Diagnostic Accuracy Value Research Articles

Machine learning classification and biochemical characteristics in the real-time diagnosis of gastric adenocarcinoma using Raman spectroscopy

This study aimed to identify biomolecular differences between benign gastric tissues (gastritis/intestinal metaplasia) and gastric adenocarcinoma and to evaluate the diagnostic power of Raman spectroscopy-based machine learning in gastric adenocarcinoma. Raman spectroscopy-based machine learning was applied in real-time during endoscopy in 19 patients (aged 51–85 years) with high-risk for gastric adenocarcinoma. Raman spectra were captured from suspicious lesions and adjacent normal mucosa, which were biopsied for matched histopathologic diagnosis. Spectral data were analyzed using principal component analysis (PCA) and linear discriminant analysis (LDA) with leave-one-out cross-validation (LOOCV) to develop a machine learning model for diagnosing gastric adenocarcinoma. High-quality spectra (800–3300 cm⁻¹) revealed distinct patterns: adenocarcinoma tissues had higher intensities below 3150 cm⁻¹, while benign tissues exhibited higher intensities between 3150 and 3290 cm⁻¹ (p < 0.001). The model achieved diagnostic accuracy, sensitivity, specificity, and AUC values of 0.905, 0.942, 0.787, and 0.957, respectively. Biochemical correlations suggested adenocarcinoma tissues had increased protein (e.g., phenylalanine), reduced lipids, and lower water content compared to benign tissues. This study highlights the potential of Raman spectroscopy with machine learning as a real-time diagnostic tool for gastric adenocarcinoma. Further validation could establish this technique as a non-invasive, accurate method to aid clinical decision-making during endoscopy.

Optimizing Diagnosis of Eustachian Tube Dysfunction: A Comparative Analysis of Clinical and Instrumental Methods

Eustachian Tube Dysfunction (ETD) is a common condition affecting millions of people worldwide, yet its diagnosis remains challenging due to the lack of a universally accepted gold-standard test. The ETDQ-7, a self-reported questionnaire, has been widely used to assess ETD symptoms and quality of life. This comparative study aimed to evaluate the diagnostic accuracy of the ETDQ-7 in ETD and assess its suitability for adoption in resource-constrained settings. A comprehensive analysis of existing studies was conducted to compare the diagnostic accuracy of the ETDQ-7 with tympanometry, a widely used gold-standard test for ETD diagnosis. The results of this study show that the ETDQ-7 has a moderate diagnostic accuracy, with sensitivity and specificity values ranging from 0.75 to 0.95. The study highlights the importance of considering the specific context and characteristics of each study when interpreting the results. The findings of this study have implications for the development of diagnostic guidelines and the improvement of middle ear health in underserved populations. The ETDQ-7 was found to be a reliable and valid tool for diagnosing ETD in resource-constrained settings, but its diagnostic accuracy should be considered in the context of the specific study population and methodology used.

Optimizing Diagnosis of Eustachian Tube Dysfunction: A Comparative Analysis of Clinical and Instrumental Methods

Eustachian Tube Dysfunction (ETD) is a common condition affecting millions of people worldwide, yet its diagnosis remains challenging due to the lack of a universally accepted gold-standard test. The ETDQ-7, a self-reported questionnaire, has been widely used to assess ETD symptoms and quality of life. This comparative study aimed to evaluate the diagnostic accuracy of the ETDQ-7 in ETD and assess its suitability for adoption in resource-constrained settings. A comprehensive analysis of existing studies was conducted to compare the diagnostic accuracy of the ETDQ-7 with tympanometry, a widely used gold-standard test for ETD diagnosis. The results of this study show that the ETDQ-7 has a moderate diagnostic accuracy, with sensitivity and specificity values ranging from 0.75 to 0.95. The study highlights the importance of considering the specific context and characteristics of each study when interpreting the results. The findings of this study have implications for the development of diagnostic guidelines and the improvement of middle ear health in underserved populations. The ETDQ-7 was found to be a reliable and valid tool for diagnosing ETD in resource-constrained settings, but its diagnostic accuracy should be considered in the context of the specific study population and methodology used.

Cytokeratin 18 fragment in liver inflammation and fibrosis: Systematic review and meta-analysis.

This meta-analysis aimed to summarize the diagnostic accuracy and cut-off values of cytokeratin (CK) 18 measurements, specifically M30 and M65, as candidate biomarkers for the pathological evaluation of biopsy specimens used to stage liver inflammation and fibrosis in patients with chronic liver diseases. Databases were searched for studies collected up to January 11th, 2025. Pooled sensitivity, specificity, area under the receiver-operating characteristic curves, and mean cut-off values were calculated using random-effects models regardless of heterogeneity. A meta-regression analysis and subgroup analysis were performed to explore heterogeneity. Sixty-three studies comprising 9137 patients were included. The summarized AUROC curve of CK18 M30 for the diagnosis of significant liver inflammation, fibrosis ≥F1, ≥F2, ≥F3, and =F4 according to the METAVIR score system were 0.82, 0.75, 0.78, 0.78 and 0.76, with mean cut-off values of 264.3, 188.0, 276.9, 322.8 and 169.4 U/L. For M65, the summarized AUROC curve for detecting significant liver inflammation, fibrosis ≥F1, ≥F2, and =F4 were 0.79, 0.70, 0.76, 0.64 and 0.72, with mean cut-off values of 541.1, 417.6, 500.1, 424.6 and 674.0 U/L. The subgroup analyses implied that ethnicity may be the primary factor related to heterogeneity in CK18 M30 when applied to detect significant inflammation. Asian patients had values 79.7 U/L higher than those of non-Asian patients (p = 0.0157). CK18 M30 and M65 have clinically meaningful accuracy as alternative diagnostic tools for determining liver inflammation and fibrosis using biopsy specimens of patients with steatotic liver disease or viral hepatitis. PROSPERO registration number: CRD42022364598.

Evaluation of Benign and Malignant Cervical Lymphadenopathy: A Comparative Study of Shear Wave Elastography and Grayscale Ultrasound

Abstract Objectives The aim of the study was to evaluate role of shear wave elastography (SWE) using a novel methodology for differentiation of benign and malignant cervical lymph nodes. Methods SWE was performed on 38 patients who presented with cervical lymph adenopathy. Color-coded elasticity maps were obtained, from which the stiffest region of interest (ROI) with a diameter of 2 mm was chosen. Maximum and mean Young's modulus values (Kpa) were calculated in selected 2-mm ROI. Finally, the results were correlated with the fine needle aspiration cytology findings in all patients to assess the diagnostic accuracy, sensitivity, and specificity at a defined cutoff value for distinguishing between benign and malignant lymphadenopathies. Results There were 20 malignant cervical lymph nodes and 18 benign cervical lymph nodes. Malignant nodes showed significantly higher mean Young's modulus value (154.2 ± 46.19 kPa) compared with benign nodes (70.39 ± 30.76 kPa), with a p-value of less than 0.0001. Our findings indicate that the mean Young modulus value within a standardized 2-mm ROI outperformed grayscale ultrasound in terms of diagnostic accuracy (92.1 vs. 78.9%), sensitivity (100 vs. 80%), and specificity (83.3 vs. 77.7%), with the established cutoff values for high diagnostic accuracy indicating malignancy as greater than 92 for mean Young's modulus with an area under the curve of 0.964. Conclusion SWE using a standardized 2-mm ROI provides improved sensitivity and diagnostic accuracy for differentiation of benign and malignant lymph node lesions.

Is the YES/NO classification accurate in screening scapular dyskinesis in asymptomatic individuals? – A novel validation study utilizing surface electromyography as a surrogate measure in identifying movement asymmetries

ABSTRACT Background Scapular dyskinesis is a known risk factor for shoulder pain, making it important to screen for prevention. Physical therapists screen scapular dyskinesis by visually comparing asymmetries in scapular movement during overhead reach using the Scapular Dyskinesis Test Yes/No classification (Y/N). Although scapular kinematics has been used to quantify scapular dyskinesis, current measurement techniques are inaccurate. Optimal scapular muscle activity is crucial for normal shoulder function and is measured using surface electromyography (sEMG). Research suggests that impaired scapular muscles can lead to scapular dyskinesis. Despite kinematics being a poor reference standard, there is currently no validated method to identify movement asymmetries using muscle activity as an alternative. We utilized sEMG to establish Y/N’s validity. We hypothesized that Y/N is a valid tool using sEMG as a viable surrogate measure for identifying scapular dyskinesis. Methods We employed a known-groups (symmetrical vs. asymmetrical shoulders) validity design following the Standards for Reporting Diagnostic Accuracy Studies. Seventy-two asymptomatic subjects were evaluated using Y/N as the index test and sEMG as the reference standard. We created a criterion to assign the sEMG as the reference standard to establish the known groups. We calculated the sensitivity (Sn), specificity (Sp), positive and negative predictive values (PPV, NPV), likelihood ratios (LR+, LR-), and diagnostic odds ratio (DOR) using a 2 × 2 table analysis. Results The diagnostic accuracy values were Sn = 0.56 (0.37–0.74), Sp = 0.36 (0.08–0.65), PPV = 0.68 (0.49–0.88), NPV = 0.25 (0.04–0.46), LR+ = 0.87 (0.50–1.53), and LR- = 1.22 (0.50–2.97). Conclusion The Y/N’s diagnostic accuracy was poor against the sEMG, suggesting clinicians should rely less on Y/N to screen scapular dyskinesis in the asymptomatic population. Our study demonstrated that sEMG might be a suitable alternative as a reference standard in validating methods designed to screen movement asymmetries.

Late intervention for type II endoleak is not determined by early sac diameter or volume changes after EVAR.

To compare the diagnostic accuracy and predictive value of aneurysm sac volume measurement versus maximum diameter measurement of abdominal aortic aneurysm sac after endovascular aneurysm repair (EVAR) in patients with type II endoleak. Retrospective study on a cohort of 103 patients who presented with a type II endoleak after EVAR for infrarenal abdominal aortic aneurysm. Maximum diameter and volumetric measurements were calculated on computed tomography follow-up scans at 3 months and 1 year after index surgery. Pearson correlation coefficient was used to determine linear association between diameter and volume; Mann-Whitney U test was used to compare patients with and without later intervention for type II endoleak with regard to diameter and volume change. The correlation between diameter and volume measurement was high (Rho: 0.890-0.980 with P < 0.0001). In 38 out of 103 patients (37%) with type II endoleak, a later intervention for endoleak management was performed; early diameter (P = 0.097), or volume (P = 0.387) change could not predict risk for later intervention. Both diameter and volume measurements can be used in the imaging follow-up of patients with endoleak type II after EVAR; however early changes in diameter or volume of the aneurysm sac cannot predict late intervention for type II endoleak.

A systematic review of biofluid phosphorylated α-synuclein in Parkinson's disease.

Parkinson's disease (PD) is a progressive neurodegenerative disease, and biomarkers are needed to enhance earlier detection and monitoring. Alpha-synuclein, phosphorylated at serine 129 (pS129-α-syn), is the predominant form of α-syn found in Lewy bodies implicating an involvement in disease pathology. This review aims to systematically evaluate the evidence for pS129-α-syn detection in human biofluid samples of PD utilizing ELISA-based protein detection methods. A systematic review was conducted following the Preferred Reported Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Electronic searches were performed in PubMed, Web of Science, and Cochrane databases from inception to November 7th, 2024, to identify studies comparing pS129-α-syn in biofluids of PD patients with controls or related neurodegenerative disease. Risk of bias was assessed for each study. Twenty-three publications met the inclusion criteria, with pS129-α-syn detected in cerebrospinal fluid, plasma, red blood cells, serum, and saliva exosomes. Overall, pS129-α-syn levels were elevated in patients with PD compared to controls, and in some studies, correlated with disease severity. There was no consistent pattern when comparing PD patients to those with related neurodegenerative diseases. Significant variability in pS129-α-syn levels and considerable overlap between groups may limit the utility as a biomarker. While pS129-α-syn for PD shows some promise as a diagnostic marker for PD, its differential diagnostic utility remains limited. Further research involving larger cohorts is required. The greatest potential for pS129-α-syn may be as part of a panel with other PD-specific markers, to enhance diagnostic accuracy and prognostic value.

Diagnostic accuracy and prognostic value of thyroid imaging reporting and data system (TIRADS) 4 in thyroid cancer: a single center study

Diagnostic accuracy and prognostic value of thyroid imaging reporting and data system (TIRADS) 4 in thyroid cancer: a single center study

DNA Methylation Panels for the Differentiation of Lung and Gastric Adenocarcinomas from Other Common Primary Adenocarcinomas.

Background/Objectives: Gastric and lung adenocarcinomas are among the most common adenocarcinomas worldwide. Our research aimed to validate methylation biomarkers that differentiate gastric and lung adenocarcinomas from hepatocellular carcinoma, cholangiocarcinoma, colorectal carcinoma, pancreatic adenocarcinoma and paired healthy tissues. Methods: The study analyzed 178 formalin-fixed, paraffin-embedded tissue samples, including 14 gastric adenocarcinomas, 15 lung adenocarcinomas, 15 hepatocellular carcinomas, 15 cholangiocarcinomas, 15 colorectal carcinomas, 15 pancreatic adenocarcinomas and their paired healthy tissues. Methylation status was determined experimentally by methylation-sensitive high resolution melting. The diagnostic panels were validated on bioinformatics datasets from The Cancer Genome Atlas and Gene Expression Omnibus, comprising 1981 and 773 samples, respectively. Sensitivity, specificity, diagnostic accuracy and predictive values for each cancer type were calculated for the experimental, Gene Expression Omnibus and The Cancer Genome Atlas datasets. Results: The gastric cancer-specific panel showed a sensitivity of 78.6-83.9%, a specificity of 86.6-94.6% and a diagnostic accuracy of 89.9-96.1% to differentiate between all tumors, and a sensitivity of 78.6-83.9%, a specificity of 89.2-96.4% and a diagnostic accuracy of 88-96.1% to differentiate between all tumors and healthy tissues. The lung adenocarcinoma-specific panel showed a sensitivity of 61.1-93.3%, a specificity of 70.3-90.8% and a diagnostic accuracy of 74.2-90.6% to differentiate between all tumors, and a sensitivity of 61.1-93.3%, a specificity of 77.9-93.4% and a diagnostic accuracy of 79.2% to 93.1% to differentiate between all tumors and healthy tissues. Conclusions: This study demonstrates the potential of using diagnostic methylation panels to differentiate gastric and lung adenocarcinomas from other common adenocarcinomas and paired healthy tissues.

Progressive Bulbar Palsy Care: Exploring the Potential of Functional MRI for Early Detection

Progressive bulbar palsy (PBP) is a neurodegenerative disorder impacting motor neurons involved in speech, swallowing, and breathing. Early diagnosis is challenging due to limited diagnostic tools. Functional MRI (fMRI) holds promise for detecting early biomarkers and tracking disease progression, potentially improving clinical management. This study aims to explore the utility of fMRI in developing imaging biomarkers for the early detection, prognostication, and monitoring of PBP. By addressing existing gaps in the literature, the research seeks to demonstrate how fMRI can enhance diagnostic accuracy, provide predictive insights into disease progression, and improve patient outcomes. A systematic literature review was conducted using databases such as Google Scholar. The search focused on articles published from 2018 onwards, using keywords related to PBP and fMRI. Inclusion criteria included peer-reviewed studies involving human subjects relevant to the use of fMRI in PBP. Exclusion criteria excluded non-peer-reviewed articles, non-English publications, and studies not specifically addressing fMRI in PBP. Data synthesis involved both qualitative and quantitative analyses of identified biomarkers, diagnostic accuracy, and prognostic value. The review identified several fMRI biomarkers that show potential for early detection and monitoring of PBP. These biomarkers, derived from functional and structural changes in corticobulbar pathways, offer enhanced sensitivity compared to traditional diagnostic methods. Predictive models based on fMRI metrics can forecast disease progression, aiding in personalized treatment planning. The study concludes that integrating fMRI into clinical practice could lead to earlier interventions, more accurate prognostic assessments, and improved management of PBP, ultimately enhancing patient quality of life and outcomes.

Spondylodiscitis of the thoraco-lumbar spine: diagnostic performance of dual-energy CT vs MRI.

Dual-energy computed tomography (DECT) could combine the high-resolution bone window images made available by multi-detector CT technology with its capability to identify bone marrow edema (BME) in the spine, for diagnosing spondylodiscitis. Our objective was to compare the diagnostic performance of contrast-enhanced MRI and non-contrast DECT to identify spondylodiscitis of the thoraco-lumbar spine. This prospective study included 77 consecutive participants (39 males; mean age of 61) who underwent DECT and MRI (within 7 days) between January 2020 and October 2023. DECT data were post-processed on a dedicated offline workstation (SyngoVia® VB20) by using a three-material decomposition algorithm. Four radiologists, blinded to clinical data, evaluated non-contrast DECT and contrast-enhanced MRI images. The diagnosis of spondylodiscitis was based on vertebral edema, disc edema, endplate erosions, and paraspinal involvement. Diagnostic accuracy values were calculated by using biopsy as a standard of reference. A multi-reader multi-case analysis was performed. Biopsy revealed a diagnosis of spondylodiscitis in 46 patients (60%). Thoracic and lumbar spondylodiscitis were diagnosed in 37/46 (80%) and 9/46 (20%) patients, respectively. DECT and MRI overall sensitivity, specificity, and AUC were 0.91, 0.89, and 0.90, and 0.94, 0.93, and 0.93, respectively. At lumbar and thoracic levels, the difference between AUC values between DECT and MRI was not significant (p = 0.15). For DECT and MRI, a very good inter-reader agreement was achieved (k = 0.90 and k = 0.97, respectively). Contrast-enhanced MRI represents the most accurate imaging tool for the diagnosis of spondylodiscitis. However, only a non-significant drop in diagnostic performance was achieved by evaluating non-contrast DECT images. Question To compare the diagnostic performance of contrast-enhanced MRI and non-contrast DECT for identifying spondylodiscitis of the thoraco-lumbar spine. Findings MRI was not significantly superior compared to DECT in diagnosing spondylodiscitis, whereas the inter-reader agreement was near perfect for both MRI and DECT. Clinical relevance DECT represents a fast and accurate imaging tool for the demonstration of BME, erosions, and peri-vertebral inflammation in thoraco-lumbar spondylodiscitis.

Diagnostic Accuracy and Prognostic Value of Relative Apical Sparing in Cardiac Amyloidosis - Systematic Review and Meta-Analysis.

Although the relative apical sparing (RAPS) pattern of left ventricular (LV) longitudinal strain is a hallmark of cardiac amyloidosis, recent studies have raised concerns about its accuracy. The aim of this systematic review was to investigate diagnostic test accuracy (DTA) and prognostic impact of RAPS in cardiac amyloidosis. We searched PubMed, Embase, and Scopus for manuscripts that could potentially be used in the DTA arm and prognosis arm. Thirty-seven studies were used for DTA analysis. The pooled sensitivity, specificity, and diagnostic odds ratio were 61% (95% confidence interval [CI] 54-68%), 83% (95% CI 80-86%), and 8.9 (95% CI 6.1-13.1), respectively. These values did not differ regardless of the presence of aortic stenosis, but the diagnostic odds ratio differed significantly among analytical software packages. For the prognosis arm, 6 studies were dichotomously assessed for RAPS, and 5 were assessed quantitatively. The pooled proportion of RAPS was 49% and the pooled estimate of the RAPS ratio was 1.40. Although RAPS was associated with outcome (hazard ratio [HR] 1.87; 95% CI 1.15-3.04; P=0.011), its significance disappeared after trim and fill analysis (HR 1.42; 95% CI 0.85-2.38; P=0.184). RAPS has a modest DTA with a significant vendor dependency and does not provide robust prognostic information.

Key issues in diagnostic accuracy of sentinel lymph node biopsy in early-stage ovarian cancer: systematic review and meta-analysis

ObjectiveSentinel lymph node (SLN) mapping may reduce the morbidity of lymphadenectomy while maintaining diagnostic accuracy. Nevertheless, SLN mapping in epithelial ovarian cancer is still under investigation. This systematic review and...

Elevated GDF-15 is associated with stroke severity, myocardial injury and poor clinical outcome in patients after acute ischemic stroke

Abstract Background GDF-15 is emerging as a biomarker of cardiometabolic risk and disease burden. Increased concentrations of circulating GDF-15 are associated with increased mortality in patients with acute coronary syndromes or heart failure. Purpose We aimed to describe relation between GDF-15 elevation with stroke severity, myocardial injury and poor clinical outcome in patients after acute ischemic stroke (AIS). Methods Patients after AIS were enrolled in our study. Blood samples were obtained from patients at the time of admission, 24 and 48 hours later to determine the plasma levels of GDF-15 and high-sensitive troponin I (hs-cTnI). Receiver-operating characteristic (ROC) curve analysis was used to determine the diagnostic accuracy and optimal elevation cut-off values of GDF-15 on day 1 for the severity of acute stroke defined by NIHSS score. The optimal cut off in our group was 1776 pg/ml (Sensitivity 0,8, Specificity 0,52). Myocardial injury was defined by fourth universal definition of myocardial infarction using hs-cTnI. Demographic characteristics, clinical data, functional outcome, and all-cause mortality at 1 year were compared between groups according to GDF-15 levels. National Institutes of Health Stroke Scale (NIHSS) at the time of admission and the modified Rankin Scale (mRS) 90 days following the patient’s discharge from the hospital were used to assess stroke severity and clinical outcome. All analyses were performed with SPSS 29.0 (SPSS Inc). Results Between August 2020 and August 2022, 177 patients after AIS were enrolled. Elevated GDF-15 was observed in 71 patients (40,1%). Most common comorbidities included arterial hypertension, dyslipidemia, type 2 DM and atrial fibrillation. In analysis, we observed a connection between elevated GDF-15 with unfavourable outcome evaluated by mRS at 90 days (HR 2.57, 95% CI 1,44 to 4,57, p=0.001) and with all-cause death at 1 year (HR 4.479, 95% CI 1,81 to 11,09, p=0.001). GDF-15 elevation was associated with myocardial injury (Figure 1C). Moreover, individuals with moderate to severe and severe strokes (NIHSS 16-42) displayed higher GDF-15 levels compared to those with minor to moderate stroke (Figure 1D). The Kaplan-Meier survival curve accentuated a significantly elevated all-cause mortality among patients with increased GDF-15 (p &amp;lt; 0.001) (Figure 2). In multivariate regression analysis elevated GDF-15 was associated with atrial fibrillation and high-sensitive troponin I elevation. Conclusion The conclusions drawn suggest that heightened GDF-15 is associated with increased stroke severity, myocardial injury and unfavourable outcome.

Design of a duplex Loop-mediated isothermal amplification assay suitable for real-time, and end-point, colorimetric detection of Vibrio parahaemolyticus, and a universal Internal Amplification Control, in mussel samples

Vibrio parahaemolyticus remains as one of the most important foodborne pathogens worldwide, causing gastrointestinal disease in humans due to the consumption of raw, or undercooked, seafood. Even though molecular techniques, like PCR and qPCR, have allowed to overcome most of the limitations associated to culture-based methods, some persist such as the need for highly trained personnel, or the need to acquire expensive equipment. Loop-mediated isothermal amplification, LAMP, has emerged as a promising tool to solve these issues. The present study reports the development of a novel LAMP-based method for the detection of V. parahaemolyticus in mussels. This assay targets the gene toxR, and implements a novel, universal, freely available Internal Amplification Control (IAC) which was detected in a multiplex real-time LAMP format, where it is differentiated by melt curve analysis (86.70 ± 0.32 °C and 90.24 ± 0.34 °C for toxR and IAC respectively) and did not impact the analytical sensitivity of the target. Alternatively, the IAC was also applied in a parallel reaction and the assays performed by end-point, colorimetric LAMP. This novel IAC allowed to identify reaction inhibition due to matrix effect, and rule out false negative results. This new assay was combined with the ISO 21872 enrichment protocol, and the evaluation of spiked mussel samples indicated that an LOD95 of 14.5 and 10.8 CFU/25g could be reached after the primary 6h and secondary 24h enrichment steps by real-time LAMP, and 27.9 and 10.9 CFU/25g by naked-eye, color LAMP. It was important to note that in addition to these differences in terms of LOD95, a higher number of samples presenting reaction inhibition was observed after the primary enrichment, compared to the secondary, all successfully identified thanks to the new IAC; and also that statistically longer amplification times were required (Cq values of 19.47 ± 7.87 and 7.90 ± 1.20 respectively). The overall evaluation of the method returned values of diagnostic sensitivity, specificity and accuracy of 100 % along with an index of concordance of 1.00. These results were consistent regardless if the real-time, or the colorimetric, LAMP strategy was followed.

Title Changes in Plasma Levels of Selected Matrix Metalloproteinases (MMPs) Enzymes in Patients with Osgood-Schlatter Disease (OSD).

Background: Osgood-Schlatter disease (OSD) belongs to the group of sterile bone necrosis and mainly affects athletically active children. The pathogenesis of OSD is currently not fully understood, so the purpose of this study was to evaluate the concentrations of selected matrix metalloproteinases (MMPs)-MMP-2, MMP-3, MMP-7, MMP-9, MMP-10 and MMP-26 in patients diagnosed with OSD compared to patients with diseases other than sterile bone necrosis Methods: The study group included 140 patients with OSD, while the control group contained 100 patients with knee pain unrelated to sterile bone necrosis. The MMPs tested were determined by an enzyme-linked immunosorbent assay in plasma. Results: Patients with OSD had higher concentrations of MMP-2 and MMP-9 compared to the control group. The concentrations of MMP-7, MMP-10 and MMP-26 were lower in affected children. High values of diagnostic parameters-diagnostic accuracy (AC), sensitivity (SE), specificity (SP) and area under curve (AUC)-were obtained for MMP-7, MMP-9 and MMP-26. Conclusions: The collected results convince that MMP-7, MMP-9 and MMP-26 can be consider as a differential ancillary test between OSD and other knee pain and may be involved in the pathogenesis of this condition.

Endoscopic ultrasound-guided fine needle biopsy using macroscopic on-site evaluation technique reduces the number passes yet maintains a high diagnostic accuracy: A randomized study.

Although rapid on-site cytological evaluation (ROSE) for endoscopic ultrasound (EUS)-guided tissue acquisition (EUS-TA) may increase diagnostic yield, it is not widely available. Macroscopic on-site evaluation (MOSE) is an alternative modality although it is not standardized for EUS-guided fine-needle biopsy (FNB). We evaluated diagnostic performance of MOSE compared with conventional technique of EUS-TA using core biopsy needle. Consecutive patients undergoing EUS-FNA for solid lesions were randomized to MOSE or conventional arms. The primary and secondary outcome measures were diagnostic accuracy, diagnostic yield, sensitivity, specificity, positive and negative predictive values, and the number of passes, respectively. The optimum parameters for macroscopic visible core (MVC, i.e., length, number) by MOSE to achieve accurate diagnosis were evaluated. Ninety-six patients (48 conventional and 48 MOSE) were enrolled. Mean lesion size was larger in MOSE arm (32.67±7.22 vs 29.31±6.98mm, P=0.023). Diagnostic accuracy (95.8% vs 91.6%), diagnostic yield (97.9% vs 95.8%), procedure duration, and adverse events of the two methods were similar. Median number of passes with MOSE was less (2 vs 3 P=0.000). Area under the receiver operating characteristic curve showed that with MOSE, obtaining a total MVC length of 11.5mm had 93.3% sensitivity, and 2.5 MVC cores (each 4mm) had 86.7% sensitivity for malignancy diagnosis. EUS-FNB with MOSE, a simple reliable technique, can achieve a high and comparable diagnostic accuracy with lesser number of passes. Obtaining longer length and greater number of MVC increase the sensitivity to diagnose malignancy with MOSE.

Diagnostic Accuracy and Incremental Value of Contrast-Enhanced Mammography Compared With Full Field Digital Mammography in a Tertiary Cancer Care Center.

To assess the diagnostic accuracy and incremental value of contrast-enhanced mammography (CEM) compared with full-field digital mammography (FFDM). A retrospective analysis was performed with 150 consecutive patients who underwent CEM at our institute between November 2020 and February 2021, fulfilling the inclusion criteria. The first round of analysis included a review of FFDM with an interpretation of findings as per the Breast Imaging Reporting and Data System (BIRADS) lexicon and the assignment of the BIRADS category to the detected abnormalities. After this documentation, a second round of analysis included a review of recombined subtracted images of CEM. The diagnostic accuracy of FFDM and CEM was calculated with histopathology as the gold standard. Among the 150 cases assessed, 202 lesions were detected with histopathological correlation, of which 42 were benign and 160 were malignant. The sensitivity of FFDM was 90.6% compared to 98.12% for CEM. The specificity of FFDM was 66.7% compared to 76.19% for CEM. The negative predictive value (NPV) of FFDM was low, at 65.12%; CEM showed a better NPV, at 91.43%. The positive predictive value (PPV) was almost the same, at 94.01% for CEM and 91.19% for FFDM. The area under the curve (AUC) was superior for CEM compared to that of FFDM, with a value of 0.87. FFDM had a low sensitivity, especially in dense breast parenchyma, at 88.79% and a specificity of 70%, whereas CEM showed a higher sensitivity, specificity, and NPV, measuring 99.14%, 76.67%, and 95.83%, respectively. Superior sensitivity and high NPV for CEM make it a preferable modality compared with FFDM, especially in dense breast parenchyma, where CEM overcomes the limitations of FFDM. We conclude that CEM is superior to FFDM in evaluating the extent of disease, additional satellite lesion detection, and ruling out ambiguous findings.

Comparison Between Endobronchial-Guided Transbronchial Biopsy and Computed Tomography-Guided Transthoracic Lung Biopsy for the Diagnosis of Central Pulmonary Lesions.

Lung cancer is one of the most common malignant tumors at present. This study aimed to compare the diagnostic accuracy, complication rates, and predictive values of computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) and electronic bronchoscopy-guided transbronchial lung biopsy (TBLB) for patients with central pulmonary lesions (CPLs) with a diameter ≥ 3 cm. We retrospectively included 110 patients with CPLs with a diameter ≥ 3 cm who underwent preoperative PTNB and TBLB examinations and ultimately underwent surgery to remove CPLs and obtained pathological results. Detailed information was collected in order to compare whether there was a difference between two groups. Data were processed using SPSS software (Version 26.0; IBM Corp). Data were compared by t-test or chi-square test. p < 0.05 was considered statistically significant. All patients underwent surgical treatment at the department of thoracic surgery and obtained a final pathological diagnosis. The rate of positive predictive value (PPV) was comparable between the two methods, and the negative predictive value (NPV) was significantly higher in the PTNB group compared with the TBLB group (p < 0.05). In addition, PTNB was more sensitive and accurate than TBLB (p < 0.05). However, the PTNB group had a higher probability of complications, and TBLB was a relatively safer examination method. PTNB demonstrated a higher accuracy and sensitivity than TBLB in the treatment of CPLs with a diameter ≥ 3 cm, but the complication rates of PTNB are relatively high. These methods exhibited different diagnostic accuracies and therefore should be selected based on different medical conditions.