• Title/Summary/Keyword: diagnostic accuracy rate

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CLINICAL STUDY OF POSITRON EMISSION TOMOGRAPHY WITH $[^{18}F]$-FLUORODEOXYGLUCOSE IN MAXILLOFACIAL TUMOR DIAGNOSIS (구강 악안면 영역의 암종 진단에 있어서 $[^{18}F]$-Fluorodeoxyglucose를 이용한 양전자방출 단층촬영의 임상적 연구)

  • Kim, Jae-Hwan;Kim, Kyung-Wook;Kim, Yong-Kack
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.5
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    • pp.462-469
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    • 2000
  • Positron Emission Tomography(PET) is a new diagnostic method that can create functional images of the distribution of positron emitting radionuclides, which when administered intravenously in the body, makes possible anatomical and functional analysis by quantity of biochemical and physiological process. After genetic and biochemical changes in initial stage, malignant tumor undergoes functional changes before undergoing anatomical changes. So, early diagnosis of malignant tumors by functional analysis with PET can be achieved, replacing traditional anatomical analysis, such as computed tomography(CT) and magnetic resonance image(MRI), etc. Similarly, PET can identify malignant tumor without confusion with scar and fibrosis in follow up check. In the Korea Cancer Center Hospital(KCCH) from October 1997 to September 1999, clinical study was performed in 79 cases that underwent 89 times PET evaluation with [18F]-Fluorodeoxyglucose for diagnosis of oral and maxillofacial tumors, and the data was analysed by Bayesian $2{\times}2$ Classification Table. The results were as follows : Evaluation for initial diagnosis with FDG-PET (P<0.005) 1. Agreement rate or accuracy rate is 88.9%. 2. Sensitivity is 95.2%, and specificity 66.7%. 3. Positive predictive rate is 90.9%, and negative predictive rate 80.0%. 4. In consideration of tumor stage, diagnostic rate in less than stage II was 90% and in greater than stage III 100%. 5. In consideration of tumor size, diagnostic rate in less than T2 was 92.3% and in greater than T3 100%. After primary treatment, evaluation for follow up check with FDG-PET (P < 0.001) 1. Agreement rate or accuracy rate is 85.4%. 2. Sensitivity is 87.5%, and specificity 82.4%. 3. Positive predictive rate is 87.5%, and negative predictive rate 82.4%. 4. In 24 recurred cases, 6 had distant metastasis, and 5 of them were diagnosed with FDG-PET, resulting in diagnostic rate of FDG-PET of 83.3%. From the above results, Positron Emission Tomography with [18F]- Fluorodeoxyglucose appears to be more sensitive and accurate for detecting the presence of oral and maxillofacial tumors, and has various clinical applications such as early diagnosis of tumor in initial and follow up check and detection of distant metastasis.

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Comparison the Diagnostic Value of Dilatation and Curettage Versus Endometrial Biopsy by Pipelle - a Clinical Trial

  • Sanam, Moradan;Majid, Mir Mohammad Khani
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.12
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    • pp.4971-4975
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    • 2015
  • Background: Several methods have been presented for the evaluation of the endometrium in patients with abnormal uterine bleeding, which include minimal invasive and invasive approaches such as diagnostic curettage or endometrial biopsy by Pipelle. Many studies have been performed in order to compare two methods; diagnostic curettage and outpatient endometrial biopsy. This investigation compared sampling adequacy, endometrial histopathology, failure rates, duration and costs between diagnostic curettage in a hospital and endometrial biopsy. Materials and Methods: This single blind clinical trial was performed on 130 patients older than 35 years who was referred to Amir training hospital in 2013 for elective diagnostic curettage because of abnormal uterine bleeding. For all patients eligible for the study, an endometrial sample by Pipelle was taken without anesthesia or dilatation. Then under general anesthesia diagnostic curettage was performed by sharp curette. Sampling duration was calculated and both samples were sent to the same pathologist. The diagnostic values of two methods in the diagnosis of normal endometrium, endometrial hyperplasia and carcinoma were compared. The costs of these two methods were also compared. Data analysis was performed by SPSS (version 16.0) software. Chi-Square, Fisher, and Pearson tests were used and were considered statistically significant at P values less than 0.05. Results: Two methods were agreed upon 88% of sampling adequacy and 94% of pathological results. Specificity of 100% and sensitivity of 90% for detection of proliferative endometrium, secretory endometrium, simple hyperplasia without atypia and 100% for cancer were recorded. Pipelle diagnostic accuracy in comparison with curettage, have been reported over 97%, so the failure rate in this study was below 5%. Sensitivity of Pipelle for detection of atrophic endometrium was reported below 50%. Duration and cost was lower in Pipelle versus curettage. Conclusions: It is concluded that due to high agreement and cohesion coefficient between curettage and Pipelle on the issue of sampling adequacy, histopathology finding (except atrophic endometrium), low failure rate, duration of sampling and cost, Pipelle can be introduced as a suitable alternative of diagnostic curettage.

A Clinical Significance of Ultrasound Guided Aspiration Cytology in Diagnosis of Impalpable Thyroid Nodule (비촉지성 갑상선 결절의 진단에서 초음파 유도하 세침검사법의 임상적 가치)

  • Choi Nak-Seon;Yoon Jung-Han;JaeGal Young-Jong
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.2
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    • pp.189-193
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    • 1999
  • Objectives: Fine needle aspiration cytology(FNAC) is a well established preoperative diagnostic procedure in the thyroid nodules. However, diagnostic accuracy of FNAC varies according to the size and the structural characteristics of thyroid nodule. We performed the ultrasound guided FNAC(US-guided FNAC) for impalpable thyroid nodule, and estimated the sampling accuracy rate through a comparison study between the cytologic diagnosis and the final histologic diagnosis of the postoperative specimens in order to determine clinical efficacy of the US-guided FNAC. Materials and Methods: We evaluated 117 patients underwent US-guided FNAC from January 1997 to December 1998. These patients had 129 thyroid nodules to need cytologic examination. Whereas the nodules were so no graphically classified into cystic, solid, and mixed type according to echo pattern, the aspirated thyroid specimens were classified into benign, malignant, suspicious, and insufficient. Results: Positive sampling for diagnositc examination was achieved in 75 nodules(58.1%), and US-guided FNAC in our study showed the accuracy rate of 95.2%, false positivity rate of 0%, and false negativity rate of 5.5%. Conclusions: US-guided FNAC is a powerful techniques for evaluating cytologic characterics and allowing a reliable diagnositc result in the impalpable thyroid nodule. However, the experienced technique is recommanded in order to obtain the sufficient samples for reliable results.

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Accuracy evaluation of diagnostic parameters estimated by uroflowmetry technique measuring hydraulic pressure (수압측정 방식의 요류검사 진단매개변수의 정확도 평가)

  • Kim, Kyung-Ah;Choi, Seong-Su;Kim, Sung-Sik;Kim, Kun-Jin;Park, Kyung-Soon;Cha, Eun-Jong
    • Journal of Sensor Science and Technology
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    • v.16 no.6
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    • pp.413-418
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    • 2007
  • Uroflowmetry is of great convenience to diagnose benign prostate hypertrophy common in aged men. The urinary flow rate is obtained by weight measurement using load cell, however, sensitive to impact noise. An alternative technique was recently proposed to measure hydraulic pressure instead of weight and demonstrated to introduce significantly reduced noise. In this paper, we described the measured diagnostic parameters between the weight and pressure measuring techniques in 10 normal men. The weight and pressure signals were simultaneously acquired during urination, converted into urine volumes, then differentiated to obtain flow rate signals, which showed very similar waveforms. Diagnostic parameters evaluated by pressure measuring technique were well correlated with the standard weight measuring technique (correlation coefficient > 0.99). Therefore, the new uroflowmetry based on hydraulic pressure measurement can provide accurate diagnostic parameters, which would be clinically valid.

Is the diagnosis of calcified laryngeal cartilages on panoramic radiographs possible?

  • Cagirankaya, Leyla Berna;Akkaya, Nursel;Akcicek, Gokcen;Dogru, Hatice Boyacioglu
    • Imaging Science in Dentistry
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    • v.48 no.2
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    • pp.121-125
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    • 2018
  • Purpose: Detecting laryngeal cartilages (triticeous and thyroid cartilages) on panoramic radiographs is important because they may be confused with carotid artery calcifications in the bifurcation region, which are a risk factor for stroke. This study assessed the efficiency of panoramic radiography in the diagnosis of calcified laryngeal cartilages using cone-beam computed tomography (CBCT) as the reference standard. Materials and Methods: A total of 312 regions(142 bilateral, 10 left, 18 right) in 170 patients(140 males, 30 females) were examined. Panoramic radiographs were examined by an oral and maxillofacial radiologist with 11 years of experience. CBCT scans were reviewed by 2 other oral and maxillofacial radiologists. The kappa coefficient(${\kappa}$) was calculated to determine the level of intra-observer agreement and to determine the level of agreement between the 2 methods. Diagnostic indicators(sensitivity, specificity, accuracy, and false positive and false negative rates) were also calculated. P values <.05 were considered to indicate statistical significance. Results: Eighty-two images were re-examined to determine the intra-observer agreement level, and the kappa coefficient was calculated as 0.709 (P<.05). Statistically significant and acceptable agreement was found between the panoramic and CBCT images (${\kappa}=0.684$ and P<.05). The sensitivity, specificity, diagnostic accuracy rate, the false positive rate, and the false negative rate of the panoramic radiographs were 85.4%, 83.5%, 84.6%, 16.5%, and 14.6%, respectively. Conclusion: In most cases, calcified laryngeal cartilages could be diagnosed on panoramic radiographs. However, due to variation in the calcifications, diagnosis may be difficult.

Comparative Study of Diagnostic Accuracy Rate by Sasang Constitutions on Measurement Method of Body Shape (체형측정 방법에 따른 사상체질 진단정확률 비교 연구)

  • Kim, Jong-Won;Sul, Yu-Kyung;Choi, Jae-Jung;Kwon, Suk-Dong;Kim, Kyu-Kon;Lee, Yong-Tae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.1
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    • pp.338-346
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    • 2007
  • For Objectivity development of the body shape that is an importance standard for the classification of sasang constitutional medicine diagnosis, We made a comparison between Automatic & Physical measuring. This study uses 2 attitude which lies down & standing. We measured the body of patients(Width 5 places and circumference 8 places) and analyzed the anthropometric data dividing into sex, age, BMI. 296 patients's data are used in the analysis.

Concordance of Three International Guidelines for Thyroid Nodules Classified by Ultrasonography and Diagnostic Performance of Biopsy Criteria

  • Younghee Yim;Dong Gyu Na;Eun Ju Ha;Jung Hwan Baek;Jin Yong Sung;Ji-hoon Kim;Won-Jin Moon
    • Korean Journal of Radiology
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    • v.21 no.1
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    • pp.108-116
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    • 2020
  • Objective: To investigate the concordance of three international guidelines: the Korean Thyroid Association/Korean Society of Thyroid Radiology, American Thyroid Association, and American College of Radiology for thyroid nodules classified by ultrasonography (US) and the diagnostic performance of simulated size criteria for malignant biopsies. Materials and Methods: A total of 2586 thyroid nodules (≥ 1 cm) were collected from two multicenter study datasets. The classifications of the thyroid nodules were based on three different guidelines according to US categories for malignancy risk, and the concordance rate between the different guidelines was calculated for the classified nodules. In addition, the diagnostic performance of criteria related to four different simulated biopsy sizes was evaluated. Results: The concordance rate of nodules classified as high- or intermediate-suspicion was high (84.1-100%), but low-suspicion or mildly-suspicious nodules exhibited relatively low concordance (63.8-83.8%) between the three guidelines. The differences in sensitivity, specificity, and accuracy between the guidelines were 0.7-19.8%, 0-40.9%, and 0.1-30.5%, respectively, when the original biopsy criteria were applied. The differences decreased to 0-5.9%, 0-10.9%, and 0.1-8.2%, respectively, when simulated, similar biopsy size criteria were applied. The unnecessary biopsy rate calculated with the original criteria (0-33.8%), decreased with the simulated biopsy size criteria (0-8.7%). Conclusion: We found a high concordance between the three guidelines for high- or intermediate-suspicion nodules, and the diagnostic performance of the biopsy criteria was approximately equivalent for each simulated size criterion. The difference in diagnostic performance between the three guidelines is mostly influenced by the various size thresholds for biopsies.

Estimation of Disease Code Accuracy of National Medical Insurance Data and the Related Factors (의료보험자료 상병기호의 정확도 추정 및 관련 특성 분석 -법정전염병을 중심으로-)

  • Shin, Eui-Chul;Park, Yong-Mun;Park, Yong-Gyu;Kim, Byung-Sung;Park, Ki-Dong;Meng, Kwang-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.3 s.62
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    • pp.471-480
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    • 1998
  • This study was undertaken in order to estimate the accuracy of disease code of the Korean National Medical Insurance Data and disease the characteristics related to the accuracy. To accomplish these objectives, 2,431 cases coded as notifiable acute communicable diseases (NACD) were randomly selected from 1994 National Medical Insurance data file and family medicine specialists reviewed the medical records to confirm the diagnostic accuracy and investigate the related factors. Major findings obtained from this study are as follows : 1. The accuracy rate of disease code of NACD in National Medical Insurance data was very low, 10.1% (95% C.I. : 8.8-11.4). 2. The reasons of inaccuracy in disease code were 1) claiming process related administrative error by physician and non-physician personnel in medical institutions (41.0%), 2) input error of claims data by key punchers of National Medical Insurer (31.3%) and 3) diagnostic error by physicians (21.7%). 3. Characteristics significantly related with lowering the accuracy of disease code were location and level of the medical institutions in multiple logistic regression analysis. Medical institutions in Seoul showed lower accuracy than those in Kyonngi, and so did general hospitals, hospitals and clinics than tertiary hospitals. Physician related characteristics significantly lowering disease code accuracy of insurance data were sex, age group and specialty. Male physicians showed significantly lower accuracy than female physicians; thirties and fortieg age group also showed significantly lower accuracy than twenties, and so did general physicians and other specialists than internal medicine/pediatric specialists. This study strongly suggests that a series of policies like 1) establishment of peer review organization of National Medical Insurance data, 2) prompt nation-wide expansion of computerized claiming network of National Medical Insurance and 3) establishment and distribution of objective diagnostic criteria to physicians are necessary to set up a national disease surveillance system utilizing National Medical Insurance claims data.

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MRI FINDINGS FOR DIAGNOSIS OF THE TEMPOROMANDIBULAR JOINT DISC PERFORATION (MRI를 이용한 악관절 원판 또는 그 주위조직의 천공에 대한 진단)

  • Kim, Hyung-Gon;Kim, Il-Soo;Park, Kwang-Ho;Huh, Jong-Ki;Yoon, Hyun-Joong;Cho, Nariya
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.2
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    • pp.191-196
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    • 2000
  • Purpose This study is to report presurgical magnetic resonance imaging(MRI) findings of the temporomandibular joint which had perforation in the disc or its surrounding tissues and to improve its diagnostic rate using MRI. Patients and Methods The sample consisted of patients who visited the TMJ clinic at Yongdong Severance Hospital, Yonsei University, during the years, 1992 and 1997. They were diagnosed as TMJ internal derangement and received surgical treatment. We divided them into two groups. The first group comprised of 85 joints with perforated disc or its surrounding tissues and which were confirmed surgically. The second group of 62 joints which only had disc displacement without perforation, hyperemia or adhesion served as control. Results The preoperative diagnostic sensitivity of TMJ perforation using MRI was 74.1%. The MRI findings for diagnosis of the TMJ perforation were degenerative change of the condyle head or the articular fossa, bone to bone contact between the condyle head and the articular eminence or the articular fossa, bony spurring or osteophytosis of the condyle head, flattening of articular surface of the condyle head or the articular eminence, discontinuity of the disc and the arthrographic effect due to joint effusion. Conclusion The preoperative diagnostic sensitivity of TMJ perforation using MRI in this study was 74.1% which was lower than the diagnostic rate using the arthrogram. Further investigations are needed to improve the diagnostic accuracy of TMJ perforation using MRI.

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Liquid-Based Cytology Using $MonoPrep2^{TM}$ System in Cervicovaginal Cytology: Comparative Study with Conventional Pap Smear and Histology (고식적 직접 도말법과 $MonoPrep2^{TM}$ system 법에 의한 자궁경부질 세포검사 성적의 비교 검토)

  • Jeon, Yoon-Kyung;Kim, Ok-Ran;Park, Ki-Wha;Kang, Soon-Beom;Park, In-Ae
    • The Korean Journal of Cytopathology
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    • v.15 no.1
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    • pp.33-39
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    • 2004
  • We compared the diagnostic accuracy of liquid-based cervicovaginal cytology using $MonoPrep2^{TM}$ system (Monogen, Herndon, Virginia, USA), a manual system based on membrane filtration method, with conventional Pap smear. Study population included 92 patients visiting the gynecologic department under the suspicion of uterine cervical disease. In thirty of them, surgical biopsy was performed. $MonoPrep2^{TM}$ system provided well-preserved monolayer specimen with good nuclear morphology. However, about 19% of specimens were inadequate to interpret due to low cellularity. The detection rate of abnormal cells more than ASCUS (atypical squamous cells of unknown significance) was 23.9% and higher than 19.4 % of conventional Pap smear. Diagnostic concordance rate with conventional Pap smear was 81%, and severe discordance rate influencing on the management of patient was 7.6 %. Among these seven cases, $MonoPrep2^{TM}$ system was more diagnostic only in four. In comparison with histology, the sensitivity of diagnosis of $MonoPrep2^{TM}$ system was 78.9% and slightly higher than 73.5% of conventional Pap smear. However, the specificity was 81.1% and lower than 90.9% of Pap smear. In conclusion, $MonoPrep2^{TM}$ system provided diagnostic accuracies similar to the conventional Pap smear. The inexpertness of slide preparation and the low cellularity were considered to endow a limitation in more accurate evaluation.