scholarly journals Diagnostic accuracy of ultrasonography with laparoscopy for assessment of benign adnexal masses

2019 ◽  
Vol 9 (1) ◽  
pp. 283
Author(s):  
Vinita Sarbhai ◽  
Medha Yadav
Keyword(s):  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Ovarian Cyst ◽  
Imaging Modality ◽  
Age Groups ◽  
Serous Cystadenoma ◽  
Histopathological Diagnosis ◽  
Adnexal Masses ◽  
Adnexal Pathology ◽  
Rule Out

Background: Adnexal masses are one of the most common pathologies among women of all age groups. Objective of this study was to assess efficacy of ultrasonography in diagnosing adnexal pathology, rule out malignancy and its comparison with laparoscopy and pathology results.Methods: A total 32 women with benign adnexal mass were evaluated by clinical examination, ultrasonography and laparoscopy. Findings of ultrasound were compared with laparoscopy and histopathology reports and diagnostic accuracy was calculated.Results: Sensitivity of USG in diagnosing simple ovarian cyst is 20% and specificity is 88.9% while laparoscopy has sensitivity of 100% and specificity of 94.4%. USG versus laparoscopy has sensitivity of 50% versus 100% and specificity of 94.1% versus 100% in diagnosing endometrioma. Sensitivity of USG in diagnosing dermoid cyst is 66.7% and specificity is 95% while laparoscopy has both sensitivity and specificity of 100%. USG and laparoscopy, both have 100% sensitivity and specificity in diagnosing ectopic pregnancy, para-ovarian cyst and TO abscess. Benign serous cystadenoma is a histopathological diagnosis and is missed by both laparoscopy and ultrasonography.Conclusions: Ultrasonography should be the primary imaging modality used to identify and characterize adnexal masses, as it is readily available, and noninvasive.

scholarly journals Study of correlation of ultrasonography with surgical evaluation of adnexal masses: a prospective study

2018 ◽  
Vol 7 (10) ◽  
pp. 4218
Author(s):  
Urmila Tripathi ◽  
Geetanjali Munda
Keyword(s):  
Prospective Study ◽  
Clinical Symptoms ◽  
Histopathological Examination ◽  
Abdominal Mass ◽  
Age Groups ◽  
Serous Cystadenoma ◽  
Ovarian Tumors ◽  
Adnexal Masses ◽  
Malignant Changes ◽  
A Prospective Study

Background: Adnexal masses are one of the most common pathologies among women of all age groups. Ovarian tumors, alone, represent two thirds of these cases. Malignant ovarian tumors are the fourth most common cause of death in women. Accurate diagnosis is required foremost for proper treatment and management of the patients.Methods: A prospective study done on 100 patients with adnexal masses presenting to Department of Obstetrics and Gynecology at Kamla Raja Hospital, G.R.M.C, Gwalior from February 2015 to August 2016. Firstly, the cases were studied by ultrasonography then intraoperatively and simultaneous sampling for HPE done. The study included women with clinical symptoms of pain abdomen/ discomfort, bleeding per vaginum, abdominal mass was subjected to ultrasonography, diagnosed with adnexal mass. 100 indicated patients were taken for surgery and intraoperative tissue and fluid samples were taken and sent for HPE.Results: No discordance found regarding laterality of adnexal masses between ultrasonographical findings and surgical findings. 69% cases were devoid of any septation/locules/nodules. Most common pathology found to be ectopic pregnancy. Most common benign ovarian mass encountered was serous cystadenoma (31.1%) and malignant mass was serous adenocarcinoma (12.7%). Apart from 13 malignant adnexal masses, 2 adnexal masses had malignant changes found on histopathological examination. 11 cases were found to be of advanced stage on surgical findings, which then confirmed by HPE.Conclusions: There is positive correlation between ultrasonographical and surgerical evaluation of adnexal masses. Correlation of the lesion’s location and appearance at imaging with the surgical findings will aid in the detection of potential pathology reporting errors.

scholarly journals Diagnostic accuracy of fine needle aspiration cytology in thyroid swellings with histopathological correlation

2018 ◽  
Vol 5 (4) ◽  
pp. 1511
Author(s):  
Mahadeo R. Patil ◽  
Sandhyarani M. Patil
Keyword(s):  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
High Specificity ◽  
Needle Aspiration ◽  
Histopathological Correlation ◽  
Malignant Lesions ◽  
Needle Aspiration Cytology ◽  
Very High ◽  
Benign Thyroid ◽  
Rule Out

Background: Thyroid swellings are common in India. It is important to differentiate malignant from benign thyroid swellings for definitive planning of appropriate surgery. This study is undertaken to study sensitivity and specificity of FNAC in diagnosis of thyroid swellings by comparing preoperative FNAC with postoperative histopathology.Methods: A total of 156 patients with thyroid swellings were evaluated for a period of three years. Pre-operatively FNAC was done and was compared with post-operative histopathology and sensitivity and specificity of FNAC was studied.Results: Thyroid swellings are more common in females. In present study of 156 thyroid swellings, 90.38% cytologies were benign while 7.05% were malignant and 2.56% were suspicious for malignancy. Sensitivity of FNAC for malignant lesions was 93.75% and specificity was 100%.Conclusions: FNAC with its very high specificity, and diagnostic accuracy approaching 100% can help to rule out malignancy in most of thyroid swellings and prevent unnecessary surgeries.

scholarly journals Role of cancer antigen-125 in diagnosing malignant adnexal masses: a prospective observational study

2020 ◽  
Vol 9 (10) ◽  
pp. 4074
Author(s):  
Shazia Ashraf Khan ◽  
Shaista Rahi ◽  
Nahida Khan
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Tertiary Care ◽  
Age Groups ◽  
Ca 125 ◽  
Histopathological Diagnosis ◽  
Cancer Antigen 125 ◽  
Cancer Antigen ◽  
Adnexal Masses

Background: Adnexal masses present a diagnostic and therapeutic dilemma across age-groups. This study aimed to evaluate the performance of cancer antigen-125 (CA-125) in distinguishing between benign and malignant adnexal masses.Methods: This was a prospective, observational, single tertiary-care center study, done in North India from January, 2011 till December, 2012. Serum CA-125 levels was obtained preoperatively in consecutive patients presenting with ultrasonography confirmed adnexal masses. The cut-off value between benign and malignant was taken as 35 IU/ml. Histopathological diagnosis was obtained in all patients.Results: A total of 126 patients presented with adnexal masses, of which 100 were enrolled (mean age: 37.5±14.4 years, range: 18-80 years). Most of the masses were benign 81% (malignant=19%). Dermoid cyst (25.9%) and endometriomas (21%) were the most common benign masses. Serous (21%) and mucinous cystadeno-carcinoma (15.8%) were the most common malignant masses, more often seen in elderly, married, parous and post-menopausal patients. Mean CA-125 levels were significantly higher in malignant masses (257.30 [105.68-408.92] versus 19.26 [16.53-22.00], p<0.001). Overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CA-125 for diagnosing malignant adnexal mass was 94.7%, 87.65%, 64.28%, 98.6%, and 88.91% respectively. The same was 100%, 85.1%, 54.5%, 100%, 87.3% in premenopausal and 85.7%, 100%, 100%, 93.3%, 95.2% in postmenopausal women respectively.Conclusion: Benign masses form the bulk of the adnexal masses in all age groups. CA-125 levels has high sensitivity and negative predictive value in premenopausal patients while as high specificity and positive predictive value in postmenopausal patients.

scholarly journals Correlation between ultrasonographic, hysteroscopic and histopathological findings in patients with abnormal uterine bleeding

2018 ◽  
Vol 7 (8) ◽  
pp. 3250
Author(s):  
Binti R. Bhatiyani ◽  
Shrikant Dhumale ◽  
Pandeeswari . ◽  
Dolly Bashani
Keyword(s):  
Endometrial Thickness ◽  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Reproductive Age ◽  
Heavy Menstrual Bleeding ◽  
Menstrual Bleeding ◽  
Complete Evaluation ◽  
Medical Visits ◽  
Adnexal Pathology ◽  
Rule Out

Background: Menstrual disorders are common indication for medical visits among women of reproductive age and heavy menstrual bleeding affects up to 30% of women throughout their reproductive lifetime. This study aims at evaluating the different causes and, the clinical presentation of AUB and to compare the role of hysteroscopy, ultrasonography and histopathology in patients with AUB.Methods: 100 women above 45 years of age, presenting with abnormal bleeding per vaginum were evaluated. All patients underwent transvaginal scan to note down the endometrial thickness and to rule out uterine and adnexal pathology. All the patients underwent diagnostic hysteroscopy, followed by a biopsy of the endometrium using a curette. The endometrium was sent to the pathologist. Findings of these diagnostic modalities then correlated.Results: Incidence of AUB was present between the age groups of 45-49 years of age (66%). The commonest presenting complaint in this series was menorrhagia or heavy menstrual bleeding (60%). The finding of thickened endometrium as the most common abnormality on USG (44%) and also on hysteroscopy (45%). As per present study the sensitivity of hysteroscopy is 97.78% and specificity was 34.55%, the negative predictive value of the test is 95%.Conclusions: TVS may be the first line of investigation while evaluating the endometrium in a perimenopausal AUB. It helps to triage the patients into high risk or low risk. Endometrial thickness >4mm as per the present study needs further evaluation. Patients with endometrial thickness less than 4 mm can be reassured. Hysteroscopy is the gold standard in the diagnosis of focal pathology like sub mucous fibroid, polyps or anomalies. Histopathology probably is an indispensable tool specially to rule out premalignant and malignant conditions. Thus, all the modalities instead of being competitive to one another, are complimentary to each other. For complete evaluation of patient with AUB all the three modalities should be used together to come at exact diagnosis.

scholarly journals Estimating the Risk of Malignancy in Adnexal Masses: Validation of the ADNEX Model in the Hands of Non-expert Ultrasonographers in a Gynecological Oncology Center in China

2021 ◽  
Author(s):  
Ping He ◽  
Jingjing Wang ◽  
Wei Duan ◽  
Chao Song ◽  
Yu Yang ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Ovarian Tumor ◽  
Ovarian Metastasis ◽  
Stage I ◽  
Ca 125 ◽  
Histopathological Diagnosis ◽  
Adnexal Masses ◽  
Gynecological Oncology ◽  
Benign Ovarian Tumor ◽  
Oncology Center

Abstract Background: The diagnosis of adnexal masses depends more on ultrasonography. This study aim to validate the diagnostic accuracy of the International Ovarian Tumor Analysis (IOTA) ADNEX model in the preoperative diagnosis of adnexal masses in the hands of non-expert ultrasonographers in a gynecological oncology center in China. Methods: This was a single oncology center, retrospective diagnostic accuracy study from 620 patients. All patients underwent surgery and the histopathological diagnosis was used as reference standard. The masses were divided into five types according to the ADNEX model: benign ovarian tumor, borderline ovarian tumor (BOT), Stage-I ovarian cancer (OC), Stages-II-IV OC and ovarian metastasis. Receiver-operating characteristics (ROC) curve analysis was used to evaluate the ability of the ADNEX model to classify tumors into different histological types with and without Cancer antigen 125 (CA 125) results. Results: Of the 620 women, 402 (64.8%) had a benign ovarian tumor and, 218 (35.2%) had a malignant ovarian tumor, including 86 (13.9%) with BOT, 75 (12.1%) with Stage-I OC, 53 (8.5%) with Stages-II-IV OC and 4 (0.6%) with ovarian metastasis. The AUC of the model to differentiate between benign and malignant adnexal masses was 0.97 (95% CI, 0.96–0.98). Performance was excellent for the discrimination between benign vs Stage II-IV OC, benign vs ovarian metastasis with AUCs of 0.99 (95% CI, 0.99-1.00) and 0.99 (95% CI, 0.98-1.00), respectively. Performance of the model was less effective at distinguishing between BOT and Stage I OC and between BOT and ovarian metastasis, with AUC of 0.54 (95% CI, 0.45–0.64) and 0.66 (95% CI, 0.56–0.77), respectively. When including CA125 in the model, performance in discriminating between Stages II–IV OC with stage I OC and ovarian metastasis were improved (AUC increased from 0.88 to 0.94, P = 0.01; 0.86 to 0.97, p = 0.01, respectively). Conclusions: The IOTA ADNEX model has excellent performance in differentiating benign and malignant adnexal masses in the hands of non-expert ultrasonographers with limited experienced in China. Between classification different subtypes of ovarian cancers, the model has difficulty to differentiate BOT from stage I OC, BOT from ovarian metastases.

scholarly journals Impact of diagnostic accuracy on the estimation of excess mortality from incidence and prevalence: simulation study and application to diabetes in German men

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 49
Author(s):  
Ralph Brinks ◽  
Thaddäus Tönnies ◽  
Annika Hoyer
Keyword(s):  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Simulation Study ◽  
Chronic Conditions ◽  
Excess Mortality ◽  
Claims Data ◽  
Age Groups ◽  
Aggregated Data ◽  
Incidence Data ◽  
Younger Age

Aggregated data about the prevalence and incidence of chronic conditions is becoming more and more available. We recently proposed a method to estimate the age-specific excess mortality in chronic conditions from aggregated age-specific prevalence and incidence data. Previous works showed that in age groups below 50 years, estimates from this method were unstable or implausible. In this article, we examine how limited diagnostic accuracy in terms of sensitivity and specificity affects the estimates. We use a simulation study with two settings, a low and a high prevalence setting, and assess the relative importance of sensitivity and specificity. It turns out that in both settings, specificity, especially in the younger age groups, dominates the quality of the estimated excess mortality. The findings are applied to aggregated claims data comprising the diagnoses of diabetes from about 35 million men in the German Statutory Health Insurance. Key finding is that specificity in the lower age groups (<50 years) can be derived without knowing the sensitivity. The false-positive ratio in the claims data increases linearly from 0.5 per mil at age 25 to 2 per mil at age 50. As a conclusion, our findings stress the importance of considering diagnostic accuracy when estimating excess mortality from aggregated data using the method to estimate excess mortality. Especially the specificity in the younger age-groups should be carefully taken into account.

scholarly journals Can Dermoscopy Be Used to Predict if a Melanoma Is In Situ or Invasive?

2021 ◽  
pp. 2021079
Author(s):  
Sam Polesie ◽  
Edvin Jergéus ◽  
Martin Gillstedt ◽  
Hannah Ceder ◽  
Johan Dahlén Gyllencreutz ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Histopathological Diagnosis ◽  
Single Center ◽  
Accuracy Rate ◽  
Initial Management ◽  
Preoperative Prediction ◽  
Accuracy Rates

Background: The preoperative prediction of whether melanomas are invasive or in situ can influence initial management. Objectives: This study evaluated the accuracy rate, interobserver concordance, sensitivity and specificity in determining if a melanoma is invasive or in situ, as well as the ability to predict invasive melanoma thickness based on clinical and dermoscopic images. Methods: In this retrospective, single-center investigation, 7 dermatologists independently reviewed clinical and dermoscopic images of melanomas to predict if they were invasive or in situ and, if invasive, their Breslow thickness. Fleiss’ and Cohen’s kappa (κ) were used for interobserver concordance and agreement with histopathological diagnosis. Results: We included 184 melanomas (110 invasive and 74 in situ). Diagnostic accuracy ranged from 67.4% to 76.1%. Accuracy rates for in situ and invasive melanomas were 57.5% (95% confidence interval [CI], 53.1%-61.8%) and 81.7% (95% CI, 78.8%-84.4%), respectively. Interobserver concordance was moderate (κ = 0.47; 95% CI, 0.44-0.51). Sensitivity for predicting invasiveness ranged from 63.6% to 91.8% for 7 observers, while specificity was 32.4%-82.4%. For all correctly predicted invasive melanomas, agreement between predictions and correct thickness over or under 1.0 mm was moderate (κ = 0.52; 95% CI, 0.45-0.58). All invasive melanomas incorrectly predicted by any observer as in situ had a thickness <1.0 mm. All 32 melanomas >1.0 mm were correctly predicted to be invasive by all observers. Conclusions: Accuracy rates for predicting thick melanomas were excellent, melanomas inaccurately predicted as in situ were all thin, and interobserver concordance for predicting in situ or invasive melanomas was moderate. Preoperative dermoscopy of suspected melanomas is recommended for choosing appropriate surgical margins.    

scholarly journals TFCC Injuries: Meta-Analysis and Comparison of Diagnostic Imaging Modalities

2018 ◽  
Vol 07 (03) ◽  
pp. 267-272 ◽  
Author(s):  
Matthew Treiser ◽  
Kayva Crawford ◽  
Matthew Iorio
Keyword(s):  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Imaging Modality ◽  
Meta Analysis ◽  
Imaging Modalities ◽  
Computed Tomographic ◽  
Pooled Data ◽  
Multiple Imaging ◽  
Magnetic Resonance Imaging Mri

Background Imaging of the triangular fibrocartilaginous complex (TFCC) remains difficult, as no single imaging modality demonstrates perfect sensitivity and specificity. Purpose This study performs a meta-analysis of multiple previous publications to guide noninvasive imaging selection for the diagnosis of TFCC injuries. Methods A literature search was performed and conducted. Studies were included that compared the diagnostic accuracy of magnetic resonance imaging (MRI), magnetic resonance arthrography (MRA), and computed tomography (CT)/computed tomographic arthrography (CTA) for the evaluation of TFCC injuries. All studies included either arthroscopic or open surgical findings as the “gold standard.” A meta-analysis was performed comparing the diagnostic accuracy of MRA, MRI, and CT for the detection of TFCC injuries. Results Initial search returned 2,568 candidate articles. Studies were then reviewed and narrowed yielding a total of 28 independent studies (20 MRI, 9 MRA, 4 CT/CTA with some studies including multiple modalities) considered in the qualitative data synthesis. Pooling of the raw data in a meta-analysis demonstrated sensitivities of 0.76 (0.72–0.80), 0.78(0.70–0.84), and 0.89 (0.81–0.95) for MRI, MRA, and CT arthrogram, respectively, with specificities of 0.82 (0.77–0.86), 0.85 (0.77–0.92), and 0.89 (0.81–0.95), respectively. Additionally, across all imaging modalities, diagnostic accuracy was highest for central TFCC lesions versus peripheral lesions. Conclusion This study represents the largest meta-analysis to date to compare multiple imaging modalities for the diagnosis of TFCC injuries. Pooled data demonstrated that CTA and MRA had statistically equivalent sensitivity and specificity for the diagnosis of TFCC injuries. Diagnostic accuracy was highest for central TFCC injuries.

scholarly journals Diagnostic accuracy of combined cardiac troponin and copeptin assessment for early rule-out of myocardial infarction: a systematic review and meta-analysis

2013 ◽  
Vol 3 (1) ◽  
pp. 18-27 ◽  
Author(s):  
Tatiana Raskovalova ◽  
Raphael Twerenbold ◽  
Paul O Collinson ◽  
Till Keller ◽  
Hélène Bouvaist ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Cardiac Troponin ◽  
Meta Analysis ◽  
Myocardial Necrosis ◽  
High Sensitivity ◽  
St Segment Elevation ◽  
Rule Out

Aims: This systematic review aimed to investigate the diagnostic accuracy of combined cardiac troponin (cTn) and copeptin assessment in comparison to cTn alone for early rule-out of acute myocardial infarction (AMI). Methods: Primary studies were eligible if they evaluated diagnostic accuracy for cTn with and without copeptin in patients with symptoms suggestive of AMI. AMI was defined according to the universal definition, using detection of cTn as a marker for myocardial necrosis. Eligible studies were identified by searching electronic databases (Medline, EMBASE, Science Citation Index Expanded, CINAHL, Pascal, and Cochrane) from inception to March 2013, reviewing conference proceedings and contacting field experts and the copeptin manufacturer. Results: In 15 studies totalling 8740 patients (prevalence of AMI 16%), adding copeptin improved the sensitivity of cTn assays (from 0.87 to 0.96, p=0.003) at the expense of lower specificity (from 0.84 to 0.56, p<0.001). In 12 studies providing data for 6988 patients without ST-segment elevation, the summary sensitivity and specificity estimates were 0.95 (95% CI 0.89 to 0.98) and 0.57 (95% CI 0.49 to 0.65) for the combined assessment of cTn and copeptin. When a high-sensitivity cTnT assay was used in combination with copeptin, the summary sensitivity and specificity estimates were 0.98 (95% CI 0.96 to 1.00) and 0.50 (95% CI 0.42 to 0.58). Conclusion: Despite substantial between-study heterogeneity, this meta-analysis demonstrates that copeptin significantly improves baseline cTn sensitivity. Management studies are needed to establish the effectiveness and safety of measuring copeptin in combination with high-sensitivity cTnT for early rule-out of AMI without serial testing.

scholarly journals Diagnostic accuracy of ultrasound and magnetic resonance imaging in detecting Stener lesions of the thumb: systematic review and meta-analysis

2021 ◽  
pp. 175319342199301
Author(s):  
Zahi Qamhawi ◽  
Karishma Shah ◽  
Gareth Kiernan ◽  
Dominic Furniss ◽  
James Teh ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Imaging Modality ◽  
Meta Analysis ◽  
Ulnar Collateral Ligament ◽  
Risk Of Bias ◽  
Joint Stability ◽  
Resonance Imaging

This study assesses the diagnostic accuracy of ultrasound and magnetic resonance imaging (MRI) in diagnosing Stener lesions of the thumb. MEDLINE, PubMed, Embase and Cochrane CENTRAL were searched for studies using ultrasound or MRI to detect Stener lesions following suspected thumb ulnar collateral ligament injuries. The reference standard was surgical exploration or clinical joint stability. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. A random-effects bivariate meta-analysis was used to estimate pooled sensitivity and specificity. Forest plots were generated. Nine ultrasound (315 thumbs) and six MRI (107 thumbs) studies were included in meta-analysis (all high risk of bias). Pooled sensitivity and specificity for ultrasound were 95% and 94%, and for MRI were 93% and 98%. Both ultrasound and MRI demonstrate high diagnostic accuracy in detecting Stener lesions. Ultrasound is an appropriate first-line imaging modality.

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