Diagnostic Performance of Magnetic Resonance Imaging and Computed Tomography for Advanced Retinoblastoma: A Systematic Review and Meta-analysis.

PURPOSE: To determine and compare the diagnostic performance of magnetic resonance imaging (MRI) and computed tomography (CT) for the diagnosis of tumor extent in advanced retinoblastoma, using histopathologic analysis as the reference standard. DESIGN: Systematic review and meta-analysis. PARTICIPANTS: Patients with advanced retinoblastoma who underwent MRI, CT, or both for the detection of tumor extent from published diagnostic accuracy studies. METHODS: Medline and Embase were searched for literature published through April 2013 assessing the diagnostic performance of MRI, CT, or both in detecting intraorbital and extraorbital tumor extension of retinoblastoma. Diagnostic accuracy data were extracted from included studies. Summary estimates were based on a random effects model. Intrastudy and interstudy heterogeneity were analyzed. MAIN OUTCOME MEASURES: Sensitivity and specificity of MRI and CT in detecting tumor extent. RESULTS: Data of the following tumor-extent parameters were extracted: anterior eye segment involvement and ciliary body, optic nerve, choroidal, and (extra)scleral invasion. Articles on MRI reported results of 591 eyes from 14 studies, and articles on CT yielded 257 eyes from 4 studies. The summary estimates with their 95% confidence intervals (CIs) of the diagnostic accuracy of conventional MRI at detecting postlaminar optic nerve, choroidal, and scleral invasion showed sensitivities of 59% (95% CI, 37%-78%), 74% (95% CI, 52%-88%), and 88% (95% CI, 20%-100%), respectively, and specificities of 94% (95% CI, 84%-98%), 72% (95% CI, 31%-94%), and 99% (95% CI, 86%-100%), respectively. Magnetic resonance imaging with a high (versus a low) image quality showed higher diagnostic accuracies for detection of prelaminar optic nerve and choroidal invasion, but these differences were not statistically significant. Studies reporting the diagnostic accuracy of CT did not provide enough data to perform any meta-analyses. CONCLUSIONS: Magnetic resonance imaging is an important diagnostic tool for the detection of local tumor extent in advanced retinoblastoma, although its diagnostic accuracy shows room for improvement, especially with regard to sensitivity. With only a few-mostly old-studies, there is very little evidence on the diagnostic accuracy of CT, and generally these studies show low diagnostic accuracy. Future studies assessing the role of MRI in clinical decision making in terms of prognostic value for advanced retinoblastoma are needed.

Field Evaluation of Elliptical Fiber Reinforced Polymer Dowel Performance, June 2003

Fiber composite materials (FRP) are making an entry into the construction market in both buildings and pavements. The application to pavements comes in the form of joint reinforcement (dowels and tie bars) to date. FRP resistance to salt corrosion in dowels has made it an alternative to standard epoxy coated dowels for pavements. Iowa State University has completed a large amount of laboratory research into the determination of diameter, spacing, and durability of FRP dowels. This report documents the installation of a series of FRP elliptical-shaped dowel joints (including instrumented units) in a field situation and the beginning of a two-year study to compare laboratory results to in-service pavements. Ten joints were constructed for each of three dowel spacings of 10, 12, and 15 inches ( 254, 305, and 381 mm) with one instrumented joint in each test section. The instrumented bars will be load tested with a loaded truck and FWD testing.

Development of Performance Properties of Ternary Mixes: Scoping Study, June 2005

Pozzolans and slag extend the market for concrete products by improving specific properties of the products, which allows the products to be constructed with materials or placed in environments that would have precluded the use of portland cement alone. In properly formulated concrete mixes, pozzolans and slag have been shown to enhance long-term strength, decrease permeability, increase durability, reduce thermal cracking of mass concrete, minimize or eliminate cracking related to alkali-silica reaction (ASR), and minimize or eliminate cracking related to sulfate attack. The purpose of this research project was to conduct a scoping study that could be used to evaluate the need for additional research in the area of supplementary cementitious materials (SCMs) that are used in concrete for highway applications. Special emphasis was given to the concept of using two or more SCMs in a single concrete mixture. The scope of the study was limited to a literature survey and panel discussions concerning issues relevant to the project. No laboratory work was conducted for this project. A problem statement with research plan was created that could be used to guide a pooled fund project.