Frequency of Significant Prostate Cancer (Gleason Score ≥ 7) in Suspected Patients Having Pi-Rads Score ≥4: Descriptive Study

2021 ◽  
Vol 15 (10) ◽  
pp. 2625-2627
Author(s):  
Madiha Bangash ◽  
Sehrish Shamrez Khan ◽  
Mahjabeen Naimat ◽  
Sana Afzal Alvi ◽  
S Kanza Afzal ◽  
...  

Background: Most common malignancy among males is prostate cancer causing many deaths. Aim: To determine the diagnostic accuracy of PI-RADS ≥4 lesions in predicting prostate tumor keeping histopathology as gold standard. Study Design: Cross-sectional validation. Methodology: The current project was conducted at Department of Radiology, Armed Forces Institute of Radiology and Imaging, Rawalpindi. Total 114 patients suspicion of prostate carcinoma between 40 to 80 years of age were included. Patients with already diagnosed carcinoma prostate and with inadequate biopsy specimens for diagnosing prostate cancer were excluded. After including the patients in this study, all patients were undergone MRI imaging findings to calculate PI-RADs score as per operational definition. After that biopsy specimens were taken and sent to the histopathology department for determination of Gleason score (GS), a patient was labelled as having significant prostate tumor. Results: Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of PI-RADS ≥4 lesions in predicting prostate tumor keeping histopathology as gold standard was 84.85%, 83.33%, 87.50%, 80% and 84.21% respectively. Conclusion: PI-RADS ≥4 is non-invasive modality of choice with high diagnostic accuracy in detecting ca prostate. Keywords: Prostate Cancer, Prostate Imaging Reporting and Sensitivity

2021 ◽  
Vol 71 (3) ◽  
pp. 1015-19
Author(s):  
Muhammad Atif ◽  
Fida Hussain ◽  
Zaigham Salim Dar ◽  
Jameela Khatoon ◽  
Saadia Ajmal ◽  
...  

Objective: To determine diagnostic accuracy of 99mTc labelled Ubiquicidin (29-41) SPECT/CT for detection of osteomyelitis in diabetic foot patients by taking bone biopsy as gold standard. Study Design: Cross-sectional validation study. Place and Duration of Study: Nuclear Medical Centre, Armed Forces Institute of Pathology, from Apr 2017 to Mar 2018. Methodology: Study assessed 122 patients of both genders, aged between 30-80 years (mean age=55.3 years), presenting with diabetic foot ulcers having suspicion of osteomyelitis, by 99mTc-Ubiquicidin (29-41) SPECT/CT followed by bone biopsy (histopathology and culture) taken as gold standard. Results: Among 122 patients [94 male (77%) and 28 female (23%)], osteomyelitis was histopathologically confirmed in 113 patients. 107 out of these patients were positive for osteomyelitis on 99mTc-UBI (29-41) SPECT/CT (true positives) while 6 were false negative. Out of 9 patients declared negative for osteomyelitis on histopathology and culture, 8 were negative on 99mTc-UBI (29-41) SPECT/CT as well (true negative) while only 1 case came out to be positive (false positive). Thus, the 99mTc-UBI (29-41) scan showed 94.6% sensitivity, 88.89% specificity, 99% positive predictive value, 57% negative predictive value with overall 94.2% diagnostic accuracy. Conclusion: 99mTc labelled Ubiquicidin (29-41) SPECT/CT scan can precisely localize infective focus, in diabetic foot osteomyelitis, with simultaneous discrimination between bone and soft tissues.


2021 ◽  
pp. 039156032110168
Author(s):  
Nassib Abou Heidar ◽  
Robert El-Doueihi ◽  
Ali Merhe ◽  
Paul Ramia ◽  
Gerges Bustros ◽  
...  

Introduction: Prostate cancer (PCa) staging is an integral part in the management of prostate cancer. The gold standard for diagnosing lymph node invasion is a surgical lymphadenectomy, with no superior imaging modality available at the clinician’s disposal. Our aim in this study is to identify if a pre-biopsy multiparametric MRI (mpMRI) can provide enough information about pelvic lymph nodes in intermediate and high risk PCa patients, and whether it can substitute further cross sectional imaging (CSI) modalities of the abdomen and pelvis in these risk categories. Methods: Patients with intermediate and high risk prostate cancer were collected between January 2015 and June 2019, while excluding patients who did not undergo a pre-biopsy mpMRI or a CSI. Date regarding biopsy result, PSA, MRI results, CSI imaging results were collected. Using Statistical Package for the Social Sciences (SPSS) version 24.0, statistical analysis was conducted using the Cohen’s Kappa agreement for comparison of mpMRI with CSI. McNemar’s test and receiver operator curve (ROC) curve were used for comparison of sensitivity of both tests when comparing to the gold standard of lymphadenectomy. Results: A total of 143 patients fit the inclusion criteria. We further stratified our patients into according to PSA level and Gleason score. Overall, agreement between mpMRI and all CSI was 0.857. When stratifying patients based on Gleason score and PSA, the higher the grade or PSA, the higher agreement between mpMRI and CSI. The sensitivity of mpMRI (73.7%) is similar to CSI (68.4%). When comparing CSI sensitivity to that of mpMRI, no significant difference was present by utilizing the McNemar test and very similar receiver operating characteristic curve. Conclusion: A pre-biopsy mpMRI can potentially substitute further cross sectional imaging in our cohort of patients. However, larger prospective studies are needed to confirm our findings.


2021 ◽  
Vol 15 (6) ◽  
pp. 1679-1681
Author(s):  
Afaque Ali ◽  
Majid Shaikh ◽  
Ahsanullah . ◽  
Adeel Ahmed ◽  
Abid Ali Sahito ◽  
...  

Objective: To determine the diagnostic accuracy of High-resolution computed tomography (HRCT) chest in detection of covid-19 infection taking PCR as gold standard. Study Design: Cross-sectional study Setting: Radiology department of Tabba Hospital, Karachi. Duration: From March 2019 to September 2020 Material and Methods: All the clinically suspected patients of covid-19, of any age, both genders and those referred to radiology for High-resolution computed tomography (HRCT) chest to detect the covid-19 infection were included. After two days, patients’ PCR reports were collected from the ward, after taking informed consent and permission from head of department. The diagnostic accuracy of HRCT was established with respect to sensitivity, PPV, NPV, and specificity by taking PCR as gold standard. All the information was collected via study proforma. Results: Total 70 patients suspected for COVID-19 were studied, and the patients’ mean age was 58.23±9.52 years. Males were in majority 54(77.1%). As per HRCT findings, COVID-19 infection was positive in 46 patients, however, 48 patients were detected positive for COVID-19 infection as per PCR findings. In the detection of COVID-19 infection, HRCT chest showed sensitivity of 91%, specificity of 90%, PPV of 83%, NPV of 84% and diagnostic accuracy of 94%; by taking PCR as gold standard. Conclusion: High-resolution computed tomography (HRCT) is a reliable diagnostic approach in promptly detecting the COVID-19; with 91% sensitivity, 90% specificity, 83% positive predictive value, 84% negative predictive value and 94% diagnostic accuracy. Keywords: Accuracy, HRCT, COVID-19


2021 ◽  
Vol 15 (12) ◽  
pp. 3175-3177
Author(s):  
Anum Iftikhar ◽  
Muhammad Arsalan ◽  
Sheeza Azaz ◽  
S H Waqar ◽  
Sajid Ali Shah ◽  
...  

Aim: To find out how accurate the Alvarado and Tzanaki scoring systems are in diagnosing acute appendicitis taking histopathology as gold standard. Methods: A cross-sectional prospective study was conducted from August 2019 to July 2020 at Department of General Surgery, Pakistan Institute of Medical Sciences Islamabad. Sixty patients were included, all of whom had appendectomies after a clinical diagnosis of acute appendicitis. Samples were submitted for histopathology, which was used as the gold standard for the definitive diagnosis of acute appendicitis. The specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy and negative appendectomy rate of Alvarado and Tzanaki scoring systems was calculated using SPSS version 23. Results: The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of Alvarado score at optimal cut-off threshold of ≥7.0, were calculated as 74%, 55%, 90%, 27% and 71.66% respectively. The cut-off threshold point of Tzanaki score was set at more than 8, which yielded a 94.11% sensitivity and an 88.88% specificity. The positive predictive value was 99.95% and the negative predictive value was 72.72%. The Alvarado and Tzanaki scoring systems had negative appendectomy rates of 9.5% and 2.04%, respectively. Conclusion: The Tzanaki scoring system has a better diagnostic accuracy for acute appendicitis as compared to the Alvarado score. Keywords: Acute appendicitis, Alvarado score, Tzanaki score


Author(s):  
Abid Ali Sahito ◽  
. Ahsanullah ◽  
Vicky Kumar ◽  
Mohsim Hussain ◽  
Humaira Ashraf ◽  
...  

Objective: To determine the diagnostic accuracy of doppler ultrasound in the diagnosis of testicular carcinoma, by taking histopathology as gold standard. Methods: This cross-sectional study was carried out at Radiology department of Liaquat University of Medical and health Sciences (LUMHS), from November 2017 to October 2019. All the clinically diagnosed cases of testicular carcinoma, those who referred for doppler ultrasound and histopathology of testes, were included. After taking informed consent all the study participants underwent testicular histopathology after doppler ultrasound. All of the information was entered into a research proforma. SPSS version 20 was used to analyze the data. Results: Overall, 70 patients of suspected testicular carcinoma were studied. The mean age of the cases was 38.38+4.55 years. Most of the cases 47(67.1%) were poor. As per Doppler ultrasound (U/S) findings out of all 55.7% cases had diagnosed testicular carcinoma, while histopathologically it was observed in 45.7% of the cases. Diagnostic accuracy of Doppler U/S in testicular carcinoma diagnosis was observed to be 77%, followed by sensitivity (SE) 84%, specificity (SP) 71%, positive predictive value (PPV) 78% and negative predictive value (NPV) 84%. Conclusion: Doppler ultrasound observed to be a non-invasive, uncomplicated, lack of pain, effective and easily available diagnostic tool for early diagnosis of testicular carcinoma.


2021 ◽  
Vol 4 (1) ◽  
pp. 3-8
Author(s):  
Zainab Mehmood ◽  
Rafia Shahzad ◽  
Ismat Fatima ◽  
Abubaker Shahid

Introduction: Some unique physiological changes occur in breast volume and water content during pregnancy which makes the radiological evaluation of the breast difficult.  As a result, diagnosis of Pregnancy Associated Breast Cancer.  is often delayed. Objective: To find out the diagnostic accuracy of ultrasonography in detection of pregnancy associated breast cancer taking histopathology as gold standard. Methodology: Present Cross-sectional study was carried out at INMOL Hospital, Lahore. Ultrasound of 200 women was performed. The patient was laid supine and then turned slightly in oblique position to scan the breast with high frequency linear probe (7.5-10 MHz). The contra-lateral breast and both axillae were also scanned in the same way. Findings were categorized on the basis of Breast Imaging Reporting and Data System (BI-RADS) assessment categories. Subsequently the breast tissue was sent to histopathology laboratory for tissue diagnosis. The pathologist was blinded of the results of ultrasonography. Results: Mean age was 34 ± 11.36 years. Twenty-eight percent patients were primi-para while 72% patients were multi-para. Diagnostic accuracy of ultrasonography taking histopathology as gold standard was analyzed and ultrasonography had sensitivity 84.78%, specificity 98.05%, positive predictive value 92.85%, negative predictive value 95.56% and diagnostic accuracy was 95%. Invasive ductal carcinoma was most commonly observed (P<0.001) malignant histopathology. On the other hand, significantly high (P = 0.033) number of benign lesions were Fibroadenomas. Conclusion: The high sensitivity and specificity along with easy availability, and non-invasive nature makes ultrasonography a very useful technique for the diagnosis of Pregnancy Associated Breast Cancer.


Author(s):  
Anshika Arora ◽  
Manju Saini ◽  
Neena Chauhan ◽  
Mayank Bhasin ◽  
Sunil Saini

Aims: Metastasis to axillary lymph nodes is an important prognostic factor in carcinoma breast patients, with implications on overall survival and progression-free survival. To evaluate the accuracy of pre-operative clinical palpation and USG axilla in patients with carcinoma breast, using histopathology as the gold standard. Study Design: Cross-sectional observational study. Place and Duration of Study: This was a retrospective study, carried out at Cancer Research Institute, SRHU, India, between January 2015 and December 2018. Methodology: Data was collected from Case records and Hospital Information System for patients having undergone surgery for breast cancer. Pre-treatment clinical, ultrasound axilla, and final histopathology details were recorded. Taking histopathology as the gold standard test, diagnostic accuracy of clinical palpation and ultrasound axilla was calculated. Results: 256 patients were enrolled in the study. Clinically, 70.7% of patients were T1/T2 stage, 53.9% were node-positive, on USG axilla 59% had abnormal nodes, pathologically 53.52% had nodal metastasis. The sensitivity, specificity for clinical palpation was 77.86% and 75%, for USG was 90.71% and 79.31%. Sensitivity and specificity of USG in c T1/2 was 88.64% and 80.21%; in c T3/4 94.23% and 65.22%; in c N negative 87% and 72.16%; in c N positive 91.74% and 75.86%. Conclusion: The diagnostic accuracy of clinical palpation of axilla alone was low; Ultrasound axilla had high sensitivity but low specificity across all T stages of breast tumor. The ultrasound had a high negative predictive value in clinically non-palpable nodes and a high positive predictive value in clinically palpable nodes.


2019 ◽  
Vol 7 (1) ◽  
pp. 144
Author(s):  
Shahaji G. Chavan ◽  
Sree Ganesh B. ◽  
Nandan Vemuri

Background: Breast cancer incidence in India is increasing and has now become the most common cancer among women. Preoperative pathology diagnosis and mammography (using breast imaging reporting and data system      (BI-RADS) scoring system) constitute an essential part of the workup of breast lesions. The present study was aimed to compare the diagnostic accuracy of BI-RADS score with histopathological finding in diagnosis of benign and malignant lesions of breast.Methods: This is a cross-sectional study. The present study was conducted on 100 randomly selected newly diagnosed cases of breast lump attending the General Surgery Department (OPD).Results: Considering histopathological examination as gold standard, the sensitivity and specificity of BI-RADS score is 93.9% and 82.3% respectively. The positive predictive value, negative predictive value and diagnostic accuracy of BI-RADS score is 91.1%, 87.5% and 90.0% respectively.Conclusions: Author conclude from the present study that BI-RADS score being non-invasive, it may become a very useful test for evaluating Breast lump lesions. However, BI-RADS score cannot be considered as gold standard and thus cannot be used as an alternative to histopathology in diagnosis of breast lumps.


2021 ◽  
Vol 15 (11) ◽  
pp. 3164-3165
Author(s):  
Mohammad Iltaf ◽  
Sana Akhtar ◽  
Dilaram Khan

Objective: To establish the diagnostic accuracy of BISAP in detecting the severe acute pancreatitis keeping computed tomography severity index as gold standard. Study Design: Cross-sectional study Place and Duration of Study: Department of Gastroenterology, Hayatabad Medical Complex, Peshawar from April 16th 2018 to 16th October 2018. Methodology: One hundred and twenty nine patients of age range of 18-60, of either gender having severe acute pancreatitis were included. While patients already diagnosed as severe acute pancreatitis and having known history of chronic pancreatitis were excluded. Patients were subjected to CT scan to confirm whether the severe acute pancreatitis is present or not. All CT scans were reported by single experiences radiologist. Results: There were 30.3% were males and 69.7% were females with mean age 42±11.03 years. BISAP had sensitivity 92.74%, specificity 80%, positive predictive value 99.13%, negative predictive value 20.76% and the overall diagnostic accuracy was 92.24%. Conclusion: BISAP had sensitivity 93.61%, specificity 100%, positive predictive value 100%, negative predictive value 40% and the overall diagnostic accuracy was 93.87% in severe acute pancreatitis keeping CT severity index as gold standard. Keywords: Accuracy, Severe acute pancreatitis, Computed tomography


2021 ◽  
Vol 15 (11) ◽  
pp. 3093-3095
Author(s):  
Iqra Rafique ◽  
Anam Manzoor ◽  
Sana Naseer

Objective: To assess the diagnostic accuracy of ultrasonography for detection of Achilles tendinopathy by taking surgical findings as gold standard. Design of the Study: It was a descriptive cross-sectional study. Study Settings: This study was carried out at Department Of Diagnostic Radiology And Diagnostic Imaging Combined Military Hospital, Lahore from 23rd December 2017 to 22nd June 2018. Material and Methods: A total of 70 patients of age 20-70 years, of either gender presenting with severe pain and swelling in area of Achilles tendon were included. Patients with heel pain having concurrent heel ulcer, eczematous changes or calcaneal fractures, muscular dystrophy and previous surgery were excluded. All the patients were then underwent ultrasonography and findings were noted for presence or absence of Achilles tendinopathy. Each Ultrasonographic finding were compared with surgical findings. Results of the Study: Mean age was 41.24 ± 10.34 years. Out of these 70 patients, 46 (65.71%) were male and 24 (34.29%) were females with male to female ratio of 1.9:1. In USG positive patients, 40 (True Positive) had Achilles tendinopathy and 04 (False Positive) had no Achilles tendinopathy on surgical findings. Among, 26 USG negative patients, 03 (False Negative) had Achilles tendinopathy on surgical findings whereas 23 (True Negative) had no Achilles tendinopathy on surgical findings. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of ultrasonography for detection of Achilles tendinopathy by taking surgical findings as gold standard was 93.02%, 85.19%, 90.91%, 88.46% and 90.0% respectively. Conclusion: This study concluded that diagnostic accuracy of ultrasonography for detection of Achilles tendinopathy is quite high. Keywords: Achilles tendinopathy, ultrasonography, sensitivity.


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