• Investigative Magnetic Resonance Imaging
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• v.25 no.4
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• pp.323-331
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• 2021

Purpose: To investigate the diagnostic criteria of T1-weighted imaging (T1W) and time-of-flight (TOF) imaging for detecting intraplaque hemorrhage (IPH) of a vertebrobasilar artery (VBA) compared with simultaneous non-contrast angiography and intraplaque hemorrhage (SNAP) imaging. Materials and Methods: Eighty-seven patients with VBA atherosclerosis who underwent high resolution MR imaging for evaluation of VBA plaque were reviewed. The presence and location of VBA plaque and IPH on SNAP were determined. The signal intensity (SI) of the VBA plaque on T1W and TOF imaging was manually measured and the SI ratio against adjacent muscles was calculated. The receiver-operating characteristic (ROC) curve was used to compare the diagnostic accuracy for detecting VBA IPH. Results: Of 87 patients, 67 had IPH and 20 had no IPH on SNAP. The SI ratio between VBA IPH and temporalis muscle on T1W was significantly higher than that in the no-IPH group (235.9 ± 16.8 vs. 120.0 ± 5.1, P < 0.001). The SI ratio between IPH and temporalis muscle on TOF was also significantly higher than that in the no-IPH group (236.8 ± 13.3 vs. 112.8 ± 7.4, P < 0.001). Diagnostic efficacies of SI ratios on TOF and TIW were excellent (AUC: 0.976 on TOF and 0.964 on T1W; cutoff value: 136.7% for TOF imaging and 135.1% for T1W imaging). Conclusion: Compared with SNAP, cutoff levels of the SI ratio between VBA plaque and temporalis muscle on T1W and TOF imaging for detecting IPH were approximately 1.35 times.

• Journal of Veterinary Clinics
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• v.32 no.4
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• pp.319-323
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• 2015

The performance of diagnostic test accuracy is usually summarized by a variety of statistics such as sensitivity, specificity, predictive value, likelihood ratio, and kappa. These indices are most commonly presented when evaluations of competing diagnostic tests are reported, and it is of utmost importance to compare the accuracies of diagnostic tests to decide on the best available test for certain medical disorder. However, it is important to emphasize that specific point values of these indices are merely estimates. If parameter estimates are reported without a measure of uncertainty (precision), knowledgeable readers cannot know the range within which the true values of the indices are likely to lie. Therefore, when evaluations of diagnostic accuracy are reported the precision of estimates should be stated in parallel. To reflect the precision of any estimate of a diagnostic performance characteristic or of the difference between performance characteristics, the computation of confidential interval (CI), an indicator of precision, is widely used in medical literatures in that CIs are more informative to interpret test results than the simple point estimates. The majority of peer-reviewed journals usually require CIs to be specified for descriptive estimates, whereas domestic veterinary journals seem less vigilant on this issues. This paper describes how to calculate the indices and associated CIs using practical examples when assessing diagnostic test performance.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10363-10366
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• 2015

Background: The aim of this study was to determine diagnostic and prognostic roles of the neutrophil to lymphocyte ratio (NLR) in breast cancer patients. To date, data are limited on associations of primary breast carcinoma (PBC) and benign proliferative breast disease (BPBD) with preoperative NLR values. Materials and Methods: Our study covered of 120 female patients with PBC and 50 with BPBD. Diagnostic values of NLR were estimated using sensitivity, specificity and areas under receiver operating characteristic curves (AUC). Results: NLR values were significantly higher in the PBC patients than in those with BPBD, with an AUC of 0.668 in the PBC case. The optimal cut-off for NLR was 2.96 and this was validated in the testing set, giving a sensitivity and a specificity of 79.7% and 76.2%, respectively, in PBC patients. Conclusions: Preoperative high NLR is a significant diagnostic predictor of distinction of breast cancer from BPBD and elevated NLR is also an important prognostic marker for primary invasive breast cancer.

• Journal of radiological science and technology
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• v.47 no.3
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• pp.167-173
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• 2024

This study purpose to establish an appropriate target exposure index(EIT) using dose area product(DAP) and exposure index(EI) based on chest radiography. First, the system response experiment was conducted with radiation quality of RQA5 to compare the dosimetry and dose area product of equipment. Next, EI and DAP were acquired and analyzed while varying the dose in the diagnostic at 70kVp using a human body model phantom. The signal to noise ratio(SNR) of the obtained results was analyzed in the diagnostic with in the diagnostic reference level(DRL) application range. The DRL at percentage 25% had a dose of 0.17 mGy and EI was 83, and at percentage 75% the dose was 0.68 mGy and EI was 344. As the dose increased, the SNR in the subdiaphragm increased. To set the EIT, calibration must first be performed using a dosimeter and set within the DRL range to reflect the needs of the medical institution.

• Proceedings of the IEEK Conference
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• 2000.07a
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• pp.39-42
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• 2000

In our study, by observing and analyzing normal liver in abdominal CT image, we estimated gray value range and generated binary image. In the binary image, we achieved the number of hole which is located between pixels. Depending on the ratio, we processed the input image to 4 kinds of mesh images to remove the noise part that has the different ratio. With the Union image of 4 kinds of mesh images, we generated the template representing general outline of liver and subtracted from the binary image so the we can represent the organ boundary to be minute. With results of proposed method, processing time is reduced compared with existing method and we compared the result image to manual image of medical specialists.

• The Korean Journal of Applied Statistics
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• v.26 no.1
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• pp.15-22
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• 2013

In clinical study or epidemic research, the $2{\times}2$ frequency table is useful to present a summary statistic The values of four cells in $2{\times}2$ table use to calculate the effect measures such as risk ratio, relative ris ratio or odds ratio. In this paper, we suggest that the improved visualization method using a radar diagram supported by MS-office Excel from the $2{\times}2$ frequency table is able to understand and draw easily betweendiagnosti measures such as sensitivity, specificity, predictivity, and likelihood ratio. We use some numerical example in order to show the usage of the proposed method.

• Journal of Veterinary Clinics
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• v.25 no.3
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• pp.146-151
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• 2008

During the clinical decision making practitioners are often faced with performing diagnostic tests to solve the presenting problems seen in the patients. The diagnostic utility of a test has traditionally been described by technical terms such as sensitivity, specificity, and positive (PPV) and negative predictive value (NPV). Although well known, clinicians are frequently unclear about the concept and application of these terms in everyday evidence-based clinical decision making. Sensitivity and specificity, which are intrinsic properties of diagnostic tests, summarizes the characteristics of the test over a population. The PPV and NPV are greatly dependent on the population prevalence of disease, and thus they do not transferable to different patients or clinical settings. Besides, considering the fact that clinicians more often interested in knowing the extent to which a test result could confirm or exclude of a condition under consideration (posttest probability), these measures do not provide answers on this question. The likelihood ratios (LR) using the information contained in sensitivity and specificity are becoming increasingly popular for reporting the usefulness of diagnostic tests because this term provide an indication of posttest probability as a function of the pretest probability. In this article, clinical applications of LR are illustrated with some practical examples. Discussion is also included of the inherent limitations regarding diagnostic test characteristics.

• Investigative Magnetic Resonance Imaging
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• v.21 no.2
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• pp.71-81
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• 2017

Purpose: To compare three, motion-resistant, T1-weighted MR sequences on the hepatobiliary phase for gadoxetic acid-enhanced MR imaging of the liver. Materials and Methods: In this retrospective study, 79 patients underwent gadoxetic acid-enhanced, 3T liver MR imaging. Fifty-nine were examined using a standard protocol, and 20 were examined using a motion-resistant protocol. During the hepatocyte-specific phase, three MR sequences were acquired: 1) gradient recalled echo (GRE) with controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA); 2) radial GRE with the interleaved angle-bisection scheme (ILAB); and 3) radial GRE with golden-angle scheme (GA). Two readers independently assessed images with motion artifacts, streaking artifacts, liver-edge sharpness, hepatic vessel clarity, lesion conspicuity, and overall image quality, using a 5-point scale. The images were assessed by measurement of liver signal-to-noise ratio (SNR), and tumor-to-liver contrast-to-noise ratio (CNR). The results were compared, using repeated post-hoc, paired t-tests with Bonferroni correction and the Wilcoxon signed rank test with Bonferroni correction. Results: In the qualitative analysis of cooperative patients, the results for CAIPIRINHA had significantly higher ratings for streak artifacts, liver-edge sharpness, hepatic vessel clarity, and overall image quality as compared to, radial GRE, (P < 0.016). In the imaging of uncooperative patients, higher scores were recorded for ILAB and GA with respect to all of the qualitative assessments, except for streak artifact, compared with CAIPIRINHA (P < 0.016). However, no significant differences were found between ILAB and GA. For quantitative analysis in uncooperative patients, the mean liver SNR and lesion-to-liver CNR with radial GRE were significantly higher than those of CAIPIRINHA (P < 0.016). Conclusion: In uncooperative patients, the use of the radial GRE sequence can improve the image quality compared to GRE imaging with CAIPIRINHA, despite the data acquisition methods used. The GRE imaging with CAIPIRINHA is applicable for patients without breath-holding difficulties.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.109-115
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• 2016

Background: P53 has been reported to be involved with tumorigenesis and has also been implicated as a significant biomarker in oral squamous cell carcinoma(OSCC). However, the diagnostic value of p53 antibodies remains controversial; hence, we comprehensively and quantitatively assessed the potential in the present systematic review. Materials and Methods: A comprehensive search was performed using PubMed and Embase, up to October 31, 2014, without language restriction. Studies were assessed for quality using QUADAS (quality assessment of studies of diagnostic accuracy). The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were pooled separately and compared with overall accuracy measures using diagnostic odds ratios (DORs) and symmetric summary receiver operating characteristic (SROC) curves. Results: Of 150 studies initially identified, 7 eligible regarding serum p53 antibodies met the inclusion criteria. Some 85.7% (6/7) were of relatively high quality (QUADAS $score{\geq}7$). The summary estimates for quantitative analysis of serum p53 antibody in the diagnosis of squamous cell carcinoma were: PLR 2.06 [95% confidence interval (CI) : 1.35-3.15], NLR 0.85 (95%CI: 0.80-0.90) and DOR 2.47 (95%CI: 1.49-4.12). Conclusions: This meta-analysis suggests that the use of s-p53-antibodies has potential diagnostic value with relatively high sensitivity and specificity for OSCC particularly with serum specimens for discrimination of OSCCs from healthy controls. However, its discrimination power is not perfect because of low sensitivity.

• Korean Journal of Radiology
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• v.21 no.12
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• pp.1355-1366
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• 2020

Objective: We aimed to evaluate the diagnostic value and prognostic relevance of FDG positron emission tomography/computed tomography (PET-CT) in extrahepatic cholangiocarcinoma patients. Materials and Methods: This study included 234 extrahepatic cholangiocarcinoma patients who underwent FDG PET-CT between June 2008 and February 2016. The diagnostic performance of FDG PEG-CT was compared to that of contrast-enhanced multidetector row CT (MDCT) and MRI. Independent prognosticators for poor survival were also assessed. Results: The sensitivity of FDG PET-CT for detecting primary tumor and regional lymph node metastases was lower than that of MDCT or MRI (p < 0.001), whereas the specificity and positive predictive value for detecting regional lymph nodes metastases was significantly better in FDG PET-CT compared to MDCT and MRI (all p < 0.001). There was no significant difference in the diagnostic yield of distant metastases detection among three diagnostic imaging techniques. In a multivariate analysis, maximum standardized uptake values (SUV_max) of the primary tumor (adjusted hazard ratio [HR], 1.75; 95% confidence interval [CI], 1.13-2.69) and of the metastatic lesions ≥ 5 (adjusted HR, 8.10; 95% CI, 1.96-33.5) were independent contributors to poor overall survival in extrahepatic cholangiocarcinoma patients. In a subgroup analysis of 187 patients with periductal infiltrating type of cholangiocarcinoma, an SUV_max of the primary tumor ≥ 5 was associated with an increased risk of regional lymph node (adjusted odds ratio [OR], 1.60; 95% CI, 0.55-4.63) and distant metastases (adjusted OR, 100.57; 95% CI, 3.94-2567.43) at diagnosis as well as with poor overall survival (adjusted HR, 1.81; 95% CI, 1.04-3.15). Conclusion: FDG PET-CT showed lower sensitivity for detecting primary tumor and regional lymph node involvement than MDCT and MRI. However, the SUV_max of primary tumors and metastatic lesions derived from FDG PET-CT could have significant implications for predicting prognoses in extrahepatic cholangiocarcinoma patients.