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At least 1,081 records · Page 60Linked to original sources
PubMed2004

Accuracy of staging in early oesophageal cancer using high resolution endoscopy and high resolution endosonography: a comparative, prospective, and blinded trial.

BACKGROUND AND AIMS: The increasing use of endoscopic resection for curative treatment of early oesophageal cancers requires accurate staging before therapy. In a prospective blinded trial, we compared staging of early oesophageal carcinoma using high resolution endoscopy (HR-E) with staging using high resolution endosonography (HR-EUS). PATIENTS AND METHODS: A total of 100 patients (89 men, 11 women; mean age 63.9 (10.8) years (range 31-91)) with a suspicion of early oesophageal adenocarcinoma (n = 81) or squamous cell carcinoma (n = 19) were enrolled in the study. After endoscopic staging with high resolution video endoscopy by two experienced endoscopists, HR-EUS was performed by an experienced endosonographer who was blinded to the endoscopic assessment. Results of the staging examinations were correlated with the histology of the resected tumours. RESULTS: Overall rates for accuracy of the endoscopic and endosonographic staging were 83.4% and 79.6%, respectively. Sensitivity for mucosal tumours (n = 68) was more than 90% (EUS 91.2%, endoscopy 94.1%) while sensitivity for submucosal tumours (n = 25) was lower, at 48% for EUS and 56% for endoscopic staging. A combination of the two techniques increased the sensitivity for submucosal tumours to 60%. Submucosal tumours in the tubular oesophagus were significantly better staged with HR-EUS than submucosal tumours close to the oesophagogastric junction (10/11 v 2/14; p<0.001). Tumours infiltrating the second and third submucosal layers were also more correctly diagnosed than tumours with slight infiltration of the first submucosal layer (sm1). CONCLUSIONS: The overall diagnostic accuracy of both HR-E and HR-EUS with a 20 MHz miniprobe in early oesophageal cancer was high (approximately 80%), with no significant differences between the two techniques. HR-E and HR-EUS provide a high level of diagnostic accuracy for mucosal tumours and submucosal tumours located in the tubular part of the oesophagus. With submucosal tumours located at the oesophagogastric junction or with infiltration of the first third of the submucosa however, the diagnostic accuracy of both techniques is not yet satisfactory.

Adenocarcinoma↗
PubMed2001

Impact of hypertension on the accuracy of exercise stress myocardial perfusion imaging for the diagnosis of coronary artery disease.

AIM: To compare the accuracy of exercise stress myocardial perfusion single photon emission computed tomography (SPECT) imaging for the diagnosis of coronary artery disease in patients with and without hypertension. METHODS: A symptom limited bicycle exercise stress test in conjunction with 99m technetium sestamibi or tetrofosmin SPECT imaging was performed in 332 patients (mean (SD) age, 57 (10) years; 257 men, 75 women) without previous myocardial infarction who underwent coronary angiography. Of these, 137 (41%) had hypertension. Rest SPECT images were acquired 24 hours after the stress test. An abnormal scan was defined as one with reversible or fixed perfusion defects. RESULTS: In hypertensive patients, myocardial perfusion abnormalities were detected in 79 of 102 patients with significant coronary artery disease and in nine of 35 patients without. In normotensive patients, myocardial perfusion abnormalities were detected in 104 of 138 patients with significant coronary artery disease and in 16 of 57 patients without. There were no differences between normotensive and hypertensive patients in sensitivity (77% (95% confidence interval (CI) 69% to 86%) v 75% (95% CI 68% to 83%)), specificity (74% (95% CI 60% to 89%) v 72% (95% CI 60% to 84%)), and accuracy (77% (95% CI 70% to 84%) v 74% (95% CI 68% to 80%)) of exercise SPECT for diagnosing coronary artery disease. The accuracy of SPECT was greater than electrocardiography, both in hypertensive patients (p = 0.005) and in normotensive patients (p = 0.0001). For the detection of coronary artery disease in individual vessels, sensitivity was 58% (95% CI 51% to 65%) v 57% (95% CI 51% to 64%), specificity was 86% (95% CI 82% to 90%) v 85% (95% CI 81% to 89%), and accuracy was 74% (95% CI 70% to 78%) v 74% (95% CI 70% to 78%) in patients with and without hypertension (NS). CONCLUSIONS: In the usual clinical setting, the value of exercise myocardial perfusion scintigraphy for diagnosing coronary artery disease is not degraded by the presence of hypertension.

Aged↗
PubMed1996

Accuracy of dobutamine stress echocardiography for the diagnosis of coronary artery stenosis in patients with myocardial infarction: the impact of extent and severity of left ventricular dysfunction.

OBJECTIVES: To assess the value of dobutamine stress echocardiography (DSE) in the prediction of the extent and location of coronary artery stenosis in symptomatic patients with old myocardial infarction and to study the impact of the severity of resting wall motion abnormalities (WMA) on the diagnostic accuracy of the test. PATIENTS: One hundred and thirty two symptomatic patients with old myocardial infarction. METHODS: DSE (up to 40 micrograms/kg/min, with atropine up to 1 mg) was performed in all patients. Ischaemia was defined as new or worsened WMA. For each coronary artery, regional wall motion in the corresponding territory was classified as normal, mildly, moderately, or severely impaired according to the wall motion score index. Significant coronary stenosis was defined as > or = 50% diameter stenosis. RESULTS: A positive DSE for ischaemia occurred in 87 of 111 patients with and three of 21 patients without coronary artery stenosis (sensitivity = 78%; CI 71 to 86, specificity = 86%; CI 79 to 92, accuracy = 80%; CI 73 to 87). The accuracy for the diagnosis of individual coronary stenosis was 69% in the presence of normal wall motion and 74%, 74%, and 61% respectively when there was mild, moderate, and severe WMA in the corresponding territories (P = NS). The sensitivity was higher in presence of mild or moderate WMA (73%) than with normal wall motion (53%) or severe WMA (56%, P < 0.05 in both). In territories subtended by a stenotic artery, the regional wall motion score index was not different with or without ischaemia. CONCLUSION: DSE had a good overall accuracy for the diagnosis of coronary artery stenosis in symptomatic patients with old myocardial infarction. The presence of resting WMA did not limit DSE as a method of eliciting myocardial ischaemia and diagnosing significant coronary artery stenosis in patients with old myocardial infarctions.

Aged↗
PubMed1975

Observations on the accuracy of point counting including a description of a new graticule.

The accuracy of point counting as a histometric technique depends very much on the number of points counted, and the number necessary varies greatly with both the level of accuracy required and the proportion the relevant tissue occupies in the section. It is shown that the number of "hits" is a more useful measure than the total number of points counted, and a simple rule derived for determining the number of hits necessary to achieve any necessary degree of accuracy. A method of progressive estimation of accuracy when attempting to measure the proportion of a tissue that is unevenly distributed is also described. The point-counting graticules commonly used, with 25 points, are inadequate with tissue proportions below 10%. A new graticule design, with 100 points optimally distributed, and usable as a 25-point array if required, is illustrated.

Histological Techniques↗
PubMed1982

Accuracy of morphological diagnosis of lung cancer in a department of respiratory medicine.

In view of the importance of determination of cell type in patients with bronchial carcinoma who are to be given chemotherapy a series of 140 histologically proved cases was analysed to assess the accuracy of pretreatment diagnosis by cytology and bronchial biopsy. Final histological diagnosis was made after thoracotomy (131 cases) or necropsy (9 cases). Before treatment, malignancy was diagnosed in 71% of cases with 91% accuracy in cell typing. Diagnostic yield was greatest in squamous carcinoma (81%) and least with adenocarcinoma (50%). Large-celled and small-celled anaplastic carcinomas gave yields of 61% and 68% respectively. Accuracy of cell typing was high (90-97%) except for large-celled anaplastic carcinoma (71%). All diagnostic methods were not employed in every case. In patients supplying samples the diagnosis was made by sputum cytology in 57%, by rigid bronchoscopy cytology in 57%, by fibreoptic bronchoscopy cytology in 71% and biopsy in 53%. Causes of diagnostic failures and possible means of increasing accuracy of pretreatment diagnosis were discussed.

Adenocarcinoma↗
PubMed2001

Observer accuracy in estimating proportions in images: implications for the semiquantitative assessment of staining reactions and a proposal for a new system.

BACKGROUND: The results of immunohistochemical staining are often assessed by semiquantitative scoring. However, these scoring systems are usually non-standardised and there has been little evaluation of the accuracy and reliability of this subjective assessment. AIMS: To assess the accuracy of observer estimation of proportions of objects in an image. METHODS: Images were generated that contained known proportions of pink squares in grids of 50 x 50 and 100 x 100 squares. Observers were shown each image for five seconds in random order and either estimated the proportion of pink squares or selected the image (from a pair of images) that contained the greater proportion of pink squares. The observers were four consultant histopathologists, seven trainee histopathologists, and six control non-histopathologists. RESULTS: The raw estimations of proportions showed a close correlation with the real proportions, with correlation coefficients of 0.94 and 0.95 for consultant and trainee histopathologists on the 50 x 50 grids. However, the performance in the comparison task was much higher, with an almost perfect classification for grids of equal size even when the proportions only differed by 5%. CONCLUSIONS: Histopathologists can estimate proportions of objects in an image with a reasonable degree of accuracy in this abstract test system. All observers, whether histopathologists or not, can discriminate between proportions that are only 5% different in equal sized image grids. This suggests that the generation and use of carefully calibrated reference images could greatly improve the accuracy and reliability of semiquantitative scoring of immunohistochemical or any other staining.

Clinical Competence↗
PubMed2005

Accuracy of transbronchial needle aspiration for mediastinal staging of non-small cell lung cancer: a meta-analysis.

BACKGROUND: The reported accuracy of transbronchial needle aspiration (TBNA) for mediastinal staging in non-small cell lung cancer (NSCLC) varies widely. We performed a meta-analysis to estimate the accuracy of TBNA for mediastinal staging in NSCLC. METHODS: Medline, Embase, and the bibliographies of retrieved articles were searched for studies evaluating TBNA accuracy with no language restriction. Meta-analytical methods were used to construct summary receiver-operating characteristic curves and to pool sensitivity and specificity. RESULTS: Thirteen studies met inclusion criteria, including six studies that surgically confirmed all TBNA results and enrolled at least 10 patients with and without mediastinal metastasis (tier 1). Methodological quality varied but did not affect diagnostic accuracy. In tier 1 studies the median prevalence of mediastinal metastasis was 34%. Using a random effects model, the pooled sensitivity and specificity were 39% (95% CI 17 to 61) and 99% (95% CI 96 to 100), respectively. Compared with tier 1 studies, the median prevalence of mediastinal metastasis (81%; p = 0.002) and pooled sensitivity (78%; 95% CI 71 to 84; p = 0.009) were higher in non-tier 1 studies. Sensitivity analysis confirmed that the sensitivity of TBNA depends critically on the prevalence of mediastinal metastasis. The pooled major complication rate was 0.3% (95% CI 0.01 to 4). CONCLUSIONS: When properly performed, TBNA is highly specific for identifying mediastinal metastasis in patients with NSCLC, but sensitivity depends critically on the study methods and patient population. In populations with a lower prevalence of mediastinal metastasis, the sensitivity of TBNA is much lower than reported in recent lung cancer guidelines.

Biopsy, Needle↗
PubMed2006

Current evidence on diagnostic accuracy of commercially based nucleic acid amplification tests for the diagnosis of pulmonary tuberculosis.

BACKGROUND: Even though commercial nucleic acid amplification tests (NAATs) have become the most frequently used molecular tests for laboratory diagnosis of pulmonary tuberculosis (TB), published studies report variable estimates of their diagnostic accuracy. We analysed the accuracy of commercial NAATs for the diagnosis of pulmonary TB in smear positive and smear negative respiratory samples using culture as a reference standard. METHODS: English language studies reporting data sufficient for calculating sensitivity and specificity of commercial NAATs on smear positive and/or smear negative respiratory samples were included. Meta-regression was used to analyse associations with reference test quality, the prevalence of TB, sample and test type. Predictive values for different levels of pre-test probability were quantified using Bayes' approach. RESULTS: Sixty three journal articles published between 1995 and 2004 met the inclusion criteria. Pooled sensitivity and specificity were 0.96 and 0.85 among smear positive samples and 0.66 and 0.98 among smear negative samples. The number of culture media used as reference test, the inclusion of bronchial samples, and the TB prevalence were found to influence the reported accuracy. The test type had no effect on the diagnostic odds ratio but seemed to be correlated with sensitivity or specificity, probably via a threshold effect. CONCLUSIONS: Commercial NAATs can be confidently used to exclude TB in patients with smear positive samples in which environmental mycobacteria infection is suspected and to confirm TB in a proportion of smear negative cases. The methodological characteristics of primary studies have a considerable effect on the reported diagnostic accuracy.

Humans↗
PubMed2003

Thoracic involvement of type A aortic dissection and intramural hematoma: diagnostic accuracy--comparison of emergency helical CT and surgical findings.

PURPOSE: To assess the accuracy of various findings at emergency helical computed tomography (CT) for the evaluation of thoracic involvement of type A aortic dissection (AD) and type A intramural hematoma (IMH) and to compare these findings with those at surgical confirmation. MATERIALS AND METHODS: Fifty-seven patients with acute chest pain underwent emergency helical CT and subsequent surgery for type A AD or IMH. Patients in whom AD or IMH was detected in three segments of the thoracic aorta or those in whom there was a site of any entry tear, arch branch vessel involvement, pericardial effusion, or aortic arch anomaly were examined at helical CT. Sensitivity, specificity, and accuracy of helical CT, along with 95% CIs, were calculated by using surgical confirmation as the reference standard. RESULTS: For the detection of AD or IMH of the thoracic aorta, the accuracy of helical CT was 100%. The sensitivity, specificity, and accuracy, respectively, were 82%, 100%, and 84% for an entry tear; 95%, 100%, and 98% for arch branch vessel involvement; and 83%, 100%, and 91% for pericardial effusion. These values were all 100% for aortic arch anomalies. CONCLUSION: Emergency helical CT of the thorax depicts findings that are highly accurate in the evaluation of acute type A AD and IMH.

Adult↗
PubMed2004

Head and neck cancer: clinical usefulness and accuracy of PET/CT image fusion.

PURPOSE: To compare diagnostic accuracy of attenuation-corrected positron emission tomography (PET) with fused PET and computed tomography (CT) in patients with head and neck cancer and to evaluate the effect of PET/CT findings on patient care. MATERIALS AND METHODS: Studies of 68 patients were reviewed by two physicians in consensus. Focal fluorodeoxyglucose (FDG) uptake in the head and neck on attenuation-corrected PET images was graded as benign, equivocal, or malignant. CT and PET/CT images were then reviewed, and initial findings were amended if necessary. Comparison was performed on a lesion-by-lesion basis. Accuracy was evaluated on the basis of follow-up and histopathologic findings. Potential effects on patient care were assessed by a head and neck surgeon. PET and PET/CT accuracy was compared with a McNemar test adjusted for clustering. RESULTS: A total of 157 foci with abnormal FDG uptake were noted, two of which were seen only on PET/CT images. PET/CT images were essential in determining the exact anatomic location for 100 lesions (74% better localization in regions previously treated surgically or with irradiation vs 58% in untreated areas; P =.06). On the basis of PET findings alone, 45 lesions were considered benign; 39, equivocal; and 71, malignant. With PET/CT, the fraction of equivocal lesions decreased by 53%, from 39 of 155 to 18 of 157 (P <.01). PET/CT had a higher accuracy of depicting cancer than did PET (96% vs 90%, P =.03). Six proved malignancies were missed with PET, but only one was missed with PET/CT. PET/CT findings altered the care for 12 (18%) of 68 patients. CONCLUSION: PET/CT is more accurate than PET alone in the detection and anatomic localization of head and neck cancer and has the clear potential to affect patient care.

Adolescent↗
PubMed2004

Soft-tissue lipomas: accuracy of sonography in diagnosis with pathologic correlation.

PURPOSE: To retrospectively determine the accuracy of sonography in helping to distinguish soft-tissue lipomas from other soft-tissue masses by using histologic proof as the reference standard. MATERIALS AND METHODS: Institutional review board approval was obtained, and informed consent was waived. Thirty-nine patients who underwent sonographic evaluation of a soft-tissue mass followed by biopsy or resection were retrospectively evaluated. Two musculoskeletal radiologists (readers 1 and 2) reviewed the sonographic images, characterized the masses, and rated the level of confidence in the diagnosis of lipoma by using a five-point scale. A level of confidence was also rated for the prospective sonographic report, which was reviewed and designated as reader 3. Receiver operating characteristic (ROC) curves, including 95% confidence intervals, were generated, and the area under the ROC curve (A(z)) was calculated for each reader. Sensitivity, specificity, and accuracy for each reader were calculated by using a confidence rating of 4 or 5 as positive for lipoma. Weighted kappa analysis was also performed to assess for interobserver variability. RESULTS: Histologic examination yielded 25 lipomas and 14 nonlipomas. The echogenicity of lipomas ranged from hypoechoic to hyperechoic relative to muscle, although most were isoechoic or hyperechoic. A(z) values were 0.79 for reader 1, 0.56 for reader 2, and 0.77 for reader 3. There was no significant difference between the A(z) for each reader and for chance. Interobserver agreement was fair, with a kappa value of 0.35 among the three readers. Sensitivities were 52%, 40%, and 52%, and accuracies were 64%, 49%, and 64% for readers 1, 2, and 3, respectively. CONCLUSION: Sonography demonstrates low accuracy in the diagnosis of soft-tissue lipomas.

Adipose Tissue↗
PubMed2005

Adding in vivo quantitative 1H MR spectroscopy to improve diagnostic accuracy of breast MR imaging: preliminary results of observer performance study at 4.0 T.

PURPOSE: To determine whether the addition of in vivo quantitative hydrogen 1 (1H) magnetic resonance (MR) spectroscopy can improve the radiologist's diagnostic accuracy in interpreting breast MR images to distinguish benign from malignant lesions. MATERIALS AND METHODS: The study was approved by the institutional review board and, where appropriate, was compliant with the Health Insurance Portability and Accountability Act. All patients provided written informed consent. Fifty-five breast MR imaging cases-one lesion each in 55 patients aged 24-66 years with biopsy-confirmed findings-were retrospectively evaluated by four radiologists. Patients were examined with contrast material-enhanced fat-suppressed T1-weighted 4.0-T MR imaging. The concentration of total choline-containing compounds (tCho) was quantified by using single-voxel 1H MR spectroscopy. For each case, the radiologists were asked to give the percentage probability of malignancy, the Breast Imaging and Reporting Data System category, and a recommendation for patient treatment. Two interpretations were performed for each case: The initial interpretation was based on the lesion's morphologic features and time-signal intensity curve, and the second interpretation was based on the lesion's morphologic features, time-signal intensity curve, and tCho concentration. Receiver operating characteristic (ROC), Wilcoxon signed rank, kappa statistic, and accuracy (based on the area under the ROC curve) analyses were performed. RESULTS: Of the 55 lesions evaluated, 35 were invasive carcinomas and 20 were benign. The addition of 1H MR spectroscopy resulted in higher sensitivity, specificity, accuracy, and interobserver agreement for all four radiologists. More specifically, two of the four radiologists achieved a significant improvement in sensitivity (P=.03, P=.03), and all four radiologists achieved a significant improvement in accuracy (P = .01, P = .05, P = .009, P < .001). CONCLUSION: Current study results suggest that the addition of quantitative 1H MR spectroscopy to the breast MR imaging examination may help to improve the radiologist's ability to distinguish benign from malignant breast lesions.

Adolescent↗
PubMed2005

Fatty atrophy of supraspinatus and infraspinatus muscles: accuracy of US.

PURPOSE: To prospectively evaluate the accuracy of ultrasonography (US) in depicting fatty atrophy of the supraspinatus (SSP) and infraspinatus (ISP) muscles, with magnetic resonance (MR) imaging as the reference standard. MATERIALS AND METHODS: Institutional review board approval and informed consent were obtained. SSP and ISP muscles of 65 consecutive patients (27 women, 38 men; mean age, 53.1 years; range, 28-83 years) with possible rotator cuff tears were evaluated with US in two planes. Visibility of muscle contour, pennate pattern, the central tendon, and muscle echogenicity was assessed by two radiologists. On the basis of these findings, diagnosis of substantial fatty atrophy was made at US. Accuracy, sensitivity, specificity, proportion of over- and underestimations, and interobserver agreement in diagnosis of substantial (grade 2 or greater) muscle atrophy were determined. Fatty atrophy was graded at MR imaging as follows: score of 0 = no intramuscular fat, score of 1 = some fatty streaks, score of 2 = fat evident but less extensive than muscle, score of 3 = fat equal to muscle, and score of 4 = fat more extensive than muscle. RESULTS: For readers 1 and 2, the accuracy of US in depicting fatty atrophy of SSP muscle was 75% (49 of 65) and 72% (47 of 65), sensitivity was 89% (eight of nine) and 100% (nine of nine), and specificity was 73% (41 of 56) and 68% (38 of 56), respectively. For readers 1 and 2, the accuracy of US in depicting fatty atrophy of ISP muscle was 85% (55 of 65) and 80% (52 of 65), sensitivity was 58% (11 of 19) and 63% (12 of 19), and specificity was 96% (44 of 46) and 87% (40 of 46), respectively. Overestimation of SSP muscle atrophy was more common (23% [15 of 65] for reader 1 and 28% [18 of 65] for reader 2) than underestimation (2% [one of 65] for reader 1 and 0% [0 of 65] for reader 2). For readers 1 and 2, overestimation of ISP muscle atrophy was 3% (two of 65) and 9% (six of 65) and underestimation was 12% (eight of 65) and 9% (seven of 65), respectively. Interobserver agreement was moderate for SSP (kappa = 0.55) and substantial for ISP (kappa = 0.71) muscles. CONCLUSION: US is moderately accurate in the diagnosis of substantial fatty atrophy of the SSP or ISP muscle.

Adipose Tissue↗
PubMed1988

Digital chest radiography: effect on diagnostic accuracy of hard copy, conventional video, and reversed gray scale video display formats.

Observer performance tests were conducted to compare the effects on diagnostic accuracy of hard copy (film) versus video display and to determine the diagnostic merits of conventional negative ("white bone") versus positive ("black bone") video displays. Subjective preferences were elicited from each observer for each display modality, and diagnostic accuracy was determined with receiver operating characteristic analysis. Digitized chest radiographs were used, including normal and abnormal cases with a variety of subtle abnormalities. The hard copy was printed with a 1,024 X 1,024-matrix by a high-quality drum scanner in conventional white bone format only. The video images were displayed on a 1,023-line monitor (30 Hz, interlaced) in both white bone and black bone formats with fixed window and brightness settings. Most observers preferred hard copy to video, but preferences were sharply divided between white bone and black bone video. Diagnostic accuracy was significantly greater with hard copy than with video display, and the conventional white bone format was significantly superior in accuracy to the black bone display.

Computer Systems↗
PubMed1990

Symptomatic lower extremity deep venous thrombosis: accuracy, limitations, and role of color duplex flow imaging in diagnosis.

Color duplex flow imaging (CDFI) permits pain- and risk-free direct imaging of the deep venous system of the lower extremities. To prospectively ascertain the accuracy and limitations of this technique, CDFI was performed in 75 lower limbs of 69 consecutive patients referred for venographic evaluation of clinically suspected lower extremity deep venous thrombosis (DVT). The CDFI study was obtained within 24 hours of the contrast venogram. Both studies were interpreted without knowledge of the patient's clinical findings or the results of the other test. Contrast venography was regarded as the standard for diagnosis of DVT. Accuracy was 99% for detection of DVT above the knee and 81% below the knee. Sonographic evaluation of the calf veins was technically adequate in 60% of limbs; accuracy was 98% in this group. In the 40% of limbs with technically limited CDFI studies of the calf, accuracy decreased to 57%. Although small nonocclusive thrombi occurred infrequently in this series of symptomatic patients, CDFI missed three of four such thrombi. It is concluded that CDFI, when not technically compromised, is sufficiently accurate to definitively diagnose symptomatic lower extremity DVT.

Adult↗
PubMed1992

Diagnosis of uterine anomalies: relative accuracy of MR imaging, endovaginal sonography, and hysterosalpingography.

The purpose of this study was to compare the relative accuracy of magnetic resonance (MR) imaging (n = 26), endovaginal sonography (EVS) (n = 14), and hysterosalpingography (HSG) (n = 20) in the classification of müllerian duct anomalies in 26 patients. There were 24 cases of surgically proved anomaly, and two patients had normal uteri (one with a vaginal septum). MR imaging allowed diagnosis of 24 of 24 cases (accuracy, 100%), and EVS was correct in 11 of 12 cases (accuracy, 92%). HSG was correct in only four cases. In the diagnosis of septate uterus, MR imaging demonstrated a sensitivity and specificity of 100% and EVS demonstrated a sensitivity of 100% and a specificity of 80%. Both MR imaging and EVS demonstrated a sensitivity and specificity of 100% in distinguishing those anomalies that did not require surgery. The high accuracy of MR imaging and EVS permit noninvasive differentiation of uterine anomalies and can spare women diagnostic laparoscopy, promoting cost-effective diagnosis.

Congenital Abnormalities↗
PubMed1995

Anterior cruciate ligament tear: prospective evaluation of diagnostic accuracy of middle- and high-field-strength MR imaging at 1.5 and 0.5 T.

PURPOSE: To compare the diagnostic efficacy of current-generation middle- and high-field-strength magnetic resonance (MR) imagers in the diagnosis of anterior cruciate ligament (ACL) tears. MATERIALS AND METHODS: In 114 of 230 patients referred for knee imaging, MR imaging at 0.5 and 1.5 T was performed with identical sequences but with a slightly longer total imaging time and bandwidth optimization at 0.5 T. Radiologists were blinded to diagnosis and field strength. Sensitivity, specificity, and accuracy were determined, and ACL tear was confirmed by means of arthroscopy and pathology. RESULTS: There was no difference between the field strengths in accuracy, sensitivity, or specificity for the diagnosis of ACL tears in 86 patients with disrupted ACLs and 28 patients with intact ACLs. Accuracy for all ACL tears was 90% at 0.5 T and 91% at 1.5 T. Similarly, there were no differences in diagnosis of meniscal tears (79 with, 149 without) or posterior cruciate ligament tears (seven with, 107 without). CONCLUSION: Higher field strength does not confer higher accuracy in the diagnosis of ACL tears at MR imaging.

Adolescent↗
PubMed1997

Pulmonary complications in children with hematologic malignancies: accuracy of diagnosis with chest radiography and CT.

PURPOSE: To determine the diagnostic accuracy of chest radiography and computed tomography (CT) in patients with complications during treatment for hematologic malignancies. MATERIALS AND METHODS: CT scans were obtained 1 week or less before bronchoscopic sampling or biopsy in 48 pediatric patients (age range, 8 months to 18 years at diagnosis) undergoing treatment for leukemia, lymphoma, or myeloproliferative disease. Radiographs were obtained less than 1 week before CT. Pulmonary complications comprised fungal (n = 11), viral (n = 4), and bacterial (n = 5) pneumonias; cryptogenic organizing pneumonia ([COP] n = 4); and pulmonary tumor (n = 4). Chest radiographs and CT scans were rated independently by three radiologists who were unaware of these diagnoses. RESULTS: Satisfactory diagnostic accuracy, defined by the area under the receiver operating characteristic (ROC) curve, was noted for fungal pneumonia (radiography, ROC area = 0.82; CT, ROC area = 0.78), COP (radiography, ROC area = 0.75; CT, ROC area = 0.75), and pulmonary tumor (radiography, ROC area = 0.73; CT, ROC area = 0.83). Generalizability was good for fungal pneumonia (radiography, generalizability coefficient [GC] = 0.84; CT, GC = 0.84) and COP (radiography, GC = 0.75; CT, GC = 0.99). There was no statistically significant difference in diagnostic accuracy between radiography and CT for any of the diagnoses. CONCLUSION: Radiography and CT have satisfactory accuracies for fungal pneumonia and COP. For these conditions, CT identified more true-positive cases than did radiography.

Adolescent↗