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Diagnostics, Volume 5, Issue 4 (December 2015) – 12 articles , Pages 399-623

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672 KiB  
Article
Association between APOE ε4 Genotype and Memory Impairment in Elderly with Normal Global Cognitive Assessment
by Yuda Turana, Yvonne Suzy Handajani and Nelly T Widjaja
Diagnostics 2015, 5(4), 615-623; https://doi.org/10.3390/diagnostics5040615 - 15 Dec 2015
Cited by 5 | Viewed by 4877
Abstract
Aim: Early prediction using cognitive evaluation tools that are less influenced by education level is beneficial for dementia screening. This study investigated the relationship between Word List Memory Immediate Recall (WLM IR) and the Saving Score (SS) with having the APOE ε4 risk [...] Read more.
Aim: Early prediction using cognitive evaluation tools that are less influenced by education level is beneficial for dementia screening. This study investigated the relationship between Word List Memory Immediate Recall (WLM IR) and the Saving Score (SS) with having the APOE ε4 risk allele in the elderly with normal global cognitive assessment. Methods: A cross-sectional study on 105 subjects ≥60 years with normal MMSE scores who met inclusion criteria. Memory impairment (MI) if: WLM IR score on the third trial <8 or an SS score <80%. Results: The majority of the subjects were female (68.6%), 65 ± 7.1 years, had undertaken formal education for <6 years (56.2%), had MI (81%), and the APOE ε4 genotype was detected in 24.8% of subjects. There was a significant relationship between APOE ε4 and lower WLMIR (p = 0.02, OR 7.92, CI 95% (1.00–62.38)). Conclusions: WLM IR score is lower in elderly people with the APOE ε4 despite their normal global cognitive assessment results, and these scores were not influenced by education level. Further research needs to confirm that the WLM IR can be used to screen for early dementia. Full article
(This article belongs to the Special Issue Early Dementia Screening and Treatment)
1753 KiB  
Review
Role of Hybrid Brain Imaging in Neuropsychiatric Disorders
by Amer M. Burhan, Nicole M. Marlatt, Lena Palaniyappan, Udunna C. Anazodo and Frank S. Prato
Diagnostics 2015, 5(4), 577-614; https://doi.org/10.3390/diagnostics5040577 - 4 Dec 2015
Cited by 11 | Viewed by 10351
Abstract
This is a focused review of imaging literature to scope the utility of hybrid brain imaging in neuropsychiatric disorders. The review focuses on brain imaging modalities that utilize hybrid (fusion) techniques to characterize abnormal brain molecular signals in combination with structural and functional [...] Read more.
This is a focused review of imaging literature to scope the utility of hybrid brain imaging in neuropsychiatric disorders. The review focuses on brain imaging modalities that utilize hybrid (fusion) techniques to characterize abnormal brain molecular signals in combination with structural and functional changes that have been observed in neuropsychiatric disorders. An overview of clinical hybrid brain imaging technologies for human use is followed by a selective review of the literature that conceptualizes the use of these technologies in understanding basic mechanisms of major neuropsychiatric disorders and their therapeutics. Neuronal network abnormalities are highlighted throughout this review to scope the utility of hybrid imaging as a potential biomarker for each disorder. Full article
(This article belongs to the Collection Hybrid Imaging in Medicine)
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676 KiB  
Review
Prevalence of Behavioural and Psychological Symptoms of Dementia in Individuals with Learning Disabilities
by Rajal Devshi, Sarah Shaw, Jordan Elliott-King, Eef Hogervorst, Avinash Hiremath, Latha Velayudhan, Satheesh Kumar, Sarah Baillon and Stephan Bandelow
Diagnostics 2015, 5(4), 564-576; https://doi.org/10.3390/diagnostics5040564 - 2 Dec 2015
Cited by 34 | Viewed by 8135
Abstract
A review of 23 studies investigating the prevalence of Behavioural and psychological symptoms of dementia (BPSD) in the general and learning disability population and measures used to assess BPSD was carried out. BPSD are non-cognitive symptoms, which constitute as a major component of [...] Read more.
A review of 23 studies investigating the prevalence of Behavioural and psychological symptoms of dementia (BPSD) in the general and learning disability population and measures used to assess BPSD was carried out. BPSD are non-cognitive symptoms, which constitute as a major component of dementia regardless of its subtype Research has indicated that there is a high prevalence of BPSD in the general dementia population. There are limited studies, which investigate the prevalence of BPSD within individuals who have learning disabilities and dementia. Findings suggest BPSDs are present within individuals with learning disabilities and dementia. Future research should use updated tools for investigating the prevalence of BPSD within individuals with learning disabilities and dementia. Full article
(This article belongs to the Special Issue Early Dementia Screening and Treatment)
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Review
The Role of Diffusion-Weighted Imaging (DWI) in Locoregional Therapy Outcome Prediction and Response Assessment for Hepatocellular Carcinoma (HCC): The New Era of Functional Imaging Biomarkers
by Johannes M. Ludwig, Juan C. Camacho, Nima Kokabi, Minzhi Xing and Hyun S. Kim
Diagnostics 2015, 5(4), 546-563; https://doi.org/10.3390/diagnostics5040546 - 30 Nov 2015
Cited by 23 | Viewed by 9141
Abstract
Reliable response criteria are critical for the evaluation of therapeutic response in hepatocellular carcinoma (HCC). Current response assessment is mainly based on: (1) changes in size, which is at times unreliable and lag behind the result of therapy; and (2) contrast enhancement, which [...] Read more.
Reliable response criteria are critical for the evaluation of therapeutic response in hepatocellular carcinoma (HCC). Current response assessment is mainly based on: (1) changes in size, which is at times unreliable and lag behind the result of therapy; and (2) contrast enhancement, which can be difficult to quantify in the presence of benign post-procedural changes and in tumors presenting with a heterogeneous pattern of enhancement. Given these challenges, functional magnetic resonance imaging (MRI) techniques, such as diffusion-weighted imaging (DWI) have been recently investigated, aiding specificity to locoregional therapy response assessment and outcome prediction. Briefly, DWI quantifies diffusion of water occurring naturally at a cellular level (Brownian movement), which is restricted in multiple neoplasms because of high cellularity. Disruption of cellular integrity secondary to therapy results in increased water diffusion across the injured membranes. This review will provide an overview of the current literature on DWI therapy response assessment and outcome prediction in HCC following treatment with locoregional therapies. Full article
(This article belongs to the Special Issue Diagnosis of Hepatocellular Carcinoma)
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3836 KiB  
Review
Imaging of HCC—Current State of the Art
by Christina Schraml, Sascha Kaufmann, Hansjoerg Rempp, Roland Syha, Dominik Ketelsen, Mike Notohamiprodjo and Konstantin Nikolaou
Diagnostics 2015, 5(4), 513-545; https://doi.org/10.3390/diagnostics5040513 - 27 Nov 2015
Cited by 35 | Viewed by 14336
Abstract
Early diagnosis of hepatocellular carcinoma (HCC) is crucial for optimizing treatment outcome. Ongoing advances are being made in imaging of HCC regarding detection, grading, staging, and also treatment monitoring. This review gives an overview of the current international guidelines for diagnosing HCC and [...] Read more.
Early diagnosis of hepatocellular carcinoma (HCC) is crucial for optimizing treatment outcome. Ongoing advances are being made in imaging of HCC regarding detection, grading, staging, and also treatment monitoring. This review gives an overview of the current international guidelines for diagnosing HCC and their discrepancies as well as critically summarizes the role of magnetic resonance imaging (MRI) and computed tomography (CT) techniques for imaging in HCC. The diagnostic performance of MRI with nonspecific and hepatobililiary contrast agents and the role of functional imaging with diffusion-weighted imaging will be discussed. On the other hand, CT as a fast, cheap and easily accessible imaging modality plays a major role in the clinical routine work-up of HCC. Technical advances in CT, such as dual energy CT and volume perfusion CT, are currently being explored for improving detection, characterization and staging of HCC with promising results. Cone beam CT can provide a three-dimensional analysis of the liver with tumor and vessel characterization comparable to cross-sectional imaging so that this technique is gaining an increasing role in the peri-procedural imaging of HCC treated with interventional techniques. Full article
(This article belongs to the Special Issue Diagnosis of Hepatocellular Carcinoma)
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1079 KiB  
Article
Performance-Based Cognitive Screening Instruments: An Extended Analysis of the Time versus Accuracy Trade-off
by Andrew J. Larner
Diagnostics 2015, 5(4), 504-512; https://doi.org/10.3390/diagnostics5040504 - 27 Nov 2015
Cited by 15 | Viewed by 5493
Abstract
Early and accurate diagnosis of dementia is key to appropriate treatment and management. Clinical assessment, including the use of cognitive screening instruments, remains integral to the diagnostic process. Many cognitive screening instruments have been described, varying in length and hence administration time, but [...] Read more.
Early and accurate diagnosis of dementia is key to appropriate treatment and management. Clinical assessment, including the use of cognitive screening instruments, remains integral to the diagnostic process. Many cognitive screening instruments have been described, varying in length and hence administration time, but it is not known whether longer tests offer greater diagnostic accuracy than shorter tests. Data from several pragmatic diagnostic test accuracy studies examining various cognitive screening instruments in a secondary care setting were analysed to correlate measures of test diagnostic accuracy and test duration, building on the findings of a preliminary study. High correlations which were statistically significant were found between one measure of diagnostic accuracy, area under the receiver operating characteristic curve, and surrogate measures of test duration, namely total test score and total number of test items/questions. Longer cognitive screening instruments may offer greater accuracy for the diagnosis of dementia, an observation which has possible implications for the optimal organisation of dedicated cognitive disorders clinics. Full article
(This article belongs to the Special Issue Early Dementia Screening and Treatment)
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685 KiB  
Review
Early Detection of Hepatocellular Carcinoma: How to Screen and Follow up Patients with Liver Cirrhosis According to the GERMAN S3 Guideline?
by Ruben R. Plentz and Nisar P. Malek
Diagnostics 2015, 5(4), 497-503; https://doi.org/10.3390/diagnostics5040497 - 25 Nov 2015
Cited by 9 | Viewed by 5725
Abstract
Hepatocellular carcinoma (HCC) is frequently detected in pre-existing liver cirrhosis, but can also develop without such pre-conditions. There is an increasing trend of HCC incidence worldwide. In patients with liver cirrhosis, HCC has become the leading cause of death. At diagnosis the tumor [...] Read more.
Hepatocellular carcinoma (HCC) is frequently detected in pre-existing liver cirrhosis, but can also develop without such pre-conditions. There is an increasing trend of HCC incidence worldwide. In patients with liver cirrhosis, HCC has become the leading cause of death. At diagnosis the tumor has very often reached an advanced stage and curative treatment options are missing. Thus, early diagnosis would help the patient and prevent increasing healthcare costs. In our review we will summarize the recommendations of the German S3 guideline for the early diagnosis of HCC and will discuss the current literature in this context. The reader will learn which diagnostic tools are available and in what order they can be usefully applied. Surveillance should be done with ultrasound by a skilled examiner, additional imaging at best with state-of-the-art dynamic magnetic resonance. Full article
(This article belongs to the Special Issue Diagnosis of Hepatocellular Carcinoma)
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Article
Risk Factors for Possible Dementia Using the Hopkins Verbal Learning Test and the Mini-Mental State Examination in Shanghai
by Xin Xu, Shifu Xiao, Tri Budi Rahardjo and Eef Hogervorst
Diagnostics 2015, 5(4), 487-496; https://doi.org/10.3390/diagnostics5040487 - 23 Nov 2015
Cited by 3 | Viewed by 6754
Abstract
Using a combination of the Hopkins Verbal Learning Test (HVLT) and the Mini-Mental State Examination (MMSE), we investigated the prevalence of possible dementia (DEM) in community-dwelling elderly in Shanghai. Subsequently, we investigated significant risk factors for DEM and generated a DEM self-checklist for [...] Read more.
Using a combination of the Hopkins Verbal Learning Test (HVLT) and the Mini-Mental State Examination (MMSE), we investigated the prevalence of possible dementia (DEM) in community-dwelling elderly in Shanghai. Subsequently, we investigated significant risk factors for DEM and generated a DEM self-checklist for early DEM detection and case management. We found that among a total of 521 participants using a HVLT cut-off score of <19 and a MMSE cut-off score of <24, a total of 69 DEM cases were identified. Risk factors, such as advanced age (≥68 years), low education (no or primary level), self-reported history of hypertension, and self-reported subjective memory complaints (SMC) were significantly predictive of DEM. The presence of ≥3 out of four of the above mentioned risk factors can effectively discriminate DEM cases from non-DEM subjects. Full article
(This article belongs to the Special Issue Early Dementia Screening and Treatment)
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679 KiB  
Article
Beyond Screening: Can the Mini-Mental State Examination be Used as an Exclusion Tool in a Memory Clinic?
by Xin Xu, Eddie Chong, Saima Hilal, Mohammad Kamran Ikram, Narayanaswamy Venketasubramanian and Christopher Chen
Diagnostics 2015, 5(4), 475-486; https://doi.org/10.3390/diagnostics5040475 - 4 Nov 2015
Cited by 8 | Viewed by 7345
Abstract
This study explores whether the Mini-Mental State Examination (MMSE) could reliably exclude definite dementia and dementia-free cases from requiring more extensive neuropsychological investigations in memory clinic settings in Singapore. Patients with memory complaints referred for possible dementia underwent the MMSE, followed by standardized [...] Read more.
This study explores whether the Mini-Mental State Examination (MMSE) could reliably exclude definite dementia and dementia-free cases from requiring more extensive neuropsychological investigations in memory clinic settings in Singapore. Patients with memory complaints referred for possible dementia underwent the MMSE, followed by standardized neuropsychological and clinical assessments which led to a consensus diagnosis. MMSE cut-off points were derived stratified for education (less and equal/above primary level). Results show that after education stratification, using an optimal Positive Likelihood Ratio (PLR) and optimal Negative Likelihood Ratio (NLR), a higher percentage of patients were correctly identified as having dementia or dementia-free, with minimal misclassification rate. The finding suggests the MMSE can be used to exclude patients not requiring full neuropsychological assessments in a memory clinic. Full article
(This article belongs to the Special Issue Early Dementia Screening and Treatment)
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823 KiB  
Review
When Prostate Cancer Circulates in the Bloodstream
by Virginie Vlaeminck-Guillem
Diagnostics 2015, 5(4), 428-474; https://doi.org/10.3390/diagnostics5040428 - 29 Oct 2015
Cited by 15 | Viewed by 7867
Abstract
Management of patients with prostate cancer is currently based on imperfect clinical, biological, radiological and pathological evaluation. Prostate cancer aggressiveness, including metastatic potential, remains difficult to accurately estimate. In an attempt to better adapt therapeutics to an individual (personalized medicine), reliable evaluation of [...] Read more.
Management of patients with prostate cancer is currently based on imperfect clinical, biological, radiological and pathological evaluation. Prostate cancer aggressiveness, including metastatic potential, remains difficult to accurately estimate. In an attempt to better adapt therapeutics to an individual (personalized medicine), reliable evaluation of the intrinsic molecular biology of the tumor is warranted, and particularly for all tumor sites (primary tumors and secondary sites) at any time of the disease progression. As a consequence of their natural tendency to grow (passive invasion) or as a consequence of an active blood vessel invasion by metastase-initiating cells, tumors shed various materials into the bloodstream. Major efforts have been recently made to develop powerful and accurate methods able to detect, quantify and/or analyze all these circulating tumor materials: circulating tumors cells, disseminating tumor cells, extracellular vesicles (including exosomes), nucleic acids, etc. The aim of this review is to summarize current knowledge about these circulating tumor materials and their applications in translational research. Full article
(This article belongs to the Special Issue Prostate Cancer Diagnosis)
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Article
Radium-223-Dichloride in Castration Resistant Metastatic Prostate Cancer—Preliminary Results of the Response Evaluation Using F-18-Fluoride PET/CT
by Kalevi Kairemo and Timo Joensuu
Diagnostics 2015, 5(4), 413-427; https://doi.org/10.3390/diagnostics5040413 - 13 Oct 2015
Cited by 35 | Viewed by 8856
Abstract
The purpose of this study was to evaluate the outcome after Radium-223-dichloride (223RaCl2) treatment of patients with skeletal metastases of castration resistant prostate cancer using whole-body 18F-Fluoride PET/CT. Sodium 18F-fluoride [18F]-NaF PET/CT was performed prior [...] Read more.
The purpose of this study was to evaluate the outcome after Radium-223-dichloride (223RaCl2) treatment of patients with skeletal metastases of castration resistant prostate cancer using whole-body 18F-Fluoride PET/CT. Sodium 18F-fluoride [18F]-NaF PET/CT was performed prior the treatment of 223RaCl2, after the first cycle and after the sixth cycle. The skeletal metastases were analyzed quantitatively using modified PET response evaluation PERCIST criteria. The patients were also analyzed for S-PSA. All ten patients responded in [18F]-NaF scans after 6 cycles, but interim analysis after the 1st cycle did not give additional information about the outcome. The S-PSA decrease correlated with [18F]-NaF response, only 1 patient demonstrated progressive disease, i.e., >25% increase in S-PSA values during 223RaCl2. Our results (although preliminary) suggest that 18F-Fluoride PET/CT is useful in the follow-up of castration resistant prostate cancer with skeletal metastases. Full article
(This article belongs to the Special Issue Prostate Cancer Diagnosis)
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Article
Scintigraphic Small Intestinal Transit Time and Defaecography in Patients with J-Pouch
by Mie Dilling Kjaer, Jane Angel Simonsen, Svend Hvidsten, Jens Kjeldsen, Oke Gerke and Niels Qvist
Diagnostics 2015, 5(4), 399-412; https://doi.org/10.3390/diagnostics5040399 - 10 Oct 2015
Cited by 4 | Viewed by 4860
Abstract
Objective methods for examination of pouch function are warranted for a better understanding of the functional result and treatment of dysfunction. The objective of this study was to evaluate the results of scintigraphic intestinal transit time and defaecography compared to the results of [...] Read more.
Objective methods for examination of pouch function are warranted for a better understanding of the functional result and treatment of dysfunction. The objective of this study was to evaluate the results of scintigraphic intestinal transit time and defaecography compared to the results of pouch function, mucosal condition and a questionnaire on quality of life (QoL). This cross-sectional study included 21 patients. Scintigraphic transit time and defaecography was determined with the use of Tc-99m. Pouch function was assessed by number of bowel movements, pouch volume, and continence. Pouch mucosal condition was evaluated by endoscopy and histology. Median transit time was 189 min (105–365). Median ejection fraction at defaecography (EF) was 49% (3–77) and 62% (17–98) after first and second defecation. Median pouch volume was 223 mL (100–360). A median daily stool frequency of nine (4–25) was reported and three (14%) patients suffered from daytime incontinence. No patients had symptomatic or endoscopic pouchitis; however, the histology showed unspecific inflammation in 19 (90%) patients. There was no correlation between transit time, evacuation fraction (EF) and pouch function in univariate analysis. However, we found a high body mass index (BMI) and a low bowel movement frequency to be associated with a longer transit time by multivariate analysis. Scintigraphic determination of transit time and defaecography are feasible methods in patients with ileal pouch anal anastomosis, but the clinical relevance is yet doubtful. Full article
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