Development of a Semiautomated Search Tool to Identify Grading From Pathology Reports for Tumors of the CNS and Prostate Cancers

2021 ◽  
pp. 1189-1196
Author(s):  
Diana Echeverria ◽  
Kristen R. Rossi ◽  
Anna Carroll ◽  
Tina Luse ◽  
Christopher Rennix
Keyword(s):  
Prostate Cancer ◽  
Cancer Surveillance ◽  
Cns Tumors ◽  
Quality Initiatives ◽  
Who Grade ◽  
Military Health ◽  
Predictive Values ◽  
Diagnostic Codes ◽  
Pathology Reports ◽  
Sensitivity Specificity

PURPOSE This study demonstrates the functionality of semiautomated algorithms to classify cancer-specific grading from electronic pathology reports generated from military treatment facilities. Two Perl-based algorithms are validated to classify WHO grade for tumors of the CNS and Gleason grades for prostate cancer. METHODS Case-finding cohorts were developed using diagnostic codes and matched by unique identifiers to obtain pathology records generated in the Military Health System for active duty service members from 2013 to 2018. Perl-based algorithms were applied to classify document-based pathology reports to identify malignant CNS tumors and prostate cancer, followed by a hand-review process to determine accuracy of the algorithm classifications. Inter-rater reliability, sensitivity, specificity, positive predictive values (PPVs), and negative predictive values were computed following abstractor adjudication. RESULTS The high PPV for the Perl-based algorithms to classify CNS tumors (PPV > 98%) and prostate cancer (PPV > 99%) supports this approach to classify malignancies for cancer surveillance operations, mediated by a hand-reviewed semiautomated process to increase sensitivity by capturing ungraded cancers. Early detection was pronounced where 33.6% and 50.7% of malignant records retained a CNS WHO grade of II or a Gleason score of 6, respectively. Sensitivity metrics met criteria (> 75%) for brain (79.9%, 95% CI, 73.0 to 85.7) and prostate (96.7%, 95% CI, 94.9 to 98.0) cancers. CONCLUSION Semiautomated, document-based text classification using Perl coding successfully leveraged identification of WHO and Gleason grades to classify pathology records for CNS tumors and prostate cancer. The process is recommended for data quality initiatives to support cancer reporting functions, epidemiology, and research.

scholarly journals Computer-Aided Diagnosis Improves the Detection of Clinically Significant Prostate Cancer on Multiparametric-MRI: A Multi-Observer Performance Study Involving Inexperienced Readers

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 973
Author(s):  
Valentina Giannini ◽  
Simone Mazzetti ◽  
Giovanni Cappello ◽  
Valeria Maria Doronzio ◽  
Lorenzo Vassallo ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Computer Aided Diagnosis ◽  
Multiparametric Mri ◽  
Performance Study ◽  
Predictive Values ◽  
Cad System ◽  
Computer Aided ◽  
Clinically Significant ◽  
Sensitivity Specificity ◽  
Aided Diagnosis

Recently, Computer Aided Diagnosis (CAD) systems have been proposed to help radiologists in detecting and characterizing Prostate Cancer (PCa). However, few studies evaluated the performances of these systems in a clinical setting, especially when used by non-experienced readers. The main aim of this study is to assess the diagnostic performance of non-experienced readers when reporting assisted by the likelihood map generated by a CAD system, and to compare the results with the unassisted interpretation. Three resident radiologists were asked to review multiparametric-MRI of patients with and without PCa, both unassisted and assisted by a CAD system. In both reading sessions, residents recorded all positive cases, and sensitivity, specificity, negative and positive predictive values were computed and compared. The dataset comprised 90 patients (45 with at least one clinically significant biopsy-confirmed PCa). Sensitivity significantly increased in the CAD assisted mode for patients with at least one clinically significant lesion (GS > 6) (68.7% vs. 78.1%, p = 0.018). Overall specificity was not statistically different between unassisted and assisted sessions (94.8% vs. 89.6, p = 0.072). The use of the CAD system significantly increases the per-patient sensitivity of inexperienced readers in the detection of clinically significant PCa, without negatively affecting specificity, while significantly reducing overall reporting time.

scholarly journals Comparative study of colour Doppler vs. FNNAC findings in WHO grade II thyroid enlargement in adult females

2019 ◽  
Vol 5 (4) ◽  
pp. 1025
Author(s):  
Sudhakar Rao M. S. ◽  
Navneeth T. P. ◽  
John C. J.
Keyword(s):  
Pulsatility Index ◽  
Low Cost ◽  
Resistive Index ◽  
Colour Doppler ◽  
Who Grade ◽  
Predictive Values ◽  
Non Invasive ◽  
Adult Females ◽  
The Mean ◽  
Sensitivity Specificity

<p class="abstract"><strong>Background:</strong> Thyroid gland disorders form one of the most common endocrinal and surgical problems encountered in clinical practice. FNNAC is widely accepted as the primary and better method than FNAC for investigation but has its disadvantages. Colour Doppler is a non-invasive, low cost, easily available and repeatable investigation with least patient discomfort and can be valuable in detection of benign and malignant thyroid enlargements.</p><p class="abstract"><strong>Methods:</strong> Forty cases of adult females with WHO grade 2 thyroid enlargement attending the department of otorhinolaryngology selected on simple random basis were included in this study. Following written consent, Colour Doppler scanning and FNNAC test were done on the thyroid swelling and the results were analysed.  </p><p class="abstract"><strong>Results:</strong> The mean age of patients was 32.44 years. The mean age of malignancy was 44.66 years and showed statistically significant association. The Resistive and Pulsatility index and combination of both were found to have statistically significant results in detecting malignant and benign lesions The sensitivity, specificity, positive and negative predictive values of RI and PI were 83.33%, 94.12%, 71.43%, 96.97% and 50%, 94.12%, 60% and 91.43% respectively. On combining both the indices, the sensitivity was 91.67% and the positive predictive value was 97.06%.</p><p class="abstract"><strong>Conclusions:</strong> Colour Doppler can differentiate between benign and malignant thyroid enlargements using Resistive index (of&gt;0.75) and Pulsatility Index (of&gt;1.5) and can be a complementary diagnostic tool in the thyroid enlargement lesions, considering its accuracy, cost-effectiveness, easy availability and non-invasive repeatable nature.</p>

The multi-cancer marker, rs6983267, located at region 3 of chromosome 8q24, is associated with prostate cancer in Greek patients but does not contribute to the aggressiveness of the disease

2012 ◽  
Vol 50 (2) ◽  
Author(s):  
Amalia Papanikolopoulou ◽  
Olfert Landt ◽  
Konstantinos Ntoumas ◽  
Stefanos Bolomitis ◽  
Stavros I. Tyritzis ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Specific Antigen ◽  
Prostate Cancer Risk ◽  
Greek Population ◽  
Cancer Case ◽  
P Value ◽  
Total Blood ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Chromosome 8Q24

AbstractRecently, several polymorphisms located on human chromosome 8q24 were found to be associated with prostate cancer risk with different frequency and incidence among the investigated populations. The authors conducted a prostate cancer case-control study in the Greek population to evaluate the association of the single nucleotide polymorphism (SNP) rs6983267, located at region 3 of chromosome 8q24, with this type of cancer.Samples of total blood from 86 patients with histologically confirmed prostate cancer and 99 healthy individuals were genotyped using real time polymerase chain reaction (PCR). Tumor-node-metastasis (TNM) stage, Gleason score and levels of prostate-specific antigen (PSA) at diagnosis were included in the analysis.A highly significant association (odds ratio=2.84 and p-value=0.002) was found between rs6983267 and prostate cancer in the Greek population. The sensitivity, specificity, negative and positive predictive values of the presence of G allele for the discrimination between patients and controls were 81.40%, 39.4%, 53.9% and 70.9%, respectively. A lower proportion of homozygotes was found in patients with PSA level <4 ng/mL compared to those with PSA level more than 4 ng/mL (p=0.019). None of the other clinical factors nor the aggressiveness of the disease were found to be significantly associated with rs6983267 genotype.The SNP rs6983267 is an established marker for a range of cancers. In prostate cancer, it indicates an enhanced risk for carriers to develop the disease in general. In our study it showed no association with aggressive forms or familial and early-onset prostate cancer families.

scholarly journals Clinical codes combined with procedure codes increase diagnostic accuracy of Crohn’s disease in a US Military health record

2020 ◽  
Vol 7 (1) ◽  
pp. e000378
Author(s):  
Manish Singla ◽  
Susan Hutfless ◽  
Elie Al Kazzi ◽  
Benjamin Rodriguez ◽  
John Betteridge ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Health Record ◽  
Medication History ◽  
Retrospective Case ◽  
Military Health ◽  
Diagnostic Codes ◽  
Conducting Research ◽  
Sensitivity Specificity ◽  
Procedure Codes

Background and aimsPrevious examinations of International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes to predict accuracy of diagnosis in inflammatory bowel disease have had limited chart review to confirm diagnosis. We aimed to evaluate using the ICD-9-CM for identifying Crohn’s disease (CD) in a large electronic health record (EHR) database.MethodsThis is a retrospective case-control study with a 3:1 allocation of EHRs of active duty service members diagnosed with CD from 1996 to 2012. Subjects were selected by having two ICD-9-CM codes for CD during the study period. Gastroenterologists reviewed each chart and confirmed the diagnosis of CD by analysing medication history and clinical, endoscopic, histological, and radiographic exams.Results300 cases of CD were selected; 14 cases were discarded due to lack of data, limiting our analysis to 284 subjects. Two diagnostic codes for CD had sensitivity, specificity, and positive predictive value (PPV) of 1.0, 0.53, and 0.69, respectively, for confirmed CD. If two encounters listing CD were with a gastroenterologist, the sensitivity, specificity, and PPV was 0.76, 0.81, and 0.80, respectively. If a colonoscopy was performed within 90 days of any three encounters with a CD code, the sensitivity, specificity, and PPV was 0.51, 0.94, and 0.89, respectively.ConclusionsThe poor PPV of ICD-9-CM codes in making the diagnosis of CD should be taken into consideration when interpreting results and when conducting research using such codes. Limiting these codes to those patients who have been given this diagnosis by a gastroenterologist, or to those who have had a colonoscopy near the time of diagnosis, increases the PPV.

DHAIS (Diagnosis-Helping-Accuracy-Imaging-Study) study: Combined endorectal MR and MR spectroscopic imaging in the diagnosis of prostate cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14562-14562
Author(s):  
G. Pomara ◽  
M. Simone ◽  
L. Fontana ◽  
S. Giusti ◽  
C. Bartolozzi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Imaging Study ◽  
Spectroscopic Imaging ◽  
Radical Retropubic Prostatectomy ◽  
Predictive Values ◽  
Trus Biopsy ◽  
Imaging Results ◽  
Sensitivity Specificity ◽  
Mr Spectroscopic Imaging

14562 Background: The DHAIS study is a prospective, three-step investigation, consisting in an initial two-step phase (Diagnosis-Accuracy) followed by an extension phase (Helping). The purpose was to compare endorectal MRI and MR spectroscopic imaging (MRSI) results with biopsy results (Diagnosis) and definitive histology after radical retropubic prostatectomy (RRP) (Accuracy). The helping extension will investigate the ability of combined MRI and MRSI to detect prostate cancer foci in men with prior negative prostate biopsy. Methods: MRI and MRSI were performed in 37 consecutive pts for increased PSA and/or abnormal rectal examination. A dedicated radiologist identified areas of interest as normal, equivocal or suspicious on MRI and MRSI separately. All pts underwent prostate biopsy (TRUS 10-core biopsy) by the urologist who was blind to imaging results. Patients with positive biopsies underwent RRP. MRI and MRSI results were compared to biopsy and step-section histology. Those pts with negative biopsies will underdo a second set of 10-core prostate biopsy with up to 4 additional biopsies targeted at the equivocal or suspected sites (Helping-phase). Results: Prostate cancer was detected in 8 of 37 subjects (21.6%). Six pts underwent RRP. The sensitivity, specificity, positive and negative predictive values (PPV, NPV) and the accuracy of MRI, MRSI and combined MRI/MRSI are shown in the Table. Conclusions: MRI and MRSI have the potential to identify cancer foci and potentially direct TRUS in patients undergoing TRUS biopsy. The third phase of this study could demonstrate the utility during repeated biopsies. Further larger studies are required to quantify the amount of benefit. [Table: see text] No significant financial relationships to disclose.

scholarly journals Utility of digital rectal examination in a population with prostate cancer treated with active surveillance

2020 ◽  
Vol 14 (9) ◽  
Author(s):  
Jaime O. Herrera-Caceres ◽  
Marian S. Wettstein ◽  
Hanan Goldberg ◽  
Ants Toi ◽  
Thenappan Chandrasekar ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Descriptive Analysis ◽  
Digital Rectal Examination ◽  
Predictive Values ◽  
Rectal Examination ◽  
Academic Center ◽  
Multivariable Regression ◽  
Clinically Significant ◽  
Sensitivity Specificity

Introduction: Digital rectal examination (DRE) is part of the clinical evaluation of men on active surveillance (AS). The purpose of the present study is to analyze the value of DRE as a predictor of upgrading in a population of men with prostate cancer (PC) treated with AS. Methods: We used the prostate biopsy (PBx) database from an academic center, including PBx from 2006–2018, and identified 2029 confirmatory biopsies (CxPBx) of men treated with AS, of which 726 men had both diagnostic (initial) and CxPBx information available. We did a descriptive analysis and evaluated sensitivity, specificity, and predictive values of DRE for the detection of clinically significant PC (csPC). Multivariable regression analysis was done to identify predictors of csPC. The primary outcome was to evaluate DRE as a predictor of the presence of csPC at CxPBx. Results: Among the 2029 patients with a CxPBx, 75% had PC, and of these, 30.3% had upgrading to ISUP Grade ≥2. Thirteen percent of men had a suspicious DRE (done by their treating physician). Sensitivity, specificity, negative and positive predictive values of DRE to detect csPC were best with a PSA <4 ng/ml (27%, 88%, 31%, and 87%, respectively). A suspicious DRE at CxPBx, particularly if the DRE at diagnosis was negative, was a predictor of csPC (odds ratio [OR] 2.34; p=0.038). The main limitation of our study is the retrospective design and the lack of magnetic resonance imaging. Conclusions: We believe DRE should still be used as part of AS and can predict the presence of csPC even with low PSA values. A suspicious nodule on DRE represents a higher risk of upgrading and should prompt further assessment.

scholarly journals Comparison Between Thromboelastography and Conventional Coagulation Tests in Surgical Patients With Localized Prostate Cancer

2017 ◽  
Vol 24 (5) ◽  
pp. 755-763 ◽  
Author(s):  
Zhengwei Wang ◽  
Jing Li ◽  
Qingwei Cao ◽  
Lei Wang ◽  
Fengzhi Shan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Rank Order ◽  
Maximum Amplitude ◽  
International Normalized Ratio ◽  
Active Bleeding ◽  
Coagulation Test ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Α Angle ◽  
Routine Coagulation

We aimed to examine hypercoagulable and hypocoagulable conditions in patients with prostate cancer using thromboelastography (TEG) and correlate TEG parameters with conventional coagulation test. The t test was used for comparing TEG parameters and routine coagulation results. Spearman rank-order correlation was used to describe the relationship of TEG and conventional tests. Sensitivity, specificity, positive predictive values, and negative predictive values were determined for bleeding and thrombosis. Totally, 20 patients had active bleeding postoperatively, 16 of whom showed hypocoagulation on TEG test and 9 of whom showed hypocoagulation by routine coagulation test ( P = .024). Overall, 60 patients did not have active bleeding postoperatively, 51 of whom showed hypercoagulation detected by TEG test and 42 of whom showed hypercoagulation found by routine coagulation test ( P = .040). Remarkably, patients had a little higher fibrinogen (FIB) compared to controls. There was no statistical difference in any of the conventional coagulation indexes between the groups. Correlation analysis showed that reaction time (R) and coagulation time (K) were positively correlated with the prothrombin time–international normalized ratio (PT-INR) and negatively correlated with FIB ( P < .001). Contrarily, α-angle and maximum amplitude (MA) were negatively correlated with PT-INR but positively correlated with FIB. Significantly, MA showed the strongest correlation with FIB and R exhibited the strongest correlation with PT-INR. Sensitivity and specificity for bleeding and thrombosis in TEG were higher than those in conventional coagulation test. Accordingly, TEG might be superior in evaluating hypercoagulation and detecting the risk of bleeding in patients with prostate cancer.

Can the Ki-67 Labeling Index in Biopsy Specimens Predict the World Health Organization Grade of Rectal Neuroendocrine Tumors?

2017 ◽  
Vol 36 (2) ◽  
pp. 118-122 ◽  
Author(s):  
Shinya Sugimoto ◽  
Kinichi Hotta ◽  
Tadakazu Shimoda ◽  
Kenichiro Imai ◽  
Sayo Ito ◽  
...  
Keyword(s):  
World Health Organization ◽  
Neuroendocrine Tumors ◽  
World Health ◽  
Ki 67 ◽  
Who Grade ◽  
Predictive Values ◽  
Biopsy Specimens ◽  
The World ◽  
Health Organization ◽  
Sensitivity Specificity

Background: Being grade 2 is a known risk factor for metastasis in rectal neuroendocrine tumors (R-NETs). We aimed to identify the efficacy of the Ki-67 labeling index (LI) in endoscopic biopsy specimens to predict the World Health Organization (WHO) grade of R-NETs. Methods: A total of 59 patients with 60 R-NETs (43 WHO grade 1 and 17 WHO grade 2), treated between October 2002 and December 2014, were retrospectively evaluated. The patients included in the study underwent biopsies followed by endoscopic submucosal resection with a ligation device, trans-anal full-thickness surgical resection, or radical surgery with lymph node dissection. The Ki-67 LI in the biopsy and resected specimens were compared between the 2 tumor grade groups, and the diagnostic sensitivity, specificity, and positive and negative predictive values for the detection of WHO grade 2 tumors were evaluated. Results: The sensitivity, specificity, and positive and negative predictive values of the Ki-67 LI in biopsy specimens for predicting grade 2 tumors were 53% (9 of 17), 95% (41 of 43), 100% (9 of 9), and 87% (41 of 47), respectively. Pearson’s rank correlation coefficient between the Ki-67 LI in the biopsy and resected specimens was 0.92. Conclusions: The Ki-67 LI of the biopsy specimen is useful for determining the appropriate treatment for R-NETs.

scholarly journals The predictive value of PSA in diagnosis of prostate cancer in non screened population

2005 ◽  
Vol 52 (4) ◽  
pp. 81-87 ◽  
Author(s):  
V. Vukotic ◽  
S. Cerovic ◽  
M. Kozomara ◽  
M. Lazic
Keyword(s):  
Prostate Cancer ◽  
Predictive Value ◽  
Prostate Cancer Screening ◽  
Predictive Values ◽  
Psa Density ◽  
Free Psa ◽  
Wide Range ◽  
Valuable Marker ◽  
Total Psa ◽  
Sensitivity Specificity

INTRODUCION : PSA is the most important tumor marker in all solid tumor, indispensable in the management of prostate cancer. Screening for prostate cancer is still not recommended, although performed in many countries, which introduced questions about the usefulness of PSA in detection of prostate cancer. The PSA threshold has also been changed, the value of PSA derivatives revised. Whether such changes are applicable in non screened population is questionable. Aim of this study was to evaluate the predictive value of PSA, free/ total PSA and PSA density in our non screened population. Patients and methods: TRUS guided prostate biopsy was performed in 579 patients. The number of cores was 6-12. Mean age of the patients was 67.5 years (30-90). PSA was ranging from 0.41 to 2250 ( mean 38.6ng/ml, median: 11.95, SD 140,45). Digitorectal examination was considered positive in 351 patients. Free PSA was measured in 352 patients with the index ranging from 0.02 to 0.88 ( mean free/total PSA: 0.14, median:0.13, ). The volume of the prostate was measured in all patients according the prostate ellipsoid model, and PSA density calculated according to the formula PSA/PV. Patients were stratified in 6 groups according to PSA value ( I: PSA ng/ml, II: PSA 2.5-4, III: PSA 4-10, IV: PSA 10-20, V: PSA:20 to 50, Group 6: PSA 50 ). RESULTS: Non homogenicity of the patients can be seen through the wide range of PSA which was from 0.4 to 2025). Prostate cancer was diagnosed in 233 pts (40.2%). As expected, the probability of detecting cancer was raised with PSA (p), and was extremely rare in pts with PSA below 4 ng/ml. PSA, free/total PSA, volume of the prostate and PSA density were significantly different according to the presence of cancer. Most of our patients had PSA between 4 and 20 ng/ml. Predictive value of PSA was 20.6% for pts with PSA from 4 to 10 and 32.7% for those with PSA from 10 to 20 ng/ml. Sensitivity, specificity, positive and negative predictive values for different cut off?s of PSA (4, 10 and 20) was performed. The best results were obtained for PSA cut off of 10 ng/ml. In the group of patient with PSA, PSA density more reliable than free/total PSA index. CONCLUSION: PSA is still valuable marker for detection of prostate cancer in our non screened population. According to our results PSA threshold should not be lowered below 4 ng/ml. PSA density is a reliable PSA derivative, free/total PSA index having less importance in pts with PSA below 20 ng/ml.

Discriminating Malignancy in Thyroid Nodules: The Nomogram Versus the Kwak and ACR TI-RADS

2020 ◽  
Vol 163 (6) ◽  
pp. 1156-1165
Author(s):  
Juan Xiao ◽  
Qiang Xiao ◽  
Wei Cong ◽  
Ting Li ◽  
Shouluan Ding ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Diagnostic Study ◽  
Diagnostic Efficiency ◽  
Training Set ◽  
Multivariable Logistic Regression Model ◽  
Predictive Values ◽  
Validation Set ◽  
Sensitivity Specificity

Objective To develop an easy-to-use nomogram for discrimination of malignant thyroid nodules and to compare diagnostic efficiency with the Kwak and American College of Radiology (ACR) Thyroid Imaging, Reporting and Data System (TI-RADS). Study Design Retrospective diagnostic study. Setting The Second Hospital of Shandong University. Subjects and Methods From March 2017 to April 2019, 792 patients with 1940 thyroid nodules were included into the training set; from May 2019 to December 2019, 174 patients with 389 nodules were included into the validation set. Multivariable logistic regression model was used to develop a nomogram for discriminating malignant nodules. To compare the diagnostic performance of the nomogram with the Kwak and ACR TI-RADS, the area under the receiver operating characteristic curve, sensitivity, specificity, and positive and negative predictive values were calculated. Results The nomogram consisted of 7 factors: composition, orientation, echogenicity, border, margin, extrathyroidal extension, and calcification. In the training set, for all nodules, the area under the curve (AUC) for the nomogram was 0.844, which was higher than the Kwak TI-RADS (0.826, P = .008) and the ACR TI-RADS (0.810, P < .001). For the 822 nodules >1 cm, the AUC of the nomogram was 0.891, which was higher than the Kwak TI-RADS (0.852, P < .001) and the ACR TI-RADS (0.853, P < .001). In the validation set, the AUC of the nomogram was also higher than the Kwak and ACR TI-RADS ( P < .05), each in the whole series and separately for nodules >1 or ≤1 cm. Conclusions When compared with the Kwak and ACR TI-RADS, the nomogram had a better performance in discriminating malignant thyroid nodules.

Sign in / Sign up

Export Citation Format

Share Document