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Good Positive and Negative Likelihood Ratios

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Small Bowel Tumor: Likelihood Ratios

Introduction: None written.

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Tags: Gastrointestinal Problem Neoplasm Tag this Diagnosis.

The likelihood ratios of findings for Small Bowel Tumor are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Good Positive and Negative Likelihood Ratios
Finding	Result	+LR	-LR
[ + ] CT Enteroclysis	+ 0 -	28.3	0.2
CT enteroclysis combines the benefit of cross-sectional CT scanning and barium contrast studies. The technique involves infusion of contrast dye via a nasoenteric tube while obtaining CT images. (UpToDate) Based on study with 219 pts Study: Possible small-bowel neoplasms: contrast-enhanced and water-enhanced multidetector CT enteroclysis. Pilleul F; Penigaud M; Milot L; Saurin JC; Chayvialle JA; Valette PJ Radiology. 2006 Dec;241(3):796-801. Epub 2006 Oct 19. PMID 17053201

Poorly Diagnostic Findings
Finding	Result	+LR	-LR
[ + ] Small bowel enema		Sensitivity = 90%
Based on a small study Small bowel enema is also called enteroclysis, which is a double contrast study that is performed by passing a tube into the proximal small bowel and injecting both barium and methylcellulose. (UpToDate) Study: Primary malignant tumors in the small bowel: a comparison of the small-bowel enema and conventional follow-through examination. Bessette JR; Maglinte DD; Kelvin FM; Chernish SM AJR Am J Roentgenol 1989 Oct;153(4):741-4. PMID 2672733
[ + ] Abdominal CT		Sensitivity = 87%
Abdominal CT with intravenous and oral contrast can be used to identify one or more of the following manifestations of a carcinoid tumor: The primary tumor Mesenteric stranding due to tumor spread admixed with a fibrotic response Liver metastases (which are invariably present when carcinoid syndrome arises from a gut primary) Mesenteric lymph node enlargement (Modified from UpToDate Study: Primary tumors of the small intestine: CT evaluation. Dudiak KM; Johnson CD; Stephens DH AJR Am J Roentgenol 1989 May;152(5):995-8. PMID 2705358 Computed tomography of abdominal carcinoid tumor. Cockey BM; Fishman EK; Jones B; Siegelman SS J Comput Assist Tomogr 1985 Jan-Feb;9(1):38-42. PMID 3968277
[ + ] UGI/SBFT		Sensitivity = 33%
Based on a small study Study: Primary malignant tumors in the small bowel: a comparison of the small-bowel enema and conventional follow-through examination. Bessette JR; Maglinte DD; Kelvin FM; Chernish SM AJR Am J Roentgenol 1989 Oct;153(4):741-4. PMID 2672733

Findings With Unspecified Accuracy
Finding	Result	+LR	-LR
[ + ] MRI		No accuracy specified.
Gadolinium-enhanced MRI of the liver is actually a more sensitive test for the presence and extent of liver metastases in patients with carcinoid(UpToDate) Study: Assessment of the extent of metastases of gastrointestinal carcinoid tumors using whole-body PET, CT, MRI, PET/CT and PET/MRI. Seemann MD; Meisetschlaeger G; Gaa J; Rummeny EJ Eur J Med Res. 2006 Feb 21;11(2):58-65. PMID 16504962
[ + ] Wireless capsule endoscopy		No accuracy specified.
Study: no study specified.
[ + ] Enteroscopy		No accuracy specified.
Study: no study specified.
[ + ] Laparotomy		No accuracy specified.
Study: no study specified.