Difference in the performance of diagnosing colorectal liver metastasis between computed tomography and carcinoembryonic antigen

Abstract Background: The study was performed to compare the diagnostic roles of computed tomography (CT) and carcinoembryonic antigen (CEA) in colorectal liver metastasis (CRLM).Methods: 255 patients with colorectal cancer (CRC) were enrolled. These patients were confirmed as CRLM by histopathological assay. CT scans of the liver were performed with a 64-slice CT system. Serum CEA levels were determined using a human circulating cancer biomarker magnetic bead panel. True positive (TP), false positive (FP), true negative (TN) and false negative (FN) were calculated for CT and CEA with histopathological assay as golden standard.Results: 142 CRLM patients and 113 non-CRLM patients were confirmed in the study. There were no obvious differences in age, sex and Dukes stage between CRLM and non-CRLM patients (P＞0.05). Diagnostic roles of CT and CEA on per-patient and per-lesion were analyzed. Detection sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of CT on per-patient basis were 74.7%, 56.4%, 52.1%, and 77.9%, respectively. Sensitivity, specificity, PPV and NPV of CEA were 64.4%, 51.4%, 49.3%, and 67.3%. In the analysis on per-lesion basis, detection sensitivity, specificity, PPV, and NPV of CT were increased to 87.8%, 88.8%, 91.5%, and 84.1%, respectively. Detection sensitivity, specificity, PPV and NPV of CEA on per-lesion basis were 82.6%, 64.4%, 63.4%, and 83.2%.Conclusion: CT exhibited better performances than CEA in diagnosis of CRLM on both of per-patient and per-lesion basis.

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Screening of Extended-Spectrum β-Lactamases (ESBL)-producing Klebsiella pneumoniae with ChromID ESBL Media

The Indonesian Biomedical Journal ◽

10.18585/inabj.v10i3.430 ◽

2018 ◽

Vol 10 (3) ◽

pp. 217-21

Author(s):

Emy Noerwidayati ◽

Andaru Dahesihdewi ◽

Osman Sianipar

Keyword(s):

Likelihood Ratio ◽

Predictive Value ◽

Clinical Laboratory ◽

False Negative ◽

Clinical Isolates ◽

True Negative ◽

Nasal Sinus ◽

Negative Results ◽

Extended Spectrum ◽

Sensitivity Specificity

BACKGROUND: Klepsiella pneumoniae, one of clinical isolates, is frequently found causative agent of hospital acquired infection. Currently, K. pneumoniae is found as extended-Spectrum β-lactamases (ESBL) producer, allowing it to become multidrugresistant. A clinical laboratory with limited facility needs a valid, reliable, inexpensive and simple laboratory test to control its infection and antimicrobial-resistancy. The aim of this study is to evaluate the diagnostic performance of a ESBL media to detect ESBL-producing K. pneumoniae.METHODS: An independent and blind comparative study of ChromID ESBL media and Double Disc Synergy Test (DDST) was conducted for detecting the clinical isolate of ESBL-producing K. pneumoniae. Clinical isolates of K. pneumoniae collected from the Clinical Laboratory of Dr. Sardjito Hospital were isolated.RESULTS: There were 103 clinical isolates of K. pneumoniae, which were isolated from urine, pus, blood, stool, cerebrospinal fluid, sputum, drain liquid, nasal sinus liquid, gastric wash, bronchi liquid, injury liquid and nasal swab. The number of true positive, true negative, false positive and false negative results were 74, 18, 9 and 2, respectively. Meanwhile, the sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio for positive result and likelihood ratio for negative result of the new ESBL media were 97.4%, 66.7%, 89.2%, 90%, 2.9 and 0.03, respectively.CONCLUSION: Since the new ESBL media and DDST results were similar, so the new ESBL media could be used for screening patients with clinical presentation that indicating a high suspicious of ESBL-producing bacteria.KEYWORDS: K. pneumoniae, ChromID ESBL, DDST, ESBL, sensitivity

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DIAGNOSIS OF SUBDURAL HAEMATOMA AND EPIDURAL HAEMATOMA BY COMPUTED TOMOGRAPHY IN PATIENTS WITH ROAD TRAFFIC ACCIDENTS

American Journal of Health, Medicine and Nursing Practice ◽

10.47672/ajhmn.535 ◽

2020 ◽

Vol 5 (2) ◽

pp. 1-12

Author(s):

Nadir Hussain ◽

Shafia Khan ◽

Rabia Rabia ◽

Kanwal Saleem ◽

Sana Aslam ◽

...

Keyword(s):

Computed Tomography ◽

Predictive Value ◽

Traffic Accidents ◽

Road Traffic ◽

Head Injuries ◽

False Negative ◽

Epidural Haematoma ◽

Female Gender ◽

True Negative ◽

Cross Sectional

Methodology: It was a cross sectional Analytical study conducted at Department of Radiology AL RAZI HOSPITAL MM ALAM LAHORE. From 1st July 2019 to 31st December 2019.The 172 subjects were selected of history and clinical examination and suspicion of head injuries requiring head CT scan evaluation. Subjects included both male and female gender age over 10 years and less than 70 years were selected. Contraindication to CT imaging and pregnant females were excluded. Patients were examined using 64 Slices dual source SIMENS CT machine. All the information of patient were noted on a specifically designed for this purpose.Results: Mean age of patient was 36.87± 13.02 years. Most frequent age group was 15-30 years having 75(42.8%) subjects. There were 125(71.4%) male and 50(28.5%) females in the study respectively. There were 126 true positive, 12 false positive, 11 false negative and 17 true negative cases. This study revealed computed tomography sensitivity (72%) specificity (94%) diagnostic accuracy is (97.1%), Positive predictive value is (97.98%) and negative predictive value is (71.69%).Conclusions: It was concluded that Computed tomography is a useful diagnostic tool after clinical evaluation in patients imaging for the diagnosis of subdural and epidural hematomas in patients of road traffic accident.

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273. Low Positive Predictive Value of β-d-Glucan in Hematology Patients Receiving Antimold Prophylaxis

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.348 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S150-S151

Author(s):

Eui Jin Chang ◽

Kang Il Jun ◽

Song Mi Moon ◽

Wan Beom Park ◽

Ji Hwan Bang ◽

...

Keyword(s):

Positive Predictive Value ◽

Predictive Value ◽

False Negative ◽

Diagnostic Value ◽

Tertiary Hospital ◽

Diagnostic Purpose ◽

True Negative ◽

Graft Vs Host Disease ◽

Sensitivity Specificity ◽

Low Prevalence

Abstract Background Detection of β-D-glucan (BDG) in serum is recognized as the mycological evidence in the diagnosis of invasive fungal infection (IFI). However, its diagnostic value in low prevalence of IFI has not been elucidated. We aimed to examine the performance of BDG in hematology patients receiving antimold prophylaxis. Methods We retrospectively reviewed all BDG results performed for the purpose of diagnosis or surveillance for IFI in hematology patients receiving posaconazole or micafungin prophylaxis from January 2017 to February 2019 in a tertiary hospital. At least two consecutive positive results of BDG were regarded as positive BDG. All the episodes were classified into true-positive (TP, positive BDG with probable/proven IFI), true-negative (TN, negative BDG without probable/proven IFI), false-positive (FP, positive BDG without probable/proven IFI), false-negative (FN, negative BDG with probable/proven IFI), and nonevaluable (could not be determined for the occurrence of breakthrough IFI). When BDG test was performed in the setting of persistent fever ≥72 hours in spite of broad-spectrum antibiotics or with a suspicion of IFI, it was defined as a diagnostic BDG episode, while others were defined as a surveillance BDG episode. Results Of a total of 140 episodes, 24 episodes were non-evaluable. Among 116 evaluable episodes, 75 received induction chemotherapy for acute leukemia or myelodysplastic syndrome, 35 underwent stem cell transplantation, and 10 had intensive treatment for graft-vs.-host disease. There were three episodes of probable/proven IFI (2.6%). Ninety-one (78.4%) were performed with diagnostic purpose, while 25 (21.6%) were performed for surveillance. TP, TN, FP, and FN were 2 (1.7%), 91, 22, and 1, respectively. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value were 66.7%, 80.5%, 8.3% and 98.9%, respectively. PPV was 13.3% and 0% in diagnostic and surveillance BDG episodes, respectively. Conclusion The PPV of BDG was low in hematology patients receiving antimold prophylaxis, even in the diagnostic-driven episodes. The routine screening of BDG is not helpful, and the BDG test may be used for exclusion of IFI rather than for diagnosis in these patients. Disclosures All authors: No reported disclosures.

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Comparison of diagnostic accuracy of papanicoloau (PAP) Smear and visual inspection using acetic acid (VIA) in screening of cervical carcinoma, taking biopsy as gold standard.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.04.34 ◽

2020 ◽

Vol 27 (04) ◽

pp. 863-869

Author(s):

Shakila Yasmin ◽

Tahira Munir ◽

Ayesha Javaid ◽

Khalid Fahim Yasin ◽

Junaid Hassan

Keyword(s):

Acetic Acid ◽

Diagnostic Accuracy ◽

Cervical Carcinoma ◽

Predictive Value ◽

Visual Inspection ◽

Pap Smear ◽

False Negative ◽

True Positive ◽

True Negative ◽

Sensitivity Specificity

Study Design: Cross-sectional descriptive study. Setting: Department of Obstetrics & Gynecology, Bahawal Victoria Hospital, Bahawalpur. Period: 05 August 2016 to 05 Feb 2017. Material & Methods: A total of 228 suspected patients of cervical carcinoma and age of 20-50 years were included. Patients with acute cervicitis, pregnant females, h/o abnormal cytology and obvious lesion on cervix were excluded. All the patients were underwent papanicoloau (PAP) smear and visual inspection using acetic acid. The results of papanicoloau (PAP) smear and visual inspection using acetic acid (VIA) were compared with cervical biopsy report. Results: In 110 papanicoloau (PAP) smear positive patients, 97 were True Positive and 13 were False Positive. Among, 118 papanicoloau (PAP) smear negative patients, 18 were False Negative whereas 100 were True Negative. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of papanicoloau ( PAP )smear in screening of cervical carcinoma was 84.35%, 88.50%, 88.18%, 84.75% and 86.40% respectively. In 114 visual inspection using acetic acid (VIA) positive patients, 95 were True Positive and 19 were False Positive. Among, 114 visual inspection using acetic acid (VIA) negative patients, 20 were False Negative whereas 94 were True Negative. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of visual inspection using acetic acid ( VIA) in screening of cervical carcinoma was 82.61%, 83.19%, 83.33% 82.46% and 82.89% respectively. Conclusion: This study concluded that papanicoloau ( PAP) smear and visual inspection using acetic acid (VIA) in screening of cervical carcinoma are highly sensitive, accurate and having almost equal diagnostic accuracy.

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ALVARADO SCORING SYSTEM

The Professional Medical Journal ◽

10.29309/tpmj/2018.25.07.131 ◽

2018 ◽

Vol 25 (07) ◽

pp. 1059-1063

Author(s):

Rizwan Ahmad ◽

Ammara Liaquat ◽

Amna Liaquat

Keyword(s):

Negative Predictive Value ◽

Predictive Value ◽

Scoring System ◽

False Negative ◽

Perforated Appendicitis ◽

Negative Appendectomy ◽

True Negative ◽

Chronic Appendicitis ◽

Group I ◽

Sensitivity Specificity

Objectives: To evaluate the diagnostic accuracy (discrimination) andimplementation performance of Alvarado score. Study Design: Cross sectional study. Setting:Surgical Unit of Nishtar Hospital Multan under supervision of consultant Surgeons of Department.Period: 01 year from November 2016 to October 2017. Methodology: For quantitative variableslike age of patients Mean and SD was calculated, and frequency percentages were calculatedfor categorical data like gender. Negative appendectomy rate, positive predictive value,negative predictive value, sensitivity, specificity was calculated by using 2-2 contingency table.Results: Overall, 100% (n=300) patients enrolled in this study, both genders. Alvarado scoringat presentation, 15% (n=45) patients were categorized into Group I. 13% (n=39) patients wereincluded in Group II. While, 72% (n=216) were enrolled in Group III. Diagnostic test was positivein 223 patients. While, acute appendicitis was confirmed histo-pathologically in 160 patients.Gangrenous appendicitis observed in 3 patients. Chronic appendicitis, perforated appendicitis,appendicular abscess, no specific pathology, gangrenous intestine and salpingo-oophoritiswas observed as 31, 6, 9, 6, 3 and 5 respectively. There were 174 patients true positive, 49 werefalse positive, 59 were false negative and 18 were true negative. Sensitivity, specificity, negativepredictive value and negative predictive value were 74.68% 26.87%, 78.02% and 23.37%respectively. Conclusion: Alvarado scoring system is useful tool in diagnosis of appendicitisin pre-operative period which can be useful for surgeons at any level of health care. Accordingto our study observations Alvarado scoring system has better sensitivity 74.68% but specificity26.87% which shows that Alvarado scoring system is helpful in diagnosis of appendicitis but notmuch helpful in preventing negative laparotomies.

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Limited Positive Predictive Value of β-d-Glucan in Hematologic Patients Receiving Antimold Prophylaxis

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa048 ◽

2020 ◽

Vol 7 (3) ◽

Author(s):

Euijin Chang ◽

Taek Soo Kim ◽

Chang Kyung Kang ◽

Kang Il Jun ◽

Dongyeop Shin ◽

...

Keyword(s):

Positive Predictive Value ◽

Predictive Value ◽

False Negative ◽

Diagnostic Value ◽

Tertiary Hospital ◽

True Positive ◽

True Negative ◽

Cell Transplants ◽

Sensitivity Specificity ◽

Low Prevalence

Abstract Background Diagnostic value of β-d-glucan (BDG) in populations with low prevalence of invasive fungal infection (IFI), such as hematologic patients receiving antimold prophylaxis, should be re-evaluated. Methods We retrospectively reviewed episodes with BDG results in hematologic patients receiving antimold prophylaxis from January 2017 to August 2019 in a tertiary hospital. The episodes were classified as true positive ([TP] positive BDG with IFI), true negative ([TN] negative BDG without IFI), false positive ([FP] positive BDG without IFI), false negative ([FN] negative BDG with IFI), and nonevaluable. Results A total of 203 episodes were analyzed: 101 episodes (49.8%) were from stem cell transplants, 89 (43.8%) were from induction chemotherapy, and 13 (6.4%) were from graft-versus-host disease treatment. There were 62 nonevaluable episodes. Among 141 evaluable ones, there were 8 (5.7%) episodes of probable/proven IFI. True positive, TN, FP, and FN cases were 4 (2.8%), 112 (79.4%), 21 (14.9%), and 4 (2.8%) episodes, respectively. Sensitivity, specificity, positive predictive value, and negative predictive value were 50.0%, 84.2%, 16.1%, and 96.5%, respectively. Positive predictive value was 26.7% and 0.0% in diagnostic and surveillance episodes, respectively. Conclusions β-d-glucan test should be used to exclude IFI rather than for diagnosis in these patients.

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Diagnostic accuracy of Mycobacterium tuberculosis cell-free DNA for tuberculosis: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0253658 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0253658

Author(s):

Guocan Yu ◽

Yanqin Shen ◽

Bo Ye ◽

Yan Shi

Keyword(s):

Mycobacterium Tuberculosis ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Meta Analysis ◽

False Negative ◽

Summary Receiver Operating Characteristic ◽

True Negative ◽

Cell Free Dna ◽

Free Dna ◽

Sensitivity Specificity

Background Diagnosis of tuberculosis (TB) is still difficult. The purpose of our study was to evaluate the diagnostic accuracy of Mycobacterium tuberculosis cell-free DNA (cfDNA) for diagnosing of TB. Methods We searched relevant databases for studies that used cfDNA to diagnose TB. We evaluated the accuracy of cfDNA compared with the composite reference standard (CRS) and culture. True positive, false positive, false negative, and true negative values for cfDNA were obtained first, then the estimated pooled sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic odds ratio (DOR), and the area under the summary receiver operating characteristic (SROC) curve (AUC) of cfDNA for diagnosing TB were calculated with 95% confidence intervals (CIs). Heterogeneity was determined using the I2 statistic. When the heterogeneity was obvious, the source of heterogeneity was further discussed. Results We included 14 independent studies comparing cfDNA with the CRS, and 4 studies compared with culture. The pooled sensitivity, specificity, PPV, NPV, DOR, and AUC of the SROC were 68%, 98%,99%, 62%, 83, and 0.97 as compared with the CRS, respectively. The pooled sensitivity, specificity, PPV, NPV, DOR, and AUC of the SROC were 48%, 91%, 92%, 60%, 5, and 0.88 as compared with culture, respectively. The heterogeneity between studies was significant. Conclusions The accuracy of cfDNA testing for TB diagnosis was good compared with CRS and culture. cfDNA can be used for rapid early diagnosis of TB.

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

The Heart Surgery Forum ◽

10.1532/hsf98.20111075 ◽

2012 ◽

Vol 15 (1) ◽

pp. 12 ◽

Cited By ~ 1

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

Background: 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).Methods: 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.Results: 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.Conclusion: Our study showed that MDCT angiography with 16-slice systems has acceptable diagnostic performance for the evaluation of coronary artery bypass graft patency.

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The role of serum periostin in the diagnosis of asthma: A meta-analysis

Allergy and Asthma Proceedings ◽

10.2500/aap.2020.41.200038 ◽

2020 ◽

Vol 41 (4) ◽

pp. 240-247

Author(s):

Lei Yang ◽

Qingtao Zhao ◽

Shuyu Wang

Keyword(s):

Diagnostic Accuracy ◽

Meta Analysis ◽

Characteristic Curve ◽

False Negative ◽

Summary Receiver Operating Characteristic ◽

True Negative ◽

Negative Results ◽

Noninvasive Biomarker ◽

Sensitivity Specificity ◽

Serum Periostin

Background: Serum periostin has been proposed as a noninvasive biomarker for asthma diagnosis and management. However, its accuracy for the diagnosis of asthma in different populations is not completely clear. Methods: This meta-analysis aimed to evaluate the diagnostic accuracy of periostin level in the clinical determination of asthma. Several medical literature data bases were searched for relevant studies through December 1, 2019. The numbers of patients with true-positive, false-positive, false-negative, and true-negative results for the periostin level were extracted from each individual study. We assessed the risk of bias by using Quality Assessment of Diagnostic Accuracy Studies 2. We used the meta-analysis to produce summary estimates of accuracy. Results: In total, nine studies with 1757 subjects met the inclusion criteria. The pooled estimates of sensitivity, specificity, and diagnostic odds ratios for the detection of asthma were 0.58 (95% confidence interval [CI], 0.38‐0.76), 0.86 (95% CI, 0.74‐0.93), and 8.28 (95% CI, 3.67‐18.68), respectively. The area under the summary receiver operating characteristic curve was 0.82 (95% CI, 0.79‐0.85). And significant publication bias was found in this meta‐analysis (p = 0.39). Conclusion: Serum periostin may be used for the diagnosis of asthma, with moderate diagnostic accuracy.

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Value of preoperative computed tomography for meso-Rex bypass in children with extrahepatic portal vein obstruction

Insights into Imaging ◽

10.1186/s13244-021-01057-8 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Huiying Wu ◽

Ning Zhou ◽

Lianwei Lu ◽

Xiwen Chen ◽

Tao Liu ◽

...

Keyword(s):

Computed Tomography ◽

Portal Vein ◽

Predictive Value ◽

Extrahepatic Portal Vein Obstruction ◽

Portal Vein Obstruction ◽

Left Portal Vein ◽

History Of ◽

Associated Malformations ◽

Sensitivity Specificity

Abstract Background Extrahepatic portal vein obstruction (EHPVO) is the most important cause of hematemesis in children. Intrahepatic left portal vein and superior mesenteric vein anastomosis, also known as meso-Rex bypass (MRB), is becoming the gold standard treatment for EHPVO. We analyzed the value of preoperative computed tomography (CT) in determining whether MRB is feasible in children with EHPVO. Results We retrieved data on 76 children with EHPVO (50 male, 26 female; median age, 5.9 years) who underwent MRB (n = 68) or the Warren procedure (n = 8) from 2013 to 2019 and retrospectively analyzed their clinical and CT characteristics. The Rex recess was categorized into four subtypes (types 1–4) depending on its diameter in CT images. Of all 76 children, 7.9% had a history of umbilical catheterization and 1.3% had leukemia. Sixteen patients (20 lesions) had associated malformations. A total of 72.4% of Rex recesses could be measured by CT, and their mean diameter was 3.5 ± 1.8 mm (range 0.6–10.5 mm). A type 1, 2, 3, and 4 Rex recess was present in 9.2%, 53.9%, 11.8%, and 25.0% of patients, respectively. MRB could be performed in patients with types 1, 2, and 3, but those with type 4 required further evaluation. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of CT were 100%, 83.8%, 42.1%, 100%, and 85.5%, respectively. Conclusions Among the four types of Rex recesses on CT angiography, types 1–3 allow for the performance of MRB.

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