• Title/Summary/Keyword: Diagnostic Accuracy

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Correction of mandibular ramus height with frontal and lateral ramal inclinations in cephalograms and its effects on diagnostic accuracy of asymmetry (2차원 방사선 규격사진에서 하악골 상행지 고경의 보정분석에 관한 3차원 CT 영상 연구)

  • Hwang, Hyeon-Shik;Kim, Hyung-Min;Lee, Ki-Heon;Lim, Hoi-Jeong
    • The korean journal of orthodontics
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    • v.37 no.5
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    • pp.319-330
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    • 2007
  • Defining right and left side differences in mandibular ramus height is one of the key elements in the diagnosis of facial asymmetry. The purpose of the present study was to evaluate the effect of correction of ramus height with frontal and lateral ramal inclinations (FRI and LRI) in 2-dimensional cephalograms and observe how this affects the diagnostic accuracy of asymmetry. Methods: Frontal and lateral cephalograms were obtained in 40 individuals with chin deviation. FRI and LRI were measured on each side and ramus height measurement was corrected with these inclinations using Pythagorean's theorem. The results of diagnosis before and after correction on cephalograms were compared with the results in 3D CT images. Results: Both FRI and LRI showed greater values in the contralateral side than in the chin-deviated side and these contributed to an increase in the right and left side ramus height differences. After comparison of diagnostic results before and after correction on cephalograms with the results on 3D CT images, the sensitivity increased significantly (from 74 to 94 %) whereas the specificity decreased (from 44 to 22 %). Overall accuracy increased from 68 to 78 % with the correction using FRI and LRI. Conclusions: The results of the present study indicate that correction of ramus height with FRI and LRI is useful for an accurate diagnosis of facial asymmetry on frontal cephalograms.

Quality Improvement on Upper Gastrointestinal Series (위장조영검사에서 화질 개선 방법)

  • Lim, Byung-Hak;Chon, Kwon Su
    • Journal of the Korean Society of Radiology
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    • v.10 no.6
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    • pp.395-401
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    • 2016
  • Upper gastrointestinal series is a diagnostic test that X-ray passes through the stomach after administering contrast media such as barium or gastrografin. Upper gastrointestinal series with an advantage of no side effect except temporary constipation or abdominal pain has been widely used to diagnose diseases of the gastrointestinal system. However, image degradation and diagnostic accuracy frequently occurred when improper movement and breath control were carried out by lack of understanding the overall inspection process for the upper gastrointestinal series. The movie of the upper gastrointestinal series was made for improving inspection accuracy and image quality. The examinees encouraged to see the movie for waiting time before doing upper gastrointestinal series. In this study, image quality and diagnostic accuracy was examined for the effect of the movie about upper gastrointestinal series. 60 patients composed of each 10 people from 30s to 80s were selected randomly among both 2,940 examinees in 2014 and 3,076 examinees in 2015. Image quality was evaluated by the full width at half maximum of profile for each image using the Image J. The measurement of the full width at half maximum showed 0.208 mm and 0.133 mm for after and before seeing the movie. Thus it was verified that the movie education could improve the image quality and diagnostic accuracy for upper gastrointestinal series.

Value of FDG PET/Contrast-Enhanced CT in Initial Staging of Colorectal Cancer - Comparison with Contrast-Enhanced CT

  • Kunawudhi, Anchisa;Sereeborwornthanasak, Karun;Promteangtrong, Chetsadaporn;Siripongpreeda, Bunchorn;Vanprom, Saiphet;Chotipanich, Chanisa
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.4071-4075
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    • 2016
  • Background: FDG PET/CT is at an equivocal stage to recommend for staging of colorectal cancer as compared to contrast-enhanced CT (ceCT). This study was intended to evaluate the value of FDG PET/ceCT in colorectal cancer staging as compared to ceCT alone. Materials and Methods: PET/ceCT was performed for 61 colorectal cancer patients who were prospectively enrolled in the study. Three patients were excluded due to loss to follow-up. PET/ceCT findings and ceCT results alone were read separately. The treatment planning was then determined by tumor board consensus. The criteria for T staging were determined by the findings of ceCT. Nodal positive by PET/ceCT imaging was determined by visual analysis of FDG uptake greater than regional background blood pool activity. The diagnostic accuracy of T and N staging was determined only in patients who received surgery without any neoadjuvant treatment. Results: Of 58 patients, there were 40 with colon cancers including sigmoid cancers and 18 with rectal cancers. PET/ceCT in pre-operative staging detected bone metastasis and metastatic inguinal lymph nodes (M1a) that were undepicted on CT in 2 patients (3%), clearly defined 19 equivocal lesions on ceCT in 18 patients (31%) and excluded 6 metastatic lesions diagnosed by ceCT in 6 patients (10%). These resulted in alteration of management plan in 15 out of the 58 cases (26%) i.e. changing from chemotherapy to surgery (4), changing extent of surgery (9) and avoidance of futile surgery (2). Forty four patients underwent surgery within 45 days after PET/CT. The diagnostic accuracy for N staging with PET/ceCT and ceCT alone was 66% and 48% with false positive rates of 24% (6/25) and 76% (19/25) and false negative rates of 47% (9/19) and 21% (4/19), respectively. All of the false negative lymph nodes from PET/ceCT were less than a centimeter in size and located in peri-lesional regions. The diagnostic accuracy for T staging was 82%. The sensitivity of the peri-lesional fat stranding sign in determining T3 stage was 94% and the specificity was 54%. Conclusions: Our study suggested promising roles of PET/ceCT in initial staging of colorectal cancer with better diagnostic accuracy facilitating management planning.

Study of threshold and opacity in three-dimensional CT volume rendering of oral and maxillofacial area (구강악안면영역의 3차원 CT 영상 재형성시 역치 및 불투명도에 대한 연구)

  • Choi, Mun-Kyung;Lee, Sam-Sun;Huh, Kyung-Hoe;Yi, Won-Jin;Choi, Soon-Chul
    • Imaging Science in Dentistry
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    • v.39 no.1
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    • pp.13-18
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    • 2009
  • Purpose: This study was designed to determine a proper threshold value and opacity in three-dimensional CT volume rendering of oral and maxillofacial area. Materials and Methods: Three-dimensional CT data obtained from 50 persons who were done orthognatic surgery in department of oral and maxillofacial radiology of Seoul National University retrospectively. 12 volume rendering post-processing protocols of combination of threshold(100HU, 150HU, 221HU, 270HU) and opacity (58%, 80%, 90%) were applied. Five observers independently evaluated image quality using a five-point range scale. The results were analyzed by receiver operating characteristic curves, ANOVA and Kappa value. And three oromaxillofacial surgeons chose the all images that they thought proper clinically in the all of images. Results: Analysis using ROC curves revealed the area under each curve which indicated a diagnostic accuracy. The highest diagnostic accuracy appear with 100HU and 58% opacity. and the lowest diagnostic accuracy appear with 221HU and 58% opacity that are being used protocol in department of oral and maxillofacial radiology of Seoul National University. But, no statistically significant difference was noted between any of the protocols. And the number of proper images clinically that chosen by three oromaxillofacial surgeons is the largest in the cases of protocol 8 (221HU, opacity 80%) and protocol 11 (270HU, opacity 80%) in one after the other. Conclusion: Threshold and opacity in volume rendering can be controled easily and these can be causes of making an diagnostic accuracy. So we need to select proper values of these factors.

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Diagnostic Value of Ceruloplasmin in the Diagnosis of Pediatric Wilson's Disease

  • Kim, Jung Ah;Kim, Hyun Jin;Cho, Jin Min;Oh, Seak Hee;Lee, Beom Hee;Kim, Gu-Hwan;Choi, Jin-Ho;Kim, Kyung Mo;Yoo, Han-Wook
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.3
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    • pp.187-192
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    • 2015
  • Purpose: Measurement of serum ceruloplasmin level is the first step in screening for Wilson's disease (WD). Despite the rarity of WD in the general population, ceruloplasmin levels are routinely measured through hepatitis screening in both adults and children. Herein, we evaluated the diagnostic value of ceruloplasmin for the diagnosis of WD among children with hepatitis. Methods: We retrospectively reviewed data on serum ceruloplasmin levels measured as a serologic marker for patients with hepatitis at Asan Medical Center (Seoul, Korea) between from January 2004 to November 2013. The diagnosis of WD was confirmed by the identification of pathogenic variants in the ATP7B gene. To determine the diagnostic accuracy of ceruloplasmin, receiver operation characteristic (ROC) curves were constructed and the area under curve (AUC) were calculated. Results: Measurements of serum ceruloplasmin were performed in 2,834 children who had hepatitis. Among these, 181 (6.4%) children were diagnosed with WD. The sensitivity, specificity, and accuracy of a ceruloplasmin level of <20 mg/dL in the discrimination of WD were 93.4%, 84.2%, and 84.8%, respectively. In this study, 418 (14.7%) false-positive cases and 12 (0.4%) false-negative cases were noted. Using a ROC curve, a ceruloplasmin level of ${\leq}16.6mg/dL$ showed the highest AUC value (0.956) with a sensitivity of 91.2%, a specificity of 94.9%, and an accuracy of 94.7%. Conclusion: The measurement of serum ceruloplasmin was frequently used for the screening of WD in children, despite a low positive rate. The diagnostic value of ceruloplasmin may be strengthened by adopting a new lower cut-off level.

Diagnostic Accuracy, Sensitivity, Specificity and Positive Predictive Value of Fine Needle Aspiration Cytology (FNAC) in Intra Oral Tumors

  • Gillani, Munazza;Akhtar, Farhan;Ali, Zafar;Naz, Irum;Atique, Muhammad;Khadim, Muhammad Tahir
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.3611-3615
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    • 2012
  • Objective: The objective of this study was to establish the diagnostic accuracy, specificity and sensitivity of fine needle aspiration cytology(FNAC) for intra-oral tumors, comparing with histopathology as the gold standard. Materials and methods: Forty cases of FNA cytology from intraoral tumors was performed in AFID along with the demographic data and clinical information and then diagnosed at AFIP, Rawalpindi. Then the cytology results obtained per FNAC were compared with the histopathological biopsy results of the same lesions. The following variables were recorded for each patient: Age, gender, site of biopsy, diagnosis. The data were entered and analyzed using Open-epi version 2.0. Diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value were calculated. Cohen Kappa was further applied to compare the agreement between the biopsy and FNAC diagnoses. A p-value of < 0.05 was considered as statistically significant. Results: Among the total patients included in the study there were 24 males and 16 females, with a ratio of 1.5:1. Age of the patients ranged from 24 to 80 years with a mean of 52 years. A total of six sites were aspirated from the oral cavity with maximum (11) aspirates taken from alveolar ridge. The results of FNAC revealed that there were 32 malignant and 8 benign aspirates. Confirmation through histopathological analysis came for 31/32 malignant cases while one was falsely given positive for malignancy on FNAC. Among a total of 40 cases, 31(77%) cases diagnosed were found to be malignant and remaining 9(23%) were benign. The FNAC results revealed 32 malignant and 8 benign lesions. Histopathology of the subsequent surgically excised specimen showed malignant lesions in 31(77%) and benign in 9(23%) patients. As a whole, it was found that the absolute sensitivity for introral FNAC was 100% and specificity 89% with positive predictive value of 97% and negative predictive value of 100%. Conclusion: Cytological diagnosis was almost corroborative with final histopathological diagnosis in all cases, with very few exceptions, exhibiting high diagnostic accuracy.

A Study about a Short-form of the Sasang Constitution Questionnaire for Patient (SSCQ-P) (환자용 사상체질설문지(SSCQ-P) 축소화에 관한 연구)

  • Jeong, Jong-Hun;Jeon, Soo-Hyung;Na, Young-Ju;Kang, Seok-Hwan;Dong, Sang-Oak;Lee, Si-Woo;Kim, Kyu-Kon;Kim, Jong-Won;Kim, Sang-Hyuk
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.4
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    • pp.339-349
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    • 2014
  • Objectives This study was performed to make a short-form of Sasang Constitution Questionnaire for Patient(SSCQ-P). Methods In order to select important questions of SSCQ-P, we got advice from 10 professors of Oriental Medicine. As a result, we chose 37 questions. In addition, we selected 69 questions which had been used more than 12 times in SSCQ-P as the variable. We used some statistical methods to reduce questions. Finally, a total of 40 questions were selected. To find diagnostic accuracy rate of this short-form, discriminant analysis was performed. We used 1378 cases which was collect ed from February 2008 to June 2013 by online system(Sasang-medi data which has selected by web site, http://www.sasangmedi.or.kr), and 68 cases which was collected from November 2006 to September 2007 by the research "Construction of a biological information collection system for the Constitutional scientific diagnosis"(Korea Constitutional Multicenter Bank data, KCMB data) Results We made a short-form of SSCQ-P consisting of 40 questions. Diagnostic accuracy rate of short-form is 66.18% using Sasang-medi data, and 42.65% using KCMB data. Conclusions More cases are needed to improve the diagnostic accuracy rate of this short-form.

Coronal Three-Dimensional Magnetic Resonance Imaging for Improving Diagnostic Accuracy for Posterior Ligamentous Complex Disruption In a Goat Spine Injury Model

  • Xuee Zhu;Jichen Wang;Dan Zhou;Chong Feng;Zhiwen Dong;Hanxiao Yu
    • Korean Journal of Radiology
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    • v.20 no.4
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    • pp.641-648
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    • 2019
  • Objective: The purpose of this study was to investigate whether three-dimensional (3D) magnetic resonance imaging could improve diagnostic accuracy for suspected posterior ligamentous complex (PLC) disruption. Materials and Methods: We used 20 freshly harvested goat spine samples with 60 segments and intact surrounding soft tissue. The animals were aged 1-1.5 years and consisted of 8 males and 12 females, which were sexually mature but had not reached adult weights. We created a paraspinal contusion model by percutaneously injecting 10 mL saline into each side of the interspinous ligament (ISL). All segments underwent T2-weighted sagittal and coronal short inversion time inversion recovery (STIR) scans as well as coronal and sagittal 3D proton density-weighted spectrally selective inversion recovery (3D-PDW-SPIR) scans acquired at 1.5T. Following scanning, some ISLs were cut and then the segments were rescanned using the same magnetic resonance (MR) techniques. Two radiologists independently assessed the MR images, and the reliability of ISL tear interpretation was assessed using the kappa coefficient. The chi-square test was used to compare the diagnostic accuracy of images obtained using the different MR techniques. Results: The interobserver reliability for detecting ISL disruption was high for all imaging techniques (0.776-0.949). The sensitivity, specificity, and diagnostic accuracy of the coronal 3D-PDW-SPIR technique for detecting ISL tears were 100, 96.9, and 97.9%, respectively, which were significantly higher than those of the sagittal STIR (p = 0.000), coronal STIR (p = 0.000), and sagittal 3D-PDW-SPIR (p = 0.001) techniques. Conclusion: Compared to other MR methods, coronal 3D-PDW-SPIR provides a more accurate diagnosis of ISL disruption. Adding coronal 3D-PDW-SPIR to a routine MR protocol may help to identify PLC disruptions in cases with nearby contusion.

A Study of Diagnostic Algorithm for Quantitative Evaluation of the Stress Urinary Incontinence (복압성요실금의 정량적 평가를 위한 진단 알고리즘에 관한 연구)

  • Min, Hae-Ki;Noh, Si-Cheol;Choi, Heung-Ho
    • Journal of IKEEE
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    • v.12 no.2
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    • pp.87-94
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    • 2008
  • Pelvic floor muscle is the main subsystem that maintains urinary continence. It is possible to diagnose the degree of the stress urinary incontinence(SUI) by evaluating the contraction pressure of the pelvic floor muscle. Bio-signal measurement system was developed to measure the contraction pressure. Diagnostic parameters were drawn out by analyzing the measured data. Statistical evaluations were done to classify the all subjects with five groups each has similar characteristics. SUI diagnostic algorithm was implemented to each group separately. The accuracy of the algorithm was about 78.9% and utility was confirmed by clinical trial.

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Application of artificial intelligence for diagnosis of early gastric cancer based on magnifying endoscopy with narrow-band imaging

  • Yusuke Horiuchi;Toshiaki Hirasawa;Junko Fujisaki
    • Clinical Endoscopy
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    • v.57 no.1
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    • pp.11-17
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    • 2024
  • Although magnifying endoscopy with narrow-band imaging is the standard diagnostic test for gastric cancer, diagnosing gastric cancer using this technology requires considerable skill. Artificial intelligence has superior image recognition, and its usefulness in endoscopic image diagnosis has been reported in many cases. The diagnostic performance (accuracy, sensitivity, and specificity) of artificial intelligence using magnifying endoscopy with narrow band still images and videos for gastric cancer was higher than that of expert endoscopists, suggesting the usefulness of artificial intelligence in diagnosing gastric cancer. Histological diagnosis of gastric cancer using artificial intelligence is also promising. However, previous studies on the use of artificial intelligence to diagnose gastric cancer were small-scale; thus, large-scale studies are necessary to examine whether a high diagnostic performance can be achieved. In addition, the diagnosis of gastric cancer using artificial intelligence has not yet become widespread in clinical practice, and further research is necessary. Therefore, in the future, artificial intelligence must be further developed as an instrument, and its diagnostic performance is expected to improve with the accumulation of numerous cases nationwide.