Placental MRI: Identification of radiological features to predict placental attachment disease regardless of reader expertise
Jeries Paolo ZawaidehSusan FreemanJanette SmithAnnemarie BruiningTimothy J SadlerLuca CarmiscianoHelen Addley
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Objective: To assess the diagnostic accuracy of rapid diagnostic kits test for diagnosis of malaria taking microscopy as gold standard Methodology: A total of 375 cases with age range 18-65 years of either gender as suspected for malaria were included in the study. We excluded all those cases already taking anti-malarial drugs. The study was conducted at Chughtais Lahore Lab, Lahore. Required blood sample were obtained following aseptic measures. Malaria RDT SD Bioline Malaria Antigen Pf/Pan (Catalogue No. 05FK60, Standard Diagnostics Inc, Hagal-Dong, Korea, from now on referred as “SD RDT”) was used. Patients were labeled as positive or negative on the basis of reports from hematology department assessed by microscopy and patients were labeled as positive or negative Results: The mean age of the patients was 41.84±13.44 years, male to female ratio of the patients was 1.01:1. The sensitivity, specificity, and diagnostic accuracy of the RDT for diagnosing malaria was 96.79%, 96.28% and 96.53% respectively taking microscopy as gold standard Conclusion: Rapid diagnostic kits is very useful reliable test with high diagnostic accuracy for diagnosis of malaria taking microscopy as gold standard Keywords: Microscopy, Rapid Diagnostic kits, Malaria,
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Rapid diagnostic test
Diagnosis of malaria
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Malaria infection is the most common diagnosis made in Africa. Efficient diagnosis of malaria parasite is very vital for treatment of malaria infection. The efficacy of rapid diagnostic tests (RDTs) in comparison to microscopy, the gold standard, in the diagnosis of malaria in Nigeria has not been fully ascertained. This study compared the sensitivity, specificity and predictive values of RDTs available in Nigeria market with microscopy. Two RDT kits were used and their results were compared with the gold standard, microscopy using thick and thin blood films (TBF and tBF). TBF had sensitivity of 85%, specificity of 30%, positive predictive value (PPV) of 55.2%, and negative predictive value (NPV) of 66.6%; tBF had sensitivity of 80%, specificity of 35%, positive predictive value (PPV) of 55.2%, and negative predictive value (NPV) of 63.6%. Among the RDTs, Care Start HRP2 kit had sensitivity of 65%, specificity of 50%, positive predictive value (PPV) of 56.5%, and negative predictive value (NPV) of 59% while SD Bioline kit had sensitivity of 55%, specificity of 65%, PPV of 61%, and NPV of 59%. It can thus be inferred that rapid diagnostic test kits are not as sensitive as microscopy in diagnosis of malaria parasite, but they are more accurate and are thus suitable alternatives to microscopy.
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Positive predicative value
Diagnosis of malaria
Rapid diagnostic test
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INTRODUCTION: It is very important to find a a non invasive, less time consuming and relatively easy modality,
non operator dependent and available even remote areas for the common bile duct stones (choledocolithiasis) in
symptomatic patients. Instant diagnosis will lead to prompt decision making for treatment strategies that will
ultimately decrease the morbidity.
OBJECTIVE: To determine the diagnostic accuracy of ultrasonography in detection of Choledocholithiasis in
suspected patients taking intraoperative findings as gold standard.
STUDY DESIGN: Descriptive Cross sectional Study
SETTING: Department of Radiology, Jinnah postgraduate Medical Center, Karachi
DURATION: Six months study from Feb 2020 onwards.
SUBJECTS AND METHODS: All patients with age 30-60 years of either gender having clinically suspected with
duration of symptoms of more than or equal to 7 days were enrolled. The ultrasound was performed and presence of
CBD diameter of > 7 mm on US was taken as CBD stones. Presence of CBD stones intra operatively was noted.
RESULTS: Mean age of the patients was 51.29 ±7.03 years. There were 75 (62%) females and 46 (38%) males.
Overall diagnostic accuracy of ultrasonography was found to be 89.25%. Sensitivity was found to be 80.48%,
specificity 93.75%, PPV 86.84% and NPV 90.36%.
CONCLUSION: The diagnostic accuracy of ultrasonography was found satisfactory in detection of
Choledocholithiasis in suspected patients taking intraoperative findings as gold standard.
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Objective: to evaluate the diagnostic accuracy of FACT in clinically suspected cases of Acute Appendicitis in adolescents and adults, taking surgical findings as gold standard. Methods: A total of 335 patients referred from emergency department with clinical suspicion of acute appendicitis were enrolled at Radiology Department, Services Hospital Lahore, from April, 2016 to October, 2016. FACT was performed using multi-slice CT. The cases underwent surgery and the results were recorded. The results of Focused Abdominal Computed Tomography and surgery were compared taking surgical findings as gold standard. Results: The mean age of patients in our study was 23.01 ± 5.479. We found 278 true-positives, 50 true-negatives, 04 false-negatives results, with sensitivity of 98.6%, a specificity of 94.3%, a PPV of 98.9%, a NPV of 92.6%, and an accuracy of 98%. An alternate diagnosis was made by FACT in 40 patients (11.9%). Conclusion: FACT (focused non-enhanced abdominal computed tomography) is a highly accurate imaging modality for diagnosis of acute appendicitis in adolescents and adults. Keywords: Focused Abdominal CT, Acute Appendicitis, FACT, Diagnostic Acuuracy
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Objective: To determine the diagnostic accuracy of colour Doppler ultrasound using twinkling artefact for the diagnosis of renal and ureteric calculi keeping non enhanced CT KUB as gold standard.
Study Design: Cross sectional study.
Place and Duration of Study: Departments of Diagnostic Radiology, HIT Hospital Taxila Cantt and Akbar Niazi Teaching Hospital, Islamabad, from Jan to Jun 2020.
Methodology: The sample size of 320 patients was calculated using WHO Calculator. Non probability consecutive sampling was used for recruitment of patients. It comprised patients between ages 12-60 years irrespective of gender presenting with acute flank pain. All patients underwent colour Doppler ultrasound and subsequently CT-KUB analysis (gold standard) to determine the diagnostic accuracy of twinkling artefact on colour Doppler imaging. Data was collected on prescribed proforma and analysed using SPSS-17. Chi-square test and ROC curve analysis were used for diagnostic accuracy measurement.
Results: Study results showed that twinkling artefact on colour Doppler had a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 91.2%, 95.7%, 98.7%, 75.2% and 92.2% respectively. Likelihood ratio for positive test was 21.8.
Conclusion: Twinkling artefact on colour Doppler allows detection of renal and ureteric calculi with reasonable accuracy and can be used as an alternative tool in settings where CT scan cannot be done.
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Doppler ultrasound
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Acute appendicitis is the most common surgical abdominal emergency. Its clinical diagnosis remains a challenge to surgeons, so different imaging options were introduced to improve diagnostic accuracy. Among these imaging modality choices, diagnostic medical sonography (DMS) is a simple, easily available, and cost effective clinical tool. The purpose of this study was to assess the accuracy of DMS, in the diagnosis of acute appendicitis compared to the histopathology report, as a gold standard. Between May 2015 and May 2016, 215 patients with suspected appendicitis were examined with DMS. The DMS findings were recorded as positive and negative for acute appendicitis and compared with the histopathological results, as a gold standard. In all, 173 patients were correctly diagnosed as having acute appendicitis by DMS out of 200 cases, with a final histopathologic result. Similarly, DMS revealed 13 normal appendices out of 15 nonappendicitis patients. This demonstrated that DMS has a sensitivity of 86.5%, specificity of 86.6%, positive predictive value of 99.8%, negative predictive value of 32.5%, and overall accuracy of 86.5%. These results suggest that DMS may be an accurate, sensitive, and specific tool for diagnosing acute appendicitis and reducing unnecessary appendectomies. DMS should be considered as a credible imaging modality for diagnosing acute appendicitis.
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Histopathology
Surgical emergency
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Background: Patients with infectious diseases often require the use of microbiologic diagnostic tests. Predictive value of tests are used to describe the usefulness of a diagnostic test in a specific setting. Sometimes an acceptable Gold standard is lacking making it difficult to evaluate the usefulness of a new diagnostic test.
Aims Of Study/project: Describe how predictive value of tests can be calculated despite the absence of an acceptable Gold Standard. Also to describe how to account for asymptomatic carriers.
Methods: Mathematical derivation shows that information from a healthy control population can, for most scenarios, be used to calculate predictive value of tests despite the absence of a Gold Standard.
Results: Rules for how the usefulness of diagnostic tests can be estimated in the absence of a Gold Standard. The new statistical method considers the influence asymptomatic carriers will have on the diagnostic process. These rules are especially suited for evaluating microbiologic diagnostic tests but can be used also in other scenarios.
Conclusions/ Recommendations: The existing Gold Standard should always be challenged when evaluating a new diagnostic test. Etiologic Predictive Value offers an alternative to comparing the new test with a conventional Gold Standard.
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Value (mathematics)
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Objective: To assess the diagnostic accuracy of magnetic resonance imaging (MRI) in detecting invasive placentas using per-operative findings as the gold standard.Methodology: A prospective cross-sectional study was conducted in the diagnostic radiology department of KRL General Hospital Islamabad during Oct 2019 to Sep 2021. Sixty prenatal individuals were identified as having a high risk of invasive placenta and underwent MRI (Phillips 1.5 T) to confirm the diagnosis. A trainee radiologist and a consultant radiologist reviewed the images. The MRI's sensitivity, specificity, positive predictive value, negative predictive value, and accuracy was calculated using a 2×2 contingency tables. Results: Ten cases of invasive placenta were detected postoperatively (gold standard). The MRI had a sensitivity of 90%, a specificity of 93%, a positive predictive value of 90%, a negative predictive value of 90%, and an accuracy of 92.3 percent, respectively. Conclusion: The study concluded that magnetic resonance imaging (MRI) offers a good diagnostic accuracy and is a reproducible technology for prenatal identification of invasive placentas.
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Positive predicative value
Contingency table
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ABSTRACT Introduction; Magnetic resonance imaging (MRCP) has been used as non-invasive technique for diagnosing common bile duct stones. Rationale of this study was to gather data about MRCP in our settings to develop our local guidelines for early and non-invasive diagnosis of common bile duct stones. This will help in early initiation of definitive therapy in these patients. Objectives; To determine diagnostic accuracy of MRCP for detection of choledocholithiasis in obstructive jaundice patients taking surgical findings as gold standard. Materials and methods; It is a Cross-sectional (validation) study of six months duration. Study was performed in department of Diagnostic Radiology. MRCP of 125 patients of either gender with age between 20-60 years who had clinical and laboratory evidence of obstructive jaundice, was performed. MRI machine of 1.5Tesla was used. MRCP results were correlated with surgical findings. Sensitivity, specificity, PPV, NPV and overall accuracy was calculated. Results; 36.0% (n=45) patients were males and 64.0% (n=80) were females. 72.0 % (n=90) of patients were positive on MRCP and 74.4% (n=93) of patients were positive on surgery. Sensitivity, specificity, PPV, NPV and accuracy were found to be 94.6%, 93.8%, 97.8%, 85.7% and 94.4% respectively. Conclusions : MRCP allows non-invasive detection of common bile duct stones with excellent accuracy. KEY WORDS: Choledocholithiasis, obstructive jaundice, MRCP.
Magnetic resonance cholangiopancreatography
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Obstructive jaundice
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Objective: To determine the diagnostic accuracy of USG and CT compared with MRCP in the patients with obstructive jaundice considering ERCP as the gold standard Methodology: This cross-sectional study at Mayo Hospital, Lahore, spanned 6 months and included 71 cases meeting predefined criteria. A senior radiologist prepared all reports. The study used preliminary ultrasound, CECT abdomen, and MRCP for patients with cholestatic jaundice, comparing results with ERCP. MRCP showed higher diagnostic accuracy. Results: MRCP proved to be the most accurate in diagnostic accuracy. Its sensitivity and specificity for benign conditions were 94.87% and 93.75% while for CT it was 87.18% and 81.25% and for USG it was 84.62% and 90.63% respectively. For malignant conditions sensitivity and specificity for MRCP was 93.75% and 97.44% for CT it was 87.5% and 92.31% and for USG it was 81.25% and 89.74% respectively. Conclusion: The results of this study demonstrate that MRCP is a superior modality, exhibiting higher sensitivity, specificity, and diagnostic accuracy for evaluating both malignant and benign conditions in patients with obstructive jaundice compared to USG and contrast-enhanced CT. MRCP's specificity for various etiologies matches that of ERCP, which is considered the gold standard. While MRCP's cost and availability may be a concern, its non-invasiveness, contrast-free nature, and high diagnostic accuracy make it an ideal choice for evaluating patients with obstructive jaundice.
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Obstructive jaundice
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