scholarly journals Diagnostic Utility of Bronchoalveolar Lavage and Bronchial Brush Cytology in Lung Lesions

2020 ◽  
Vol 7 (8) ◽  
pp. A394-399
Author(s):  
Jofy George ◽  
Umashankar T
Keyword(s):  
Positive Predictive Value ◽  
Bronchoalveolar Lavage ◽  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Diagnostic Yield ◽  
Diagnostic Value ◽  
Bronchial Brushing ◽  
Brushing Cytology ◽  
Bronchoscopic Biopsy

Background: In 1960’s, flexible fiberoptic bronchoscope, was first used to give a better yield to diagnose pulmonary diseases. Bronchial brushing cytology (BBC) and Broncho-alveolar lavage (BAL) are two important adjuncts done along with bronchoscopic biopsy. Bronchial brushings yield better diagnostic material than simple exfoliative cytology. Therefore, both techniques are of much diagnostic value and is widely accepted as it is safe, economical and evaluation requires much less time. Methods: All the bronchial brush and bronchoalveolar lavage smears obtained from January 2018 to December 2018 were assessed. Correlation was done with histopathology wherever was available. Result: BBC showed a sensitivity and specificity of   59.28% and 100%. The positive predictive value and negative predictive value were 100% and 47.62%. BAL showed a sensitivity and specificity of 51% and 100%. The positive predictive value and negative predictive value was 100% and 43.18%. The diagnostic accuracy of BBC and BAL were 70.27% and 64.86%. Conclusion: Universally bronchial washings and bronchial brushings should be considered important adjunct to bronchoscopic biopsies to diagnose pulmonary lesions as both are safe, economical and can will give better diagnostic yield if incorporated together.

scholarly journals Added value of diffusion-weighted MRI in assessment of pleural lesions

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Youssriah Yahia Sabri ◽  
Ikram Hamed Mahmoud ◽  
Lamis Tarek El-Gendy ◽  
Mohamed Raafat Abd El-Mageed ◽  
Sally Fouad Tadros
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Added Value ◽  
Adc Value ◽  
Pleural Diseases ◽  
Conventional Mri ◽  
Malignant Lesions

Abstract Background There are many causes of pleural disease including variable benign and malignant etiologies. DWI is a non-enhanced functional MRI technique that allows qualitative and quantitative characterization of tissues based on their water molecules diffusivity. The aim of this study was to evaluate the diagnostic value of DWI-MRI in detection and characterization of pleural diseases and its capability in differentiating benign from malignant pleural lesions. Results Conventional MRI was able to discriminate benign from malignant lesions by using morphological features (contour and thickness) with sensitivity 89.29%, specificity 76%, positive predictive value 89%, negative predictive value 76.92%, and accuracy 85.37%. ADC value as a quantitative parameter of DWI found that ADC values of malignant pleural diseases were significantly lower than that of benign lesions (P < 0.001). Hence, we discovered that using ADC mean value of 1.68 × 10-3 mm2/s as a cutoff value can differentiate malignant from benign pleural diseases with sensitivity 89.3%, specificity 100%, positive predictive value 100%, negative predictive value 81.2%, and accuracy 92.68% (P < 0.001). Conclusion Although DWI-MRI is unable to differentiate between malignant and benign pleural effusion, its combined morphological and functional information provide valid non-invasive method to accurately characterize pleural soft tissue diseases differentiating benign from malignant lesions with higher specificity and accuracy than conventional MRI.

scholarly journals Immunocytochemistry Test of Protein BRAF Expression for Diagnosis of Well Differentiated Thyroid Carcinoma

2018 ◽  
Vol 11 (3) ◽  
pp. 843-849 ◽  
Author(s):  
I. Wayan Sudarsa ◽  
Elvis Deddy Kurniawan Pualillin ◽  
Putu Anda Tusta Adiputra ◽  
Ida Bagus Tjakra Wibawa Manuaba
Keyword(s):  
Positive Predictive Value ◽  
Thyroid Carcinoma ◽  
Negative Predictive Value ◽  
Diagnostic Test ◽  
Predictive Value ◽  
Preoperative Diagnosis ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Differentiated Thyroid Carcinoma ◽  
Inclusion Criteria

Background: Thyroid carcinoma generally has a good prognosis. The main focus of current research on thyroid carcinoma is to increase the accuracy of preoperative diagnosis of thyroid nodules. When the result of fine needle aspiration biopsy (FNAB) is indeterminate, clinicians often have doubts in determining the surgical management. Objective: Protein BRAF expression analysis can help improve the accuracy of FNAB and optimize the management of differentiated thyroid carcinoma. Methods: This study is a diagnostic test performed from October 2016 at Sanglah General Hospital with 38 patients as subjects who fulfilled the inclusion criteria. Data is being presented in descriptive form before diagnostic test is done to determine sensitivity, specificity, positive predictive value, negative predictive value and the accuracy of immunocytochemistry test for BRAF on indeterminate thyroid nodule. Results: Thirty-eight samples met the inclusion criteria during the study period. Three samples were male (7.9%) and 35 samples (92.1%) were female. The mean age of the sample was 45.21 years (SD ±10.910 years) with ages ranging from 23 to 66 years. Of the 12 samples undergoing isthmolobectomy, 7 samples (58.4%) were determined to be malignant from histopathological results. The sensitivity value of BRAF immunocytochemistry test is 45.45% with a specificity value of 81.25%, a positive predictive value of 76.92%, a negative predictive value of 52% and an accuracy of 60.50%. Analysis of the receiver operator (ROC) curve shows the area under the curve (AUC) of 63.4% with a confidence interval of 45.5–81.2%. Conclusion: Immunocytochemistry BRAF test have a reliable diagnostic value and can be taken into consideration in the preoperative diagnosis of thyroid malignancies.

scholarly journals Diagnostic Value of Different Biomarkers to Identify Bacterial Coinfection in Vietnamese Children with Severe Rhinovirus Pneumonia

2020 ◽  
Vol 10 (01) ◽  
pp. e25-e31
Author(s):  
Hien Thu Pham ◽  
Tran Thi Ngoc Nguyen ◽  
Ngo Thi Tam
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Severe Pneumonia ◽  
Diagnostic Value ◽  
Optimal Cutoff ◽  
Optimal Cutoff Point ◽  
Hs Crp ◽  
Bacterial Coinfection ◽  
Children Under 5

AbstractThis study aims to assess the diagnostic value of high-sensitivity C-reactive protein (hs-CRP), procalcitonin (PCT), and interleukin (IL)-6 in the diagnosis of pneumonia caused by Rhinovirus alone or with bacterial coinfection in Vietnamese children under 5 years of age. A cross-sectional study was conducted on 26 children under 5 years of age with severe pneumonia due to Rhinovirus at the National Pediatric Hospital. IL-6, hs-CRP, and PCT tests were performed. The diagnostic values of PCT, IL-6, and hs-CRP in classifying those with viral alone and those with bacterial coinfection were determined. Of 26 children, 10 children were diagnosed to have bacterial coinfections (38.5%). The optimal cutoff point for PCT was > 2.30 ng/mL (sensitivity 50%, specificity 94%, positive predictive value 83%, and negative predictive value 75%). The optimal cutoff point for hs-CRP was > 1.53 mg/dl (sensitivity 90%, specificity 56%, positive predictive value 56%, and negative predictive value 90%). Finally, the optimal cut-off point for IL-6 was > 441.5 pg/mL (sensitivity 20%, specificity 100%, positive predictive value 100%, and negative predictive value 60%). The accuracy rate of PCT was the highest with 69.2%, followed by hs-CRP with 65.4%. Inflammatory biomarkers such as PCT and hs-CRP were able to distinguish children with severe pneumonia caused by Rhinovirus alone and those with bacterial coinfection.

Sensitivity and Specificity of Histoplasma Antigen Detection by Enzyme Immunoassay

2015 ◽  
Vol 51 (5) ◽  
pp. 306-310 ◽  
Author(s):  
Lauren Cunningham ◽  
Audrey Cook ◽  
Andrew Hanzlicek ◽  
Kenneth Harkin ◽  
Joseph Wheat ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Positive Predictive Value ◽  
Enzyme Immunoassay ◽  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Kappa Coefficient ◽  
Urine Samples ◽  
Specificity And Sensitivity ◽  
Antigen Assay

The objective of this study was to evaluate the sensitivity and specificity of an antigen enzyme immunoassay (EIA) on urine samples for the diagnosis of histoplasmosis in dogs. This retrospective medical records review included canine cases with urine samples submitted for Histoplasma EIA antigen assay between 2007 and 2011 from three veterinary institutions. Cases for which urine samples were submitted for Histoplasma antigen testing were reviewed and compared to the gold standard of finding Histoplasma organisms or an alternative diagnosis on cytology or histopathology. Sensitivity, specificity, negative predictive value, positive predictive value, and the kappa coefficient and associated confidence interval were calculated for the EIA-based Histoplasma antigen assay. Sixty cases met the inclusion criteria. Seventeen cases were considered true positives based on identification of the organism, and 41 cases were considered true negatives with an alternative definitive diagnosis. Two cases were considered false negatives, and there were no false positives. Sensitivity was 89.47% and the negative predictive value was 95.35%. Specificity and the positive predictive value were both 100%. The kappa coefficient was 0.9207 (95% confidence interval, 0.8131–1). The Histoplasma antigen EIA test demonstrated high specificity and sensitivity for the diagnosis of histoplasmosis in dogs.

scholarly journals Performance of the New Automated Latex Immunoturbidometric Assay in the Diagnosis of Heparin Induced Thrombocytopenia: A Single Institution Experience

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4689-4689
Author(s):  
Sriman Swarup ◽  
Somedeb Ball ◽  
Nimesh Adhikari ◽  
Anita Sultan ◽  
Khatrina Swarup ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Serotonin Release ◽  
Small Sample ◽  
Second Phase ◽  
Heparin Induced Thrombocytopenia ◽  
Study Population ◽  
Release Assay

Introduction: Heparin induced thrombocytopenia (HIT) is a severe prothrombotic condition, usually triggered by exposure to heparin products. It is characterized by platelet activation induced by the formation of antibodies to the platelet factor 4 (PF4)/ heparin polyanion complexes. Diagnostic algorithm includes clinical scoring (4T score) alongside serological test for detection of these antibodies (HIT-Ab), while serotonin release assay (SRA) remains the gold- standard for confirmation. The automated latex immunoturbidometric assay (LIA) has recently been FDA approved as a screening tool for HIT and is a potential alternative to the conventional particle immunofiltration assay (PIFA) for time-sensitive detection of HIT-Ab to guide treatment considerations. We recently introduced LIA in our institution. In this study, we present our experience with LIA in comparison to PIFA in the diagnosis of HIT. Methods: We retrospectively reviewed the charts of all the patients on whom a PIFA was ordered between March 2017 and March 2018 in our hospital. We collected information on the results of the PIFA and SRA (if available). We replaced PIFA with LIA for HIT screening. Then, we introduced a structured protocol for diagnosis of HIT in our institution by incorporating 4T scoring alongside LIA order in the electronic medical record (EMR), in December 2018. We reviewed the EMR of all the patients on whom HIT-Ab test (LIA) was ordered between January and June of 2019, and collected similar information as before. All the data were compiled in a single master excel sheet for calculation of performance characteristics (sensitivity, specificity, positive and negative predictive values) for both PIFA and LIA. A patient was considered to have the diagnosis of HIT if the result of SRA was available and positive. Results: In the first phase, a total of 31 orders for SRA was noted against 170 PIFA orders. Five patients had a positive SRA, of whom two were PIFA negative. Half the patients with a negative SRA result were positive for PIFA. Hence, the sensitivity and specificity of PIFA test for our study population were noted to be 60% and 50%, respectively. PIFA had a positive predictive value (PPV) of mere 18.75% for the diagnosis of HIT, whereas the negative predictive value (NPV) was found to be 86.66%. Introduction of structured protocol for HIT diagnosis substantially reduced the number of inappropriate SRA orders in the second phase. On review of data for six months with the new HIT-Ab test LIA, SRA was ordered in only eight patients, to go with 69 orders for the LIA. The result of LIA was positive in all three patients with a positive SRA, whereas it was false positive in four instances. Only one patient was negative for both LIA and SRA during this period. LIA was found to be 100% sensitive and 20% specific for the diagnosis of HIT in our sample. PPV and NPV for LIA were 42.85% and 100%, respectively. Conclusion: The sensitivity and specificity of LIA were found to be 100% and 20%, respectively, in our study population, which is different from the earlier report (Warkentin et al. 2017). The small sample size is a limitation of our study. Higher PPV and NPV for LIA, with its quick turnaround time, make it a useful alternative for the time-sensitive determination of post-test probability for HIT in patients. [HIT- Ab- Heparin Induced Thrombocytopenia Antibody, PIFA- Particle Immunofiltration Assay, LIA- Latex Immunoturbidometric Assay, SRA- Serotonin Release Assay, +ve- Positive, -ve - Negative, PPV- Positive Predictive Value, NPV- Negative Predictive Value] Disclosures No relevant conflicts of interest to declare.

ROLE OF MRI IN DIAGNOSIS OF ROTATOR CUFF TEAR ASSUMING ARTHROSCOPY AS GOLD STANDARD

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
Dr. Chaturbhuj Prasad Swarnkar ◽  
Dr. Shiv Raj Meena
Keyword(s):  
Rotator Cuff ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Shoulder Pain ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Gold Standard ◽  
Shoulder Joint ◽  
Rotator Cuff Tears ◽  
Arthroscopic Findings

Background- Rotator cuff tears are one of the most common causes of shoulder pain for which patients seek treatment. As in our daily work, the shoulder joint is the most frequently used, there is higher chance of having shoulder joint injury. The aim of the study is to compare the efficacy of MRI in diagnosing shoulder pathologies in comparison to arthroscopy, considering arthroscopy as the gold standard. Methods- 30 Patient with suspected rotator cuff injury patients, between 18-80 years of age was included in the study. MRI of the shoulder joint was done followed by shoulder arthroscopy. The data collected was analysed for the significant correlation between MRI of shoulder and arthroscopic findings by kappa statistics. Results- The accuracy of MRI in diagnosis of rotator cuff partial tears, was 90%, while sensitivity and specificity was 100.00%, 78.57% and positive predictive value was 84.21% and negative predictive value was 100.00% and accuracy of MRI in diagnosis of rotator cuff full tears, was 86.67%, while sensitivity and specificity was 63.64%, 100.00%) and positive predictive value was 100.00% and negative predictive value was 82.61% in our study. Conclusion- Our study demonstrates a high sensitivity and specificity for the MRI diagnosis of both partial and full thickness rotator cuff tears and good correlation with arthroscopic findings. Keywords: Rotator cuff, Shoulder pain, Arthroscopy, MRI.

Comparative Analysis of Diagnostic Value for Shear Wave Elastography and Real-Time Elastographic Imaging for Thyroid Nodules

2019 ◽  
Vol 9 (2) ◽  
pp. 334-338
Author(s):  
Qing Yang ◽  
Wenhong Zhou ◽  
Jiyu Li ◽  
Guojun Wu ◽  
Feng Ding ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Shear Wave ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Roc Curves ◽  
Diagnostic Value ◽  
Sensitivity Specificity

Objective: To compare the diagnostic value of shear wave elastography (SWE) and real-time elastography (RTE) in the diagnosis of benign and malignant thyroid nodules. Methods: A total of 34 patients who ever received thyroidectomy in our hospital from January 2016 to January 2018 were identified. Meanwhile, all the patients received SWE and RTE before surgery, and all the diagnoses were confirmed by pathological examinations. With respect to SWE technique, the Subject Operating Characteristics (ROC) curves were drawn, in order to obtain the optimal threshold and then make differential diagnoses of benign and malignant thyroid nodules. In terms of RTE, the Rago 5 scoring method was utilized to make differential diagnoses of benign and malignant thyroid nodules. Besides, the pathological examinations after surgery could be considered as the golden standard. At last, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of SWE and RTE were calculated, respectively. Results: A total of 51 thyroid nodules were identified, and 41 nodules were benign, 10 nodules were malignant. On the basis of ROC curves, with respect to SWE, the best threshold for differential diagnosis of benign and malignant thyroid nodules is 38.3 kPa. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of SWE were 72.7% (8/11), 85% (34/40), 82.4% (42/51), 68.4% (13/19), and 87.5% (35/40), respectively. And the diagnostic indicators of RTE were 81.8% (9/11), 87.5% (35/40), 84.3% (43/51), 73.7% (14/19), and 90.0% (36/40). The sensitivity of quasi-static elastography in differential diagnosis of benign and malignant thyroid nodules with diameter ≤1 cm was 87.5% (7/8), and the sensitivity of SWE was 50.0% (5/10). In addition, the accuracy of SWE in differential diagnosis of benign and malignant thyroid nodules with diameter ≥3 cm was 100% (6/6), and the accuracy of RTE for this kind of thyroid nodules was 66.7% (4/6). Conclusion: Both SWE and RTE technology have good application value in differential diagnosis of benign and malignant thyroid nodules. But, SWE is preferable when making diagnosis of benign and malignant thyroid nodules with diameter ≥3 cm, and RTE was superior in detecting benign and malignant thyroid nodules with diameter ≤1 cm.

Impact of Changes in Intraoperative Somatosensory Evoked Potentials on Stroke Rates After Clipping of Intracranial Aneurysms

Neurosurgery ◽  
2012 ◽  
Vol 70 (5) ◽  
pp. 1114-1124 ◽  
Author(s):  
Robert T. Wicks ◽  
Gustavo Pradilla ◽  
Shaan M. Raza ◽  
Uri Hadelsberg ◽  
Alexander L. Coon ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Intracranial Aneurysms ◽  
Fisher Exact Test ◽  
Stroke Rate ◽  
Unruptured Aneurysms ◽  
Ruptured Aneurysms ◽  
Postoperative Stroke

Abstract BACKGROUND: Somatosensory evoked potential (SSEP) monitoring is used during intracranial aneurysm surgery to track the effects of anesthesia, surgical manipulation, and temporary clipping. OBJECTIVE: To present the outcomes of 663 consecutive patients (691 cases) treated surgically for intracranial aneurysms who underwent intraoperative SSEP monitoring and to analyze the sensitivity and specificity of significant SSEP changes in predicting postoperative stroke. METHODS: Of 691 surgeries analyzed, 403 (391 anterior circulation, 12 posterior circulation) were unruptured aneurysms and 288 (277 anterior, 11 posterior) were ruptured. Postoperatively, symptomatic patients underwent computed tomography imaging. Positive predictive value, negative predictive value, sensitivity, and specificity were calculated with a Fisher exact test (2-tailed P value). RESULTS: Changes in SSEP occurred in 45 of 691 cases (6.5%): 16 of 403 (4.0%) in unruptured aneurysms and 29 of 288 (10%) in ruptured aneurysms. In unruptured aneurysms, reversible SSEP changes were associated with a 20% stroke rate, but irreversible changes were associated with an 80% stroke rate. In ruptured aneurysms, however, reversible changes were associated with a 12% stroke rate, and irreversible changes were associated with a 42% stroke rate. The overall accuracy of SSEP changes in predicting postoperative stroke was as follows: positive predictive value, 30%; negative predictive value, 94%; sensitivity, 25%; and specificity, 95%. CONCLUSION: Intraoperative SSEP changes are more reliable in unruptured aneurysm cases than in ruptured cases. Whereas irreversible changes in unruptured cases were associated with an 80% stroke rate, such changes in ruptured cases did not have any adverse ischemic sequelae in 58% of patients. This information is helpful during the intraoperative assessment of reported SSEP changes.

scholarly journals EVALUATION OF MODIFIED CYTOSPIN SLIDE MICROSCOPY FOR DETECTION OF ACID FAST BACILLI IN BRONCHOALVEOLAR LAVAGE FLUID FOR DIAGNOSIS OF PULMONARY TUBERCULOSIS

2021 ◽  
Vol 71 (3) ◽  
pp. 920-23
Author(s):  
Anam Imtiaz ◽  
Aamer Ikram ◽  
Gohar Zaman ◽  
Luqman Satti ◽  
Fatima Sana
Keyword(s):  
Positive Predictive Value ◽  
Bronchoalveolar Lavage ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Armed Forces ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Becton Dickinson ◽  
Acid Fast Bacilli ◽  
Sensitivity Specificity

Objective: To evaluate the cytospin slide microscopy method for detection of acid fast bacilli (AFB) in bronchoalveolar lavage (BAL) fluid comparing it with concentrated smear microscopy. Study Design: Cross-sectional validation study. Place and Duration of Study: Department of Microbiology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, from Dec 2016 to Sep 2018. Methodology: BAL specimens from suspected tuberculosis patients who were sputum smear negative, submitted to AFIP for diagnosis were included in the study. Smears for microscopy were prepared with the modified cytospin method as well as the standard concentrated technique. The prepared smears from both methods were stained with Ziehl–Neelsen (ZN) staining method and examined under 100 × oil immersion lens. TB culture performed on BACTEC MGIT 960 automated culture system (Becton Dickinson, USA) was taken as gold standard for TB diagnosis. The two methods were compared in terms of sensitivity, specificity, positive predictive value and negative predictive value. Results: Out of the 130 samples tested, 62 (47.7%) were positive on culture using MGIT 960 system. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of the modified cytospin method for pulmonary TB diagnosis was found to be 68.3%, 100%, 100%, 77% and 84.6%, respectively. Conclusion: The sensitivity of the modified cytopsin smear method was significantly higher than that of the concentrated method. The study concludes that this is a simpler and more accurate method for BAL fluid microscopy.

Sign in / Sign up

Export Citation Format

Share Document