Detection Rate Of CT Research Articles

Multi-site DNA methylation alterations of peripheral blood mononuclear cells serve as novel biomarkers for the diagnosis of AIS/stage I lung adenocarcinoma: A multi-center cohort study.

Early diagnosis remains an obstacle for improving the outcome of lung adenocarcinoma (LUAD). DNA methylation changes in peripheral blood mononuclear cells (PBMCs) could reflect immune response to tumorigenesis, providing the theoretical basis for early cancer diagnosis based on immune cell profiling. This multi-center study evaluated the DNA methylation patterns based on PBMCs samples from 1115 individuals at nine medical centers. Genome-wide DNA methylation profiling of PBMCs in a discovery cohort (35 LUAD patients and 50 healthy controls) was performed using Illumina 850K microarray. Candidate differentially methylated CpG positions (DMPs) were selected and validated in a two-step DMPs screening cohort (65 LUAD patients and 80 healthy controls) by pyrosequencing and multiple target region methylation enrichment sequencing (MTRMES). Then, an early LUAD Diagnostic Panel (LDP score) based on multi-site methylation-specific chip-based digital PCR was constructed in a training set and then confirmed in a validation set from the LDP score development cohort (389 AIS/stage I LUAD patients and 293 healthy controls). Besides, we included 157 other cancer patients, including 52 gastric cancer (GC) patients, 50 breast cancer (BC) patients, and 55 colorectal cancer (CRC) patients to assess the specificity of LDP score. In addition, we also evaluated the early warning ability of LDP score for LUAD in a prospective cohort (46 people who were at high-risk of developing LC). A total of 1415 LUAD-specific DMPs were identified. Then, six DMPs were selected for validation and three DMPs were finally verified. The LDP score was constructed by combining the three DMPs, age, and gender, and showed an AUC of 0.916, sensitivity of 88.17%, and specificity of 80.20% in combined set, outperforming traditional methods, such as CEA and CT (detection rate: 87.79% vs. 4.69%; 87.79% vs. 35.21%). This diagnostic performance was confirmed in sub-types of LUAD with clinical challenges, such as 6-20mm LUAD (AUC: 0.914, 95%CI: 0.889-0.934) and ground-glass nodules (AUC: 0.916, 95%CI: 0.889-0.938). Importantly, our LDP score had significant improvement in terms of selecting high-risk individuals who should receive low-dose computed tomography (87.80% vs. 9.28%). Remarkably, LDP score could predict LUAD around two years before clinical diagnosis in our prospective cohort. The novel developed LDP score represented a convenient and effective assay for the detection of AIS/stage I LUAD with high sensitivity and specificity, and had demonstrated unique advantages over traditional detection methods.

Comparison of MRI and CT Scan for the Detection of Liver Cancer.

The objective of the paper was to compare the value of CT and MRI in the diagnosis of primary carcinoma of the liver. A retrospective analysis was performed on 132 cases of suspected primary liver carcinoma. CT and MRI diagnosis were performed and pathological results were compared to determine the diagnostic value of the two methods. 96 cases were diagnosed as primary liver carcinoma by pathological examination after operation. The total detection rate of 96 lesions through MRI was 93.75%, while 84.38% through CT (P<0.05). For lesions with a <3 cm diameter, the CT detection rates of lesions in the plain, arterial, portal, and equilibrium phases were 52.94%, 73.53%, 58.82%, and 58.82% respectively. For lesions with a diameter ≥ 3 cm, the CT detection rate was 80.65 %, 93.55%, 85.48%, and 83.87%, respectively (P<0.05). For lesions with <3cm diameter, the MRI detection rates of lesions in the T1WI, T2WI, LAVA arterial phase, LAVA portal phase, and LAVA balance phase were 61.76%, 76.47%, 88.24%, 79.41%, and 52.94%, respectively, and for lesions with ≥3cm diameter, the detection rates of MRI were 77.42%, 87.10%, 91.94%, 90.32%, and 90.32%, respectively, and the detection rate of lesions with ≥3cm diameter in the balance phase of LAVA was higher (P<0.05). Taking pathological results as the gold standard, the sensitivity of diagnosing primary liver carcinoma through CT is 81.25%, specificity is 75.00%, accuracy is 79.55%, the positive predictive value is 89.66%, the negative predictive value is 60.00%, and the values of the same parameters for the MRI are 93.75. %, 86.11%, 91.67%, 94.74%, and 83.78% respectively. Both CT and MRI have diagnostic value for primary liver carcinoma. The comparison showed that MRI has a higher diagnostic value and higher detection rate for small lesions. However, the actual process of diagnosis cannot rely solely on MRI, and a comprehensive combination of diagnosis methods will be effective.

Role of 18F-fluorodeoxyglucose PET/computed tomography in the diagnosis and treatment response assessment of primary bone lymphoma.

Primary bone lymphoma (PBL) is a rare type of extranodal lymphoma, and the clinical application value of 18F-fluorodeoxyglucose PET/computed tomography ( 18 F-FDG PET/CT) in PBL has not been fully evaluated. This study aimed to determine the imaging characteristics of PBL and investigate the value of 18 F-FDG PET/CT parameters. A total of 25 patients with PBL who underwent PET/CT examination before treatment were included in this study. The clinicopathological parameters and PET/CT parameters were analyzed. Among the 25 patients, 7 patients had single lesions, 15 patients had nonsingle lesions (≥2) and 3 patients had diffuse distribution in the medullary cavity. The bone destruction types included osteolytic, osteogenic, normal density, mixed lytic and osteogenic. All patients showed increased FDG uptake, and the CT detection rate was 88%. Five patients underwent PET/CT assessment mid-treatment, and when assessed using the Deauville five-point scale, four patients were PET-negative and one patient was PET-positive. There were two PET-positive and three PET-negative patients when assessed using the Δ maximum standardized uptake value (SUV max ) method. Six patients underwent PET/CT imaging at the end of treatment. When assessed using the Deauville five-point scale, five patients (83%) were PET-negative and one patient (17%) was PET-positive. The same results were obtained when evaluated by the ΔSUV max method. PET/CT plays a substantial role in the diagnosis and treatment efficacy evaluation of PBL, and it should be recognized by clinicians and radiologists. Changes in metabolic parameters such as SUV, metabolic tumor volume and total lesion glycolysis have considerable potential for application in PBL diagnostics and treatment efficacy evaluation.

Patterns and Timing of Recurrence following CRS and HIPEC in Colorectal Cancer Peritoneal Metastasis.

Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS/HIPEC) is an established treatment of Colorectal Peritoneal Metastases (CRPM). This study aims to determine the timing and patterns of recurrent disease on imaging following complete CRS/HIPEC. Retrospective analysis of a national peritoneal tumour service database identified CRPM patients with complete CRS/HIPEC(CC0) from 2005 to-2018. Patients with<2 years follow-up or and those where post-operative histology from the CRS/HIPEC procedure did not confirm CRPM from their original colorectal cancer were excluded. Time to recurrence was measured from surgery to first radiologically illustrated recurrence. CT was the primary modality used, supplemented by PET-CT or MRI if required. Outcomes of interest were survival data (including overall survival (OS), disease-free survival (DFS) and peritoneal-recurrence free survival (PRFS)), timing and patterns of recurrent disease. 146 of the 176 patients identified were eligible for inclusion. Median OS for all study patients was 45.2 months (95% CI 38-53 months), median DFS was 11.7 months (95% CI 9-14 months), and median PRFS was 25.2 months (95% CI 14.7-30 months). Recurrent disease was seen in 112 cases (77%), radiologically classified as intraperitoneal in 50 patients (44%), single site systemic in 21 patients (19%) and multi-site in 41 patients (37%). CT detection rate for disease recurrence was 88%. Subgroup analyses showed that PCI ≥12, positive nodal primary disease and synchronous peritoneal disease were associated with worse outcomes. Patients selected for CRS/HIPEC for CRPM have an OS>45 months, with the majority recurring systemically within a year. Peritoneal recurrence is a later event after several years. Surveillance programs in this group should be most intensive in the first 2 years after surgery, using CT with oral and intravenous contrast.

Imaging observation and analysis of condylar osteosclerosis in temporomandibular joint osteoarthrosis

Objective: To observe the different imaging manifestations of condylar sclerosis in temporomandibular joint osteoarthrosis and explore the imaging significance of condylar sclerosis. Methods: From January 2018 to December 2020, 50 patients with temporomandibular joint condylar sclerosis were examined by cone-beam CT (CBCT) and underwent spiral CT, MRI and radionuclide bone imaging at the Department of Oral and Maxillofacial Surgery in General Hospital of Chinese PLA. There were 15 males and 35 females aged from 16 to 65 years with age of (42.7±14.5) years. The imaging manifestations of CBCT, spiral CT, MRI and radionuclide bone imaging, joint disc displacement and abnormal bone metabolism of condylar sclerosis were analyzed. And the area of condylar sclerosis was graded according to the image of CBCT. Results: A total of 50 patients were included, including 38 unilateral condylar sclerosis, 12 patients with bilateral condylar sclerosis, the total condylar sclerosis were 66. There was no significant difference between the detection rate of further spiral CT (95.5%, 63/66) and CBCT (100.0%, 66/66) (corrected χ²=1.36,P=0.244). The area of condylar sclerosis was (35.5±4.5) mm2, ranged from 1 to 100 mm2. In addition, spiral CT showed more clearly condylar sclerosis than CBCT. Sclerosis can occur in all parts of condyle, mainly in the upper middle region (68.2%,45/66) in coronal position and in the upper front region (71.2%,47/66) in sagittal position. Fifty-seven condylar sclerosis were detected by MRI, including 4(4/19) condylar sclerosis less than 4 mm2. There was significant difference in the displacement of temporomandibular joint disc between the sclerotic side and the non sclerotic side (χ²=10.09, P=0.006). MRI display the condylar sclerosis showed low signal (56/62), followed by high signal (5/62) and medium signal (1/62). Radionuclide bone imaging showed that 4 of the 38 patients with unilateral condyle sclerosis had symmetrical bone metabolism, 34 had abnormal bone metabolism, and 21 patients had concentrated on the non-sclerotic side. Radionuclide bone imaging showed that 4 of the 38 patients with unilateral condyle sclerosis had symmetrical bone metabolism and 34 had abnormal bone metabolism. Conclusions: Spiral CT is more accurate than CBCT in terms of condyle sclerosis through different imaging analysis, and the detection rate of both is higher than MRI. Most of condylar sclerosis showed different degrees of low signal on MRI. The condylar sclerosis side is usually manifested by abnormal bone metabolism.

Application of spectral CT combined with perfusion scan in diagnosis of pancreatic neuroendocrine tumors

BackgroundPancreatic neuroendocrine tumors (pNETs) are heterogeneous tumors from the pancreatic neuroendocrine system, and early diagnosis is important for tumor prognosis and treatment. In this study, we aimed to explore the diagnostic value of spectral CT combined with perfusion scanning in improving the detection rate of pNETs.MethodsFrom December 2018 to December 2020, 58 patients with clinically suspected pNETs were prospectively enrolled in the study for one-stop spectral CT combined with perfusion scanning, 36 patients were confirmed with pNETs by histopathology. An independent cohort of 30 patients with pNETs who underwent routine pancreatic perfusion scanning in our hospital during the same period were retrospectively collected. The image characters of pNETs versus tumor-free pancreatic parenchymal were examined.ResultsThe detection rate of spectral CT combined with perfusion was 83.1–96.2%. CT values of the pNETs lesions under each single energy in the arterial phase were statistically higher than those of the adjacent normal pancreatic parenchyma. IC, WC and NIC, in the arterial phase of pNETs lesion were all statistically higher than those of the adjacent normal pancreatic parenchyma. The perfusion parameters of pNETs including BF, BV and MSI were significantly higher than those in normal parenchyma. The average effective radiation dose during the perfusion combined energy spectrum enhanced scanning process was 17.51 ± 2.18 mSv.ConclusionThe one-stop spectral CT combined with perfusion scan improves the detection of pNETs according to morphological features, perfusion parameters and energy spectrum characters with a relatively small radiation dose.

Carcinoma of Unknown Primary (CUP) versus CUP Turned to Primary Carcinoma of the Head and Neck-An Analysis of Diagnostic Methods and the Impact of Primary Tumor on Clinical Outcome.

Background. The purpose of this study was to analyze the value of different diagnostic methods in detecting the primary site and the impact of primary tumors on the clinical outcome of carcinoma of unknown primary (CUP). Methods. In this multicenter, retrospective study, 124 patients with true CUP (n = 94) and CUP turned to primary carcinoma (n = 30) were included. Patients with evidence of primary site during the clinical examination were excluded a priori. The diagnostic procedure was comprised of imaging and invasive methods (fine-needle-aspiration, tonsillectomy and panendoscopy). All patients were treated with curative intent. Results. Despite extensive diagnostic workup, the primary site remained unknown in 75.8%. Invasive diagnostic methods showed higher primary detection rates than imaging modalities (15.1% vs. 7.8%). Tonsillectomy and panendoscopy revealed the primary tumor in 14.9% and 15.2% of patients, whereas the detection rates of CT, MRI and FDG-PET-CT were 10.1%, 4.8% and 6.5%, respectively. The occurrence of primary tumors led to a significantly deteriorating 5-year overall survival (p = 0.002) and emerged as survival prognosticator (HR = 2.764, p = 0.003). Conclusion. Clinical examination in combination with tonsillectomy and panendoscopy was superior to imaging alone in detecting the primary tumor. When the CUP of patients turned to a primary tumor, clinical outcome was significantly worse than in CUP patients.

Application of SPECT combined with CT and MRI in malignant tumors Clinical value in the diagnosis of bone metastasis

Objective：To evaluate the value of single-photon emission computerized tomography (SPECT) combined with CT and MRI in the diagnosis of bone metastasis of malignant tumors. Method：Eighty patients with bone metastasis from malignant tumors who admitted to Affiliated Hospital of Chengde Medical College were selected from March 2019 to June 2021. SPECT bone imaging, CT and MRI were used to analyze the regional distribution of primary tumor bone metastasis and the efficacy of three detection methods in the diagnosis of bone metastasis. Results: A total of 464 lesions were detected by SPECT and CT in the same scanning field，with SPECT detection rate of 92. 5% ( 429 /464) and CT detection rate of 77. 8% ( 361 /464) ( P＜0. 05). In addition，143 lesions were detected by SPECT beyond the same scanning field. A total of 321 lesions were detected by SPECT and MＲI in the same scanning field，with SPECT detection rate of 95. 6% ( 307 /321) and MRI detection rate of 82. 6% ( 265 /321) ( P＜0. 05)，and other 286 lesions were detected by SPECT beyond the same scanning field. In all，259 lesions were detected by CT and MＲI scans in the wild same scanning field. The detection rate was 71. 4% ( 185 /259) for CT，and 95. 7% ( 248 /259) for MRI( P＜0. 05). The sensitivity，specificity and accuracy of SPECT imaging combined with CT and MＲI were higher than single SPECT imaging，CT and MＲI ( P＜0. 05). Conclusion: SPECT may be the preferred screening modality for suspected bone metastases and when combined with CT and MＲI，it can clarify the regional distribution of bone metastasis from malignant tumors and improve the sensitivity，specificity and accuracy of diagnosis with high clinical significance.

Evaluation of Effect and Detection Rate of Multispiral CT and MRI in Diagnosis of Wrist Injury

Evaluation of Effect and Detection Rate of Multispiral CT and MRI in Diagnosis of Wrist Injury

Postoperative Curative Effect of Cardiac Surgery Diagnosed by Compressed Sensing Algorithm-Based E-Health CT Image Information and Effect of Baduanjin Exercise on Cardiac Autonomic Nerve Function of Patients.

This research was aimed at exploring the effect of CT images reconstructed by optimized compressed sensing algorithm on postoperative diagnosis of patients with hypertensive heart disease and the influence of Baduanjin on cardiac autonomic nerve function. Based on the compressed sensing algorithm, the maximum likelihood expectation maximization algorithm was introduced to optimize it, and the optimization algorithm was established. The optimized algorithm and filtered back projection algorithm (FBP) were compared regarding the root mean squared error (RMSE), peak signal-to-noise ratio (PSNR), and structural similar image metric (SSIM). A total of 126 patients with hypertensive heart disease who underwent CT examination in the hospital were selected as study subjects. According to whether Baduanjin intervention was adopted, patients were divided into observation group (conventional treatment +Baduanjin) and control group (conventional treatment), with 63 patients in each group. The effect of CT examination on postoperative diagnosis was analyzed. Systolic blood pressure (SBP), diastolic blood pressure (DBP), differential pressure (DP), respiratory rate and heart rate (HR), very low-frequency (VLF) power, low-frequency (LF) power, high-frequency (HF) power, total power (TP) of HR variability, and changes in LF/HF of patients before and after treatment were compared. The RMSE of the compressed sensing optimization algorithm (3.28 ± 0.36) was significantly lower than that of the FBP algorithm (9.25 ± 1.03) (P < 0.05). The SSIM and PNSR of the compressed sensing optimization algorithm were (0.87 ± 0.10) and (21.22 ± 1.60) dB, respectively. The SSIM was significantly higher than the FBP algorithm (P < 0.01), and the PNSR was also higher than the FBP algorithm (P < 0.05). The detection rate of CT for pleural effusion was 16 cases (25.40%) higher than 5 cases (7.94%) with TTE (P < 0.01). After treatment, SBP, DBP, HR, LF, VLF, LF/HF, and DP values in the observation group were lower than those in the control group (P < 0.05), and TP and HF were higher than those in the control group (P < 0.05). It suggested that a novel algorithm was established based on compressed sensing algorithm to improve image quality. CT image had important guiding significance for postoperative diagnosis of heart. Baduanjin intervention could improve the integrated function of patient's autonomic nervous system and the regulation ability of the vagus nerve.

Application of SPECT Combined with CT and MRI in Malignant Tumors Clinical Value in the Diagnosis of Bone Metastasis

Introduction: Bone is the most common site of hematogenous metastasis of malignant tumors. Patients with bone metastasis can have a series of bone related adverse events, which seriously affect the quality of life and survival time of patients. Imaging examination is the main means of clinical diagnosis and evaluation of bone metastasis. Aim of the Work: To evaluate the value of single-photon emission computerized tomography (SPECT) combined with CT and MRI in the diagnosis of bone metastasis of malignant tumors. Subjects and Methods: Eighty patients with bone metastasis from malignant tumors who were admitted to Affiliated Hospital of Chengde Medical College were selected from March 2019 to June 2021. They underwent bone scan with SPECT imaging, CT and MRI separately. The distribution of bone metastasis from primary tumors as well as efficacy of the above three detection methods for bone metastasis was analyzed. Results: A total of 464 lesions were detected by SPECT and CT in the same scanning field, with SPECT detection rate of 92.5% (429/464) and CT detection rate of 77.8% (361/464) (P P P P < 0.05). Conclusion: SPECT may be the preferred screening modality for uspected bone metastases, and when combined with CT and MRI, it can clarify the regional distribution of bone metastasis from malignant tumors and improve the sensitivity, specificity and accuracy of diagnosis with high clinical significance.

MRI versus CT in the detection of brain lesions in patients with infective endocarditis before or after cardiac surgery

PurposeImaging of brain involvement in infective endocarditis can drive the clinical management of this serious condition. MRI is very sensitive, but CT is more readily available. In this retrospective study, we compared the detection rates of CT and MRI.MethodsAfter Ethics Committee approval, we retrospectively reviewed a series of 20 patients (13 males, median age 64 years) who underwent both CT and MRI either before or after cardiac surgery for definite infective endocarditis. Plain CT and MRI were evaluated for acute ischemic lesions, both punctuate and large, intraparenchymal hemorrhages, cerebral microbleeds, subarachnoid hemorrhages, abscesses, microabscesses, and meningitis. Qualitative assessment and McNemar test were performed. The value of contrast-enhanced scans (MRI, n = 14; CT, n = 9) and cognitive status were also assessed.ResultsA total of 166 lesions were identified on either technique: 137 (83%) on MRI only, 4 (2%) on CT only, and 25 (15%) on both techniques (p < 0.001). For these last 25 lesions, concordance on lesion type was only 16/25 (64%). MRI detected more microbleeds and ischemic lesions, while the 4 CT-only findings were false positives. Contrast-enhanced scans identified 68 enhancing lesions, mainly abscesses and microabscesses, and allowed a better characterization for 61/117 lesions (52%) with MRI, and for 11/81 (14%) with CT. Follow-up identified mild cognitive impairment in 6/13 and dementia in 3/13 patients.ConclusionWhile CT rapidly excludes large hemorrhages in patients with infective endocarditis, MRI accurately distinguishes the whole spectrum of brain lesions, including small ischemic lesions, microbleeds, and microabscesses.

Body CT and PET/CT detection of extracranial lymphoma in patients with newly diagnosed central nervous system lymphoma.

We aimed to investigate the detection rate of body CT or PET/CT for sites of extracranial disease in patients with a new pathological diagnosis of CNS DLBCL and to identify factors associated with sites of extracranial disease. An international multicenter cohort study of consecutive immunocompetent patients with a new diagnosis of CNS DLBCL confirmed by brain biopsy who underwent CT and/or PET/CT to evaluate for sites of extracranial disease between 1998 and 2019. The primary outcome was the detection rate of extracranial lymphoma by CT or PET/CT. Subgroup analyses according to age and EBV status were also performed. Logistic regression analyses were performed to determine factors related to sites of extracranial disease. Detection rates of CT and PET/CT were compared. One thousand and forty-three patients were included. The overall detection rate of CT or PET/CT was 2.6% (27/1043). The treatment approach was adjusted in 74% of these patients. Multivariable analysis demonstrated that age >61 years (OR, 3.10; P = .016) and EBV positivity (OR, 3.78; P = .045) were associated with greater odds of extracranial lymphoma. There was no statistically significant difference in detection rate between CT and PET/CT (P = .802). In patients ≤61 years old, the false-referral rates were significantly higher than the detection rates (P < .001). Our results showed increased odds of extracranial lymphoma in patients with older age or EBV-positive lymphoma. Treatment was adjusted in a majority of patients diagnosed with extracranial lymphoma, thereby supporting the current guidelines for the use of contrast-enhanced body CT or PET/CT in patients with newly diagnosed CNS DLBCL.

Comparison of the Imaging Manifestations and Diagnostic Values of Multi-slice Spiral CT and Enhanced MRI Scans of Primary Liver Cancer (PLC) Intrahepatic Lesions

Objective: To compare and analyze the clinical diagnostic value of multi-slice spiral CT and enhanced MRI for primary liver cancer (PLC), and to summarize the imaging findings. Methods: The research subjects in this article were 50 patients with PLC who were admitted to our hospital from 2017 April to 2018 September. After the patients were admitted, they were examined by multi-slice spiral CT and enhanced MRI scanning, and the pathological diagnosis results were followed up. Relevant information was reviewed and analyzed. Results: The detection rate of multi-slice spiral CT was higher than that of MRI in the portal venous phase lesion detection. The difference was statistically significant (P&lt;0.05). The detection rate of lesions in the arterial phase and delayed phase was not statistically significant (P&gt;0.05); the diagnostic accuracy of multi-slice spiral CT was 85.96%, and the diagnostic accuracy of enhanced MRI scanning was 91.11%, which was not statistically significant (P&gt;0.05). MRI scans showed the capsules of primary liver cancer better than CT, but the difference was not statistically significant (P&gt;0.05). Conclusion: In conclusion, both multi-slice spiral CT and enhanced MRI can be used for the effective diagnosis of primary liver cancer intrahepatic lesions. The diagnostic value of the two is equivalent, but enhanced MRI has a slightly higher diagnostic accuracy and can be used as the preferred method.

Feasibility and acceptability in health centers of screening for chlamydia in deprived population

Abstract Issue The French Health Insurance (FHI) is in charge of the governance of 100 Health Examination Centers (HEC). HEC provide evidence-based interventions in prevention, focused on deprived population. In France, Chlamydia trachomatis (Ct) infection is the most sexually transmitted infection, especially among young women. Description of the problem To assess the feasibility of systematic screening Ct infection, in HEC, among 18-25 years women and 18-30 years men, with a focus on self-sampling. Pragmatics questions were: how the youth accept the screening of Ct infection (especially the self-taken vaginal swabs)? Was the feasibility and Ct positivity similar between deprived and non-deprived population (according to the EPICES score)? A cross-sectional multicenter survey was performed in 13 HEC in January 2018. Results Screening was proposed to 1702 eligible young people (sexually active and no recent Ct treatment). 90.3% [88.8-91.6] accepted and participated: 44% women, 54% deprived people. Among women, 76.8% [73.4-79.9] used self-taken vaginal swabs, others urinary tests. Rates did not differ according to deprivation (p = 0.96). Screening was performed in 1487 people (96.7% for deprived vs 97.7% for non-deprived population, p = 0.258). Ct detection rate was 4.7% [3.7%-5.9%], significantly higher for deprived population (6.5% vs 2.5%, p &amp;lt; 0.001). Lessons The results demonstrated the feasibility of Ct screening in HEC with a good acceptance among youth even among young deprived. The performance rate of the test was similar according to deprivation. However, deprivation was associated with having a positive Ct result. This feasibility led to the implementation of Ct screening in all HEC. Key messages Chlamydia trachomatis screening can be easily implemented even in deprived populations that accept and perform it as well as non-deprived populations. Promoting access to Chlamydia trachomatis screening to deprived populations might contribute to reduce social inequalities in health.

Diagnostic Value of Spiral CT Chest Enhanced Scan in Adult with Active Pulmonary Tuberculosis

Aim: To explore the diagnostic value of spiral CT chest enhanced scan for adults with active pulmonary tuberculosis. Methods: The clinical data of 60 adult patients with active pulmonary tuberculosis who were treated in our hospital from January 2018 to November 2019 were retrospectively analyzed. All patients underwent conventional chest radiography and spiral CT chest enhanced scan. The number of tuberculosis diagnosis, the detection rate of special site lesions, and the detection rate of active pulmonary tuberculosis signs by the two methods were compared. Results: In 60 patients, the pathological results confirmed the existence of 75 tuberculosis lesions. The detection rate of spiral CT was 98.67%, which was not statistically significant compared with the detection rate of 92.00% (P&gt;0.05) in the conventional chest X-ray. The detection rate of spiral CT enhanced scans for tuberculosis lesions in special sites was 100.00%, which was significantly higher than that of conventional chest X-ray of 7.69%, and the accuracy rate of active pulmonary tuberculosis signs was 98.85% higher than that of conventional chest X-ray of 79.31%. P&lt;0.05). The difference was statistically significant (P&lt;0.05). Conclusion: Spiral CT chest enhanced scan can not only find special tuberculosis lesions that cannot be detected by conventional chest radiography, but also accurately determine active pulmonary tuberculosis in adults, which is of high diagnostic value.

Correlation of diaphragm surgical findings with preoperative CT scans in ovarian cancer

Objective: Correlation of diaphragm surgical findings in ovarian cancer patients with and without diaphragm metastases with pre-operative CT diaphragm findings to assess sensitivity and specificity for diaphragm disease. Material and Methods: A retrospective study of 120 ovarian cancer patients (60 with and 60 without diaphragm metastases at surgery), FIGO Stage IIIC or IV, undergoing cytoreductive surgery at Mayo Clinic, Arizona, between January 2000 and October 2014. All patients had preoperative imaging with CT scan of abdomen and pelvis including the lower lung fields. CTs were not reviewed retrospectively. Results: Among 60 patients with diaphragm metastases, preoperative CTs were positive for diaphragm disease in 17 patients, with a sensitivity rate of 28% (CI 95%: 0.17- 0.41). All 60 patients with no diaphragm metastases had negative CTs, with a specificity of 100% (CI 95%: 94.0%-100%). When analyzed by lesion size, CTs were negative in 66.7-80% of patients with diaphragm lesions ranging from 1-15 mm. There was a trend towards increased detection rate with increasing size of lesions, but it did not reach significance (p = 0.529). CT detection rate for single metastatic lesion was 18.2% (6/33) and for multiple lesions it was 25.9% (7/27). There was no difference for CT identification of right, left, or bilateral metastases (p = 0.399). The sensitivity and specificity of CT for pleural effusion was 100% (CI 95%: 72.2%-100%) and 88% (CI 95%: 76.2%- 94.4%), respectively. The area under the receiver operating characteristic (ROC) curve was 0.680 (CI 95%: 55.3%-72.2%) for CT detection of diaphragm metastases and 0.957 (CI 95%: 79.9%-95.3%) for pleural effusions. Conclusion: CT has a low sensitivity and a high specificity for the prediction of diaphragm metastases in ovarian cancer. The size, location, and number of diaphragm lesions do not significantly improve CT detection rate.

Importance of Long-term Low-Dose CT Follow-up after Negative Findings at Previous Lung Cancer Screening.

Purpose To assess the incidence of lung cancer in a cohort of patients with negative findings at previous lung cancer screening. Materials and Methods In this prospective cohort study, the authors first identified 4782 individuals who had negative screening results as part of the International Early Lung Cancer Action Program (1993-2005). Subjects were assigned a lung cancer risk score by using a validated risk model. Starting with those at highest risk, subjects were interviewed by phone and invited to undergo low-dose CT between March 2013 and October 2016. Subjects with a diagnosis of lung cancer and those who had died of lung cancer were determined. Descriptive statistics were used to summarize data. The independent samples t test and Fisher exact test were used to compare age, sex, and risk scores. Results A total of 327 study participants were contacted, and 200 subjects participated in this study. The average age was 74 years (range, 57-88 years), and the median time since previous CT was 7 years. The incidence rate of developing lung cancer during the next 6 years was estimated at 5.6%. The period prevalence of lung cancer was 20.8% (new and preexisting lung cancer, 68 of total cohort of 327). The detection rate of low-dose CT was 7% (14 of 200 subjects). Of the 14 screening-detected cancers, 12 were stage I or II. Conclusion High-risk individuals have a high incidence of lung cancer after previous negative lung cancer screening. Early-stage lung cancer can be successfully detected in older high-risk individuals. © RSNA, 2018 Online supplemental material is available for this article.

Co-infection Of Ureaplasma urealyticum And Human Papilloma Virus In Asymptomatic Sexually Active Individuals.

This study aimed to determine the role of asymptomatic bacterial sexually transmitted infections (STIs), such as Chlamydia trachomatis (Ct), Mycoplasma genitalium (Mg), Mycoplasma hominis (Mh), and Ureaplasma urealyticum (Uu) in human papillomavirus (HPV) infection.In total, 264 asymptomatic outpatients aged between 21 and 80 years were prospectively enrolled in this study during routine gynecological screening tests. Specimens collected with a Cervex Brush were routinely analyzed with the Hybrid Capture 2 assay for HPV. Simultaneously, a specimen obtained with an endocervical swab was used to detect Ct and Mg with a monoplex real-time polymerase chain reaction (PCR) and to confirm Mh and Uu with a Mycoplasma IST 2 kit.The detection rates (%) of HPV, Ct, Mg, Mh, and Uu were 82/264 (31.1), 6/264 (2.3), 5/264 (1.9), 16/264 (6.1), and 95/264 (36.0), respectively. Of 95 Uu, 32 (33.7%) showed high density colonization (HDC, ≥104 color-changing units/mL). HDC-Uu was significantly associated with HPV infection (p=0.014, chi-square test). Mg infection and Mh infection were not associated with HPV infection (p=0.981 and p=0.931, chi-square test). Age was not associated with HPV infection or bacterial infection.Our data suggested that asymptomatic HDC-Uu was closely associated with HPV infection. Therefore, simultaneous evaluation for Uu and HPV should be performed during gynecological screening, even in asymptomatic individuals.

Prophylactic central neck dissection in 68 patients with lateral compartment metastases from well-differentiated thyroid cancer.

Skip metastasis (SM) in Well Differentiated Thyroid Cancer (WDTC) patients are lateral neck lymph node metastasis that have skipped the central neck compartment. In these patients, prophylactic central neck dissection remains controversial. We sought to identify clinicopathological factors associated with SM and determine the accuracy of central neck metastasis imaging in 68 patients at our institution over 16 years. 12 patients (17.6%) had SMs. Compared to the patients with occult central neck metastases, those with SM were more likely to have T1 tumors (p=0.005) and less likely to have extracapsular spread (p=0.032), thyroid capsule extension (p=0.003), soft tissue extension (p=0.006), and multifocal primary tumors (p=0.006). In assessing the preoperative imaging, we compared central neck dissection pathology reports to the detection rates of CT and ultrasound. We found CT and ultrasound sensitivities of 31.8% and 45%, respectively and specificities of 80% and 85.7%, respectively. WDTC patients with SM are more likely to have smaller, less aggressive primary tumors. However, the majority (82.4%) had central compartment disease and given the lack of sensitive preoperative imaging, we recommend prophylactic central neck dissections. This article is protected by copyright. All rights reserved.