What does diagnostic threshold mean? Deterministic and probabilistic considerations

Nakajima, Kénichi; Okuda, Koichi; Komatsu, Junji

doi:10.1007/s12350-019-01899-2

Cited by 6 publications

(4 citation statements)

References 19 publications

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“…When the HMR was classified by a threshold of 2. 2, which is applied in neurology to differentiate Alzheimer dementia and DLB ( 16 ), the HMR concordance between the cameras was >90%. These findings indicated equivalent diagnostic accuracy between the two systems from a neurological perspective.…”

Section: Discussionmentioning

confidence: 99%

Phantom-Based Standardization Method for <sup>123</sup>I-meta-iodobenzylguanidine Heart-to-Mediastinum Ratio Validated by D-SPECT Versus Anger Camera

Yamashita,

Nakajima,

Okuda

et al. 2023

Annals of Nuclear Cardiology

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Background : The 123 I-metaiodobenzylguanidine heart-to-mediastinum ratios (HMRs) have been standardized between D-SPECT and Anger cameras in a small patient cohort using a phantom-based conversion method. This study aimed to determine the validity of this method and compare the diagnostic performance of the two cameras in a larger patient cohort. Methods : We retrospectively calculated HMRs from early and late anterior-planar equivalent and planar images acquired from 173 patients in 177 studies using D-SPECT and Anger cameras, respectively. The D-SPECT HMRs were cross-calibrated to an Anger camera using conversion coefficients based on previous phantom findings, then standardized to medium-energy general-purpose collimator conditions. Relationships between HMRs before and after corrections were investigated. Late HMRs were classified into four cardiac mortality risk groups and divided into two groups using a threshold of 2.2 to verify diagnostic performance concordance. Results : Correction improved linear regression lines and differences in HMRs among the groups. The overall ratios of perfect concordance were (134 [75.7%] of 177), and higher in groups with very low (49 [80.3%] of 61) and high (51 [86.4%] of 59) HMRs when the standardized HMR was classified according to cardiac mortality risk. That between the systems was the highest (164 [92.7%] of 177) when the HMR was divided by a threshold value of 2.2. Conclusions : Phantom-based conversion can standardize HMRs between D-SPECT and Anger cameras because the standardized HMR provided comparable diagnostic performance. Our findings indicated that this conversion could be applied to multicenter studies that include both D-SPECT and Anger cameras.

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Section: Discussionmentioning

confidence: 99%

Phantom-Based Standardization Method for <sup>123</sup>I-meta-iodobenzylguanidine Heart-to-Mediastinum Ratio Validated by D-SPECT Versus Anger Camera

Yamashita,

Nakajima,

Okuda

et al. 2023

Annals of Nuclear Cardiology

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“…The response rate to CRT treatment was analysed by a multi-variable logistic regression model. 32 Mathematical calculation for creating ROC analysis and models was based on Mathematica 12 (Wolfram Research Inc., Champaign, IL, USA). Other statistical analyses were performed with SPSS, release 25.0 (SPSS Inc., Chicago, IL, USA 2017).…”

Section: Methodsmentioning

confidence: 99%

The relation between cardiac 123I-mIBG scintigraphy and functional response 1 year after CRT implantation

Verschure

Poel

Vincentis

et al. 2020

European Heart Journal - Cardiovascular Imaging

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Aims Cardiac resynchronization therapy (CRT) is a disease-modifying therapy in patients with chronic heart failure (CHF). Current guidelines ascribe CRT eligibility on three parameters only: left ventricular ejection fraction (LVEF), QRS duration, and New York Heart Association (NYHA) functional class. However, one-third of CHF patients does not benefit from CRT. This study evaluated whether 123I-meta-iodobenzylguanidine (123I-mIBG) assessed cardiac sympathetic activity could optimize CRT patient selection. Methods and results A total of 78 stable CHF subjects (age 66.8 ± 9.6 years, 73% male, LVEF 25.2 ± 6.7%, QRS duration 153 ± 23 ms, NYHA 2.2 ± 0.7) referred for CRT implantation were enrolled. Subjects underwent 123I-mIBG scintigraphy prior to implantation. Early and late heart-to-mediastinum (H/M) ratio and 123I-mIBG washout were calculated. CRT response was defined as either an increase of LVEF to >35%, any improvement in LVEF of >10%, QRS shortening to <150 ms, or improvement in NYHA class of >1 class. In 33 patients LVEF increased to >35%, QRS decreased <150 ms in 36 patients, and NYHA class decreased in 33 patients. Late H/M ratio and hypertension were independent predictors of LVEF improvement to >35% (P = 0.0014 and P = 0.0149, respectively). In addition, early H/M ratio, LVEF, and absence of diabetes mellitus (DM) were independent predictors for LVEF improvement by >10%. No independent predictors were found for QRS shortening to <150 ms or improvement in NYHA class. Conclusion Early and late H/M ratio were independent predictors of CRT response when improvement of LVEF was used as measure of response. Therefore, cardiac 123I-mIBG scintigraphy may be used as a tool to optimize selection of subjects that might benefit from CRT.

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“…Further, even within an individual- a biomarker profile measured is a “snapshot” of the current biochemical state and will vary with time in response to external influences 14 . The availability of systematic, reliable, baseline signature profiles of healthy individuals that accounts for inter- and intra- individual variability is essential for assessing and characterizing disease-specific biomarker expression 15 . The work presented herein aims to advance us a step further in that direction.…”

Section: Introductionmentioning

confidence: 99%

Methods to capture proteomic and metabolomic signatures from cerebrospinal fluid and serum of healthy individuals

Lilley

Sanche

Moore

et al. 2022

Sci Rep

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Discovery of reliable signatures for the empirical diagnosis of neurological diseases—both infectious and non-infectious—remains unrealized. One of the primary challenges encountered in such studies is the lack of a comprehensive database representative of a signature background that exists in healthy individuals, and against which an aberrant event can be assessed. For neurological insults and injuries, it is important to understand the normal profile in the neuronal (cerebrospinal fluid) and systemic fluids (e.g., blood). Here, we present the first comparative multi-omic human database of signatures derived from a population of 30 individuals (15 males, 15 females, 23–74 years) of serum and cerebrospinal fluid. In addition to empirical signatures, we also assigned common pathways between serum and CSF. Together, our findings provide a cohort against which aberrant signature profiles in individuals with neurological injuries/disease can be assessed—providing a pathway for comprehensive diagnostics and therapeutics discovery.

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What does diagnostic threshold mean? Deterministic and probabilistic considerations

Cited by 6 publications

References 19 publications

Phantom-Based Standardization Method for <sup>123</sup>I-meta-iodobenzylguanidine Heart-to-Mediastinum Ratio Validated by D-SPECT Versus Anger Camera

Phantom-Based Standardization Method for <sup>123</sup>I-meta-iodobenzylguanidine Heart-to-Mediastinum Ratio Validated by D-SPECT Versus Anger Camera

The relation between cardiac 123I-mIBG scintigraphy and functional response 1 year after CRT implantation

Methods to capture proteomic and metabolomic signatures from cerebrospinal fluid and serum of healthy individuals

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