scholarly journals Evaluation of undiagnosed solitary lung nodules according to the probability of malignancy in the American College of Chest Physicians (ACCP) evidence-based clinical practice guidelines

2014 ◽  
Vol 48 (1) ◽  
pp. 50-55 ◽  
Author(s):  
Shinji Shinohara ◽  
Takeshi Hanagiri ◽  
Masaru Takenaka ◽  
Yasuhiro Chikaishi ◽  
Soich Oka ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Roc Curve ◽  
Predictive Value ◽  
Lung Tumor ◽  
Malignant Tumors ◽  
Final Diagnosis ◽  
Benign Disease ◽  
Smoking History ◽  
Lung Nodules ◽  
Nodule Size

Abstract Background. This study retrospectively investigated the clinical significance of undiagnosed solitary lung nodules removed by surgical resection. Patients and methods. We retrospectively collected data on the age, smoking, cancer history, nodule size, location and spiculation of 241 patients who had nodules measuring 7 mm to 30 mm and a final diagnosis established by histopathology. We compared the final diagnosis of each patient with the probability of malignancy (POM) which was proposed by the American College of Chest Physicians (ACCP) guidelines. Results. Of the 241 patients, 203 patients were diagnosed to have a malignant lung tumor, while 38 patients were diagnosed with benign disease. There were significant differences in the patients with malignant and benign disease in terms of their age, smoking history, nodule size and spiculation. The mean value and the standard deviation of the POM in patients with malignant tumors were 51.7 + 26.1%, and that of patients with benign lesions was 34.6 + 26.7%. The area under the receiver operating characteristic (ROC) curve (AUC) was 0.67. The best cut-off value provided from the ROC curve was 22.6. When the cut-off value was set at 22.6, the sensitivity was 83%, specificity 52%, positive predictive value 90%, negative predictive value 36% and accuracy 77%, respectively. Conclusions. The clinical prediction model proposed in the ACCP guidelines showed unsatisfactory results in terms of the differential diagnosis between malignant disease and benign disease of solitary lung nodules in our study, because the specificity, negative predictive value and AUC were relatively low.

scholarly journals Comparison of RMI 3 and RMI 4 in pre-operative evaluation of ovarian masses

2019 ◽  
Vol 8 (9) ◽  
pp. 3602
Author(s):  
Badugu Rao Bahadur ◽  
Gangadhara Rao Koneru ◽  
Prabha Devi Kodey ◽  
Jyothi Melam
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Malignant Tumors ◽  
Clinical Approach ◽  
Ovarian Mass ◽  
Medical College ◽  
Operative Evaluation ◽  
Sensitivity Specificity ◽  
Final Confirmation

Background: To differentiate ovarian mass as benign or malignant could change clinical approach. Finding a screening and diagnostic method for ovarian cancer is challenging due to high mortality and insidious symptoms. Risk malignancy index (RMI) has the advantage of rapid and exact triage of patients with ovarian mass.Methods: Prospective study carried for 2 years at NRI Medical College and General Hospital, Chinakakani, Mangalagiri, Andhra Pradesh, India. 79 patients with ovarian mass were investigated and risk malignancy index (RMI-3 and RMI-4) calculated. Final confirmation was done based on histopathological report. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for RMI 3 and RMI 4 taking histopathology as control and comparison was done.Results: (n=79); 50 (63.29%) cases were benign and 29 (36.70%) were malignant based on histopathology. RMI 4 is more sensitive (68.96%) than RMI 3 (62.06%), but RMI 3 is more specific (94%) than RMI 4 (92%).The positive predictive value of RMI-3 and RMI-4 were 85.71%  and 83.33% respectively. The negative predictive value for RMI-4 and RMI-3 were 83.63% and 81.03% respectively.Conclusions: With increasing age, chance of malignancy increases. RMI 4 was more sensitive than RMI-3, however less specific than RMI 3 in differentiating benign and malignant tumors. The positive predictive value is slightly more for RMI 3, than RMI 4. Negative predictive value is slightly more for RMI 4, than RMI 3. 

Using single-operator cholangioscopy for endoscopic evaluation of indeterminate biliary strictures: results from a large multinational registry

Endoscopy ◽  
2020 ◽  
Vol 52 (07) ◽  
pp. 574-582 ◽  
Author(s):  
Majid A. Almadi ◽  
Takao Itoi ◽  
Jong Ho Moon ◽  
Mahesh K. Goenka ◽  
Dong Wan Seo ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Predictive Value ◽  
Life Experience ◽  
Real Life ◽  
Final Diagnosis ◽  
Filling Defect ◽  
Biliary Strictures ◽  
Single Operator ◽  
Duct Stricture ◽  
Malignant Diagnosis

Abstract Background Peroral cholangioscopy (POCS) of indeterminate biliary strictures aims to achieve a diagnosis through visual examination and/or by obtaining targeted biopsies under direct visualization. In this large, prospective, multinational, real-life experience of POCS-guided evaluation of indeterminate biliary strictures, we evaluated the performance of POCS in this difficult-to-manage patient population. Methods This prospective registry enrolled patients, with indeterminate biliary strictures across 20 centers in Asia, the Middle East, and Africa. The primary end points were the ability to visualize the lesion, obtain histological sampling when intended, and an assessment of the diagnostic accuracy of POCS for malignant strictures. Patients were followed for 6 months after POCS or until a definitive malignant diagnosis was made, whichever occurred first. Results 289 patients underwent 290 POCS procedures with intent to biopsy in 182 cases. The stricture/filling defect was successfully visualized in 286/290 (98.6 %), providing a visual diagnostic impression in 253/290 (87.2 %) and obtaining adequate biopsies in 169/182 (92.9 %). Procedure-related adverse events occurred in 5/289 patients (1.7 %). POCS influenced patient management principally by elucidating filling defects or the causes of bile duct stricture or dilation. The visual impression of malignancy showed 86.7 % sensitivity, 71.2 % specificity, 65.8 % positive and 89.4 % negative predictive value, and 77.2 % overall accuracy compared with final diagnosis. Histological POCS-guided samples showed 75.3 % sensitivity, 100 % specificity, 100 % positive and 77.1 % negative predictive value, and 86.5 % overall accuracy. Conclusion In this large, real-life, prospective series, POCS was demonstrated to be an effective and safe intervention guiding the management of patients with indeterminate biliary strictures.

scholarly journals VES-13 and WHOQOL-bref cutoff points to detect quality of life in older adults in primary health care

2019 ◽  
Vol 53 ◽  
pp. 26 ◽  
Author(s):  
Samira Monteiro Silva ◽  
Alfredo Nicodemos Cruz Santana ◽  
Nayhane Nayara Barbosa da Silva ◽  
Maria Rita Carvalho Garbi Novaes
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Primary Health Care ◽  
Negative Predictive Value ◽  
Roc Curve ◽  
Predictive Value ◽  
Older Individuals ◽  
Primary Health ◽  
Cutoff Points

OBJECTIVE: To determine Vulnerable Elders Survey (VES-13) and WHOQOL-bref cutoff points to detect poor quality of life (QoL) in older individuals. METHODS: This is a cross-sectional study, performed in all primary health care units in Samambaia, DF, Brazil. The data were collected from August 2016 to May 2017. The sample size of 466 older individuals treated in primary health care was obtained considering a 5% margin of error, 95% confidence level, 50% prevalence, and 20% possible losses, in a population of 13,259 older individuals. The subjects answered the VES-13 and WHOQOL-bref questionnaires. They were divided into 3 subgroups: poorQoL (older individuals with self-reported very poor or poor QoL AND very dissatisfied or dissatisfied with their health), goodQoL (very good or good QoL AND very satisfied or satisfied with Health) and indeterminateQoL (NOT belonging to poorQoL or goodQoL subgroups). A receiver-operating characteristic (ROC) curve was performed with poorQoL (case) versus goodQoL (control) to determine the cutoff score in VES-13 and WHOQOLbref. A diagnostic test using these cutoffs was carried out in all older individuals (n = 466). RESULTS: The VES-13 and WHOQOL-bref cutoff points to detect poorQoL were ≥ 2 and < 60, respectively. The area under ROC curve of VES-13 and WHOQOL-bref was 0.741 (CI95% 0.659- 0.823; p < 0.001) and 0.934 (CI95% 0.881-0.987; p < 0.001), respectively. In diagnostic tests, VES-13 showed 84% sensitivity and 98.2% negative predictive value, and WHOQOL-bref, 88% sensitivity and 99% negative predictive value. CONCLUSIONS: VES-13 score ≥ 2 and WHOQOL-bref score < 60 adequately detected poorQoL in patients treated in primary health care. Our data suggest that older individuals with these scores require special treatment such as geriatrics collaborative care to improve this scenario, considering QoL impact on mortality.

scholarly journals Can Tc-99m labeled erythrocyte scintigraphy be an alternative non-invasive method to endometriosis diagnosis?

2017 ◽  
Vol 5 (2) ◽  
pp. 588
Author(s):  
Fatih Demirel ◽  
Gokhan Koca ◽  
Koray Demirel ◽  
Huseyin Aydogmus ◽  
Aylin Akbulut ◽  
...  
Keyword(s):  
Healthy Volunteer ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diagnostic Procedure ◽  
Benign Disease ◽  
Control Group ◽  
Pelvic Mri ◽  
Endometrial Gland ◽  
Non Invasive ◽  
Invasive Method

Background: Endometriosis is defined as the implantation of endometrial gland and stroma ectopically outside the uterus. Clinically, it is a hormone dependent benign disease accompanied by pelvic pain and infertility. The aim of this study was to demonstrate the activated implants with 99m-Tc labeled erythrocyte scintigraphy (99mTc-RBCs) in patients with recurrent endometriosis and compare the results with pelvic MRI results.Methods: Patients who were diagnosed histopathologically as endometriosis either with operation and / or therapeutic laparascopy or laparotomy and, were included to present study. Thirty patients, who were diagnosed as recurrence by clinical, and laboratory terms and 10 healthy volunteer (control group) patients were included in the study. Between the second and fifth days of menstruation when the endometriotic lesions were highly activated, radionuclide imaging was performed by 99mTc-RBCs and compared with pelvic MRI findings.Results: In 27 patients out of 30 patients (90%) pathological accumulation of radioactivity foci with 99mTc-RBCs were present. The focal pathological accumulation was significant in 26 patients and moderate in 1 patient. In 22 patients (81.5%) the increased radioactivity accumulation in radionuclide images was concordant with MRI images. Regarding the MRI as reference, the sensitivity of 99mTc-RBCs was determined as 96%, specificity 29%, positive predicitive value 81% and negative predictive value was 66%.Conclusions: Imaging of endometriosis regions with 99m-Tc-RBCs can be an alternative diagnostic procedure for the patients with recurrent endometriosis.

scholarly journals RADIOLOGICAL AND PATHOLOGICAL CORRELATION OF LUNG NODULES IN A BACKGROUND OF METASTATIC DISEASE

2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Azra Akhtar ◽  
Noreen Akhtar ◽  
Sajid Mushtaq ◽  
Usman Hassan ◽  
Ali Raza Khan
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Lung Nodule ◽  
Age Groups ◽  
Lung Nodules ◽  
Diagnostic Challenge ◽  
Radiographic Appearance ◽  
Histopathological Findings

Background: Computed tomography (CT) imaging has improved the chances of detecting small indeterminate (<1 cm) lung nodules. The determination of the underlying malignant or benign nature of a lung nodule poses a great diagnostic challenge and depends on a number of factors, including the radiographic appearance of nodule, the presence of non-pulmonary metastases, characteristics of growth and histological criteria. Methods: The medical records of 89 patients admitted to our specialist cancer centre between 2008 and 2013 were reviewed. Patients of all age groups and tumour category were included in the study. Clinical data of these patients were collected and the following parameters were analysed: Radiographic diagnosis, location, size, laterality and number of nodules and histological impression. The radiological findings were then correlated with histopathological findings. The nodules were sub-classified into groups on the basis of size (A = 0–0.5 cm; B = 0.5–0.9 cm; C = 1.0–1.5 cm and D = >1.5 cm). Results: CT scan reports of 89 patients with lung nodules were reviewed. On radiology, 73/89 (82%) were reported to be malignant nodule. Histopathological review of the biopsies of these 89 nodules confirmed malignancy in 50/89 (56.2%) patients. CT scan was found to be highly sensitive (94%, 95% confidence interval [CI]: 83.43–98.68%) but with a very low specificity (33.3%, 95% CI: 19.10–50.22%). CT scan was found to have a higher negative predictive value (81.2%, 95% CI: 54.34–95.73%) and a lower positive predictive value 64.4% (95% CI: 52.31–75.25%) when correlated with histopathological findings. Pathology of these nodules included metastatic sarcoma (27/89; 30.3%) and carcinoma (18/89; 20.2%). The frequency of the biopsy-proven malignant nodules on the right side was 26/45 (57.8%) and on the left side was 24/44 (54.5%) (P = 0.832). Malignant nodules were more frequent in lower lobes (28/43, 65.1%) than in upper lobes (14/32, 43.8%). These two sites combined accounted for 84% of all malignant nodules. There was a significant correlation between nodule size and likelihood of underlying malignancy. The overall prevalence of malignancy in the larger nodules (C and D) was much higher (23/30 and 76.7%) compared to the smaller sized (A and B) nodules (27/58 and 46.8%), P < 0.05.Conclusion: CT scan is a useful tool in the initial clinical assessment of indeterminate lung nodules with high sensitivity (94%) and a high negative predictive value (81.2%).Key words: Computed tomography, fibrosis, indeterminate lung nodule, infection, lung nodule, malignancy, metastases

scholarly journals Comparison of Tzanakis Score vs Alvarado Score in the Effective Diagnosis of Acute Appendicitis

2015 ◽  
Vol 12 (1) ◽  
pp. 48-50 ◽  
Author(s):  
BR Malla ◽  
H Batajoo
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Scoring System ◽  
Final Diagnosis ◽  
Negative Appendectomy ◽  
Alvarado Score ◽  
Effective Diagnosis ◽  
Sensitivity Specificity

Background Acute appendicitis is the most frequent surgical emergency encountered worldwide. This study was conducted to compare the efficacy of Tzanakis score and Alvarado score in diagnosing acute appendicitis.Objectives The aim of this study is to compare the efficacy of Tzanakis scoring system with Alvarado scoring system in diagnosing AA.Methods This was a retrospective and nonrandomized observational study conducted in Dhulikhel hospital. It included 200 clinically diagnosed cases of acute appendicitis who underwent emergency open or laparoscopic appendectomy during the year 2012. Final diagnosis of acute appendicitis was based on histological findings given by pathologist.Results The sensitivity, specificity, positive predictive value and negative predictive value of Tzanakis score was 86.9%, 75.0, 97.5% and 33.3% respectively. The sensitivity, specificity, positive predictive value and negative predictive value of Alvarado score was 76.0%, 75.0%, 97.2% and 21.4% respectively. Negative appendectomy was 8.0%. Conclusion Tzanakis scoring system is an effective scoring system in diagnosing acute appendicitis.Kathmandu University Medical Journal Vol.12(1) 2014: 48-50

scholarly journals Characteristics of an Albumin Cobalt Binding Test for Assessment of Acute Coronary Syndrome Patients: A Multicenter Study

2001 ◽  
Vol 47 (3) ◽  
pp. 464-470 ◽  
Author(s):  
Robert H Christenson ◽  
Show Hong Duh ◽  
Wendy R Sanhai ◽  
Alan H B Wu ◽  
Verena Holtman ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Negative Predictive Value ◽  
Roc Curve ◽  
Predictive Value ◽  
Reference Interval ◽  
Reference Population ◽  
Human Albumin ◽  
Roc Curve Analysis ◽  
Coronary Syndrome ◽  
Cobalt Binding

Abstract Background: The ability of the N-terminal region of human albumin to bind cobalt is diminished by myocardial ischemia. The characteristics of an assay based on albumin cobalt binding were assessed in suspected acute coronary syndrome patients and in a control reference population. The ability of the Albumin Cobalt Binding (ACBTM) Test measurement at presentation to predict troponin-positive or -negative results 6–24 h later was also examined. Methods: We enrolled 256 acute coronary syndrome patients at four medical centers. Blood specimens were collected at presentation and then 6–24 h later. The dichotomous decision limit and performance characteristics of the ACB Test for predicting troponin-positive or -negative status 6 h-24 h later were determined using ROC curve analysis. Results for 32 patients could not be used because the time of onset of ischemia appeared to have been &gt;3 h before presentation or was uncertain. The reference interval was determined by parametric analysis to estimate the upper 95th percentile of a reference population (n = 109) of ostensibly healthy individuals. Results: Increased cTnI was found in 35 of 224 patients. The ROC curve area for the ACB Test was 0.78 [95% confidence interval (CI), 0.70–0.86]. At the optimum decision point of 75 units/mL, the sensitivity and specificity of the ACB Test were 83% (95% CI, 66–93%) and 69% (95% CI, 62–76%). The negative predictive value was 96% (95% CI, 91–98%), and the positive predictive value was 33% (95% CI, 24–44%). The within-run CV of the ACB Test was 7.3%. Results for the reference population were normally distributed; the one-sided parametric 95th percentile was 80.2 units/mL. Conclusions: This exploratory study suggests that the ACB Test has high negative predictive value and sensitivity in the presentation sample for predicting troponin-negative or -positive results 6–24 h later.

scholarly journals DIFFERENTIAL DIAGNOSTICS OF LIVER HYPERECHOIC LESIONS

2017 ◽  
pp. 19-25 ◽  
Author(s):  
S. N. Berdnikov ◽  
V. N. Sholokhov ◽  
G. T. Siniukova ◽  
E. A. Goodilina ◽  
M. G. Abgarian ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Liver Metastases ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Colorectal Liver Metastases ◽  
Malignant Tumors ◽  
Threshold Level ◽  
Differential Diagnostics ◽  
Manual Compression ◽  
Liver Hemangioma

PURPOSE. Development of elastometry and elastography in differential diagnostics of liver hyperechoic lesions (hemangioma and colorectal cancer metastases) MATERIALS AND METHODS. 180 patients examined due to liver hyperechoic lesions. All patients underwent elastography in manual compression mode, ultrasound examination in the аcoustic radiationforce impulse (ARFI) mode and in shear wave velocity (SWV) mode. RESULTS. According to the data from elastography in manual compression mode in patient's group with colorectal liver metastases in 71 % cases lesions were rigid. In patient's group with hemangioma lesions in 88 % cases were soft. According to the data from elastography in the ARFI mode in patient's group with colorectal liver metastases in 71 % cases lesions were rigid. In group of patients with liver hemangioma in 88 % cases lesions were soft. According to the tumor tissue elastometry data in patients with colorectal liver metastases RSTW was high - 3,24 m/sec (range 1,4-4,22 m/sec), median of RTSW was 3,38 m/sec. In patient's group with liver hemangioma RSTW was the lowest -1,07 m/sec (range 0,75-3,86 m/sec), median - 0,93 m/sec. CONCLUSION. Informativeness of elastography in manual compression mode for colorectal liver metastases (n=110): 98 % sensitivity, 98 % accuracy, 100 % positive predictive value. Informativeness of elastography in manual compression mode for liver hemangioma (n=70): 94 % sensitivity, 94 % accuracy, 100 % negative predictive value._ 19 ДИФФЕРЕНЦИАЛЬНАЯ ДИАГНОСТИКА ОЧАГОВЫХ ГИПЕРЭХОГЕННЫХ ОБРАЗОВАНИЙ В ПЕЧЕНИ Informativeness of elastography in ARFI mode for colorectal liver metastases (n=110): 100 % sensitivity, 100 % accuracy, 100 % positive predictive value. Informativeness of elastography in ARFI mode for liver hemangioma (n=45): 94 % sensitivity, 100 % accuracy, 100 % negative predictive value. Elastometry data for liver malignant tumors detection were more informative when RSTW threshold level was 2,0 m/sec (if more than 2,0 m/sec then malignant tumor, if less than 2 m/sec then benign tumor): 94 % accuracy, 91 % sensitivity, 97 % specificity, 92 % negative predictive value.

scholarly journals Second-look breast ultrasonography after galactography in patients with nipple discharge

2020 ◽  
Vol 1 (1) ◽  
pp. 58 ◽  
Author(s):  
Hyeonseon Kim ◽  
Bong Joo Kang ◽  
Sung Hun Kim ◽  
Jeong min Lee
Keyword(s):  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Breast Imaging ◽  
Nipple Discharge ◽  
Final Diagnosis ◽  
Second Look ◽  
Significant Difference ◽  
Before And After ◽  
Malignant Lesions

Aim: The objective of this study was to evaluate the diagnostic performance of second-look breast ultrasound (US) immediately after galactography in patients with nipple discharge.Materials and methods: Between January 2010 and November 2018, 89 patients with nipple discharge were retrospectively analyzed. All patients were examined by galactography and US. US was performed twice, before and after galactography. Galactography, mammography and US findings were categorized according to the Breast Imaging Reporting and Data System (BI-RADS). The final diagnosis was established by histopathological examination.Results: Out of 89 patients, 25 (28.1%) patients had positive findings as evident by US before galactography. Forty-eight (53.9%) patients had positive findings as demonstrated by galactography. Fifty-nine (66.3%) patients had positive findings as evident by second-look US after galactography (13 patients with benign, 37 with borderline and 9 with malignant lesions). Second-look US after galactography showed the highest diagnostic accuracy (83.2%), sensitivity (95.8%) and negative predictive value (93.3%) for borderline and malignant lesions. For the detection of malignant lesions, secondlook US after galactography showed the highest sensitivity (90%) and negative predictive value (96.7%). Agreement between imaging and histological result using Bland-Altman analysis exhibited no significant difference between the size establishedby ultrasound and galactography.Conclusion: The second-look US after galactography is a powerful diagnostic tool for the detection of lesions in patients with nipple discharge and demonstrates high diagnostic accuracy, sensitivity and negative predictive value.

scholarly journals Three-hour post-ERCP amylase level: a useful indicator for early prediction of PEP

2019 ◽  
Author(s):  
Ze-Hui Lv ◽  
Da-Qing Kou ◽  
Shi-Bin Guo
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Roc Curve ◽  
Predictive Value ◽  
Serum Amylase ◽  
Amylase Level ◽  
Early Prediction ◽  
Serum Amylase Level ◽  
Significant Difference

Abstract Background : To evaluate the value of the 3-hour post-ERCP serum amylase level for early prediction of post-ERCP pancreatitis (PEP). Method: A study of 206 patients performed ERCP at a single centre was collected from 2011 to 2016. The serum amylase or lipase level was measured at 3 h after ERCP. The patients with PEP were recorded. ROC curves were used to statistically analyze the data: The enrolled patients were divided into two groups according to gender, then be analyzed respectively. We comprehensively evaluated the predictive value of PEP by serum amylase level 3-hour post-ERCP based on the results above. Results : In the 206 patients, the 3-hour post-ERCP pancreatic amylase level was used as the test variable, and the PEP occurrence as the state variable to plot the ROC curve. The optimal cut-off value was 351U/L (sensitivity 76.19%, specificity 83.24%, positive likelihood ratio 4.55, negative likelihood ratio 0.29, Youden index 59.43%). There were 83 patients with both 3-hour post-ERCP amylase level and lipase level detected. The area under the ROC curve for the 3-hour post-ERCP serum amylase was 0.780, and the 95% confidence interval was 0.676-0.864. The optimal cut-off is 380U/L, and there was no statistically significant difference between the two for diagnostic accuracy. According to gender, there was no statistically significant difference in the diagnostic accuracy of the two groups. In the male group, 436 U/L serum amylase provided the greatest diagnostic accuracy with sensitivity(SE) of 70.5%, specificity(SP) of 89.2%, positive predictive value (PPV) 87.5%, and negative predictive value (NPV) 78.1%. Whereas, in the female group, 357U/L serum amylase provided the greatest diagnostic accuracy with sensitivity of 76.9%, specificity of 81.2%, positive predictive value of 80.4%, negative predictive value of 77.9%. Conclusions: 1. The 3-hour post-ERCP serum amylase level is a useful measurement for predicting post-ERCP pancreatitis. 2. There was no significant difference between serum amylase and lipase 3-hour post-ERCP for predicting PEP. 3. There was no statistically significant difference between male and female using the 3-hour post-ERCP serum amylase level to prediction PEP . For female, the optimal cut-off value was 357 U/L, whereas male 436U/L .

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