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

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.

2001 ◽  
Vol 7 (6) ◽  
pp. 359-363 ◽  
Author(s):  
M Tintoré ◽  
A Rovira ◽  
L Brieva ◽  
E Grivé ◽  
R Jardí ◽  
...  

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.


Author(s):  
Mehran PEYVASTEH ◽  
Shahnam ASKARPOUR ◽  
Hazhir JAVAHERIZADEH ◽  
Sepideh BESHARATI

ABSTRACT Background: Appendicitis is one of the most common abdominal emergency. Some predictive scoring systems are recommended to decrease the rate of negative appendectomy. Aim: To evaluate sensitivity, specificity, positive predictive value, and negative predictive value of modified Alvarado score in children who underwent appendectomy. Methods: Four hundred children with initial diagnosis of appendicitis were randomly selected from patients who underwent appendectomy. Modified Alvarado score was used for evaluation of the appendicitis, that was confirmed using histology. Results: Of modified Alvarado score components, anorexia; nausea and vomiting and rebound tenderness were significantly more common in children with positive appendectomy in contrast to patients with negative appendectomy. Sensitivity, specificity, positive predictive value, and negative predictive value for modified Alvarado score were: 91.3%; 38.4%; 87.7%; and 51.2% respectively. Conclusion: Alvarado score has high sensitivity but low specificity for diagnosis of acute appendicitis in children.


Author(s):  
Youssriah Yahia Sabri ◽  
Ikram Hamed Mahmoud ◽  
Lamis Tarek El-Gendy ◽  
Mohamed Raafat Abd El-Mageed ◽  
Sally Fouad Tadros

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.


Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 503
Author(s):  
Thomas F. Monaghan ◽  
Syed N. Rahman ◽  
Christina W. Agudelo ◽  
Alan J. Wein ◽  
Jason M. Lazar ◽  
...  

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.


2021 ◽  
Vol 10 (1) ◽  
pp. 20-25
Author(s):  
Sujan Shrestha ◽  
Mamen Prasad Gorhaly ◽  
Manil Ratna Bajracharya

Background Diabetic peripheral neuropathy (DPN) is a significant independent risk factor for diabetic foot, and an effective screening instrument is required to diagnose DPN early to prevent future ulceration and amputation. This study aims to determine the diagnostic accuracy of monofilament test to detect diabetic peripheral neuropathy. Methods This cross-sectional study was conducted in National Academy of Medical Sciences, Bir hospital, Mahabouddha, Kathmandu from February 2016 to January 2017. A total of 96 diabetic patients attending inpatient and outpatient Department were selected. Diabetic peripheral neuropathy was assessed by measurement of loss of protective sensation (LOPS) by monofilament test and compared with vibration perception threshold by standard biothesiometer. The sensitivity, specificity, positive predictive value and negative predictive value of monofilament test were calculated. Results The prevalence of diabetic peripheral neuropathy was 26%. The sensitivity, specificity, positive predictive value and negative predictive value of monofilament test were found to be 92.0%, 95.8%, 88.5% and 97.1% respectively. There was strong association between LOPS by monofilament and vibration perception threshold by biothesiometer. Conclusion This study showed a strong diagnostic accuracy of monofilament test to detect DPN when compared with biothesiometer. As monofilament test is a cheap, easily available, and portable, it can be used in the periphery where biothesiometer is not available.  


2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Tahir Iqbal ◽  
Muhammad Usman Shahid ◽  
Ishfaq Ahmad Shad ◽  
Shahzad Karim Bhatti ◽  
Syed Amir Gilani ◽  
...  

ABSTRACT: BACKGROUND: A common surgical emergency is acute appendicitis. Various diagnostic tools are available to diagnosis acute appendicitis. Radiological investigations play an important role in making accurate and early diagnosis and thus preventing morbidity associated with the disease. OBJECTIVE: To determine the diagnostic accuracy of gray scale ultrasonography versus color Doppler in suspected cases of acute appendicitis. MATERIALS AND METHODS: The study was carried in the department of Radiology of Mayo Hospital, Lahore. A total of 75 patients were enrolled of age 18-40 years, both genders who were suspected cases of acute appendicitis. All patients underwent baseline investigations along with gray scale ultrasonography and color Doppler. All patients were subjected to surgery to confirm the diagnosis and findings were subjected to statistical analysis. RESULTS: The mean age of the patients was 23.25 ±10.55 and mean transverse diameter of appendix was 8.37 ±3.39. There were 62.7% males and 37.3%females. Findings of gray scale ultrasonography and color Doppler were then correlated with surgical findings to calculate the diagnostic accuracy of these modalities. The results revealed that gray scale ultrasonography sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 92.7%, 94.32%, 95%, 91.4% and 93.3% respectively, whereas color Doppler had sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 97.7%, 93.9%, 95.3%, 97% and 96% respectively. Diagnostic accuracy of both modalities together was 98.6%. CONCLUSION: Color Doppler has better diagnostic accuracy than gray scale ultrasonography for diagnosis of acute appendicitis and the combination of both modalities yields diagnostic accuracy that is similar to gold standard.


2021 ◽  
Vol 24 (2) ◽  
pp. 196-203
Author(s):  
Elahe Fini ◽  
◽  
Neda Nasirian ◽  
Bahram Hosein Beigy ◽  
◽  
...  

Background and Aim: Ovarian cancer is among the most common cancers in women worldwide. CA125 is the most frequent biomarker used in the screening for ovarian cancer. CA125 has no high sensitivity and specificity as a screening test in the medical community; however, because of being simple and noninvasive, it is almost always requested for evaluation and ruling out cancer. It plays an important role in the treatment and post-treatment process, the prediction of prognosis, and the relapse of the disease. The present study aimed to determine the relationship between a high level of CA125 tumor marker and ovarian cancer by detecting spesivity, sensivity, positive and negative predictive values. Methods & Materials: In this cross-sectional study, all cases undergoing CA125 test in Velayat Hospital in 2017-1028 were evaluated for having ovarian cancer. In addition, the CA125 level was compared between healthy individuals and patients with ovarian cancer. Finally, the obtained data were analyzed using SPSS. Ethical Considerations: The present study was approved by the Qazvin University of Medical Sciences (Ethics Code: IR.QUMS.REC.1396.316). Results: In this study, 35.3% of the study participants received a definite diagnosis of ovarian cancer. Generally, CA125 values were negative in 41.8% and positive in.58.2% of the study subjects. The sensitivity of the test was measured as 80.1%, the specivity as 53.6%, the positive predictive value equaled 48.4%, and the negative predictive value was measured as 83%. There was a significant relationship between age and the presence of ovarian cancer, and serum CA125 levels. Conclusion: The present study suggested that age and the serum level of CA125 were statistically significant. Finally, CA125 levels were significantly related to ovarian cancer. It provided moderate specivity and specivity as well as low positive predictive value and high negative predictive value as a tumor marker; it is valuable for ruling out of tumor but not appropriate as a screening test.


Author(s):  
Badugu Rao Bahadur ◽  
Gangadhara Rao Koneru ◽  
Prabha Devi Kodey ◽  
Jyothi Melam

Background: To differentiate ovarian mass as benign or malignant could change clinical approach. Finding a screening and diagnostic method for ovarian cancer is challenging due to high mortality and insidious symptoms. Risk malignancy index (RMI) has the advantage of rapid and exact triage of patients with ovarian mass.Methods: Prospective study carried for 2 years at NRI Medical College and General Hospital, Chinakakani, Mangalagiri, Andhra Pradesh, India. 79 patients with ovarian mass were investigated and risk malignancy index (RMI-3 and RMI-4) calculated. Final confirmation was done based on histopathological report. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for RMI 3 and RMI 4 taking histopathology as control and comparison was done.Results: (n=79); 50 (63.29%) cases were benign and 29 (36.70%) were malignant based on histopathology. RMI 4 is more sensitive (68.96%) than RMI 3 (62.06%), but RMI 3 is more specific (94%) than RMI 4 (92%).The positive predictive value of RMI-3 and RMI-4 were 85.71%  and 83.33% respectively. The negative predictive value for RMI-4 and RMI-3 were 83.63% and 81.03% respectively.Conclusions: With increasing age, chance of malignancy increases. RMI 4 was more sensitive than RMI-3, however less specific than RMI 3 in differentiating benign and malignant tumors. The positive predictive value is slightly more for RMI 3, than RMI 4. Negative predictive value is slightly more for RMI 4, than RMI 3. 


2017 ◽  
Author(s):  
Ευστάθιος Δράμπαλος

Σκοπός: H εφαρμογή για πρώτη φορά διεθνώς της μορφομετρίας της σπονδυλικής στήλης με χρήση απορροφησιομετρίας (VFA) σε ασθενείς με κυφοπλαστική. Αναλύονται τα πλεονεκτήματα και μειονεκτήματα της μεθόδου, ελέγχεται η αξιοπιστία της και συγκρίνεται με την μορφομετρία κατά τον κλασσικό ακτινολογικό έλεγχο (ΜRΧ) στην εκτίμηση των σπονδυλικών παραμορφώσεων στους συγκεκριμένους ασθενείς.Υλικά και Μέθοδος: Πραγματοποιήθηκαν μετρήσεις σε 42 ασθενείς με κυφοπλαστική λόγω οστεοπορωτικών σπονδυλικών καταγμάτων και αναλύθηκαν οι σπόνδυλοι από τον T4 μέχρι τον L4 με την VFA και την MRX. Μετρήθηκαν το πρόσθιο (ha), μέσο (hm) και οπίσθιο (hp) ύψος του σπονδυλικού σώματος και προσδιορίσθηκαν οι λόγοι ha/hp και hm/hp. Αναλύθηκαν για την VFA η συμφωνία αποτελεσμάτων του ίδιου παρατηρητή (IOA) και η συμφωνία αποτελεσμάτων μεταξύ ανεξάρτητων παρατηρητών (INA) για τους λόγους ha/hp και hm/hp καθώς και για την μέθοδο Genant σε επίπεδο σπονδύλου, ‘περιοχής της σπονδυλικής στήλης (θωρακική/ΘΜΣΣ ή οσφυϊκή/ΟΜΣΣ), σε επίπεδο ‘γειτονικών προς την κυφοπλαστική σπονδύλων’, και σε επίπεδο ‘σπονδύλων με κυφοπλαστική’. Σε κάθε επίπεδο χρησιμοποιήθηκε η μέση τιμή ha/hp και hm/hp. Στη συνέχεια, αναλύσαμε την συμφωνία μεταξύ VFA και MRX στον καθορισμό των λόγων ha/hp και hm/hp καθώς και μετά την διχοτόμηση των λόγων ha/hp περί της τιμής όριο που συνήθως χρησιμοποιείται για τον καθορισμό ενός κατάγματος. Αποτελέσματα: Οι IOA και INA για τους λόγους ha/hp και hm/hp στην VFA ήταν ‘σχεδόν τέλεια’ σε όλα τα επίπεδα (ICC 0.94-0.98). Η εφαρμογή της μεθόδου Genant κατά την VFA ανέδειξε επίσης ‘σχεδόν τέλεια’ INA (ICC=0.833). Η ανάλυση σε επίπεδο σπονδύλου έδειξε ‘σχεδόν τέλεια’ συμφωνία μεταξύ VFA και MRX για τον λόγο ha/hp [intraclass correlation coefficient, ICC=0.85], και ‘ισχυρή συμφωνία’ για τον λόγο hm/hp (ICC=0.78). Για τον λόγο ha/hp η συμφωνία ήταν ‘σχεδόν τέλεια’ τόσο στην ΘΜΣΣ (ICC=0.82) όσο και στην ΟΜΣΣ (ICC=0.87), ενώ για τον λόγο hm/hp η συμφωνία ήταν ‘ισχυρή’ στην ΘΜΣΣ (ICC=0.75) και ‘σχεδόν τέλεια’ στην ΟΜΣΣ (ICC=0.80). Η συμφωνία ήταν εξίσου ‘σχεδόν τέλεια’ σε επίπεδο ‘σπονδύλων με κυφοπλαστική’ (ICC=0.83) όσο και σε επίπεδο ‘γειτονικών προς την κυφοπλαστική σπονδύλων’ (ICC=0.80) για τον λόγο ha/hp. Όταν οι λόγοι ha/hp μετατράπηκαν σε κατάγματα (ναι ή όχι κάταγμα) χρησιμοποιώντας διαφορετικές τιμές κατώφλι για την διάγνωση κατάγματος (λόγοι ha/hp 0.75, 0.80 και 0.85) η συμφωνία μεταξύ των μεθόδων ήταν λιγότερο καλή, από μέτρια έως ουσιώδης (κ 0.52-0.63 στην ΟΜΣΣ και 0.53-0.66 στην ΘΜΣΣ). Χρησιμοποιώντας την κατάταξη Genant οι διαφορές στην ταξινόμηση των σπονδύλων ήταν περισσότερο προς την κατεύθυνση της MRX με 32 αναγνωρισμένα κατάγματα μόνο από την MRX και μόνο 5 μόνο από την VFA. Στη μελέτη αυτή, με επιπολασμό σφηνοειδών σπονδυλικών καταγμάτων 9.3%, οι δείκτες ακρίβειας sensitivity, specificity, positive predictive value (PPV) και negative predictive value (NPV) υπολογίστηκαν σε 0.522, 0.97, 0.87 και 0.92 αντίστοιχα. Συμπεράσματα: Η εφαρμογή της VFA σε ασθενείς με κυφοπλαστική έχει υψηλή επαναληψιμότητα και αναπαραγωγιμότητα. Η συμφωνία μεταξύ VFA και MRX στην εκτίμηση των λόγων ha/hp και hm/hm ήταν από ‘ισχυρή’ έως ‘σχεδόν τέλεια’ ανάλογα με το επίπεδο εξέτασης. Η συμφωνία στην αναγνώριση των σπονδυλικών καταγμάτων ήταν μέτρια. Οι διαφορές ήταν περισσότερο προς την κατεύθυνση της MRX. Η υψηλή τιμή του δείκτη NPV της VFA στους ασθενείς με κυφοπλαστική, δείχνει ότι η μέθοδος θα μπορούσε να χρησιμοποιηθεί για τον εντοπισμό αυτών που χρήζουν περαιτέρω ακτινολογικού ελέγχου.


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