Diagnostic value of 12-zone lung ultrasound protocol for diagnosing COVID-19-associated pneumonia in outpatients

Introduction: In the SARS-CoV-2 pandemic, lung ultrasound can be of decisive importance for planning further treatment approach in patients with infection. There is still no clear priority for the choice of lung ultrasound protocol in an outpatient setting. Aim: The objective of the study was to evaluate the applicability of 12-zone protocol lung ultrasound for the diagnosis of COVID- 19 associated pneumonia in outpatients. Materials and methods: We examined 39 outpatients meeting the diagnostic criteria of COVID-19 infection (17 men and 22 women) aged 31–75 years (median 49 years). All patients underwent lung ultrasound immediately after chest computed tomography performed by a blinded specialist. Correlation analysis of the results of a quantitative assessment of the detected signs, assessment of the diagnostic significance of lung ultrasound for identifying signs of pneumonia were performed. Results: Pneumonia was diagnosed by computed tomography in 25 (64%; 95% CI 47–79) out of 39 patients. At the same time, ultrasound signs of interstitial abnormalities were detected in 31 patients. Multiple (narrow) B-lines, confluent (wide) B-lines, as well as areas of subpleural consolidation and “white lung” were the most common lung ultrasound abnormalities. When evaluating the method, the optimal sensitivity/ specificity ratio was obtained for a value of ≥2 points, the area under the curve = 0.970 (95% CI 0.858–0.999; p <0.0001). The score of lung ultrasound significantly correlated with computed tomography quantitative assessment (r = 0.928, p <0.001). Conclusion: Despite some limitations, lung ultrasound can be extremely useful in primary care settings, also in the case of a significant number of admitted patients, to detect features of COVID-19 associated pneumonia.

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Evaluation of alpha-l-fucosidase for the diagnosis of hepatocellular carcinoma based on meta-analysis

LaboratoriumsMedizin ◽

10.1515/labmed-2019-0152 ◽

2020 ◽

Vol 0 (0) ◽

Cited By ~ 1

Author(s):

Lei Xi ◽

Chunqing Yang

Keyword(s):

Hepatocellular Carcinoma ◽

Operating Characteristic ◽

Meta Analysis ◽

Area Under The Curve ◽

Diagnostic Odds Ratio ◽

Diagnostic Value ◽

Receiver Operating Characteristic Curves ◽

Sensitivity Specificity ◽

Review Manager

AbstractObjectivesThe main aim of the present study was to assess the diagnostic value of alpha-l-fucosidase (AFU) for hepatocellular carcinoma (HCC).MethodsStudies that explored the diagnostic value of AFU in HCC were searched in EMBASE, SCI, and PUBMED. The sensitivity, specificity, and DOR about the accuracy of serum AFU in the diagnosis of HCC were pooled. The methodological quality of each article was evaluated with QUADAS-2 (quality assessment for studies of diagnostic accuracy 2). Receiver operating characteristic curves (ROC) analysis was performed. Statistical analysis was conducted by using Review Manager 5 and Open Meta-analyst.ResultsEighteen studies were selected in this study. The pooled estimates for AFU vs. α-fetoprotein (AFP) in the diagnosis of HCC in 18 studies were as follows: sensitivity of 0.7352 (0.6827, 0.7818) vs. 0.7501 (0.6725, 0.8144), and specificity of 0.7681 (0.6946, 0.8283) vs. 0.8208 (0.7586, 0.8697), diagnostic odds ratio (DOR) of 7.974(5.302, 11.993) vs. 13.401 (8.359, 21.483), area under the curve (AUC) of 0.7968 vs. 0.8451, respectively.ConclusionsAFU is comparable to AFP for the diagnosis of HCC.

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Diagnostic value of endobronchial ultrasound elastography for differentiating benign and malignant hilar and mediastinal lymph nodes: a systematic review and meta-analysis

Medical Ultrasonography ◽

10.11152/mu-2971 ◽

2021 ◽

Author(s):

Jiangfeng Wu ◽

Yue Sun ◽

Yunlai Wang ◽

Lijing Ge ◽

Yun Jin ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Likelihood Ratio ◽

Meta Analysis ◽

Area Under The Curve ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Diagnostic Value ◽

Endobronchial Ultrasound ◽

Mediastinal Lymph Nodes ◽

Sensitivity Specificity

Aims: In the present study, a meta-analysis was performed to evaluate the diagnostic value of endobronchial ultrasound (EBUS) elastography for differentiating benign and malignant hilar and mediastinal lymph nodes (LNs). Material and methods: A comprehensive literature search was carried out through PubMed, Embase, and Cochrane Library. Two authors screened the papers and extracted the data independently and any discrepancies were resolved by discussion. The methodolog-ical quality of each included study was assessed by the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and area under the curve were calculated to evaluate the value of EBUS elastography for hilar and mediastinal LNs. Results: Seventeen studies with the number of 2307 LNs were included. There was significant heterogeneity across the included studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for the diagnosis of hilar and mediastinal LNs by EBUS elastography were 0.90 (95% confidence interval [CI], 0.84-0.94), 0.78 (95% CI, 0.74-0.81), 4.1 (95% CI, 3.4-4.9), 0.12 (95% CI, 0.07-0.21) and 33 (95% CI, 17-64), respectively. Furthermore, area under the curve was calculated to be 0.86 (95% CI, 0.82-0.88). Conclusion: EBUS elastography is a valuable technology in the differentiation of benign and malignant hilar and mediastinal LNs and could provide supplementary diagnostic information during endobronchial ultrasound-guided transbronchial needle aspiration. The combination of EBUS elastography and B-mode EBUS could improve the diagnostic accuracy for hilar and mediastinal LNs.

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Clinical performance of lung ultrasound in predicting ARDS morphology

Annals of Intensive Care ◽

10.1186/s13613-021-00837-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Andrea Costamagna ◽

Emanuele Pivetta ◽

Alberto Goffi ◽

Irene Steinberg ◽

Pietro Arina ◽

...

Keyword(s):

Computed Tomography ◽

Gold Standard ◽

Diagnostic Performance ◽

Lung Ultrasound ◽

Clinical Performance ◽

Training Set ◽

Mechanically Ventilated ◽

Validation Set ◽

Lung Ct ◽

B Lines

Abstract Background To assess diagnostic performance of lung ultrasound (LUS) in identifying ARDS morphology (focal vs non-focal), compared with the gold standard computed tomography. Methods Mechanically ventilated ARDS patients undergoing lung computed tomography and ultrasound were enrolled. Twelve fields, were evaluated. LUS score was graded from 0 (normal) to 3 (consolidation) according to B-lines extent. Total and regional LUS score as the sum of the four ventral (LUSV), intermediate (LUSI) or dorsal (LUSD) fields, were calculated. Based on lung CT, ARDS morphology was defined as (1) focal (loss of aeration with lobar distribution); (2) non-focal (widespread loss of aeration or segmental loss of aeration distribution associated with uneven lung attenuation areas), and diagnostic accuracy of LUS in discriminating ARDS morphology was determined by AU-ROC in training and validation set of patients. Results Forty-seven patients with ARDS (25 training set and 22 validation set) were enrolled. LUSTOT, LUSV and LUSI but not LUSD score were significantly lower in focal than in non-focal ARDS morphologies (p < .01). The AU-ROC curve of LUSTOT, LUSV, LUSI and LUSD for identification of non-focal ARDS morphology were 0.890, 0.958, 0.884 and 0.421, respectively. LUSV value ≥ 3 had the best predictive value (sensitivity = 0.95, specificity = 1.00) in identifying non-focal ARDS morphology. In the validation set, an LUSV score ≥ 3 confirmed to be highly predictive of non-focal ARDS morphology, with a sensitivity and a specificity of 94% and 100%. Conclusions LUS had a valuable performance in distinguishing ARDS morphology.

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Diagnostic value of neutrophil CD64, procalcitonin, and interleukin-6 in sepsis: A meta-analysis

10.21203/rs.3.rs-60957/v1 ◽

2020 ◽

Author(s):

Ke Wang ◽

Shan Cong ◽

Tiangang Ma ◽

Xin Di ◽

Chang Tian ◽

...

Keyword(s):

Likelihood Ratio ◽

Interleukin 6 ◽

Meta Analysis ◽

Area Under The Curve ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Diagnostic Value ◽

Summary Receiver Operating Characteristic ◽

Neutrophil Cd64 ◽

Sensitivity Specificity

Abstract The aim of the study was to conduct a meta-analysis to evaluate the accuracy of neutrophil CD64, procalcitonin (PCT), and interleukin-6 (IL-6) for the diagnosis of sepsis. The sample articles were searched in various databases to collect published studies on the diagnosis of sepsis by neutrophil CD64, PCT, and IL-6. By using the Stata SE 15.0 software, forest plots and the area under the summary receiver operating characteristic curves were drawn. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve (AUC) were calculated. 54 articles were included in the study. The number of studies that evaluated the diagnostic value of neutrophil CD64, PCT, and interleukin-6 were 20, 39, and 15, respectively. The pooled sensitivity, specificity, and AUC of neutrophil CD64 for the diagnosis of sepsis were 0.88 [95% confidence interval (CI), 0.81–0.92], 0.88 (95% CI, 0.83–0.91), and 0.94 (95% CI, 0.91–0.96), respectively. The pooled sensitivity, specificity, and AUC of PCT for the diagnosis of sepsis were 0.82 (95% CI, 0.78–0.85), 0.78 (95% CI, 0.74–0.82), and 0.87 (95% CI, 0.83–0.89), respectively. Subgroup analysis showed that the AUC for PCT diagnosis of intensive care unit (ICU) sepsis was 0.86 (95% CI, 0.83–0.89) and the AUC for PCT diagnosis of non-ICU sepsis was 0.82 (95% CI, 0.78–0.85). The pooled sensitivity, specificity, and AUC of IL-6 for the diagnosis of sepsis were 0.72 (95% CI, 0.65–0.78), 0.70 (95% CI, 0.62–0.76), and 0.77 (95% CI, 0.73–0.80), respectively. Of the three biomarkers studied, neutrophil CD64 showed the highest diagnostic value for sepsis, followed by PCT, and IL-6. On the other hand, PCT showed a better diagnostic value for the diagnosis of sepsis in patients with severe conditions compared with that in patients with non-severe conditions.

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Review on Diagnosis of COVID-19 from Chest CT Images Using Artificial Intelligence

Computational and Mathematical Methods in Medicine ◽

10.1155/2020/9756518 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10 ◽

Cited By ~ 2

Author(s):

Ilker Ozsahin ◽

Boran Sekeroglu ◽

Musa Sani Musa ◽

Mubarak Taiwo Mustapha ◽

Dilber Uzun Ozsahin

Keyword(s):

Artificial Intelligence ◽

Computed Tomography ◽

Neural Networks ◽

Deep Learning ◽

Chest Radiography ◽

Area Under The Curve ◽

Chest Ct ◽

Chest Computed Tomography ◽

Classification Tasks ◽

Sensitivity Specificity

The COVID-19 diagnostic approach is mainly divided into two broad categories, a laboratory-based and chest radiography approach. The last few months have witnessed a rapid increase in the number of studies use artificial intelligence (AI) techniques to diagnose COVID-19 with chest computed tomography (CT). In this study, we review the diagnosis of COVID-19 by using chest CT toward AI. We searched ArXiv, MedRxiv, and Google Scholar using the terms “deep learning”, “neural networks”, “COVID-19”, and “chest CT”. At the time of writing (August 24, 2020), there have been nearly 100 studies and 30 studies among them were selected for this review. We categorized the studies based on the classification tasks: COVID-19/normal, COVID-19/non-COVID-19, COVID-19/non-COVID-19 pneumonia, and severity. The sensitivity, specificity, precision, accuracy, area under the curve, and F1 score results were reported as high as 100%, 100%, 99.62, 99.87%, 100%, and 99.5%, respectively. However, the presented results should be carefully compared due to the different degrees of difficulty of different classification tasks.

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OP0167 THE ROLE OF LUNG ULTRASOUND IN THE DIAGNOSIS OF INTERSTITIAL LUNG DISEASE IN CHILDREN WITH DERMATOMYOSISTIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.4033 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 100.3-100

Author(s):

R. Dertkgil ◽

C. Cappello ◽

S. Dertkigil ◽

R. Marini ◽

S. Appenzeller

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Interstitial Lung Disease ◽

Lung Disease ◽

Gold Standard ◽

Lung Ultrasound ◽

Pulmonary Involvement ◽

High Resolution Computed Tomography ◽

B Lines ◽

Transthoracic Ultrasound

Background:Dermatomyositis is a multi organ autoimmune disease wich is commonly complicated with interstitial lung disease. Chest high-resolution computed tomography (HRCT) is still considered the diagnostic gold standard for interstitial lung disease and is quantification, however he increasing use of lung ultrasound may play an important role in the future.Objectives:The aim of our study was to determine the diagnostic value of lung ultrasound in the detection and progression of interstitial pulmonary disease in patients with dermatomyositis.Methods:Twenty two subjects with dermatomyositis diagnosed according to the American College of Rheumatology criteria were enrolled (6 males, 16 females; mean age: 15,8 ± 8.8 years; range: 6 to 29 years). All subjects underwent high resolution computed tomography followed by transthoracic ultrasound for comet tail sign detection and pleural irregularity in order to predict the degree of interstitial lung disease. The modified transthoracic ultrasound assessment was performed at 06 thoracic regions each side. The Warrick score was calculated according standard high-resolution chest computed tomography images that were evaluated independently from each other by two thoracics radiologists.Results:A significantly positive correlation between transthoracic ultrasound and the severity of pulmonary involvement, as seen by the number of B lines (Spearman ‘s correlation coefficient = 0.80, p < 0.001), and the number of positive areas (regions wih more than 3 B lines) (Spearman ‘s correlation coefficient = 0.75, p < 0.001) were found. When compared with high-resolution chest computed tomography as the gold standard method, the sensitivity, specificity, of transthoracic ultrasound was 96.4%, 83,3% respectively. Addicionally the number of B lines (sum of 35 or more B lines) and a number of B lines positive areas (7 or more regions with at least 3 B lines) cut of allowed to discriminate the inflamatory pattern (ground glass) to those with structural pattern (honeycomb and pulmonary cysts).Conclusion:Our study showed that transthoracic ultrasound comet tails scoring system could be useful in the assessment of the pulmonary involvement in patients with dermatomyositis, and should be considered as a primary screening exam to exclude lung involvement, rather than routine chest CT scans in assimptomatic patients.Disclosure of Interests:None declared

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On the Replica of US Pulmonary Artifacts by Means of Physical Models

Diagnostics ◽

10.3390/diagnostics11091666 ◽

2021 ◽

Vol 11 (9) ◽

pp. 1666

Author(s):

Marcello Demi

Keyword(s):

Visual Inspection ◽

Lung Ultrasound ◽

Diagnostic Value ◽

Experimental Results ◽

Physical Models ◽

Ultrasound Images ◽

Pulmonary Disorder ◽

Visual Characteristics ◽

Artifact Formation ◽

B Lines

Currently, the diagnostic value of the artefactual information provided by lung ultrasound images is widely recognized by physicians. In particular, the existence of a correlation between the visual characteristics of the vertical artifacts, which arise from the pleura line, and the genesis (pneumogenic or cardiogenic) of a pulmonary disorder is commonly accepted. Physicians distinguish vertical artifacts from vertical artifacts which extend to the bottom of the screen (B-lines) and common vertical artifacts from well-structured artifacts (modulated B-lines). However, the link between these visual characteristics and the causes which determine them is still unclear. Moreover, the distinction between short and long artifacts and the distinction between common and structured artifacts are not on/off, and their classification can be critical. In order to derive further information from the visual inspection of the vertical artifacts, the mechanisms which control the artifact formation must be identified. In this paper, the link between the visual characteristics of the vertical artifacts (the observed effect) and the distribution of the aerated spaces at the pleural level (the cause) is addressed. Plausible mechanisms are suggested and illustrated through experimental results.

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Diagnosis Value of Procalcitonin Variation on Early Pneumonia after Adult Cardiac Surgery

The Heart Surgery Forum ◽

10.1532/hsf.3987 ◽

2021 ◽

Vol 24 (4) ◽

pp. E734-E740

Author(s):

Hua Jin ◽

Su-Ping Gu ◽

Yan Wang ◽

Ke Pan ◽

Zhong Chen ◽

...

Keyword(s):

Cardiac Surgery ◽

White Blood Cells ◽

Area Under The Curve ◽

Diagnostic Value ◽

Postoperative Pneumonia ◽

Diagnostic Significance ◽

Reactive Protein ◽

Wbc Count ◽

Age And Sex ◽

Adult Cardiac Surgery

Background: Postoperative pneumonia (PP) is a complication after cardiac surgery. This study aimed to investigate the ability of procalcitonin (PCT) variation to diagnose postoperative pneumonia. Method: In this prospective observational study, patients with PP and age- and sex-matched cases in our center from October 10, 2020, to January 31, 2021, were included. Patients diagnosed with PP in this study met both clinical and microbiological diagnostic criteria. Blood samples were collected in all patients from the first postoperative day (POD1) to POD5 to measure PCT, white blood cells (WBCs), and C-reactive protein (CRP). PCT variation was calculated by the equation: (PCTdelayed – PCTPOD1)/PCTPOD1. The receiver operating characteristic and area under the curve (AUC) analyses were used to evaluate the diagnostic performance of different biomarkers. Results: Our study enrolled 272 patients, including 24 patients with PP and 248 age- and sex-matched cases. From POD1 to POD5, the absolute value of PCT showed diagnostic significance for pneumonia (P < .05), WBC showed no differences, and CRP had no diagnostic value until POD4. Furthermore, PCT variation showed the best diagnostic value among those biomarkers (AUC 0.84, 95% confidence interval [CI] 0.71, 0.91). Multivariable logistic regression showed that PCT variation on POD2 had significant value to predict PP (odds ratio 5.602, 95% CI 2.178, 14.409, P < .01). Conclusion: Compared with PCT level, WBC count, and CRP level, PCT variation had the best diagnostic value in predicting PP.

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DIAGNOSTIC VALUE OF LABORATORY MARKERS OF NEONATAL SEPSIS IN PREMATURE INFANTS

PEDIATRIA Journal named after G N SPERANSKY ◽

10.24110/0031-403x-2021-100-1-95-100 ◽

2021 ◽

Vol 100 (1) ◽

pp. 95-100

Author(s):

G.V. Kulizhnikov ◽

◽

E.G. Furman ◽

A.V. Nikolenko ◽

◽

...

Keyword(s):

Premature Infants ◽

Neonatal Sepsis ◽

Diagnostic Value ◽

C Reactive Protein ◽

Diagnostic Significance ◽

Reactive Protein ◽

Advantages And Disadvantages ◽

Negative Results ◽

Laboratory Markers ◽

Sensitivity Specificity

Neonatal sepsis (NS) is the leading cause of mortality in premature newborns. It is a difficult diagnostic task for clinicians. This article provides a review of the literature on laboratory markers of NS. The latest methods for the diagnosis of sepsis in premature infants in various studies are considered in the article. The results of studying the diagnostic value of a general blood test, cytokines, C-reactive protein, procalcitonin, prespepsin, microRNA polymorphism, bacterial blood culture, their advantages and disadvantages, as well as diagnostic significance – sensitivity, specificity, prognostic value of positive and negative results are presented.

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Utility of PET/CT in the diagnosis of recurrent ovarian cancer depending on CA 125 serum level

Nuklearmedizin ◽

10.3413/nukmed-0709-14-11 ◽

2015 ◽

Vol 54 (04) ◽

pp. 158-162 ◽

Cited By ~ 9

Author(s):

M. Fularz ◽

P. Adamiak ◽

R. Czepczynski ◽

G. Jarzabek-Bielecka ◽

A. Rewers ◽

...

Keyword(s):

Ovarian Cancer ◽

Serum Level ◽

Area Under The Curve ◽

Recurrent Ovarian Cancer ◽

Diagnostic Value ◽

Ca 125 ◽

Ct Examination ◽

Level Measurement ◽

Pet Ct ◽

Sensitivity Specificity

SummaryThe aim of this study was to estimate the diagnostic value of common application of CA 125 level measurement and 18F-FDG PET/CT examination in patients with a suspicion of recurrent ovarian cancer. Patients, methods: A retrospective analysis was performed on a group of 68 patients aged 31–77 (average 57.7) with a suspicion of relapsing ovarian cancer who had CA 125 serum level measurement and PET/CT examination done with a maximum interval of 60 days. Results: PET/CT examination result was positive in 33 patients (48.5%) and negative in 35 (51.5%). Level of CA 125 was significantly higher in women with a positive PET/ CT result than in patients with a negative one (average 199.9 U/ml and 15.7 U/ml, respectively, p < 0.001). Nevertheless, comparison of CA 125 level in groups defined according to the localization of the relapse showed no significant differences. Moreover, the ROC analysis revealed that the optimal cut-off point of CA 125 concentration to predict positive PET/CT result was 17.6 U/ml. Area under the curve was 0.91. Sensitivity, specificity and accuracy in prognosticating positive PET/CT result for the selected cut-off point of 17.6 U/ml were 90.9%, 80.0% and 85.3%, respectively. Conclusion: CA 125 level does not depend on the localization of the recurrence. PET/CT is particularly useful in patients with a suspicion of relapsing ovarian cancer with CA 125 value of at least 17.6 U/ml.

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