Diagnostic Accuracy Of Ultrasound Research Articles

Ultrasound for the diagnosis of malrotation and volvulus in children and adolescents: a systematic review and meta-analysis

ContextDespite the advantages of ultrasound (US), upper gastrointestinal contrast series (UGI) remains the first-line diagnostic modality in the diagnosis of midgut malrotation and volvulus in children.ObjectiveEvaluate the diagnostic accuracy of...

Abdominal ultrasound and alpha-foetoprotein for the diagnosis of hepatocellular carcinomain adults with chronic liver disease.

Abdominal ultrasound and alpha-foetoprotein for the diagnosis of hepatocellular carcinomain adults with chronic liver disease.

Diagnostic Accuracy of Ultrasonography in Diagnosing Morbidly Adherent Placenta, Taking Intra-Operative Findings as Gold Standard

Objective: Various imaging modalities can be employed for the placenta accreta diagnosis like USG and MRI, however, their exact diagnostic accuracy is yet to be established. This study was conducted for determining the accuracy of ultrasonography in diagnosing morbidly adherent placenta in women with a previous scar, taking the per-operative findings as gold standard. Methods: This descriptive cross-sectional study was carried out at department of Radiology, Benazir Bhutto Hospital, Rawalpindi from 6th January 2019 to 5th July 2019. Using non-probability purposive sampling 118 pregnant women with single pregnancy of age 18-40 years were included. Both grey scale and color doppler findings of ultrasound were employed for ascertaining presence or absence of morbidly adherent placenta. Per-operative findings of all patients who underwent cesarean section afterwards in their respective wards were registered. The findings of USG were then compared with the per-operative observations. Results: Among patients in whom USG findings were of morbidly adherent placenta, 60 were true positive while 05 were false positive, whereas, in the patients with no evidence of morbidly adherent placenta on USG, 03 were false negative while 50 were true negative. The sensitivity, specificity, positive predictive value negative predictive value and diagnostic accuracy of USG in diagnosing morbidly adherent placenta in previous scar women, taking per -operative findings as gold standard was 95.24%, 90.91%, 92.31%, 94.34% and 93.22% respectively. Conclusion: It can be inferred from our study that USG is a very sensitive and accurate non-invasive imaging technique for the diagnosis of morbidly adherent placenta. Keywords: morbidly adherent placenta, ultrasonography, sensitivity. How to cite: Yousaf A., Durrani M., Riaz K., Kalsoom U., Parvez H. Diagnostic accuracy of ultrasonography in diagnosing morbidly adherent placenta, taking intra-operative findings as gold standard. Esculapio. 2021; 17(01): 71-74

Incorporating Lung Ultrasound in Clinical Pulmonary Infection Score as an Added Tool for Diagnosing Ventilator-associated Pneumonia: A Prospective Observational Study from a Tertiary Care Center.

Background: Clinical pulmonary infection score (CPIS) is an established diagnostic parameter for ventilator-associated pneumonia (VAP). Lung ultrasound (LUS) is an evolving tool for diagnosing VAP. Various scores have been proposed for the diagnosis of VAP, taking LUS as a parameter. We proposed whether replacing LUS with chest radiograph in CPIS criteria will add to the diagnosis of VAP. The current study was done to evaluate the diagnostic accuracy of LUS alone and in combination with clinical and microbiological criteria for VAP by replacing chest radiograph with LUS in CPIS.Materials and methods: We conducted a prospective single-center observational study including 110 patients with suspected VAP to investigate the diagnostic accuracy of LUS. Quantitative mini-bronchoalveolar lavage (mini-BAL) culture was considered the gold standard for diagnosis of VAP. Here, the authors have explored the combination of LUS, clinical, and microbiology parameters for diagnosing VAP. On replacing chest radiograph with LUS, sono-pulmonary infection score (SPIS) and modified SPIS (SPIS-mic, SPIS-cult) was formulated as a substitute for CPIS.Results: Overall LUS performance for VAP diagnosis was good with sensitivity, specificity, positive or negative predictive value, and positive or negative likelihood ratios of 91.3%, 70%, 89%, 75%, 3, and 0.1, respectively. Adding microbiology culture to LUS increased diagnostic accuracy. The areas under the curve for SPIS and modified SPIS were 0.808, 0.815, and 0.913, respectively.Conclusion: The diagnosis of VAP requires agreement between clinical, microbiological, and radiological criteria. Replacing chest radiograph with LUS in CPIS criteria (SPIS) increases diagnostic accuracy for VAP. Adding clinical and culture data to SPIS provided the highest diagnostic accuracy. Clinical parameters along with lung ultrasound increase diagnostic accuracy for VAP.How to cite this article: Samanta S, Patnaik R, Azim A, Gurjar M, Baronia AK, Poddar B, et al. Incorporating Lung Ultrasound in Clinical Pulmonary Infection Score as an Added Tool for Diagnosing Ventilator-associated Pneumonia: A Prospective Observational Study from a Tertiary Care Center. Indian J Crit Care Med 2021;25(3):284–291.

Diagnostic Accuracy of Ultrasonography for Evaluation Solid Breast Lesions – A Systematic Review

Breast cancer in women in both developed and developing countries is the most common cancer, and remains a major public health problem.
 Methods: Analytical cross-sectional studies and only highquality studies were included. The searched databases were: Pub Med (2008-2020), Google scholar (2008-2020) and science direct (20082020). The key terms searched were ultrasound imaging, Breast solid mass or lesions, papillary lesions, Fibro-adenoma, breast cancer. Using these key terms, researchers found total 101 studies from the above-mentioned databases. Among these researchers found 56 studies from Google scholars, 11 from science direct and 34 from Pub Med. After this, researchers separated the relevant and irrelevant data.
 Results: Table 1 shows the Descriptive results of age from 12 studies, 17641 individuals. The mean age was 46.14697 SD 10.56736. The mean Sensitivity was 91.0200 and mean specificity was 89.35. The pooled results of 8 studies and 2612 individuals, out of 2612 individuals we found 1220 (46.71) benign lesions and 1392 (53.29%) malignant lesions are also shown.
 Conclusions: In conclusion, Ultrasound can differentiate benign and malignant breast lesions to great extent. This technique has the potential ability to altering the handling of cases in where a biopsy may be recommended, but the risk of carcinoma is known to be relatively low. Ultrasound accuracy is recommended as the first option for follow-up examinations of lesions because of its high sensitivity and ability to detect lesions outside of breast density.

Abdominal ultrasound and alpha-foetoprotein for the diagnosis of hepatocellular carcinoma. A diagnostic test accuracy Cochrane review

Introduction: Hepatocellular carcinoma (HCC) ranks fifth in terms of global instances of cancer and second in terms of cancer deaths for men. Current guidelines recommend ultrasound (US) with or without alpha-foetoprotein (AFP) as surveillance programme in high risk population even if there is no clear evidence of benefit in terms of overall-survival. Assessing the diagnostic accuracy of US and AFP may clarify whether the absence of benefit might be related to under-diagnosis.

Role of Ultrasonography in The Differentiation of Solid Breast Mass

Background: Breast cancer is the major cause of cancer death in women. Breast ultrasound is of a great value in differentiating malignant from benign masses.
 Objective: To distinguish benign from malignant solid breast lesions by Ultrasonography (USG).
 Materials and Methods: This cross sectional study was performed in Radiology and Imaging department of Dhaka Community Medical College Hospital (DCMCH) in collaboration with the department of Pathology and Surgery, DCMCH from January 2017 to December 2017. The benign and malignant solid breast mass were differentiated by using USG and correlated these with histopathological findings.
 Results: Total 60 female with breast mass, aged 20 to 60 years, were studied. Out of 60 cases, 34 cases were solid breast mass on USG. Eleven cases were diagnosed as malignant and 23 cases as benign. Among the USG diagnosed 11 cases, 10 cases found truly malignant (true +ve) and 1 (one) case was benign (false+ve) whereas out of the 23 benign cases, 21 were benign (true -ve) and 2 (two) were found malignant(false-ve), and all were confirmed by histopathology.The sensitivity of USG for malignant breast mass was found 83.33% and specificity was 95.45%. The positive and negative predictive values of USG were 90.91% and 91.3% respectively. The diagnostic accuracy of USG in differentiating breast mass into malignant and benign was 91.318%.
 Conclusion: The USG is a very good diagnostic modality for differentiating benign and malignant breast mass.
 KYAMC Journal Vol. 11, No.-4, January 2021, Page 204-207

Contrast-enhanced ultrasonography in the evaluation of Crohn disease activity in children: comparison with histopathology.

Contrast-enhanced ultrasound (US) of the bowel wall has been suggested as an alternative imaging modality for the follow-up of children with Crohn disease. To evaluate the diagnostic performance of contrast-enhanced US in the estimation of Crohn disease activity in children with histopathology as the reference standard. In 24 children with Crohn disease confirmed on histopathology, disease activity was evaluated on 40 bowel segments using US score and subjective and quantitative contrast-enhanced US evaluation. Contrast-enhanced US evaluation included enhancement pattern analysis with a graphic representation of log time-intensity curve and calculation of kinetic parameters with the definition of thresholds for disease activity, as determined by receiver operating characteristics curve analysis. The diagnostic accuracy of US with colour Doppler imaging and subjective and quantitative contrast-enhanced US were calculated. Moderate or severe inflammation was identified in 18 segments and remission or mild inflammation was identified in 22 segments on histopathology. The quantitative contrast-enhanced US, namely the peak enhancement value, had 72.2% sensitivity (95% confidence interval [CI] 46.5-90.3), 100% specificity (95% CI 84.6-100.0) and 87.5% diagnostic accuracy (95% CI 73.2-95.8) in predicting moderate or severe grade inflammation at histopathology. The sensitivity, specificity and diagnostic accuracy of subjective contrast-enhanced US were 77.8% (95% CI 52.4-93.6), 77.3% (95% CI 54.6-92.2) and 77.5% (95% CI 61.6-89.2), respectively, and of US with colour Doppler imaging were 55.6% (95% CI 30.8-78.5), 86.4% (95% CI 65.1-79.1) and 72.5% (95% CI 56.1-85.4), respectively. Quantitative contrast-enhanced US has the potential of becoming a complementary method in the evaluation of Crohn disease activity in children. Fibrosis may affect peak enhancement results and underestimate inflammatory activity.

Diagnostic value of lung ultrasound in COVID-19: systematic review and meta-analysis

BACKGROUND:Effective and safe tools assisting triage decisions for COVID-19 patients could optimize the pressure on the healthcare system. COVID-19 often has respiratory manifestations, and medical imaging techniques provide an opportunity to assess the diseases severity.
 AIMS:To estimate the sensitivity and specificity of lung ultrasound for different degrees of pulmonary involvement in COVID-19 patients by a systematic review of English articles using PubMed and Google Scholar databases. Search terms included lung ultrasound, chest ultrasound, thoracic ultrasound, ultrasonography, COVID-19, SARS-CoV-2, coronavirus, diagnosis, diagnostic value, specificity, and sensitivity. Only studies addressing lung ultrasound diagnostic accuracy for patients with suspected COVID-19 using thoracic computed tomography, reverse transcription polymerase chain reaction, or laboratory data as a reference standard were included. Independent extraction of articles was performed by two authors using predefined data fields with subsequent assessment of study quality indicators. The random-effect model was used to analyze and pool lung ultrasound sensitivity and specificity across the included studies. Sixteen studies met our inclusion criteria, but only three of them divided patients into distinct and defined groups depending on the disease severity. We used the remaining studies data to assess the secondary outcomes: the values of sensitivity and specificity of lung ultrasound for COVID-19 regardless of the patients clinical status. Heterogeneity for primary and secondary outcomes was observed that remained when pooling for different scenarios (screening, assessing severity) and cohorts of participants. Lung ultrasound had the highest accuracy for confirmed COVID-19 patients with severe disease (sensitivity 87.6% 12.3%, specificity 80.5% 7.1%), and the lowest accuracy for the patients with mild disease (sensitivity 72.8% 7.1%, specificity 74.3% 2.7%).
 CONCLUSIONS:Lung ultrasound can be used in patients with confirmed COVID-19 to detect serious damage to the lung tissue. The diagnostic value of the method for assessing mild and moderate lung lesions is relatively low.

The Diagnostic Accuracy of Ultrasonography for the Diagnosis of Rib Fractures in Patients Presenting to Emergency Department With Blunt Chest Trauma.

Rib fractures are the most common complications of blunt chest trauma (BCT). Computed tomography (CT) is the modality of choice for BCT, but with several disadvantages. Ultrasonography (US) is an inexpensive, readily available, and relatively harmless imaging alternative. However, a direct comparison of the sonographic evaluation of the rib as a whole with CT as a reference has not been performed to date. This study aimed to compare the diagnostic accuracy of US with CT for the detection of rib fractures in patients who presented to emergency department (ED) with BCT. We included a convenience sample of adult patients who presented to the ED with thoracic pain after BCT in the last 24h in this prospective, observational, diagnostic accuracy study. The diagnostic utility of US performed by an emergency physician was compared with thorax CT. The final study population included 145 patients. The diagnostic accuracy of US was 80% with a sensitivity of 91.2% and specificity of 72.7% for the detection of any rib fracture (positive likelihood ratio 3.4 and negative likelihood ratio 0.12). If we considered each rib separately, the sensitivity of US decreased to 76.7% and specificity increased to 82.7% (81.3% accuracy). A negative US of the site of the highest tenderness and neighboring ribs in a patient with BCT who presented to the ED with lateralizing pain decreases the possibility of a rib fracture significantly. However, a positive US performs poorly to specify the exact location and number of the fractured ribs.

Blinding practices during acute point-of-care ultrasound research: the BLIND-US meta-research study

ObjectivesPoint-of-care ultrasound (POCUS) diagnostic accuracy research has significant variation in blinding practices. This study characterises the blinding practices during acute POCUS research to determine whether research methodology adequately reflects POCUS...

Primer hiperparatiroidide Tc99m-MIBI sintigrafi sonuçlarının biyokimyasal ve histopatolojik bulgular ile ilişkisi

It was aimed to evaluate the relationship between clinical, laboratory, and histopathological findings with the scintigraphy performed with Technetium-99m MIBI in patients with primary hyperparathyroidism (PHPT). 516 patients who applied for parathyroid scintigraphy between 2012-2018 were retrospectively scanned. Files of 105(94 female, 11 male) patients, which were diagnosed as PHPT, were included in the study and laboratory, ultrasonography (USG), and findings were recorded. The scintigraphically parathyroid tissues that can be localized were examined in two groups as MIBI-positive(n=92) and those that could not be MIBI-negative (n=13). Sensitivity and diagnostic accuracy of USG and scintigraphy and combinations were evaluated. The calcium value (11.48±0.75 mg/dl) in MIBI-positive group was higher than MIBI-negative group (11±0.68 mg/dl) (p=0.047). While the sensitivity of USG in lesion detection was 60.2%, and scintigraphy was 89.1%, the sensitivity in the combination of the those was 91.9%. Diagnostic acuity of scintigraphy was 87.6%, USG+scintigraphy was 92%. A positive correlation was found between parathyroid adenoma size and PTH and ALP (p<0.001 r=0.572; p=0.003 r=0.424, respectively). Parathyroid scintigraphy is more likely to define a parathyroid pathology when calcium is high, and the adenoma size increases consistent with increasing PTH. Although scintigraphy is much more effective than USG for preoperative localization in PHPT, its combination with USG contributes to the localization of PHPT.

DIAGNOSIS, MANAGEMENT AND CLINICOPATHOLOGICAL FEATURES OF ACUTE APPENDICITIS IN PREGNANT WOMEN AND ITS IMPACT ON FETAL OUTCOMES

Objective: To evaluate the clinicopathological features and feto-maternal outcomes of appendicitis during pregnancy. Material and Method: This study involved comparisons of laboratory findings, preoperative ultrasonography (US), pathology and clinical outcomes of 17 pregnant and 59 age-matched non-pregnant women undergoing appendectomy. Results: The total number of US scans, rates of non-visualized appendix on US, and length of hospital stay were higher in pregnant women than in non-pregnant subjects (p&lt;0.001, p=0.035, and p=0.014; respectively). The rate of negative appendectomy was 1.5-times higher and the rate of complicated appendicitis was 7-times higher in pregnant compared with non-pregnant patients. The diagnostic accuracy of US was higher in the non-pregnant group (72.9% vs. 64.7%). In terms of the hematological parameters, no significant difference was found between the pregnant patients with and without appendicitis. There was one premature birth and one abortus in the second trimester, and one premature birth followed by a negative appendectomy in the third trimester. Conclusion: The diagnosis of acute appendicitis in pregnancy may remain inconclusive despite comprehensive evaluation with clinical examination, laboratory studies, and US. We recommend that clinicians consider additional imaging scans when they suspect appendicitis during pregnancy to avoid unnecessary surgical interventions. Both complicated appendicitis and negative appendectomy can cause a non-negligible rate of fetal morbidity and mortality.&nbsp;&nbsp;

Diagnostic accuracy of ultrasonography in the assessment of anterior knee pain

BackgroundAnterior knee pain (AKP) is a problematic complaint, considered to be the most frequent cause of orthopedic consultancy for knee problems. This study aimed to highlight diagnostic accuracy of ultrasonography as a fast imaging technique in assessment of patients with AKP.Methods and resultsA prospective study was conducted on 143 patients with clinically confirmed AKP. All patients underwent ultrasonography and MRI examinations of the knee. The diagnostic accuracy of ultrasonography compared to MRI for evaluating different findings of possible causes of AKP were analyzed using receiver operating characteristic (ROC) curve and judged by area under curve (AUC). A total of 155 knees were included in the study; 26 knees showed no abnormalities, 19 knees showed positive MRI only, and 110 knees showed positive ultrasonography and MRI. Ultrasonography and MRI reported 11 different findings of possible causes of AKP or related to it. Joint effusion was the most common finding (38%) followed by trochlear cartilage defect (20.6%) and superficial infrapatellar subcutaneous edema (20%). The overall accuracy of ultrasonography was 85.3% sensitivity and 100% specificity. The ultrasonography provided the highest sensitivity (100%) in detecting bipartite patella, followed by 91.5% for joint effusion, and 87.5% for quadriceps tendinopathy. The ROC curve analysis of overall accuracy of ultrasonography showed an AUC of 0.93. The overall Kappa agreement between ultrasonography and MRI was good (k = 0.66).ConclusionUltrasonography can be used to make a swift screening and assessment of painful anterior knee and as an alternative to MRI when it is unavailable or contraindicated.

Comparison of diagnostic accuracy of bedside ultrasonography and radiography for calcaneal fractures in the emergency department

Objective: Ultrasonography (US) is not the method of choice for the diagnosis of calcaneal fractures. The aim of this study was to compare the diagnostic accuracy of US with plain radiography in the diagnosis of calcaneus fractures following blunt ankle and foot trauma. Methods: In this cross-sectional study, 214 patients (over 18 years) presenting to the emergency department (ED) with suspicion of traumatic calcaneus fracture following acute blunt trauma, were enrolled. Bedside ultrasonography was performed and interpreted by emergency physicians. After that, plain radiography was performed. Furthermore, all the patients were assessed by computed tomography (CT) scan as the gold standard. Results: Finally, 193 patients were enrolled with a mean age of 29.4±15.7 years (85.5% male). Fractures in the calcaneus were detected in 49 patients. The sensitivity and specificity of ultrasonography in the detection of calcaneal fractures were 83.6%, (confidence interval (CI), 69.7 –92.2) and 100% (95% CI, 96.7 –100), while the sensitivity and specificity of X-ray were 87.7% (95% CI, 74.5 –94.9) and 100% (95% CI, 96.7 –100). There was no false positive result for X-ray and US. Conclusion: Our findings suggest that bedside US with an acceptable sensitivity and specificity can be used as a promising alternative for the diagnosis of calcaneal fracture in ED.

Optimal Choice of Ultrasound-Based Measurements for the Diagnosis of Ulnar Neuropathy at the Elbow: A Meta-Analysis of 1961 Examinations.

OBJECTIVE. The purpose of this study was to determine the optimal ultrasound (US) measurement technique and cutoff value for the diagnosis of ulnar neuropathy at the elbow. MATERIALS AND METHODS. A systematic literature search was conducted of the PubMed, Embase, Scopus, and Web of Science databases for studies evaluating the diagnostic accuracy of US of patients with ulnar neuropathy at the elbow before April 2019. Random-effects modeling was performed to compare the sensitivity, specificity, and diagnostic odds ratio (DOR) of different US measurements, including diameter and cross-sectional area (CSA) of the nerve at the medial epicondyle or proximal and distal levels, maximal diameter, maximal CSA, and nerve ratios. Sensitivity and metaregression analyses were performed to assess the impact of clinical and imaging-based variables on the DOR of US. RESULTS. Among 820 retrieved studies, 19 studies (1961 examinations) were included. Measuring the CSA of the ulnar nerve at the medial epicondyle with a cutoff value greater than 10-10.5 mm2 had higher sensitivity (80.4%, 95% CI, 75.4-84.7%) than other techniques. Nerve ratios had higher specificity (89.1%, 95% CI, 85.8-91.8%) than other measurements; however, the definition of ratios and cutoff values varied across studies. ROC analysis showed higher diagnostic performance for measuring CSA at the medial epicondyle (AUC, 0.931). The mean CSA value was a significant predictor of the DOR of US (β coefficient, 0.307 ± 0.074; p < 0.001). Every 1-mm2 larger CSA was associated with a 36% increase in DOR. The diagnostic performance of US was the same in any degree of elbow flexion. CONCLUSION. Measuring CSA of the ulnar nerve at the medial epicondyle has sensitivity and diagnostic performance superior to those of other techniques for the diagnosis of ulnar neuropathy at the elbow.

The role of grey-scale ultrasound in the diagnosis of adhesive capsulitis of the shoulder: a systematic review and meta-analysis.

In this systematic review and meta-analysis, we discuss the value of grey-scale ultrasonography (US) in diagnosing adhesive capsulitis of the shoulder (ACS). We retrieved relevant studies from PubMed, Cochrane Library, and Embase before 8 April 2019. We selected 7 studies concerning 446 patients (490 shoulders) that used grey-scale US to diagnose ACS and magnetic resonance imaging (MRI) or arthroscopy as the reference standard. We assessed the diagnostic accuracy of US on the basis of combined sensitivity, specificity, likelihood ratio (LR), and the area under the summary receiver operating characteristic (SROC) curve (AUC). The combined sensitivity, specificity, positive LR and negative LR were found to be 88% (95%CI: 74-95), 96% (95%CI: 88-99), 23.89 (95%CI: 6.31-90.51) and 0.12 (95%CI: 0.05-0.29), respectively. The AUC was 0.97 (95%CI: 0.96-0.98). ACS was diagnosed on the basis of four US features: coracohumeral ligament thickening, inferior capsule/axillary recess capsule thickening, rotator interval abnormality, and restriction of the range of motion. The corresponding sensitivities were 64.4 (95%CI: 48.8-78.1), 82.1 (95%CI: 73.8-88.7), 82.6 (95%CI: 74.1-89.2) and 94.3 (95%CI: 84.3-98.8), respectively, and specificities were 88.9 (95%CI: 76.0-96.3), 95.7 (95%CI: 90.3-98.6), 93.9 (95%CI: 89.8-96.7), and 90.9 (95%CI: 75.7-98.1), respectively. Our meta-analysis showed that grey-scale US plays a significant role in the diagnosis of ACS. Because of its high sensitivity and specificity, US can be added to the existing clinical diagnosis program.

Concordance and Diagnostic Accuracy of Ultrasonography and Mammography Findings with Pathology Results in Breast Cancer

Concordance and Diagnostic Accuracy of Ultrasonography and Mammography Findings with Pathology Results in Breast Cancer

The impact of pathological analysis on endobronchial ultrasound diagnostic accuracy.

Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive procedure used for lung cancer diagnosis and staging. Several aspects, including pathological analysis, may impact on its diagnostic accuracy. Differences in diagnostic accuracy between the different specimen processing techniques have not been demonstrated. Cytological slides are generally adequate for diagnosis, subtyping and genotyping. However, some pathological laboratories may require cell blocks or histological core biopsies for a complete molecular profiling. Rapid on-site evaluation (ROSE) is a technique for immediate evaluation of samples obtained with EBUS-TBNA. The aims of ROSE are to increase sampling adequacy, improving diagnostic yield of EBUS-TBNA and ensuring collection of adequate material for ancillary studies. However, the reported data on the impact of ROSE in the diagnostic yield of EBUS-TBNA and in lung cancer diagnosis and staging are controversial. Some series reported a valuable contribution of ROSE to diagnosis and staging of lung cancer and a high concordance between ROSE and the final diagnosis. However, randomized trials failed in finding differences in diagnostic yield between EBUS-TBNA performed with and without ROSE. The yield of EBUS-TBNA for molecular analyses varies between 72% and 98%, and ROSE may warrant the collection of adequate material for molecular profiling. In lung cancer diagnosis and staging a recommended number of three to four passes during EBUS-TBNA at each target is a minimum requirement to obtain enough material for molecular analysis. The use of ROSE may reduce the number of passes for molecular profiling and the number of additional invasive diagnostic procedures. EBUS-TBNA is a procedure with a high accuracy rate and ROSE may contribute to a further improvement of the results. The possibility to avoid additional invasive procedure is an important advantage leading to an overall improvement of patient care.

Concordance and Diagnostic Accuracy of Ultrasonography and Mammography Findings with Pathology Results in Breast Cancer

Background: Ultrasonography and mammography are two radiologic approaches for screening breast cancer; however, the pathology report is required for the ultimate diagnosis of malignancy. This study aimed to assess the concordance of ultrasonography (US) and mammography with the pathology in breast cancer.Methods: A cross-sectional study was conducted to assess the breast US and the mammography findings based on the BI-RADS model in comparison with the definitive pathology reports in a single medical center. The sensitivity, the specificity, positive (PPV) and negative predictive value (NPV) and also the concordance between the US and the mammography data were analyzed.Results: In this study, 126 patients were included. The sensitivity, specificity, PPV, and NPV for the US were 69.8, 71.9, 75.6 and 81.3 and for mammography were 91.9, 76.6, 80.8 and, 94.6 percent, respectively. The ROC-curve for either the US or the mammography showed that the BI-RADS 4 was accompanied with the highest sensitivity and specificity for the screening of the malignant breast lesions regarding the final diagnosis. Although an overall higher correlation between mammography report and presence of a malignant lesion was observed, the total relative concordance between the results of US and mammography as screening tools proved to be statistically significant (P&lt;0.01).Conclusion: Both the US and the mammography were sensitive and specific screening tools, particularly for the malignant breast lesions. Furthermore, when evidence of the BI-RADS?4 in either the mammography or the US was present, utilization of the other test could be ignored before biopsy.