• Title/Summary/Keyword: Receiver sensitivity

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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.

IPMN-LEARN: A linear support vector machine learning model for predicting low-grade intraductal papillary mucinous neoplasms

  • Yasmin Genevieve Hernandez-Barco;Dania Daye;Carlos F. Fernandez-del Castillo;Regina F. Parker;Brenna W. Casey;Andrew L. Warshaw;Cristina R. Ferrone;Keith D. Lillemoe;Motaz Qadan
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.2
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    • pp.195-200
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    • 2023
  • Backgrounds/Aims: We aimed to build a machine learning tool to help predict low-grade intraductal papillary mucinous neoplasms (IPMNs) in order to avoid unnecessary surgical resection. IPMNs are precursors to pancreatic cancer. Surgical resection remains the only recognized treatment for IPMNs yet carries some risks of morbidity and potential mortality. Existing clinical guidelines are imperfect in distinguishing low-risk cysts from high-risk cysts that warrant resection. Methods: We built a linear support vector machine (SVM) learning model using a prospectively maintained surgical database of patients with resected IPMNs. Input variables included 18 demographic, clinical, and imaging characteristics. The outcome variable was the presence of low-grade or high-grade IPMN based on post-operative pathology results. Data were divided into a training/validation set and a testing set at a ratio of 4:1. Receiver operating characteristics analysis was used to assess classification performance. Results: A total of 575 patients with resected IPMNs were identified. Of them, 53.4% had low-grade disease on final pathology. After classifier training and testing, a linear SVM-based model (IPMN-LEARN) was applied on the validation set. It achieved an accuracy of 77.4%, with a positive predictive value of 83%, a specificity of 72%, and a sensitivity of 83% in predicting low-grade disease in patients with IPMN. The model predicted low-grade lesions with an area under the curve of 0.82. Conclusions: A linear SVM learning model can identify low-grade IPMNs with good sensitivity and specificity. It may be used as a complement to existing guidelines to identify patients who could avoid unnecessary surgical resection.

Factors associated with long head of the biceps tendon tear severity and predictive insights for grade II tears in rotator cuff surgery

  • Dong-Hyun Lee;Gyu-Min Lee;Hyung Bin Park
    • Clinics in Shoulder and Elbow
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    • v.27 no.2
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    • pp.149-159
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    • 2024
  • Background: In rotator cuff repair, the long head of the biceps tendon (LHB) is commonly used as graft material. However, factors influencing LHB tear severity are poorly understood, and predicting grade II LHB tears is challenging. This study aimed to identify these factors preoperatively. Methods: The demographics, medical parameters, and pain severity of 750 patients who underwent arthroscopic surgery from January 2010 to February 2021 were evaluated to determine the factors associated with LHB tear severity and grade II tears. Both overall and large-to-massive rotator cuff tear (RCT) cohorts underwent ordinal and binary logistic regression analyses. Predictive accuracy for grade II LHB tears was determined using the area under the receiver operating characteristic curve (AUC). Results: In the overall cohort, high-sensitivity C-reactive protein (hs-CRP) >1 mg/L (P<0.001), subscapularis tear (P<0.001), hypothyroidism (P=0.031), and the tangent sign (P=0.003) were significantly associated with LHB tear severity, and hs-CRP>1 mg/L, subscapularis tear, and Patte retraction degree were significantly associated with grade II LHB tears (P<0.001). In the large-to-massive RCT cohort, hs-CRP>1 mg/L, hypertension, and age ≥50 years (P<0.05) were significantly associated with LHB tear severity, and hs-CRP>1 mg/L (P<0.001) and hypertension (P=0.026) were significantly associated with grade II LHB tears. In both cohorts, hs-CRP >1 mg/L demonstrated good predictive accuracy for grade II LHB tears (AUCs: 0.72 and 0.70). Conclusions: Serum hs-CRP >1 mg/L is associated with LHB tear severity and serves as a reliable predictor of grade II LHB tears, facilitating preoperative assessment of the LHB as potential graft material in arthroscopic rotator cuff repair. serves as a reliable predictor of grade II LHB tears, facilitating preoperative assessment of the LHB as potential graft material in arthroscopic rotator cuff repair. Level of evidence: III.

Design and Fabrication of APD-FET Module for 2.5 Gbps Optical Communicating System (광통신용 APD-FET 광수신모듈 설계 및 제작)

  • 강승구;송민규;윤형진;박경현;박찬용;박형무;윤태열;이창희;심창섭
    • Korean Journal of Optics and Photonics
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    • v.5 no.1
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    • pp.166-172
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    • 1994
  • The fiber optic receiver, ETRI APD-FET 1.0, is developed for the application of optical communication. This fiber optic receiver includes PD sub-module and pre-amplifier case. A single lens system is introduced for the PD sub-module. The sub-module consists of the avalenche photodiode(APD), GRIN rod lens, and a single mode fiber. The above components are enclosed into the stainless steel 304L housings. By bevelling the fiber end, the single mode fiber provides less than ~ 28 dB of optical return loss. The area of image focus is controlled by adjusting the length of spacer located in-between the fiber and the GRIN rod lens. The laser welding technique is applied to achieve the maximum coupling efficiency for the joining of each housing. In the pre-amplifier case, GaAs FET pre-amplifier workes for photocurrent amplification and the thermister is mounted to control the APD bias. The performance of ETRI APD-FET1.0 shows the sensitivity of - 30.3 dBm at $10^{-10}$ BER(bit error rate) and 2.5 Gbps optical random signal of $2^{23}-1$ word length. The fiber optic receiver is one of the essensial parts of the transmission module for B-ISDN. Also, the above optical packaging technology will be adapted for the developement of 10 Gbps transmission application 2.5 Gbps 5 Gbps

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TV White Space Low-noise and High-Linear RF Front-end Receiver (텔레비전 유휴 주파수 대역을 지원하는 저잡음 및 고선형 특성의 RF 수신기 설계)

  • Kim, Chang-wan
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.22 no.1
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    • pp.91-99
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    • 2018
  • This paper has proposed a low-noise and high-linear RF receiver supporting TV white space from 470 MHz to 698 MHz), which is implemented in $0.13-{\mu}m$ CMOS technology. It consists of a low-noise amplifier, a RF band-pass filter, a RF amplifier, a passive down-conversion mixer, and a channel-selection low-pass filter. A low-noise amplifier and RF amplifier provide a high voltage gain to improve the sensitivity level. To suppress strong and nearby interferers, two RF filtering schemes have been performed by using a RF BPF and a down-conversion mixer. The proposed LPF has been based on the common-gate topology and adopted a bi-quad cell to achieve -24dB/oct characteristics. In addition, the RF receiver can support the overall TV band by controlling a LO frequency. The simulated results show a voltage gain of 56 dB, a noise figure of less than 2 dB, and an out-of-channel IIP3 of -2.3 dBm. It consumes 37 mA from a 1.5 V supply voltage.

Usefulness of $^{18}F$-Fluoride PET/CT in Bone Metastasis of Prostate Cancer (전립선암 환자의 뼈 전이에 대한 $^{18}F$-Fluoride PET/CT의 유용성)

  • Park, Min-Soo;Kim, Jung-Yul;Park, Hoon-Hee;Kang, Chun-Goo;Lim, Han-Sang;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.24-30
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    • 2009
  • Purpose: Today, Prostate cancer has been gradually increasing, according to the change of internal incidence rate of cancer. Generally, prostate cancer has lead to dead over 90%, in case of metastasis of lymph node and bone. So, innovative development of new radiopharmaceutical and imaging modality is progressed for detection of that metastasis, in nuclear medicine, now. Therefore, this study shows the usefulness of $^{18}F$-Fluoride PET/CT improved diagnosability on bone metastasis of prostate cancer. Materials and Methods: In this study, 33 male patients with prostate cancer were examined (The mean age: $67.8{\pm}10.2$ years old). Every patient was done each whole body bone scan (WBBS) and $^{18}F$-Fluoride positron emission tomography/computed tomography ($^{18}F$-Fluoride PET/CT). And then, using Receiver Operating Characteristic Curve (ROC curve), each sensitivity and specificity of two modalities was measured and compared with. Results: In 22 patients (66.6%) of all, bone metastasis was detected. And, in WBBS, sensitivity was 63.6%, specificity, 81.8%; in $^{18}F$-Fluoride PET/CT, sensitivity was 100% and specificity was 90.9%. As a result of ROC curve, AUROC (The Area under an ROC) of WBBS was 0.778, and that of $^{18}F$-Fluoride PET/CT, 0.942. Conclusions: $^{18}F$-Fluoride PET/CT was higher both sensitivity and specificity than WBBS, and it was valuable to detect bone metastasis of prostate cancer more definitely, with 3D imaging realization. Also, in $^{18}F$-Fluoride PET/CT, physiological images were acquired in more short time than WBBS, so, it was possible to reduce patient's waiting time and complaint. Therefore, it is considered that $^{18}F$-Fluoride PET/CT is able to improve diagnosability by offering more accurate images, as cuts in a share of high cost.

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Diagnostic accuracy of Insight intraoral film on dental caries (Kodak Insight 구내필름의 치아우식증 진단능에 대한 연구)

  • Yoon Young Nam;Lee Sang-Rae;Lee Byung-Do
    • Imaging Science in Dentistry
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    • v.34 no.1
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    • pp.19-23
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    • 2004
  • Purpose: To compare the diagnostic accuracy of Kodak Insight film with other intra-oral films in the detection of dental caries. Materials and Methods : Periapical radiographs of 99 extracted human teeth with sound proximal surfaces and interproximal artificial cavities were made on Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Kodak Insight films and automatically processed. Six dentists examined the presence of dental caries using a five-point confidence rating scale and compared the diagnostic accuracy by ROC (Receiver Operating Characteristic) analysis and ANOVA test. Results: The sensitivity of Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Insight film were 0.84, 0.77, 0.75 and 0.79 respectively. The specificity of Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Insight film were 0.97. 0.95. 0.96 and 0.94 respectively. The mean ROC areas (Az) of Kodak Ultra speed, Ektaspeed, Agfa Ektaspeed and Insight film were 0.917, 0.910, 0.894, 0.909 respectively. There was no significant differences between Az of Insight film and other films (p = 0.178). Conclusion: Theses results suggested that Kodak Insight film have the comparative diagnostic accuracy of dental caries with Ultraspeed and Ektaspeed films.

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Evaluating the Validity of the Pediatric Index of Mortality Ⅱ in the Intensive Care Units (소아중환자를 대상으로 한 PIM Ⅱ의 타당도 평가)

  • Kim, Jung-Soon;Boo, Sun-Joo
    • Journal of Korean Academy of Nursing
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    • v.35 no.1
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    • pp.47-55
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    • 2005
  • Purpose: This study was to evaluate the validity of the Pediatric Index of Mortality Ⅱ(PIM Ⅱ). Method: The first values on PIM Ⅱ variables following ICU admission were collected from the patient's charts of 548 admissions retrospectively in three ICUs(medical, surgical, and neurosurgical) at P University Hospital and a cardiac ICU at D University Hospital in Busan from January 1, 2002 to December 31, 2003. Data was analyzed with the SPSSWIN 10.0 program for the descriptive statistics, correlation coefficient, standardized mortality ratio(SMR), validity index(sensitivity, specificity, positive predictive value, negative predictive value), and AUC of ROC curve. Result: The mortality rate was 10.9% (60 cases) and the predicted death rate was 9.5%. The correlation coefficient(r) between observed and expected death rates was .929(p<.01) and SMR was 1.15. Se, Sp, pPv, nPv, and the correct classification rate were .80, .96, .70, .98, and 94.0% respectively. In addition, areas under the curve (AUC) of the receiver operating characteristic(ROC) was 0.954 (95% CI=0.919~0.989). According to demographic characteristics, mortality was underestimated in the medical group and overestimated in the surgical group. In addition, the AUCs of ROC curve were generally high in all subgroups. Conclusion: The PIM Ⅱ showed a good, so it can be utilized for the subject hospital. better.

Predictive Bayesian Network Model Using Electronic Patient Records for Prevention of Hospital-Acquired Pressure Ulcers (전자의무기록을 이용한 욕창발생 예측 베이지안 네트워크 모델 개발)

  • Cho, In-Sook;Chung, Eun-Ja
    • Journal of Korean Academy of Nursing
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    • v.41 no.3
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    • pp.423-431
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    • 2011
  • Purpose: The study was designed to determine the discriminating ability of a Bayesian network (BN) for predicting risk for pressure ulcers. Methods: Analysis was done using a retrospective cohort, nursing records representing 21,114 hospital days, 3,348 patients at risk for ulcers, admitted to the intensive care unit of a tertiary teaching hospital between January 2004 and January 2007. A BN model and two logistic regression (LR) versions, model-I and .II, were compared, varying the nature, number and quality of input variables. Classification competence and case coverage of the models were tested and compared using a threefold cross validation method. Results: Average incidence of ulcers was 6.12%. Of the two LR models, model-I demonstrated better indexes of statistical model fits. The BN model had a sensitivity of 81.95%, specificity of 75.63%, positive and negative predictive values of 35.62% and 96.22% respectively. The area under the receiver operating characteristic (AUROC) was 85.01% implying moderate to good overall performance, which was similar to LR model-I. However, regarding case coverage, the BN model was 100% compared to 15.88% of LR. Conclusion: Discriminating ability of the BN model was found to be acceptable and case coverage proved to be excellent for clinical use.

Analysis of Risk Factors to Predict Intensive Care Unit Transfer in Medical in-Patients (내과 환자의 중환자실 전동에 대한 위험요인 분석)

  • Lee, Ju Ry;Choi, Hye Ran
    • Journal of Korean Biological Nursing Science
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    • v.16 no.4
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    • pp.259-266
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    • 2014
  • Purpose: The purpose of this study was to analyze risk factors in predicting medical patients transferred to Intensive Care Unit (ICU) on the general ward. Methods: We reviewed retrospectively clinical data of 120 medical patients on the general ward and a Modified Early Warning Score (MEWS) between ICU group and general ward group. Data were analyzed with multivariate logistic regression and the area under the receiver operating characteristic curves using SPSS/WIN 18.0 program. Results: Fifty-two ICU patients and 68 general ward patients were included. In multivariate logistic regression, the MEWSs (Odds Ratio [OR], 1.91; 95% confidence interval [CI], 1.32-2.76), sequential organ failure assessment score (OR, 1.28; 95% CI, 1.10-1.72), $PaO_2/FiO_2$ ratio (OR, 0.98; 95% CI, 0.98-0.99), and saturation (OR, 0.93; 95% CI, 0.88-0.99) were predictive of ICU transfer. The sensitivity and the specificity of the MEWSs used with a cut-off value of six were 80.8% and 70.6% respectively for ICU transfer. Conclusion: These findings suggest that early prediction and treatment of patients with high risk of ICU transfer may improve the prognosis of patients.