Mucociliary clearance scan to evaluate primary ciliary dyskinesia in children with bronchiectasis
Bibliographic record
Abstract
1394 Objectives Primary ciliary dyskinesia (PCD) is characterized by functional or structural defects in the cilia causing abnormal ciliary motion and impaired mucociliary clearance. This leads to recurrent respiratory infections and bronchiectasis. Ciliary ultrastructure abnormalities can be identified. However, in some patients the ciliary ultrastructure may appear normal, suggesting functional abnormalities. Mucociliary clearance scan is a noninvasive procedure and can be used to evaluate mucociliary clearance function. The aim of this study was to evaluate the feasibility to use the mucociliary clearance scan in the PCD workup in children. Methods Six mucociliary clearance scans were reviewed retrospectively in children with bronchiectasis and recurrent respiratory infection. Scans were performed using 99mTc Sulfur Colloid inhaled for 10 minutes with oxygen flow by whisper jet nebulizer system. Imaging in anterior view was obtained dynamically for 30 sec/frame over 60 minutes with the patient in supine position. Cinematic review of the data was performed by two experienced Nuclear Medicine physicians. The evaluation is based on the bolus movement of tracer from the main bronchi to the trachea and frequency. The final Clinical diagnosis was based on the combination of spirometry, chest radiograph, history and symptoms, ultrastructure evaluation, and nasal nitric oxide test. Results Scans were normal in 4 children consistent with final diagnosis and clinical workup. Two children had a final diagnosis of PCD. One of them with a history of situs inversus had abnormal scan. No ciliary ultrastructure abnormalities were found. The study was limited in one patient due to noncooperation and suboptimal tracer distribution. However, no evidence of effective ciliary motion was noted. The nasal nitric oxide test was abnormal. Conclusions Mucociliary Clearance Scan is a noninvasive procedure and can be used effectively as an adjunctive test in the work up of pediatric patient with suspected primary ciliary dyskinesia
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".