Update on the Diagnosis of Gestational Trophoblastic Disease

Penyakit trofoblas gestasional (PTG)/Gestational trophoblastic disease (GTD) terdiri dari kelompok mola hidatidosa yang terbagi menjadi komplit dan parsial, hingga kelompok Tumor trofoblas gestasional (TTG)/Gestational trophoblastic neoplasia (GTN) yang terdiri dari mola invasif, koriokarsinoma, dan placental site trophoblastic tumour/epithelioid trophoblastic tumour (PSTT/ETT). TTG dikategorikan menjadi dua yaitu yang tidak bermetastasis (hanya terbatas di uterus) dan yang bermetastasis (telah menyebar ke vagina, paru-paru atau otak). Penegakan diagnosis inisial PTG melalui pendekatan multimodalitas mencakup gejala klinis, kadar hCG dan pemeriksaan USG pelvis. Doppler membantu menilai angiogenesis dan karakterisitik neovaskularisasi PTG. Gambaran yang tampak pada USG akan menjelaskan gambaran pada histopatologinya. Pemeriksaan penunjang lain untuk PTG adalah rontgen thoraks, CT Scan dan MRI. Saat ini pemeriksaan imunohistokimia (IHK) dan polymerase chain reaction (PCR) sudah mulai digunakan untuk menentukan diagnosis PTG. Pemantauan hCG mempunyai peran penting dalam penatalaksanaan PTG. Tetapi karena terdapat beberapa pedoman yang menyatakan protokol berbeda-beda dalam pemantauan hCG, hal ini membuat para dokter spesialis obgin mempertanyakan mengenai pemantauan hCG pasca evakuasi. Himpunan Onkologi Ginekologi Indonesia mengeluarkan suatu Pedoman Nasional Pelayanan Kedokteran (PNPK) Tumor Trofoblas Gestasional yang didalamnya terkait diagnosis dan penatalaksaan TTG.

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A meta-analysis of accuracy and sensitivity of chest CT and RT-PCR in COVID-19 diagnosis

Scientific Reports ◽

10.1038/s41598-020-80061-2 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Fatemeh Khatami ◽

Mohammad Saatchi ◽

Seyed Saeed Tamehri Zadeh ◽

Zahra Sadat Aghamir ◽

Alireza Namazi Shabestari ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Reverse Transcriptase ◽

Ct Scan ◽

Predictive Value ◽

Meta Analysis ◽

Chest Ct ◽

Rt Pcr ◽

Chain Reaction ◽

Polymerase Chain ◽

Chest Ct Scan

AbstractNowadays there is an ongoing acute respiratory outbreak caused by the novel highly contagious coronavirus (COVID-19). The diagnostic protocol is based on quantitative reverse-transcription polymerase chain reaction (RT-PCR) and chests CT scan, with uncertain accuracy. This meta-analysis study determines the diagnostic value of an initial chest CT scan in patients with COVID-19 infection in comparison with RT-PCR. Three main databases; PubMed (MEDLINE), Scopus, and EMBASE were systematically searched for all published literature from January 1st, 2019, to the 21st May 2020 with the keywords "COVID19 virus", "2019 novel coronavirus", "Wuhan coronavirus", "2019-nCoV", "X-Ray Computed Tomography", "Polymerase Chain Reaction", "Reverse Transcriptase PCR", and "PCR Reverse Transcriptase". All relevant case-series, cross-sectional, and cohort studies were selected. Data extraction and analysis were performed using STATA v.14.0SE (College Station, TX, USA) and RevMan 5. Among 1022 articles, 60 studies were eligible for totalizing 5744 patients. The overall sensitivity, specificity, positive predictive value, and negative predictive value of chest CT scan compared to RT-PCR were 87% (95% CI 85–90%), 46% (95% CI 29–63%), 69% (95% CI 56–72%), and 89% (95% CI 82–96%), respectively. It is important to rely on the repeated RT-PCR three times to give 99% accuracy, especially in negative samples. Regarding the overall diagnostic sensitivity of 87% for chest CT, the RT-PCR testing is essential and should be repeated to escape misdiagnosis.

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The exact place of PCR and chest CT in screening, staging, and diagnosis of Covid-19: A meta-analysis

10.21203/rs.3.rs-32961/v1 ◽

2020 ◽

Author(s):

Fatemeh Khatami ◽

Mohammad Saatchi ◽

Seyed Saeed Tamehri Zadeh ◽

Zahra Sadat Aghamir ◽

Alireza Namazi Shabestari ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Reverse Transcriptase ◽

Ct Scan ◽

Predictive Value ◽

Meta Analysis ◽

Chest Ct ◽

Rt Pcr ◽

Chain Reaction ◽

Polymerase Chain ◽

Chest Ct Scan

Abstract Introduction: Nowadays there is an ongoing acute respiratory outbreak causing by the novel highly contagious coronavirus (nCoV). There are two diagnostic protocol based on chest CT scan and quantitative reverse-transcription polymerase chain reaction (RT-PCR) which their diagnostic accuracy is under the debate. We designed this meta-analysis study to determine the diagnostic value of initial chest CT scan in patients with nCoV infection in comparison with RT- PCR.Search strategy and statistical analysis: Three main databases the PubMed (MEDLINE), Scopus, and EMBASE was systematically searched for all published literatures from January 1st, 2019, to the 27th march 2020 with key grouping of “COVID19 virus”, “2019 novel coronavirus”, “Wuhan coronavirus”, “2019-nCoV”, “X-Ray Computed Tomography”, “Polymerase Chain Reaction”, “Reverse Transcriptase PCR”, and “PCR Reverse Transcriptase”. All relevant case- series, cross-sectional, and cohort studies were selected. Data extraction was done in Excel 2007 (Microsoft Corporation, Redmond, CA) and their analysis was performed using STATA v.14.0SE (College Station, TX, USA) and RevMan 5.Result: From first recruited 668 articles we end up to the final 47 studies, which comprised a total sample size of 4238 patients. In compare to RT-PCR, the overall sensitivity, specificity, positive predictive value, and negative predictive value of chest CT scan were 86% (95% CI: 83% -90%), 43 % (95% CI: 26% -60%), 67% (95% CI: 57% -78%), and 84% (95% CI: 74% -95%) respectively. However the RT-PCR should be repeated for three times in order to give the 99% accuracy especially in negative samples.Conclusion: According to the acceptable sensitivity of chest CT scan, it can be employed complement to RT-PCR to diagnosis patients who are clinically suspicious for nCoV.

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Radiological changes observed in Covid 19 Pneumonia and utilization of CT scan as a screening tool along with a real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) for effective diagnosis

Medical Science and Discovery ◽

10.36472/msd.v7i8.411 ◽

2020 ◽

Vol 7 (8) ◽

pp. 578-583

Author(s):

Bisma Mukhtar ◽

Omar Mukhtar ◽

Bilal Malik

Keyword(s):

Polymerase Chain Reaction ◽

Reverse Transcriptase ◽

Viral Infection ◽

Ct Scan ◽

Screening Tool ◽

Review Article ◽

Chain Reaction ◽

Radiological Changes ◽

Polymerase Chain ◽

Effective Diagnosis

Objective: In this review article, Symptom and diagnosis of SARS-COV-2 or more commonly known as COVID-19 viral infection have been reviewed based on current literature. The CT scan, rRT-PCR results for infected patients have been focused on.

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Computed Tomography of the Chest in COVID-19: A Pictorial Review of Indian Patients

Annals of the National Academy of Medical Sciences (India) ◽

10.1055/s-0041-1728973 ◽

2021 ◽

Author(s):

Kumble Seetharama Madhusudhan ◽

Deep Narayan Srivastava ◽

Kushagra V. Garg ◽

Niranjan Khandelwal

Keyword(s):

Computed Tomography ◽

Polymerase Chain Reaction ◽

Severe Acute Respiratory Syndrome ◽

Ct Scan ◽

High Accuracy ◽

Rt Pcr ◽

Chain Reaction ◽

Pictorial Review ◽

The Common ◽

Polymerase Chain

AbstractThe Coronavirus disease 2019, caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), has evolved into a pandemic and has affected more than 130 million people globally to date and continues to infect more. The disease primarily involves the respiratory system and manifests as fever, dry cough, dyspnea, and myalgia. Nearly half of the infected patients may be asymptomatic. The real-time reverse transcriptase polymerase chain reaction (RT-PCR) performed on the blood or respiratory samples is the diagnostic test with high accuracy. Although imaging with CT is not routinely indicated in this disease, this modality may provide a quick answer and assist in making a diagnosis in certain situations. In addition, imaging with CT also aids in evaluating the progress of the disease and in prognostication. A thorough knowledge of the common findings on the CT scan helps a radiologist in suggesting a diagnosis when it is performed in unsuspected patients. In this review, we describe the common and uncommon chest findings of COVID-19 on the CT scan.

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Results of treatment of gestational trophoblastic neoplasia in the Slovak Republic in the years 1993–2017

Česká gynekologie ◽

10.48095/cccg202194 ◽

2021 ◽

Vol 86 (2) ◽

pp. 94-101

Author(s):

Miroslav Korbeľ ◽

◽

Jozef Šufliarsky ◽

Ľudovít Danihel ◽

Zuzana Nižňanská

Keyword(s):

Slovak Republic ◽

Staging System ◽

Gestational Trophoblastic Disease ◽

World Health ◽

Gestational Trophoblastic Neoplasia ◽

Trophoblastic Disease ◽

Gynecology And Obstetrics ◽

Placental Site ◽

Invasive Mole ◽

Trophoblastic Tumours

Overview Objective: Gestational trophoblastic neoplasia epidemiology and treatment results in the Slovak Republic in the years 1993–2017. Methods: Retrospective analysis results of gestational trophoblastic neoplasia treatment in the Centre for gestational trophoblastic disease in the Slovak Republic in Bratislava in the years 1993–2017 according to prognostic scoring and staging system FIGO/WHO (International Federation of Gynecology and Obstetrics/World Health Organization). Results: The Centre for Gestational Trophoblastic Disease was created in the Slovak Republic in the year 1993, after the split of former Czechoslovakia. A total of 100 patients with gestational trophoblastic neoplasia were treated in this Centre in the years 1993–2017. According to prognostic scoring and staging system FIGO/ WHO, 74% patients were at a low risk and 26% of patients were at a high-risk of gestational trophoblastic neoplasia. There were 56, 2, 32 and 10% patients in stages I, II, III, and IV, respectively. The total curability and mortality rates were 96 and 4%, respectively. The curability rate 100% was achieved in stages I–III and in all placental site trophoblastic tumours, and the curability rate 60% was achieved in stage IV. In the years 1993 –2017, the incidences were 1 in 59,315 pregnancies and 1 in 42,299 deliveries for choriocarcinoma, 1 in 489,348 pregnancies and 1 in 348,965 deliveries for placental site trophoblastic tumours, 1 in 139,814 pregnancies and 1 in 99,704 deliveries for invasive mole, and 1 in 39,947 pregnancies and 1 in 28,487 deliveries for persistent gestational trophoblastic neoplasia. In the Czech Republic in the same period of time, there were treated 281 (301) patients with the curability rate 98.6% (98.7%). Conclusion: The results of the treatment of gestational trophoblastic neoplasia in the Slovak Republic are comparable with those achieved by leading centers specialized for the treatment of this disease in Europe and in the world. Early detection and centralisation of the treatment are crucial points for successful treatment, as the high curability rate of gestational trophoblastic neoplasia is achieved by effective therapy. Keywords: gestational trophoblastic neoplasia – choriocarcinoma – placental site trophoblastic tumour – epithelioid trophoblastic tumour – invasive mole – curability – mortality – reproductive outcomes

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Peran pemeriksaan radiologis pada diagnosis Coronavirus disease 2019

Jurnal Kedokteran Syiah Kuala ◽

10.24815/jks.v20i1.18300 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Budi Yanti ◽

Ulfa Hayatun

Keyword(s):

Polymerase Chain Reaction ◽

Ct Scan ◽

Real Time ◽

False Negative ◽

Ground Glass Opacity ◽

Rt Pcr ◽

Chain Reaction ◽

Lung Abnormalities ◽

Polymerase Chain ◽

Radiological Examinations

Abstrak. Coronavirus Disease 19 (COVID-19) telah menjadi pandemi di seluruh dunia dengan angka kejadian yang terus meningkat di beberapa negara. Kecepatan dan ketepatan diagnosis diperlukan untuk mencegah perburukan kondisi pasien. Real-Time Transcription Polymerase Chain Reaction (RT-PCR) sampai saat ini masih menjadi baku emas untuk menegakkan diagnosis COVID-19, namun uji diagnostik ini dilaporkan banyak menunjukkan hasil negatif palsu. Pemeriksaan radiologi berupa foto toraks dan CT-Scan dada banyak dilakukan untuk menunjang diagnosis COVID-19. Gambaran foto toraks yang paling sering ditemukan adalah konsolidasi, ground-glass opacity (GGO), distribusi bilateral, perifer dan di lobus bawah paru-paru, namun pemeriksaan ini dianggap tidak sensitif untuk menemukan kelainan paru pada tahap awal penyakit. Meskipun demikian, foto toraks dapat digunakan untuk memantau perkembangan kelainan paru akibat COVID-19, salah satunya dengan metode Brixia Score. Pada sisi lain,CT-scan dada dinilai lebih sensitif daripada foto toraks serta mampu menunjukkan kelainan paru tahap awal pada pasien dengan hasil RT-PCR yang negatif. Gambaran pada CT-scan dada umumnya menunjukkan GGO, konsolidasi, crazy-paving stone, dan air bronchogram. CT-scan dapat mengurangi angka negatif palsu pada RT-PCR dan sebagai alat skrining pada pasien yang dicurigai COVID-19 di lokasi epidemis saat hasil RT-PCR tidak tersedia. Penggunaan pemeriksaan radiologi dan RT-PCR dapat menghemat waktu serta membantu diagnosis dan manajemen COVID-19. Kata Kunci: Pencitraan COVID-19, Radiologi SARS-CoV-2Abstract. Coronavirus Disease 19 (COVID-19) has become a worldwide pandemic with an increasing incidence in several countries. Speed and accuracy of diagnosis are needed to prevent worsening of patient's condition. Real-Time Transcription Polymerase Chain Reaction (RT-PCR) is still a gold standard of COVID-19 diagnosis, however, this test shown false negative results in several case. Radiological examinations, chest X-Ray (CXR) and CT scan, are used to support the diagnosis. The most commonly found in CXR are consolidation, ground-glass opacity (GGO), bilateral distribution, peripheral and in the lower lobe, but this examination is insensitive to find lung abnormalities in early stages of disease. However, CXR can be used to monitor the development of lung abnormalities due to COVID-19, such as the Brixia Score method. On the other hand, CT-Scan is more sensitive than CXR and able to show early lung abnormalities in negative RT-PCR results. CT scan show the presence of GGO, consolidation, crazy-paving stone, and air bronchogram. CT-scanning can reduce the false-negative rate on RT-PCR and become a screening tool in suspected COVID-19 patients at epidemic area where RT-PCR is not available. The use of radiological examinations and RT-PCR can save the time and help in the diagnosis and management of COVID-19.Keywords: COVID-19’s Radiology, Imaging of SARS-CoV-2

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Detection of Coronavirus Disease (COVID-19) using Radiological Examinations

Journal of Pure and Applied Microbiology ◽

10.22207/jpam.14.spl1.28 ◽

2020 ◽

Vol 14 (suppl 1) ◽

pp. 911-920 ◽

Cited By ~ 2

Author(s):

Muhammad Shahzeb ◽

Areena Khan ◽

Anees Muhammad

Keyword(s):

Polymerase Chain Reaction ◽

Ct Scan ◽

Real Time ◽

The United States ◽

Chain Reaction ◽

Imaging Technology ◽

Qrt Pcr ◽

The World ◽

Polymerase Chain ◽

Radiological Examinations

An outbreak of Coronavirus disease 2019 (COVID-19) occurred in China. The causative agent of COVID-19 is Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The disease rapidly spreads from China to the world by trading and traveling. Until April 24, 2020, approximately 2,544,792 cases were confirmed with 175,694 deaths throughout the world. The highest number of cases were identified from the United States of America (USA) whereas the mortality rate is high in Portugal. The diagnosis of COVID-19 is based on Computed Tomography Scanning (CT Scan) and Real-Time Reverse Transcription Polymerase Chain Reaction (qRT-PCR). Assessing the extension of pathology, the exact location of the area involved, and assessment of the disease severity makes CT scan superior to other modalities. This review shows that real-time polymerase chain reaction and imaging technology both play an important role in the diagnosis of COVID-19. However, imaging modalities have more importance in diagnosis and screening than qRT-PCR. The qRT-PCR was positive in 81.3% whereas CT scan abnormality was observed in 89.8%. Bilateral lobe (51.4%) abnormality was found more than a single lobe (21.5%) in COVID-19 infected patients. The CT scan reports show a high-level abnormality in right lower lung lobe than others in COVID-19 infected patients. The CT scan evaluates different manifestations such as the presence of ground-glass opacities, consolidations, crazy paying linear, cavitation, discrete nodules, pleural effusion, and lymphadenopathy. It is concluded that imaging technology especially CT scan and X-rays play an important role in the screening and diagnosis of COVID-19 infected patients in limited access to qRT-PCR regions. The common radiological manifestation was also determined, which will be helpful for the radiologist to diagnosed COVID-19 infected patients in the early stages. Follow up studies required regarding the radiological examinations.

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High performance Nanogold™-in situ hybridzation and its use in the detection of hybridized and PCR-amplified microscopical preparations

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100166944 ◽

1996 ◽

Vol 54 ◽

pp. 896-897

Author(s):

G. W. Hacker ◽

I. Zehbe ◽

J. Hainfeld ◽

A.-H. Graf ◽

C. Hauser-Kronberger ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Messenger Rna ◽

High Performance ◽

Detection System ◽

Direct Methods ◽

Genetic Alterations ◽

Chain Reaction ◽

Protein Encoding ◽

Polymerase Chain

In situ hybridization (ISH) with biotin-labeled probes is increasingly used in histology, histopathology and molecular biology, to detect genetic nucleic acid sequences of interest, such as viruses, genetic alterations and peptide-/protein-encoding messenger RNA (mRNA). In situ polymerase chain reaction (PCR) (PCR in situ hybridization = PISH) and the new in situ self-sustained sequence replication-based amplification (3SR) method even allow the detection of single copies of DNA or RNA in cytological and histological material. However, there is a number of considerable problems with the in situ PCR methods available today: False positives due to mis-priming of DNA breakdown products contained in several types of cells causing non-specific incorporation of label in direct methods, and re-diffusion artefacts of amplicons into previously negative cells have been observed. To avoid these problems, super-sensitive ISH procedures can be used, and it is well known that the sensitivity and outcome of these methods partially depend on the detection system used.

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