CLINICAL APPLICATION OF COVID-19 REPORTING AND DATA SYSTEM IN COMPUTED TOMOGRAPHY OF BILATERAL PNEUMONIA DIAGNOSTIC

Background: the 2019 coronavirus disease pandemic (COVID-19) has spread at an astonishing speed across the world, causing major morbidity and mortality. Computed tomography (CT) examination plays an important role in crisis areas in the diagnosis of COVID-19. COVID-19 Reporting and Data System (CO-RADS) has a five-point scale of suspicion for COVID-19 pneumonia in chest CT picture which standardizes the evaluation scheme and simplifies reporting. Aim: to summarise and present the role of COVID-19 Reporting and Data System in computed tomography of bilateral pneumonia diagnostic. Materials and methods: recently published studies were reviewed to evaluate COVID-19 Reporting and Data System scale as effective tool to detect COVID-19 pneumonia on chest CT scans. Databases from the subscription list of Lithuanian University of Health Sciences were selected: Medline (PubMed), SpringerLink and ScienceDirect. Results: chest CT features, as bilateral involvement, subpleural or peripherally distributed GGO, consolidation, reticulation, crazy paving pattern, air bronchogram signs, intralobular septal thickening, pulmonary vascular enlargement, are considered to be characteristic manifestations of COVID-19 infection. Studies show that Dutch Radiological Society presented CO-RADS scale sensitivity and specificity may vary from 61-88% and 66,4-98%, respectively. Conclusion: chest CT scan has a high sensitivity for COVID-19 diagnosis and could reduce false negative results obtained from RT-PCR tests. Furthermore, a standardized reporting system could increase clarification, minimize reporting variability and help radiologists recognize the results they observe, especially, for less experienced specialists.

Download Full-text

Pearls and Pitfalls of Interpretation in CT Colonography

Canadian Association of Radiologists Journal ◽

10.1177/0846537119892881 ◽

2020 ◽

Vol 71 (2) ◽

pp. 140-148

Author(s):

Michael Schonberger ◽

Philippe Lefere ◽

Abraham H. Dachman

Keyword(s):

Computed Tomography ◽

Sensitivity And Specificity ◽

False Positive ◽

Ct Colonography ◽

False Negative ◽

High Sensitivity ◽

Negative Results ◽

False Negative Results ◽

The Common

The accuracy of computed tomography (CT) colonography (CTC) requires that the radiologist be well trained in the recognition of pitfalls of interpretation. In order to achieve a high sensitivity and specificity, the interpreting radiologist must be well versed in the causes of both false-positive and false-negative results. In this article, we review the common and uncommon pitfalls of interpretation in CTC.

Download Full-text

Visualization of Lesions of Metaphyses and Epiphyses of Bones in Newborns and Young Children

Radiology - Practice ◽

10.52560/2713-0118-2021-5-82-90 ◽

2021 ◽

pp. 82-90

Author(s):

N. A. Sholokhova

Keyword(s):

Young Children ◽

False Negative ◽

Age Groups ◽

High Sensitivity ◽

Negative Results ◽

False Negative Results ◽

Inflammatory Processes ◽

Group 5 ◽

Magnetic Resonance Imaging Mri ◽

Diagnostic Capabilities

The aim of this study was to determine the diagnostic capabilities of various methods of radiological diagnostics for lesions of the metaphyses and epiphyses of bones in newborns and young children.The study involved 108 children in the age group 5 days – 12 months with pathological changes in the pineal gland and bone metaphysis. The possibilities and advantages of standard radiography (СR), ultrasound examination (US) and magnetic resonance imaging (MRI) in the early and differential diagnosis of the osteomyelitis process and epiphyseolysis have been determined. High sensitivity (98 %), specificity (99 %) and accuracy (98 %) for ultrasound and sensitivity (94 %), specificity (89 %) and accuracy (95 %) of MRI in diagnosing osteomyelitis in patients of this age groups. At the same time, the possibilities of standard radiography at the stages of early diagnosis of inflammatory processes in the distal parts of the bones were limited due to a number of factors. The use of diagnostic algorithms greatly facilitates the work of a radiologist and reduces the number of false negative results during the initial treatment of patients.

Download Full-text

Prozone-like phenomenon in travellers with fatal malaria: report of two cases

The Journal of Infection in Developing Countries ◽

10.3855/jidc.5454 ◽

2015 ◽

Vol 9 (03) ◽

pp. 321-324 ◽

Cited By ~ 6

Author(s):

Lurdes Santos ◽

Nuno Rocha Pereira ◽

Paulo Andrade ◽

Paulo Figueiredo Dias ◽

Carlos Lima Alves ◽

...

Keyword(s):

Diagnostic Tests ◽

False Negative ◽

Specific Antigen ◽

Malaria Diagnosis ◽

High Sensitivity ◽

Rapid Diagnostic Tests ◽

Microscopy Observation ◽

Negative Results ◽

False Negative Results ◽

Potential Benefits

Malaria diagnosis remains a concern in non-endemic countries, with rapid diagnosis being crucial to improve patients’ outcome. Rapid diagnostic tests have high sensitivity but they also have flaws and false-negative results that might jeopardize malaria diagnosis. Some false-negative results might relate to a prozone-like effect. The authors describe two patients with false-negative rapid diagnostic tests in which a prozone-like effect might have been involved. The authors highlight that these tests should not be used without accompanying light microscopy observation of blood films and discuss potential benefits of using rapid diagnostic tests with more than one specific antigen for Plasmodium falciparum.

Download Full-text

Cell-free DNA screening for aneuploidies in 7113 pregnancies: single Italian centre study

Genetics Research ◽

10.1017/s001667232000004x ◽

2020 ◽

Vol 102 ◽

Cited By ~ 1

Author(s):

Alvaro Mesoraca ◽

Katia Margiotti ◽

Claudio Dello Russo ◽

Anthony Cesta ◽

Antonella Cima ◽

...

Keyword(s):

Sex Chromosome ◽

Clinical Performance ◽

False Negative ◽

Prenatal Testing ◽

High Sensitivity ◽

Trisomy 13 ◽

Sequencing Platform ◽

Non Invasive ◽

Negative Results ◽

False Negative Results

Abstract Introduction Non-invasive prenatal testing (NIPT) using cell-free foetal DNA has been widely accepted in recent years for detecting common foetal chromosome aneuploidies, such as trisomies 13, 18 and 21, and sex chromosome aneuploidies. In this study, the practical clinical performance of our foetal DNA testing was evaluated for analysing all chromosome aberrations among 7113 pregnancies in Italy. Methods This study was a retrospective analysis of collected NIPT data from the Ion S5 next-generation sequencing platform obtained from Altamedica Medical Centre in Rome, Italy. Results In this study, NIPT showed 100% sensitivity and 99.9% specificity for trisomies 13, 18 and 21. Out of the 7113 samples analysed, 74 cases (1%) were positive by NIPT testing; foetal karyotyping and follow-up results validated 2 trisomy 13 cases, 5 trisomy 18 cases, 58 trisomy 21 cases and 10 sex chromosome aneuploidy cases. There were no false-negative results. Conclusion In our hands, NIPT had high sensitivity and specificity for common chromosomal aneuploidies such as trisomies 13, 18 and 21.

Download Full-text

Unexplained False Negative Results in Noninvasive Prenatal Testing: Two Cases Involving Trisomies 13 and 18

Case Reports in Genetics ◽

10.1155/2015/926545 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

R. Hochstenbach ◽

G. C. M. L. Page-Christiaens ◽

A. C. C. van Oppen ◽

K. D. Lichtenbelt ◽

J. J. T. van Harssel ◽

...

Keyword(s):

False Negative ◽

Prenatal Testing ◽

High Sensitivity ◽

Trisomy 13 ◽

Maternal Weight ◽

Noninvasive Prenatal Testing ◽

Root Cause ◽

Negative Results ◽

False Negative Results ◽

Negative Case

Noninvasive prenatal testing (NIPT) validation studies show high sensitivity and specificity for detection of trisomies 13, 18, and 21. False negative cases have rarely been reported. We describe a false negative case of trisomy 13 and another of trisomy 18 in which NIPT was commercially marketed directly to the clinician. Both cases came to our attention because a fetal anatomy scan at 20 weeks of gestation revealed multiple anomalies. Karyotyping of cultured amniocytes showed nonmosaic trisomies 13 and 18, respectively. Cytogenetic investigation of cytotrophoblast cells from multiple placental biopsies showed a low proportion of nontrisomic cells in each case, but this was considered too small for explaining the false negative NIPT result. The discordant results also could not be explained by early gestational age, elevated maternal weight, a vanishing twin, or suboptimal storage or transport of samples. The root cause of the discrepancies could, therefore, not be identified. The couples involved experienced difficulties in accepting the unexpected and late-adverse outcome of their pregnancy. We recommend that all parties involved in caring for couples who choose NIPT should collaborate to clarify false negative results in order to unravel possible biological causes and to improve the process of patient care from initial counseling to communication of the result.

Download Full-text

Assessment of the IgA Immunoassay Diagnostic Potential of the Mycobacterium tuberculosis MT10.3-MPT64 Fusion Protein in Tuberculous Pleural Fluid

Clinical and Vaccine Immunology ◽

10.1128/cvi.00372-10 ◽

2010 ◽

Vol 17 (12) ◽

pp. 1963-1969 ◽

Cited By ~ 10

Author(s):

Leonardo Silva Araujo ◽

Renata Maciel Moraes ◽

Anete Trajman ◽

Maria Helena Féres Saad

Keyword(s):

Pleural Fluid ◽

Histopathological Examination ◽

False Negative ◽

High Sensitivity ◽

Enzyme Linked Immunosorbent Assay ◽

Negative Results ◽

Diagnostic Potential ◽

False Negative Results ◽

Sds Page ◽

Increased Sensitivity

ABSTRACT Pleural tuberculosis (PL-TB) remains difficult to diagnose. An enzyme-linked immunosorbent assay (ELISA) was developed based on a construction containing the fusion of the Rv3019c (MT10.3) and Rv1980c (MPT64) gene sequences, and its performance was evaluated in an area where TB is endemic. A total of 92 pleural fluid (PF) samples at serial dilutions of 1:50 to 1:800 were included in the ELISA IgA MT10.3-MPT64 evaluation: 70 from TB patients and 22 from patients with other pleurisies. Confirmation of the expression and subsequent purification of the protein was made by SDS-PAGE and Western blot assays, resulting in a 36-kDa protein. ELISA IgA MT10.3-MPT64 showed sensitivities of 61.4%, 58.6%, 62.9%, 67.1%, and 70% at each PF dilution, respectively. The cumulative results of all dilutions increased sensitivity to 81.4% without jeopardizing specificity. Similar results were also obtained at the combined dilutions of 1:50, 1:200, and 1:800 or 1:50 plus 1:800 dilutions (80%). The overall sensitivity of the reference test, i.e., histopathological examination, was 74%. But, via the ELISA IgA MT10.3-MPT64 test, sensitivity was high for specimens with a negative culture (23/27; 85.2%) or nonspecific histopathology (17/18; 94.4%). Our findings demonstrated the promising use of this test as an adjunct in PL-TB diagnoses, particularly in cases with lower bacterial loads and false-negative results in the reference tests, since the new test includes such important features as quick and easy application, high sensitivity and, perhaps most importantly, affordability, which is so crucial for its widespread use in developing countries.

Download Full-text

The frequency and character of community-acquired pneumonia comparison before and during the COVID-19 epidemic in the multi-specialty hospital

Digital Diagnostics ◽

10.17816/dd46833 ◽

2020 ◽

Vol 1 (1) ◽

pp. 37-47

Author(s):

Stepan A. Yaremenko ◽

Natalia A. Rucheva ◽

Kirill N. Zhuravlev ◽

Valentin E. Sinitsyn

Keyword(s):

Retrospective Analysis ◽

False Negative ◽

Community Acquired Pneumonia ◽

Chest Ct ◽

Viral Pneumonia ◽

Negative Results ◽

False Negative Results ◽

Polymerase Chain ◽

Ct Data ◽

Suspected Pneumonia

BACKGROUND:The 2019 coronavirus disease outbreak (COVID-19) quickly swept the world in just a month. Polymerase chain reaction (PCR) is used in the diagnosis of this disease, but this test has limitations related to false negative results, as well as PCR is a time-consuming procedure. Under these conditions, chest computed tomography (CT) can become one of the main methods in the Clinicians Arsenal used for early detection of COVID-19 in patients who first seek medical help. AIMS:comparison of the frequency of community-acquired pneumonia and its characteristics according to CT data before and during the COVID-19 epidemic and study of the possibilities of their timely detection and differential diagnosis. MATERIALS AND METHODS:A retrospective analysis of chest CT scans results was performed in Davydovsky hospital (Moscow) from April 1 to April 17, 2020. It included all patients diagnosed with viral pneumonia at the CT. All patients with suspected diagnosis of viral pneumonia underwent PCR testing. Retrospective analysis of chest CT data from patients admitted to the hospital with suspected pneumonia for the same period in 2019 was taken as a comparison group. RESULTS:For the period from April 1 to April 17, 2020 according to chest CT, pneumonia was diagnosed in 140 cases, of which 65 (46.4%) were described as viral, compared with the same period in 2019 7 diagnoses of viral pneumonia (10.3%) were described a significant increase in cases of viral pneumonia (5.723;p0.01). Results of PCR test in patients with viral pneumonia according to CT data was: positive in 34 (52.3%), negative in 22 (33.8%), 9 (13.9%) patients were not tested. When comparing the frequency of detection on CT of viral pneumonia patterns in patients for the same period of time in 2019 and 2020, no significant differences were found. The probability of COVID-19 due to results of chest CT was: average 13.8%, high 75.4%. The severity of viral pneumonia according to CT data was: light 38.5%, medium 46.2%, severe 12.3%, extremely severe 3.1%. CONCLUSIONS:Rapid CT diagnostics of COVID-19, even with false negative results of PCR tests, can help to isolate a patient with suspected COVID-19, start treatment on time and prevent the further spread of viral infection in a pandemic. Nevertheless, due to the non-specificity of the revealed picture, the possibilities of CT to identify lung lesions by specific viral agents are limited.

Download Full-text

Role and limits of testicular phleboscintigraphy in the diagnostic evaluation of varicocele

Urologia Journal ◽

10.1177/039156039406100202 ◽

1994 ◽

Vol 61 (2) ◽

pp. 98-102

Author(s):

A. Raimoldi ◽

G.L. Berti ◽

V. Giola ◽

G.L. Leidi ◽

A. Maccaroni ◽

...

Keyword(s):

Doppler Ultrasonography ◽

Low Cost ◽

False Negative ◽

High Sensitivity ◽

Diagnostic Evaluation ◽

Ultrasound Technique ◽

Negative Results ◽

False Negative Results ◽

First Choice ◽

Choice Method

The Authors wanted to check the reliability of testicular phleboscintigraphy in the diagnostic evaluation of varicocele, comparing it to Doppler ultrasonography. To this end, 98 patients affected by clinically evident left idiopathic varicocele were tested. The two methods gave equivalent results in all patients affected by 2nd and 3rd clinical degree varicocele, while testicular phleboscintigraphy gave false negative results in 7 patients with 1st degree varicocele, due to renospermatic retrograde flow. Therefore, in the Authors' opinion, the Doppler ultrasound technique can be considered as a first choice method in the study of varicocele, thanks to its high sensitivity associated with low cost, whereas testicular phleboscintigraphy can be used either when Doppler ultrasonography evaluation is not reliable or as a second examination to confirm the Doppler results, especially in patients with 2nd and 3rd clinical degree varicocele.

Download Full-text

Development of a Direct and Rapid Detection Method for Viable but Non-culturable State of Pediococcus acidilactici

Frontiers in Microbiology ◽

10.3389/fmicb.2021.687691 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yu Guan ◽

Kan Wang ◽

Yang Zeng ◽

Yanrui Ye ◽

Ling Chen ◽

...

Keyword(s):

Detection Method ◽

Ph Value ◽

False Negative ◽

High Sensitivity ◽

Pediococcus Acidilactici ◽

Propidium Monoazide ◽

Vbnc State ◽

Negative Results ◽

False Negative Results ◽

Standard Culture

Pediococcus acidilactici may significantly reduce the pH-value, and thus has different influence, including serving as a probiotic in human microbiota but a spoilage in human food as it could change the flavor. Pediococcus acidilactici is also capable of entering into the viable but non-culturable (VBNC) state causing false negative results of standard culture-based detection method. Thus, development of detection method for VBNC state P. acidilactici is of great significance. In this study, propidium monoazide (PMA) combined with cross priming amplification (CPA) was developed to detect the VBNC cells of P. acidilactici and applied on the detection in different systems. With detection limit of 104 cells/ml, high sensitivity, and 100% specificity, PMA-CPA can successfully detect VBNC cells of P. acidilactici and be applied in with high robustness.

Download Full-text

Clinical risk assessment of biotin interference with a high-sensitivity cardiac troponin T assay

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2019-0962 ◽

2020 ◽

Vol 58 (11) ◽

pp. 1931-1940 ◽

Cited By ~ 1

Author(s):

Bryn Mumma ◽

Deborah Diercks ◽

Raphael Twerenbold ◽

André Valcour ◽

André Ziegler ◽

...

Keyword(s):

Troponin T ◽

False Negative ◽

High Sensitivity ◽

Minimal Impact ◽

Coronary Syndrome ◽

Negative Results ◽

False Negative Results ◽

Random Samples ◽

Emergency Department Patients ◽

Roche Diagnostics

AbstractObjectivesBiotin >20.0 ng/mL (81.8 nmol/L) can reduce Elecsys® Troponin T Gen 5 (TnT Gen 5; Roche Diagnostics) assay recovery, potentially leading to false-negative results in patients with suspected acute myocardial infarction (AMI). We aimed to determine the prevalence of elevated biotin and AMI misclassification risk from biotin interference with the TnT Gen 5 assay.MethodsBiotin was measured using an Elecsys assay in two cohorts: (i) 797 0-h and 646 3-h samples from 850 US emergency department patients with suspected acute coronary syndrome (ACS); (ii) 2023 random samples from a US laboratory network, in which biotin distributions were extrapolated for higher values using pharmacokinetic modeling. Biotin >20.0 ng/mL (81.8 nmol/L) prevalence and biotin 99th percentile values were calculated. AMI misclassification risk due to biotin interference with the TnT Gen 5 assay was modeled using different assay cutoffs and test timepoints.ResultsACS cohort: 1/797 (0.13%) 0-h and 1/646 (0.15%) 3-h samples had biotin >20.0 ng/mL (81.8 nmol/L); 99th percentile biotin was 2.62 ng/mL (10.7 nmol/L; 0-h) and 2.38 ng/mL (9.74 nmol/L; 3-h). Using conservative assumptions, the likelihood of false-negative AMI prediction due to biotin interference was 0.026% (0-h result; 19 ng/L TnT Gen 5 assay cutoff). US laboratory cohort: 15/2023 (0.74%) samples had biotin >20.0 ng/mL (81.8 nmol/L); 99th percentile biotin was 16.6 ng/mL (68.0 nmol/L). Misclassification risk due to biotin interference (19 ng/L TnT Gen 5 assay cutoff) was 0.025% (0-h), 0.0064% (1-h), 0.00048% (3-h), and <0.00001% (6-h).ConclusionsBiotin interference has minimal impact on the TnT Gen 5 assay’s clinical utility, and the likelihood of false-negative AMI prediction is extremely low.

Download Full-text