• Title/Summary/Keyword: Diagnostic assessment

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Fast Real-Time Cardiac MRI: a Review of Current Techniques and Future Directions

  • Wang, Xiaoqing;Uecker, Martin;Feng, Li
    • Investigative Magnetic Resonance Imaging
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    • v.25 no.4
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    • pp.252-265
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    • 2021
  • Cardiac magnetic resonance imaging (MRI) serves as a clinical gold-standard non-invasive imaging technique for the assessment of global and regional cardiac function. Conventional cardiac MRI is limited by the long acquisition time, the need for ECG gating and/or long breathhold, and insufficient spatiotemporal resolution. Real-time cardiac cine MRI refers to high spatiotemporal cardiac imaging using data acquired continuously without synchronization or binning, and therefore of potential interest in overcoming the limitations of conventional cardiac MRI. Novel acquisition and reconstruction techniques must be employed to facilitate real-time cardiac MRI. The goal of this study is to discuss methods that have been developed for real-time cardiac MRI. In particular, we classified existing techniques into two categories based on the use of non-iterative and iterative reconstruction. In addition, we present several research trends in this direction, including deep learning-based image reconstruction and other advanced real-time cardiac MRI strategies that reconstruct images acquired from real-time free-breathing techniques.

Liquid Biopsy: An Emerging Diagnostic, Prognostic, and Predictive Tool in Gastric Cancer

  • Hye Sook Han;Keun-Wook Lee
    • Journal of Gastric Cancer
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    • v.24 no.1
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    • pp.4-28
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    • 2024
  • Liquid biopsy, a minimally invasive procedure that causes minimal pain and complication risks to patients, has been extensively studied for cancer diagnosis and treatment. Moreover, it facilitates comprehensive quantification and serial assessment of the whole-body tumor burden. Several biosources obtained through liquid biopsy have been studied as important biomarkers for establishing early diagnosis, monitoring minimal residual disease, and predicting the prognosis and response to treatment in patients with cancer. Although the clinical application of liquid biopsy in gastric cancer is not as robust as that in other cancers, biomarker studies using liquid biopsy are being actively conducted in patients with gastric cancer. Herein, we aimed to review the role of various biosources that can be obtained from patients with gastric cancer through liquid biopsies, such as blood, saliva, gastric juice, urine, stool, peritoneal lavage fluid, and ascites, by dividing them into cellular and acellular components. In addition, we reviewed previous studies on the diagnostic, prognostic, and predictive biomarkers for gastric cancer using liquid biopsy and discussed the limitations of liquid biopsy and the challenges to overcome these limitations in patients with gastric cancer.

Diagnostic Approaches for Idiopathic Pulmonary Fibrosis

  • Jae Ha Lee;Jin Woo Song
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.1
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    • pp.40-51
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    • 2024
  • Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrosing interstitial pneumonia with a very poor prognosis. Accurate diagnosis of IPF is essential for good outcomes but remains a major medical challenge due to variability in clinical presentation and the shortcomings of existing diagnostic tests. Medical history collection is the first and most important step in the IPF diagnosis process; the clinical probability of IPF is high if the suspected patient is 60 years or older, male, and has a history of cigarette smoking. Systemic assessment for connective tissue disease is essential in the initial evaluation of patients with suspected IPF to identify potential causes of interstitial lung disease (ILD). Radiologic examination using high-resolution computed tomography plays a pivotal role in the evaluation of patients with ILD, and prone and expiratory computed tomography images can be considered. If additional tests such as surgical lung biopsy or transbronchial lung cryobiopsy are needed, transbronchial lung cryobiopsy should be considered as an alternative to surgical lung biopsy in medical centers with experience performing this procedure. Diagnosis through multidisciplinary discussion (MDD) is strongly recommended as MDD has become the cornerstone for diagnosis of IPF, and the scope of MDD has expanded to monitoring of disease progression and suggestion of appropriate treatment options.

E-learning system to improve the endoscopic diagnosis of early gastric cancer

  • Kenshi Yao;Takashi Yao;Noriya Uedo;Hisashi Doyama;Hideki Ishikawa;Satoshi Nimura;Yuichi Takahashi
    • Clinical Endoscopy
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    • v.57 no.3
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    • pp.283-292
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    • 2024
  • We developed three e-learning systems for endoscopists to acquire the necessary skills to improve the diagnosis of early gastric cancer (EGC) and demonstrated their usefulness using randomized controlled trials. The subjects of the three e-learning systems were "detection", "characterization", and "preoperative assessment". The contents of each e-learning system included "technique", "knowledge", and "obtaining experience". All e-learning systems proved useful for endoscopists to learn how to diagnose EGC. Lecture videos describing "the technique" and "the knowledge" can be beneficial. In addition, repeating 100 self-study cases allows learners to gain "experience" and improve their diagnostic skills further. Web-based e-learning systems have more advantages than other teaching methods because the number of participants is unlimited. Histopathological diagnosis is the gold standard for the diagnosis of gastric cancer. Therefore, we developed a comprehensive diagnostic algorithm to standardize the histopathological diagnosis of gastric cancer. Once we have successfully shown that this algorithm is helpful for the accurate histopathological diagnosis of cancer, we will complete a series of e-learning systems designed to assess EGC accurately.

Urinary Concentrations of Human Epidydimis Secretory Protein 4 (He4) in The Diagnosis of Ovarian Cancer: A Case-Control Study

  • Macuks, Ronalds;Baidekalna, Ieva;Donina, Simona
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4695-4698
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    • 2012
  • Objective: To analyze differential diagnostic accuracy of urinary human epidydimis secretory protein 4 (HE4) in patients with ovarian tumors. Materials and methods: In the case-control study 23 patients with ovarian cancer, 37 patients with benign ovarian tumors and 18 women in the control group were included. Serum CA125 values and urinary concentrations of HE4were assessed quantitatively. Urinary creatinine concentrations and glomerular filtration rate were also determined and used to calculate ratios to HE4. Results: Higher urinary HE4 concentrations were observed in patients with late stage ovarian cancer (p=0.001) and also in patients with early stage ovarian cancer when compared to patients with benign ovarian tumors (p=0.044). On analysis where all ovarian cancer patients were included, higher diagnostic accuracy was observed with calculated ratio of HE4 to glomerular filtration rate (GFR) to unchanged urinary HE4 concentrations -AUC 0.861 vs. 0.858. When discriminatory accuracy was calculated for urinary HE4/GFR ratio and unchanged urinary HE4 concentrations, the last demonstrated a higher area under the curve - 0.701 vs. 0.602. The urinary HE4/creatinine ratio had lower discriminatory characteristics than unchanged concentrations of urinary HE4. However, HE4 serum concentration was more accurate for discrimination of patients with benign and malignant ovarian tumors when compared to urinary HE4 and CA125 in sera (AUCs were 0.868 for serum HE4 and 0.856 and 0.653 for urinary HE4 and CA125, respectively). Conclusions: Ovarian cancer patients have higher urinary concentrations of human epidydimis secretory protein 4 than patients with benign ovarian tumors. Urinary HE4 has comparable discriminatory accuracy with serum HE4 for benign and malignant ovarian tumors and can be recommended as a non-invasive ovarian cancer risk assessment method.

Diagnostic Significance of Apparent Diffusion Coefficient Values with Diffusion Weighted MRI in Breast Cancer: a Meta-Analysis

  • Sun, Jiang-Hong;Jiang, Li;Guo, Fei;Zhang, Xiu-Shi
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8271-8277
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    • 2014
  • Aims: Apparent diffusion coefficient (ADC) values of nodes in diffusion-weighted imaging (DWI) are widely used in differentiating metastatic from non-metastatic lymph nodes. The purpose of this meta-analysis was to demonstrate whether DWI could contribute to the precise diagnosis of breast cancer (BC) with and without lymph node metastasis (LNM). Materials and Methods: English and Chinese electronic databases were searched for relevant studies followed by a comprehensive literature search. Two reviewers independently assessed the methodological quality of the included trials based on the quality assessment of diagnostic accuracy studies (QUADAS). Summary odds ratios (ORs) and corresponding 95% confidence intervals (95% CIs) were calculated. Results: Final analysis of 624 BC subjects (patients with LNM = 254, patients without LNM = 370) were incorporated into the current meta-analysis from 9 eligible cohort studies. Combined ORs of ADCs suggested that ADC values in BC patients without LNM were higher than in patients with LNM (OR=0.56, 95%CI: 0.11-1.01, p=0.015). Subgroup analysis stratified by country indicated a low ADC value in BC patients with LNM rather than those without LNM among Chinese (OR=1.27, 95%CI: 0.89-1.66, p<0.001), Italians (OR=0.75, 95%CI: 0.13-1.38, p=0.018), and Egyptians (OR=1.27, 95%CI: 0.71-1.84, p<0.001). The findings of subgroup analysis by MRI machine type revealed that ADC values from diffusion MRI may be potential diagnostic indicators for BC using Non-Philips 1.5T (OR=1.10, 95%CI: 0.84-1.36, p<0.001). Conclusions: The main findings of our meta-analysis demonstrated that increased signal intensity on DWI and decreased signals on ADC are helpful in diagnosis of BC patients with or without LNM. DWI could therefore be an important imaging investigation in patients suspected of BC.

Relationships between Intermittent Locking History and Self-Reported Bruxism in Temporomandibular Joint

  • Lee, Myeong-Ok;Lee, Yeon-Hee;Kang, Soo-Kyung;Chun, Yang-Hyun;Hong, Jung-Pyo;Auh, Q-Schick
    • Journal of Oral Medicine and Pain
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    • v.42 no.2
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    • pp.29-34
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    • 2017
  • Purpose: To evaluate aggravating factors of intermittent locking among temporomandibular joint using magnetic resonance imaging (MRI) and diagnostic criteria for temporomandibular disorder (DC/TMD) diagnosis. Methods: A retrospective analysis was conducted of 35 patients with intermittent locking history but normal intra-articular findings between September 2012 and June 2015 in Kyung Hee University Dental Hospital. A standardized DC/TMD assessment was performed on subjects with MRI findings. Clinical findings were assessed on the basis of maximum mouth opening (active & passive), self-reported habits, patients' age, gender, systemic diseases at the initial visit. First, chi square test was used to examine differences with variables and then risk factors for intermittent locking were assessed using multivariate logistic regression. Results: Self-reported bruxism was strongly associated with intermittent locking history. Conclusions: The new DC/TMD protocol is intended for use within any clinical setting and supports the full range of diagnostic activities from screening to definitive evaluation and diagnosis. Self-reported sleep bruxism has been associated with a higher likelihood of intermittent locking. Comorbidity is therefore a factor that must be assessed. It is necessary to consider the amount of contact of the teeth and the duration.

Evaluation of compression ratios using JPEG 2000 on diagnostic images in dentistry (치과병원에서 사용되는 진단영상에 대한 JPEG2000 압축률에 대한 평가)

  • Jung Gi-Hun;Han Won-Jeong;Yoo Dong-Soo;Choi Soon-Chul;Kim Eun-Kyung
    • Imaging Science in Dentistry
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    • v.35 no.3
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    • pp.157-165
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    • 2005
  • Purpose : To find out the proper compression ratios without degrading image quality and affecting lesion detectability on diagnostic images used in dentistry compressed with JPEG 2000 algorithm. Materials and Methods : Sixty Digora periapical images, sixty panoramic computed radiographic (CR) images, sixty computed tomographic (CT) images, and sixty magnetic resonance (MR) images were compressed into JPEG 2000 with ratios of 10 levels from 5:1 to 50:1. To evaluate the lesion detectability, the images were graded with 5 levels (1 : definitely absent; 2: probably absent; 3: equivocal; 4: probably present; 5: definitely present), and then receiver operating characteristic analysis was performed using the original image as a gold standard. Also to evaluate subjectively the image quality, the images were graded with 5 levels (1 definitely unacceptable; 2: probably unacceptable; 3: equivocal, 4: probably acceptable; 5· definitely acceptable), and then paired t-test was performed. Results : In Digora, CR panoramic and CT images, compressed images up to ratios of 15 : 1 showed nearly the same lesion detectability as original images, and in MR images, compressed images did up to ratios of 25 : 1. In Digora and CR panoramic Images, compressed images up to ratios of 5 : 1 showed little difference between the original and reconstructed images in subjective assessment of image quality In CT images, compressed images did up to ratios of 10: 1 and in MR images up to ratios of 15 : 1 Conclusion : We considered compression ratios up to 5 : 1 in Digora and CR panoramic images, up to 10 : 1 in CT images, up to 15 : 1 in MR images as clinically applicable compression ratios.

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A Study on Quality Assurance(QA) Guideline for Diagnostic Monitor (판독용 모니터 정도관리 항목 및 시행기준안 개발 연구)

  • Son, Gi-Gyeong;Sung, Dong-Wook;Jung, Hae-Jo;Jeong, Jae-Ho;Kang, Hee-Doo;Shin, Jin-Ho;Lee, Sun-Geun;Kim, Yong-Hwan
    • Korean Journal of Digital Imaging in Medicine
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    • v.9 no.1
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    • pp.53-65
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    • 2007
  • PACS has been run at the Kyung Hee University Medical Center(KHMC) since 2001, and the installation and operation of PACS have contributed to automation and quantification of KHMC's medical environment During these five years our greatest concern is how to make our own guiding principle of diagnostic monitor QA which is adapted to international standards. In accordance with the terms of 'KHMC QA Guideline', 'AAPM TG18', 'SMPTE RP133', 'DICOM Part14', 'DIN V 6868-57', 'JESRA X-0093', 'JIS Z4752-2-5' and 'KCARE', concern about quality assurance of medical images are on the increase. With the investigation of acceptance testing and quality control of international standards for medical display devices, and data collection and analysis for recommended guideline, it is reported that acceptance testing(quality control), including geometrical distortion, display reflection, luminance response, luminance uniformity, display resolution, display noise, veiling glare and color chromaticity being adequate and effective to domestic hospital environments for medical display devices and assessment methods according to each performance. Accordingly, KHMC classified the checkpoint items by period, at the time of monitor setting, monthly, quarterly, half-yearly and annually. Periodic classification of checkpoint items for monitor QA makes a good guideline for image QA/QC and useful guideline for persistent good quality of monitor.

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A Diagnostic Study on Middle School Students' Health Hazard Behaviors and Influential Variables - Based on the PRECEDE model- (중학생의 건강위해 행위 및 관련요인에 대한 진단적 연구 -PRECEDE 모형을 근간으로-)

  • Yoo, Jae-Soon
    • Journal of the Korean Society of School Health
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    • v.15 no.1
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    • pp.31-48
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    • 2002
  • The middle school students' health hazard behaviors, health education needs, related to health hazard behaviors and life, were investigated on the basis of the PRECEDE model, for the purpose of a diagnostic research on health education. The data for this study were collected from the sample consisted of the middle school in Chongju for two weeks period in December, 2001. In analyzing the data, t-test, one-way ANOVA and $x^2$-test were done by using SPSS 10.1 for window to compare data between the sexes of the students and grades of the students. A Pearson's correlation analysis was carried out to determine the relationships among the diagnostic variables. The Pearson's correlation between health behavior and life satisfaction was .52, which was significant at the level of P<.01. The Pearson's correlation between drug use behavior and mental health was .40, which was significant at the level of P<.01. The relationships between each diagnosis variable suggested by the PRECEDE model had been experimentally proven to be valid, supporting the conceptual framework of the study as appropriate for assessing the students' health and health education needs. The significance of this research is that it has diagnosed the needs of middle school health education by assessment of factors related to health hazard behaviors and meantal health of the students. The research findings suggest an integrated system of school health education to be contrieved to enhance the effectiveness of the education by strengthening the related factors such as parents' interest to improve the health of middle school students.