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ABSTRACT: PURPOSE: To assess diffusion-weighted magnetic resonance imaging (DWI-MRI) performed with apparent diffusion coefficient (ADC) values for the detection of cervical lymphadenopathy. MATERIALS AND METHODS: Studies evaluating DWI-MRI for the detection of cervical lymphadenopathy were systematically searched for in the MEDLINE, EMBASE, Cancerlit, and Cochrane Library and other database from January 1995 to November 2010. By node-based data analyses, Cochrane methodology was used for the results of this meta-analysis. RESULTS: Eight studies enrolling a total of 229 individuals were eligible for inclusion. Significant differences were found between malignant nodes and benign nodes of the mean ADC value (WMD [weighted-mean difference]: 1.19, 95% CI: [1.02, 1.35] × 10(-3) mm(2) /s, [P < 0.05]). In the secondary outcomes, significant differences were found between lymphomatous nodes and benign nodes (WMD: 1.33, 95% CI: [0.89, 1.77] × 10(-3) mm(2) /s), and nodes originating from highly or moderately differentiated cancer (WMD: 0.24, 95% CI: [0.21, 0.28] × 10(-3) mm(2) /s, [P < 0.05]), and nodes originating from poorly differentiated cancers (WMD: 0.10, 95% CI: [0.06, 0.14] × 10(-3) mm(2) /s, [P < 0.05]). CONCLUSION: DWI-MRI performed with ADC values shows significant differences among malignant nodes, lymphomatous nodes, and benign nodes in cervical lymphadenopathy. J. Magn. Reson. Imaging 2012;. © 2012 Wiley Periodicals, Inc.
Journal of Magnetic Resonance Imaging 06/2013; · 2.70 Impact Factor
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ABSTRACT: OBJECTIVE: This meta-analysis aimed to evaluate the accuracy of magnetic resonance imaging (MRI) in predicting responses in patients with locally advanced rectal cancer after preoperative neoadjuvant therapy. METHODS: Articles in English language relating to the accuracy of MRI for this utility were retrieved. Methodological quality was assessed by Quality Assessment of Diagnostic Accuracy Studies tool. Pooled estimation and subgroup analysis data were obtained by statistical analysis. RESULTS: Fourteen studies involved 751 pathologically confirmed patients met the inclusion criteria. Methodological quality was relatively high. To predict histopathological response in locally advanced rectal cancer by MRI, the pooled sensitivity and specificity were 0.78 [95 % confidence intervals (CI), 0.65, 0.87] and 0.81 (95 % CI, 0.72, 0.87), respectively. Positive likelihood ratio and negative likelihood ratio were 4.1 (95 %CI, 2.9, 5.8) and 0.27 (95 % CI, 0.17, 0.43), respectively. Subgroup analysis showing that imaging was performed at 3.0 T MRI devices had higher pooled sensitivity (0.92, 95 % CI, 0.84, 1.00) than the subgroup of MRI with ≤1.5 T (0.68, 95 % CI, 0.53, 0.82) (p < 0.05).The sensitivity and specificity of T2-weighted imaging (T2WI) with diffusion-weighted imaging (DWI) were 0.92 (95 % CI, 0.81, 1.00) and 0.75 (95 % CI, 0.54, 0.95); those of T2WI alone were 0.64 (95 % CI, 0.47, 0.82) and 0.88 (95 % CI, 0.81, 0.94) (p > 0.05). CONCLUSION: This meta-analysis indicates that MRI is an accurate tool in predicting pathologic response after preoperative therapy in patients with locally advanced rectal cancer. It is suggested to perform MRI by 3.0 T devices, which might be sensitive to identify responder. The addition of DWI to T2WI showed a non-significant improvement in sensitivity, which deserves further investigation.
International Journal of Colorectal Disease 03/2013; · 2.38 Impact Factor
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ABSTRACT: GOALS:: To evaluate the overall diagnostic accuracy of magnetic resonance imaging (MRI) in assessing the activity of Crohn's disease (CD) in the small bowel. BACKGROUND:: Cross-sectional imaging techniques are playing an increasing role in the evaluation of suspected CD. Advantages of MRI include a lack of ionizing radiation, the ability to provide dynamic information regarding bowel distention and motility, improved soft-tissue contrast, and a relatively safe intravenous contrast agent profile. STUDY:: Two reviewers searched MEDLINE, EMBASE, and other electronic databases to identify studies in which MRI imaging was evaluated for assessing the activity of CD in the small bowel from January 2001 to September 2011. Bivariate random-effects meta-analytic methods were used to estimate summary, sensitivity, specificity, and receiver operating characteristic curves. RESULTS:: MRI had a pooled sensitivity of 0.87 [95% confidence interval (CI): 0.77, 0.93] and a pooled specificity of 0.91 (95% CI: 0.81, 0.96). Overall, likelihood ratio (LR)+ was 9.5 (95% CI: 4.4, 20.6) and LR- was 0.14 (95% CI: 0.08, 0.26). In patients with high pretest probabilities, MRI enabled confirmation of active CD; in patients with low pretest probabilities, MRI enabled exclusion of active CD. Worst-case-scenario (pretest probability, 50%) posttest probabilities were 90% and 13% for positive and negative MRI results, respectively. CONCLUSIONS:: A limited number of small studies suggest that MRI has high sensitivity and specificity for diagnosis of active CD in the small bowel; MRI will likely also prove to be suitable as the primary modality for active CD imaging surveillance.
Journal of clinical gastroenterology 01/2013; · 2.21 Impact Factor
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ABSTRACT: The aim of this study was to evaluate the diagnostic accuracy of diffusion-weighted magnetic resonance imaging (DWI) in prostate cancer.
The MEDLINE, Embase, CANCERLIT, and Cochrane Library databases were searched for studies published from January 2001 to August 2011 evaluating the diagnostic performance of DWI in detecting prostate carcinoma. Sensitivities and specificities were determined across studies, and summary receiver-operating characteristic curves were constructed using hierarchical regression models.
Sixteen studies (18 subsets) with a total of 852 patients were included. Six studies (seven subsets) examining men with pathologically confirmed prostate cancer (260 patients) had pooled sensitivity and specificity of 0.88 (95% confidence interval [CI], 0.76-0.95) and 0.84 (95% CI, 0.76-0.90), respectively. Compared to patients at high risk for clinically relevant cancer, sensitivity was higher in low-risk patients (0.94 [95% CI, 0.89-0.97] vs 0.62 [95% CI, 0.54-0.70], P < .05), but specificity was lower (0.86 [95% CI, 0.72-0.94] vs 0.89 [95% CI, 0.83-0.93], P < .05). Ten studies (11 subsets) examining patients with suspected prostate cancer (592 patients) had pooled sensitivity and specificity of 0.76 (95% CI, 0.68-0.84) and 0.86 (95% CI, 0.79-0.91). Sensitivity was lower in high-risk patients (0.74 [95% CI, 0.57-0.87] vs 0.78 [95% CI, 0.70-0.84], P > .05), but specificity was higher (0.92 [95% CI, 0.89-0.94] vs 0.78 [95% CI, 0.70-0.84], P < .05).
A limited number of small studies suggest that DWI could be a rule-in test for high-risk patients. Further prospective studies including larger populations are necessary to confirm the actual value of DWI in this field.
Academic radiology 10/2012; 19(10):1215-24. · 2.09 Impact Factor
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ABSTRACT: Recent developments in diffusion-weighted magnetic resonance imaging (DWI) make it possible to image malignant tumors to provide tissue contrast based on difference with the diffusion of water molecules among tissues, which can be measured by the apparent diffusion coefficient (ADC) value. We aimed to assess the diagnostic accuracy of DWI for benign/malignant discrimination of pulmonary nodules/masses with a meta-analysis. The MEDLINE, EMBASE, Cancerlit and Cochrane Library database, from January 2001 to August 2011, were searched for studies evaluating the diagnostic accuracy of DWI for benign/malignant discrimination of pulmonary nodules. We determined sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LRP and LRN), and constructed summary receiver operating characteristic SROC) curves. Across 10 studies (545 patients), there was no evidence of publication bias (P=.22, bias=-19.19). DWI had a pooled sensitivity of 0.84 (95% CI, 0.76-0.90) and a pooled specificity of 0.84 (95% CI, 0.64-0.94). Overall, LRP was 5.3 (95% CI, 2.1-13.0) and LRN was 0.19 (95% CI, 0.12-0.30). In patients with high pretest probabilities, DWI enabled confirmation of malignant pulmonary lesion; in patients with low pretest probabilities, DWI enabled exclusion of malignant pulmonary lesion. Worst-case-scenario (pretest probability, 50%) posttest probabilities were 84% and 16% for positive and negative DWI results, respectively. Diffusion-weighted magnetic resonance imaging can be used to differentiate malignant from benign pulmonary lesions. High-quality prospective studies regarding DWI in the evaluation of pulmonary nodules are still needed to be conducted.
Magnetic Resonance Imaging 08/2012; · 1.99 Impact Factor
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ABSTRACT: BACKGROUND: To obtain diagnostic performance values of T2-weighted imaging (T2WI) and contrast-enhanced magnetic resonance imaging (CE-MRI) in the prediction of myometrial invasion in patients with endometrial cancer. METHODS: Databases including MEDLINE and EMBASE were searched for relevant original articles published from January1995 to March 2012. Pooled estimation data were obtained by statistical analysis. RESULTS: Eleven articles (548 patients) were included. For assessing any myometrial involvement, the pooled sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for CE-MRI were 0.81 (95% CI, 0.72, 0.88), 0.72 (95% CI, 0.64, 0.79), 0.65 (95% CI, 0.56, 0.73) and 0.85 (95% CI, 0.78, 0.91); for T2WI, they were 0.87 (95% CI, 0.78, 0.94), 0.58 (95% CI, 0.47, 0.69), 0.64 (95% CI, 0.54, 0.73), 0.84 (95% CI, 0.73, 0.92) respectively. The pooled specificity of CE-MRI (0.72) was significantly higher than T2WI (0.58) (P < 0.05). For assessing deep myometrial involvement, there was no statistically significant difference between CE-MRI and T2WI, (P > 0.05). CONCLUSIONS: CE-MRI has a good diagnostic performance in the prediction of any myometrial invasion and is superior to T2WI. But its PPV is somewhat suboptimal. For assessing deep myometrial involvement, its NPV appears relative high and negative findings strongly suggest an absence of deep myometrial involvement, which can guide therapeutic decision-making. KEY POINTS : • CE-MRI is widely used for endometrial carcinoma • CE-MRI has a good performance in the prediction of any myometrial invasion • CE-MRI is superior to T2WI in the prediction of any myometrial invasion • For assessing deep myometrial involvement, its NPV appears relatively high.
European Radiology 08/2012; · 3.22 Impact Factor
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ABSTRACT: To compare the diagnostic capability of diffusion-weighted magnetic resonance imaging (DWI) and (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in the N stage assessment in patients with non-small-cell lung cancer.
We performed a meta-analysis of all available studies of the diagnostic performance of DWI and (18)F-FDG PET/CT in the N stage assessment of patients with non-small-cell lung cancer. We determined the sensitivity and specificity across studies, calculated the positive and negative likelihood ratios (LR+ and LR-, respectively), and constructed the summary receiver operating characteristic curves using hierarchical regression models. The methodologic quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool.
A total of 19 studies met the inclusion criteria and included a total of 2845 pathologically confirmed patients. No publication bias was found. The methodologic quality was relatively high. The pooled sensitivity estimate of DWI (0.72, 95% confidence interval [CI] 0.63-0.80) was not significantly difference between PET/CT (0.75, 95% CI 0.68-0.81; P = 0.09). The pooled specificity estimate for DWI (0.95, 95% CI 0.85-0.98) was significantly greater than (18)F-FDG PET/CT (0.89, 95% CI 0.85-0.91; P = 0.02). For DWI, the overall LR+ was 13.80 (95% CI 4.54-41.95) and the LR- was 0.29 (95% CI 0.21-0.40). For (18)F-FDG PET/CT, LR+ was 6.67 (95% CI 5.20-8.56) and LR- was 0.28 (95% CI 0.22-0.37).
Our study has confirmed that DWI has a high specificity for N staging of non-small-cell lung cancer compared with (18)F-FDG PET/CT and has the potential to be a reliable alternative noninvasive imaging method for the preoperative staging of mediastinal and hilar lymph nodes in patients with non-small-cell lung cancer.
Journal of Surgical Research 04/2012; 178(1):304-14. · 2.25 Impact Factor
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ABSTRACT: Clinical evidence regarding the value of MRI for therapy responses assessment in breast cancer is increasing. The objective of this study is to compare the diagnostic capability of diffusion-weighted MR imaging (DW-MRI) and contrast-enhanced MR imaging (CE-MRI) to evaluate and predict pathological response in breast cancer patients receiving neoadjuvant chemotherapy (NAC). We performed a meta-analysis of all available studies of the diagnostic performance of DW-MRI or CE-MRI to evaluate and predict pathological response to NAC in patients with breast cancer. We determined sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-), diagnostic odds ratio (DOR) and constructed summary receiver operating characteristic curves using hierarchical regression models. Methodological quality was assessed by QUADAS tool. Thirty-four studies met the inclusion criteria and involved 1,932 pathologically confirmed patients in total. Methodological quality was relatively high. DW-MRI sensitivity was 0.93 (95 % CI 0.82-0.97) and specificity was 0.82 (95 % CI 0.70-0.90). Overall LR+ was 5.09 (95 % CI 3.09-8.38), LR- was 0.09 (95 % CI 0.04-0.22), and DOR was 55.59 (95 % CI 21.80-141.80). CE-MRI sensitivity was 0.68 (95 % CI 0.57-0.77) and specificity was 0.91 (95 % CI 0.87-0.94). Overall LR+ was 7.48 (95 % CI 5.29-10.57), LR- was 0.36 (95 % CI 0.27-0.48), and DOR was 20.98 (95 % CI 13.24-33.24). Our study confirms that DW-MRI is a high sensitive and CE-MRI is a high specific modality in predicting pathological response to NAC in breast cancer patients. The combined use of DW-MRI and CE-MRI has the potential to improve the diagnostic performance in monitoring NAC. Further large prospective studies are warranted to assess the actual value of this combination in breast cancer preoperative treatment screening.
Breast Cancer Research and Treatment 04/2012; 135(1):17-28. · 4.43 Impact Factor
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ABSTRACT: We aimed to explore the role of diffusion-weighted imaging (DWI) in the discrimination of pancreatic lesions through meta-analysis.
The MEDLINE, EMBASE, Cancerlit, and Cochrane Library databases, from January 2001 to August 2011, were searched for studies evaluating the diagnostic performance of DWI in the discrimination of pancreatic lesions. We determined sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic curves.
A total of 11 studies with 586 patients, who fulfilled all of the inclusion criteria, were considered for the analysis. No publication bias was found. The pooled sensitivity of DWI was 0.86 [95% (confidence interval (CI), 0.78, 0.91] and the pooled specificity was 0.91 (95% CI, 0.81, 0.96). Overall, LR+ was 9.8 (95% CI, 4.1, 23.3) and LR- was 0.15 (95% CI, 0.09, 0.26). The area under the curve of the summary receiver operating characteristic was 0.94 (95% CI, 0.91-0.96). In subgroup analysis, prospectively designed studies had the highest pooled sensitivity (0.87, 95% CI 0.75, 0.94) and specificity (0.96, 95% CI 0.91, 0.99) (P<0.05). Study sensitivity was not correlated with the prevalence of pancreatic lesions (R=0.1076, P=0.3247).
A limited number of small studies suggest that DWI is a potentially technically feasible measure to differentiate malignant from benign pancreatic lesions. However, it is still controversial and is limited in that it can only distinguish certain lesions. High-quality prospective studies on DWI for the discrimination of pancreatic lesions still need to be conducted.
European journal of gastroenterology & hepatology 02/2012; 24(2):134-42. · 1.66 Impact Factor
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ABSTRACT: We aimed to explore the role of the diagnostic accuracy of (18) F-fluorodeoxyglucose positron emission tomography ((18) F-FDG PET) in detecting recurrent gastric cancer through a systematic review and meta-analysis.
The MEDLINE, EMBASE, Cancerlit, and Cochrane Library database, from January 2001 to July 2011, were searched for studies evaluating the diagnostic performance of (18) F-FDG PET in detecting recurrent gastric cancer. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic curves. We also compared the performance of (18) F-FDG PET with computed tomography (CT) by analyzing studies that had also used these diagnostic methods on the same patients.
Across nine studies (526 patients), the overall sensitivity of (18) F-FDG PET was 0.78 (95% confidence interval [CI]: 0.68-0.86), and the overall specificity was 0.82 (95% CI: 0.76-0.87). Overall, LR+ was 3.52 (95% CI: 2.68-4.63) and LR- was 0.32 (95% CI: 0.22-0.46). In studies in which both (18) F-FDG PET and other diagnostic tests were performed, the sensitivity and specificity of (18) F-FDG PET were 0.72 (95% CI: 0.62-0.80) and 0.84 (95% CI: 0.77-0.90), respectively; of contrast CT, they were 0.74 (95% CI: 0.64-0.83) and 0.85 (95% CI: 0.78-0.90), respectively; and of combined PET and CT, they were 0.75 (95% CI: 0.67-0.82) and 0.85 (95% CI 0.79-0.90), respectively. Study sensitivity was not correlated with the prevalence of recurrent gastric cancer.
(18) F-FDG PET has good diagnostic performance in the overall evaluation of recurrent gastric cancer, but still has some limited performance compared with contrast CT. (18) F-FDG PET combined with CT might improve the diagnostic performance in detecting recurrent gastric cancer.
Journal of Gastroenterology and Hepatology 09/2011; 27(3):472-80. · 2.87 Impact Factor
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ABSTRACT: To assess the overall diagnostic accuracy of whole-body magnetic resonance imaging (WB-MRI) in detecting bone metastases with a meta-analysis.
The MEDLINE, EMBASE, Cancerlit, and Cochrane Library databases were searched from January 1995 to September 2010 for studies evaluating the accuracy of WB-MRI in detecting bone metastases. Histopathologic analysis and/or close clinical and imaging follow-up for at least 6 months was assessed. Meta-analysis methods were used to pool sensitivity and specificity and to construct summary receiver-operating characteristics.
A total of 11 studies with 495 patients who fulfilled all of the inclusion criteria were considered for the analysis. No publication bias was found. WB-MRI had a pooled sensitivity of 0.899 (95% confidence interval [CI], 0.845-0.939) and a pooled specificity of 0.918 (95% CI, 0.882-0.946). The subgroup without diffusion-weighted imaging (DWI) positive results had higher pooled specificity 0.961 (95% CI, 0.922-0.984) than the subgroup with DWI (P < 0.05).
WB-MRI was an accurate, cost-effective tool in detecting bone metastases. WB-MRI without DWI may improve the specificity of detecting bone metastases. DWI seems to be a sensitive but rather unspecific modality for the detection of bone metastatic disease. High-quality prospective studies regarding WB-MRI in detecting bone metastases still need to be conducted.
Journal of Magnetic Resonance Imaging 07/2011; 34(1):128-35. · 2.70 Impact Factor
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ABSTRACT: Ultrasonography has been proposed to enhance preoperative assessment of cervical lymph node status in patients with papillary thyroid carcinoma (PTC). Management is most controversial for patients with a clinically negative (cN0) neck. We aimed to evaluate the diagnostic properties of ultrasonography in the detection of cervical lymph node metastasis in patients with PTC.
Studies evaluating the diagnostic accuracy of Ultrasonography in the diagnosis of cervical lymph node metastasis in patients with PTC were systematically searched for in the MEDLINE, EMBASE, Cancerlit and Cochrane Library and other database from January 1995 to November 2010. Two reviewers independently abstracted data including research design, sample size, imaging technique and technical characteristics, method of image interpretation. By patient-based and region- or node-based data analyses, we determined pooled sensitivities and specificities across studies, and constructed summary receiver operating characteristic curves, and area under summary receiver operating characteristic curves were calculated.
The pooled patient-based sensitivity for ultrasonography was 0.72 (95% CI, 0.46-0.88), specificity was 0.98 (95% CI, 0.84-1.00), and the area under the curve (AUC) was 0.94 (95% CI, 0.92-0.0.96). The pooled region- or node-based sensitivity for ultrasonography was 0.63 (95% CI, 0.47-0.76), specificity was 0.93 (95% CI, 0.73-0.99), and the AUC was 0.81 (95% CI, 0.77-0.84). For lesion-based analysis, the subgroup of lateral compartment lymph node involvement was found to have the highest sensitivity (0.72, 95% CI 0.68-0.75) and specificity (0.97, 95% CI 0.93-0.99) among the studies (p<0.05). Study sensitivity was not correlated with the prevalence of cervical lymph node metastasis (patient-based: R(2)=0.0196, p=0.7915; region- or node-based: R(2)=0.3835, p=0.1381).
We conclude that preoperative ultrasonography is a good technique for the preoperative lymph node staging of PTC and is helpful for detecting metastatic cervical lymph nodes at the lateral group. High-quality prospective studies regarding ultrasonography in the evaluation of cervical lymph node status in patients with PTC are still needed to be conducted.
European journal of radiology 04/2011; 81(8):1798-805. · 2.65 Impact Factor
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ABSTRACT: To study the effect of maternal vitamin D deficiency on lung morphogenesis and platelet-derived growth factor-A (PDGF-A) expression in rat offspring.
Sprague-Dawley (SD) female rats were randomly divided into two groups: normal control and vitamin D deficiency, with 6 rats in each group. The vitamin D deficiecy group was kept away from light and fed with the forage without vitamin D. After 2 weeks, the rats were mated with normal SD male rats. The morphological changes of fetal rat lungs on day 20 of gestation and 1-day-old neonatal rat lungs were observed by light microscope and electronic microscope. The levels of PDGF-A mRNA and protein in fetal and neonatal rat lungs were measured by reverse transcriptase-polymerase chain reaction (RT-PCR) technique and Western blot method respectively.
Under the light microscope, smaller alveolar space, smaller diameter of the respiratory membrane and thicker alveolus mesenchyma were observed in lungs of fetal and neonatal rats from the vitamin D deficiency group compared with the controls (P<0.05). Under the electronic microscope, fewer lamellar bodies but more glycogen deposition in intracytoplasm were observed in the lungs of fetal rats from the vitamin D deficiency group compared with the controls. There was an increased number of empty lamellar bodies in neonatal rats from the vitamin D deficiency group. The levels of PDGF-A mRNA and protein in lungs of fetal and neonatal rats from the vitamin D deficiency group were significantly lower than the controls (P<0.05).
Maternal vitamin D deficiency during pregnancy may inhibit the development of lung morphogenesis and PDGF-A expression in late fetal and neonatal rats. The low expression of PDGF-A may be involved in the inhibitory effect of vitamin D deficiency on the lung development.
Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics 04/2011; 13(4):326-30.
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ABSTRACT: Recently, there are very few research on endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of bile duct and gallbladder masses. The objective of this study was to assess the overall diagnostic accuracy of EUS-FNA in the evaluation of patients with bile duct strictures and gallbladder masses with a meta-analysis.
The MEDLINE, EMBASE, Cancerlit and Cochrane Library, and other database, from January 1995 to July 2010, were searched for studies evaluating EUS-FNA accuracy. Meta-analysis methods were used to obtain pooled estimates of sensitivity, specificity, diagnostic odds ratio, summary receiver operating characteristic curves, and the Q* index.
A total of nine studies with 284 patients, who fulfilled all the inclusion criteria, were considered for the analysis. EUS-FNA had a pooled sensitivity of 0.84 (95% confidence interval: 0.78-0.88) and a pooled specificity of 1.00 (95% confidence interval: 0.94-1.00). Overall area under the curve was 0.9254, The Q* index was 0.8598 and the calculated diagnostic odds ratio was 75.1. No complications occurred.
EUS-FNA was an accurate and safe tool in the evaluation bile duct and gallbladder masses. High-quality prospective studies regarding EUS-FNA in the evaluation of patients with bile duct and gallbladder masses are still needed to be conducted.
European journal of gastroenterology & hepatology 02/2011; 23(2):113-20. · 1.66 Impact Factor
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ABSTRACT: Evaluation of bone marrow infiltration is an essential step in the staging of lymphoma. The accuracy of (18)F-fluorodeoxyglucose-positron emission tomography ((18)F-FDG PET), combined (18)F-fluorodeoxyglucose-positron emission tomography/computed tomography ((18)F-FDG-PET/CT) and magnetic resonance imaging (MRI) in diagnosing bone marrow involvement of lymphoma has never been systematically assessed, and the present systematic review was aimed at this issue.
MEDLINE, EMBASE, Cochrane library and some other databases, from January 1995 to July 2010, were searched for initial studies. All the studies published in English or Chinese relating to the diagnostic value of (18)F-FDG PET, PET/CT and MRI for patients with bone marrow involvement of lymphoma were collected. We extracted data to calculate sensitivity, specificity, SROC curves and AUC and to test for heterogeneity. The statistic software called "Meta-Disc 1.4" was used for data analysis.
In 32 included studies, PET/CT had the highest pooled sensitivity, 91.6% (95%CI: 85.1, 95.9) and highest pooled specificity, 90.3% (95%CI: 85.9, 93.7). PET/CT also had the highest pooled DOR, 68.89 (95%CI: 15.88, 298.92). The AUC of PET, PET/CT, and MRI were 0.9430, 0.9505 and 0.8764. There was heterogeneity among studies and no evidence of publication bias.
PET/CT was a highly sensitive and specific modality in diagnosing patients with bone marrow involvement in lymphoma. Compared with MRI and PET alone, PET/CT can play important roles in the staging of lymphoma.
European journal of radiology 12/2010; 81(2):303-11. · 2.65 Impact Factor
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ABSTRACT: Clinical diagnosis of lateral collateral ligamentous injury caused by ankle sprains depends primarily on clinical signs, and X-ray and CT images. None of these, however, provide direct or accurate information about ligamentous injury. MRI has long been testified as a useful tool in the demonstration of ligaments due to its good resolution of soft tissues. We confirmed the appearance of the lateral collateral ligaments of the ankle joints on MR images by comparing MR images with CT images of the ligaments enhanced by coating with contrast medium after dissection of six cadaver feet. Compare study of MR images reveals no difference in the natural position and the dorsal position (P > 0.05), whereas, taken into the consideration the long hour of MRI examination, the natural position is regarded as the optimal position for MRI performance. Measured on transverse MR images, lateral ligaments of acutely injured ankles were significantly thicker than those of normal ankles (P < 0.01). According to the MR images of normal and injured ankles, the lateral collateral ligaments injuries were classified as type I and type II. Osteal contusion, cartilaginous injury, musculotendinous injury, tenosynovitis, and peritenosynovitis were also observed by MRI in type I and type II acute lateral collateral ligament injury. All these complications have higher incidence in type II than in type I injury (P < 0.05). Thus, by comparing with the CT images and the anatomy we confirmed the normal appearance of the lateral collateral ligaments on MR images and figured out that the natural position is the optimal position for MRI performance. The thickness of the ligaments and incidence of the complications could be regarded as useful cue for the assistant in clinical diagnosis of the lateral collateral ligament injury.
Surgical and Radiologic Anatomy 07/2008; 30(4):361-7. · 1.06 Impact Factor
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ABSTRACT: To investigate the prevalence and causes of blindness and low vision among adults aged > or = 60 years in the urban population of Nantong.
Cluster sampling was used to select 8 from 14 communities in Xinchengqiao Blocks, in which all individuals aged > or = 60 years were visited. The visual acuity without correction and the presenting acuity with the participants' habitual distance correction were measured separately for each eye. In individuals with visual acuity less than 0.6, pinhole visual acuity was tested with pinhole spectacle. External eye, anterior segment and ocular fundus were examined by the ophthalmologist using a slit lamp-microscope and direct ophthalmoscopy. The survey was preceded by a pilot study.
Of 3352 enumerated subjects, 3040 individuals participated in this survey (90.69% response rate). According to pinhole visual acuity and World Health Organization (WHO) visual impairment criterion (blindness: less than 0.05 in the better eye; low vision: less than 0.3 to 0.05 in the better eye), the prevalence of blindness and low vision was 1.35% and 1.84% respectively. The prevalence of blindness and low vision for females were 1.92% and 2.33%, respectively, which were differenced from that in males (0.66% and 1.24%, respectively). The prevalence of blindness and low vision increased with age. The survey showed that the most important cause leading to blindness and low vision was cataract. According to the presenting visual acuity and visual impairment criterion (blindness: less than 0.1 in both eyes), the prevalence of blindness and visual impairment was 1.58% and 13.59%, respectively, 2.10% and 15.98% in females and 0.95% and 10.66% in males, respectively. The prevalence of blindness and visual impairment was raised with increasing age. Cataract was also the leading cause for blindness.
The prevalence of blindness in the Nantong area was lower than that in northern, southern and western China. Females and illiteracy were more likely to have blindness and low vision than that of males and literate. The leading causes of blindness in Nantong are, in descending sequence, cataract, ocular fundus diseases, ametropia and corneal scar/opacity.
[Zhonghua yan ke za zhi] Chinese journal of ophthalmology 09/2006; 42(9):802-7.
