Dual-energy computed tomography for the diagnosis of acute gouty arthritis

2021 ◽  
Vol 17 ◽  
Author(s):  
Zengfa Huang ◽  
Zuoqin Li ◽  
Jianwei Xiao ◽  
Yuanliang Xie ◽  
Yun Hu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Gouty Arthritis ◽  
Dual Energy ◽  
Multicenter Studies ◽  
Acute Gouty Arthritis ◽  
Dual Energy Computed Tomography ◽  
Sensitivity Specificity

Aims: To investigate the diagnostic value of dual-energy computed tomography (DECT) in acute gouty arthritis (AGA) or patients presenting with suspected gouty arthritis. Methods: This retrospective study was performed in a single centre from May 2017 to August 2018. Two hundred and twenty-six patients with an initial diagnosis of AGA in the preceding 15 days were included. All patients were referred for a DECT scan of the affected joints. The diagnosis criteria of gout with the American College of Rheumatology Classification Standard were regarded as the reference standard. Results: Two hundred patients were included in the present study at last. The sensitivity, specificity, positive predictive value, and negative predictive value of DECT in the diagnosis of all AGA were 83.83%, 60.61%, 91.5% and 42.55% respectively. When AGA was subdivided according to the joint site, the sensitivity, specificity, positive predictive value, and negative predictive value were 80.68%, 61.11%, 91.03%, and 39.29% in feet, 93.55%, 40%, 93.55%, and 40% in knees and 87.5%, 71.43%, 91.3%, and 62.5% in ankles, respectively. Conclusions: DECT had a high sensitivity for the diagnosis of AGA. However, the specificity was limited, particularly for the diagnosis of acute gouty knee arthritis. Prospective multicenter studies of large samples will enhance the application of DECT among the AGA patients in the future.

Detection of local failures after management of nasopharyngeal carcinoma: a prospective, controlled trial

2008 ◽  
Vol 122 (11) ◽  
pp. 1230-1234 ◽  
Author(s):  
S M Ragab ◽  
F A Erfan ◽  
M A Khalifa ◽  
E M Korayem ◽  
H A Tawfik
Keyword(s):  
Computed Tomography ◽  
Nasopharyngeal Carcinoma ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
External Beam Radiotherapy ◽  
Reliability Coefficient ◽  
Histological Findings ◽  
Significant Agreement ◽  
Sensitivity Specificity

AbstractObjectives:To conduct a prospective study (1) to evaluate and compare the efficacies of nasopharyngeal endoscopy and computed tomography in the diagnosis of local failure of external beam radiotherapy for nasopharyngeal carcinoma, and (2) to assess whether multiple endoscopic nasopharyngeal biopsies are superior to a single, targeted biopsy, for the same purpose.Methods:Forty-six patients who had been treated with external beam radiotherapy for primary nasopharyngeal carcinoma were enrolled in the study. For every patient recruited, computed tomography, rigid nasopharyngeal endoscopy and nasopharyngeal biopsies were performed 12 weeks after radiotherapy.Results:Twelve weeks after treatment, six patients (13 per cent) had evident disease on histological examination of biopsies. Nasopharyngeal endoscopy showed a sensitivity, specificity, positive predictive value and negative predictive value of 66.6, 95, 66.6 and 95 per cent, respectively. There was statistically significant agreement between the endoscopic findings and the histological findings (Kappa reliability coefficient = 0.617, p < 0.01). Computed tomography showed a sensitivity, specificity, positive predictive value and negative predictive value of 50, 45, 12 and 85.7 per cent, respectively. There was no statistically significant agreement between the computed tomography findings and the histological findings (Kappa reliability coefficient = 0.021, p > 0.05). A targeted, single biopsy performed under endoscopic control demonstrated excellent sensitivity, specificity, positive predictive value and negative predictive value, being 83.3, 100, 100 and 97.5 per cent, respectively. The Kappa test showed a very statistically significant agreement between the histological findings for the single and the multiple endoscopic biopsies (Kappa reliability coefficient = 0.897, p < 0.001).Conclusions:Rigid nasopharyngeal endoscopy should be considered the primary follow-up tool after radiotherapy treatment of nasopharyngeal carcinoma, with computed tomography being reserved for patients with histological or symptomatic indications. Routine postnasal biopsies are not necessary, given the excellent specificity and negative predictive value of rigid nasopharyngeal endoscopy. Single, targeted endoscopic biopsy provides an excellent alternative to the usual multiple biopsies. In addition, it reduces cost, time, morbidity and patient discomfort.

scholarly journals Computed tomography versus ureteroscopy in identification of renal tract stone with ureteral stent in situ

2011 ◽  
Vol 93 (8) ◽  
pp. 639-641 ◽  
Author(s):  
VCY Tang ◽  
A Attwell-Heap
Keyword(s):  
Computed Tomography ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Ureteral Stent ◽  
The Difference ◽  
Contrast Ct ◽  
Sensitivity Specificity

INTRODUCTION The aim of this study was to validate the use of non-contrast computed tomography (CT) with a ureteral stent in situ instead of ureteroscopy for identification of renal tract stones. METHODS All patients who had stents inserted for renal tract stones and underwent non-contrast CT with the stent in situ followed by ureteroscopy between May 2008 and October 2009 at The Canberra Hospital, Australia, were analysed retrospectively. Statistical analysis was performed to compare any differences between CT and ureteroscopy in the identification of stones. RESULTS Overall, 57 patients were included in the study. The difference between CT and ureteroscopy findings was statistically significant. CT identification of stones with a stent in situ had a sensitivity of 86%, a specificity of 46%, a positive predictive value of 63%, a negative predictive value of 76% and an accuracy of 67%. CONCLUSIONS Our study suggests that non-contrast CT is inferior to the ‘gold standard’ of ureteroscopy. It lacks sensitivity, specificity, positive predictive value, negative predictive value and accuracy. Therefore, we cannot recommend using non-contrast CT to replace ureteroscopy.

The application of dual-energy computed tomography in the diagnosis of acute gouty arthritis

2014 ◽  
Vol 33 (7) ◽  
pp. 975-979 ◽  
Author(s):  
Huaxiang Wu ◽  
Jing Xue ◽  
Lu Ye ◽  
Qijing Zhou ◽  
Dan Shi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Gouty Arthritis ◽  
Dual Energy ◽  
Acute Gouty Arthritis ◽  
Dual Energy Computed Tomography

scholarly journals Accuracy of Ultrasound Scanning in Diagnosing Acute Appendicitis in Patients Admitted at Vicente Sotto Memorial Medical Center

2020 ◽  
Vol 3 (2) ◽  
pp. 134-139
Author(s):  
Uma Gurung ◽  
Dhiraj Gurung
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Medical Center ◽  
Diagnostic Tools ◽  
Advantages And Disadvantages ◽  
Sensitivity Specificity ◽  
Suspected Acute Appendicitis

Introduction: Acute appendicitis is the most common abdominal surgical emergency. Both abdominal ultrasonography and computed tomography are common diagnostic tools in its diagnosis with each having its own advantages and disadvantages. Methods: Patients of suspected acute appendicitis were evaluated with an ultrasound to see the sensitivity, specificity, positive and negative predictive value of ultrasound for intraoperative appendicitis diagnosis. The study included 113 patients of suspected acute appendicitis presenting in the emergency during a one year duration. Sensitivity, specificity, positive predictive value and negative predictive value was calculated from their respective formulae. Results: The majority of the patients were male patients between the age group of 18 to 30. The sensitivity of ultrasound for diagnosis of acute appendicitis was 96% and specificity was 33%. The positive predictive value was 98% and the negative predictive value was 20% Conclusion: Ultrasound has good sensitivity and the low cost along with no radiation exposure makes this an acceptable screening investigative modality though due to low specificity, it would be recommended to go for a computed tomography scan if ultrasound shows negative result for appendicitis.  

scholarly journals Detection of Coronary Artery Diseases: Comparative Study of Multidetector Computed Tomography Angiogram (64 slice scanner) and Conventional Angiogram

2012 ◽  
Vol 4 (2) ◽  
pp. 120-126
Author(s):  
M Shirin ◽  
SA Azad ◽  
M Rahman ◽  
S Dina ◽  
E Karim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Positive Predictive Value ◽  
Comparative Study ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Vessel Disease ◽  
Triple Vessel Disease ◽  
Sensitivity Specificity

Background: Multislice computed tomography (MDCT) is a promising noninvasive method of detecting coronary artery disease. It is not yet being widely used in Bangladesh. We aimed to assess the diagnostic accuracy of the of 64 slice CT in detecting CAD with reference to conventional coronary angiography. Methods: It was cross sectional comparative study conducted in National Institute of Cardiovascular Diseases and Bangabandhu Sheikh Mujib Medical University. Total 80 patients were included in the study who underwent MDCT and coronary angiogram. Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy or efficacy for single vessel disease were 87.5%, 96.4%, 91.3%, 94.7% and 93.75% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy or efficacy for double vessel disease were 84.0%, 94.5%, 87.5%, 92.85% and 91.25% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy or efficacy for triple vessel disease were 69.5%, 91.22%, 76.19%, 88.13% and 85.0% respectively. Conclusion: Coronary angiography is a promising technology that already appears to have high performance to assess patient base, vessel base and segment base sensitivity, specificity, positive predictive value, negative predictive value and accuracy in detecting coronary artery stenosis. DOI: http://dx.doi.org/10.3329/cardio.v4i2.10455 Cardiovasc. j. 2012; 4(2): 120-126

Accuracies of Diagnostic Methods for Acute Appendicitis

2013 ◽  
Vol 79 (1) ◽  
pp. 101-106 ◽  
Author(s):  
Jong Seob Park ◽  
Jin Ho Jeong ◽  
Jong In Lee ◽  
Jong Hoon Lee ◽  
Jea Kun Park ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Physical Examination ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Negative Appendectomy ◽  
Pathologic Findings ◽  
Negative Appendectomy Rate ◽  
Sensitivity Specificity

The objectives were to evaluate the effectiveness of ultrasonography, computed tomography, and physical examination for diagnosing acute appendicitis with analyzing their accuracies and negative appendectomy rates in a clinical rather than research setting. A total of 2763 subjects were enrolled. Sensitivity, specificity, positive predictive value, and negative predictive value and negative appendectomy rate for ultrasonography, computed tomography, and physical examination were calculated. Confirmed positive acute appendicitis was defined based on pathologic findings, and confirmed negative acute appendicitis was defined by pathologic findings as well as on clinical follow-up. Sensitivity, specificity, positive predictive value, and negative predictive value for ultrasonography were 99.1, 91.7, 96.5, and 97.7 per cent, respectively; for computed tomography, 96.4, 95.4, 95.6, and 96.3 per cent, respectively; and for physical examination, 99.0, 76.1, 88.1, and 97.6 per cent, respectively. The negative appendectomy rate was 5.8 per cent (5.2% in the ultrasonography group, 4.3% in the computed tomography group, and 12.2% in the physical examination group). Ultrasonography/computed tomography should be performed routinely for diagnosis of acute appendicitis. However, in view of its advantages, ultrasonography should be performed first. Also, if the result of a physical examination is negative, imaging studies after physical examination can be unnecessary.

Acute Appendicitis - Study of Role of Ultrasound and CT Scan in Decision Making for Surgery in a Tertiary Care Government Hospital in Eastern India

2021 ◽  
Vol 8 (33) ◽  
pp. 3048-3053
Author(s):  
Jainendra Kumar ◽  
Akriti Komal
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Imaging Modality ◽  
Tertiary Care ◽  
Accurate Diagnosis ◽  
Final Decision ◽  
Sensitivity Specificity

BACKGROUND Acute appendicitis (AA) is one of the commonest causes of acute abdominal emergencies. Accurate diagnosis and earlier surgery is imperative in such cases. Ultrasonography (US), and computed tomography (CT), are main stays accurate diagnosis of this disease. This study was conducted to compare the accuracy of US and CT in the diagnosis of AA and reduce number of negative appendectomies. METHODS This prospective study was done after approval from institutional ethical committee and obtaining written consent. 164 patients with clinical features suggestive of AA, were selected from emergency department of Patna Medical College, Patna India during the period from January 2019 to December 2020. 98 were males and 66 females, mean age being 18.08 years. 142 patents (86.58 %) underwent surgery, and 22 patients (13.41 %) were kept on clinical observation in hospital after imaging. After detailed clinical workup and laboratory investigations, all patients were subjected to both US and CT examination. Each patient was reevaluated clinically, and a clinical correlation was done between both sets of results. Based on these, final decision was made. Accuracy was decided based on intra-operative findings in appendectomy group and were correlated with imaging findings later with histopathologic findings. RESULTS Males outnumbered females, abdominal pain was present in 100%. The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of US in diagnosis of AA in our study were 92.6 %, 76.4 %, 95.3%, 71.0% and 88.9 % respectively. The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of CT in diagnosis of AA were 99.1 %, 90.5 %, 98.6%, 87.8% and 97.8 % respectively. CONCLUSIONS US should be the first-line imaging modality as it is free from radiation. CT is recommended as additional imaging tool to raise accuracy in diagnosis except in pregnancy and selected pediatric patients. KEYWORDS Acute Appendicitis, Computed Tomography, Ultrasound

scholarly journals Foundational Statistical Principles in Medical Research: Sensitivity, Specificity, Positive Predictive Value, and Negative Predictive Value

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 503
Author(s):  
Thomas F. Monaghan ◽  
Syed N. Rahman ◽  
Christina W. Agudelo ◽  
Alan J. Wein ◽  
Jason M. Lazar ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Medical Literature ◽  
Disease Prevalence ◽  
Positive Test Result ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Test Result ◽  
Test Probability

Sensitivity, which denotes the proportion of subjects correctly given a positive assignment out of all subjects who are actually positive for the outcome, indicates how well a test can classify subjects who truly have the outcome of interest. Specificity, which denotes the proportion of subjects correctly given a negative assignment out of all subjects who are actually negative for the outcome, indicates how well a test can classify subjects who truly do not have the outcome of interest. Positive predictive value reflects the proportion of subjects with a positive test result who truly have the outcome of interest. Negative predictive value reflects the proportion of subjects with a negative test result who truly do not have the outcome of interest. Sensitivity and specificity are inversely related, wherein one increases as the other decreases, but are generally considered stable for a given test, whereas positive and negative predictive values do inherently vary with pre-test probability (e.g., changes in population disease prevalence). This article will further detail the concepts of sensitivity, specificity, and predictive values using a recent real-world example from the medical literature.

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