• Radiation Oncology Journal
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• 제35권4호
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• pp.340-348
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• 2017

Purpose: To evaluate the diagnostic accuracy of computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT) in predicting pelvic lymph node (LN) metastases in patients with cervical cancer. Materials and Methods: From January 2009 to March 2015, 114 patients with FIGO stage IA1-IIB uterine cervical cancer who underwent hysterectomy with pelvic lymphadenectomy and took CT, MRI, and PET/CT before surgery were enrolled in this study. The criteria for LN metastases were a LN diameter ${\geq}1.0cm$ and/or the presence of central necrosis on CT, a LN diameter ${\geq}1.0cm$ on MRI, and a focally increased FDG uptake on PET/CT. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for pelvic LN metastases were estimated. Results: The sensitivity, specificity, PPV, NPV, and accuracy for detection of pelvic LN metastases were 51.4%, 85.9%, 41.3%, 90.1%, and 80.3% for CT; 24.3%, 96.3%, 56.3%, 86.8%, and 84.6% for MRI; and 48.6%, 89.5%, 47.4%, 90.0%, and 82.9% for PET/CT, respectively. The sensitivity of PET/CT and CT was higher than that of MRI (p=0.004 and p= 0.013, respectively). The specificity of MRI was higher than those of PET/CT and CT (p=0.002 and p=0.001, respectively). The difference of specificity between PET/CT and CT was not statistically significant (p=0.167). Conclusion: These results indicate that preoperative CT, MRI, and PET/CT showed low to moderate sensitivity and PPV, and moderate to high specificity, NPV, and accuracy. More efforts are necessary to improve sensitivity of imaging modalities in order to predict pelvic LN metastases.

• Korean Journal of Radiology
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• 제23권12호
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• pp.1260-1268
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• 2022

Objective: To propose standardized MRI-proton density fat fraction (PDFF) cutoff values for diagnosing hepatic steatosis, evaluated using contemporary PDFF measuring methods in a large population of healthy adults, using histologic fat fraction (HFF) as the reference standard. Materials and Methods: A retrospective search of electronic medical records between 2015 and 2018 identified 1063 adult donor candidates for liver transplantation who had undergone liver MRI and liver biopsy within a 7-day interval. Patients with a history of liver disease or significant alcohol consumption were excluded. Chemical shift imaging-based MRI (CS-MRI) PDFF and high-speed T2-corrected multi-echo MR spectroscopy (HISTO-MRS) PDFF data were obtained. By temporal splitting, the total population was divided into development and validation sets. Receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic performance of the MRI-PDFF method. Two cutoff values with sensitivity > 90% and specificity > 90% were selected to rule-out and rule-in, respectively, hepatic steatosis with reference to HFF ≥ 5% in the development set. The diagnostic performance was assessed using the validation set. Results: Of 921 final participants (624 male; mean age ± standard deviation, 31.5 ± 9.0 years), the development and validation sets comprised 497 and 424 patients, respectively. In the development set, the areas under the ROC curve for diagnosing hepatic steatosis were 0.920 for CS-MRI-PDFF and 0.915 for HISTO-MRS-PDFF. For ruling-out hepatic steatosis, the CS-MRI-PDFF cutoff was 2.3% (sensitivity, 92.4%; specificity, 63.0%) and the HISTO-MRI-PDFF cutoff was 2.6% (sensitivity, 88.8%; specificity, 70.1%). For ruling-in hepatic steatosis, the CS-MRI-PDFF cutoff was 3.5% (sensitivity, 73.5%; specificity, 88.6%) and the HISTO-MRI-PDFF cutoff was 4.0% (sensitivity, 74.7%; specificity, 90.6%). Conclusion: In a large population of healthy adults, our study suggests diagnostic thresholds for ruling-out and ruling-in hepatic steatosis defined as HFF ≥ 5% by contemporary PDFF measurement methods.

• Asian Pacific Journal of Cancer Prevention
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• 제14권4호
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• pp.2627-2630
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• 2013

Background: Ovarian cancer continues to pose a major challenge to physicians and radiologists. It is the third most common gynecologic malignancy and estimated to be fifth leading cancer cause of death in women, constituting 23% of all gynecological malignancies. Multi-detector computed tomography (MDCT) appears to offer an excellent modality in diagnosing ovarian cancer based on combination of its availability, meticulous technique, efficacy and familiarity of radiologists and physicians. The aim of this study was to compute sensitivity, specificity, positive and negative predictive values and diagnostic accuracy of 64-slice MDCT in classifying ovarian masses; 95% confidence intervals were reported. Materials and Methods: We prospectively designed a cross-sectional analytical study to collect data from July 2010 to August 2011 from a tertiary care hospital in Karachi, Pakistan. A sample of 105 women aged between 15-80 years referred for 64-MDCT of abdomen and pelvis with clinical suspicion of malignant ovarian cancer, irrespective of stage of disease, were enrolled by non-probability purposive sampling. All patients who were already known cases of histologically proven ovarian carcinoma and having some contraindication to radiation or iodinated contrast media were excluded. Results: Our prospective study reports sensitivity, specificity; positive and negative predictive values with 95%CI and accuracy were computed. Kappa was calculated to report agreement among the two radiologists. For reader A, MDCT was found to have 92% (0.83, 0.97) sensitivity and 86.7% (0.68, 0.96) specificity, while PPV and NPV were 94.5% (0.86, 0.98) and 86.7% (0.63, 0.92), respectively. Accuracy reported by reader A was 90.5%. For reader B, sensitivity, specificity, PPV and NPV were 94.6% (0.86, 0.98) 90% (0.72, 0.97) 96% (0.88, 0.99) and 87.1% (0.69, 0.95) respectively. Accuracy computed by reader B was 93.3%. Excellent agreement was found between the two radiologists with a significant kappa value of 0.887. Conclusion: Based on our study results, we conclude MDCT is a reliable imaging modality in diagnosis of ovarian masses accurately with insignificant interobserver variability.

• 동의생리병리학회지
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• 제21권6호
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• pp.1581-1585
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• 2007

To report Sensitivity and specificity about utility as diagnosis criteria for deficiency of Qi in stroke. Korean medicine doctor surveyed deficiency of Qi of the symptoms for the Stroke case report form in stroke patients within 1 month of onset. We analyzed 643 patients have diagnosed stroke, neurological deficit continued over twenty-four hours and within one month of onset, except traumatic cerebrovascular attack (EDH, SDH) using the result by medical specialist and residents diagnosed differentiation and written CRF(Case Report Forms) which based on 'Korean Standard Differentiation of the Symptoms and Signs II' in twenty multi centers. The sensitivity of "more 1/5 in major sings and 1/5 in helpful signs", "more 1/5 in major signs and 2/5 in helpful signs", "more 2/5 in major signs and 1/5 in helpful signs", "more 2/5 in major signs and 2/5 in helpful signs""more 3/5 in major signs and 1/5 in helpful signs""more 3/5 in major signs and 2/5 in helpful signs" are respectively 83%, 50%, 72%, 46%, 47%, 32%. The specificity are respectively 28%, 59%, 55%, 74%, 80%, 89%. The sensitivity(72%) and specificity(55%) of "more 2/5 in major signs and 1/5 in helpful signs" that to be implanted. Although this values are not high, after values of sensitivity and specificity should be more than current value, and then we should be able to suggest as objective diagnosing criteria.

• Journal of Preventive Medicine and Public Health
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• 제29권3호
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• pp.507-519
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• 1996

The objectives of this study are to investigate the prevalence of occupation related carpal tunnel syndrome(CTS) among workers in a condom industry : to analyse the sensitivity and specificity of clinical signs or symptoms such as hand diagram, Tinel's sign and Phalen's sign in carpal tunnel syndrome : and to test vibration threshold test using audiometry as a technically easy and noninvasive method in the diagnosis of carpal tunnel syndrome in stead of nerve conduction velocity (NCV). The study group was divided into exposed group(39 cases) and non-exposed group(48 cases) based on whether or not excessive use of wrist movements exsist. 1. There are stastically significant differences in symptoms and signs of carpal tunnel syndrome such as hand diagram, Tinel's sign and Phalen's sign between exposed and non-exposed group(p<0.05). 2. Six cases(9 hands) were comfirmed as carpal tunnel syndrome by NCV. Five cases(7 hands) belonged to exposed group, 1 case(2 hands) to nonexposed group. As there are significant differences in prevalence of carpal tunnel syndrome between two groups(p<0.05), excessive use of wrist in occupation is a risk factor of carpal tunnel syndrome. 3. When we use NCV as a gold standard in the diagnosis of carpal tunnel syndrome, sensitivity and specificity of hand diagram, Tinel's sign and Phalen's sign is as followed; hand diagram , sensitivity 88.9%, specificity 84.2% Tinel's sign ; sensitivity 55.6%, specificity 72.8% Phalen's sign ; sensitivity 14.3%, specificity 88.4%. Among above clinical signs and symptoms, hand diagram is the best clinical screening test. 4. The differences of vibration threshold between median and ulnar nerve at the same time are useful in the diagnosis of carpal tunnel syndrome but the time change of vibration threshold of median nerve over time are not sensitive enough. It is concluded that vibration threshold between median and ulnar nerve at the same time can be used as a supplementary or alternative criterion to indicate that the nerve dysfunction is located in the carpal tunnel.

• 핵의학기술
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• 제14권2호
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• pp.60-64
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• 2010

유방암의 진단을 위해 단순유방촬영, 유방초음파검사, $^{18}F$-FDG PET 검사가 대부분 함께 이루어지고 있다. 그러나 이들 검사의 단점을 보완하고자 보다 더 높은 예민도, 특이도, 정확도를 가진 PEM이 도입되었다. 본 연구에서는 유방암의 진단을 향상시키는 PEM의 유용성을 알아보고자한다. 2010년 1월부터 3월까지 유방외과에서 유방암 진단을 받은 환자 100명을 대상으로 PEM 검사를 시행하였다. 장비는 Naviscan사의 PEM Flex Solo II scanner를 사용하였다. PEM 영상결과와 수술 후 병리결과를 비교하여 PEM 검사의 예민도, 특이도, 정확도를 평가하였다. 환자 100명에서 PEM 영상과 수술 후 병리결과를 통해 알아본 결과로 진양성은 89, 위양성은 9, 위음성은 7, 진음성은 87이었다. PEM 검사의 예민도, 특이도, 정확도는 각각 92.7%, 90.6%, 91.7%로 나타났다. 단순유방촬영에서 예민도 86.2%, 특이도 64.5%로 보고되어 있고 유방초음파검사에서 예민도 87.9%, 특이도 76.7%로 알려져 있다. 본 연구에서 PEM은 예민도 92.7%, 특이도 90.6%로 다른 검사보다 높게 나타났다. 이로써 PEM은 유방암을 진단하고 수술하기 전의 더 나은 수술 계획에 사용될 수 있으며 국소 부위 재발의 발견에 도움이 될 것으로 사료된다.

• Korean Journal of Radiology
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• 제22권7호
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• pp.1066-1076
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• 2021

Objective: To evaluate the performance of the 2018 Korean Liver Cancer Association-National Cancer Center (KLCA-NCC) Practice Guidelines (hereafter, PG) for the diagnosis of hepatocellular carcinoma (HCC) using gadoxetic acid-enhanced MRI, compared to the Liver Imaging-Reporting and Data System (LI-RADS) version 2018 (hereafter, v2018). Materials and Methods: From January 2013 to October 2015, treatment-naïve hepatic lesions (≥ 1 cm) on gadoxetic acid-enhanced MRI in consecutive patients with chronic hepatitis B or cirrhosis were retrospectively evaluated. For each lesion, three radiologists independently analyzed the imaging features and classified the lesions into categories according to the 2018 KLCA-NCC PG and LI-RADS v2018. The imaging features and categories were determined by consensus. Generalized estimating equation (GEE) models were used to compare the per-lesion diagnostic performance of the 2018 KLCA-NCC PG and LI-RADS v2018 using the consensus data. Results: In total, 422 lesions (234 HCCs, 45 non-HCC malignancies, and 143 benign lesions) from 387 patients (79% male; mean age, 59 years) were included. In all lesions, the definite HCC (2018 KLCA-NCC PG) had a higher sensitivity and lower specificity than LR-5 (LI-RADS v2018) (87.2% [204/234] vs. 80.8% [189/234], p < 0.001; 86.2% [162/188] vs. 91.0% [171/188], p = 0.002). However, in lesions of size ≥ 2 cm, the definite HCC had a higher sensitivity than the LR-5 (86.8% [164/189] vs. 82.0 (155/189), p = 0.002) without a reduction in the specificity (80.0% [48/60] vs. 83.3% [50/60], p = 0.15). In all lesions, the sensitivity and specificity of the definite/probable HCC (2018 KLCA-NCC PG) and LR-5/4 did not differ significantly (89.7% [210/234] vs. 91.5% [214/234], p = 0.204; 83.5% [157/188] vs. 79.3% [149/188], p = 0.071). Conclusion: For the diagnosis of HCC of size ≥ 2 cm, the definite HCC (2018 KLCA-NCC PG) had a higher sensitivity than LR-5, without a reduction in specificity. The definite/probable HCC (2018 KLCA-NCC PG) had a similar sensitivity and specificity to that those of the LR-5/4.

• 대한세포병리학회지
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• 제8권1호
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• pp.20-26
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• 1997

The specificity of cytologic examination in effusions is high but the sensitivity is low. Therefore, various ancillary methods for the detection of malignant cells in effusions have been proposed. The presence of an aneuploid cell population is generally considered diagnostic of malignancy. The purpose of this study is to determine whether the routine use of flow cytometry adds to standard cytologic evaluation in effusions. We did flow cytometric DNA analysis in 76 effusions(28 malignant and 48 benign fluids). All the 48 benign effusions were diploid. There were 12(42.9%) aneuploid and 16(67.1%) diploid malignant effusions. Based on these results flow cytometric DNA analysis had a sensitivity of 42.9% and a specificity of 100%. These results suggest that flow cytometric DNA analysis may be a useful adjunct to conventional cytology, but its principal limitation is us relatively low sensitivity.

• 한국콘텐츠학회논문지
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• 제12권10호
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• pp.385-394
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• 2012

본 연구의 목적은 생애전환기 건강진단 골밀도 검사시 측정도구(DEXA, QUS, RA)에 따른 진단범위의 유효성을 평가하는 것이다. DEXA를 이용한 골밀도 검사 결과 T-score -2.5를 기준으로 할 때 QUS의 cutoff 값은 -1.733이며, 이때 민감도는 70.4%, 특이도는 59.5%이었고 T-score -3.0을 기준으로 할 때 cutoff 값은 -2.323으로 이때 민감도는 70.4%, 특이도는 56.8%이었다. DEXA를 이용한 골밀도 검사 결과 T-score -2.5를 기준으로 할 때 RA의 cutoff 값은 -1.675이며, 이때 민감도는 70.0%, 특이도는 63.7%이었고 T-score -3.0을 기준으로 할 때 cutoff 값은 -2.325로 이때 민감도는 70.0%, 특이도는 42.9%로 QUS와 RA의 측정도구 간에 큰 차이를 보이지 않았다. 골밀도 측정도구의 상관관계와 재현성에 대한 평가에서는 일부 차이를 제외하고는 측정도구 간 및 측정도구의 반복 측정값 간에 유의한 차이를 보이지 않았다. ROC 분석에서 측정도구별 평균골밀도 측정결과는 DEXA를 기준으로 할 때 RA와 QUS는 모두 유효한 것으로 판단된다. 다만, 생애전환기 골다공증 진단에 보다 정확한 결과를 얻기 위해서는 성별이나 연령층, 다양한 측정부위별 정량화된 결과를 진단기준의 보정지표로 고려하는 것이 필요하다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권4호
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• pp.1667-1670
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• 2014

Background: Calprotectin in feces seems to be a more sensitive marker for gastrointestinal (GI) cancers than fecal occult blood, but its specificity may be too low for screening average risk populations. This study aims at evaluating the diagnostic value of fecal calprotectin as a screening biomarker for GI malignancies. Materials and Methods: In a case-control study, 100 patients with GI malignancies (50 patients with colorectal cancer and 50 patients with gastric cancer) and 50 controls were recruited in Tabriz Imam Reza and Sina hospitals during a 24-month period. One to two weeks after the last endoscopy/colonoscopy, fecal specimens were collected by the patients and examined by ELISA method for quantitative measurement of calprotectin content. The results were compared between the three groups. Results: The mean fecal calprotectin level was $109.1{\pm}105.3$ (2.3-454.3, median:74), $241.1{\pm}205.2$ (3.4-610.0, median:19.3) and $45.9{\pm}55.1{\mu}g/g$ (1.3-257.1, median:19.3) in gastric cancer, colorectal cancer and control group, respectively, the differences being significant (p<0.001) and remaining after adjustment for age. The optimal cut-off point for fecal calprotectin was ${\geq}75.8{\mu}g/g$ for distinguishing colorectal cancer from normal cases (sensitivity and specificity of 80% and 84%, respectively). This value was ${\geq}41.9{\mu}g/g$ for distinguishing gastric cancer from normal cases (sensitivity and specificity of 62%). Conclusions: Our results revealed that fecal calprotectin might be a useful and non-invasive biomarker for distinguishing colorectal cancer from non-malignant GI conditions. However, due to low sensitivity and specificity, this biomarker may not help physicians distinguishing gastric cancer cases from healthy subjects.