Diagnostics

3132 KiB

Open AccessArticle

Auto Diagnostics of Lung Nodules Using Minimal Characteristics Extraction Technique

by Diego M. Peña, Shouhua Luo and Abdeldime M. S. Abdelgader

Diagnostics 2016, 6(1), 13; https://doi.org/10.3390/diagnostics6010013 - 4 Mar 2016

Cited by 23 | Viewed by 6838

Computer-aided detection (CAD) systems provide useful tools and an advantageous process to physicians aiming to detect lung nodules. This paper develops a method composed of four processes for lung nodule detection. The first step employs image acquisition and pre-processing techniques to isolate the [...] Read more.

Computer-aided detection (CAD) systems provide useful tools and an advantageous process to physicians aiming to detect lung nodules. This paper develops a method composed of four processes for lung nodule detection. The first step employs image acquisition and pre-processing techniques to isolate the lungs from the rest of the body. The second stage involves the segmentation process using a 2D algorithm to affect every layer of a scan eliminating non-informative structures inside the lungs, and a 3D blob algorithm associated with a connectivity algorithm to select possible nodule shape candidates. The combinations of these algorithms efficiently eliminate the high rates of false positives. The third process extracts eight minimal representative characteristics of the possible candidates. The final step utilizes a support vector machine for classifying the possible candidates into nodules and non-nodules depending on their features. As the objective is to find nodules bigger than 4mm, the proposed approach demonstrated quite encouraging results. Among 65 computer tomography (CT) scans, 94.23% of sensitivity and 84.75% in specificity were obtained. The accuracy of these two results was 89.19% taking into consideration that 45 scans were used for testing and 20 for training. The rate of false positives was 0.2 per scan. Full article

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Open AccessEditorial

Diagnostics Now in PubMed and PubMed Central

by Andreas Kjaer

Diagnostics 2016, 6(1), 12; https://doi.org/10.3390/diagnostics6010012 - 23 Feb 2016

Cited by 1 | Viewed by 4746

Abstract

It is with great pleasure and proud that we can announce that Diagnostics is now indexed and searchable in PubMed.[...] Full article

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Open AccessArticle

Cluster Analysis of Physical and Cognitive Ageing Patterns in Older People from Shanghai

by Stephan Bandelow, Xin Xu, Shifu Xiao and Eef Hogervorst

Diagnostics 2016, 6(1), 11; https://doi.org/10.3390/diagnostics6010011 - 22 Feb 2016

Cited by 3 | Viewed by 6283

Abstract

This study investigated the relationship between education, cognitive and physical function in older age, and their respective impacts on activities of daily living (ADL). Data on 148 older participants from a community-based sample recruited in Shanghai, China, included the following measures: age, education, [...] Read more.

This study investigated the relationship between education, cognitive and physical function in older age, and their respective impacts on activities of daily living (ADL). Data on 148 older participants from a community-based sample recruited in Shanghai, China, included the following measures: age, education, ADL, grip strength, balance, gait speed, global cognition and verbal memory. The majority of participants in the present cohort were cognitively and physically healthy and reported no problems with ADL. Twenty-eight percent of participants needed help with ADL, with the majority of this group being over 80 years of age. Significant predictors of reductions in functional independence included age, balance, global cognitive function (MMSE) and the gait measures. Cluster analysis revealed a protective effect of education on cognitive function that did not appear to extend to physical function. Consistency of such phenotypes of ageing clusters in other cohort studies may provide helpful models for dementia and frailty prevention measures. Full article

(This article belongs to the Special Issue Early Dementia Screening and Treatment 2016)

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Open AccessDiscussion

Replacing Myalgic Encephalomyelitis and Chronic Fatigue Syndrome with Systemic Exercise Intolerance Disease Is Not the Way forward

by Frank N.M. Twisk

Diagnostics 2016, 6(1), 10; https://doi.org/10.3390/diagnostics6010010 - 5 Feb 2016

Cited by 12 | Viewed by 9661

Abstract

Myalgic encephalomyelitis (ME), described in the medical literature since 1938, is characterized by distinctive muscular symptoms, neurological symptoms, and signs of circulatory impairment. The only mandatory feature of chronic fatigue syndrome (CFS), introduced in 1988 and redefined in 1994, is chronic fatigue, which [...] Read more.

Myalgic encephalomyelitis (ME), described in the medical literature since 1938, is characterized by distinctive muscular symptoms, neurological symptoms, and signs of circulatory impairment. The only mandatory feature of chronic fatigue syndrome (CFS), introduced in 1988 and redefined in 1994, is chronic fatigue, which should be accompanied by at least four or more out of eight “additional” symptoms. The use of the abstract, polythetic criteria of CFS, which define a heterogeneous patient population, and self-report has hampered both scientific progress and accurate diagnosis. To resolve the “diagnostic impasse” the Institute of Medicine proposes that a new clinical entity, systemic exercise intolerance disease (SEID), should replace the clinical entities ME and CFS. However, adopting SEID and its defining symptoms, does not resolve methodological and diagnostic issues. Firstly, a new diagnostic entity cannot replace two distinct, partially overlapping, clinical entities such as ME and CFS. Secondly, due to the nature of the diagnostic criteria, the employment of self-report, and the lack of criteria to exclude patients with other conditions, the SEID criteria seem to select an even more heterogeneous patient population, causing additional diagnostic confusion. This article discusses methodological and diagnostic issues related to SEID and proposes a methodological solution for the current “diagnostic impasse”. Full article

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Open AccessReview

Computed Tomography and Ultrasounds for the Follow-up of Hepatocellular Carcinoma Ablation: What You Need to Know

by Alexios Kelekis and Dimitrios Filippiadis

Diagnostics 2016, 6(1), 9; https://doi.org/10.3390/diagnostics6010009 - 4 Feb 2016

Cited by 4 | Viewed by 6249

Abstract

Image-guided tumor ablation provides curative treatment in properly selected patients or appropriate therapeutic options whenever surgical techniques are precluded. Tumor response assessment post ablation is important in determining treatment success and future therapy. Accurate interpretation of post-ablation imaging findings is crucial for therapeutic [...] Read more.

Image-guided tumor ablation provides curative treatment in properly selected patients or appropriate therapeutic options whenever surgical techniques are precluded. Tumor response assessment post ablation is important in determining treatment success and future therapy. Accurate interpretation of post-ablation imaging findings is crucial for therapeutic and follow-up strategies. Computed Tomography (CT) and Ultrasound (US) play important roles in patients’ follow-up post liver thermal ablation therapies. Contrast-enhanced ultrasound (CEUS) can provide valuable information on the ablation effects faster and at a lower cost than computed tomography or magnetic resonance imaging. However, a disadvantage is that the technique cannot examine total liver parenchyma for disease progression as CT and Magnetic Resonance (MR) imaging can. Follow-up strategies for assessment of tumor response includes contrast enhanced multiphasic (non-contrast, arterial, portal, delayed phases) imaging with Computed Tomography at three, six, and 12 months post ablation session and annually ever since in order to prove sustained effectiveness of the ablation or detect progression. Full article

(This article belongs to the Special Issue Diagnosis of Hepatocellular Carcinoma)

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678 KiB

Open AccessEditorial

Acknowledgement to Reviewers of Diagnostics in 2015

by Diagnostics Editorial Office

Diagnostics 2016, 6(1), 7; https://doi.org/10.3390/diagnostics6010007 - 2 Feb 2016

Viewed by 3954

Abstract

The editors of Diagnostics would like to express their sincere gratitude to the following reviewers for assessing manuscripts in 2015. [...] Full article

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Open AccessArticle

Interobserver and Intraobserver Reproducibility with Volume Dynamic Contrast Enhanced Computed Tomography (DCE-CT) in Gastroesophageal Junction Cancer

by Martin Lundsgaard Hansen, Eva Fallentin, Thomas Axelsen, Carsten Lauridsen, Rikke Norling, Lars Bo Svendsen and Michael Bachmann Nielsen

Diagnostics 2016, 6(1), 8; https://doi.org/10.3390/diagnostics6010008 - 1 Feb 2016

Cited by 4 | Viewed by 6154

Abstract

The purpose of this study was to assess inter- and intra-observer reproducibility of three different analytic methods to evaluate quantitative dynamic contrast-enhanced computed tomography (DCE-CT) measures from gastroesophageal junctional cancer. Twenty-five DCE-CT studies with gastroesophageal junction cancer were selected from a previous longitudinal [...] Read more.

The purpose of this study was to assess inter- and intra-observer reproducibility of three different analytic methods to evaluate quantitative dynamic contrast-enhanced computed tomography (DCE-CT) measures from gastroesophageal junctional cancer. Twenty-five DCE-CT studies with gastroesophageal junction cancer were selected from a previous longitudinal study. Three radiologists independently reviewed all scans, and one repeated the analysis eight months later for intraobserver analysis. Review of the scans consisted of three analysis methods: (I) Four, fixed small sized regions of interest (2-dimensional (2D) fixed ROIs) placed in the tumor periphery, (II) 2-dimensional regions of interest (2D-ROI) along the tumor border in the tumor center, and (III) 3-dimensional volumes of interest (3D-VOI) containing the entire tumor volume. Arterial flow, blood volume and permeability (k^trans) were recorded for each observation. Inter- and intra-observer variability were assessed by Intraclass Correlation Coefficient (ICC) and Bland-Altman statistics. Interobserver ICC was excellent for arterial flow (0.88), for blood volume (0.89) and for permeability (0.91) with 3D-VOI analysis. The 95% limits of agreement were narrower for 3D analysis compared to 2D analysis. Three-dimensional volume DCE-CT analysis of gastroesophageal junction cancer provides higher inter- and intra-observer reproducibility with narrower limits of agreement between readers compared to 2D analysis. Full article

(This article belongs to the Collection Feature Papers)

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Open AccessReview

Early Dementia Screening

by Peter K. Panegyres, Renee Berry and Jennifer Burchell

Diagnostics 2016, 6(1), 6; https://doi.org/10.3390/diagnostics6010006 - 21 Jan 2016

Cited by 61 | Viewed by 16530

Abstract

As the population of the world increases, there will be larger numbers of people with dementia and an emerging need for prompt diagnosis and treatment. Early dementia screening is the process by which a patient who might be in the prodromal phases of [...] Read more.

As the population of the world increases, there will be larger numbers of people with dementia and an emerging need for prompt diagnosis and treatment. Early dementia screening is the process by which a patient who might be in the prodromal phases of a dementing illness is determined as having, or not having, the hallmarks of a neurodegenerative condition. The concepts of mild cognitive impairment, or mild neurocognitive disorder, are useful in analyzing the patient in the prodromal phase of a dementing disease; however, the transformation to dementia may be as low as 10% per annum. The search for early dementia requires a comprehensive clinical evaluation, cognitive assessment, determination of functional status, corroborative history and imaging (including MRI, FDG-PET and maybe amyloid PET), cerebrospinal fluid (CSF) examination assaying Aβ_1–42, T-τ and P-τ might also be helpful. Primary care physicians are fundamental in the screening process and are vital in initiating specialist investigation and treatment. Early dementia screening is especially important in an age where there is a search for disease modifying therapies, where there is mounting evidence that treatment, if given early, might influence the natural history—hence the need for cost-effective screening measures for early dementia. Full article

(This article belongs to the Special Issue Early Dementia Screening and Treatment)

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Open AccessInteresting Images

Potential Pitfalls on the ^99mTc-Mebrofenin Hepatobiliary Scintigraphy in a Patient with Biliary Atresia Splenic Malformation Syndrome

by Jane Maestri Brittain and Lise Borgwardt

Diagnostics 2016, 6(1), 5; https://doi.org/10.3390/diagnostics6010005 - 7 Jan 2016

Viewed by 6239

Abstract

Biliary atresia (BA) is an obliterative cholangiopathy affecting 1:10.000–14.000 of newborns. Infants with Biliary Atresia Splenic Malformation syndrome (BASM) are a subgroup of BA patients with additional congenital anomalies. Untreated the disease will result in fatal liver failure within the first years of [...] Read more.

Biliary atresia (BA) is an obliterative cholangiopathy affecting 1:10.000–14.000 of newborns. Infants with Biliary Atresia Splenic Malformation syndrome (BASM) are a subgroup of BA patients with additional congenital anomalies. Untreated the disease will result in fatal liver failure within the first years of life. Kasai portoenterostomy restores bile flow and delay the progressive liver damage thereby postponing liver transplantation. An early diagnosis is of most importance to ensure the effectiveness of the operation. The ^99mTc-Mebrofenin hepatobiliary scintigraphy is part of the diagnostic strategy when an infant presents jaundice due to conjugated hyperbilirubinemia (>20 µmol/L total bilirubin of which 20% is conjugated) with its high sensitivity of 97%–100% in refuting BA. Rapid extraction of tracer by the liver and no visible tracer in the small bowl after 24 h is indicative of BA. Laparotomy with antegrade cholangiography is then performed giving the final diagnosis when the remains of the obliterated biliary tree are revealed in the case of BA. We present a case demonstrating some of the challenges of interpreting the ^99mTc-Mebrofenin hepatobiliary scintigraphy in an infant with BASM and stress the importance that the ^99mTc-Mebrofenin hepatobiliary scintigraphy is part of a spectrum of imaging modalities in diagnosing BA. Full article

(This article belongs to the Collection Hybrid Imaging in Medicine)

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Open AccessArticle

Economic Analysis of Alternative Strategies for Detection of ALK Rearrangements in Non Small Cell Lung Cancer

by Shivang Doshi, David Ray, Karen Stein, Jie Zhang, Prasad Koduru, Franz Fogt, Axel Wellman, Ricky Wat and Charles Mathews

Diagnostics 2016, 6(1), 4; https://doi.org/10.3390/diagnostics6010004 - 6 Jan 2016

Cited by 23 | Viewed by 9813

Abstract

Identification of alterations in ALK gene and development of ALK-directed therapies have increased the need for accurate and efficient detection methodologies. To date, research has focused on the concordance between the two most commonly used technologies, fluorescent in situ hybridization (FISH) and [...] Read more.

Identification of alterations in ALK gene and development of ALK-directed therapies have increased the need for accurate and efficient detection methodologies. To date, research has focused on the concordance between the two most commonly used technologies, fluorescent in situ hybridization (FISH) and immunohistochemistry (IHC). However, inter-test concordance reflects only one, albeit important, aspect of the diagnostic process; laboratories, hospitals, and payors must understand the cost and workflow of ALK rearrangement detection strategies. Through literature review combined with interviews of pathologists and laboratory directors in the U.S. and Europe, a cost-impact model was developed that compared four alternative testing strategies—IHC only, FISH only, IHC pre-screen followed by FISH confirmation, and parallel testing by both IHC and FISH. Interviews were focused on costs of reagents, consumables, equipment, and personnel. The resulting model showed that testing by IHC alone cost less ($90.07 in the U.S., $68.69 in Europe) than either independent or parallel testing by both FISH and IHC ($441.85 in the U.S. and $279.46 in Europe). The strategies differed in cost of execution, turnaround time, reimbursement, and number of positive results detected, suggesting that laboratories must weigh the costs and the clinical benefit of available ALK testing strategies. Full article

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Open AccessBrief Report

Hepatocellular Carcinoma, Fibrolamellar Variant: Diagnostic Pathologic Criteria and Molecular Pathology Update. A Primer

by Consolato M. Sergi

Diagnostics 2016, 6(1), 3; https://doi.org/10.3390/diagnostics6010003 - 30 Dec 2015

Cited by 16 | Viewed by 11314

Abstract

Fibrolamellar hepatocellular carcinoma (FL-HCC) is generally a fairly rare event in routine pathology practice. This variant of hepatocellular carcinoma (HCC) is peculiarly intriguing and,in addition, poorly understood. Young people or children are often the target individuals with this type of cancer. Previously, I [...] Read more.

Fibrolamellar hepatocellular carcinoma (FL-HCC) is generally a fairly rare event in routine pathology practice. This variant of hepatocellular carcinoma (HCC) is peculiarly intriguing and,in addition, poorly understood. Young people or children are often the target individuals with this type of cancer. Previously, I highlighted some pathology aspects of FL-HCC, but in this review, the distinctive clinico-pathologic features of FL-HCC and the diagnostic pathologic criteria of FL-HCC are fractionally reviewed and expanded upon. Further, molecular genetics update data with reference to this specific tumor are particularly highlighted as a primer for general pathologists and pediatric histopathologists. FL-HCC may present with metastases, and regional lymph nodes may be sites of metastatic spread. However, peritoneal and pulmonary metastatic foci have also been reported. To the best of our knowledge, FL-HCC was initially considered having an indolent course, but survival outcomes have recently been updated reconsidering the prognosis of this tumor. Patients seem to respond well to surgical resection, but recurrences are common. Thus, alternative therapies, such as chemotherapy and radiation, are ongoing. Overall, it seems that this aspect has not been well-studied for this variant of HCC and should be considered as target for future clinical trials. Remarkably, FL-HCC data seem to point to a liver neoplasm of uncertain origin and unveiled outcome. A functional chimeric transcript incorporating DNAJB1 and PRKACA was recently added to FL-HCC. This sensational result may give remarkable insights into the understanding of this rare disease and potentially provide the basis for its specific diagnostic marker. Detection of DNAJB1-PRKACA seems to be, indeed, a very sensitive and specific finding in supporting the diagnosis of FL-HCC. In a quite diffuse opinion, prognosis of this tumor should be reconsidered following the potentially mandatory application of new molecular biological tools. Full article

(This article belongs to the Special Issue Diagnosis of Hepatocellular Carcinoma)

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Open AccessReview

Ultrasonography of the Kidney: A Pictorial Review

by Kristoffer Lindskov Hansen, Michael Bachmann Nielsen and Caroline Ewertsen

Diagnostics 2016, 6(1), 2; https://doi.org/10.3390/diagnostics6010002 - 23 Dec 2015

Cited by 50 | Viewed by 75982

Abstract

Ultrasonography of the kidneys is essential in the diagnosis and management of kidney-related diseases. The kidneys are easily examined, and most pathological changes in the kidneys are distinguishable with ultrasound. In this pictorial review, the most common findings in renal ultrasound are highlighted. [...] Read more.

Ultrasonography of the kidneys is essential in the diagnosis and management of kidney-related diseases. The kidneys are easily examined, and most pathological changes in the kidneys are distinguishable with ultrasound. In this pictorial review, the most common findings in renal ultrasound are highlighted. Full article

(This article belongs to the Collection Feature Papers)

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704 KiB

Open AccessInteresting Images

Angiosarcoma of the Scalp: Metastatic Pulmonary Cystic Lesions Initially Misinterpreted as Benign Findings on 18F-FDG PET/CT

by Kim Francis Andersen, Elisabeth Albrecht-Beste, Anne Kiil Berthelsen and Annika Loft

Diagnostics 2016, 6(1), 1; https://doi.org/10.3390/diagnostics6010001 - 22 Dec 2015

Cited by 8 | Viewed by 6921

Abstract

Angiosarcomas are rare and only represent about 2% of all soft tissue sarcomas. They arise from vascular or lymphatic endothelial cells and are most commonly located in the heart, liver, breast, and skin. Cutaneous angiosarcoma of the scalp is highly malignant and with [...] Read more.

Angiosarcomas are rare and only represent about 2% of all soft tissue sarcomas. They arise from vascular or lymphatic endothelial cells and are most commonly located in the heart, liver, breast, and skin. Cutaneous angiosarcoma of the scalp is highly malignant and with dismal prognosis. Reported five-year survival is <30%. The mainstay of treatment is surgical resection and adjuvant radiation therapy, but failure rates following local therapy are high. Cutaneous angiosarcoma of the scalp has a predilection for pulmonary metastases with a variety of morphologic patterns on imaging. Metastatic disease in terms of pulmonary thin-walled, cystic lesions, may not be hypermetabolic on ¹⁸F-FDG PET and, as such, could be misinterpreted as benign findings. We present a case demonstrating the diagnostic uncertainty and delay in an elderly male with angiosarcoma of the scalp presenting with metastatic lung lesions following failure of local therapy. Full article

(This article belongs to the Collection Hybrid Imaging in Medicine)

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Diagnostics, Volume 6, Issue 1 (March 2016) – 13 articles

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