scholarly journals A prospective comparative study of detection of colonic polyposis by magnetic resonance colonography versus conventional colonoscopy

2019 ◽  
Vol 6 (9) ◽  
pp. 3258
Author(s):  
Kada Venkata Ramana ◽  
Tripuraneni Rajesh Kumar

Background: Colorectal cancer mostly arises from adenomatous polyp and the transition time to convert into carcinoma is around ten years. As the progress to adenocarcinoma is a slow process so, early detection and endoscope resection is claimed to be effective in decreasing incidence and mortality by colorectal cancer. MR colonography is a non-invasive method for evaluating entire colon. It can detect precancerous lesion, cancer and staging. It is non-invasive tool for screening. Acceptability of the patient is better for MR colonography.Methods: Present study is a prospective comparative evaluation of magnetic resonance colonography verses colonoscopy conducted in the Department of Radiology, Konaseema Institute of Medical Science, and other establishments from August 2015 to January 2018. The sample size was calculated to be 112. Specificity, sensitivity and predictive value were calculated by medical statistical software.Results: For all size of tumours, sensitivity was 85.71%, specificity was 92.85%, positive predictive value was 92.30%, negative predictive value was 86.66% and accuracy was 94.34%. The positive predictive value was 90.00% negative predictive value was 92.68% and accuracy was 92.16%. For 1 mm to 4 mm size of polyp the sensitive was 28.57%, specificity was 92.31%, positive predictive value was 66.67%, negative predictive value was 70.59% and accuracy was 70%.Conclusions: In present study we have found that there was male predominance in patient and gastrointestinal bleeding was common clinical presentation. We have also observed that all size of poly MR colonography as having sensitivity and specificity around 90% but MR colonography is highly sensitive and specific for polyp size above 8mm but it is less sensitive for size below 4 mm. 

Author(s):  
Sondipon Biswas ◽  
Naman Kanodia ◽  
Rajat Tak ◽  
Siddharth Agrawal ◽  
Kiran Shankar Roy

<p class="abstract"><strong>Background:</strong> Shoulder pathologies can cause significant pain, discomfort, and affect the activity of daily living. The aim of this study was to compare the efficacy of clinical examination, ultrasound, magnetic resonance imaging (MRI) with shoulder arthroscopy in diagnosing various shoulder pathologies, considering shoulder arthroscopy as the gold standard tool.</p><p class="abstract"><strong>Methods:</strong> This was a prospective, comparative study conducted over 35 patients, between 18-75 years of age presenting with chronic shoulder pain or instability of more than 2 months duration. All patients were examined clinically, followed by high resolution ultrasound, MRI, arthroscopy of the affected shoulder.<strong></strong></p><p class="abstract"><strong>Results:</strong> The sensitivity and specificity of ultrasonography (USG) for diagnosing full thickness tear was 100% each and for MRI was 88% and 100% respectively. For subacromial impingement USG had sensitivity of 66.67%, specificity of 94.12%, positive predictive value of 50% and negative predictive value of 88.89%. For rotator cuff tear USG had sensitivity of 92.86%, specificity of 50%, positive predictive value of 81.25% and negative predictive value of 75% considering shoulder arthroscopy as gold standard.</p><p class="abstract"><strong>Conclusions:</strong> USG and MRI both are sensitive techniques for diagnosing of rotator cuff pathologies. USG has high accuracy in diagnosing partial thickness tears as compare to MRI. MRI proved to be superior in estimation of site and extent of tear. Considering shoulder arthroscopy as gold standard, it can be reserved for patients with suspicious of USG/MRI findings or those who may need surgical intervention simultaneously.</p>


2002 ◽  
Vol 30 (6) ◽  
pp. 806-809 ◽  
Author(s):  
William B. Stetson ◽  
Kevin Templin

Background Tears of the superior labrum of the shoulder, anterior to posterior, are difficult to diagnose clinically. Purpose We examined whether the crank or O'Brien tests were reliable tools for detecting glenoid labral tears. Study Design Nonrandomized prospective study. Methods Results of diagnostic shoulder arthroscopy were compared with those of the preoperative tests and magnetic resonance imaging for 65 patients who had symptoms of shoulder pain. Results The crank test result was positive in 29 patients (45%), and the O'Brien test was positive in 41 patients (63%). The crank test had a positive predictive value of 41%, was 56% specific, 46% sensitive, and had a negative predictive value of 61%. The O'Brien test had a positive predictive value of 34%, was 31% specific, 54% sensitive, and had a negative predictive value of 50%. Magnetic resonance imaging had a positive predictive value of 63%, was 92% specific, 42% sensitive, and had a negative predictive value of 83%. Conclusions The O'Brien and crank tests were not sensitive clinical indicators for detecting glenoid labral tears and other tears of the anterior and posterior labrum. Results were often falsely positive for patients with other shoulder conditions, including impingement or rotator cuff tears.


2020 ◽  
Vol 7 (1) ◽  
pp. e000355 ◽  
Author(s):  
Rohit Hariharan ◽  
Mark Jenkins

BackgroundCirculating tumour DNA from colorectal cancer (CRC) is a biomarker for early detection of the disease and therefore potentially useful for screening. One such biomarker is the methylated SEPT9 (mSEPT9) gene, which occurs during CRC tumourigenesis. This systematic review and meta-analysis aims to establish the sensitivity, specificity and accuracy of mSEPT9 tests for the early diagnosis of CRC.MethodsA systematic search of the relevant literature was conducted using Medline and Embase databases. Data were extracted from the eligible studies and analysed to estimate pooled sensitivity, specificity and diagnostic test accuracy.ResultsBased on 19 studies, the pooled estimates (and 95% CIs) for mSEPT9 to detect CRC were: sensitivity 69% (62–75); specificity 92% (89–95); positive likelihood ratio 9.1 (6.1–13.8); negative likelihood ratio 0.34 (0.27–0.42); diagnostic OR 27 (15–48) and area under the curve 0.89 (0.86–0.91). The test has a positive predictive value of 2.6% and negative predictive value of 99.9% in an average risk population (0.3% CRC prevalence), and 9.5% (positive predictive value) and 99.6% (negative predictive value) in a high-risk population (1.2% CRC prevalence).ConclusionThe mSEPT9 test has high specificity and moderate sensitivity for CRC and is therefore a potential alternative screening method for those declining faecal immunochemical test for occult blood (FIT) or other screening modalities. However, it is limited by its poor diagnostic performance for precancerous lesions (advanced adenomas and polyps) and its relatively high costs, and little is known about its acceptability to those declining to use the FIT.


2016 ◽  
Vol 27 (2) ◽  
pp. 20-22
Author(s):  
Md Naushad Ali ◽  
Rehana Parvin ◽  
Md Abul Kalam Azad ◽  
AKM Mazharul Islam

This cross sectional study was carried out in the department of gastroenterology, Rangpur Medical College Hospital, Rangpur from January 2014 to July 2014 to compare between Invasive & Non-Invasive Diagnostic Evaluation of Tuberculosis Peritonitis In our prospective in clinically suspected patients. Total 30 patients (age 39.69±21.26, 18M/12F) with clinical suspicion of peritoneal tuberculosis were included in this study after analyzing selection criteria. Laparoscopic peritoneal biopsy with 'histopathological' diagnosis was considered as gold standard against which accuracies non-invasive test of two biomarkers (ADA & CA-125) were compared. Cut off value of ADA and CA-125 is 24 U/l, 35 U/ml respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ADA as a diagnostic modality in peritoneal tuberculosis were 87.5%, 83.33%, 95.45%, 62.5% and 86.67% respectively whereas CA-125 was found to have 83.33% sensitivity, 50% specificity, 86.9% positive predictive value, 42.85% negative predictive value and 76.6% accuracy. Both biomarkers were simple, non-invasive, rapid and relatively cheap diagnostic test whereas laparoscopy was an invasive procedure, costly & requires trained staff and not without risk and also not feasible in the entire centre in our country. So ascitic fluid ADA and serum CA-125 was important non-invasive diagnostic test for peritoneal tuberculosis.Medicine Today 2015 Vol.27(2): 20-22


2021 ◽  
Vol 71 (1) ◽  
pp. 12-17
Author(s):  
Laima Alam ◽  
Farrukh Saeed

Objective: To assess the non-invasive biomarkers of fibrosis for predicting varices-needing-treatment in patients with cirrhosis secondary to chronic-hepatitis-C. Study Design: Cross sectional comparative study. Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital Rawalpindi, from Jan 2017 to Dec 2017. Methodology: A total of 153 patients aged 18-79 with cirrhosis, whether compensated or decompensated, secondary to chronic-hepatitis-C were enrolled. Relevant serum tests were used to calculate non-invasive fibrosis indices and their diagnostic performance to predict the presence of varices and varices-needing-treatment was calculated. Results: King’s score showed the best performance in detecting varices due to high positive predictive value of 96.4% and positive likelihood ratio of 2.4. Overall, all the non-invasive fibrosis indices exhibited good performance with positive predictive value >85% but none could rule out the presence of varices with adequate reliability due to low negative-predictive-value (<65%). King’s score exhibited relatively higher positive-predictivevalue (70%) and negative predictive value (51.1%) and the lowest negative-likelihood-ratio (0.6) for predicting varices needing treatment. Taken together, none of the non-invasive biomarkers of fibrosis could predict the presence of varices-needing-treatment with adequate accuracy due to low positive-predictive-value (<85%) andlow negative-predictive-value (<65%). Conclusion: The calculated non-invasive biomarkers of fibrosis and their optimum cutoff values showed modest accuracy for predicting varices and varices-needing-treatment. These indices may be used as first-line screening method for segregation of clinically significant portal hypertension and high risk esophageal varices-needingtreatment but may not be able to replace the gold standards like Fibroscan liver and Hepatic Venous Pressure Gradient measurements.


2020 ◽  
Vol 5 (3) ◽  
pp. 1196-1200
Author(s):  
Manish Raj Pathak ◽  
Mahesh Gautam ◽  
Rashmita Bhandari

Introduction: Breast carcinoma is the second leading cause of cancer related mortality in females around the world. Ultrasound plays a key role in differentiating cystic and solid lesions and is a convenient and non-invasive diagnostic tool to differentiate between benign and malignant lesions. Objectives: The aim of this study is to evaluate the diagnostic accuracy of ultrasound in palpable breast lesions. Methodology: A prospective cross-sectional study was carried out in patients with palpable breast lesions who presented in Department of radio diagnosis and imaging of Nobel Medical collegefor a period of one-year from February 2019- January 2020 using ultrasound. A total of 60 patientswereevaluated in the study. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated. Results: Out of 60 patients evaluated, ultrasound showed 46 (76.7%) cases to be benign and 14 (23.3%) cases to be malignant. FNAC revealed benign disease in 47 (78.3%) patients and malignant disease in 13 (21.7%) patients. The most common benign lesion was fibroadenoma. We found nearly 91.7% of the malignant lesions had spiculated margins and microcalcification. The sensitivity of ultrasound was 95.74% and specificity 92.3% with diagnostic accuracy 95%. Conclusion: Ultrasound is a convenient and non-invasive diagnostic tool with good sensitivity, specificity, positive predictive value, negative predictive value and accuracy in palpable breast lesions.


2018 ◽  
Vol 10 (2) ◽  
pp. 116-122
Author(s):  
Prasong Tanmahasamut ◽  
Ratthiporn Preukthanathorn ◽  
Chongdee Dangrat

Background: The role of interleukin 6 in endometriosis has been extensively studied but results were inconsistent. The purpose of this study was to determine the performance of serum interleukin 6 and serum cancer antigen 125 for non-invasive diagnosis of endometriosis. Methods: In this prospective diagnostic study, 100 reproductive women who underwent laparoscopy were studies. Patients were divided into endometriosis group (n = 60) and control group (n = 40). Blood samples were taken preoperatively for analysis of serum interleukin 6 and cancer antigen 125 levels. Results: Level of serum interleukin 6 and cancer antigen 125 in endometriosis group were significantly higher than those in control group (1.93 versus <1.50 pg/mL and 41.85 versus 11.86 IU/mL, respectively). A cutoff level of interleukin 6 at 1.52 pg/mL provided sensitivity of 63.3%, specificity of 55%, positive predictive value of 67.9%, and negative predictive value of 50%. The threshold level of cancer antigen 125 at 31 IU/mL had sensitivity of 70%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 69%. The combined test had sensitivity of 86.7%, specificity of 60%, positive predictive value of 76.5%, and negative predictive value of 75%. The area under receiver operating characteristic curve of serum interleukin 6, cancer antigen 125, and combined test were 0.614, 0.945, and 0.945, respectively. Conclusion: Serum interleukin 6 is not suitable to be a candidate of serum marker for the diagnosis of endometriosis. Serum cancer antigen 125 is better than interleukin 6 for detection of endometriosis stage III/IV. Both of them had low performance for diagnostic test in minimal to mild endometriosis. The combined test does not add more benefit than using cancer antigen 125 alone.


2018 ◽  
Vol 127 (12) ◽  
pp. 919-925 ◽  
Author(s):  
Roman D. Laske ◽  
Thomas N. Roth ◽  
Krisztina Baráth ◽  
Bernhard Schuknecht ◽  
Alexander M. Huber ◽  
...  

Introduction: The aim of this study was to analyze the sensitivity and specificity of non-echoplanar (non-EPI) diffusion-weighted (DW) magnetic resonance imaging (MRI) for the detection of cholesteatoma, with a focus on its value as an adjunct to clinical examination. Methods: In a prospective cohort study, 92 cases were divided into 2 groups: “clinically cholesteatoma” ( n = 79) and “clinically no cholesteatoma” ( n = 13). Non-EPI DW MRI was performed preoperatively in all cases. The presence of a cholesteatoma was assessed by clinicians otoscopically, by neuroradiologists on non-EPI DW MRI, by the surgeon intraoperatively, and finally by the pathologist postoperatively. Data analysis was performed for specificity, sensitivity, positive predictive value, negative predictive value, and interrater variability. Results: The sensitivity and specificity were 89.3% and 75%, respectively, in the “clinically cholesteatoma” group and 0% and 100% in the “clinically no cholesteatoma” group. Non-EPI DW MRI had a positive predictive value of 98.5% when cholesteatoma was suspected clinically and a negative predictive value of 84.6% when cholesteatoma was not suspected clinically. Conclusion: If cholesteatoma is suspected clinically, non-EPI DW MRI is not necessary. If there is no clinical suspicion of cholesteatoma in second-look situations, sensitivity is low and serial follow-up MRI with long intervals is advised.


2002 ◽  
Vol 91 (4) ◽  
pp. 322-327 ◽  
Author(s):  
M. P. Achiam ◽  
S. Bülow ◽  
J. Rosenberg

Background: Colorectal cancer is the second most frequent cancer and adenomas are widely accepted as precursors to colorectal cancer. Diagnosis and removal of adenomas are recommended to reduce cancer incidence and mortality. The current diagnostic methods include sigmoidoscopy and colonoscopy. Lately, CT- and MR colonography have emerged as non-invasive methods for colon imaging. Methods: At present, CTC and MRC require bowel preparation. However, preliminary studies have been carried out without colon preparation. After the colon has been filled with air or contrast, the patient is scanned in the supine and prone positions. Data are then downloaded to a workstation for post processing and image-analysis. Results: Results have shown a high sensitivity and specificity for polyps ≥ 10 mm, comparable to the sensitivity of conventional colonoscopy and superior to double contrast barium enema. Conclusions: With the exponential development in computer processing power, CT- and MR colonography holds the promise for future colon examination with the advantages of non-invasiveness, no need for sedation, and probably no bowel preparation. major disadvantage, however, is the radiation dose during CT colonography. Future developments with the use of “intelligent” computers, better resolution and faster examinations will make CT and/or MR colonography realistic options to replace conventional diagnostic colonoscopy.


2020 ◽  
Vol 5 (2) ◽  
pp. 167-171
Author(s):  
Rachmi Fauziah Rahayu ◽  
Luths Maharina ◽  
Yuyun Yueniwati

Background: Ultrasonography (USG) is still the first imaging modality for initial examination in patients with obstructive jaundice. Abdominal ultrasonography is quite good in seeing the morphology of the biliary tract, although the diagnostic etiological sensitivity of various causes of obstruction is very low. Magnetic resonance cholangio pancreatography (MRCP) is a new technique and can show the same picture as ERCP examination and no contrast media is needed. Aim: Aim for this study is knowing the results of ultrasound diagnostic tests in detecting Obstruction jaundice which was confirmed by the results of MRCP examination at Dr. Moewardi public hospital. Method: This study uses a diagnostic test that assesses sensitivity, big specifications, negative predictive value and positive predictive value of ultrasound in detecting jaundice obstruction confirmed by the results of the MRCP examination. Sampling was done by purposive sampling, on 68 research subjects. Results: This study show the characteristics of jaundice in the form of stones with sensitivity and specificity values ​​of 84% and 83%, positive predictive value 75% and negative predictive value 90% and in biliary tract tumors 83% and 84%, positive predictive value 75% and predictive value negative 90%. Conclusions: Ultrasound has a high sensitivity and specificity value in diagnosing obstructive jaundice in the case of biliary tract stones and biliary tract tumors


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