic review aimed to estimate the performance of CBPM and HBPM compared with ambulatory blood pressure measurement(ABPM) and to pool prevalence of WCHT and MHT. Methods Medline, Scopus, Cochrane Central Register of Controlled Trials and WHO's International Clinical Trials Registry Platform databases were searched up to 23rd January 2020. Studies having diagnostic tests as CBPM or HBPM with reference standard as ABPM, reporting sensitivity and specificity of both tests and/or proportion of WCHT or MHT were eligible. Diagnostic performance of CBPM and HBPM were pooled using bivariate mixed-effect regression model. Random effect model was applied to pool prevalence of WCHT and MHT. Results Fifty-eight studies were eligible. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) of CBPM, when using 24-h ABPM as the reference standard, were 74% (95% CI: 65–82%), 79% (95% CI: 69%, 87%), and 11.11 (95% CI: 6.82, 14.20), respectively. Pooled prevalence of WCHT and MHT were 0.24 (95% CI 0.19, 0.29) and 0.29 (95% CI 0.20, 0.38). Pooled sensitivity, specificity, and DOR of HBPM were 71% (95% CI 61%, 80%), 82% (95% CI 77%, 87%), and 11.60 (95% CI 8.98, 15.13), respectively. Conclusions Diagnostic performances of HBPM were slightly higher than CBPM. However, the prevalence of MHT was high in negative CBPM and some persons with normal HBPM had elevated BP from 24-h ABPM. Therefore, ABPM is still necessary for confirming the diagnosis of HT.

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The role of serum periostin in the diagnosis of asthma: A meta-analysis

Allergy and Asthma Proceedings ◽

10.2500/aap.2020.41.200038 ◽

2020 ◽

Vol 41 (4) ◽

pp. 240-247

Author(s):

Lei Yang ◽

Qingtao Zhao ◽

Shuyu Wang

Keyword(s):

Diagnostic Accuracy ◽

Meta Analysis ◽

Characteristic Curve ◽

False Negative ◽

Summary Receiver Operating Characteristic ◽

True Negative ◽

Negative Results ◽

Noninvasive Biomarker ◽

Sensitivity Specificity ◽

Serum Periostin

Background: Serum periostin has been proposed as a noninvasive biomarker for asthma diagnosis and management. However, its accuracy for the diagnosis of asthma in different populations is not completely clear. Methods: This meta-analysis aimed to evaluate the diagnostic accuracy of periostin level in the clinical determination of asthma. Several medical literature data bases were searched for relevant studies through December 1, 2019. The numbers of patients with true-positive, false-positive, false-negative, and true-negative results for the periostin level were extracted from each individual study. We assessed the risk of bias by using Quality Assessment of Diagnostic Accuracy Studies 2. We used the meta-analysis to produce summary estimates of accuracy. Results: In total, nine studies with 1757 subjects met the inclusion criteria. The pooled estimates of sensitivity, specificity, and diagnostic odds ratios for the detection of asthma were 0.58 (95% confidence interval [CI], 0.38‐0.76), 0.86 (95% CI, 0.74‐0.93), and 8.28 (95% CI, 3.67‐18.68), respectively. The area under the summary receiver operating characteristic curve was 0.82 (95% CI, 0.79‐0.85). And significant publication bias was found in this meta‐analysis (p = 0.39). Conclusion: Serum periostin may be used for the diagnosis of asthma, with moderate diagnostic accuracy.

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

Diagnostics ◽

10.3390/diagnostics11061110 ◽

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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