Diagnostic Accuracy of Ultrasound in Palpable Breast Lesions

2020 ◽  
Vol 5 (3) ◽  
pp. 1196-1200
Author(s):  
Manish Raj Pathak ◽  
Mahesh Gautam ◽  
Rashmita Bhandari
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Diagnostic Tool ◽  
Predictive Value ◽  
Breast Lesions ◽  
Non Invasive ◽  
Malignant Lesions ◽  
Palpable Breast ◽  
Sensitivity Specificity

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

scholarly journals Unenhanced breast MRI: could it replace dynamic breast MRI in detecting and characterizing breast lesions?

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Reham Khalil ◽  
Noha Mohamed Osman ◽  
Nivine Chalabi ◽  
Enas Abdel Ghany
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Breast Mri ◽  
Breast Lesions ◽  
Dce Mri ◽  
Contrast Enhanced ◽  
Mri Protocol ◽  
Sensitivity Specificity

Abstract Background We aimed to evaluate the unenhanced MRI of the breast (UE-MRI) as an effective substitute for dynamic contrast-enhanced breast MRI (DCE-MRI) in both detecting and characterizing breast lesions. We enrolled in our retrospective study 125 females (232 breasts, as 18 patients had unilateral mastectomy) with breast mass at MRI of variable pathologies. Routine DCE-MRI protocol of the breast was conducted. We compared the conventional unenhanced images including STIR, T2, and DWIs to the DCE-MRI by two blinded radiologists, to detect and characterize breast lesions, and then we compared their results with the final reference diagnoses supplied by the histopathology or serial negative follow-ups. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy for UE-MRI and DCE-MRI were calculated. UE-MRI results of each observer were also compared with DCE- MRI. Results The calculated UE-MRI sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for the first observer were 95%, 80%, 83%, 94%, and 89% respectively, and for the second observer, they were 94%, 79%, 81%, 93%, and 86%. On the other hand, those for the DCE-MRI by the first observer were 98%, 82%, 84%, 98%, and 90% and were 97%, 81%, 84%, 97%, and 89% by the second observer. The intraobserver agreement between the UE-MRI and DCE-MRI results of each observer was 94% and 95%, while the interobserver agreement for each section was 97.4% for UE-MRI and 98.3% for DCE-MRI. Conclusion UE-MRI of the breast can be a reliable and effective substitute for breast DCE-MRI. It can be used with comparable accuracy to DCE-MRI whenever contrast administration is not feasible or contraindicated.

UTILITY OF FNAC AS A FIRST LINE INVESTIGATION IN THE EVALUATION OF PALPABLE BREAST LUMPS WITH HISTOPATHOLOGICAL CORRELATION: A FIVE YEAR STUDY.

2021 ◽  
pp. 253-255
Author(s):  
Manisha Khare ◽  
Saraswathi J ◽  
Yogita Sable ◽  
Yasmeen Khatib ◽  
Prajakta Gupte
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Ductal Carcinoma ◽  
Benign Lesion ◽  
Breast Lesions ◽  
Benign Lesions ◽  
Malignant Lesions ◽  
Palpable Breast ◽  
Breast Lumps

Introduction: Fine needle aspiration cytology (FNAC) is a simple cost-effective and rapid diagnostic modality for the evaluation of breast lumps. The aim of the present study was to correlate the cytological diagnosis with histopathological ndings and to nd out the accuracy of FNAC in the evaluation of breast lesions. FNAC is very helpful in distinguishing benign from malignant lesions and deciding the further management of the patient. Materials And Methods: The study comprised of 250 cases of FNAC of palpable breast lesions with histological correlation. All the aspirates were examined using PAP and Giemsa stains. The accuracy of FNAC was calculated by determining the sensitivity, specicity, positive predictive value, negative predictive value and accuracy. Results: Total 250 cases were studied of which there were 246 female and 4 male patients. A concordant diagnosis was made on FNAC in 134 out of 136 of benign lesions, one of two cases of suspicious for malignancy and all 112 cases of malignant lesions. Fibroadenoma(FA) (63.2%) was the commonest benign lesion observed while ductal carcinoma (42%) was the most frequent malignancy seen. In the diagnosis of breast lesions FNAC had a sensitivity of 99.12%, specicity of 98.54%, positive predictive value of 98.25%, negative predictive value of 99.26% and accuracy of 98.8%. Conclusion: FNAC is a reliable tool for diagnosis of breast lesions. It is minimally invasive and is a good alternative to biopsy in the diagnosis of benign lesions. However for the cases which fall into “suspicious for malignancy” category biopsy is advisable.

Diagnostic accuracy of monofilament test to detect diabetic neuropathy

2021 ◽  
Vol 10 (1) ◽  
pp. 20-25
Author(s):  
Sujan Shrestha ◽  
Mamen Prasad Gorhaly ◽  
Manil Ratna Bajracharya
Keyword(s):  
Peripheral Neuropathy ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diabetic Peripheral Neuropathy ◽  
Perception Threshold ◽  
Sensitivity Specificity ◽  
Vibration Perception ◽  
Monofilament Test

Background Diabetic peripheral neuropathy (DPN) is a significant independent risk factor for diabetic foot, and an effective screening instrument is required to diagnose DPN early to prevent future ulceration and amputation. This study aims to determine the diagnostic accuracy of monofilament test to detect diabetic peripheral neuropathy. Methods This cross-sectional study was conducted in National Academy of Medical Sciences, Bir hospital, Mahabouddha, Kathmandu from February 2016 to January 2017. A total of 96 diabetic patients attending inpatient and outpatient Department were selected. Diabetic peripheral neuropathy was assessed by measurement of loss of protective sensation (LOPS) by monofilament test and compared with vibration perception threshold by standard biothesiometer. The sensitivity, specificity, positive predictive value and negative predictive value of monofilament test were calculated. Results The prevalence of diabetic peripheral neuropathy was 26%. The sensitivity, specificity, positive predictive value and negative predictive value of monofilament test were found to be 92.0%, 95.8%, 88.5% and 97.1% respectively. There was strong association between LOPS by monofilament and vibration perception threshold by biothesiometer. Conclusion This study showed a strong diagnostic accuracy of monofilament test to detect DPN when compared with biothesiometer. As monofilament test is a cheap, easily available, and portable, it can be used in the periphery where biothesiometer is not available.  

DIAGNOSTIC ACCURACY OF GRAY SCALE ULTRASONOGRAPHY VERSUS COLOR DOPPLER IN SUSPECTED CASES OF ACUTE APPENDICITIS

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Tahir Iqbal ◽  
Muhammad Usman Shahid ◽  
Ishfaq Ahmad Shad ◽  
Shahzad Karim Bhatti ◽  
Syed Amir Gilani ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Color Doppler ◽  
Diagnostic Tools ◽  
Gray Scale ◽  
Versus Color ◽  
Sensitivity Specificity

ABSTRACT: BACKGROUND: A common surgical emergency is acute appendicitis. Various diagnostic tools are available to diagnosis acute appendicitis. Radiological investigations play an important role in making accurate and early diagnosis and thus preventing morbidity associated with the disease. OBJECTIVE: To determine the diagnostic accuracy of gray scale ultrasonography versus color Doppler in suspected cases of acute appendicitis. MATERIALS AND METHODS: The study was carried in the department of Radiology of Mayo Hospital, Lahore. A total of 75 patients were enrolled of age 18-40 years, both genders who were suspected cases of acute appendicitis. All patients underwent baseline investigations along with gray scale ultrasonography and color Doppler. All patients were subjected to surgery to confirm the diagnosis and findings were subjected to statistical analysis. RESULTS: The mean age of the patients was 23.25 ±10.55 and mean transverse diameter of appendix was 8.37 ±3.39. There were 62.7% males and 37.3%females. Findings of gray scale ultrasonography and color Doppler were then correlated with surgical findings to calculate the diagnostic accuracy of these modalities. The results revealed that gray scale ultrasonography sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 92.7%, 94.32%, 95%, 91.4% and 93.3% respectively, whereas color Doppler had sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 97.7%, 93.9%, 95.3%, 97% and 96% respectively. Diagnostic accuracy of both modalities together was 98.6%. CONCLUSION: Color Doppler has better diagnostic accuracy than gray scale ultrasonography for diagnosis of acute appendicitis and the combination of both modalities yields diagnostic accuracy that is similar to gold standard.

scholarly journals Validation of the Dutch leakage score as a predictor of anastomotic leakage in intestinal surgery in a third level hospital

2021 ◽  
Vol 9 (11) ◽  
pp. 3251
Author(s):  
Alan Barker-Antonio ◽  
Arturo Jarquin-Arremilla ◽  
Elias Hernandez Cruz ◽  
Roberto Armando Garcia-Manzano ◽  
Ediel Osvaldo Davila-Ruiz
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Anastomotic Leakage ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Intestinal Anastomosis ◽  
Intestinal Surgery ◽  
Patient Death ◽  
Versatile Tool ◽  
Sensitivity Specificity

Background: Intestinal surgery can present multiple complications that can lead to patient death; therefore, it is important to design early detection strategies to reduce complications in patients with intestinal anastomosis and thus avoid patient death. The aim of this work is to evaluate the diagnostic performance of the Dutch leakage score in 125 patients with intestinal anastomosis as a predictor of anastomotic leakage.Methods: In a sample of 125 patients undergoing intestinal anastomosis, demographic variables were identified and the Dutch leakage score was applied. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were obtained using a 2×2 table.Results: The Dutch leakage score was positive in 23.2% (29 patients) of whom 24 had anastomotic leakage and 5 had no anastomotic leakage. It presents a sensitivity in the test of 100%, a specificity of 95%, a positive predictive value of 82.7%, a negative predictive value of 100%. The diagnostic accuracy is 96%.Conclusions: The Dutch leakage score is a versatile tool, inexpensive, easy to apply and available in any hospital center. It is capable of early diagnosis of anastomotic leakage. It favors early re-intervention, improves prognosis and survival, decreases hospital stay and health care costs.

scholarly journals A Comparative Analysis Between RIPASA and Alvarado Scoring Systems for the Diagnosis of Acute Appendicitis- A Nepalese Perspective

2018 ◽  
Vol 6 (2) ◽  
Author(s):  
Suman Baral ◽  
Neeraj Thapa ◽  
Raj Kumar Chhetri ◽  
Rupesh Sharma
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Scoring System ◽  
Scoring Systems ◽  
Negative Appendectomy ◽  
Alvarado Score ◽  
Sensitivity Specificity

Introduction: Various diagnostic criteria have been described for acute appendicitis. For decades the most commonly used one has been Alvarado score. RIPASA scoring system has also been developed for Asian population which has shown highest sensitivity and diagnostic accuracy. This study aimed to compare these two diagnostic criteria in Nepalese population attending a tertiary center. Methods: Patients with clinically suspected acute appendicitis were classified according to both Alvarado and RIPASA scoring systems before undergoing surgery. Histopathological examination was taken as the gold standard for diagnosis. Statistical analysis was done using McNemar's test as applicable. Results: Ninety nine (90 %) patients had histologically confirmed appendicitis. With the cut-off value greater than 7.5 for RIPASA score; sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and negative appendectomy rates were 94.5%, 27.27 %, 92.16 %, 37.5 %, 88.18% and 7.84% respectively. With the cut-off value greater than 7 for Alvarado score, sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and negative appendectomy rates were 71.72%, 72.73 %, 95.95 %, 22.22%, 71.82 %, and 4.05 % respectively. 94.5% of patients were correctly stratified by RIPASA under higher probability group while only 71.8 % were classified by Alvarado (p value= 0.0001). Conclusion: RIPASA scoring system showed high sensitivity and diagnostic accuracy in comparison to Alvarado scoring system. So, this method can be applied in Nepalese setting for the diagnosis of acute appendicitis.

scholarly journals ROLE OF DOPPLER INDICES IN THE PREDICTION OF ADVERSE PERINATAL OUTCOME IN PREECLAMPSIA

2021 ◽  
Vol 71 (4) ◽  
pp. 1209-1213
Author(s):  
Shakra Tabasam ◽  
Zaib Malik ◽  
Asifa Siraj ◽  
Sadaf Afroz
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Perinatal Outcome ◽  
Military Hospital ◽  
Reference Standard ◽  
Adverse Perinatal Outcome ◽  
Doppler Study ◽  
Sensitivity Specificity

Objective: To determine diagnostic accuracy of systolic/diastolic ratio and cerebro-placental index in predicting adverse perinatal outcome among patients in preeclampsia. Study Design: Cross-sectional validation study. Place and Duration of Study: Department of Obstetrics and Gynaecology, Pak Emirates Military Hospital, Rawalpindi, from Jun to Dec 2017. Methodology: A total of 191 patients with preeclampsia were included. Doppler ultrasound (including doppler wave forms obtained from free floating portion of umbilical artery and doppler waveform from middle cerebral artery at the level of circle of Willis) examination was done after gestational age 30 weeks and Doppler study repeated at 2-4 weeks interval depending on severity of preeclampsia and abnormalities of waveform. Cases were followed and results of last Doppler examination within 10 days of delivery were considered and perinatal outcome noted. Results: The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of systolic/diastolic ratio in predicting adverse perinatal outcome among patients in preeclampsia, keeping actual adverse perinatal outcome as reference standard was 82.35%, 86.52%, 87.50%, 81.05% and 84.29% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of cerebro-placental index in predicting adverse perinatal outcome among patients in preeclampsia, keeping actual adverse perinatal outcome as reference standard was 78.67%, 92.24%, 86.76%, 86.99% and 86.91% respectively. Conclusion: The diagnostic accuracy of systolic/diastolic ratio, cerebro-placental index in predicting adverse perinatal outcome among patients in preeclampsia is quite high.

scholarly journals Diagnosis of Congenital Anomalies of Kidney and Ureter by Ultrasonography

2015 ◽  
Vol 5 (1) ◽  
pp. 8-11
Author(s):  
Fathima Nusrath Halim ◽  
Mohammad Ali Sarker ◽  
Farah Nazlee ◽  
Md Nazrul Islam
Keyword(s):  
Kidney Disease ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Congenital Anomalies ◽  
Transabdominal Ultrasonography ◽  
Imaging Tool ◽  
Congenital Kidney Anomalies ◽  
Sensitivity Specificity

Present study was conducted to investigate the diagnostic accuracy of transabdominal ultrasonography in correlation with IVU in suspected patients of Congenital anomalies of kidney and Ureter. In study, ultrasonography and IVU was done in 50 clinically suspected patients of congenital anomalies of kidney that was admitted in BSMMU, BIRDEM & DMCH during the period of July 2008 to May 2009. Patients of all ages and both sexes were included. Findings of USG and IVU were correlated. Sonographically abnormalities were diagnosed in 46 (92%) cases, out of which 45 (95.7%) also diagnosed by IVU and 1 (33.3) was normal in IVU. Out of 4 (8%) Sonographically demonstrated normal cases, 2 (4.3%) were proved normal by IVU and 2 (66.7%) cases which missed by sonography were diagnosed by IVU. Sensitivity of ultrasonography in diagnosing congenital kidney disease was 95.7% and specificity was 66.7%, positive predictive value was 97.8%, negative predictive value was 50.0% and accuracy was 94.0%. So, we conclude that ultrasonography has significant sensitivity, specificity, positive predictive value, and accuracy in diagnosis of congenital kidney anomalies correlating with IVU. As such, USG can be considered as an appropriate imaging tool for diagnosis of congenital anomalies of kidney.J. Paediatr. Surg. Bangladesh 5(1): 8-11, 2014 (January)

scholarly journals A comparative study of RIPASA score and modified Alvarado score in diagnosis of acute appendicitis

2019 ◽  
Vol 6 (11) ◽  
pp. 3937
Author(s):  
Waleed Yusif El Sherpiny
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Scoring System ◽  
Negative Appendectomy ◽  
Alvarado Score ◽  
Sensitivity Specificity ◽  
Ripasa Score

Background: Various diagnostic criteria have been described for diagnosing acute appendicitis. Of these, Alvarado score has been the most commonly used. The RIPASA score is a new diagnostic scoring system developed for the diagnosis of acute appendicitis and showed higher sensitivity, specificity and diagnostic accuracy as compared to Alvarado score. we want to compare prospectively Alvarado and RIPASA score by applying them to patients attending emergency department complaining of right iliac fossa pain that could probably be acute appendicitis.Methods: Patients with clinically suspected acute appendicitis were classified according to both Alvarado and RIPASA scoring systems before undergoing surgery. Histopathological examination of the removed appendix was taken as the gold standard for diagnosis of acute appendicitis.Results: Among (90%) patients had histologically confirmed appendicitis. With the cut-off value greater than 7.5 for RIPASA score; sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy  were 88.2%, 14.5%, 73.1%, 32%,and 68% respectively. With the cut-off value greater than 7 for Alvarado score, sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and negative appendectomy rates were 51.2%, 80 %, 91 %, 29%, and 57%, respectively. 87.5% of patients were correctly stratified by RIPASA under higher probability group while only 45% were classified by Alvarado as high probability.Conclusions: RIPASA scoring system showed high sensitivity and diagnostic accuracy in comparison to Alvarado scoring system. So, it can be applied   for the diagnosis of acute appendicitis.

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.

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