Evaluation of a handheld creatinine measurement device for real-time determination of serum creatinine in radiology departments

AIM: To assess the feasibility/accuracy of a commercial handheld device in the context of increased demand for point-of-care serum creatinine (SCr) determination. METHODS: In this institutional review board-approved, prospective study, 401 patients referred for contrastenhanced computed tomography were included at two centres. Capillary (c)SCr was determined using two devices A+B and venous (v)SCr was determined in the centre's laboratory. Method comparison statistics for both centres and for vSCr<>1.2 mg/dL, receiver operating characteristic analysis, negative predictive values (NPV), sensitivity and specificity were calculated pre-/ post-curve offset correction with vSCr. RESULTS: Pearson's coefficients for cSCr vs vSCr were: centre 1-A:0.93/B:0.92; centre 2-A:0.85/B:0.82 (all P < 0.0001). Overall correlation was better for vSCr > 1.2 mg/dL. The area under the receiver operating characteristic curves showed a high accuracy for cSCr, but the device underestimated SCr, which was confirmed by Bland-Altman plot. Addition of the offset correction factor to the original data from centre 1 resulted in an improvement in sensitivity for detecting patients at risk (> 1.2 mg/dL), whilst maintaining acceptable specificity and improving NPV. CONCLUSION: This study showed the feasibility of SCr determination using the evaluated handheld device in a routine clinical setting. The device showed high sensitivity and high NPV, but may significantly underestimate SCr without offset correction to local laboratories.

腹的散开加权的磁性的回声成像上的领域力量和 RF 刺激的影响

AIM:To retrospectively and prospectively compare diffusion-weighted(DW)images in the abdomen in a1.5T system and 3.0T systems with and without twochannel functionality for B1shimming.METHODS:DW images of the abdomen were obtained on 1.5T and 3.0T(with and without two-channel functionality for B1shimming)scanners on 150 patients(retrospective study population)and 10 volunteers(prospective study population).Eight regions were selected for clinical significance or artifact susceptibility(at higher field strengths).Objective grading quantified signal-to-noise ratio(SNR),and subjective evaluation qualified image quality,ghosting artifacts,anddiagnostic value.Statistical significance was calculated usingχ2tests(categorical variables)and independent two-sided t tests or Mann-Whitney U tests(continuous variables).RESULTS:The 3.0T using dual-source parallel transmit(dpTX 3.0T)provided the significantly highest SNRs in nearly all regions.In regions susceptible to artifacts at higher field strengths(left lobe of liver,head of pancreas),the SNR was better or similar to the 1.5T system.Subjectively,both dpTX 3.0T and 1.5T systems provided higher image quality,diagnostic value,and less ghosting artifact(P【0.01,most values)compared to the 3.0T system without dual-source parallel transmit(non-dpTX 3.0T).CONCLUSION:The dpTX 3.0T scanner provided the highest SNR.Its image quality,lack of ghosting,and diagnostic value were equal to or outperformed most currently used systems.