Prospective comparative study of spiral computer tomography and magnetic resonance imaging for detection of hepatocellular carcinoma

BACKGROUND: Hepatocellular carcinoma (HCC) is often detected at a relatively late stage when tumour size prohibits curative surgery. Screening to detect HCC at an early stage is performed for patients at risk. AIM: The aim of this study was to compare prospectively the diagnostic accuracy and classification for management of the two state of the art secondline imaging techniques: triphasic spiral computer tomography (CT) and super paramagnetic iron oxide (SPIO) enhanced magnetic resonance imaging (MRI). PATIENTS: Sixty one patients were evaluated between January 1996 and January 1998. Patients underwent CT and MRI within a mean interval of 6.75 days. METHODS: CT and MRI were evaluated blindly for the presence and number of lesions, characterisation of these lesions, and classification for management. For comparison of the data on characterisation, the CT and MRI findings were compared with histopathological studies of the surgical specimens and/or follow up imaging. Data of patients not lost to follow up were available to January 2001. RESULTS: SPIO enhanced MRI detected more lesions and overall smaller lesions than triphasic spiral CT (number of lesions 189 v 124; median diameter 1.0 v 1.8 cm; Spearman rank's correlation coefficient 0.63, p<0.001). There was no significant difference in accuracy between CT and MRI for lesion characterisation. The agreement in classification for management was very good (weighted kappa 0.91, 95% CI 0.83-0.99). CONCLUSION: SPIO enhanced MRI detects more and smaller lesions, but both techniques are comparable in terms of classification for management. SPIO enhanced MRI may be preferred as there is no exposure to ionising radiation

Translation and validation of the Revised Dental Beliefs Survey (DBS-R) in China

Patient perceptions of behaviours and attitudes of dentists are associated with dental fear and poor dental attendance in Western countries. However, there is a paucity of research exploring patient perceptions of the dentist in China. One reason for this may be the lack of a valid and reliable scale in Chinese (Standard Mandarin) to measure this. This study aimed to translate the Revised Dental Beliefs Survey (DBS-R) into Chinese and then explore the reliability and validity of this measure (both the short and longer versions) in a Chinese population. We translated the DBS-R using the forwards-backwards method and pilot tested it on a small sample of adults in China. Following this, 480 Chinese adults completed the newly translated scale, as well as well as a standardised dental anxiety questionnaire (the Modified Dental Anxiety Scale Chinese version) to test convergent validity. 109 participants completed the DBS-R again 2 weeks later for test-retest reliability. Both versions of the Chinese DBS-R were internally consistent and demonstrated convergent validity; test-retest reliability was also good. Both versions of the scale performed similarly, but for now we would suggest the 28-item version may be superior as items relating to the technical competence of the dentist appear important to Chinese adults