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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Aplicação do Sonobreast e comparação de Acurácia e concordância com o sistema BI-RADS em nódulos mamários sólidos ao ultrassonografia / Sonobreast application and comparison of Acuracia and concordance with the BI-RADS system in ultrasonography solid momary nodules

Oliveira, Luís Fernando Pádua 18 December 2014 (has links)
Submitted by JÚLIO HEBER SILVA (julioheber@yahoo.com.br) on 2017-09-12T19:30:28Z No. of bitstreams: 2 Tese - Luís Fernando Pádua Oliveira - 2014.pdf: 1592628 bytes, checksum: 36eb6ae0c7aaec37028cc39dc69c9a78 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-09-19T13:56:14Z (GMT) No. of bitstreams: 2 Tese - Luís Fernando Pádua Oliveira - 2014.pdf: 1592628 bytes, checksum: 36eb6ae0c7aaec37028cc39dc69c9a78 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-09-19T13:56:14Z (GMT). No. of bitstreams: 2 Tese - Luís Fernando Pádua Oliveira - 2014.pdf: 1592628 bytes, checksum: 36eb6ae0c7aaec37028cc39dc69c9a78 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2014-12-18 / Objectives: To compare the accuracy and concordance of SONOBREAST with the BI-RADS system for predicting malignancy in solid breast masses observed on ultrasound; and application the SONOBREAST in women with breast lumps. Methods: 274 women were included prospectively, with the assessment of 500 breast masses observed on ultrasound and that presented any surgical indication. Sonographic features were assessed, the patients' age and family history of first degree. The likelihood of malignancy according to SONOBREAST model was calculated through the webpage <www.sonobreast.com.br>, and the BI-RADS system. The result was compared to anatomopathological examination. Results: The average age of patients was 41.92 (± 14.40) years. There were 87 (17.40%) malignant tumors; and 382 (76.40%) nonpalpable lesions. For the cutoff of 2%, the lesions were regarded as suspicious in 171 cases (34.20%) by both SONOBREAST and BI-RADS. The Kappa coefficient of concordance between the methods was 1 (p <0.001). SONOBREAST was identical to the BI-RADS system for sensitivity (95.40)%, specificity (78.69%), positive predictive value (48.54%), negative predictive value (98.78%) and accuracy (81.60 %). Compared to categorical variables (3, 4 and 5) classified by BIRADS, the area under the ROC curve by SONOBREAST was of 94.41 (92.20 to 96.62) and by BI-RADS of 89.99 (86.60 to 93.37). Conclusion: The SONOBREAST model presents identical accuracy compared to the BIRADS system, when using the same parameters for the cutoff for malignancy suspicion. Considering the increasing likelihood of malignancy for categories 3, 4 and 5 of the BI-RADS system, SONOBREAST model allowed a more precise and individualized assessment. / Objetivos: Comparar a acurácia e a concordância do SONOBREAST com o sistema BI-RADS, na predição de malignidade em nódulos sólidos da mama vistos à ultrassonografia; e aplicar o SONOBREAST em mulheres com nódulos mamários. Metodologia: Foram incluídas 274 mulheres, de forma prospectiva, com avaliação de 500 nódulos mamários vistos à ultrassonografia e que apresentavam alguma indicação cirúrgica. Foram avaliadas as características ultrassonográficas, a idade das pacientes e o histórico familiar de primeiro grau. Foi calculada a probabilidade de malignidade de acordo com o modelo SONOBREAST, através da página de internet, <www.sonobreast.com.br>, e pelo sistema BI-RADS. O resultado foi comparado com o exame anatomopatológico. Resultados: A média de idade das pacientes foi de 41,92 (±14,40) anos. Havia 87 (17,40%) tumores malignos; e 382 (76,40%) nódulos não palpáveis. Para o ponto de corte de 2%, as lesões foram consideradas suspeitas em 171 casos (34,20%) tanto pelo SONOBREAST quanto pelo BI-RADS. O índice de concordância Kappa entre os métodos foi de 1 (p<0,001). O SONOBREAST foi idêntico ao sistema BI-RADS quanto à sensibilidade (95,40)%, especificidade (78,69%), valor preditivo positivo (48,54%), valor preditivo negativo (98,78%) e acurácia (81,60%). Em comparação com as variáveis categóricas (3, 4 e 5) classificadas pelo BI-RADS, a área sob a curva ROC foi, pelo SONOBREAST, de 94,41 (92,20-96,62) e, pelo BI-RADS, de 89,99 (86,60- 93,37). Conclusão: O modelo SONOBREAST possui acurácia idêntica ao do sistema BI-RADS, quando se usam os mesmos parâmetros para o ponto de corte da suspeição de malignidade. Considerando a probabilidade contínua de malignidade para as categorias 3, 4 e 5 do sistema BI-RADS, o modelo SONOBREAST permitiu uma avaliação mais precisa e individualizada.

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