Diagnostic accuracy of nasal endoscopy and contrast magnetic resonance imaging in COVID-19 associated mucormycosis (CAM)

Key Points 1. COVID-19 associated mucormycosis (CAM) is a life-threatening fungal disease that has become an epidemic and notifiable disease after the second wave of COVID-19 in India 2. The target group for CAM includes severely immunocompromised individuals either by COVID-19, or corticosteroid therapy, or uncontrolled glycemic index. 3. With an intention to find out the sensitivity and specificity of diagnostic nasal endoscopy (DNE) and contrast-enhanced magnetic resonance imaging (CEMRI), one hundred two consecutive patients of target group with clinical features of CAM were enrolled in the study. 4. The sensitivity and specificity of DNE as compared to KOH mount were 73.4% and 94.7% respectively. The sensitivity and specificity of CEMRI as compared to KOH mount were 87.5% and 50% respectively. 5. CEMRI misses fewer cases than DNE. In cases of normal endoscopy in the target group, imaging and biopsy should be advised to reduce false-negative results. Nasal endoscopy, biopsy, and imaging can reliably detect the majority of cases of CAM.

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Sensitivity of prostate cancer foci using 1.5 T multiparametric magnetic resonance imaging

10.21203/rs.3.rs-61567/v1 ◽

2020 ◽

Author(s):

Suguru Ito ◽

SEI NAITO ◽

Takafumi Narisawa ◽

Mayu Yagi ◽

Yuta Kurota ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Prostate Cancer ◽

Magnetic Resonance ◽

False Negative ◽

Resonance Imaging ◽

Prostate Imaging ◽

Multiparametric Magnetic Resonance Imaging ◽

Negative Results ◽

False Negative Results ◽

Clinically Significant

Abstract Background The detection of prostate cancer (CaP) has increasingly being carried out by multiparametric magnetic resonance imaging (mpMRI). Despite many previous studies, the sensitivity for clinically significant CaP (csCaP) was high, information on mpMRI false-negative lesions is limited. Therefore, the aim of this study was to evaluate the use and limitations of mpMRI in CaP. Methods A total of 228 CaP foci in 100 patients who underwent 1.5 T mpMRI and radical prostatectomy between December 2015 and June 2017 were retrospectively analyzed. The sensitivities of CaP foci, csCaP, and index tumors (ITs) were measured. Clinically significant CaP was defined into two categories based on the Gleason score (GS): csCaP/GS ≥ 3 + 4 (GS ≥ 3 + 4 or diameter > 10 mm) and csCaP/GS ≥ 4 + 3 (GS ≥ 4 + 3 or diameter > 10 mm). In addition, the characteristics of false-negative lesions were identified. The Prostate Imaging Reporting and Data System version 2 was used to determine an mpMRI positive lesion, defined as a lesion having a score of ≥ 3. Results The sensitivity of all legions, csCaP/GS ≥ 3 + 4, csCaP/GS ≥ 4 + 3, and ITs were 61.4%, 75.8%, 83.0%, and 91%, respectively. There were 91 lesions that were mpMRI false, 40% of which were csCaP/GS ≥ 3 + 4. There were three lesions with a GS of ≥ 8 and ≥ 10 mm in the false-negative results. Conclusions mpMRI can highly detect ITs and csCaP/GS ≥ 4 + 3; however, a few large and high-GS CaPs constitute undetectable lesions in 1.5 T mpMRI.

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Sensitivity of Prostate Cancer Foci using 1.5 T Multiparametric Magnetic Resonance Imaging

10.21203/rs.3.rs-70151/v1 ◽

2020 ◽

Author(s):

Suguru Ito ◽

SEI NAITO ◽

Takafumi Narisawa ◽

Mayu Yagi ◽

Yuta Kurota ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Prostate Cancer ◽

Magnetic Resonance ◽

False Negative ◽

Resonance Imaging ◽

Prostate Imaging ◽

Multiparametric Magnetic Resonance Imaging ◽

Negative Results ◽

False Negative Results ◽

Clinically Significant

Abstract Background: The detection of prostate cancer (CaP) has increasingly being carried out by multiparametric magnetic resonance imaging (mpMRI). Despite many previous studies, the sensitivity for clinically significant CaP (csCaP) was high, information on mpMRI false-negative lesions is limited. Therefore, the aim of this study was to evaluate the use and limitations of mpMRI in CaP.Methods: A total of 228 CaP foci in 100 patients who underwent 1.5 T mpMRI and radical prostatectomy between December 2015 and June 2017 were retrospectively analyzed. The sensitivities of CaP foci, csCaP, and index tumors (ITs) were measured. Clinically significant CaP was defined into two categories based on the Gleason score (GS): csCaP/GS ≥3 + 4 (GS ≥3 + 4 or diameter >10 mm) and csCaP/GS ≥4 + 3 (GS ≥4 + 3 or diameter >10 mm). In addition, the characteristics of false-negative lesions were identified. The Prostate Imaging Reporting and Data System version 2 was used to determine an mpMRI positive lesion, defined as a lesion having a score of ≥3.Results: The sensitivity of all legions, csCaP/GS ≥3 + 4, csCaP/GS ≥4 + 3, and ITs were 61.4%, 75.8%, 83.0%, and 91%, respectively. There were 91 lesions that were mpMRI false, 40% of which were csCaP/GS ≥3 + 4. There were three lesions with a GS of ≥8 and ≥10 mm in the false-negative results.Conclusions: mpMRI can highly detect ITs and csCaP/GS ≥4 + 3; however, a few large and high-GS CaPs constitute undetectable lesions in 1.5 T mpMRI.

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The Possibilities of Diffusion-Weighted Magnetic Resonance Imaging in Determining the Burden of a Tumor in Patients with Follicular Lymphoma

Blood ◽

10.1182/blood-2019-126502 ◽

2019 ◽

Vol 134 (Supplement_1) ◽

pp. 5264-5264 ◽

Cited By ~ 1

Author(s):

Ekaterina S Nesterova ◽

Galina A Yatsyk ◽

Natalia S Lutsik ◽

Sergey K. Kravchenko ◽

Eduard G Gemdzhian ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Bone Marrow ◽

Magnetic Resonance ◽

False Negative ◽

Whole Body ◽

Resonance Imaging ◽

Negative Results ◽

False Negative Results ◽

Pet Ct ◽

Weighted Magnetic Resonance Imaging

BACKGROUND: Follicular lymphoma (FL) is a B-cell tumor, which in most patients is characterized by slow growth and an "indolent" clinical course. In 80% of patients bone marrow is affected, which is a reflection of the pathogenesis of the tumor. The "watch and wait" tactic is a frequently used variant of patient management. For effective therapy, it is necessary to establish the stage of the disease, which requires the examination of the bone marrow (bilateral trepanobiopsy) and the identification of nodal and extranodal lesions (using PET/CT or CT of the whole body). The use of these methods is associated with high radiation exposure and the risk of complications in the intravenous radiopharmaceuticals and contrast agents. Whole body diffusion-weighted magnetic resonance imaging (WB-DWI) makes it possible to detect the burden of the tumor process without the use of contrast agents. AIM: Assess the capabilities of the WB-DWI method for determining the prevalence of a tumor and the detection of BM lesions in patients with FL. PATIENTS AND METHODS: The study was conducted during the fourth quarter of 2018 in the National Research Center for Hematology (Moscow), covered 8 patients (3 men and 5 women, with an average age of 53 years). According to the developed design of the study at the time of diagnosis of PL, all patients underwent a WB-MRI study, and then performed (with masking of participants): PET/CT, a histological examination of the bone marrow and the determination of B-cell clonality in bone marrow punctate (using PCR method). The results of the last two examinations were taken as reference (true) estimates for the detection of bone marrow lesions, and compared with the results obtained using the WB-MRI and PET/CT methods. Cohen's kappa statistical coefficient was used to assess the agreement between comparing methods. RESULTS: All 8 patients had a generalized lesion of the lymph nodes and extranodal foci (stage 4 according to An-Arbor). It was found that the measured diffusion coefficient in the lesions of the BM was 0,5‒0,9 х 10-3 mm/s. Reference tests showed that in 7 out of 8 patients, BM was affected. PET/CT gave two false-negative results, WB-DWI - one false-negative results (Tables 1‒2). Estimates of the prevalence of lesions of the lymph nodes and extranodal foci by WB-DWI and PET/CT were consistent with the accuracy of the methods. Estimates of the extent of lymph node involvement and extranodal lesions using WB-DWI and PET/CT were coincided with the accuracy of the methods errors. CONCLUSION: The results (Table 3.) of this exploratory research show that the WB-DWI method reveals a bone marrow damage not worse than the PET/CT method: kappa coefficient for WB-DWI was 0.6 and for PET/CT ‒ 0,5, respectively (due to the small sample size, strict statistical significance was not reached). WB-DWI allows you to quickly and informatively determine the affected areas and the involvement of BM, and thereby establish the stage of the disease. The results suggest an opportunity (along with the PET/CT method) to use the WB-DWI method as well. Disclosures No relevant conflicts of interest to declare.

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Artifacts and pitfalls in shoulder magnetic resonance imaging

Radiologia Brasileira ◽

10.1590/0100-3984.2013.0006 ◽

2015 ◽

Vol 48 (4) ◽

pp. 242-248 ◽

Cited By ~ 6

Author(s):

Gustavo Felix Marconi ◽

Tulio Augusto Alves Macedo

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

False Positive ◽

False Negative ◽

Anatomical Variations ◽

Imaging Findings ◽

Resonance Imaging ◽

Negative Results ◽

False Negative Results ◽

Comprehensive Reference

Abstract Magnetic resonance imaging has revolutionized the diagnosis of shoulder lesions, in many cases becoming the method of choice. However, anatomical variations, artifacts and the particularity of the method may be a source of pitfalls, especially for less experienced radiologists. In order to avoid false-positive and false-negative results, the authors carried out a compilation of imaging findings that may simulate injury. It is the authors’ intention to provide a useful, consistent and comprehensive reference for both beginner residents and skilled radiologists who work with musculoskeletal magnetic resonance imaging, allowing for them to develop more precise reports and helping them to avoid making mistakes.

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Influence of biopsy cores number performed with targeted prostate biopsy on the likelihood of a positive result in patients with clinically significant prostate cancer

Cancer Urology ◽

10.17650/1726-9776-2020-16-3-62-69 ◽

2020 ◽

Vol 16 (3) ◽

pp. 62-69

Author(s):

A. V. Zyryanov ◽

G. A. Gulin ◽

N. A. Rubtsova ◽

V. O. Mager ◽

A. E. Putintsev ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Prostate Cancer ◽

Magnetic Resonance ◽

False Negative ◽

Histological Structure ◽

Targeted Biopsy ◽

Resonance Imaging ◽

Negative Results ◽

False Negative Results ◽

Clinically Significant

Background. Targeted biopsy is proposed as a method of choice in the algorithm of prostate cancer diagnosis, but not all the features of method has been evaluated.Objective: determine the rational number of targeted biopsy samples in patients with clinically significant prostate cancer.Materials and methods. The magnetic resonance imaging and fusion biopsy data of 156 patients with suspected prostate cancer were retrospectively evaluated.Results and conclusion. In the study statistically significant dependence of the positive histological results in patients with clinically significant prostate cancer from the number of biopsy samples was found. The potential probability of a false negative histological examination with an insufficient number of biopsy samples was noted. These results confirm the latest published data of potential targeted biopsy false in true positive patients after multiparametric magnetic resonance imaging. An increase in the number of biopsy samples in the target lesion reduces the likelihood of false-negative results. The main causes of such discrepancy are some technical laxity and the heterogeneous histological structure of prostate cancer. Increase the number of biopsy cores can reduce the likelihood of false-negative results.

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Magnetic resonance imaging versus ultrasonography for the in utero evaluation of central nervous system anomalies

Journal of Neurosurgery Pediatrics ◽

10.3171/2010.7.peds09511 ◽

2010 ◽

Vol 6 (4) ◽

pp. 340-345 ◽

Cited By ~ 19

Author(s):

Pierpaolo Peruzzi ◽

Rebecca J. Corbitt ◽

Corey Raffel

Keyword(s):

Magnetic Resonance Imaging ◽

Prenatal Diagnosis ◽

Mr Imaging ◽

False Negative ◽

In Utero ◽

Resonance Imaging ◽

Fetal Ultrasonography ◽

Negative Results ◽

False Negative Results ◽

Fetal Mr

Object The use of fetal MR imaging for the in utero evaluation of pathological conditions of the CNS is widely accepted as an adjunct to fetal ultrasonography studies. Magnetic resonance imaging is thought to characterize CNS anomalies better, and to provide a more exact diagnosis and accurate prognosis. The purpose of this study was to determine the role of and indications for fetal MR imaging in evaluating fetuses with different CNS abnormalities that were seen initially on prenatal sonograms. Methods Over a 3-year period, fetuses with prior sonographic evidence of CNS abnormalities who consequently received prenatal MR imaging at Columbus Nationwide Children's Hospital within 2 weeks of the fetal ultrasonography study were included in this study. For each patient, radiological reports from both studies were reviewed, analyzed, and compared with the findings at postnatal imaging or physical examination. Results of the 2 modalities were then compared in terms of diagnostic accuracy. Results Twenty-six fetuses were included in this study on the basis of an in utero sonogram showing a CNS anomaly. Their gestational age ranged from 17 to 35 weeks, with a mean of 25 weeks at the time of fetal ultrasonography. Hydrocephalus was identified in 16 fetuses, 6 had evidence of a spinal dysraphic defect, 2 had holoprosencephaly, 1 had an encephalocele, and 1 had multiple body abnormalities requiring detailed CNS evaluation. Twenty-five of the fetuses were correctly evaluated as having abnormal CNS findings on both fetal ultrasonography and fetal MR imaging. Fetal ultrasonography provided a correct prenatal diagnosis in 20 cases, whereas fetal MR imaging was correct in 22 cases. There were 9 cumulative false-positive results for fetal ultrasonography and 7 for fetal MR imaging, whereas for false-negative results there were a total of 34 and 19, respectively. Conclusions Fetal MR imaging is more sensitive in detecting fetal CNS abnormalities, but its ability to provide a correct prenatal diagnosis is only marginally superior to fetal ultrasonography. Moreover, fetal MR imaging is not exempt from misdiagnosis, and still shows a significantly high rate of false-negative results. Particularly for spinal dysraphic defects, fetal MR imaging does not seem to add important diagnostic or prognostic details when compared with fetal ultrasonography.

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Accuracy of multiparametric magnetic resonance imaging for diagnosing prostate Cancer: a systematic review and meta-analysis

BMC Cancer ◽

10.1186/s12885-019-6434-2 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 5

Author(s):

Liang Zhen ◽

Xiaoqiang Liu ◽

Chen Yegang ◽

Yang Yongjiao ◽

Xu Yawei ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Prostate Cancer ◽

Magnetic Resonance ◽

Likelihood Ratio ◽

Sensitivity And Specificity ◽

Meta Analysis ◽

False Negative ◽

Positive Likelihood Ratio ◽

Resonance Imaging ◽

Multiparametric Magnetic Resonance Imaging

Abstract Background The application of multiparametric magnetic resonance imaging (mpMRI) for diagnosis of prostate cancer has been recommended by the European Association of Urology (EAU), National Comprehensive Cancer Network (NCCN), and European Society of Urogenital Radiology (ESUR) guidelines. The purpose of this study is to systematically review the literature on assessing the accuracy of mpMRI in patients with suspicion of prostate cancer. Method We searched Embase, Pubmed and Cochrane online databases from January 12,000 to October 272,018 to extract articles exploring the possibilities that the pre-biopsy mpMRI can enhance the diagnosis accuracy of prostate cancer. The numbers of true- and false-negative results and true- and false-positive ones were extracted to calculate the corresponding sensitivity and specificity of mpMRI. Study quality was assessed using QUADAS-2 tool. Random effects meta-analysis and a hierarchical summary receiver operating characteristic (HSROC) plot were performed for further study. Results After searching, we acquired 3741 articles for reference, of which 29 studies with 8503 participants were eligible for inclusion. MpMRI maintained impressive diagnostic value, the area under the HSROC curve was 0.87 (95%CI,0.84–0.90). The sensitivity and specificity for mpMRI were 0.87 [95%CI, 0.81–0.91] and 0.68 [95%CI,0.56–0.79] respectively. The positive likelihood ratio was 2.73 [95%CI 1.90–3.90]; negative likelihood ratio was 0.19 [95% CI 0.14,-0.27]. The risk of publication bias was negligible with P = 0.96. Conclusion Results of the meta-analysis suggest that mpMRI is a sensitive tool to diagnose prostate cancer. However, because of the high heterogeneity existing among the included studies, further studies are needed to apply the results of this meta-analysis in clinic.

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Magnetic resonance imaging of the breasts: Clinical practice and further development

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0408260m ◽

2004 ◽

Vol 132 (7-8) ◽

pp. 260-266 ◽

Cited By ~ 1

Author(s):

Zorica Milosevic ◽

Nenad Spasic

Keyword(s):

Magnetic Resonance Imaging ◽

Clinical Practice ◽

Magnetic Resonance ◽

False Negative ◽

Cancer Staging ◽

Resonance Imaging ◽

Complementary Method ◽

Negative Results ◽

Low Sensitivity ◽

Further Development

Magnetic resonance imaging (MRI) of the breasts was introduced in clinical practice over 10 years ago. The method is based on visualization of morphology of the lesion and pathophysiology of their vascularization. It is useful complementary method to mammography and breasts ultrasound, with potential to detect clinically or mammography occult lesions. Compared to the conventional visualization methods, MRI of the breasts is more sensitive, although specificity of the method is lower than sensitivity. The indications for MRI of the breasts are: differentiation between recurrent malignant disease and postoperative or post irradiation changes, local cancer staging in preoperative planning, breasts implants, axillary metastases with occult primary tumor and cases with inconclusive conventional imaging. The limitations of MRI of the al Bezanijska kosa, Belgrade breasts are: low sensitivity for in situ carcinomas, false negative results for 10% carcinomas and hormone-induced false positive results. The further development of the method includes: breasts cancer screening in the patients with high risk, monitoring of the effects of neo-adjuvant chemotherapy, MR-guided biopsy and new contrast agents.

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