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 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In this study, we examined the usefulness of whole body coronal images and whole body cine display MIP images (CMIP) upon which image processing was carried out after whole body SPECT in comparison to the usefulness of whole body images (WB/SC) compensated by scattered radiation in tumor/inflammation scintigraphy with 67Ga-citrate (67Ga). Image interpretation was performed for the 120 patients with confirmed diagnoses, and the accuracy of their diagnoses was studied by three nuclear medical physicians and two clinical radiological technologists by means of sensitivity, specificity and ROC analysis. The resultant data show that sensitivity, specificity, accuracy and the area under the ROC curve Az in the WB/SC were approximately 65%, 86%, 74% and 0.724, respectively, whereas sensitivity, specificity, accuracy and Az of the image reading system in which CMIP is combined with whole body coronal images reconstructed by the OS-EM method were approximately 93%, 95%, 94% and 0.860, respectively. Furthermore, coronal images reconstructed by the OS-EM method tended to be superior to those produced by the FBP method in both diagnostic accuracy and ROC analysis. In conclusion, the image reading system in which CMIP is combined with whole body coronal images reconstructed by the OS-EM method was shown to be superior in diagnostic accuracy and ROC analysis. Our data suggest that whole body SPECT is an excellent technique as an alternative to WB/SC.
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PMID:Study on the usefulness of whole body SPECT coronal image, MIP image in 67Ga scintigraphy. 1212 48

The aim of the present study was to evaluate the clinical performance of the CA 15-3 assay on Elecsys systems in an international multicenter study (11 centers). A total of 1326 single samples (272 apparently healthy individuals, 34 pregnant women, 308 benign diseases, 273 cancers other than breast, 439 breast cancer) and 538 serial samples of 98 breast cancer patients during follow-up were analyzed. 95% of values in healthy individuals were below 25 kU/L, and 88% in benign breast diseases, respectively. In malignant breast disease at primary diagnosis the value distribution of Elecsys CA 15-3, sensitivity at 95% specificity, as well as the areas under the curve in ROC analysis were clearly correlated to tumor stages: UICC I to IV 88 to 25% of values < 25 kU/L, sensitivity 7 to 78%, areas under the curve 0.53 to 0.94. During follow-up, sensitivity/specificity for detection of recurrences were 90%/71%. In metastatic disease clinical progression/response to therapy were indicated in 91%/78% of patients at a specificity of 92%/78%. The findings indicate that the Elecsys CA 15-3 assay is very suitable in routine work for detection of recurrences as well as for therapy control in metastatic breast cancer.
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PMID:Clinical evaluation of the Elecsys CA 15-3 test in breast cancer patients. 1259 71

Mortality due to hepatocellular carcinoma (HCC) has not improved over the last 20 years. This is in part due to the poor performance of available tumor markers leading to delays in diagnosis. Des-gamma carboxy-prothrombin (DCP) has been reported to be more sensitive and specific for the diagnosis of HCC in Japanese patients compared with alpha-fetoprotein (AFP). We conducted a cross-sectional case control study to evaluate whether DCP is more sensitive and specific than AFP for differentiating HCC from nonmalignant liver disease in a cohort of American patients from a single referral center. Four groups were studied: G1, normal healthy subjects; G2, patients with noncirrhotic chronic hepatitis; G3, patients with compensated cirrhosis; and G4, patients with histologically proven HCC. A total of 207 subjects were enrolled. Both DCP and AFP levels increased progressively from G1 to G4, but DCP values had less overlap among the groups than AFP. ROC curve indicated that a DCP value of 125 mAU/mL yielded the best sensitivity (89%; 95% CI, 77%-95%) and specificity (95%; 95% CI, 82%-96%) for differentiating patients with HCC from those with cirrhosis and chronic hepatitis. The optimal AFP cutoff value was 11 ng/mL and was inferior to the DCP value of 125 mAU/mL, the area under the ROC curves being 0.928 versus 0.810, respectively (P =.002). In conclusion, DCP was more sensitive and specific than AFP for differentiating HCC from nonmalignant chronic liver disease. Prospective studies to evaluate the role of DCP in early HCC are underway.
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PMID:Des-gamma carboxyprothrombin can differentiate hepatocellular carcinoma from nonmalignant chronic liver disease in american patients. 1271 92

Because ultrasound (US) imaging offers benefits compared with other medical imaging techniques, it is used routinely in nearly all hospitals and many clinics. However, the surface features and internal structure of a tumor are not easily demonstrated simultaneously using the traditional 2-D US. The newly developed three-dimensional (3-D) US can capture the morphology of a breast tumor and overcome the limitations of the traditional 2-D US. This study deals with pixel relation analysis techniques for use with 3-D breast US images and compares its performance to 2-D versions of the images. The 3-D US imaging was performed using a Voluson 530 scanner. The rectangular subimages of the volume-of-interest (VOI) were manually selected and the selected VOIs were outlined to include the entire extent of the tumor margin. The databases in this study included 54 malignant and 161 benign tumors. All solid nodules at US belong over C3 (probably benign) according to ACR BI-RADS category. All or some selected 2-D slices were used separately to calculate the diagnosis features for a 3-D US data set. We have proposed and compared several different methods to extract the characteristics of these consecutive 2-D images. As shown in our experiments, the diagnostic results were better than those of the conventional 2-D US. In the experiments, the area index Az under ROC curve of the proposed 3-D US method can achieve 0.9700 +/- 0.0118, but Az of the 2-D US is only 0.8461 +/- 0.0315. The p value of these two Az differences using z test is smaller than 0.01. Furthermore, we can find that the features from only several slices are enough to provide good diagnostic results if the adopted features are modified from the 2-D features.
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PMID:Breast cancer diagnosis using three-dimensional ultrasound and pixel relation analysis. 1287 49

The aim of the study was to investigate whether a combination of serum CA-125, CA-72.4; CA-19.9 and VEGF levels along with several currently used gray-scale criteria and pulsed and semiquantitative color Doppler blood flow assessment can be useful in preoperative discrimination of ovarian tumors. Ultrasound examinations were performed between 1994 and 1999 with the use of transvaginal probes 5-6.5-7.0 MHz and transabdominal 3.5 MHz probe (B&K Medical 3535 and 2002 ADI, Denmark). Preoperative serum CA-125 and CA-19.9 (Roche, Switzerland) and CA-72.4 (Centocor, USA) were measured with EIA II immunoassays. VEGF (R&D Systems, USA) serum levels were measured by microplate immunoenzymatic method. Retrospective study included 4,876 women referred for sonography of pelvic structures. For final analysis 451 patients with persistent adnexal tumors were available. In all these women age, menopausal status, tumor size, volume and morphology as well as blood flow indices (PI, RI, PSV) and semiquantitative color assessment were noted. In women who were not operated the cysts were followed for 10-12 weeks until resolution which was confirmed by repeated sonography. Multiple regression analysis was used to determine which of the independent variables had prognostic significance in the constructed predictive model. ROC curves were plotted and areas under ROC for each test were calculated and compared. 286 women were operated and in 118 patients their tumors regressed. The sensitivity for Doppler indices was between 85% (RI), 67% (PSV) and 66% (PI). For the subjective color assessment sensitivity was 87%. 294 women had their CA-125 serum levels available. For CA-19.9, CA-72.4 and VEGF the corresponding numbers were 109, 92 and 116 patients, respectively. Optimal cutoff level for CA-125 was 67.5 U/ml and this produced diagnostic accuracy of 69.4%. For CA-19.9 the best predictive value was 13.4 U/ml (accuracy of 74%) and for the cut-off CA-72.4 level of 4.1 U/ml the accuracy of the test was 77.8%. Multiple regression analysis revealed that only RI measurements and subjective color assessment had significant influence on the constructed predictive model. The best cut-off value of regression index "Z" was obtained following ROC curves construction for sensitivity (true positive rate) and 1-specificity (false positive rate). In all 116 patients who had Doppler indices with both CA-125 and VEGF levels measured the highest accuracy was associated with "Z" = 1.45 in postmenopausal women. The prognostic model proposed in this study can be log transformed and further used in the estimation of the true probability of malignancy of a given mass in the new set of prospectively studied patients with ovarian tumors. Color and pulsed Doppler can improve preoperative diagnosis of adnexal tumors when compared to transvaginal sonography alone or tumor markers assessment. The proposed semiquantitative evaluation of tumor vascularity increases the predictive value in terms of sensitivity and specificity. VEGF serum concentration was not useful in the preoperative discrimination of malignant and benign ovarian tumors.
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PMID:Studies on angiogenesis in the benign and malignant ovarian neoplasms with the use of color and pulsed Doppler sonography and serum CA-125, CA-19.9, CA-72.4 and vascular endothelial growth factor measurements. 1289 13

A new system for prostate diagnostics based on multifeature tissue characterization is proposed. Radiofrequency (RF) ultrasonic echo data are acquired during the standard transrectal ultrasound (US) imaging examination. Nine spectral, texture, first order and morphologic parameters are calculated and fed into two adaptive neuro-fuzzy inference systems (FIS) working in parallel. The outputs of the FISs are fed into a postprocessing procedure evaluating contextual information before being combined to form a malignancy map in which areas of high cancer probability are marked in red. The malignancy map is presented to the physician during the examination to improve the early detection of prostate cancer. The system has been evaluated on 100 patients undergoing radical prostatectomy. The ROC curve area using leave-one-out cross-validation over patients is A(Z) = 0.86 when distinguishing between hyperechoic and hypoechoic tumors and normal tissue and A(Z) = 0.84 when distinguishing between isoechoic tumors and healthy tissue, respectively. Tumors that are not visible in the conventional B-mode image can be located. Diagnosis of the prostate carcinoma using multifeature tissue characterization in combination with US imaging allows the detection of tumors at an early stage. Also, biopsy guidance and therapy planning can be improved.
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PMID:Ultrasonic multifeature tissue characterization for prostate diagnostics. 1294 17

The purpose of this study was to assess the ability of [(18)F]FDG-PET, CT/MRI and serum tumor marker (TM) to predict the viability of residual masses after high-dose chemotherapy (HD-Ctx) in patients with metastatic germ cell tumors (GCT). In a prospective study, 60 residual tumors in 28 GCT patients were classified as viable/nonviable by FDG-PET, CT/MRI and TM levels. The results were validated either by histological examination of a resected mass and/or biopsy or by clinical/radiological follow-up for at least 6 months. There were no significant differences among the sensitivities observed with PET, CT/MRI and TM, but PET was significantly more specific than CT/MRI in predicting residual mass viability. TM showed the highest specificity. The highest accuracy in classification of residual tumors was achieved by a combination of PET, CT/MRI and TM (area under the ROC curve =0.91). All mature teratomas showed false-negative PET results with SUVs in the same range as necrosis. For classification of residual masses after HD-Ctx of metastatic GCT, [(18)F]FDG-PET is a valuable diagnostic method to complement the established procedures CT and TM. Positive PET results are highly correlated with the presence of viable tumor, but residual masses with negative PET findings still require resection. In cases of tumor progression diagnosed by CT and elevated TM, additional PET examinations are without benefit. PET seems useful in patients with stable disease or partial remission in CT/MRI and normalized TM as well as in marker-negative disease.
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PMID:The role of [(18)F] FDG-PET, CT/MRI and tumor marker kinetics in the evaluation of post chemotherapy residual masses in metastatic germ cell tumors--prospects for management. 1473 10

It was suggested that there are no stronger prognostic factors in gastric cancer than nodal involvement or depth of wall invasion. The present paper evaluated the influence of maximum tumor diameter (MTD) value, measured on fixed resected specimens, on the extent of disease progression and the outcome in gastric cancer patients. Clinicopathological data were retrospectively retrieved from records of 122 patients who underwent curative gastrectomy. The patients' MTD values were grouped as follows: MTD1, up to 26 mm; MTD2, between 26 and 50 mm; and MTD3, over 50 mm. The three groups evidenced significant differences with regard to 5 year survival (MTD1: 54%, MTD2: 31%, MTD3: 20%; p = 0.00027), furthermore they were significantly different with respect to the type of gastrectomy (p = 0.021), depth wall invasion (p = 0.000), lymphatic microinvasion (p = 0.014), perineural microinvasion (p = 0.017), stromal reaction (p = 0.025), and stage (p = 0.035). ROC curve analysis individuated a best accurate MTD threshold value for nodal involvement of 32 mm (sensitivity = 56.6%; specificity = 60.9%; positive predictive value = 52.6%; negative predictive value = 64.6%). The logistic regression analysis suggested that the depth of wall invasion was the only independent variable associated with MTD value (p = 0.0005). Multivariate analysis showed that independent prognostic risk factors were sex (p < 0.0025), number of involved nodes (p < 0.001) and MTD (p < 0.001). In conclusion, the maximum tumor diameter value of gastric cancer may be a factor with greater prognostic implications than previously believed.
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PMID:Maximum gastric cancer diameter as a prognostic indicator: univariate and multivariate analysis. 1505 93

Ovarian cancer is the most deadly gynecological malignancy, with an overall survival rate of about 35%. Approximately 60% of the cases of ovarian cancer are lethal. Ultrasonic examination, including Doppler imaging, is a commonly used technique for the diagnosis of ovarian masses. Two major clinical parameters, currently derived from the Doppler flow waveform, are the resistance index (RI) and the pulsatility index (PI). The decay constant of the Doppler waveform, which characterizes its decrease from systole to diastole as an exponential decay, has recently been presented as an additional measure of tumor malignancy. In this paper, we have analyzed the velocity spectrum of the Doppler flow signal to determine if it reveals differences that might contribute to the diagnosis of malignancy. We designed a new parameter characterizing the slope of the mean velocity spectrum at end-diastole ("End Diastolic Velocity Distribution Slope," referred to as DVD_S). Additional indices, related to various approaches for the analysis of the Doppler image, were also derived. However, they proved to be inferior to the DVD_S. The DVD_S was tested on 20 benign and 33 malignant ovarian images. This new parameter seems to provide a good ability to discriminate between the two types of tumor. Its mean value is 1.90 +/- 1.33 for malignant tumors, compared to 9.21 +/- 5.34 for benign masses (area under ROC curve: 0.983), yielding a detection rate of about 94%. In fact, this parameter provides much better results than the previously used variables, and has the potential to significantly improve the detection of malignancy.
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PMID:A sensitive new indicator for diagnostics of ovarian malignancy, based on the Doppler velocity spectrum. 1506 11

Our purpose is to correlate thin section CT of peripheral bronchogenic carcinomas with histologically detected lymphatic or vascular invasion. Retrospective 3-year database search revealed 186 surgical resections for primary bronchogenic carcinoma, of which 58 had available preoperative imaging performed at our institution. Cases with prior surgery, nonconfirmatory pathology, remote imaging, or central location were excluded, resulting in a study population of 42 patients, 25 men, 17 women, with a mean age of 69 years. Imaging with 1-3 mm collimation was performed within a mean of 32 days prior to surgery. Histologic diagnoses included adenocarcinoma (n = 24, 57%), squamous cell carcinoma (n = 13, 31%), large cell carcinoma (n = 4, 10%), and small cell carcinoma (n = 1, 2%), with a mean tumor size of 27 mm. Three radiologists blindly and independently recorded bronchovascular thickening, septal and nonseptal opacities, and the extent of each beyond tumor margins: 1) <5 mm, 2) 5-10 mm, and 3) >10 mm. Lymphangio-invasion was correlated with imaging findings, tumor size, and histology. Adjacent parenchymal abnormalities were recorded in 40 (95%) of 42 masses, with isolated nonseptal opacities representing the most frequent abnormality in 21 (50%), followed by bronchovascular thickening in 16 (38%), and septal opacities in 12 (29%). Lymphangio-invasion was present in 16 (38%) of cases. The frequency of lymphangio-invasion was highest (53%) in cases with 2 or more positive findings, and extension beyond 10mm from the tumor margin. This trend did not achieve statistical significance by ROC analysis. Lymphangio-invasion was positively correlated with tumor size, P =.03, but not histology.In conclusion, parenchymal abnormalities beyond tumor margins shown by CT may be due to lymphangio-invasion but imaging findings did not reliably distinguish cases with and without lymphangio-invasion.
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PMID:Adjacent parenchymal abnormalities in peripheral bronchogenic carcinoma: correlation of thin-section CT with histology. 1507 25


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