The transthoracic electrocardiography (TTE) produced images of the heart.
Rows 1-2:
I examined the TTE image of the heart (test location) and found calcified mitral valve annulus (result location).
Row 3-4:
I examined the TTE image of the heart (test location) and found that the mitral valve (result location) had become stenotic.
Rows 5-6:
I examined the TTE image of the heart (test location) and regurgitation of blood in the mitral valve back into the left atrium.
Row Captions Debug Message
Please construct row caption labels as instructed in <ac:link><ri:page ri:content-title="Constructing labels for row captions" ri:space-key="TTD"/></ac:link>.
There is a leading, trailing, or non-breaking space in the dataset.
Please remove all paragraph and/or line breaks.
Dataset Wrapper Debug Message
Please add a row column to your dataset.
Row 1:
I measured the diameter of the aneurysm in the left renal artery (test location).
Row 2:
I measured the diameter of the aneurysm in the Infrarenal Aorta (test location).
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Row
STUDYID
DOMAIN
USUBJID
TRSEQ
TRLNKID
TRTEST
TRORRES
TRLOC
TRMETHOD
VISITNUM
VISIT
TRDTC
1
ABC
TR
ABC-456
1
CAL 1
Calcification Severity
Severe
Mitral Valve Annulus
TTE
1
BASELINE
2020-04-27
2
ABC
TR
ABC-456
2
STEN 1
Cardiac Valvular Regurgitation Severity
Severe
Mitral Valve
TTE
1
BASELINE
2020-04-27
3
ABC
TR
ABC-456
3
REGUR 1
Cardiac Valvular Stenosis Severity
Moderate
Mitral Valve
TTE
1
BASELINE
2020-04-27
$warningHtml
Dataset Wrapper Debug Message
Please add a row column to your dataset.
The problem with the way TU is set up now, which is originally designed for tumor identification and response evaluation, and you only care about "already identified tumors", is that it only allows the creation of only positive records. It doesn't allow the creation of a "pertinent negative" record. If I were to model case 1 in TU the way TU is designed now, I would lose the ability to represent the negative record for the Thoracic Region as shown above because an aneurysm is not identified in this region. The locations where an aneurysm is found, are mapped to TULOC instead of TURESLOC. Because when a large AAA is found, the chance of a TAA (or an aneurysm developed elsewhere) is high (the reverse holds true as well), in the presence of a diagnosed large AAA or TAA, it is recommended to also screen for the other. A TAA is synchronous if diagnosed within 2 years from the diagnosis of an AAA. All TAAs diagnosed at a later date were considered metachronous and must have had prior chest imaging that did not show the presence of TAA.
In the original DUKE data element, the responses provided for TAA and AAA, and all other types of aneurysms all have the responses: present, absent and unknown.
Row 1:
An aneurysm is present in the left renal artery.
Row 2:
An aneurysm is present in the Infrarenal Aorta
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Row
STUDYID
DOMAIN
USUBJID
TUSEQ
TULNKID
TUTEST
TUORRES
TULOC
TULAT
TUMETHOD
VISITNUM
VISIT
TUDTC
1
ABC
TU
ABC-456
1
Aneurysm 1
Aneurysm Identification
Target
Renal Artery
Left
MRI
1
BASELINE
2020-04-27
2
ABC
TU
ABC-456
2
Aneurysm 2
Aneurysm Identification
Target
Infrarenal Aorta
MRI
1
BASELINE
2020-04-27
Dataset Debug Message
There is a leading, trailing, or non-breaking space in the dataset.
Dataset Wrapper Debug Message
Please add a row column to your dataset.
Case 2 - Subject has both TAA and AAA
The subject had a chest CT scan and an abdominal CT scan.
Are chest and abdomen really location of the procedure? See questions and comments under case 1
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Row
STUDYID
DOMAIN
USUBJID
PRSEQ
PRTRT
PRLOC
VISIT
1
ABC
PR
ABC-123
1
CT SCAN
CHEST??? or not needed
BASELINE
2
ABC
PR
ABC-123
2
CT SCAN
ABDOMEN???? or not needed
BASELINE
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An evaluator examines the images of the thoracic and abdominal regions produced by the CT scan and decides whether TAA and AAA are present as well as their location. Note for viewing simplicity, some variables are omitted from the table below.
Rows 1-2:
I examined the image of the thoracic region (test location) and found an aneurysm in the Thoracic Aorta (result location) spanning from the aortic arch to the descending aorta (result location detail). In this case result location detail further qualifies both ORRES and RESLOC, hence this is a variable qualifier.
Rows 3-4:
I examined the image of the thoracic region (test location) and found that the descending aorta (result location) had dissected (the artery is tore and a false lumen had formed), most likely due to the enormous pressure caused by the large aneurysm in this area.
Rows 5-6:
I examined the image of the abdominal region (test location) and found an aneurysm in the infrarenal aorta (result location), proximal to the iliac bifurcation (result location detail). In this case result location detail is a variable qualifier for the result, I am trying to say that the aneurysm is located in the segment of the infrarenal aorta closer (proximal) to the iliac bifurcation.
Rows 7-8:
I examined the image of the abdominal region (test location) and found that the infrarenal aorta (result location) had dissected.
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Row
STUDYID
DOMAIN
USUBJID
TUSEQ
TUGRPID
TULNKID
TUTEST
TUORRES
TULOC
TUMETHOD
VISITNUM
VISIT
TUDTC
TURESLOC
TURESLOC Detail
1
ABC
TU
ABC-123
1
1
Aneurysm 1
Aneurysm Indicator
Y
Thoracic region
CT SCAN
1
BASELINE
2020-04-27
2
ABC
TU
ABC-123
2
1
Aneurysm 1
Aneurysm Location/Identification
Target?
Identified
Thoracic region
CT SCAN
1
BASELINE
2020-04-27
Thoracic Aorta
Aortic Arch to Descending aorta
3
ABC
TU
ABC-123
3
2
Dissection 1
Dissection Indicator
Y
Thoracic region
CT SCAN
1
BASELINE
2020-04-27
4
ABC
TU
ABC-123
4
2
Dissection 1
Dissection Location/Identification
Target?
Identified
Thoracic region
CT SCAN
1
BASELINE
2020-04-27
Descending aorta
5
ABC
TU
ABC-123
5
3
Aneurysm 2
Aneurysm Indicator
Y
Abdominal region
CT SCAN
1
BASELINE
2020-04-27
6
ABC
TU
ABC-123
6
3
Aneurysm 2
Aneurysm Location/Identification
Target?
Identified
Abdominal region
CT SCAN
1
BASELINE
2020-04-27
Infrarenal aorta
proximal to the iliac bifurcation
7
ABC
TU
ABC-123
7
4
Dissection 2
Dissection Indicator
Y
Abdominal region
CT SCAN
1
BASELINE
2020-04-27
8
ABC
TU
ABC-123
8
4
Dissection 2
Dissection Location/Identification
Target?
Identified
Abdominal region
CT SCAN
1
BASELINE
2020-04-27
Infrarenal aorta
proximal to the iliac bifurcation
Dataset Debug Messages
There are two leading, trailing, or non-breaking spaces in the dataset.
I measured the diameter of the aneurysm from aortic arch to the descending aorta (test location).
Row 2:
I measured the diameter of the infrarenal aortic (test location) aneurysm.
Row 3:
The dissected descending aorta (test location) is classified based on the Stanford Aortic Dissection System as type B.
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Row
STUDYID
DOMAIN
USUBJID
TRSEQ
TRLNKID
TRTEST
TRORRES
TRORRESU
TRLOC
TRLOCDTL
TRMETHOD
VISITNUM
VISIT
CVDTC
1
ABC
TR
ABC-123
1
Aneurysm 1
Aneurysm Diameter
6
cm
Thoracic Aorta
Aortic Arch to Descending aorta
CT SCAN
1
BASELINE
2020-04-27
2
ABC
TR
ABC-123
2
Aneurysm 2
Aneurysm Diameter
7
cm
Infrarenal aorta
proximal to the iliac bifurcation
CT SCAN
1
BASELINE
2020-04-27
4
ABC
TR
ABC-123
3
Dissection 1
Stanford AoD Classification
Stanford B
Descending aorta
CT SCAN
1
BASELINE
2020-04-27
$warningHtml
Dataset Wrapper Debug Message
Please add a row column to your dataset.
Questions and Thoughts
The results for TU, TUORRES = target, non-target, or new target. This convention was designed for tumor assessment. Target and non-target have very specific definitions depending on the tumor under study. Generally for solid tumor, according to RECIST:
Measurable lesions - lesions that can be accurately measured in at least one dimension with longest diameter 20 mm using conventional techniques or 10 mm with spiral CT scan.
All measurable lesions up to a maximum of five lesions per organ and 10 lesions in total, representative of all involved organs should be identified as target lesions and recorded and measured at baseline.
Non-measurablelesions - all other lesions, including small lesions (longest diameter <20 mm with conventional techniques or <10 mm with spiral CT scan), i.e., bone lesions, leptomeningeal disease, ascites, pleural/pericardial effusion, inflammatory breast disease, lymphangitis cutis/pulmonis, cystic lesions, and also abdominal masses that are not confirmed and followed by imaging techniques.
All other lesions (or sites of disease) should be identified as non-target lesions and should also be recorded at baseline. Measurements of these lesions are not required, but the presence or absence of each should be noted throughout follow-up.
Since TU is also shared by Lesion Identification, to have a result as "target" is misleading and doesn't always apply to non-tumor settings. When you say there is a target aneurysm, what does that mean? Target for treatment and response evaluation? what is the criteria that makes it a target? Usually an aneurysm larger than 5cm requires surgery. Does that mean the ones that are smaller than 5 cm are considered "non-target"? and non-target for what? surgery not needed? The values for TU responses right now, doesn't make sense for non-tumor lesion identification process.
After all this, i struggle with what values should go into TULOC. When a CT scans the chest, it produces cross-sectional images of the thorax. You can view the images in three angles: axial view (you are looking at the picture of the thorax from the direction of head to toe), the coronal view (you are looking at the images of the thorax as if you are standing in front of the person), sagittal view (you are looking at the picture of the thorax from the side). Hence TULOCs are populated with Thoracic Region and Abdominal Region. Especially in the axial view, as you move from cross-sectional images of the thorax to images of the abdomen, you are looking at sectioned images of the thoracic region to abdominal region, there is no mistake about it.
