scholarly journals Role of in-phase and out-of-phase chemical shift MRI in differentiation of non-neoplastic versus neoplastic benign and malignant marrow lesions

2021 ◽  
Vol 94 (1119) ◽  
pp. 20200710
Author(s):  
Niels van Vucht ◽  
Rodney Santiago ◽  
Ian Pressney ◽  
Asif Saifuddin
Keyword(s):  
Chemical Shift ◽  
No Value ◽  
Predictive Value ◽  
Bone Tumours ◽  
Imaging Features ◽  
Malignant Bone Tumours ◽  
Neoplastic Lesions ◽  
Chemical Shift Mri ◽  
Sensitivity Specificity ◽  
Benign Bone Tumours

Objective: To determine its ability of in-phase (IP) and out-of-phase (OOP) chemical shift imaging (CSI) to distinguish non-neoplastic marrow lesions, benign bone tumours and malignant bone tumours. Methods: CSI was introduced into our musculoskeletal tumour protocol in May 2018 to aid in characterisation of suspected bone tumours. The % signal intensity (SI) drop between IP and OOP sequences was calculated and compared to the final lesion diagnosis, which was classified as non-neoplastic (NN), benign neoplastic (BN) or malignant neoplastic (MN). Results: The study included 174 patients (84 males; 90 females: mean age 44.2 years, range 2–87 years). Based on either imaging features (n = 105) or histology (n = 69), 44 lesions (25.3%) were classified as NN, 66 (37.9%) as BN and 64 (36.8%) as MN. Mean % SI drop on OOP for NN lesions was 36.6%, for BN 3.19% and for MN 3.24% (p < 0.001). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of CSI for differentiating NN from neoplastic lesions were 65.9%, 94.6%, 80.6%, 89.1%% and 87.4% respectively, and for differentiating BN from MN were 9.1%, 98.4%, 85.7%, 51.2 and 53.1% respectively. Conclusion: CSI is accurate for differentiating non-neoplastic and neoplastic marrow lesions, but is of no value in differentiating malignant bone tumours from non-fat containing benign bone tumours. Advances in knowledge: CSI is of value for differentiating non-neoplastic marrow lesions from neoplastic lesions, but not for differentiating benign bone tumours from malignant bone tumours as has been previously reported.

scholarly journals The Role of Osteocalcin and Alkaline Phosphatase Immunohistochemistry in Osteosarcoma Diagnosis

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Hasrayati Agustina ◽  
Ita Asyifa ◽  
Afiati Aziz ◽  
Bethy S. Hernowo
Keyword(s):  
Alkaline Phosphatase ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Bone Tumours ◽  
Small Specimen ◽  
Primary Bone ◽  
The Mean ◽  
Sensitivity Specificity ◽  
Primary Bone Tumours

Background. The diagnosis of Osteosarcoma (OSA) is not always straightforward. OSA may resemble Other Primary Bone Tumours (OPBT). The diagnosis of osteosarcoma is sometimes difficult especially in a very small specimen. Immunohistochemistry is one of ancillary testing types that can help the diagnosis of many tumours. The aim of this study was to evaluate the validity of Osteocalcin (OCN) and Alkaline Phosphatase (ALP) immunohistochemistry in discriminating OSA from OPBT. Method. This study included 50 selected human primary bone tumours, 25 cases of OSA and 25 cases of OPBT. Immunohistochemical evaluation of OCN and ALP was done for all cases. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were calculated. Result. The mean age of OSA and OPBT patients was 19.6±13.6 and 40.0±16.3 years, respectively. Osteocalcin was positive in 17/25 (68%) cases of OSA and 16/25 (64%) cases of OPBT (p=0.061). Alkaline Phosphatase was positive in 24/25 (96%) cases of OSA and 5/25 (20%) cases of OPBT (p<0.001). The sensitivity of OCN in OSA diagnosis was 68%, with specificity, PPV, NPV, and overall accuracy being 36%, 52%, 53%, and 52%, respectively. The sensitivity of ALP in OSA diagnosis was 96%, with specificity, PPV, NPV, and overall accuracy being 80%, 82.7%, 95.2%, and 88%, respectively. Conclusion. ALP immunohistochemistry is useful in discriminating OSA from OPBT. ALP is superior to OCN in OSA diagnosis. OCN cannot be used to differentiate between OSA and OPBT.

scholarly journals Cytological analysis of small branch-duct intraductal papillary mucinous neoplasms provides a more accurate risk assessment of malignancy than symptoms

CytoJournal ◽  
2011 ◽  
Vol 8 ◽  
pp. 21 ◽  
Author(s):  
Jill Ono ◽  
Kurt A. Yaeger ◽  
Muriel Genevay ◽  
Mari Mino-Kenudson ◽  
William R. Brugge ◽  
...  
Keyword(s):  
Predictive Value ◽  
High Threshold ◽  
Imaging Features ◽  
High Grade ◽  
Positive Cytology ◽  
Intraductal Papillary Mucinous Neoplasms ◽  
Branch Duct ◽  
Small Branch ◽  
Mucinous Neoplasms ◽  
Sensitivity Specificity

Objectives: The Sendai guidelines for management of patients with clinically suspected intraductal papillary mucinous neoplasms (IPMN) recommend resection of cysts > 30 mm, a dilated main pancreatic duct (MPD) > 6 mm, a mural nodule (MN), symptoms or positive cytology. Although sensitive, asymptomatic cysts, nonspecific symptoms, and a high threshold for positive cytology limit the specificity of the guidelines. We have assessed the value of cytology relative to symptom for predicting malignancy in IPMNs without high-risk imaging features. Materials and Methods: We retrospectively reviewed the clinical, radiological, and cytological data of 31 small branch-duct IPMNs without a MN. The cytological presence of high-grade atypical epithelial cells (HGA) was considered true positive, with a corresponding histology of high-grade dysplasia or invasive carcinoma. The performance of cytology versus symptoms was evaluated by calculating the sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy. Results: The sensitivity (0.80), specificity (0.85), and accuracy (0.84) of HGA were higher than the corresponding performance characteristics of symptoms (0.60, 0.45, and 0.48, respectively). The NPV of no HGA on cytology was > 95%. Conclusions: Cytology is a better predictor of malignancy than symptoms, for the conservative management of small branch-duct IPMNs. Cytology contributes to a highly accurate triple negative test for malignancy in small IPMN: No dilated MPD, MN or HGA.

scholarly journals CLINICOHISTOPATHOLOGICAL PROFILE OF NASAL AND SINONASAL LESIONS: A STUDY FROM CENTRAL INDIA

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Manjiri G Khade ◽  
Rekha N Patil ◽  
Dinkar T Kumbhalkar ◽  
Suwarna B Patil ◽  
Pradip S Umap
Keyword(s):  
Predictive Value ◽  
Treatment Plan ◽  
Central India ◽  
Clinical History ◽  
P Value ◽  
Histopathological Diagnosis ◽  
Age Group ◽  
Female Ratio ◽  
Neoplastic Lesions ◽  
Sensitivity Specificity

Background: Nasal and sinonasal lesions comprise common as well as rarest rare lesions. This region being a site of histopathologically diverse lesions, interests pathologists. Objectives: The study aimed to find out incidence of nasal and sinonasal lesion with frequency of non-neoplastic, neoplastic  lesions,  to study spectrum of lesions histopathologically along with correlation of clinical and radiology findings. Material and methods: It was a 2 year retrospective observational study involving 102 cases from January 2012 to December 2013 carried out at Government medical college, Nagpur. Study included all specimens received as nasal and sinonasal lesions. Complete clinical history and radiological findings were correlated with histopathology findings.  Results: Nasal and sinonasal lesions are rare having 1.07 % incidence rate. Majority of patients of nonneoplastic and benign neoplastic category belonged to 11-20 age group while malignancies were common in 41-50 age group. We encountered more neoplastic lesions (53.92%) compared to nonneoplastic lesion (46.08%).  Male to female ratio was 1.5:1. Sensitivity, specificity and diagnostic accuracy of clinical diagnosis was 94.73%, 97.67 % and 96 % respectively while positive predictive value and negative predictive value was 98.18 % and 93.33 %. p value was 0.317. Discordance in clinic-histopathological diagnosis was in 5.88 % Conclusion: Though there was good correlation between clinicoradiology findings and histopathology, however in 5.88% discordant cases histopathology diagnosis led to significant alteration of treatment plan proving key role of histopathology diagnosis. Keywords: Benign, Central India, Clinicohistopathology, Profile, Malignant, Nasal, Sinonasal.

Osteoarticular pathology

2017 ◽  
Author(s):  
James Carton
Keyword(s):  
Rheumatoid Arthritis ◽  
Soft Tissue ◽  
Septic Arthritis ◽  
Paget’S Disease ◽  
Bone Tumours ◽  
Soft Tissue Tumours ◽  
Crystal Arthropathies ◽  
Malignant Bone Tumours ◽  
Benign Bone Tumours ◽  
Malignant Soft Tissue

This chapter discusses osteoarticular pathology, including osteoporosis, osteopetrosis, rickets and osteomalacia, Paget’s disease, osteomyelitis, osteoarthritis, rheumatoid arthritis, spondyloarthropathies, crystal arthropathies, septic arthritis, periprosthetic reactions, soft tissue and bone tumours, benign soft tissue tumours, malignant soft tissue tumours, benign bone tumours, and malignant bone tumours.

Osteoarticular pathology

2012 ◽  
Author(s):  
James Carton
Keyword(s):  
Rheumatoid Arthritis ◽  
Soft Tissue ◽  
Septic Arthritis ◽  
Hip Joint ◽  
Paget’S Disease ◽  
Bone Tumours ◽  
Soft Tissue Tumours ◽  
Crystal Arthropathies ◽  
Malignant Bone Tumours ◽  
Benign Bone Tumours

Osteoarticular malformations 306Osteoporosis 307Paget's disease 308Osteomalacia 309Osteomyelitis 310Benign bone tumours 311Malignant bone tumours 312Osteoarthritis 313Rheumatoid arthritis 314Spondyloarthropathies 315Crystal arthropathies 316Septic arthritis 317Soft tissue tumours 318• An imperfect development of the hip joint, which predisposes the joint to dislocation....

Noninvasive Evaluation of Coronary Artery Bypass Grafts with 16-Slice Multidetector Computed Tomography

2012 ◽  
Vol 15 (1) ◽  
pp. 12 ◽  
Author(s):  
Levent Sahiner ◽  
Ali Oto ◽  
Kudret Aytemir ◽  
Tuncay Hazirolan ◽  
Musturay Karcaaltincaba ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Diagnostic Accuracy ◽  
Multidetector Computed Tomography ◽  
Coronary Artery Bypass ◽  
Predictive Value ◽  
Artery Bypass ◽  
Time Interval ◽  
Mdct Angiography ◽  
Sensitivity Specificity

<p><b>Background:</b> The aim of this study was to investigate the diagnostic accuracy of 16-slice multislice, multidetector computed tomography (MDCT) angiography for the evaluation of grafts in patients with coronary artery bypass grafting (CABG).</p><p><b>Methods:</b> Fifty-eight consecutive patients with CABG who underwent both MDCT and conventional invasive coronary angiography were included. The median time interval between the 2 procedures was 10 days (range, 1-32 days). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MDCT for the detection of occluded grafts were calculated. The accuracy of MDCT angiography for detecting significant stenoses in patent grafts and the evaluability of proximal and distal anastomoses were also investigated.</p><p><b>Results:</b> Optimal diagnostic images could not be obtained for only 3 (2%) of 153 grafts. Evaluation of the remaining 150 grafts revealed values for sensitivity, specificity, PPV, NPV, and diagnostic accuracy of the MDCT angiography procedure for the diagnosis of occluded grafts of 87%, 97%, 94%, 93%, and 92%, respectively. All of the proximal anastomoses were optimally visualized. In 4 (8%) of 50 patent arterial grafts, however, the distal anastomotic region could not be evaluated because of motion and surgical-clip artifacts. The accuracy of MDCT angiography for the detection of significant stenotic lesions was relatively low (the sensitivity, specificity, PPV, and NPV were 67%, 98%, 50%, and 99%, respectively). The number of significant lesions was insufficient to reach a reliable conclusion, however.</p><p><b>Conclusion:</b> Our study showed that MDCT angiography with 16-slice systems has acceptable diagnostic performance for the evaluation of coronary artery bypass graft patency.</p>

Accuracy of Rotator Cuff Tears and Tendinosis Diagnoses on Shoulder Ultrasound Performed by a Short-experienced Operator

2018 ◽  
Vol 1 ◽  
pp. 9
Author(s):  
Harshad Arvind Vanjare ◽  
Jyoti Panwar
Keyword(s):  
Rotator Cuff ◽  
Negative Predictive Value ◽  
Rotator Cuff Tear ◽  
Predictive Value ◽  
Rotator Cuff Tears ◽  
Mri Findings ◽  
Cuff Tear ◽  
Experienced Operator ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Objective The objective of the study was to assess the accuracy of ultrasound examination for the diagnosis of rotator cuff tear and tendinosis performed by a short experienced operator, compared to magnetic resonance imaging (MRI) results. Method A total of 70 subjects suspected to have rotator cuff tear or tendinosis and planned for shoulder MRI were included in the study. Shoulder ultrasound was performed either before or after the MRI scan on the same day. Ultrasound operator had a short experience in performing an ultrasound of the shoulder. Ultrasound findings were correlated to MRI findings. Results Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the diagnosis of tendinosis were 58%, 84%, 63%, 80%, and 75%, respectively, and it was 68%, 91%, 73%, 88%, and 85%, respectively, for the diagnosis of rotator cuff tear. Conclusions Sensitivity for diagnosing rotator cuff tear or tendinosis was moderate but had a higher negative predictive value. Thus, the ultrasound operator with a short experience in performing shoulder ultrasound had moderate sensitivity in diagnosing tendinosis or tears; however, could exclude them with confidence.

VALUE OF ST-SEGMENT ELEVATION IN LEAD AVR IN PREDICTING LEFT MAIN AND OR 3-VESSEL DISEASE IN PATIENTS WITH ACUTE CORONARY SYNDROMES

2017 ◽  
pp. 59-63
Author(s):  
Thanh Hung Dieu ◽  
Anh Vu Nguyen
Keyword(s):  
Predictive Value ◽  
Acute Coronary Syndromes ◽  
Independent Predictor ◽  
Left Main ◽  
St Segment Elevation ◽  
Vessel Disease ◽  
St Segment ◽  
Coronary Syndromes ◽  
Lead Avr ◽  
Sensitivity Specificity

Objects: We assessed the ability of ST-segment elevation in lead aVR to predict left main and/or 3-vessel disease (LM/3VD) in patients with acute coronary syndromes (ACS). Meterial and Method: 410 patients with ACS, who underwent coronary angiography, were evaluated. Results: 131 (31.9%) patients have been LM/3VD. ST segment elevation > 0.05 mV in leads aVR have been an independent predictor LM/3VD with sensitivity, specificity, positive predictive value PPV) and negative predictive value (NPV) 74.0%, 78.1%, 61.4% and 86.5%, respectively (p<0.001). ST segment elevation > 0.05 mV in leads aVR with ST segment depression in leads V4-V6 have related LM/3VD with sensitivity, specificity, PPV and NPV 44.3%, 92.8%, 74.4% and 75.2%, respectively (p<0.001). ST segment elevation > 0.1 mV in leads aVR have related LM/3VD with sensitivity, specificity, PPV and NPV 51.9%, 87.1%, 65.1% and 79.4%, respectively (p<0.001). Conclusions: ST segment elevation > 0.05 mV in leads aVR have been an independent predictor LM/3VD in patients with ACS. Key words: Acute coronary syndromes, ST-segment elevation, aVR

Evaluation of aseptic loosening of knee prostheses by quantitative bone scintigraphy

2008 ◽  
Vol 47 (04) ◽  
pp. 163-166 ◽  
Author(s):  
D. Steiner ◽  
S. Laurich ◽  
R. Bauer ◽  
J. Kordelle ◽  
R. Klett
Keyword(s):  
Aseptic Loosening ◽  
Bone Scintigraphy ◽  
Revision Surgery ◽  
Predictive Value ◽  
Knee Prostheses ◽  
Treatment Regimes ◽  
Golden Standard ◽  
The Difference ◽  
Sensitivity Specificity ◽  
Asymptomatic Control

SummaryIn not infected knee prostheses bone scintigraphy is a possible method to diagnose mechanical loosening, and therefore, to affect treatment regimes in symptomatic patients. However, hitherto studies showed controversial results for the reliability of bone scintigraphy in diagnosing loosened knee prostheses by using asymptomatic control groups. Therefore, the aim of our study was to optimize the interpretation procedure and to evaluate the accuracy using results from revision surgery as standard. Methods: Retrospectively, we were able to examine the tibial component in 31 cemented prostheses. In this prostheses infection was excluded by histological or bacteriological examination during revision surgery. To quantify bone scintigraphy, we used medial and lateral tibial regions with a reference region from the contralateral femur. Results: To differentiate between loosened and intact prostheses we found a threshold of 5.0 for the maximum tibia to femur ratio of the both tibial regions and a threshold of 18% for the difference of the ratio of both tibial regions. Using these thresholds, values of 0.9, 1, 0.85, 1, and 0.94 were calculated for sensitivity, specificity, negative predictive value, positive predictive value, and accuracy, respectively. To get a sensitivity of 1, we found a lower threshold of 3.3 for the maximum tibia to femur ratio. Conclusion: Quantitative bone scintigraphy appears to be a reliable diagnostic tool for aseptic loosening of knee prostheses with thresholds evaluated by revision surgery results being the golden standard.

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