Arash Anvari | Massachusetts General Hospital (original) (raw)
Papers by Arash Anvari
ABSTRACT http://link.springer.com/chapter/10.1007/978-3-642-54047-9\_10#page-1 Interventional radi... more ABSTRACT http://link.springer.com/chapter/10.1007/978-3-642-54047-9_10#page-1 Interventional radiologists can now perform multiple urological interventions including focal and nonfocal renal biopsies, renal cell cancer ablation (discussed in a different chapter), percutaneous nephrostomy tube placement, and percutaneous catheter drainage of renal and perirenal fluid collections and provide access for percutaneous lithotomy, ureteral balloon dilatation and stenting, ureteral embolization, and suprapubic tube placement. ... Urological interventions entail a multidisciplinary approach in close cooperation with urologists and nephrologists. ...
Radiology, May 7, 2015
Purpose To evaluate the diagnostic accuracy of shear-wave elastography (SWE) for the diagnosis of... more Purpose To evaluate the diagnostic accuracy of shear-wave elastography (SWE) for the diagnosis of malignancy in follicular lesions and to identify the optimal SWE measurement plane. Materials and Methods The institutional review board approved this HIPAA-compliant, single-institution, prospective pilot study. Subjects scheduled for surgery after a previous fine-needle aspiration report of "atypia of undetermined significance" or "follicular lesion of undetermined significance," "suspicion for follicular neoplasm," or "suspicion for Hurthle cell neoplasm," were enrolled after obtaining informed consent. Subjects underwent conventional ultrasonography (US), Doppler evaluation, and SWE preoperatively, and their predictive value for thyroid malignancy was evaluated relative to the reference standard of surgical pathologic findings. Results Thirty-five patients (12 men, 23 women) with a mean age of 55 years (range, 23-85 years) and a fine-needle aspiration diagnosis of atypia of undetermined significance or follicular lesion of undetermined significance (n = 16), suspicion for follicular neoplasm (n = 14), and suspicion for Hurthle cell neoplasm (n = 5) were enrolled in the study. Male sex was a statistically significant (P = .02) predictor of malignancy, but age was not. No sonographic morphologic parameter, including nodule size, microcalcification, macrocalcification, halo sign, taller than wide dimension, or hypoechogenicity, was associated with malignancy. Similarly, no Doppler feature, including intranodular vascularity, pulsatility index, resistive index, or peak-systolic velocity, was associated with malignancy. Higher median SWE tissue Young modulus estimates from the transverse insonation plane were associated with malignancy, yielding an area under the receiver operating characteristic curve of 0.81 (95% confidence interval: 0.62, 1.00) for differentiation of malignant from benign nodules. At a cutoff value of 22.3 kPa, sensitivity, specificity, positive predictive value, and negative predictive value of 82%, 88%, 75%, and 91%, respectively, were observed. Conclusion This prospective pilot study indicates that SWE may be a valuable tool in preoperative malignancy risk assessment of follicular-patterned thyroid nodules. (©) RSNA, 2015.
AJR. American journal of roentgenology, 2016
The purpose of this study is to determine the reliability of shear-wave elastographic estimates o... more The purpose of this study is to determine the reliability of shear-wave elastographic estimates of the Young modulus in thyroid follicular neoplasms. In this study, 35 adults with follicular nodules diagnosed by fine-needle aspiration (FNA) biopsy were enrolled. A single sonographer examined all nodules in three planes (sagittal, transverse, and transverse center). Two raters independently placed ROIs in each nodule. Intra- and interrater reliability were computed as intraclass correlation coefficients (ICCs) and were reported using the Guidelines for Reporting Reliability and Agreement Studies. Thirty-five subjects with 35 follicular pattern nodules diagnosed by FNA biopsy were enrolled; 23 (65.7%) patients were female, with a mean age of 55.1 years (range, 23-85 years). For rater 1, intrarater agreement showed ICCs for single measurements of 0.87, 0.87, and 0.90 in the sagittal, transverse, and transverse center plans, respectively; ICCs for the median of multiple measurements wer...
Journal of vascular and interventional radiology : JVIR, 2016
To evaluate the technique, efficacy, safety, and clinical outcomes of CT-guided microwave ablatio... more To evaluate the technique, efficacy, safety, and clinical outcomes of CT-guided microwave ablation of tumors in the hepatic dome. Retrospective review was conducted of 46 consecutive patients (31 men and 15 women; mean age, 64 y) treated with CT-guided microwave ablation for hepatic-dome tumors between June 2011 and December 2014. Baseline demographics of sex, tumor diagnosis, tumor location, tumor size, and technical details were recorded. Technical success was evaluated. Treatment response was assessed per European Association for the Study of the Liver criteria. Overall success and overall survival were calculated, and complications were recorded. Forty-eight tumors were treated. Tumor locations included segments VIII (n = 32), VII (n = 10), and VIa (n = 6). Mean tumor size was 2.4 cm (range, 0.9-5.2 cm). Thirty-four tumors (70%) were treated following creation of artificial ascites with 0.9% normal saline solution (mean volume, 1,237 mL; range, 300-3,000 mL). The technical succe...
Radiographics : a review publication of the Radiological Society of North America, Inc
Tissue harmonic imaging (THI) is a routinely used component of diagnostic ultrasonography (US). I... more Tissue harmonic imaging (THI) is a routinely used component of diagnostic ultrasonography (US). In this method, higher-frequency harmonic waves produced by nonlinear fundamental US wave propagation are used to generate images that contain fewer artifacts than those seen on conventional fundamental wave US tissue imaging. Harmonic frequencies are integer multiples of the fundamental frequency. The majority of current clinical US systems use second harmonic echoes for THI image formation. Image processing techniques (ie, bandwidth receive filtering, pulse inversion, side-by-side phase cancellation, and pulse-coded harmonics) are used to eliminate the fundamental frequency echoes, and the remaining harmonic frequency data are used to generate the diagnostic image. Advantages of THI include improved signal-to-noise ratio and reduced artifacts produced by side lobes, grating lobes, and reverberation. THI has been accepted in US practice, and variations of the technology are available on ...
Radiographics : a review publication of the Radiological Society of North America, Inc, 2015
Diagnostic tests have wide clinical applications, including screening, diagnosis, measuring treat... more Diagnostic tests have wide clinical applications, including screening, diagnosis, measuring treatment effect, and determining prognosis. Interpreting diagnostic test results requires an understanding of key statistical concepts used to evaluate test efficacy. This review explains descriptive statistics and discusses probability, including mutually exclusive and independent events and conditional probability. In the inferential statistics section, a statistical perspective on study design is provided, together with an explanation of how to select appropriate statistical tests. Key concepts in recruiting study samples are discussed, including representativeness and random sampling. Variable types are defined, including predictor, outcome, and covariate variables, and the relationship of these variables to one another. In the hypothesis testing section, we explain how to determine if observed differences between groups are likely to be due to chance. We explain type I and II errors, st...
PURPOSE/AIM Review the role of imaging in the management of inflammatory bowel disease (IBD), dis... more PURPOSE/AIM Review the role of imaging in the management of inflammatory bowel disease (IBD), discuss pros and cons of different modalities, and define an algorithm for imaging these young patients. CONTENT ORGANIZATION 1. Epidemiology and pathophysiology 2. Role of imaging in management of patients at diagnosis, during treatment, and recurrence a. Disease distribution b. Extraintestinal manifestations c. Disease activity d. Extraluminal complications 3. Current IBD treatment a. Goals of treatment b. Traditional and molecule-targeted anti-inflammatory medications c. Medical and surgical options for perianal disease 4. Imaging modalities: diagnostic performance, advantages and limitations a. Fluoroscopic small bowel series and enteroclysis b. CT c. CT enterography d. CT/MR enteroclysis e. Pelvic MRI for perianal disease f. MR enterography g. Ultrasound (US) 5. Potential risks from ionizing radiation 6. Potential long-term risks from IBD and treatment 7. Radiation reduction strategies...
PURPOSE/AIM This educational poster will review staging system for all gastrointestinal tumors, a... more PURPOSE/AIM This educational poster will review staging system for all gastrointestinal tumors, and explain the role of imaging in their clinical management. We will show how key imaging findings “tipping points” can dictate changes in management and prognosis. CONTENT ORGANIZATION 1. Review the TNM staging system. 2. Describing the concept of “tipping point” in clinical management of gastrointestinal tumors by imaging 3. Assimilate American Cancer Society cancer staging systems for all GI tumors and identifying points at which imaging findings change tumor stage, management, and prognosis. 4. Gain understanding that specific imaging findings are critical for most tumor staging systems and that reporting of these specific findings is critical in changing staging and management for many GI abdominal tumors. 5. Key questions to ask and why: a. Pancreatic Adenocarcinoma b. Hepatocellular Carcinoma c. Cholangiocarcinoma d. Gastric Adenocarcinoma e. Small Bowel Carcinoma f. Colorectal Ca...
PURPOSE/AIM Sonoelastography uses ultrasound imaging techniques to quantify and map tissue stiffn... more PURPOSE/AIM Sonoelastography uses ultrasound imaging techniques to quantify and map tissue stiffness. Sonoelastography has an expanding role in the detection and characterization of a variety of pathologies in different organs. This educational exhibit will explain the physical principles that underlie the different types of sonoelastography in simple language with figures, schematic diagrams. CONTENT ORGANIZATION • History: evolution from basic physics to clinical trials. • Definitions: elasticity, stress, strain and Young’s (elastic) modulus. • Describe Bulk Modulus B and compressional wave; Shear Modulus G and shear wave and their relationship with Young’s modulus. • US elastography techniques classification: quasi-quantitative and quantitative methods. • General principles of real-time elastography: strain and strain ratio, estimating Young’s modulus from strain change, strain change with depth. • General principles of shear wave elastography: estimating Young’s modulus by measu...
PURPOSE/AIM This exhibit will provide a review of the statistical methods for assessing measureme... more PURPOSE/AIM This exhibit will provide a review of the statistical methods for assessing measurement reproducibility in quantitative imaging. CONTENT ORGANIZATION 1. Definition of reliability(reproducibility) and measurement error. 2. The difference between reliability and validity. 3. Describing sources of measurement variability, with a special focus on intra- and inter-observer variability 4. Considerations when designing reliability and agreement studies 5. Statistical methods for analyzing reliability of quantitative measurement, including Standard Error of measurement and coefficient of variation (CV), Intraclass Correlation Coefficient (ICC), and Bland-Altman Analysis. 6. Guidelines for reporting reliability and agreement studies (GRRAS). 7. Why Pearson’s Correlation Coefficient should not be used to assess reliability. 8. Role of reliability in generalizability and clinical decision studies. 9. Strategies for reducing variability. SUMMARY Quantitative imaging has a promising ...
PURPOSE/AIM This exhibit provides a practical review of nonparametric statistical tests for clini... more PURPOSE/AIM This exhibit provides a practical review of nonparametric statistical tests for clinical radiology researchers. The description of each statistical test will be accompanied by a clinical question that the statistical test would address. CONTENT ORGANIZATION 1. What are nonparametric tests? 2. Parametric tests vs. nonparametric tests, advantages and limitations 3. Why are nonparametric tests popular in radiology research? 4. One Sample with Two Paired Measurements a. Dichotomous scale: McNemar test b. Ordinal scale: Sign test 5. Comparing Two Related Samples: Wilcoxon Signed Rank Test 6. Comparing Two Unrelated Samples: a. Categorical data: The Chi-Square & Fisher Exact tests b. Continuous data with an interval/rational Scale: Wilcoxon rank sum test (Mann-Whitney U-Test) 7. Comparing More Than Two Related Samples: a. Categorical data with dichotomous scale: Cochran Q test b. Categorical data with ordinal scale OR Continuous data with an interval/rational Scale : Two-way A...
PURPOSE/AIM This exhibit will provide a review of the potential clinical applications and role of... more PURPOSE/AIM This exhibit will provide a review of the potential clinical applications and role of various ultrasound elastography techniques in diffuse liver disease. CONTENT ORGANIZATION • Role of liver biopsy in staging of liver fibrosis as an imperfect reference standard in diagnosis and prognosis of Chronic Hepatitis C (CHC) and Nonalcoholic steatohepatitis (NASH), and its limitations. • Non-invasive methods for liver fibrosis assessment: biological markers, biophysical makers and their clinical roles in reducing liver biopsy in some patients. • Introduction of US Elastography Techniques: Transient Elastography, Real-Time Elastography, ARFI Elastography and the technical differences between them. • Comparison of different US Elastography methods in clinical evaluation of hepatic fibrosis, in chronic viral hepatitis and NASH, to the liver biopsy and each other; and their advantages and limitations. • The future trend of US elastography applications in diffuse liver diseases. SUMM...
PURPOSE OF THE STUDY The current gold standard to distinguish benign from malignant thyroid nodul... more PURPOSE OF THE STUDY The current gold standard to distinguish benign from malignant thyroid nodules is fine needle aspiration biopsy (FNAB). Twenty percent of biopsied nodules are interpreted as follicular neoplasms (FN). FNAB cannot distinguish benign follicular adenoma from follicular carcinoma. This is clinically important as follicular adenoma is adequately treated with hemithyroidectomy whereas follicular carcinoma requires total thyroidectomy followed by lifelong thyroid hormone replacement. Shear wave elastography (SWE) has been shown to be a promising technology that can distinguish benign from malignant thyroid lesions. This study was undertaken to evaluate the capacity of SWE to differentiate benign from malignant FN’s and to determine inter-observer variability in SWE thyroid nodule elasticity quantification. MATERIALS AND METHODS Patients with indeterminate cytology on FNAB comprising (1) FN / suspicious for FN or (2) follicular lesion of unknown significance (FLUS) unde...
ABSTRACT http://link.springer.com/chapter/10.1007/978-3-642-54047-9\_10#page-1 Interventional radi... more ABSTRACT http://link.springer.com/chapter/10.1007/978-3-642-54047-9_10#page-1 Interventional radiologists can now perform multiple urological interventions including focal and nonfocal renal biopsies, renal cell cancer ablation (discussed in a different chapter), percutaneous nephrostomy tube placement, and percutaneous catheter drainage of renal and perirenal fluid collections and provide access for percutaneous lithotomy, ureteral balloon dilatation and stenting, ureteral embolization, and suprapubic tube placement. ... Urological interventions entail a multidisciplinary approach in close cooperation with urologists and nephrologists. ...
Radiology, May 7, 2015
Purpose To evaluate the diagnostic accuracy of shear-wave elastography (SWE) for the diagnosis of... more Purpose To evaluate the diagnostic accuracy of shear-wave elastography (SWE) for the diagnosis of malignancy in follicular lesions and to identify the optimal SWE measurement plane. Materials and Methods The institutional review board approved this HIPAA-compliant, single-institution, prospective pilot study. Subjects scheduled for surgery after a previous fine-needle aspiration report of "atypia of undetermined significance" or "follicular lesion of undetermined significance," "suspicion for follicular neoplasm," or "suspicion for Hurthle cell neoplasm," were enrolled after obtaining informed consent. Subjects underwent conventional ultrasonography (US), Doppler evaluation, and SWE preoperatively, and their predictive value for thyroid malignancy was evaluated relative to the reference standard of surgical pathologic findings. Results Thirty-five patients (12 men, 23 women) with a mean age of 55 years (range, 23-85 years) and a fine-needle aspiration diagnosis of atypia of undetermined significance or follicular lesion of undetermined significance (n = 16), suspicion for follicular neoplasm (n = 14), and suspicion for Hurthle cell neoplasm (n = 5) were enrolled in the study. Male sex was a statistically significant (P = .02) predictor of malignancy, but age was not. No sonographic morphologic parameter, including nodule size, microcalcification, macrocalcification, halo sign, taller than wide dimension, or hypoechogenicity, was associated with malignancy. Similarly, no Doppler feature, including intranodular vascularity, pulsatility index, resistive index, or peak-systolic velocity, was associated with malignancy. Higher median SWE tissue Young modulus estimates from the transverse insonation plane were associated with malignancy, yielding an area under the receiver operating characteristic curve of 0.81 (95% confidence interval: 0.62, 1.00) for differentiation of malignant from benign nodules. At a cutoff value of 22.3 kPa, sensitivity, specificity, positive predictive value, and negative predictive value of 82%, 88%, 75%, and 91%, respectively, were observed. Conclusion This prospective pilot study indicates that SWE may be a valuable tool in preoperative malignancy risk assessment of follicular-patterned thyroid nodules. (©) RSNA, 2015.
AJR. American journal of roentgenology, 2016
The purpose of this study is to determine the reliability of shear-wave elastographic estimates o... more The purpose of this study is to determine the reliability of shear-wave elastographic estimates of the Young modulus in thyroid follicular neoplasms. In this study, 35 adults with follicular nodules diagnosed by fine-needle aspiration (FNA) biopsy were enrolled. A single sonographer examined all nodules in three planes (sagittal, transverse, and transverse center). Two raters independently placed ROIs in each nodule. Intra- and interrater reliability were computed as intraclass correlation coefficients (ICCs) and were reported using the Guidelines for Reporting Reliability and Agreement Studies. Thirty-five subjects with 35 follicular pattern nodules diagnosed by FNA biopsy were enrolled; 23 (65.7%) patients were female, with a mean age of 55.1 years (range, 23-85 years). For rater 1, intrarater agreement showed ICCs for single measurements of 0.87, 0.87, and 0.90 in the sagittal, transverse, and transverse center plans, respectively; ICCs for the median of multiple measurements wer...
Journal of vascular and interventional radiology : JVIR, 2016
To evaluate the technique, efficacy, safety, and clinical outcomes of CT-guided microwave ablatio... more To evaluate the technique, efficacy, safety, and clinical outcomes of CT-guided microwave ablation of tumors in the hepatic dome. Retrospective review was conducted of 46 consecutive patients (31 men and 15 women; mean age, 64 y) treated with CT-guided microwave ablation for hepatic-dome tumors between June 2011 and December 2014. Baseline demographics of sex, tumor diagnosis, tumor location, tumor size, and technical details were recorded. Technical success was evaluated. Treatment response was assessed per European Association for the Study of the Liver criteria. Overall success and overall survival were calculated, and complications were recorded. Forty-eight tumors were treated. Tumor locations included segments VIII (n = 32), VII (n = 10), and VIa (n = 6). Mean tumor size was 2.4 cm (range, 0.9-5.2 cm). Thirty-four tumors (70%) were treated following creation of artificial ascites with 0.9% normal saline solution (mean volume, 1,237 mL; range, 300-3,000 mL). The technical succe...
Radiographics : a review publication of the Radiological Society of North America, Inc
Tissue harmonic imaging (THI) is a routinely used component of diagnostic ultrasonography (US). I... more Tissue harmonic imaging (THI) is a routinely used component of diagnostic ultrasonography (US). In this method, higher-frequency harmonic waves produced by nonlinear fundamental US wave propagation are used to generate images that contain fewer artifacts than those seen on conventional fundamental wave US tissue imaging. Harmonic frequencies are integer multiples of the fundamental frequency. The majority of current clinical US systems use second harmonic echoes for THI image formation. Image processing techniques (ie, bandwidth receive filtering, pulse inversion, side-by-side phase cancellation, and pulse-coded harmonics) are used to eliminate the fundamental frequency echoes, and the remaining harmonic frequency data are used to generate the diagnostic image. Advantages of THI include improved signal-to-noise ratio and reduced artifacts produced by side lobes, grating lobes, and reverberation. THI has been accepted in US practice, and variations of the technology are available on ...
Radiographics : a review publication of the Radiological Society of North America, Inc, 2015
Diagnostic tests have wide clinical applications, including screening, diagnosis, measuring treat... more Diagnostic tests have wide clinical applications, including screening, diagnosis, measuring treatment effect, and determining prognosis. Interpreting diagnostic test results requires an understanding of key statistical concepts used to evaluate test efficacy. This review explains descriptive statistics and discusses probability, including mutually exclusive and independent events and conditional probability. In the inferential statistics section, a statistical perspective on study design is provided, together with an explanation of how to select appropriate statistical tests. Key concepts in recruiting study samples are discussed, including representativeness and random sampling. Variable types are defined, including predictor, outcome, and covariate variables, and the relationship of these variables to one another. In the hypothesis testing section, we explain how to determine if observed differences between groups are likely to be due to chance. We explain type I and II errors, st...
PURPOSE/AIM Review the role of imaging in the management of inflammatory bowel disease (IBD), dis... more PURPOSE/AIM Review the role of imaging in the management of inflammatory bowel disease (IBD), discuss pros and cons of different modalities, and define an algorithm for imaging these young patients. CONTENT ORGANIZATION 1. Epidemiology and pathophysiology 2. Role of imaging in management of patients at diagnosis, during treatment, and recurrence a. Disease distribution b. Extraintestinal manifestations c. Disease activity d. Extraluminal complications 3. Current IBD treatment a. Goals of treatment b. Traditional and molecule-targeted anti-inflammatory medications c. Medical and surgical options for perianal disease 4. Imaging modalities: diagnostic performance, advantages and limitations a. Fluoroscopic small bowel series and enteroclysis b. CT c. CT enterography d. CT/MR enteroclysis e. Pelvic MRI for perianal disease f. MR enterography g. Ultrasound (US) 5. Potential risks from ionizing radiation 6. Potential long-term risks from IBD and treatment 7. Radiation reduction strategies...
PURPOSE/AIM This educational poster will review staging system for all gastrointestinal tumors, a... more PURPOSE/AIM This educational poster will review staging system for all gastrointestinal tumors, and explain the role of imaging in their clinical management. We will show how key imaging findings “tipping points” can dictate changes in management and prognosis. CONTENT ORGANIZATION 1. Review the TNM staging system. 2. Describing the concept of “tipping point” in clinical management of gastrointestinal tumors by imaging 3. Assimilate American Cancer Society cancer staging systems for all GI tumors and identifying points at which imaging findings change tumor stage, management, and prognosis. 4. Gain understanding that specific imaging findings are critical for most tumor staging systems and that reporting of these specific findings is critical in changing staging and management for many GI abdominal tumors. 5. Key questions to ask and why: a. Pancreatic Adenocarcinoma b. Hepatocellular Carcinoma c. Cholangiocarcinoma d. Gastric Adenocarcinoma e. Small Bowel Carcinoma f. Colorectal Ca...
PURPOSE/AIM Sonoelastography uses ultrasound imaging techniques to quantify and map tissue stiffn... more PURPOSE/AIM Sonoelastography uses ultrasound imaging techniques to quantify and map tissue stiffness. Sonoelastography has an expanding role in the detection and characterization of a variety of pathologies in different organs. This educational exhibit will explain the physical principles that underlie the different types of sonoelastography in simple language with figures, schematic diagrams. CONTENT ORGANIZATION • History: evolution from basic physics to clinical trials. • Definitions: elasticity, stress, strain and Young’s (elastic) modulus. • Describe Bulk Modulus B and compressional wave; Shear Modulus G and shear wave and their relationship with Young’s modulus. • US elastography techniques classification: quasi-quantitative and quantitative methods. • General principles of real-time elastography: strain and strain ratio, estimating Young’s modulus from strain change, strain change with depth. • General principles of shear wave elastography: estimating Young’s modulus by measu...
PURPOSE/AIM This exhibit will provide a review of the statistical methods for assessing measureme... more PURPOSE/AIM This exhibit will provide a review of the statistical methods for assessing measurement reproducibility in quantitative imaging. CONTENT ORGANIZATION 1. Definition of reliability(reproducibility) and measurement error. 2. The difference between reliability and validity. 3. Describing sources of measurement variability, with a special focus on intra- and inter-observer variability 4. Considerations when designing reliability and agreement studies 5. Statistical methods for analyzing reliability of quantitative measurement, including Standard Error of measurement and coefficient of variation (CV), Intraclass Correlation Coefficient (ICC), and Bland-Altman Analysis. 6. Guidelines for reporting reliability and agreement studies (GRRAS). 7. Why Pearson’s Correlation Coefficient should not be used to assess reliability. 8. Role of reliability in generalizability and clinical decision studies. 9. Strategies for reducing variability. SUMMARY Quantitative imaging has a promising ...
PURPOSE/AIM This exhibit provides a practical review of nonparametric statistical tests for clini... more PURPOSE/AIM This exhibit provides a practical review of nonparametric statistical tests for clinical radiology researchers. The description of each statistical test will be accompanied by a clinical question that the statistical test would address. CONTENT ORGANIZATION 1. What are nonparametric tests? 2. Parametric tests vs. nonparametric tests, advantages and limitations 3. Why are nonparametric tests popular in radiology research? 4. One Sample with Two Paired Measurements a. Dichotomous scale: McNemar test b. Ordinal scale: Sign test 5. Comparing Two Related Samples: Wilcoxon Signed Rank Test 6. Comparing Two Unrelated Samples: a. Categorical data: The Chi-Square & Fisher Exact tests b. Continuous data with an interval/rational Scale: Wilcoxon rank sum test (Mann-Whitney U-Test) 7. Comparing More Than Two Related Samples: a. Categorical data with dichotomous scale: Cochran Q test b. Categorical data with ordinal scale OR Continuous data with an interval/rational Scale : Two-way A...
PURPOSE/AIM This exhibit will provide a review of the potential clinical applications and role of... more PURPOSE/AIM This exhibit will provide a review of the potential clinical applications and role of various ultrasound elastography techniques in diffuse liver disease. CONTENT ORGANIZATION • Role of liver biopsy in staging of liver fibrosis as an imperfect reference standard in diagnosis and prognosis of Chronic Hepatitis C (CHC) and Nonalcoholic steatohepatitis (NASH), and its limitations. • Non-invasive methods for liver fibrosis assessment: biological markers, biophysical makers and their clinical roles in reducing liver biopsy in some patients. • Introduction of US Elastography Techniques: Transient Elastography, Real-Time Elastography, ARFI Elastography and the technical differences between them. • Comparison of different US Elastography methods in clinical evaluation of hepatic fibrosis, in chronic viral hepatitis and NASH, to the liver biopsy and each other; and their advantages and limitations. • The future trend of US elastography applications in diffuse liver diseases. SUMM...
PURPOSE OF THE STUDY The current gold standard to distinguish benign from malignant thyroid nodul... more PURPOSE OF THE STUDY The current gold standard to distinguish benign from malignant thyroid nodules is fine needle aspiration biopsy (FNAB). Twenty percent of biopsied nodules are interpreted as follicular neoplasms (FN). FNAB cannot distinguish benign follicular adenoma from follicular carcinoma. This is clinically important as follicular adenoma is adequately treated with hemithyroidectomy whereas follicular carcinoma requires total thyroidectomy followed by lifelong thyroid hormone replacement. Shear wave elastography (SWE) has been shown to be a promising technology that can distinguish benign from malignant thyroid lesions. This study was undertaken to evaluate the capacity of SWE to differentiate benign from malignant FN’s and to determine inter-observer variability in SWE thyroid nodule elasticity quantification. MATERIALS AND METHODS Patients with indeterminate cytology on FNAB comprising (1) FN / suspicious for FN or (2) follicular lesion of unknown significance (FLUS) unde...