Added value of diffusion-weighted MRI in assessment of pleural 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.

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Role of diffusion-weighted magnetic resonance imaging in assessment of mammographically detected asymmetric densities

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00361-5 ◽

2020 ◽

Vol 51 (1) ◽

Author(s):

Mohamed Zidan ◽

Shimaa Ali Saad ◽

Eman Abo Elhamd ◽

Hosam Eldin Galal ◽

Reem Elkady

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Benign Lesions ◽

Adc Value ◽

Dce Mri ◽

Diffusion Weighted ◽

Breast Asymmetries ◽

Malignant Lesions

Abstract Background Asymmetric breast density is a potentially perplexing finding; it may be due to normal hormonal variation of the parenchymal pattern and summation artifact or it may indicate an underlying true pathology. The current study aimed to identify the role of diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) values in the assessment of breast asymmetries. Results Fifty breast lesions were detected corresponding to the mammographic asymmetry. There were 35 (70%) benign lesions and 15 (30%) malignant lesions. The mean ADC value was 1.59 ± 0.4 × 10–3 mm2/s for benign lesions and 0.82 ± 0.3 × 10–3 mm2/s for malignant lesions. The ADC cutoff value to differentiate between benign and malignant lesions was 1.10 × 10–3 mm2/s with sensitivity 80%, specificity 88.6%, positive predictive value 75%, negative predictive value 91%, and accuracy 86%. Best results were achieved by implementation of the combined DCE-MRI and DWI protocol, with sensitivity 93.3%, specificity 94.3%, positive predictive value 87.5%, negative predictive value 97.1%, and accuracy 94%. Conclusion Dynamic contrast-enhanced MRI (DCE-MRI) was the most sensitive method for the detection of the underlying malignant pathology of breast asymmetries. However, it provided a limited specificity that may cause improper final BIRADS classification and may increase the unnecessary invasive procedures. DWI was used as an adjunctive method to DCE-MRI that maintained high sensitivity and increased specificity and the overall diagnostic accuracy of breast MRI examination. Best results can be achieved by the combined protocol of DCE-MRI and DWI.

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Immunocytochemistry Test of Protein BRAF Expression for Diagnosis of Well Differentiated Thyroid Carcinoma

Case Reports in Oncology ◽

10.1159/000495029 ◽

2018 ◽

Vol 11 (3) ◽

pp. 843-849 ◽

Cited By ~ 1

Author(s):

I. Wayan Sudarsa ◽

Elvis Deddy Kurniawan Pualillin ◽

Putu Anda Tusta Adiputra ◽

Ida Bagus Tjakra Wibawa Manuaba

Keyword(s):

Positive Predictive Value ◽

Thyroid Carcinoma ◽

Negative Predictive Value ◽

Diagnostic Test ◽

Predictive Value ◽

Preoperative Diagnosis ◽

Area Under The Curve ◽

Diagnostic Value ◽

Differentiated Thyroid Carcinoma ◽

Inclusion Criteria

Background: Thyroid carcinoma generally has a good prognosis. The main focus of current research on thyroid carcinoma is to increase the accuracy of preoperative diagnosis of thyroid nodules. When the result of fine needle aspiration biopsy (FNAB) is indeterminate, clinicians often have doubts in determining the surgical management. Objective: Protein BRAF expression analysis can help improve the accuracy of FNAB and optimize the management of differentiated thyroid carcinoma. Methods: This study is a diagnostic test performed from October 2016 at Sanglah General Hospital with 38 patients as subjects who fulfilled the inclusion criteria. Data is being presented in descriptive form before diagnostic test is done to determine sensitivity, specificity, positive predictive value, negative predictive value and the accuracy of immunocytochemistry test for BRAF on indeterminate thyroid nodule. Results: Thirty-eight samples met the inclusion criteria during the study period. Three samples were male (7.9%) and 35 samples (92.1%) were female. The mean age of the sample was 45.21 years (SD ±10.910 years) with ages ranging from 23 to 66 years. Of the 12 samples undergoing isthmolobectomy, 7 samples (58.4%) were determined to be malignant from histopathological results. The sensitivity value of BRAF immunocytochemistry test is 45.45% with a specificity value of 81.25%, a positive predictive value of 76.92%, a negative predictive value of 52% and an accuracy of 60.50%. Analysis of the receiver operator (ROC) curve shows the area under the curve (AUC) of 63.4% with a confidence interval of 45.5–81.2%. Conclusion: Immunocytochemistry BRAF test have a reliable diagnostic value and can be taken into consideration in the preoperative diagnosis of thyroid malignancies.

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Diagnostic Value of Different Biomarkers to Identify Bacterial Coinfection in Vietnamese Children with Severe Rhinovirus Pneumonia

Journal of Child Science ◽

10.1055/s-0040-1713362 ◽

2020 ◽

Vol 10 (01) ◽

pp. e25-e31

Author(s):

Hien Thu Pham ◽

Tran Thi Ngoc Nguyen ◽

Ngo Thi Tam

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Severe Pneumonia ◽

Diagnostic Value ◽

Optimal Cutoff ◽

Optimal Cutoff Point ◽

Hs Crp ◽

Bacterial Coinfection ◽

Children Under 5

AbstractThis study aims to assess the diagnostic value of high-sensitivity C-reactive protein (hs-CRP), procalcitonin (PCT), and interleukin (IL)-6 in the diagnosis of pneumonia caused by Rhinovirus alone or with bacterial coinfection in Vietnamese children under 5 years of age. A cross-sectional study was conducted on 26 children under 5 years of age with severe pneumonia due to Rhinovirus at the National Pediatric Hospital. IL-6, hs-CRP, and PCT tests were performed. The diagnostic values of PCT, IL-6, and hs-CRP in classifying those with viral alone and those with bacterial coinfection were determined. Of 26 children, 10 children were diagnosed to have bacterial coinfections (38.5%). The optimal cutoff point for PCT was > 2.30 ng/mL (sensitivity 50%, specificity 94%, positive predictive value 83%, and negative predictive value 75%). The optimal cutoff point for hs-CRP was > 1.53 mg/dl (sensitivity 90%, specificity 56%, positive predictive value 56%, and negative predictive value 90%). Finally, the optimal cut-off point for IL-6 was > 441.5 pg/mL (sensitivity 20%, specificity 100%, positive predictive value 100%, and negative predictive value 60%). The accuracy rate of PCT was the highest with 69.2%, followed by hs-CRP with 65.4%. Inflammatory biomarkers such as PCT and hs-CRP were able to distinguish children with severe pneumonia caused by Rhinovirus alone and those with bacterial coinfection.

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Biomarkers and Hematological Indices in the Diagnosis of Iron Deficiency in Children with Inflammatory Bowel Disease

Nutrients ◽

10.3390/nu12051358 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1358 ◽

Cited By ~ 1

Author(s):

Paulina Krawiec ◽

Elżbieta Pac-Kożuchowska

Keyword(s):

Inflammatory Bowel Disease ◽

Iron Deficiency ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Bowel Disease ◽

Predictive Value ◽

Iron Homeostasis ◽

Added Value ◽

Predictive Values ◽

Inflammatory Bowel

Inflammation may affect many routinely available parameters of iron homeostasis. Thus, the recognition of iron deficiency in inflammatory bowel disease (IBD) remains a diagnostic challenge in a clinical routine. The aim of the study was to detect the most efficient marker of iron deficiency in IBD children. In a group of 75 IBD children, we evaluated the sensitivity, specificity, accuracy, and positive and negative predictive values of erythrocytes’ indices, including MCV, MCH, MCHC and RDW, and biochemical markers, including iron, transferrin, sTfR and sTfR/log ferritin, for identifying iron deficiency. Receiver operating characteristic (ROC) analysis was used to compare the ability of these parameters to detect iron deficiency. The best predictors of iron deficiency were sTfR/log ferritin, with accuracy 0.86, sensitivity 0.98, specificity 0.63, positive predictive value 0.83 and negative predictive value 0.94, and sTfR, with accuracy 0.77, sensitivity 0.82, specificity 0.67, positive predictive value 0.82 and negative predictive value 0.67. Moreover, sTfR/log ferritin exhibited the largest area under ROC (0.922), followed by sTfR (0.755) and MCH (0.720). The sTfR/log ferritin index appears to be the most efficient marker of iron depletion in pediatric IBD, and it may give an added value in the management of IBD patients.

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

Journal of Medical Imaging and Health Informatics ◽

10.1166/jmihi.2019.2594 ◽

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.

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Role of imprint cytology in thoracic endoscopy suite

Egyptian Journal of Bronchology ◽

10.1186/s43168-020-00025-y ◽

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.

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DIAGNOSTIC VALUE OF CA-125 IN PATIENTS WITH EPITHELIAL OVARIAN CANCER AT THE DR. SOETOMO GENERAL HOSPITAL SURABAYA IN 2016

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v25i2.1380 ◽

2019 ◽

Vol 25 (2) ◽

pp. 145

Author(s):

Kintan Putri ◽

Betty Agustina Tambunan ◽

Willy Sandhika

Keyword(s):

Ovarian Cancer ◽

Positive Predictive Value ◽

Epithelial Ovarian Cancer ◽

Tumor Marker ◽

General Hospital ◽

Negative Predictive Value ◽

Predictive Value ◽

Diagnostic Value ◽

Ca 125 ◽

Ovarian Malignancy

Ovarian cancer is the fourth cancer with most incidence in Indonesian female with 10.238 cases in 20141. Tumor marker CA-125 is assosciated with ovarian cancer, importantly epithelial ovarian cancer. This study aims to find out diagnostic value (sensitivity, specificity, positive predictive value, negative predictive value) of CA-125 among patients with epithelial ovarian cancer in Dr. Soetomo General Hospital Surabaya in 2016. This study used analytic cross sectional method and was performed by evaluating medical records of patients suspected for ovarian malignancy in Dr. Soetomo General Hospital Surabaya in 2016. There were total 97 patients found fit for criteria of inclusion in this study. Tissue histopathological examination confirmed 66 patients have epithelial ovarian malignancy and 31 patients do not. Samples distributed using 35 U/ml as CA-125 upper limit, TP: 54.64%, FP: 19.59%, FN: 13.40%, dan TN: 12.37%. Diagnostic value obtained as follows: sensitivity 80.30%, spesificity 38.71%, positive predictive value 73.61%, negative predictive value 48%, and accuracy 67.01%. Tumor marker associated with ovarian cancer CA-125 has found high in sensitivity but low in specificity among patients with epithelial ovarian cancer in Dr. Soetomo General Hospital Surabaya in 2016.

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NILAI DIAGNOSTIK MALARIA ANTIGEN CASSETTE PENYAKIT MALARIA

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v16i1.1031 ◽

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.

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The study of use of toluidine blue as an adjunctive tool to clinical examination in early diagnosis of clinically suspicious oral premalignant and malignant lesions: a study of fifty cases

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20194931 ◽

2019 ◽

Vol 5 (6) ◽

pp. 1585 ◽

Cited By ~ 1

Author(s):

Himanshu Chhagan Bayad ◽

Sanjeev Bhagat ◽

Dimple Sahni ◽

Navneet Kaur ◽

Ravinder Singh ◽

...

Keyword(s):

Early Detection ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Sensitivity And Specificity ◽

Toluidine Blue ◽

Predictive Value ◽

Blue Staining ◽

Histopathological Diagnosis ◽

Toluidine Blue Staining ◽

Malignant Lesions

Background: Oral carcinoma is among the most prevalent malignancies of head and neck region and is often diagnosed in the advanced stage with significant morbidity and treatment cost. Thus, there is a need for early detection of oral premalignant and malignant lesions. Toluidine blue staining can be used for early detection of these lesions.Methods: The study included 50 patients with clinically suspicious oral premalignant and malignant lesions. These lesions were subjected to toluidine blue staining and biopsy. Diagnoses were confirmed by histopathological examination. Results: Sensitivity and specificity of toluidine blue for oral premalignant lesions was 92.30% and 80% respectively with the positive predictive value of 92.30%, negative predictive value of 80% and accuracy of 88.88%. Sensitivity and specificity of toluidine blue for oral malignant lesions was 96.30% and 80% respectively with the positive predictive value of 96.30%, negative predictive value of 80% and accuracy of 93.75%.Conclusions: The simplicity of toluidine blue staining and its accuracy suggest that it can be a useful adjunctive tool to diagnosis of oral lesions. Results should be carefully evaluated and correlated with clinical findings and histopathological diagnosis.

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Diagnostic Accuracy of Ultrasound in Palpable Breast Lesions

Birat Journal of Health Sciences ◽

10.3126/bjhs.v5i3.33697 ◽

2020 ◽

Vol 5 (3) ◽

pp. 1196-1200

Author(s):

Manish Raj Pathak ◽

Mahesh Gautam ◽

Rashmita Bhandari

Keyword(s):

Positive Predictive Value ◽

Diagnostic Accuracy ◽

Negative Predictive Value ◽

Diagnostic Tool ◽

Predictive Value ◽

Breast Lesions ◽

Non Invasive ◽

Malignant Lesions ◽

Palpable Breast ◽

Sensitivity Specificity

Introduction: Breast carcinoma is the second leading cause of cancer related mortality in females around the world. Ultrasound plays a key role in differentiating cystic and solid lesions and is a convenient and non-invasive diagnostic tool to differentiate between benign and malignant lesions. Objectives: The aim of this study is to evaluate the diagnostic accuracy of ultrasound in palpable breast lesions. Methodology: A prospective cross-sectional study was carried out in patients with palpable breast lesions who presented in Department of radio diagnosis and imaging of Nobel Medical collegefor a period of one-year from February 2019- January 2020 using ultrasound. A total of 60 patientswereevaluated in the study. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated. Results: Out of 60 patients evaluated, ultrasound showed 46 (76.7%) cases to be benign and 14 (23.3%) cases to be malignant. FNAC revealed benign disease in 47 (78.3%) patients and malignant disease in 13 (21.7%) patients. The most common benign lesion was fibroadenoma. We found nearly 91.7% of the malignant lesions had spiculated margins and microcalcification. The sensitivity of ultrasound was 95.74% and specificity 92.3% with diagnostic accuracy 95%. Conclusion: Ultrasound is a convenient and non-invasive diagnostic tool with good sensitivity, specificity, positive predictive value, negative predictive value and accuracy in palpable breast lesions.

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