scholarly journals MR Imaging of Pancreatic Lesions

2021 ◽  
pp. 128-136
Author(s):  
Mohamed Shawky Mohamed Abd Rabou ◽  
Khaled Ismail El Shafey ◽  
Rania Essam El Deen Mohamed ◽  
Rasha Mahmoud Dawoud
Keyword(s):  
B Value ◽  
Pancreatic Pseudocysts ◽  
High Signal ◽  
P Value ◽  
Simple Cyst ◽  
Pancreatic Masses ◽  
Mri Study ◽  
Sensitivity Specificity ◽  
Signal Intensities ◽  
T2 Weighted Images

Aim: The aim of this work was to evaluate the role of MRI in differentiating between benign and malignant pancreatic lesions and its correlation with histopathological results as the reference standard. Patients and Methods: This MRI study included 30 patients, 17 females and 13 males with a mean age 50 years. Sixteen patients had malignant masses (14 patients were adenocarcinoma, one patient was lymphoma and one patient was metastasis) and 14 patients had benign masses (7 patients were pancreatic pseudocysts, two patients were pancreatic abscesses, three patients were simple cysts and two patients were focal pancreatitis). The main clinical symptom was abdominal pain and most of masses were located in the head of the pancreas. Results: In our study, 25 cases of the 30 patients showed increased intensity at T2-weighted images. Most of malignant cases showed low or equal intensity on T1- and high intensity on T2-weighted images compared to normal pancreatic parenchyma. In our study, DW-MRI was performed on all subjects at b-values of 500 and 1000 s/mm2. Benign pancreatic masses as pancreatic pseudocyst, simple cyst and abscess show low signal intensities on DWI, however malignant pancreatic masses as adenocarcinoma, lymphoma and metastasis show high signal intensities on DWI with a cut-off value of 1.5 x10-3 s/mm2 for the differentiation of benign from malignant pancreatic masses by b-value 1000 s/mm2 with the sensitivity, specificity, PPV, NPV& p value were 100%, 83.33%, 100%, 88.88% and <0.001 respectively. Conclusion: MRI plays an important role in the diagnosis of different pancreatic lesions and can assess the neoplastic pancreatic lesions with accurate detection of extension, nodal involvement and hepatic metastatic lesions. It also has a major role in differentiation between benign and malignant pancreatic lesions by the aids of DWI.

scholarly journals Head and neck osteosarcoma: CT and MR imaging features

2020 ◽  
Vol 49 (2) ◽  
pp. 20190202
Author(s):  
Zhendong Luo ◽  
Weiguo Chen ◽  
Xinping Shen ◽  
Genggeng Qin ◽  
Jianxiang Yuan ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Head And Neck ◽  
Giant Cell ◽  
High Signal ◽  
Imaging Features ◽  
Matrix Mineralization ◽  
Imaging Characteristics ◽  
Mri Features ◽  
Signal Intensities ◽  
Ct And Mri

Objective: This study aims to assess the CT and MRI features of head and neck osteosarcoma (HNO). Methods: 37 HNOs were identified, and the following imaging characteristics were reviewed on CT and MRI. Results: A total of 37 patients(age 41.5 ± 15.0 years old; 16 males, 21 females) were included in the study. Tumours occurred in the maxilla (16, 43.2%), mandible (8, 21.6%), skull base (6, 16.2%), calvarium (5, 13.5%), paranasal sinuses (1, 2.7%) and cervical soft tissue (1, 2.7%). 16 patients received radiotherapy for nasopharyngeal carcinoma. Three patients (8.1%) developed osteosarcomas related to a primary bone disease. 16 of the (43.2%) tumours demonstrated lytic density on CT scans, followed by 13 (35.1%) showing mixed density and 7 (18.9%) with sclerotic density. Matrix mineralization was present in 32 (86.5%). 3 out of 24 (12.5%) tumours showed lamellar periosteal reactions, 21 out of 24 (87.5%) showed spiculated periosteal reactions. 12 tumours showed low signal intensities on T1WI, with 16 having heterogeneous signal intensities. 10 tumours showed high signal intensities on T2WI, and 18 showed heterogeneous signal intensities. With contrast-enhanced images, 3 tumours showed homogeneous enhancement (2 osteoblastic and 1 giant cell-rich), 18 tumours showed heterogeneous enhancement (13 osteoblastic, 4 fibroblastic and 1 giant cell-rich), and 7 tumours showed peripheral enhancement (6 chondroblastic and 1 osteoblastic). These tumours were characterized by soft tissue masses with a diameter of 5.6 ± 1.8 cm. Conclusions: HNO is a rare condition and is commonly associated with previous radiation exposure. This study provides age, sex distribution, location, CT and MRI features of HNO.

scholarly journals Assessment of intramyocardial hemorrhage with dark-blood T2*-weighted cardiovascular magnetic resonance

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Xingmin Guan ◽  
Yinyin Chen ◽  
Hsin-Jung Yang ◽  
Xinheng Zhang ◽  
Daoyuan Ren ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Major Adverse Cardiovascular Events ◽  
Observer Variability ◽  
Dark Blood ◽  
Imaging Characteristics ◽  
Inter Observer Variability ◽  
Sensitivity Specificity ◽  
Bright Blood ◽  
T2 Weighted Images

Abstract Background Intramyocardial hemorrhage (IMH) within myocardial infarction (MI) is associated with major adverse cardiovascular events. Bright-blood T2*-based cardiovascular magnetic resonance (CMR) has emerged as the reference standard for non-invasive IMH detection. Despite this, the dark-blood T2*-based CMR is becoming interchangeably used with bright-blood T2*-weighted CMR in both clinical and preclinical settings for IMH detection. To date however, the relative merits of dark-blood T2*-weighted with respect to bright-blood T2*-weighted CMR for IMH characterization has not been studied. We investigated the diagnostic capacity of dark-blood T2*-weighted CMR against bright-blood T2*-weighted CMR for IMH characterization in clinical and preclinical settings. Materials and methods Hemorrhagic MI patients (n = 20) and canines (n = 11) were imaged in the acute and chronic phases at 1.5 and 3 T with dark- and bright-blood T2*-weighted CMR. Imaging characteristics (Relative signal-to-noise (SNR), Relative contrast-to-noise (CNR), IMH Extent) and diagnostic performance (sensitivity, specificity, accuracy, area-under-the-curve, and inter-observer variability) of dark-blood T2*-weighted CMR for IMH characterization were assessed relative to bright-blood T2*-weighted CMR. Results At both clinical and preclinical settings, compared to bright-blood T2*-weighted CMR, dark-blood T2*-weighted images had significantly lower SNR, CNR and reduced IMH extent (all p < 0.05). Dark-blood T2*-weighted CMR also demonstrated weaker sensitivity, specificity, accuracy, and inter-observer variability compared to bright-blood T2*-weighted CMR (all p < 0.05). These observations were consistent across infarct age and imaging field strengths. Conclusion While IMH can be visible on dark-blood T2*-weighted CMR, the overall conspicuity of IMH is significantly reduced compared to that observed in bright-blood T2*-weighted images, across infarct age in clinical and preclinical settings at 1.5 and 3 T. Hence, bright-blood T2*-weighted CMR would be preferable for clinical use since dark-blood T2*-weighted CMR carries the potential to misclassify hemorrhagic MIs as non-hemorrhagic MIs.

scholarly journals Abbreviated MRI Protocol for the Assessment of Ablated Area in HCC Patients

2021 ◽  
Vol 18 (7) ◽  
pp. 3598
Author(s):  
Vincenza Granata ◽  
Roberta Grassi ◽  
Roberta Fusco ◽  
Sergio Venanzio Setola ◽  
Andrea Belli ◽  
...  
Keyword(s):  
Treatment Response ◽  
Predictive Value ◽  
Random Order ◽  
P Value ◽  
Liver Imaging ◽  
Data Systems ◽  
Post Contrast ◽  
Conventional Mri ◽  
Mri Protocol ◽  
Mri Study

Background: Liver Imaging Reporting and Data Systems (LI-RADS) Treatment Response Algorithm (TRA) was created to provide a standardized assessment of hepatocellular carcinoma (HCC) following loco regional therapy. The aim of this study was to compare sensitivity of standard MRI protocol versus abbreviated protocol (only T1-Weigthed fat suppressed (FS) sequences pre- and post-contrast phase) in the detection of ablated area according to LI-RADS Treatment Response (LR-TR) categories. Methods: From January 2015 to June 2020, we selected 64 patients with HCC, who underwent Radiofrequency ablation (RFA) or Microwave ablation (MWA) treatment. According to inclusion criteria, 136 pathologically proven treated HCC (median 2, range 1–3 per patient; mean size 20.0 mm; range 15–30 mm) in 58 patients (26 women, 32 men; median age, 74 years; range, 62–83 years) comprised our study population. For each ablated area, abbreviated protocol, and standard Magnetic Resonance Imaging (MRI) studies were independently and blindly assessed in random order within and between three expert radiologists. Each radiologist assessed the ablated area by using the following categories: “LR-TR Non-viable” = 1; “LR-TR Equivocal” = 2 and “LR-TR Viable” = 0. Results: According to the concordance between MRI and Contrast enhancement ultrasound (CEUS) among 136 treated HCCs, 115 lesions were assessed as non-viable or totally ablate and 21 as viable or partially ablate. The accuracy for standard MRI protocol and abbreviated MRI protocol for predicting pathologic tumor viability of a consensus reading was 98.6% (sensitivity = 100%; specificity = 98.3%; positive predictive value = 91.3% and negative predictive value = 100%). No differences were found in sensitivity or specificity between standard MRI LR-TR viable and abbreviated MRI LR-TR viable categories (p value > 0.05 at McNemar test). Conclusion: The abbreviated dynamic protocol showed similar diagnostic accuracy to conventional MRI study in the assessment of treated HCCs, with a reduction of the acquisition study time of 30% respect to conventional MRI.

scholarly journals Influence of the Computer-Aided Decision Support System Design on Ultrasound-Based Breast Cancer Classification

Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 277
Author(s):  
Zuzanna Anna Magnuska ◽  
Benjamin Theek ◽  
Milita Darguzyte ◽  
Moritz Palmowski ◽  
Elmar Stickeler ◽  
...  
Keyword(s):  
Breast Lesion ◽  
Characteristic Curve ◽  
Cancer Diagnostics ◽  
Lesion Detection ◽  
Machine Learning Algorithms ◽  
Classification Model ◽  
P Value ◽  
Future Design ◽  
Sensitivity Specificity ◽  
Derivatives Of

Automation of medical data analysis is an important topic in modern cancer diagnostics, aiming at robust and reproducible workflows. Therefore, we used a dataset of breast US images (252 malignant and 253 benign cases) to realize and compare different strategies for CAD support in lesion detection and classification. Eight different datasets (including pre-processed and spatially augmented images) were prepared, and machine learning algorithms (i.e., Viola–Jones; YOLOv3) were trained for lesion detection. The radiomics signature (RS) was derived from detection boxes and compared with RS derived from manually obtained segments. Finally, the classification model was established and evaluated concerning accuracy, sensitivity, specificity, and area under the Receiver Operating Characteristic curve. After training on a dataset including logarithmic derivatives of US images, we found that YOLOv3 obtains better results in breast lesion detection (IoU: 0.544 ± 0.081; LE: 0.171 ± 0.009) than the Viola–Jones framework (IoU: 0.399 ± 0.054; LE: 0.096 ± 0.016). Interestingly, our findings show that the classification model trained with RS derived from detection boxes and the model based on the RS derived from a gold standard manual segmentation are comparable (p-value = 0.071). Thus, deriving radiomics signatures from the detection box is a promising technique for building a breast lesion classification model, and may reduce the need for the lesion segmentation step in the future design of CAD systems.

scholarly journals Performance of the BD FACSPresto near to patient Analyzer in comparison with representative conventional CD4 instruments in Cameroon.

2020 ◽  
Author(s):  
Bertrand Sagnia ◽  
Fabrice MBAKOP Ghomsi ◽  
Ana Gutierrez ◽  
Samuel SOSSO ◽  
Rachel KAMGAING ◽  
...  
Keyword(s):  
T Lymphocytes ◽  
T Lymphocyte ◽  
Statistical Significance ◽  
P Value ◽  
Resource Constrained ◽  
Inform Consent ◽  
Remote Areas ◽  
Significant Difference ◽  
Sensitivity Specificity ◽  
Cd4 Testing

Abstract Background In the context of scaling the viral load in resource limited settings, following HIV infected patient’s adults and children with CD4+ T-lymphocyte count still very important in settings where the decentralization of treatment still has some challenges. Effective HIV monitoring in these resource-constrained settings needs affordable and reliable CD4+ T lymphocytes enumeration methods. We investigated the validity of a BD FACSPresto POC which is a dedicated system for enumeration that uses immunofluorescent technologies. In this study, we have assessed the sensitivity, specificity and correlation between most representative flow cytometry instruments present in Cameroon with more than 5000 CD4 T cells tests per year including FACSCalibur, FACSCount, and PIMA POC from Becton dinkinson and ALERE respectively. Methods 268 patients aged from 1 to 72 years old were enrolled and included in the study after inform consent. The BD FACSPresto POC CD4+ T cell technology was placed at CIRCB and operated by technician staff. HIV infected patients were from Chantal BIYA international reference Center (CIRCB), Centre de Sante Catholique de NKOLODOM, Centre de Sante Catholique de BIKOP and CASS de Nkolndongo – Yaounde We compared the accuracy of the BD FACSPresto and three existing reference technologies with more than 5000 tests per year like FACSCalibur, FACSCount and PIMA according to the number of CD4 test done per year and their repartition in the country. Bland – Altman method and correlation analysis were used to estimate mean bias and 95% limits of agreement and to compare the methods, including analysis by subgroup of participant gestational age. In addition sensitivity and specificity were determined. Statistical significance was set at p-value < 0.05 Results The BD FACSPresto POC system has excellent precision, accuracy and linearity for CD4+ T lymphocytes enumeration. Good correlations were obtained between the BD FACSPresto poc system and other single platform methods. Bland–Altman plots showed interchangeability between two machines mean bias BD-FACSPresto vs PIMA= -126,522(-161,221 to -91,822) BD-FACSPresto vs FACSCount= -38,708 (-58,935 to -18,482) and FACSPresto vs FACSCALIBUR= 0,791(-11,908 to 13,491). Mean difference with Absolute CD4+ T-lymphocyte values obtained from the BD FACSPresto system correlated well with PIMA, FACSCount, and FACSCalibur method with R 2 equal to 0.88, 0.92 and 0.968 respectively with P < 0.001 for all. The mean comparison between values obtained from BD FACSPresto with PIMA, FACSCount, and FACSCalibur using paired T test give P=0.17, P=0.5 and P=0.6 respectively meaning that there is no significant differences between values obtained with BD FACSPresto and PIMA, FACSCount or FACSCalibur CD4 enumeration machines. Further analysis revealed close agreement between all the three instruments with no significant difference between the forth methods (P=0.91) Conclusion This BD-FACSPresto POC system is a simple, robust and reliable system for enumeration of absolute and percentage of CD4+ T-lymphocytes especially suitable for remote areas with limited resources. Having one BD-FACSPresto POC system easy to use, should reduce the cost and thus increase and improved access to CD4 testing for HIV infected patients in resource-constrained countries. BD-FACSPresto POC CD4 will enable reduction in patient time and improve the overall quality of ART service count and may improve test access in remote areas. This technology can allow for greater decentralization and wider access to CD4 testing and ART

scholarly journals Clinical impact of EUS elastography followed by contrast-enhanced EUS in patients with focal pancreatic masses and negative EUS-guided FNA

2016 ◽  
Vol 18 (1) ◽  
pp. 18 ◽  
Author(s):  
Sevastiţa Iordache ◽  
Mădălin Ionuţ Costache ◽  
Carmen Florina Popescu ◽  
Costin Teodor Streba ◽  
Sergiu Cazacu ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Diagnostic Algorithm ◽  
High Sensitivity ◽  
Clinical Decision ◽  
Needle Aspiration ◽  
Clinical Tool ◽  
Decision Algorithm ◽  
Contrast Enhanced ◽  
Pancreatic Masses ◽  
Sensitivity Specificity

Aims: It is well known that endoscopic ultrasound guided fine needle aspiration (EUS-FNA) has a high sensitivity (over 85%) and specificity (100%) for diagnosis of pancreatic cancer. The aim of the study was to establish a EUS based clinical diagnostic algorithm in patients with pancreatic masses and negative cytopathology after EUS-FNA, based on previously published results and cut-offs of real-time elastographic (RTE) EUS and contrast-enhanced harmonic (CEH) EUS. Material and methods: We included in the study a subgroup of 50 consecutive patients with focal pancreatic masses which underwent EUS examinations with negative EUS-FNA. RTE-EUS and CEH-EUS were performed sequentially in all patients. The sensitivity, specificity and accuracy of these methods were calculated separately. A clinical decision algorithm based on elastography followed by CEH was established. Results: For the diagnosis of possible malignancy, the sensitivity, specificity and accuracy of RTE-EUS were: 97.7%, 77.4%, and 84% respectively. CEH-EUS had similar results: 89.5%, 80.7%, and 84%, respectively. In 25 patients with soft/mixed appearance during elastography,sequential assessment using contrast-enhanced EUSwas performed. The specificity of CEH-EUS for detection of chronic pancreatitis in this sub-set of patients was excellent (100%). In other 25 patients with hard appearance in elastography (low strain) CEH-EUS had an excellent specificity (100%) and accuracy (93%) in the detection of pancreatic cancer. Conclusions: The proposed algorithm with sequential use of elastography followed by CEH could be a good clinical tool in the set of patients with negative EUS-FNA results for the differentiation between benign and malignant focal pancreatic masses. 

scholarly journals Role of Chemical Biomarkers in Prediction of Intra-Amniotic Infection in Cases with Preterm Premature Rupture of Membrane, Observational Study

2019 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Interleukin 6 ◽  
Mean Value ◽  
Maternal Serum ◽  
P Value ◽  
Subclinical Infection ◽  
Premature Rupture ◽  
Cutoff Value ◽  
The Mean ◽  
Sensitivity Specificity

Introduction: Early recognition of subclinical intra-amniotic infection before development of clinical Chorioamnionitis dramatically improve neonatal outcome before affection of fetal neurological function. Objective: this study was conducted to evaluate the role of procalcitonin and interleukin-6 in early prediction of intrauterine infection in pregnant women with premature rupture of membranes. Methods: This observational prospective cohort study was conducted on 100 pregnant women with preterm premature rupture of membrane (PPROM), Patients were divided into 2 groups: Group I: with normal CRP and WBCs level. Group2: with subclinical infection which was detected by elevated WBCs count >15,000 c/mm3 and / or positive CRP. This group was divided into two groups (Group (II) and Group (III) according to development of Chorioamnionitis. follow up of these patients was done to detect the cutoff value of procalcitonin and interleukin-6 as a predictive indicator of clinical intra-amniotic infection in patients with premature rupture of membrane. Results: This study showed that the mean value of maternal serum PCT concentration was higher in patients with clinical infection than its concentration in patients without infection or with subclinical infection with P-value 0.0001 which is highly significant between the studied cases and with cutoff value was >0.67ng/ml, sensitivity, specificity, PPV, NPV was 88.7%, 42.9%, 79.7% and 60% respectively and the mean value of maternal serum IL-6 concentration was also higher in patients with clinical infection than its concentration in patients without infection or with subclinical infection with P-value 0.001which is highly significant between the studied cases and with cutoff value was >11.1pg/ ml, sensitivity, specificity, PPV, NPV was 67.9%, 61.9%, 81.8% and 43.3% respectively. Conclusion: maternal serum procalcitonin is a good predictor of clinical intra-amniotic infection with good sensitivity, specificity, PPV, NPV which is nearly good as CRP which is better than serum interleukin-6 regarding sensitivity

scholarly journals Analysis of the Specificity, Sensitivity and Accuracy of Goniometry Method Compared to Tape Method for Measuring Trunk Mobility in Normal Adults

2021 ◽  
pp. 138-145
Author(s):  
Purvi Patel
Keyword(s):  
Range Of Motion ◽  
Standard Technique ◽  
Cross Sectional Study ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Spine Mobility ◽  
The Difference ◽  
Sensitivity Specificity ◽  
Normal Adults

Measurement of lumbar range of motion (LROM) is a routine method in the examination of patients with low back pain. There is no standard technique which may be used to accurately describe the range of motion in the different plane. So in present study, an attempt has been made to compare goniometric measurement with tape measurement for its sensitivity, specificity and accuracy for measuring spine mobility in normal adults. In this cross sectional study, 137 healthy adults between the ages of 18-26 years of age were included consecutively and assessed using Tape method and goniometry for trunk mobility in all planes (sagittal, frontal and transverse). The association of goniometry with tape method was assessed using chi square test. The study showed that the difference between goniometry and tape method was statistically significant (p value <0.05) for all movements except flexion (p value 0.215). Also the sensitivity, specificity and accuracy of goniometry is not as good as tape method except for flexion compared to tape method. So, from this study we can conclude that Goniometry was not as good as tape method for all movements except forward flexion where both can be equally used.

scholarly journals Significance of serum-pleural effusion albumin gradient in differentiating transudative and exudative pleural effusions in comparison to light’s criteria

2017 ◽  
Vol 4 (2) ◽  
pp. 457
Author(s):  
Sujatha G. ◽  
Vindhya P. ◽  
Kalyan Kumar K.
Keyword(s):  
Pleural Effusion ◽  
Clinical Outcome ◽  
Pleural Fluid ◽  
Venous Blood ◽  
P Value ◽  
Protein Ratio ◽  
Clinical Disorder ◽  
Significant Difference ◽  
The Difference ◽  
Sensitivity Specificity

Background: Approximately one million patients develop pleural effusion every year. It is a common clinical disorder and is either a manifestation or a complication of one or other respiratory or non-respiratory disorders. It leads to serious prognosis, if not diagnosed and treated properly. To calculate SEAG and Light’s criteria and to compare SEAG with Light’s criteria in analyzing pleural effusions.Methods: A total of hundred patients were selected for the study. Pleural fluid of patients who met the inclusion and exclusion criteria were collected, when pleural fluid is being tapped for diagnostic thoracocentesis. Venous blood sample was collected along with diagnostic thoracocentesis or within 24 hours of thoracocentesis.  Written informed consent was obtained from them for thoracocentesis.Results: In our study we compared the clinical outcome with outcome as per Pleural fluid/Serum protein ratio (p value of <0.0001), pleural fluid/serum LDH (p value of <0.0001) and pleural fluid LDH (p value of <0.0001) separately and the p values were statistically significant. The sensitivity, specificity, PPV and NPV of Light’s criteria were 77.2%, 100%, 100%, 93.9% respectively. We compared Light’s criteria outcome with clinical outcome and the difference was statistically significant (p value of <0.0001). SEAG showed 100% sensitivity, 97.43% specificity, 91.6% PPV and is 91.66% and NPV is 100%. We compared the clinical outcome with SEAG and there was statistically significant difference (p value of <0.0001). We compared SEAG with Light’s criteria and the difference was statistically significant (p <0.0001). We compared Light’s plus pleural fluid protein gradient with SEAG and the difference is statistically significant (p value of <0.0001).Conclusions: SEAG is more sensitive for classifying transudates and more specific for exudates than Light’s criteria.

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