scholarly journals Spiral Flow Fube for Contrast Medium Reduction in Coronary CT Angiography

2017 ◽  
Vol 9 ◽  
Author(s):  
Nobuo Tomizawa ◽  
Yayoi Hayakawa ◽  
Shinichi Inoh ◽  
Takeshi Nojo ◽  
Satoshi Uemura ◽  
...  
Keyword(s):  
Contrast Medium ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Left Main ◽  
Spiral Flow ◽  
Flow Tube ◽  
Coronary Ct ◽  
Shaped Tube ◽  
Significant Difference ◽  
Sensitivity Specificity

<p align="left"><strong>Objectives</strong></p><p align="left">To assess the diagnostic performance and enhancement of coronary CT with reduced contrast medium using the spiral flow tube compared with the T-shaped tube.</p><p align="left"><strong>Methods</strong></p><p align="left">We retrospectively included 444 patients who underwent catheter examination within 2 months after coronary CT. The first 222 patients received 21.0 mgI/kg/s of contrast medium using the T-shaped tube and the injected contrast medium was reduced by 6% (19.8 mgI/kg/s) in the last 222 patients using the spiral flow tube. We compared the per vessel diagnostic performance for detecting obstructive stenosis (≥50%) by catheter examination and the enhancement of proximal coronary arteries.</p><p align="left"><strong>Results</strong></p><p align="left">The sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 96%, 84%, 72%, 98% and 87% using the spiral flow tube and 93%, 83%, 68%, 97% and 86% using the T-shaped tube, respectively, without significance. The enhancement of left main (spiral flow vs T-shape, 407 ± 53 vs 407 ± 62 HU, <em>p</em> = 0.95) and right coronary (419 ± 58 vs 415 ± 61 HU, <em>p</em> = 0.49) arteries did not show significant difference.</p><p align="left"><strong>Conclusions</strong></p><p align="left">The spiral flow tube would maintain the diagnostic performance and coronary enhancement with reduced contrast medium compared with the T-shaped tube.</p>

scholarly journals Diagnostic Performance of Plain Film, Ultrasonography, and Computed Tomography in Nasal Bone Fractures: A Systematic Review

2018 ◽  
Vol 26 (4) ◽  
pp. 286-292 ◽  
Author(s):  
Kun Hwang ◽  
Joon Soo Jung ◽  
Hun Kim
Keyword(s):  
Computed Tomography ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Bone Fractures ◽  
Nasal Bone ◽  
Plain Film ◽  
Lateral View ◽  
Performance Accuracy ◽  
Significant Difference ◽  
Sensitivity Specificity

Purpose: The aim of this study was to compare the diagnostic performance (accuracy, sensitivity, specificity, positive predictive value, and negative predictive value) of plain film (PF), ultrasonography (USG), and computed tomography (CT) in diagnosing nasal bone fractures (NBFs). Methods: In a search of PubMed and Scopus, “nasal bone fracture” AND “X-ray OR CT OR USG OR MRI” were searched. Among the 369 titles from PubMed and 379 titles from Scopus, 257 duplicate titles were excluded and 491 titles were reviewed. Among them, 36 full articles were reviewed. From these, 21 were excluded and 1 mined article was added; thus, 16 articles were reviewed. Results: The accuracy of CT (94.4% ± 2.3%) was significantly higher ( P < .001) than that of USG (85.0% ± 3.6%). The accuracy of USG was significantly higher ( P < .001) than that of PF (67.7% ± 4.7%). Computed tomography (89.3% ± 3.1%) and USG (87.2% ± 3.3%) were significantly more sensitive than PF ( P < .001 and P < .001, respectively). The specificity of CT (94.2% ± 2.3%) was significantly higher ( P = .001) than that of USG (87.4% ± 3.3%). The specificity of USG was significantly higher ( P < .001) than that of PF (67.8% ± 4.7%). Among the PF techniques, combining a lateral view and the Water’s view (71.8% ± 4.5%) had significantly higher accuracy than a lateral view alone (62.4% ± 4.8%) or the Water’s view alone (61.0% ± 4.9%). In USG, there was no significant difference ( P = .300) in accuracy among lateral and dorsal views (95.8% ± 2.0%), a lateral view alone (84.2% ± 3.7%), and a dorsal view alone (84.2% ± 3.6%). Conclusion: The results of this review might be helpful in choosing the most appropriate diagnostic tool in patients suspected having NBF.

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

scholarly journals Predictive Evaluation on Cytological Sample of Metastatic Melanoma: The Role of BRAF Immunocytochemistry in the Molecular Era

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1110
Author(s):  
Andrea Ronchi ◽  
Marco Montella ◽  
Federica Zito Marino ◽  
Michele Caraglia ◽  
Anna Grimaldi ◽  
...  
Keyword(s):  
Metastatic Melanoma ◽  
Molecular Analysis ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Cost Effective ◽  
Needle Aspiration ◽  
Braf V600e ◽  
Mutational Status ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity

Background: Cutaneous malignant melanoma is an aggressive neoplasm. In advanced cases, the therapeutic choice depends on the mutational status of BRAF. Fine needle aspiration cytology (FNA) is often applied to the management of patients affected by melanoma, mainly for the diagnosis of metastases. The evaluation of BRAF mutational status by sequencing technique on cytological samples may be inconvenient, as it is a time and biomaterial-consuming technique. Recently, BRAF immunocytochemistry (ICC) was applied for the evaluation of BRAF V600E mutational status. Although it may be useful mainly in cytological samples, data about BRAF ICC on cytological samples are missing. Methods: We performed BRAF ICC on a series of 50 FNA samples of metastatic melanoma. BRAF molecular analysis was performed on the same cytological samples or on the corresponding histological samples. Molecular analysis was considered the gold standard. Results: BRAF ICC results were adequate in 49 out of 50 (98%) cases, positive in 15 out of 50 (30%) cases and negative in 34 out of 50 (68%) of cases. Overall, BRAF ICC sensitivity, specificity, positive predictive value and negative predictive value results were 88.2%, 100%, 100% and 94.1%, respectively. The diagnostic performance of BRAF ICC results was perfect when molecular evaluation was performed on the same cytological samples. Hyperpigmentation represents the main limitation of the technique. Conclusions: BRAF ICC is a rapid, cost-effective method for detecting BRAF V600E mutation in melanoma metastases, applicable with high diagnostic performance to cytological samples. It could represent the first step to evaluate BRAF mutational status in cytological samples, mainly in poorly cellular cases.

scholarly journals Reliability of digital panoramic radiography in the diagnosis of carotid artery calcifications

2014 ◽  
Vol 47 (1) ◽  
pp. 28-32 ◽  
Author(s):  
Vilson Lacerda Brasileiro Junior ◽  
Aníbal Henrique Barbosa Luna ◽  
Marcelo Augusto Oliveira de Sales ◽  
Tânia Lemos Coelho Rodrigues ◽  
Priscilla Lopes da Fonseca Abrantes Sarmento ◽  
...  
Keyword(s):  
High Risk ◽  
Carotid Artery ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Carotid Arteries ◽  
Panoramic Radiography ◽  
Digital Panoramic Radiography ◽  
Significant Difference ◽  
Mcnemar’S Test ◽  
Sensitivity Specificity

Objective The present study evaluated the reliability of digital panoramic radiography in the diagnosis of carotid artery calcifications. Materials and Methods Thirty-five patients under high-risk for development of carotid artery calcifications who had digital panoramic radiography were referred to undergo ultrasonography. Thus, 70 arteries were assessed by both methods. The main parameters utilized to evaluate the panoramic radiography reliability in the diagnosis of carotid artery calcifications were accuracy, sensitivity, specificity and positive predictive value of this method as compared with ultrasonography. Additionally, the McNemar's test was utilized to verify whether there was a statistically significant difference between digital panoramic radiography and ultrasonography. Results Ultrasonography demonstrated carotid artery calcifications in 17 (48.57%) patients. Such individuals presented with a total of 29 (41.43%) carotid arteries affected by calcification. Radiography was accurate in 71.43% (n = 50) of cases evaluated. The degree of sensitivity of this method was 37.93%, specificity of 95.12% and positive predictive value of 84.61%. A statistically significant difference (p < 0.001) was observed between the methods evaluated in their capacity to diagnose carotid artery calcifications. Conclusion Digital panoramic radiography should not be indicated as a method of choice in the investigation of carotid artery calcifications.

35. Accuracy of anal cytology in predicting histological HSIL: baseline results from the Australian Study of the Prevention of Anal Cancer (SPANC)

Sexual Health ◽  
2013 ◽  
Vol 10 (6) ◽  
pp. 587
Author(s):  
Jennifer Roberts ◽  
Clare Biro ◽  
Annabelle Farnsworth ◽  
Debbie Ekman ◽  
Marjorie Adams ◽  
...  
Keyword(s):  
Predictive Value ◽  
Screening Program ◽  
Anal Carcinoma ◽  
Hiv Positive ◽  
Homosexual Men ◽  
Significant Difference ◽  
Anal Cytology ◽  
Cytological Abnormality ◽  
Sensitivity Specificity ◽  
The Bethesda System

Background Anal cytology may form the basis of a future screening program to prevent anal carcinoma. Therefore, the accuracy of anal Papanicolaou tests in detecting histological HSIL needs to be evaluated. Methods: SPANC is a 3-year prospective study in homosexual men aged ≥35 years. At each of five visits, men undergo collection of a ThinPrep® anal cytological sample, high-resolution anoscopy (HRA) and biopsy of any abnormalities. Cytology is reported using the Bethesda system. Histology is reported using lower anogenital squamous terminology. Results: 351 men had a baseline visit by end July 2013. Median age was 49 (range: 35–79) years and 101 (28.8%) men were HIV positive. Anal cytology results were: unsatisfactory in 21 (6.0%), negative in 143 (40.7%), ASC-US in 51 (14.5%), LSIL in 22 (6.3%), ASC-H in 45 (12.8%) and HSIL in 69 (19.7%). 293 of 351 (83.5%) men had baseline histology. The most severe abnormality for each was: negative for SIL in 98 (33.4%), LSIL in 87 (29.7%) and HSIL in 108 (36.9%). Anal cytology sensitivity for histological HSIL (at ASC-US threshold) was 79.0%. Specificity was 53.8%. Positive predictive value (PPV) of any cytological abnormality for histological HSIL was 44.4% and PPV of HSIL cytoprediction was 63.8%. Negative predictive value (NPV) was 84.6%. Overall there was no significant difference between HIV positive and negative men with respect to sensitivity, specificity, PPV or NPV. Conclusions: These results indicate that histological HSIL is common in homosexual men. The finding of any cytological abnormality should prompt HRA. However, both cytology and HRA can miss or underestimate significant lesions in a single screening.

Diagnostic Performance of Nanoparticle-Enhanced Magnetic Resonance Imaging in the Diagnosis of Lymph Node Metastases in Patients With Endometrial and Cervical Cancer

2005 ◽  
Vol 23 (12) ◽  
pp. 2813-2821 ◽  
Author(s):  
Andrea G. Rockall ◽  
Syed A. Sohaib ◽  
Mukesh G. Harisinghani ◽  
Syed A. Babar ◽  
Naveena Singh ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Lymph Node ◽  
Magnetic Resonance ◽  
Lymph Node Metastases ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Resonance Imaging ◽  
Lymph Node Sampling ◽  
Node Metastases ◽  
Sensitivity Specificity

Purpose Lymph node metastases affect management and prognosis of patients with gynecologic malignancies. Preoperative nodal assessment with computed tomography or magnetic resonance imaging (MRI) is inaccurate. A new lymph node–specific contrast agent, ferumoxtran-10, composed of ultrasmall particles of iron oxide (USPIO), may enhance the detection of lymph node metastases independent of node size. Our aim was to compare the diagnostic performance of MRI with USPIO against standard size criteria. Methods Forty-four patients with endometrial (n = 15) or cervical (n = 29) cancer were included. MRI was performed before and after administration of USPIO. Two independent observers viewed the MR images before lymph node sampling. Lymph node metastases were predicted using size criteria and USPIO criteria. Lymph node sampling was performed in all patients. Results Lymph node sampling provided 768 pelvic or para-aortic nodes for pathology, of which 335 were correlated on MRI; 17 malignant nodes were found in 11 of 44 patients (25%). On a node-by-node basis, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) by size criteria were 29%*, 99%, 56%, and 96%, and by USPIO criteria (reader 1/reader 2) were 93%/82%* (*P = .008/.004), 97%/97%, 61%/59%, and 100%/99%, respectively (where [*] indicates the statistical difference of P = x/x between the two results marked by the asterisk). On a patient-by-patient basis, sensitivity, specificity, PPV, and NPV by size criteria were 27%*, 94%, 60%, and 79%, and by USPIO criteria (reader 1/reader 2) were 100%/91%* (*P = .031/.06), 94%/87%, 82%/71%, and 100%/96%, respectively. The κ statistic was 0.93. Conclusion Lymph node characterization with USPIO increases the sensitivity of MRI in the prediction of lymph node metastases, with no loss of specificity. This may greatly improve preoperative treatment planning.

Abstract 13551: Identifying Left Main Coronary Artery Disease Using Coronary Artery Calcium Scans

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Joel E Money ◽  
Joseph B Muhlestein ◽  
Steve M Mason ◽  
Tami L Bair ◽  
Kirk U Knowlton ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Data Sets ◽  
Left Main ◽  
Coronary Ct ◽  
Therapy Strategy ◽  
Significant Difference ◽  
Routine Medical Practice ◽  
Heavy Burden ◽  
Artery Disease

Introduction: The ISCHEMIA trial tested an invasive vs. an initial medical strategy in patients (pts) with stable coronary disease and evidence of ischemia. No significant difference between strategies in cardiovascular events was found at 3.2 years. However, pts were screened before randomization by coronary CT angiography (CCTA) to exclude ≥50% left main coronary stenosis (LMCS). CCTA adds complexity to routine medical practice, including time delays, expense, and safety concerns. We tested whether a coronary artery calcium scan (CACS), a simpler, less expensive test, could replace CCTA to exclude significant LMCS. Methods: We hypothesized that pts with ≥50% LMCS would have a LM CACS score>0. As a corollary, we postulated that a LM CACS=0 would exclude pts with LMCS. To test this, we searched Intermountain Healthcare’s electronic medical records database for all adult pts who had undergone non-contrast cardiac CT for quantitative CACS scoring prior to selective coronary angiography (SCA) and were found to have a LMCS ≥50%. Pts aged <50 and those with a heart transplant were excluded. Cases with incomplete (qualitative) angiographic reports for LMCS and those with incomplete or discrepant LM CACS results were reviewed and reassessed blinded to CACS or SCA findings, respectively. Results: Among 674 candidate pts with CACS followed by SCA, 24 qualifying pts were identified who had a quantitative CACS score and LMCS ≥50%. Their age averaged 71 ± 11 years, and 83% were men. Angiographic LMCS averaged 77% (range 50%-99%). A heavy burden of both total CAC and LM CAC was typically present. Total CACS score averaged 2,545 Agatston Units (AU), range 571-6,636. LM CACS score averaged 214 AU, range 47-610. Importantly, no LMCS pt had a LM CACS score of 0 vs. 57% (368/650) of non-LMCS controls (p<0.00001). Conclusions: Our results support the hypothesis that an easily administered, inexpensive, low radiation CACS can identify a large subset of pts with a very low risk of LMCS without the need for routine CCTA. Using CACS to exclude LMCS may efficiently allow for safe implementation of an initial medical therapy strategy in clinical practice for ISCHEMIA trial-like pts with at least moderate ischemia on stress testing. These promising results deserve validation in larger data sets.

scholarly journals Evaluation of GeneXpert MTB/RIF for detecting Mycobacterium tuberculosis in a hospital in China

2017 ◽  
Vol 45 (2) ◽  
pp. 816-822 ◽  
Author(s):  
Tingyu Tang ◽  
Fang Liu ◽  
Xiaoling Lu ◽  
Qingdong Huang
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Predictive Value ◽  
Rate Sensitivity ◽  
Turnaround Time ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
Kappa Value ◽  
Positive Rate ◽  
Sensitivity Specificity

Objective To evaluate the performance of GeneXpert MTB/RIF in diagnosing pulmonary tuberculosis (TB) in China. Methods This cross-sectional study included sputum specimens of 240 suspected TB cases. Specimens were examined by light microscopy for the presence of acid-fast bacilli, which were cultured by the BACTEC MGIT 960 (M960) system and detected by the GeneXpert MTB/RIF assay. The positive rate, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and average turnaround time of methods were evaluated. Results The positive rate was 36.6% (87/238) for the GeneXpert MTB/RIF assay and 34.0% (81/238) by M960 culture, with no significant difference between methods (χ2 = 0.33, p > 0.05). According to culture results, sensitivity of the GeneXpert MTB/RIF assay was 84.0% (68/81), specificity was 87.8% (129/147), the PPV was 78.2% (68/87), and the NPV was 87.2% (129/148). The agreement for results between Gene Xpert MTB/RIF and the M960 system was 82.8% and the Kappa value was 0.73. Conclusion The GeneXpert MTB/RIF assay is a simple, rapid, and accurate test for detecting Mycobacterium tuberculosis in sputum specimens.

scholarly journals Amide Proton Transfer-Weighted (APTw) Imaging of Intracranial Infection in Children: Initial Experience and Comparison with Gadolinium-Enhanced T1-Weighted Imaging

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Hong Zhang ◽  
Xiaolu Tang ◽  
Yanqiu Lv ◽  
Di Hu ◽  
Jihang Sun ◽  
...  
Keyword(s):  
Proton Transfer ◽  
Predictive Value ◽  
Amide Proton ◽  
High Signal ◽  
Noninvasive Technique ◽  
Intracranial Infection ◽  
Amide Proton Transfer ◽  
Significant Difference ◽  
Sensitivity Specificity ◽  
Age Range

Purpose. To evaluate the performance of amide proton transfer-weighted (APTw) imaging against the reference standard of gadolinium-enhanced T1-weighted imaging (Gd-T1w) in children with intracranial infection. Materials and Methods. Twenty-eight pediatric patients (15 males and 13 females; age range 1-163 months) with intracranial infection were recruited in this study. 2D APTw imaging and conventional MR sequences were conducted using a 3 T MRI scanner. Kappa (κ) statistics and the McNemar test were performed to determine whether the hyperintensity on APTw was related to the enhancement on Gd-T1w. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of APTw imaging to predict lesion enhancement were calculated. Result. In twelve patients with brain abscesses, the enhancing rim of the abscesses on the Gd-T1w images was consistently hyperintense on the APTw images. In eight patients with viral encephalitis, three showed slight spotted gadolinium enhancement, while the APTw image also showed a slight spotted high signal. Five of these patients showed no enhancement on Gd-T1w and isointensity on the APTw image. In eleven patients with meningitis, increased APTw signal intensities were clearly visible in gadolinium-enhancing meninges. Sixty infectious lesions (71%) showed enhancement on Gd-T1w images. The sensitivity and specificity of APTw were 93.3% (56/60) and 91.7% (22/24). APTw demonstrated excellent agreement (κ=0.83) with Gd-T1w, with no significant difference (P=0.69) in detection of infectious lesions. Conclusions. These initial data show that APTw MRI is a noninvasive technique for the detection and characterization of intracranial infectious lesions. APTw MRI enabled similar detection of infectious lesions to Gd-T1w and may provide an injection-free means of evaluation of intracranial infection.

scholarly journals Role of FIB-4 for reassessment of hepatic fibrosis burden in referral center

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yun Hwa Roh ◽  
Bo-Kyeong Kang ◽  
Dae Won Jun ◽  
Chul-min Lee ◽  
Mimi Kim
Keyword(s):  
Liver Disease ◽  
Hepatic Fibrosis ◽  
Predictive Value ◽  
Abdominal Ultrasound ◽  
Advanced Fibrosis ◽  
Referral Center ◽  
Significant Difference ◽  
Advanced Liver Fibrosis ◽  
Sensitivity Specificity

AbstractLow cut-off of FIB-4 is a widely used formula to exclude advanced liver fibrosis in primary care centers. However, the range of reported threshold of FIB-4 to rule in advanced fibrosis is too broad across etiologies, and no consensus has been reached. In the present study, we investigated the role of FIB-4 for a reassessment of hepatic fibrosis burden in a referral center. We compared the diagnostic performance of FIB-4 among patients with liver disease of various causes and tried to find an optimal cut-off value for predicting advanced fibrosis. Among 1068 patients, the AUROC of FIB-4 to diagnose advanced fibrosis showed no significant difference among the various etiologies of liver disease, ranging from 0.783 to 0.821. The optimal cut-off value obtained by maximizing Youden's index was 2.68, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for predicting advanced fibrosis were 70.7%, 79.1%, 43.5%, and 92.2%, respectively. The PPV was low in patients with autoimmune disease (6.67%). When we incorporated the new cut-off of FIB-4 into abdominal ultrasound findings, 81% of unnecessary work-ups would be appropriately avoided. In conclusion, the cut-off value of 2.68 showed an acceptable PPV while maintaining a high NPV to predict advanced fibrosis, most etiology except for autoimmune diseases. This result could assist in establishing an appropriate timing to reassess the hepatic fibrosis burden during monitoring in the referral center.

Sign in / Sign up

Export Citation Format

Share Document