• Title/Summary/Keyword: ROC AUC

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Utility of FDG PET-CT Scans on Nodal Staging of Squamous Cell Carcinoma in the Oral Cavity and Oropharynx (구강 및 구인두 편평상피암종의 림프절 전이에 대한 PET-CT 영상의 유용성)

  • Joo, Young-Hoon;Sun, Dong-Il;Park, Jun-Ook;Yoo, Ie-Ryung;Kim, Min-Sik
    • Korean Journal of Head & Neck Oncology
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    • v.26 no.1
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    • pp.14-18
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    • 2010
  • Objectives : We evaluated the use of FDG PET/CT for the identification of cervical nodal metastases of SCC of the oral cavity and oropharynx with histological correlation. Material and Methods : We reviewed 46 medical records, from January 2004 to July 2007, of patients who underwent FDG PET/CT and CT/MRI for SCC of the oral cavity and oropharynx before surgery. We recorded the lymph node metastases according to the neck level affected and the system used for the imaging-based nodal classification. Results : The FDG PET/CT had a sensitivity of 75.6% and a specificity of 96.7% ; it had a higher sensitivity than the CT/MRI for identification of cervical metastases on the side of the neck(26/28 vs. 20/28, p=0.031) and at each of the cervical levels(34/45 vs. 26/45, p=0.008). There was a significant difference in the $SUV_{max}$ between the benign and malignant cervical lymph nodes($3.31{\pm}3.23$ vs. $4.22{\pm}2.57$, p=0.028). The receiver-operating-characteristic (ROC) curve analysis for differentiating the benign from the malignant cervical lymph nodes, showed that the area under the curve(AUC) of the FDG PET/CT was 0.775. The cut-off value for the $SUV_{max}$ was 2.23 based on the ROC curve. There was a significant correlation between the $SUV_{max}$ and the size of the cervical lymph nodes(Spearman r=0.353, p=0.048). Conclusion : FDG PET/CT images were more accurate than the CT/MRI images. In addition, the $SUV_{max}$ cut-off values were important for evaluating cervical the cervical nodes in the patients with SCC of the oral cavity and oropharynx.

Preliminary Evaluation of Clinical Utility of CYFRA 21-1, CA 72-4, NSE, CA19-9 and CEA in Stomach Cancer

  • Gwak, Hee Keun;Lee, Jai Hyuen;Park, Seok Gun
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.12
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    • pp.4933-4938
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    • 2014
  • Background: Although various tumor markers have been utilized in management of stomach cancer (SC), only a few reports have described relevance of examples such as CYFRA 21-1 and neuron-specific enolase (NSE). The purpose of this study was to evaluate the potential diagnostic performance of carcinoembryonic antigen (CEA), CA 19-9, CA72-4, CYFRA 21-1 and NSE in patients with SC. Materials and Methods: Ninety-six SC patients with pathologic confirmation between 2012 and 2013 were enrolled. Serum levels of five tumor markers were analyzed using a solid-phase immunoradiometric assay. Receiver operating characteristic (ROC) curves were plotted for the five tumor markers to investigate their diagnostic powers and adjusted cutoff values derived from analysis of ROC curves were evaluated to calculate the sensitivity of each for SC with recommended cutoff values. Results: Based on two different cutoff values (recommended and adjusted), CYFRA 21-1 (${\geq}2.0$ and 1.2 ng/ml) had a respective sensitivity of 50% and 78.1%, compared with 8.3% and 18.8% for CEA (${\geq}7.0$ and 3.9 ng/ml), 15.6% and 18.8% for CA 19-9 (${\geq}37$ and 26.7 ng/ml), 28.1% and 9.6% for CA 72-4 (${\geq}4.0$ and 13 ng/ml) and 7.3% and 7.3% for NSE (${\geq}14.7$ and 15.0 ng/ml) in the initial staging of primary SC. The area under the curve (AUC) for CYFRA 21-1, with a value of 0.978 (95% confidence interval, 0.964-0.991) was comparatively the highest. Univariate analysis revealed significant relationships between tumor marker level and lymph node involvement, metastasis and staging with CYFRA 21-1, CA 72-4 and NSE. Conclusions: CYFRA 21-1 was the most sensitive tumor marker and showed the most powerful diagnostic performance among the five SC tumor markers. NSE and CA 72-4 are significantly related to lymph node involvement, metastasis or stage. Further evaluations are warranted to clarify the clinical usefulness and prognostic prediction of these markers in SC.

Diagnostic Utility of Pleural Fluid Soluble Triggering Receptor Expressed on Myeloid Cells 1 Protein in Patients with Exudative Pleural Effusion (삼출성흉수에서 Soluble Triggering Receptor Expressed on Myeloid Cells 1 Proteion의 진단적 유용성)

  • Sim, Yun Su;Lee, Jin Hwa;Cheun, En Mi;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.6
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    • pp.499-505
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    • 2007
  • Background: Triggering receptor expressed on myeloid cells 1 protein (TREM-1) is a cell surface molecule expressed on neutrophils and monocytes, and it plays an important role in myeloid cell-activated inflammatory response. The aim of this study was to investigate the diagnostic efficiency of soluble (s) TREM-1 in the patients who had pleural effusion from various causes. Methods: Forty-five patients with exudative pleural effusion were included in this study. The level of sTREM-1 was measured in both the serum and pleural fluids by immunoblot assay with using human-sTREM-1 antibody. Results: The pleural fluid sTREM-1 was significantly different in the three groups of exudative pleural effusion (p=0.011). Particularly, the patients with parapneumonic effusion were found to have significantly higher pleural fluid levels of sTREM-1 than patients with tuberculous (p<0.05) and malignant effusion, respectively (p<0.05). However, the serum sTREM-1 did not show a significant difference in the three groups. In order to evaluate the diagnostic utility of pleural fluid sTREM-1, the receiver operating characteristic (ROC) curve was constructed and the area under the curve (AUC) was 0.818 (p=0.001). Using a cutoff value of 103.5 pg/mL for the pleural fluid sTREM-1, the sensitivity and specificity were 73% and 81%, respectively, for differentiating parapneumonic effusion from tuberculous or malignant effusions. Conclusion: Pleural fluid sTREM-1 can be an additional marker for making the differential diagnosis of pleural effusion.

Analysis of Risk factors & Morphological Ultrasound Image for Gallbladder Polyp in Adults Living in Busan and Gyeongnam Provinces (부산·경남 지역 성인의 담낭용종 위험인자 및 초음파 영상의 형태학적 분석)

  • An, Hyeon;Hwang, Chul-Hwan;Ko, Sung-Jin;Kim, Chang-Soo
    • Journal of radiological science and technology
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    • v.39 no.3
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    • pp.353-359
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    • 2016
  • This study were to evaluate risk factors of GB polpy in Busan and Gyeongnam area. This study was performed with patients by abdominal ultrasonography among the patients who came to the P hospital from January to May 2016. Among them, risk factors were analyzed on 399 people at the same time when abdominal ultrasonography and hematological test. The statistical analysis of risk factors related to the GB ployp was performed by independent t-test and chi-square test. In consider of difference verification result for calculations odds ratio about independent variables, multiple logistic regression analysis to conduct verify adequacy by calculating forecasting model from variable. As a result, GB polyp risk factors have relevance to male, HBsAg positive, triglyceride. GB polyp risk factors confirmed to male, HBsAg positive, triglyceride were calculated forecasting model and forecasting probability value. Forecasting probability sensitivity 61.0%, specificity 76.8%, ROC area under curve 0.735 showed, it confirmed validity of forecasting model. When analyzing the GB polyps morphologically, among the GB polyp types observed from abdominal ultrasonography, the hyperechoic and homogeneous pattern with neck was the largest as shown from 27.5% and two GB polyps were shown most from 38%, sizes were shown most by maximum diameter, 5 to 10mm from 53%. As a disease accompany with GB polyp showed mild fatty liver(23%), diffuse hepatopathy(21%).

Usefulness of End-tidal Carbon Dioxide as a Predictor of Emergency Intervention in Major Trauma Patients (중증 외상 환자에서의 응급중재술 시행 예측 인자로서의 호기말 이산화탄소 분압의 유용성)

  • Kim, Sung Ho;Kim, Seunghwan;Lee, Jae Gil;Chung, Sung Phil;Kim, Seung Ho
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.133-138
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    • 2014
  • Purpose: If the survival of patients suffering from severe blunt trauma is to be improved, appropriate interventions should be taken immediately. The purpose of this study is to evaluate the clinical utility of end-tidal carbon dioxide ($ETCO_2$) as a surrogate marker for predicting both the need for intervention and the prognosis. Methods: This is a prospective observational study. Nasal cannula was applied to measure $ETCO_2$, and the following parameters, which are known to be related to the prognosis for a patient, were recorded: injury severity score (ISS), revised trauma score (RTS), arterial blood gas (ABG), lactate, and hemoglobin (Hb). To evaluate the outcome, we investigated the details of emergent interventions and expired patients. Results: A total of 93 patients were enrolled in this study. Emergent intervention was significantly associated with systolic blood pressure (sBP, p-value=0.001), $ETCO_2$ (p-value<0.001), serum lactate level (p-value<0.001), pH (p-value< 0.003), $HCO_3$ (p-value=0.004), base excess (p-value<0.002), ISS (p-value<0.001) and RTS (p-value=0.005). In the multivariate logistic regression, only $ETCO_2$ (odds ratio (OR): 0.897, 95% confidence interval (CI): 0.792-0.975, p-value= 0.048) and ISS (OR: 1.132, 95% CI: 1.053-1.233, p-value=0.002) were associated with emergent intervention whereas $ETCO_2$ (p-value=0.973) and ISS (p-value=0.511) were not statistically significant in predicting the survival of patients in the univariate analysis. An optimal ETCO cut-off of 29 mmHg on the ROC curve was determined, with the area under the ROC curve (AUC) being 0.824 (0.732-0.917)]. Conclusion: This study has revealed that $ETCO_2$, which can be rapid and easily measured through a nasal cannula, and the ISS may be prognostic indicators of emergent interventions in Emergency Departments.

Accuracy of Accelerometer for the Prediction of Energy Expenditure and Activity Intensity in Athletic Elementary School Children During Selected Activities (초등학교 운동선수를 대상으로 대표 신체활동의 에너지 소비량 및 활동 강도 추정을 위한 가속도계의 정확도 검증)

  • Choi, Su-Ji;An, Hae-Sun;Lee, Mo-Ran;Lee, Jung-Sook;Kim, Eun-Kyung
    • Korean Journal of Community Nutrition
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    • v.22 no.5
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    • pp.413-425
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    • 2017
  • Objectives: Accurate assessment of energy expenditure is important for estimation of energy requirements in athletic children. The objective of this study was to evaluate the accuracy of accelerometer for prediction of selected activities' energy expenditure and intensity in athletic elementary school children. Methods: The present study involved 31 soccer players (16 males and 15 females) from an elementary school (9-12 years). During the measurements, children performed eight selected activities while simultaneously wearing the accelerometer and carrying the portable indirect calorimeter. Five equations (Freedson/Trost, Treuth, Pate, Puyau, Mattocks) were assessed for the prediction of energy expenditure from accelerometer counts, while Evenson equation was added for prediction of activity intensity, making six equations in total. The accuracy of accelerometer for energy prediction was assessed by comparing measured and predicted values, using the paired t-test. The intensity classification accuracy was evaluated with kappa statistics and ROC-Curve. Results: For activities of lying down, television viewing and reading, Freedson/Trost, Treuth were accurate in predicting energy expenditure. Regarding Pate, it was accurate for vacuuming and slow treadmill walking energy prediction. Mattocks was accurate in treadmill running activities. Concerning activity intensity classification accuracy, Pate (kappa=0.72) had the best performance across the four intensities (sedentary, light, moderate, vigorous). In case of the sedentary activities, all equations had a good prediction accuracy, while with light activities and Vigorous activities, Pate had an excellent accuracy (ROC-AUC=0.91, 0.94). For Moderate activities, all equations showed a poor performance. Conclusions: In conclusion, none of the assessed equations was accurate in predicting energy expenditure across all assessed activities in athletic children. For activity intensity classification, Pate had the best prediction accuracy.

Added Value of Contrast Leakage Information over the CBV Value of DSC Perfusion MRI to Differentiate between Pseudoprogression and True Progression after Concurrent Chemoradiotherapy in Glioblastoma Patients

  • Pak, Elena;Choi, Seung Hong;Park, Chul-Kee;Kim, Tae Min;Park, Sung-Hye;Won, Jae-Kyung;Lee, Joo Ho;Lee, Soon-Tae;Hwang, Inpyeong;Yoo, Roh-Eul;Kang, Koung Mi;Yun, Tae Jin
    • Investigative Magnetic Resonance Imaging
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    • v.26 no.1
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    • pp.10-19
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    • 2022
  • Purpose: To evaluate whether the added value of contrast leakage information from dynamic susceptibility contrast magnetic resonance imaging (DSC MRI) is a better prognostic imaging biomarker than the cerebral blood volume (CBV) value in distinguishing true progression from pseudoprogression in glioblastoma patients. Materials and Methods: Forty-nine glioblastoma patients who had undergone MRI after concurrent chemoradiotherapy with temozolomide were enrolled in this retrospective study. Twenty features were extracted from the normalized relative CBV (nCBV) and extraction fraction (EF) map of the contrast-enhancing region in each patient. After univariable analysis, we used multivariable stepwise logistic regression analysis to identify significant predictors for differentiating between pseudoprogression and true progression. Receiver operating characteristic (ROC) analysis was employed to determine the best cutoff values for the nCBV and EF features. Finally, leave-one-out cross-validation was used to validate the best predictor in differentiating between true progression and pseudoprogression. Results: Multivariable stepwise logistic regression analysis showed that MGMT (O6-methylguanine-DNA methyltransferase) and EF max were independent differentiating variables (P = 0.004 and P = 0.02, respectively). ROC analysis yielded the best cutoff value of 95.75 for the EF max value for differentiating the two groups (sensitivity, 61%; specificity, 84.6%; AUC, 0.681 ± 0.08; 95% CI, 0.524-0.837; P = 0.03). In the leave-one-out cross-validation of the EF max value, the cross-validated values for predicting true progression and pseudoprogression accuracies were 69.4% and 71.4%, respectively. Conclusion: We demonstrated that contrast leakage information parameter from DSC MRI showed significance in differentiating true progression from pseudoprogression in glioblastoma patients.

Consideration of Predictive Indices for Metabolic Syndrome Diagnosis Using Cardiometabolic Index and Triglyceride-glucose Index: Focusing on Those Subject to Health Checkups in the Busan Area (Cardiometabolic Index, Triglyceride-glucose Index를 이용한 대사증후군 진단 예측지수에 대한 고찰: 부산지역 건강검진대상자 중심으로)

  • Hyun An;Hyun-Seo Yoon;Chung-Mu Park
    • Journal of radiological science and technology
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    • v.46 no.5
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    • pp.367-377
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    • 2023
  • This study investigates the utility of the Triglyceride-glucose(TyG) index and Cardiometabolic Index(CMI) as predictors for diagnosing metabolic syndrome. The study involved 1970 males, 1459 females, totaling 3429 participants who underwent health checkups at P Hospital in Busan between January 2023 and June 2023. Metabolic syndrome diagnosis was based on the presence of 3 or more risk factors out of the 5 criteria outlined by the American Heart Association/National Heart, Lung, and Blood Institute(AHA/NHLBI), and participants with 2 or fewer risk factors were categorized as normal. Statistical analyses included independent sample t-tests, chi-square tests, Pearson's correlation analysis, Receiver Operating Characteristic(ROC) curve analysis, and logistic regression analysis, using the Statistical Package for the Social Sciences(SPSS) program. Significance was established at p<0.05. The comparison revealed that the metabolic syndrome group exhibited attributes such as advanced age, male gender, elevated systolic and diastolic blood pressures, high blood sugar, elevated triglycerides, reduced LDL-C, elevated HDL-C, higher Cardiometabolic Index, Triglyceride-glucose index, and components linked to abdominal obesity. Pearson correlation analysis showed strong positive correlations between waist circumference/height ratio, waist circumference, Cardiometabolic Index, and triglycerides. Weak positive correlations were observed between LDL-C, body mass index, and Cardiometabolic index, while a strong negative correlation was found between Cardiometabolic Index and HDL-C. ROC analysis indicated that the Cardiometabolic Index(CMI), Triglyceride-glucose(TyG) index, and waist circumference demonstrated the highest Area Under the Curve(AUC) values, indicating their efficacy in diagnosing metabolic syndrome. Optimal cut-off values were determined as >1.34, >8.86, and >84.5 for the Cardiometabolic Index, Triglyceride-glucose index, and waist circumference, respectively. Logistic regression analysis revealed significant differences for age(p=0.037), waist circumference(p<0.001), systolic blood pressure(p<0.001), triglycerides(p<0.001), LDL-C(p=0.028), fasting blood sugar(p<0.001), Cardiometabolic Index(p<0.001), and Triglyceride-glucose index (p<0.001). The odds ratios for these variables were 1.015, 1.179, 1.090, 3.03, and 69.16, respectively. In conclusion, the Cardiometabolic Index and Triglyceride-glucose index are robust predictive indicators closely associated with metabolic syndrome diagnosis, and waist circumference is identified as an excellent predictor. Integrating these variables into clinical practice holds the potential for enhancing early diagnosis and prevention of metabolic syndrome.

A Comparative Study on Prediction Performance of the Bankruptcy Prediction Models for General Contractors in Korea Construction Industry

  • Seung-Kyu Yoo;Jae-Kyu Choi;Ju-Hyung Kim;Jae-Jun Kim
    • International conference on construction engineering and project management
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    • 2011.02a
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    • pp.432-438
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    • 2011
  • The purpose of the present thesis is to develop bankruptcy prediction models capable of being applied to the Korean construction industry and to deduce an optimal model through comparative evaluation of final developed models. A study population was selected as general contractors in the Korean construction industry. In order to ease the sample securing and reliability of data, it was limited to general contractors receiving external audit from the government. The study samples are divided into a bankrupt company group and a non-bankrupt company group. The bankruptcy, insolvency, declaration of insolvency, workout and corporate reorganization were used as selection criteria of a bankrupt company. A company that is not included in the selection criteria of the bankrupt company group was selected as a non-bankrupt company. Accordingly, the study sample is composed of a total of 112 samples and is composed of 48 bankrupt companies and 64 non-bankrupt companies. A financial ratio was used as early predictors for development of an estimation model. A total of 90 financial ratios were used and were divided into growth, profitability, productivity and added value. The MDA (Multivariate Discriminant Analysis) model and BLRA (Binary Logistic Regression Analysis) model were used for development of bankruptcy prediction models. The MDA model is an analysis method often used in the past bankruptcy prediction literature, and the BLRA is an analysis method capable of avoiding equal variance assumption. The stepwise (MDA) and forward stepwise method (BLRA) were used for selection of predictor variables in case of model construction. Twenty two variables were finally used in MDA and BLRA models according to timing of bankruptcy. The ROC-Curve Analysis and Classification Analysis were used for analysis of prediction performance of estimation models. The correct classification rate of an individual bankruptcy prediction model is as follows: 1) one year ago before the event of bankruptcy (MDA: 83.04%, BLRA: 93.75%); 2) two years ago before the event of bankruptcy (MDA: 77.68%, BLRA: 78.57%); 3) 3 years ago before the event of bankruptcy (MDA: 84.82%, BLRA: 91.96%). The AUC (Area Under Curve) of an individual bankruptcy prediction model is as follows. : 1) one year ago before the event of bankruptcy (MDA: 0.933, BLRA: 0.978); 2) two years ago before the event of bankruptcy (MDA: 0.852, BLRA: 0.875); 3) 3 years ago before the event of bankruptcy (MDA: 0.938, BLRA: 0.975). As a result of the present research, accuracy of the BLRA model is higher than the MDA model and its prediction performance is improved.

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Nitroglycerin-Challenged Tc-99m MIBI Quantitative Gated SPECT to Predict Functional Recovery After Coronary Artery Bypass Surgery (니트로글리세린 투여 Tc-99m-MIBI 정량 게이트 심근SPECT를 이용한 관상동맥우회로술 후 심근 기능 회복 예측)

  • Lee, Dong-Soo;Kim, Yu-Kyeong;Cheon, Gi-Jeong;Paeng, Jin-Chul;Lee, Myoung-Mook;Kim, Ki-Bong;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.5
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    • pp.278-287
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    • 2003
  • Purpose: The performance of nitroglycerin-challenged Tc-99m-MIBI quantitative gated SPECT for the detection of viable myocardium was compared with rest/24-hour redistribution Tl-201 SPECT Materials and Methods: In 22 patients with coronary artery disease, rest Tl-20l/ dipyridamole stress Tc-99m-MIBI gated/24-hour redistribution Tl-201 SPECT were peformed, and gated SPECT was repeated on-site after sublingual administration of nitroglycerin (0.6 mg). Follow-up gated SPECT was done 3 months after coronary artery bypass graft surgery. For 20 segments per patient, perfusion at rest and 24-hour redistribution, and wall motion and thickening at baseline and nitroglycerin-challenged state were quantified. Quantitative viability markers were evaluated and compared;(1) rest thallium uptake, (2) thallium uptake on 24-hour redistribution SPECT, (3) systolic wall thickening at baseline, and (4) systolic wall thickening with nitroglycerin-challenge. Results: Among 100 revascularized dysfunctional segments, wall motion improved in 66 segments (66%) on follow-up gated myocardial SPECT after bypass surgery. On receiver operating characteristic (ROC) curve analysis, the sensitivity and specificity of rest and 24-hour delayed redistribution Tl-201 SPECT were 79%, 44% and 82%, 44%, respectively, at the optimal cutoff value of 50% of Tl-201 uptake. The sensitivity and specificity of systolic wall thickening at baseline and nitroglycerin-challenge were 49%, 50% and 64%, 65% at the optimal cutoff value of 15% of systolic wall thickening. Area under the ROC curve of nitroglycerin-challenged systolic wall thickening was significantly larger than that of baseline systolic wall thickening (p=0.004). Conclusion: Nitroglycerin-challenged quantitative gated Tc-99m-MIBI SPECT was a useful method for predicting functional recovery of dysfunctional myocardium.