• Title/Summary/Keyword: False Negative Rate

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Clinical experience with $^{18}F$-fluorodeoxyglucose positron emission tomography and $^{123}I$-metaiodobenzylguanine scintigraphy in pediatric neuroblastoma: complementary roles in follow-up of patients

  • Gil, Tae Young;Lee, Do Kyung;Lee, Jung Min;Yoo, Eun Sun;Ryu, Kyung-Ha
    • Clinical and Experimental Pediatrics
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    • v.57 no.6
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    • pp.278-286
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    • 2014
  • Purpose: To evaluate the potential utility of $^{123}I$-metaiodobenzylguanine ($^{123}I$-MIBG) scintigraphy and $^{18}F$-fluorodeoxyglucose ($^{18}F$-FDG) positron emission tomography (PET) for the detection of primary and metastatic lesions in pediatric neuroblastoma (NBL) patients, and to determine whether $^{18}F$-FDG PET is as beneficial as $^{123}I$-MIBG imaging. Methods: We selected 8 NBL patients with significant residual mass after operation and who had paired $^{123}I$-MIBG and $^{18}F$-FDG PET images that were obtained during the follow-up. We retrospectively reviewed the clinical charts and the findings of 45 paired scans. Results: Both scans correlated relatively well with the disease status as determined by standard imaging modalities during follow-up; the overall concordance rates were 32/45 (71.1%) for primary tumor sites and 33/45 (73.3%) for bone-bone marrow (BM) metastatic sites. In detecting primary tumor sites, $^{123}I$-MIBG might be superior to $^{18}F$-FDG PET. The sensitivity of $^{123}I$-MIBG and $^{18}F$-FDG PET were 96.7% and 70.9%, respectively, and their specificity were 85.7% and 92.8%, respectively. $^{18}F$-FDG PET failed to detect 9 true NBL lesions in 45 follow-up scans (false negative rate, 29%) with positive $^{123}I$-MIBG. For bone-BM metastatic sites, the sensitivity of $^{123}I$-MIBG and $^{18}F$-FDG PET were 72.7% and 81.8%, respectively, and the specificity were 79.1% and 100%, respectively. $^{123}I$-MIBG scan showed higher false positivity (20.8%) than $^{18}F$-FDG PET (0%). Conclusion: $^{123}I$-MIBG is superior for delineating primary tumor sites, and $^{18}F$-FDG PET could aid in discriminating inconclusive findings on bony metastatic NBL. Both scans can be complementarily used to clearly determine discrepancies or inconclusive findings on primary or bone-BM metastatic NBL during follow-up.

Diagnostic Value of Ceruloplasmin in the Diagnosis of Pediatric Wilson's Disease

  • Kim, Jung Ah;Kim, Hyun Jin;Cho, Jin Min;Oh, Seak Hee;Lee, Beom Hee;Kim, Gu-Hwan;Choi, Jin-Ho;Kim, Kyung Mo;Yoo, Han-Wook
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.3
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    • pp.187-192
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    • 2015
  • Purpose: Measurement of serum ceruloplasmin level is the first step in screening for Wilson's disease (WD). Despite the rarity of WD in the general population, ceruloplasmin levels are routinely measured through hepatitis screening in both adults and children. Herein, we evaluated the diagnostic value of ceruloplasmin for the diagnosis of WD among children with hepatitis. Methods: We retrospectively reviewed data on serum ceruloplasmin levels measured as a serologic marker for patients with hepatitis at Asan Medical Center (Seoul, Korea) between from January 2004 to November 2013. The diagnosis of WD was confirmed by the identification of pathogenic variants in the ATP7B gene. To determine the diagnostic accuracy of ceruloplasmin, receiver operation characteristic (ROC) curves were constructed and the area under curve (AUC) were calculated. Results: Measurements of serum ceruloplasmin were performed in 2,834 children who had hepatitis. Among these, 181 (6.4%) children were diagnosed with WD. The sensitivity, specificity, and accuracy of a ceruloplasmin level of <20 mg/dL in the discrimination of WD were 93.4%, 84.2%, and 84.8%, respectively. In this study, 418 (14.7%) false-positive cases and 12 (0.4%) false-negative cases were noted. Using a ROC curve, a ceruloplasmin level of ${\leq}16.6mg/dL$ showed the highest AUC value (0.956) with a sensitivity of 91.2%, a specificity of 94.9%, and an accuracy of 94.7%. Conclusion: The measurement of serum ceruloplasmin was frequently used for the screening of WD in children, despite a low positive rate. The diagnostic value of ceruloplasmin may be strengthened by adopting a new lower cut-off level.

QSAR Approach for Toxicity Prediction of Chemicals Used in Electronics Industries (전자산업에서 사용하는 화학물질의 독성예측을 위한 QSAR 접근법)

  • Kim, Jiyoung;Choi, Kwangmin;Kim, Kwansick;Kim, Dongil
    • Journal of Environmental Health Sciences
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    • v.40 no.2
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    • pp.105-113
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    • 2014
  • Objectives: It is necessary to apply quantitative structure activity relationship (QSAR) for the various chemicals with insufficient toxicity data that are used in the workplace, based on the precautionary principle. This study aims to find application plan of QSAR software tool for predicting health hazards such as genetic toxicity, and carcinogenicity for some chemicals used in the electronics industries. Methods: Toxicity prediction of 21 chemicals such as 5-aminotetrazole, ethyl lactate, digallium trioxide, etc. used in electronics industries was assessed by Toxicity Prediction by Komputer Assisted Technology (TOPKAT). In order to identify the suitability and reliability of carcinogenicity prediction, 25 chemicals such as 4-aminobiphenyl, ethylene oxide, etc. which are classified as Group 1 carcinogens by the International Agency for Research on Cancer (IARC) were selected. Results: Among 21 chemicals, we obtained prediction results for 5 carcinogens, 8 non-carcinogens and 8 unpredictability chemicals. On the other hand, the carcinogenic potential of 5 carcinogens was found to be low by relevant research testing data and Oncologic TM tool. Seven of the 25 carcinogens (IARC Group 1) were wrongly predicted as non-carcinogens (false negative rate: 36.8%). We confirmed that the prediction error could be improved by combining genetic toxicity information such as mutagenicity. Conclusions: Some compounds, including inorganic chemicals and polymers, were still limited for applying toxicity prediction program. Carcinogenicity prediction may be further improved by conducting cross-validation of various toxicity prediction programs, or application of the theoretical molecular descriptors.

MRI Diagnosis of the Tear Pattern of Menisci (반월상 연골판 파열 양상의 자기공명영상 진단)

  • Ahn, Jin Hwan;Ha, Chul Won;Ahn, Joong Mo;Kim, Sang Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.2
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    • pp.151-154
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    • 1998
  • In the diagnosis of the meniscal tear of the knee, the high accuracy of the MRI diagnosis is well-known, but the accuracy of the MRI in the diagnosis of the very pattern of the tear of menisci is not well-established. The purpose of this study is to give some informations to consider in the diagnosis and therapeutic planning of torn menisci. The authors performed a retrospective study comparing the MRI and arthroscopic findings of 141 knees which had undergone arthroscopic surgery from Mar. 1997 to Mar. 1998. The results are as follows. In the diagnosis of tear of the menisci, MRI had sensitivity of 91%, specificity of 96%, accuracy of 95%. The mismatch of the tear patterns of the menisci between MRI and arthroscopic findings was identified in 59%, especially high in flap tear(100%), complex tear(84%), peripheral tear(55%). In conclusion, MRI is very accurate in the diagnosis of the tear of menisci, but the tear patterns of the menisci cannot be accurately determined by MRI. In the cases of flap tears, complex tears and peripheral tears, it is more difficult to determine the tear patterns of the menisci by MRI. False-negative rate of MRI was especially high(44%) in the peripheral tear type. So, other clinical correlations should be made in determination of the presence of the tear in the diagnosis of peripheral tear of the menisci.

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Application of monoclonal antibody to develop diagnostic techniques for infectious bovine rhinotracheitis virus. II. Diagnosis of infectious bovine rhinotracheitis by using monoclonal antibody (소 전염성비기관염(傳染性鼻氣管炎) 바이러스에 대한 monoclonal antibody 생산(生産)과 진단법(診斷法) 개발 II. Monoclonal antibody를 이용한 소 전염성비기관염(傳染性鼻氣管炎)의 진단(診斷))

  • Jun, Moo-hyung;Kim, Duck-hwan;An, Soo-hwan;Lee, Jung-bok;Min, Won-gi
    • Korean Journal of Veterinary Research
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    • v.29 no.1
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    • pp.27-35
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    • 1989
  • To develop more specific and sensitive diagnostic methods for infectious bovine rhinotracheitis, 7-C-2 monoclonal antibody specific to polypeptides of infectious bovine rhinotracheitis virus (IBRV) was applied in indirect immunofluorescence antibody assay (IFA), indirect immunoperoxidase assay(IPA) and radial immunodiffusion enzyme assay (RIDEA). It was found that IBRV infected in MDBK cells could be detected as early as 8 hours post infection by IFA, and that IFA was more rapid and specific to identify IBRV antigen than IPA. The diagnostic efficacy of RIDEA and SN test was studied with 88 bovine sera. It was evident that RIDEA could eliminate the false positive reaction encountered in serum neutralization(SN) test, being more rapid and sensitive than the latter. Highly significant correlation coefficiency (r=0.76, p<0.01) was evaluated between the titers of sera and the diameters of RIDEA. Tracheal membranes and sera collected from 96 slaughtered cattle with lesions in respiratory organs were examined to detect IBRV antigen and antibody by IFA, RIDEA and SN test. It was presented that positive rates were 32.3% in IFA, 20.8% in RIDEA and 21.9% in SN test, and that coincidence rate between RIDEA and SN test were 100% in positive sera and 98.7% in negative sera. In conclusion, it was assumed that application of monoclonal antibody could improve the diagnostic efficacy of IBR by enhancing sensitivity and specificity of IPA, IFA and RIDEA.

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The Efficiency of Cell Block in the Diagnosis of Non-gynecologic Cytology (비 산부인과 세포 검사 진단에 있어서세포 군집절편(Cell-Block)법의 유용성)

  • Han, Seung Hee;Youn, Mi Ja;Park, Byung Kyu;Lim, Byung Soo;Ahn, Mi Jung;Yang, Chul Kyu;Jeon, Geum Hee;Sung, Ha Ok
    • Korean Journal of Clinical Laboratory Science
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    • v.36 no.1
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    • pp.38-42
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    • 2004
  • Because of the lack of resources on the importance of cell block, the diagnosis of cytologic specimen has been overlooked. Out of 1,243 cases of non-gynecologic cytology specimen, about 87.1% has been proven to be diagnostically useful. About 0.9% of those were rendered diagnostic by cell block alone. If cell block was not made it could have resulted in misdiagnosis. The effect on making cell block might not be directly linked to the patient but to the pathologist, it can be a helpful secondary tool in lowering the chance of giving false negative results hence. Giving the patient the opportunity of an adequate treatment. This study has proven that cell block has diagnostic value in non-gynecologic cytology. We are doing our best to increase the production rate of cell block and to improve the quality of cytology smears and cell block, so that we can increase the accuracy of diagnosis.

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Discriminatory ability of cervical vertebral maturation stages in predicting attainment of the legal age threshold of 14 years: A pilot study using lateral cephalograms

  • Banda, Thirupathi Reddy;Komuravelli, Anil Kumar;Balla, Sudheer B.;Korrai, Bala Raju;Alluri, Kavya;Kondapaneni, Jayasurya;Abhyankar, Sourab
    • Imaging Science in Dentistry
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    • v.50 no.3
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    • pp.209-216
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    • 2020
  • Purpose: In India, the age of 14 years is the legal age threshold for child labour. Therefore, in suspected instances of child labour, age assessment plays a crucial role in determining whether a violation of the law on the employment of children has occurred. The aim of this retrospective cross-sectional study was to assess the discriminatory ability of stages of cervical vertebral maturation (CVM) in predicting the legal age threshold of 14 years. Materials and Methods: Routinely taken lateral cephalograms from 408 subjects aged 10 to 18 years were evaluated retrospectively using the CVM stages described by Baccetti et al. Descriptive statistics, accuracy, sensitivity, specificity, positive and negative predictive values, and likelihood ratios were calculated for stages 2, 3, and 4 of CVM. Results: Real age increased as the CVM stage gradually increased. The results of 2×2 contingency tables showed that CVM stage 4 produced an accuracy of 71% and 73%, a false positive rate of 7% and 18%, and a post-test probability of 59% and 68% for boys and girls, respectively. Conclusion: Based on these findings, it can be concluded that the stages of CVM are of limited use for predicting the attainment of the legal age threshold of 14 years. Future studies should investigate whether combinations of skeletal and dental methods could achieve better accuracy and post-test probability.

FDG-PET/CT Complements Bone Scan with Respect to the Detection of Skip Metastasis of Osteosarcoma: A Case Report (골육종의 도약전이 진단에서 골스캔의 보완검사로서의 FDG-PET/CT: 증례 보고)

  • Cheon, Gi-Jeong;Choe, Jae-Gol;Chae, In-Jung;Lee, Dae-Hee;Song, Sang-Heon;Kim, Myo-Jong;Park, Jong-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.1
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    • pp.45-49
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    • 2012
  • Skip lesion is not uncommon feature in osteosarcoma and considered to be importantly associated with poor prognosis factor, and thus, should be excised with the main mass. The accurate pre-operative evaluation of the intramedullary extent of osteosarcoma is essential, because it determines the level of bone resection. Among the reliable detection methods, bone scan has a drawback of high rate of false negative results and regional MRI has a difficulty to cover the whole involved lesions without clinical suspicion. The authors report a case of osteosarcoma of the distal femur with a proximal skip lesion that was not detected by either regional MR imaging or by bone scan, but which was visualized by FDG-PET/CT.

A Comparative Evaluation of Three Rapid Tests of Syphilis and ARCHITECT Syphilis TP

  • Kim, Won-Shik
    • Korean Journal of Clinical Laboratory Science
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    • v.43 no.1
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    • pp.1-5
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    • 2011
  • The infection rate of syphilis is still increasing in the world especially in developing countries and the infection is often seen in large amounts of clinical specimens. For the diagnosis of this disease, Rapid Plasma Reagin (RPR)/Venereal Disease Research Laboratory (VDRL) has still been used as one of major primary methods to diagnose syphilis even though the test readings are somewhat subjective with high false positive rates. Recently, the automatic ARCHITECT Syphilis TP, which is based on the detection of the TP-specific antibodies, has been introduced in many laboratories. Therefore, the clinical assessment of the method is needed to provide primary diagnosis of syphilis at the moment. We evaluated 3 different manual rapid kits and ARCHITECT Syphilis TP comparing with RPR/FTA-ABS and analysed their diagnostic properties. From February 2006 to April 2008, 203 positive and 250 negative specimens, obtained from Chungbuk National University Hospital were used for the evaluation. In the evaluation between manual rapid kits, their specificities were as high as 99.2 ~ 99.6% while their sensitivities were observed with little differences; 98.0% (199/203) for Kit A, 96.6% (196/203) for Kit B, and 97.4% (197/203) for Kit S. In the case of ARCHITECT Syphilis TP test, it showed 100% specificity (250/250) and 98.5% sensitivity (249/250). Kappa values comparing with RPR/FTA-ABS were 0.978 for Kit A, 0.964 for Kit B and Kit S, and 0.987 for ARCHITECT Syphilis TP. From our evaluation, we found out that manual rapid tests and ARCHITECT Syphilis TP have very good clinical accuracies and high kappa agreements with RPR/FTA-ABS. Due to its automation and quick simultaneous diagnosis with another serological markers, we suggest that the ARCHITECT Syphilis TP is one of best suitable method for the primary diagnosis of syphilis and that it might be able to replace RPR method in the laboratories.

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Personalized Diabetes Risk Assessment Through Multifaceted Analysis (PD- RAMA): A Novel Machine Learning Approach to Early Detection and Management of Type 2 Diabetes

  • Gharbi Alshammari
    • International Journal of Computer Science & Network Security
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    • v.23 no.8
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    • pp.17-25
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    • 2023
  • The alarming global prevalence of Type 2 Diabetes Mellitus (T2DM) has catalyzed an urgent need for robust, early diagnostic methodologies. This study unveils a pioneering approach to predicting T2DM, employing the Extreme Gradient Boosting (XGBoost) algorithm, renowned for its predictive accuracy and computational efficiency. The investigation harnesses a meticulously curated dataset of 4303 samples, extracted from a comprehensive Chinese research study, scrupulously aligned with the World Health Organization's indicators and standards. The dataset encapsulates a multifaceted spectrum of clinical, demographic, and lifestyle attributes. Through an intricate process of hyperparameter optimization, the XGBoost model exhibited an unparalleled best score, elucidating a distinctive combination of parameters such as a learning rate of 0.1, max depth of 3, 150 estimators, and specific colsample strategies. The model's validation accuracy of 0.957, coupled with a sensitivity of 0.9898 and specificity of 0.8897, underlines its robustness in classifying T2DM. A detailed analysis of the confusion matrix further substantiated the model's diagnostic prowess, with an F1-score of 0.9308, illustrating its balanced performance in true positive and negative classifications. The precision and recall metrics provided nuanced insights into the model's ability to minimize false predictions, thereby enhancing its clinical applicability. The research findings not only underline the remarkable efficacy of XGBoost in T2DM prediction but also contribute to the burgeoning field of machine learning applications in personalized healthcare. By elucidating a novel paradigm that accentuates the synergistic integration of multifaceted clinical parameters, this study fosters a promising avenue for precise early detection, risk stratification, and patient-centric intervention in diabetes care. The research serves as a beacon, inspiring further exploration and innovation in leveraging advanced analytical techniques for transformative impacts on predictive diagnostics and chronic disease management.