1,721,165 research outputs found
Prevalence of noncardiac findings in computed tomography angiography before transcatheter aortic valve replacement
No full textImpact of breast density on computer-aided detection in full-field digital mammography
No full textThe goal of this study was to evaluate the performance of a computer-aided detection (CAD) system in full-field digital mammography (Senographe 2000D, General Electric, Buc, France) in finding out carcinomas depending on the parenchymal density. A total of 226 mediolateral oblique (MLO) and 186 craniocaudal (CC) mammographic views of histologically proven cancers were retrospectively evaluated with a digital CAD system (ImageChecker V2.3 R2 Technology, Los Altos, CA, USA). Malignant tumors were detected correctly by CAD in MLO view in 84.85% in breasts with parenchymal tissue density of the American College of Radiology (ACR) type 1, in 70.33% of the ACR type 2, in 68.12% of the ACR type 3, and in 69.70% of the ACR type 4. For the CC view, similar results were found according to the ACR types. Using the chi-square and McNemar tests, there was no statistical significance. However, a trend of better detection could be seen with decreasing ACR type. In conclusion, there seems to be a tendency for breast tissue density to affect the detection rate of breast cancer when using the CAD system
Supraventricular tachycardia with 'A-A-V' response upon ventricular entrainment and transient 2:1 AV conduction block
No full textComputer-aided detection in full-field digital mammography: Detection in dependence of the BI-RADS categories
No full textThe object of this study was to determine the performance of a computer-aided detection system in full-field digital mammography (Senographe 2000D, General Electric, Buc, France) in detecting carcinomas in breasts in dependence of the initial Breast Imaging Reporting and Data System (BI-RADS) categories. A total of 226 mediolateral oblique (MLO) and 186 craniocaudal (CC) view mammograms of histologically proven cancers were retrospectively evaluated with a primary digital computer-aided detection system (Image Checker V2.3; R2 Technology, Los Altos, CA). According to BI-RADS of the American College of Radiology (ACR), the lesions were classified in MLO view as BI-RADS 1 in 2 cases, BI-RADS 2 in 11 cases, BI-RADS 3 in 37 cases, BI-RADS 4 in 56 cases, and BI-RADS 5 in 120 cases, and in CC view as BI-RADS 1 in 2 cases, BI-RADS 2 in 8 cases, BI-RADS 3 in 26 cases, BI-RADS 4 in 46 cases, and BI-RADS 5 in 104 cases. The computer-aided detection system shows markers also in mammograms classified as BI-RADS categories 1-3 by the radiologist. Furthermore, BI-RADS categories 4 and 5 in most cases demonstrate masses in mammography. With increasing BI-RADS category, the computer-aided detection system shows decreasing numbers of overlooked carcinomas. In MLO view, no markers were found in 100% (2/2), 81.8% (9/11), 59.5% (22/37), 46.4% (26/56), and 15% (18/120) for BI-RADS categories 1-5, respectively. False-positive markers, however, were seen in 0.5 per image (205/412). In conclusion, the high rate of false-positive markers shows that the specificity of the computer-aided detection system is limited and that improvements are necessary
The 2024 European Society of Cardiology Guidelines for Diagnosis and Management of Atrial Fibrillation: A Viewpoint from a Practicing Clinician's Perspective
No full textAtrial fibrillation (AF) is a complex disease requiring a multidomain and (usually) long-term management, thus posing a significant burden to patients with AF, practitioners, and health care system. Unlike cardiovascular conditions with a narrow referral pathway (e.g., acute coronary syndrome), AF may be first detected by a wide range of specialties (often noncardiology) or a general practitioner. Since timely initiated optimal management is essential for the prevention of AF-related complications, a concise and simple guidance is essential for practitioners managing AF patients, regardless of their specialty. Guideline-adherent management of patients with AF has been shown to translate to improved patient outcomes compared with guideline-nonadherent treatment. To facilitate guideline implementation in routine clinical practice, a good guideline document on AF should introduce only evidence-based new recommendations, while avoiding arbitrary changes, which may be confusing to practitioners. Herein, we discuss the main changes in the 2024 European Society of Cardiology (ESC) AF Guidelines relative to the previous 2020 ESC document. Whether the updates and new recommendations issued by the new guidelines will translate in high adherence in clinical practice (and hence improved prognosis of patients with AF) will need to be addressed in upcoming years
Retrospektive Analyse eines computerassistierten Detektions-Systems (CAD) in der digitalen Vollfeldmammographie in Abhängigkeit von der Histologie
No full textPurpose: To evaluate the usefulness of a computer-aided detection (CAD) system in full-field digital mammography in correlation to tumor histology. Material and Methods: A total of 476 patients (226 patients with histologically proven malignant tumors, 250 healthy women) took part in this study. The mammograms were studied retrospectively, using the CAD system Image Checker. For 226 patients digital mammograms in MLO-projection were available. For 186 of these patients the CC-projection was also available. CAD markers that correlated with histologically proven carcinomas were considered to be true-positive markers. All other CAD markers were considered to be false-positive. Histologically proven carcinomas without markers were false-negative results. The dependence of the CAD markers pla-cement upon the different carcinoma histologies was studied L using the Chi-square test. Results: No significant difference could be proven for the detectability of malignant breast lesions of different histologic types. For the detectability of ductal carcinoma in situ (DCIS), invasive ductal carcinoma (IDC), invasive lobular carcinoma (ILC), lobular carcinoma in situ (LCIS), tubular carcinoma and ductulo-lobular carcinoma, the true positives were 71.1%, 75%, 70.7%, 70%, 60% and 80%, respectively, in the MLO projection and 83.9%, 75.9%, 81.8%, 77.8%, 87.5% and 33.3%, respectively, in the CC projection. There was an average of 0.5 false-positive markers per mammographic image. Conclusion: The histologic type of carcinoma seems to have no influence on detectability when using the CAD system. The high rate of false-positive markers shows, however, the limited specificity of the CAD system and that improvements are necessary
Value of the BI-RADS classification in MR-Mammography for diagnosis of benign and malignant breast tumors
Full text linkTo assess whether the BI-RADS classification in MR-Mammography (MRM) can distinguish between benign and malignant lesions. 207 MRM investigations were categorised according to BI-RADS. The results were compared to histology. All MRM studies were interpreted by two examiners. Statistical significance for the accuracy of MRM was calculated. A significant correlation between specific histology and MRM-tumour-morphology could not be reported. Mass (68%) was significant for malignancy. Significance raised with irregular shape (88%), spiculated margin (97%), rim enhancement (98%), fast initial increase (90%), post initial plateau (65%), and intermediate T2 result (82%). Highly significant for benignity was an oval mass (79%), slow initial increase (94%) and a hyperintense T2 result (77%), also an inconspicuous MRM result (77%) was often seen in benign histology. Symmetry (90%) and further post initial increase (90%) were significant, whereas a regional distribution (74%) was lowly significant for benignity. On basis of the BI-RADS classification an objective comparability and statement of diagnosis could be made highly significant. Due to the fact of false-negative and false-positive MRM-results, histology is necessary
Ranolazine Maintained Sinus Rhythm in a Patient with Refractory Symptomatic Atrial Fibrillation
No full textWe report on a patient who was treated with several antiarrhythmic drugs as well as different ablation strategies. Nevertheless, symptomatic atrial fibrillation always recurred until an off-label use with ranolazine was started. We could demonstrate potent effects of ranolazine on atrial fibrillation in a "wash-in wash-out" situation. Although promising controlled studies are needed to investigate a potential role of ranolazine for the treatment of atrial fibrillation.DFG [SFB 1002
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