Tests

Afirma test for thyroid nodules: ACEG – pro

The majority of FNAs of tyroid nodules show benign histological findings but some are indeterminate or non-diagnostic. In an attempt to separate out patients with a worse prognosis, Afirma has develoiped a proprietory tests, Benign Gene Expression Classifier.  In 2010, two modest-sized validation studies showed that the AGEC test could identify a benign gene expression signature in indeterminate cytology thyroid FNA samples with a negative predictive

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Bone marrow aspiration and biopsy

A fever of unknown origin is often worked up with a bone marrow, but this test is not appropraite before a full workup failes to reveal other explanation of fever. A  bone marrow aspiration and biopsy is not the appropriate tests for workup of fever that is not FUO. For example, the medically necessary approach to rule out a suspected lymphoma involves locating a lymph area that may be invovled by it. This test remains important in investigating

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NMP-22 to screen for bladder cancer

 NMP-22 urine assays for bladder cancer  detect nuclear mitotic apparatus protein 1 (NUMA-1) using monoclonal antibodies. This protein can be elevated in the urine if bladder cancer cells that are rapidly dividing are present.  It is not a partticularly specific tests, with many described non-cancer  factors that elevate its values,  and there is ongoing controversy as to whether its advantages in sensitivity over urine cytology are sufficient

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New type of brochoscopy: ENB

ENB (Electromagnetic Navigation Bronchoscopy) or EMN bronchoscopy is a type of bronchoscopy that uses electromagnetic guidance to project catheters into and through bronchial passages. Using a virtual, three-dimensional (3D) bronchial map from a recent CT scan and disposable catheters, it makes it possible toget to preselected spaces and to take biopsies or plan radiation.  FDA cleared it in 2004 through the 510(k) process. Studies suggest a higher success

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Colovantage test

ColoVantage is a new test available from Quest. Although it is a screening test, Quest says that it is not meant to be a substitute for colonoscopy. It was approved by NY State in March of 2011. It  detects circulating methylated DNA from the SEPT9 gene, which is involved in cell frowth and cell cycle control. A case-control study performed at Quest Diagnostics showed that the ColoVantage test is 70% sensitive for colorectal cacner detection at

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Genetic test for Coumadin

Warfarin (Coumadin®) dose is sometimes difficult to adjust. Now there is a genetic tests that can identify people who have an increased response to conventional doses of Coumadin, which can cause bleeding. The labeling for a popular formulation of warfarin was revised in August 2007 and February 2010 to include information about how the three most widely studied pharmacogenetic mutations (CYP2C9*2, CYP2C9*3, and VKORC1 -1639G>A) affect dose requirements

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FAP and AFAP testing: Genetic colon cancer

A small proportion of colon and rectal cancers arise in individuals who have genetic mutations. Familial Adenomatous Polyposis(FAP) and AFAP are autosomal dominant disorders with 50% risk of inheritance and about 75–80% of individuals with these conditions have an affected parent. Autosomal dominant inheritance means that an offspring of an affected individual has a 50% risk of inheriting the altered APC gene. Adenomas develop in approximately

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Veristrat: Current Status

Veristrat is a new test that was presented in April 2012. at the 3rd European Lung Cancer Conference in Geneva, Switzerland.  The Veristrat test was validated through a retrospective analysis was performed on serum samples from advanced non-squamous non-small cell lung cancer (NSCLC) patients treated with the combination therapy of Avastin and plus erlotinib. This means that after the study was finished, the researchers when back and checked tissue

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MRI in the Diagnosis and Followup of Multiple Sclerosis

Magnetic Resonance Imaging (MRI) of the brain is useful in the diagnosis and treatment of multiple sclerosis (MS), because it is an inflammatory, demyelinating condition of the central nervous system (CNS) that MRI can visualize. Therefore, the activity of the disease can be quantified and tracked over time, with treatment. White matter tracts are affected, including those of the upper brain, lower brain, and spinal cord. MS lesions, known as plaques,

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OVA-1 Testing in Ovarian Cancer

OVA1 test is FDA cleared for women who meet the following criteria: (i) over age 18, (ii) ovarian mass present for which surgery is planned, and (iii) not yet referred to an oncologist. It is an aid to assess the likelihood that ovarian cancer is present when a physician is not sure. The test should not be used without a prior independent prior clinical/radiological evaluation and is not intended to be a screening test or to determine whether a patient

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