• Title/Summary/Keyword: Diagnostic value

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Cone-Beam CT-Guided Percutaneous Transthoracic Needle Lung Biopsy of Juxtaphrenic Lesions: Diagnostic Accuracy and Complications

  • Wonju Hong;Soon Ho Yoon;Jin Mo Goo;Chang Min Park
    • Korean Journal of Radiology
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    • v.22 no.7
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    • pp.1203-1212
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    • 2021
  • Objective: To investigate the diagnostic accuracy and complications of cone-beam CT-guided percutaneous transthoracic needle biopsy (PTNB) of juxtaphrenic lesions and identify the risk factors for diagnostic failure and complications. Materials and Methods: In total, 336 PTNB procedures for lung lesions (mean size ± standard deviation [SD], 4.3 ± 2.3 cm) abutting the diaphragm in 326 patients (189 male and 137 female; mean age ± SD, 65.2 ± 11.4 years) performed between January 2010 and December 2014 were included. The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the PTNB procedures for the diagnosis of malignancy were measured based on the intention-to-diagnose principle. The risk factors for diagnostic failures and complications were evaluated using logistic regression analysis. Results: The accuracy, sensitivity, specificity, PPV, and NPV were 92.7% (293/316), 91.3% (219/240), 91.4% (74/81), 96.9% (219/226), and 77.9% (74/95), respectively. There were 23 diagnostic failures (7.3%), and lesion sizes ≤ 2 cm (p = 0.045) were the only significant risk factors for diagnostic failure. Complications occurred in 98 cases (29.2%), including 89 cases of pneumothorax (26.5%) and 7 cases of hemoptysis (2.1%). The multivariable analysis showed that old age (> 65 years) (p = 0.002), lesion size of ≤ 2 cm (p = 0.003), emphysema (p = 0.006), and distance from the pleura to the target lesion (> 2 cm) (p = 0.010) were significant risk factors for complications. Conclusion: The diagnostic accuracy of cone-beam CT-guided PTNB of juxtaphrenic lesions for malignancy was fairly high, and the target lesion size was the only significant predictor of diagnostic failure. Complications of cone-beam CT-guided PTNB of juxtaphrenic lesions occurred at a reasonable rate.

Diagnostic Value of Superoxide Dismutase in Tuberculous and Malignant Pleural Effusions

  • Wang, Xin-Feng;Wu, Yan-Hua;Jiao, Jin;Guan, Cui-Ping;Yang, Xiao-Guang;Wang, Mao-Shui
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.821-824
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    • 2013
  • The aim of this study was to investigate the diagnostic value of superoxide dismutase (SOD) in tuberculous pleural effusions (TPEs) and malignant pleural effusions (MPEs). Pleural effusion (PE) samples from 100 patients were classified on the basis of diagnosis as TPE (n=57) and MPE (n=43). The activity of SOD was determined by pyrolgallol assay. A significant difference was observed in SOD activity (P<0.01) between TPE and MPE, levels of being significantly higher in TPE compared to MPE. With a threshold value of 41 U/L, the area under the ROC curve was 0.653, SOD had a sensitivity of 61.4% and a specificity of 61.0% for differential diagnosis. Thus, SOD activity in PE was not a good biomarker in differentiating TPE and MPE. To the best of our knowledge, five SOD isoforms may be present in PE. Identification of which SOD contributes to the difference of SOD level between TPE and MPE is very important for illustrating mechanisms and improving the differential diagnostic value.

Development of a flexible composite based on vulcanized silicon casting with bismuth oxide and characterization of its radiation shielding effectiveness in diagnostic X-ray energy range and medium gamma-ray energies

  • Ibrahim Demirel;Haluk Yucel
    • Nuclear Engineering and Technology
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    • v.56 no.7
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    • pp.2570-2575
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    • 2024
  • The study aims to develop a novel, lead-free, flexible and lightweight composite shielding material against ionizing radiation. For this, it was used bismuth oxide (Bi2O3) in RTV-2 silicon matrix. The shielding tests were carried out in both diagnostic X-ray energies and intermediate gamma-ray energy range of up to 662 keV to determine the radiation attenuation properties of this material in terms of attenuation ratio, half value layer, tenth value layer, mean free path and lead equivalency of samples in weight of 30%, 40%, 50% in Bi2O3. In the diagnostic X-ray energy range, half value layer, tenth value layer and lead equivalency (in mm Pb) of the produced samples were measured at 80 and 100 kVp narrow beam conditions according to the requirements of EN IEC 61331-1 standard. The results show that lead equivalent values of the produced novel sheets was measured to be 0.16 mm Pb, corresponding to a 6 mm thickness of the flexible sample when it contains 30% wt. Bi2O3 in RTV matrix. The experimental findings for durability and flexibility also indicated that this new RTV-based flexible, lead -free shielding composite can be used safely for especially for manufacturing aprons, garments and thyroid guards used in mammography, radiology, nuclear medicine and dental applications in practice.

Combination of Quantitative Parameters of Shear Wave Elastography and Superb Microvascular Imaging to Evaluate Breast Masses

  • Eun Ji Lee;Yun-Woo Chang
    • Korean Journal of Radiology
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    • v.21 no.9
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    • pp.1045-1054
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    • 2020
  • Objective: This study aimed to evaluate the diagnostic value of combining the quantitative parameters of shear wave elastography (SWE) and superb microvascular imaging (SMI) to breast ultrasound (US) to differentiate between benign and malignant breast masses. Materials and Methods: A total of 200 pathologically confirmed breast lesions in 192 patients were retrospectively reviewed using breast US with B-mode imaging, SWE, and SMI. Breast masses were assessed based on the breast imaging reporting and data system (BI-RADS) and quantitative parameters using the maximum elasticity (Emax) and ratio (Eratio) in SWE and the vascular index in SMI (SMIVI). The area under the receiver operating characteristic curve (AUC) value, sensitivity, specificity, accuracy, negative predictive value, and positive predictive value of B-mode alone versus the combination of B-mode US with SWE or SMI of both parameters in differentiating between benign and malignant breast masses was compared, respectively. Hypothetical performances of selective downgrading of BI-RADS category 4a (set 1) and both upgrading of category 3 and downgrading of category 4a (set 2) were calculated. Results: Emax with a cutoff value of 86.45 kPa had the highest AUC value compared to Eratio of 3.57 or SMIVI of 3.35%. In set 1, the combination of B-mode with Emax or SMIVI had a significantly higher AUC value (0.829 and 0.778, respectively) than B-mode alone (0.719) (p < 0.001 and p = 0.047, respectively). B-mode US with the addition of Emax, Eratio, and SMIVI had the best diagnostic performance of AUC value (0.849). The accuracy and specificity increased significantly from 68.0% to 84.0% (p < 0.001) and from 46.1% to 79.1% (p < 0.001), respectively, and the sensitivity decreased from 97.6% to 90.6% without statistical loss (p = 0.199). Conclusion: Combining all quantitative values of SWE and SMI with B-mode US improved the diagnostic performance in differentiating between benign and malignant breast lesions.

A Diagnostic Technique for Distribution Transformers using Top Oil Temperature (최상부 유온을 이용한 배전용 변압기의 진단 기법)

  • Choe, Do-Hyeok;Yun, Yong-Han;Min, Gyeong-Rae;Kim, Jae-Cheol
    • The Transactions of the Korean Institute of Electrical Engineers A
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    • v.49 no.5
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    • pp.242-251
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    • 2000
  • In this paper, we argued the possibility of the diagnostic technique for distribution transformers using the top oil temperature rising above the ambient temperature. The proposed diagnostic technique used the reference top oil temperature rising at rated current. We determined the emergency value of the transformer using the limitation of the top oil temperature rising and calculated the loss of life. The top oil temperature rises because of the load currents. In this point, the proposed diagnostic technique was explained. The proposed system measures the load current, top oil temperature and ambient temperature. With the diagnostic device, we tested the top oil temperature rising of t재 transformers. Then the loss of life was calculated by the top oil temperature.

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EVALUATION OF DIAGNOSTIC TESTS WITH MULTIPLE DIAGNOSTIC CATEGORIES

  • Birkett N.J.
    • 대한예방의학회:학술대회논문집
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    • 1994.02b
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    • pp.154-157
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    • 1994
  • The evaluation of diagnostic tests attempts to obtain one or more statistical parameters which can indicate the intrinsic diagnostic utility of a test. Sensitivity. specificity and predictive value are not appropriate for this use. The likelihood ratio has been proposed as a useful measure when using a test to diagnose one of two disease states (e.g. disease present or absent). In this paper, we generalize the likelihood ratio concept to a situation in which the goal is to diagnose one of several non-overlapping disease states. A formula is derived to determine the post-test probability of a specific disease state. The post-test odds are shown to be related to the pre-test odds of a disease and to the usual likelihood ratios derived from considering the diagnosis between the target diagnosis and each alternate in turn. Hence, likelihood ratios derived from comparing pairs of diseases can be used to determine test utility in a multiple disease diagnostic situation.

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The Influence of Heart Rate and Coronary Calcification on the Diagnostic Accuracy of 64-slice Multidetector Cardiac CT in Coronary Artery Disease (심박동수 및 관상동맥 석회화가 64 절편 다중검출기 심장 CT의 관상동맥 질환 진단일치도에 미치는 영향)

  • Kang, Yeong-Han;Park, Jong-Sam
    • The Journal of the Korea Contents Association
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    • v.9 no.12
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    • pp.339-347
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    • 2009
  • Purpose : This study was to investigate the influence of heart rate and coronary calcification on diagnostic accuracy of 64-slice multidetector CT(MDCT) in coronary artery disease. Methods : 178 patients(84 men, 94 women) undergoing cardiac CT were included in this study. 3 coronary arteries(LAD, LCX, RCA) were assessed the presence of significant stenosis($\geq50%$) and the results compared with those of coronary angiography. Results : On a patient-based analysis, the diagnostic accuracy of 64-slice MDCT was 96.6%. The diagnostic accuracy on left anterior descending, left circumflex, right coronary artery were 86.5%, 84.3%, 92.1% respectively. Body mass index and blood pressure were not influenced on diagnostic accuracy of 64-slice MDCT. In less than 60/min of heart rate, accuracy was 90.1% and $\kappa$ value was 0.78. While in more than 70/min of heart rate, accuracy was 75.8% and $\kappa$ value was 0.52. In less than 100 of coronary calcification, accuracy was 91.3% and $\kappa$ value was 0.81. While in more than 400, accuracy was 68.6% and $\kappa$ value was 0.33. Conclusion : 64-slice MDCT shows similar diagnostic accuracy as coronary angiography. But in the context of more than 70/min of heart rate and 400 of coronary calcification, diagnostic accuracy was decreased. So there needs to identify heart rate and coronary calcification in cardiac CT, and if heart rate shows more than 70/min, use beta-blocker to regulate it.

Diagnostic Value of Endorectal Ultrasound in Preoperative Assessment of Lymph Node Involvement in Colorectal Cancer: a Meta-analysis

  • Li, Li;Chen, Shi;Wang, Ke;Huang, Jiao;Liu, Li;Wei, Sheng;Gao, Hong-Yu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3485-3491
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    • 2015
  • Background: Nodal invasion by colorectal cancer is a critical determinant in estimating patient survival and in choosing appropriate preoperative treatment. The present meta-analysis was designed to evaluate the diagnostic value of endorectal ultrasound (EUS) in preoperative assessment of lymph node involvement in colorectal cancer. Materials and Methods: We systematically searched PubMed, Web of Science, Embase, and China National Knowledge Infrastructure (CNKI) databases for relevant studies published on or before December 10th, 2014. The sensitivity, specificity, likelihood ratios, diagnostic odds ratio (DOR) and area under the summary receiver operating characteristics curve (AUC) were assessed to estimate the diagnostic value of EUS. Subgroup analysis and meta-regression were performed to explore heterogeneity across studies. Results: Thirty-three studies covering 3,016 subjects were included. The pooled sensitivity and specificity were 0.69 (95%CI: 0.63-0.75) and 0.77 (95%CI: 0.73-0.82), respectively. The positive and negative likelihood ratios were 3.09 (95%CI: 2.52-3.78) and 0.39 (95%CI: 0.32-0.48), respectively. The DOR was 7.84 (95%CI: 5.56-11.08), and AUC was 0.80 (95%CI: 0.77-0.84). Conclusions: This meta-analysis indicated that EUS has moderate diagnostic value in preoperative assessment of lymph node involvement in colorectal cancer. Further refinements in technology and diagnostic criteria are necessary to improve the diagnostic accuracy of EUS.

Diagnostic Performance and Prognostic Relevance of FDG Positron Emission Tomography/Computed Tomography for Patients with Extrahepatic Cholangiocarcinoma

  • Nam Hee Kim;Sung Ryol Lee;Young Hwan Kim;Hong Joo Kim
    • 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 (SUVmax) 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 SUVmax 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 SUVmax of primary tumors and metastatic lesions derived from FDG PET-CT could have significant implications for predicting prognoses in extrahepatic cholangiocarcinoma patients.

Diagnostic Accuracy of Clinical Test for Anterior Cruciate Ligament Injury: Systematic Review

  • Deniz Yasemin;Sang-Woo Pyun;HyungSu Lee;Seong-Eun Kim;SunGyu Han;Dongyeop Lee;Ji-Heon Hong;Jae-Ho Yu;Jin-Seop Kim;Seong-gil Kim
    • The Journal of Korean Physical Therapy
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    • v.35 no.3
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    • pp.57-63
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    • 2023
  • Purpose: The aim of this study was to conduct a systematic review of randomized controlled studies from 2012 to present that explore the diagnostic accuracy of clinical tests used for diagnosing anterior cruciate ligament (ACL) injury. Methods: Study design: Systematic review. Literature search of the PubMed and Scholar databases was conducted using keywords related to diagnostic accuracy of clinical tests for ACL injury. The PRISMA Guidelines were followed to conduct this study. The Cochrane Risk of Bias Tool was utilized to assess the quality of each included study. Results: As a result, 8 studies were included, and 6 clinical tests used in ACL tears were evaluated for diagnostic accuracy. The pivot shift test was reported as having the highest +LR (29.5) value with a sensitivity of 59% and a specificity of 98%. However, the test with the lowest -LR value was the lever test, and the values were as follows: -LR (0.08), +LR (4.7), specificity (80%), sensitivity (94%). Conclusion: In this study, it was concluded that a single clinical test is not sufficient to determine the presence of ACL injury. Test combinations have a higher diagnostic accuracy than a single test. In this study, the accuracy of the clinical tests was examined without considering the amount of ACL rupture and acute-chronic condition. Further research is required to examine the impact of these two factors on diagnostic accuracy of clinical test.