• Title/Summary/Keyword: Diagnostic yield

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Mucosal incision-assisted biopsy versus endoscopic ultrasound-assisted tissue acquisition for subepithelial lesions: a systematic review and meta-analysis

  • Suprabhat Giri;Shivaraj Afzalpurkar;Sumaswi Angadi;Sridhar Sundaram
    • Clinical Endoscopy
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    • v.55 no.5
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    • pp.615-625
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    • 2022
  • Background/Aims: Mucosal incision-assisted biopsy (MIAB) for tissue acquisition (TA) from subepithelial lesions (SELs) is emerging as an alternative to endoscopic ultrasound (EUS)-guided TA. Only a limited number of studies compared the diagnostic utility of MIAB and EUS for upper gastrointestinal (GI) SELs; therefore, we conducted this systematic review and meta-analysis. Methods: A comprehensive literature search from January 2020 to January 2022 was performed to compare the diagnostic accuracy and safety of MIAB and EUS-guided TA for upper GI SELs. Results: Seven studies were included in this meta-analysis. The pooled technical success rate (risk ratio [RR], 0.96; 95% confidence interval [CI], 0.89-1.04) and procedural time (mean difference=-4.53 seconds; 95% CI, -22.38 to 13.31] were comparable between both the groups. The overall chance of obtaining a positive diagnostic yield was lower with EUS than with MIAB for all lesions (RR, 0.83; 95% CI, 0.71-0.98) but comparable when using a fine-needle biopsy needle (RR, 0.93; 95% CI, 0.83-1.04). The positive diagnostic yield of MIAB was higher for lesions <20 mm (RR, 0.75; 95% CI, 0.63-0.89). Six studies reported no adverse events. Conclusions: MIAB can be considered an effective alternative to EUS-guided TA for upper GI SELs without an increased risk of adverse events.

Cytopathology of Urinary Tract Neoplasms (요로 종양의 세포병리)

  • Hong, Eun-Kyung
    • The Korean Journal of Cytopathology
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    • v.17 no.1
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    • pp.1-17
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    • 2006
  • Urine cytology is the most useful technique for detecting either primary or recurrent neoplasms in the urinary tract. Although urine cytology is the traditional method of detecting these neoplasms, its diagnostic accuracy has been underevaluated because of low sensitivity. The cytologic interpretation of urinary samples is not an easy task, even with some expertise in this area, for many reasons. In low-grade urothelial carcinoma, no reliable or reproducible diagnostic cytologic criteria can be provided because of the lack of obvious cytologic features of malignancy, which is one of the main factors lowering its diagnostic accuracy. Many diagnostic markers have been developed recently to enhance its diagnostic yield, but the results have not been satisfactory. However, urine cytology plays a role in detecting high-grade urothelial carcinoma or its precursor lesions. It still shows higher specificity than any of the newly developed urine markers. Understanding the nature of urine samples and the nature of neoplasms of the urinary tract, recognizing their cytologic features fully, and using cytologic findings under appropriate conditions in conjunction with a detailed clinical history would make urine cytology a very valuable diagnostic tool.

Radial Probe Endobronchial Ultrasound Using Guide Sheath-Guided Transbronchial Lung Biopsy in Peripheral Pulmonary Lesions without Fluoroscopy

  • Hong, Kyung Soo;Ahn, Heeyun;Lee, Kwan Ho;Chung, Jin Hong;Shin, Kyeong-Cheol;Jin, Hyun Jung;Jang, Jong Geol;Lee, Seok Soo;Jang, Min Hye;Ahn, June Hong
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.4
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    • pp.282-290
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    • 2021
  • Background: Radial probe endobronchial ultrasound-guided transbronchial lung biopsy (RP-EBUS-TBLB) has improved the diagnostic yield of bronchoscopic biopsy of peripheral pulmonary lesions (PPLs). The diagnostic yield and complications of RP-EBUS-TBLB for PPLs vary depending on the technique, such as using a guide sheath (GS) or fluoroscopy. In this study, we investigated the utility of RP-EBUS-TBLB using a GS without fluoroscopy for diagnosing PPLs. Methods: We retrospectively reviewed data from 607 patients who underwent RP-EBUS of PPLs from January 2019 to July 2020. TBLB was performed using RP-EBUS with a GS without fluoroscopy. The diagnostic yield and complications were assessed. Multivariable logistic regression analyses were used to identify factors affecting the diagnostic yields. Results: The overall diagnostic accuracy was 76.1% (462/607). In multivariable analyses, the size of the lesion (≥20 mm; odds ratio [OR], 2.06; 95% confidence interval [CI], 1.27-3.33; p=0.003), positive bronchus sign in chest computed tomography (OR, 2.30; 95% CI, 1.40-3.78; p=0.001), a solid lesion (OR, 2.40; 95% CI, 1.31-4.41; p=0.005), and an EBUS image with the probe within the lesion (OR, 6.98; 95% CI, 4.38-11.12; p<0.001) were associated with diagnostic success. Pneumothorax occurred in 2.0% (12/607) of cases and chest tube insertion was required in 0.5% (3/607) of patients. Conclusion: RP-EBUS-TBLB using a GS without fluoroscopy is a highly accurate diagnostic method in diagnosing PPLs that does not involve radiation exposure and has acceptable complication rates.

Diagnostic Yield of Primary Circulating Tumor Cells in Women Suspected of Breast Cancer: the BEST (Breast Early Screening Test) Study

  • Murray, Nigel P;Miranda, Roxana;Ruiz, Amparo;Droguett, Elsa
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.1929-1934
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    • 2015
  • Purpose: To determine the diagnostic yield of primary circulating tumor cells in women with suspicion of breast cancer, detected as a result of an abnormal mammography. Materials and Methods: Consecutive women presenting for breast biopsy as a result of a mammogram BiRADs of 3 or more, had an 8ml blood sample taken for primary circulating tumor cell (CTC) detection. Mononuclear cells were obtained using differential gel centrifugation and CTCs identified using standard immunocytochemistry using anti-mammoglobin. A test was determined to be positive if 1 CTC was detected. Results: A total of 144 women with a mean age of $54.7{\pm}15.6$ years participated, 78/144 (53.0%) had breast cancer on biopsy, 65/140 (46.3%) benign pathologies and 1(0.7%) non-Hogkins lymphoma. Increasing BiRADs scores were associated with increased cancer detection (p=0.004, RR 1.00, 4.24, 8.50). CTC mammoglobin positive had a sensitivity of 81.1% and specificity of 90.9%, with positive and negative predictive values of 90.9% and 81.1% respectively. Mammoglobin positive CTCs detected 87% of invasive cancers, while poorly differentiated cancers were negative for mammoglobin. Only 50% of in situ cancers and none of the intraductal cancers had CTCs detected. Menopausal status did not affect the diagnostic yield of the CTC test, which was higher in women with BiRADS 4 mammograms. There was a significant trend (p<0.0001 Chi squared for trends) in CTC detection frequency from intraductal, in situ and invasive (OR 1.00, 8.00, 472.00). Conclusions: The use of primary CTC detection in women suspected of breast cancer has potential uses, especially with invasive cancer, but it failed to detect intra-ductal cancer and 50% of in situ cancer. There was no difference in the diagnostic yield between pre and post menopausal women. To confirm its use in reducing biopsies in women with BIRADs 4a mammagrams and in the detection of interval invasive breast cancer, larger studies are needed.

Diagnostic Value of Transbronchial Lung Biopsy -Including Diagnostic Yield According to Tumor-bronchus Relationship- (경기관지폐생검의 진단적 가치 -병변과 기관지의 관계에 따른 진단율을 포함한 연구-)

  • Kang, Tae-Kyong;Cha, Seung-Ick;Park, Jae-Yong;Chae, Sang-Chul;Kim, Chang-Ho;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.4
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    • pp.438-447
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    • 2000
  • Background : Transbronchial lung biopsy (TBLB) is a relatively simple and convenient procedure to obtain lung tissue from a patient with diffuse or localized lesion on chest radiographs, whose disease cannot be diagnosed through routine tests. The authors tried to evaluate the diagnostic value of TBLB, especially, the concordance between CT scan and TBLB with respect to the location of the lesion and diagnostic yield according to tumor-bronchus relationship. Method : We reviewed the medical records, plain chest films, and chest CT scans of 278 patients who underwent TBLB at Kyungpook National University Hospital between January 1996 and June 1998. Results : One hundred and sixteen (41.7 %) patients were diagnosed by TBLB. Diagnostic yield of TBLB of malignant tumors tended to be higher than that of benign diseases (64.7% versus 53.9%, p=0.09). Of primary lung cancers, TBLB was more diagnostic in adenocarcinoma and small-cell carcinoma than other cell types (p<0.01) and, of benign diseases, more diagnostic in tuberculosis than in non-tuberculous diseases (p<0.05). There was no significant difference in the diagnostic rate according to the location of the tumor. The diagnostic rate tended to increase with the size of tumor (p=0.06). The diagnootic rate of TBLB did not differ according to the pattern of lesion in benign diseases. However, in malignant diseases TBLB was more diagnostic in diffuse/multiple nodular lesions than in localized lesions(p<0.05). According to the tumor-bronchus relationship, TBLB was more diagnootic in type I/II groups than in other types. CT scan and TBLB showed a strong correlation with respect to the localization of the lesion (r=0.994, p<0.01). Conclusion : The above results show that TBLB is useful in the diagnosis of lung disease. CT scan and TBLB showed a strong correlation in determining the location of the lesion. Diagnostic yield of TBLB is higher in lesions with 'bronchus sign' (type I and II). TBLB and other diagnootic methods such as transthoracic needle aspiration are expected to complement one another in the diagnosis of lung diseases.

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Radiologic Imaging of Traumatic Bowel and Mesenteric Injuries: A Comprehensive Up-to-Date Review

  • Rathachai Kaewlai;Jitti Chatpuwaphat;Worapat Maitriwong;Sirote Wongwaisayawan;Cheong-Il Shin;Choong Wook Lee
    • Korean Journal of Radiology
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    • v.24 no.5
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    • pp.406-423
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    • 2023
  • Diagnosing bowel and mesenteric trauma poses a significant challenge to radiologists. Although these injuries are relatively rare, immediate laparotomy may be indicated when they occur. Delayed diagnosis and treatment are associated with increased morbidity and mortality; therefore, timely and accurate management is essential. Additionally, employing strategies to differentiate between major injuries requiring surgical intervention and minor injuries considered manageable via non-operative management is important. Bowel and mesenteric injuries are among the most frequently overlooked injuries on trauma abdominal computed tomography (CT), with up to 40% of confirmed surgical bowel and mesenteric injuries not reported prior to operative treatment. This high percentage of falsely negative preoperative diagnoses may be due to several factors, including the relative rarity of these injuries, subtle and non-specific appearances on CT, and limited awareness of the injuries among radiologists. To improve the awareness and diagnosis of bowel and mesenteric injuries, this article provides an overview of the injuries most often encountered, imaging evaluation, CT appearances, and diagnostic pearls and pitfalls. Enhanced diagnostic imaging awareness will improve the preoperative diagnostic yield, which will save time, money, and lives.

Chromosomal Microarray Testing in 42 Korean Patients with Unexplained Developmental Delay, Intellectual Disability, Autism Spectrum Disorders, and Multiple Congenital Anomalies

  • Lee, Sun Ho;Song, Wung Joo
    • Genomics & Informatics
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    • v.15 no.3
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    • pp.82-86
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    • 2017
  • Chromosomal microarray (CMA) is a high-resolution, high-throughput method of identifying submicroscopic genomic copy number variations (CNVs). CMA has been established as the first-line diagnostic test for individuals with developmental delay (DD), intellectual disability (ID), autism spectrum disorders (ASDs), and multiple congenital anomalies (MCAs). CMA analysis was performed in 42 Korean patients who had been diagnosed with unexplained DD, ID, ASDs, and MCAs. Clinically relevant CNVs were discovered in 28 patients. Variants of unknown significance were detected in 13 patients. The diagnostic yield was high (66.7%). CMA is a superior diagnostic tool compared with conventional karyotyping and fluorescent in situ hybridization.

Fabrication and Simulation of Fluid Wing Structure for Microfluidic Blood Plasma Separation

  • Choe, Jeongun;Park, Jiyun;Lee, Jihye;Yeo, Jong-Souk
    • Applied Science and Convergence Technology
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    • v.24 no.5
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    • pp.196-202
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    • 2015
  • Human blood consists of 55% of plasma and 45% of blood cells such as white blood cell (WBC) and red blood cell (RBC). In plasma, there are many kinds of promising biomarkers, which can be used for the diagnosis of various diseases and biological analysis. For diagnostic tools such as a lab-on-a-chip (LOC), blood plasma separation is a fundamental step for accomplishing a high performance in the detection of a disease. Highly efficient separators can increase the sensitivity and selectivity of biosensors and reduce diagnostic time. In order to achieve a higher yield in blood plasma separation, we propose a novel fluid wing structure that is optimized by COMSOL simulations by varying the fluidic channel width and the angle of the bifurcation. The fluid wing structure is inspired by the inertial particle separator system in helicopters where sand particles are prevented from following the air flow to an engine. The structure is ameliorated in order to satisfy biological and fluidic requirements at the micro scale to achieve high plasma yield and separation efficiency. In this study, we fabricated the fluid wing structure for the efficient microfluidic blood plasma separation. The high plasma yield of 67% is achieved with a channel width of $20{\mu}m$ in the fabricated fluidic chip and the result was not affected by the angle of the bifurcation.

Advanced Bronchoscopic Diagnostic Techniques in Lung Cancer

  • Dongil Park
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.3
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    • pp.282-291
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    • 2024
  • The increasing incidence of incidental pulmonary nodules necessitates effective biopsy techniques for accurate diagnosis and treatment planning. This paper reviews the widely used advanced bronchoscopic techniques, such as radial endobronchial ultrasound-guided transbronchial lung biopsy, electromagnetic navigation bronchoscopy, and the cutting-edge robotic-assisted bronchoscopy. In addition, the cryobiopsy technique, which can enhance diagnostic yield by combination with conventional biopsy tools, is described for application to peripheral pulmonary lesions and mediastinal lesions, respectively.