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Controlled attenuation parameter for evaluating liver steatosis in chronic viral hepatitis

World Journal of Gastroenterology 2014年第21期20卷 6626-6631页

作者： Giovanna Ferraioli Carmine Tinelli Raffaella Lissandrin Mabel Zicchetti Barbara Dal Bello Gaetano filice carlo filice Department of Infectious Diseases Fondazione IRCCS Policlinico San MatteoMedical School University of Pavia27100 PaviaItaly Clinical Epidemiology and Biometric Unit Fondazione IRCCS Policlinico San Matteo27100 PaviaItaly Department of Pathology Fondazione IRCCS Policlinico San Matteo27100 PaviaItaly

AIM:To assess the performance of controlled attenuation parameter(CAP)in patients with chronic viral ***:CAP is a new technique that measures the attenuation in the liver of an ultrasound beam,which is directly related to lipid *** patients undergoing liver biopsy for chronic viral hepatitis were studied using the M probe of FibroScan device(Echosens,Paris,France).The device estimates liver st-eatosis in decibel per meter(dB/m).An expert operator performed all *** was graded according to Kleiner’s *** or Spearman rank coefficient was used to test correlation between two study *** regression was used for multivariate model to assess the association between CAP and other *** operating characteristic curve analysis was performed to calculate area under the curve(AUROC)for S0 vs S1-S3 and S0-S1 vs ***:115 subjects(85 males and 30 females)were prospectively *** mean values of CAP were 227.1±43.1 for S0;254.6±38.9 for S1;297.8±49.4 dB/m for *** univariate analysis CAP showed a significant correlation with age,body mass index(BMI),degree of steatosis,and *** regression analysis confirmed the correlation with the degree of steatosis[coefficient,1.2(0.60-1.83);P<10-5]and BMI[coefficient,4.1(0.5-7.8);P=0.03]but not with all other *** cutoff values for S≥1 and S≥2 were 219 dB/m[AUROC,0.76(0.67-0.84);sensitivity,91.1%(78.8-97.5);specificity,51.6%(38.7-64.2);positive predictive value,56.9%(44.7-68.6);negative predictive value,89.2%(74.3-97.0);positive likelihood ratio,1.88(1.4-2.5);negative likelihood ratio,0.17(0.07-0.5)]and 296 dB/m[AUROC,0.82(0.74-0.89);sensitivity,60.0%(32.3-83.7);specificity,91.5%(83.9-96.3);positive predictive value,52.9%(27.8-77.0);negative predictive value,93.5%(86.3-97.6);positive likelihood ratio,7.05(3.2-15.4);negative likelihood ratio,0.44(0.2-0.8)],***:Controlled attenuatio

关键词： Liver steatosis Noninvasive techniques Controlled

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Point shear wave elastography method for assessing liver stiffness

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World Journal of Gastroenterology 2014年第16期20卷 4787-4796页

AIM:To estimate the validity of the point shear-wave elastography method by evaluating its reproducibility and accuracy for assessing liver ***:This was a single-center,cross-sectional *** patients with chronic viral hepatitis scheduled for liver biopsy(LB)(Group 1)and healthy volunteers(Group 2)were *** each subject 10 consecutive point shear-wave elastography(PSWE)measurements were performed using the iU22 ultrasound system(Philips Medical Systems,Bothell,WA,United States).Patients in Group 1 underwent PSWE,transient elastography(TE)using FibroScan(Echosens,Paris,France)and ultrasound-assisted *** the assessment of PSWE reproducibility two expert raters(rater 1 and rater 2)independently performed the *** performance of PSWE was compared to that of TE using LB as a reference *** was staged according to the METAVIR scoring *** operating characteristic curve analyses were performed to calculate the area under the receiver operating characteristic curve(AUC)for F≥2,F≥3and F=*** intraobserver and interobserver reproducibility of PSWE were assessed by calculating Lin’s concordance correlation ***:To assess the performance of PSWE,134consecutive patients in Group 1 were *** median values of PSWE and TE(in kilopascals)were 4.7(IQR=3.8-5.4)and 5.5(IQR=4.7-6.5),respectively,in patients at the F0-F1 stage and 3.5(IQR=3.2-4.0)and 4.4(IQR=3.5-4.9),respectively,in the healthy volunteers in Group 2(P<10-5).In the univariate analysis,the PSWE and TE values showed a high correlation with the fibrosis stage;low correlations with the degree of necroinflammation,aspartate aminotransferase and gamma-glutamyl transferase(GGT);and a moderate negative correlation with the platelet count.A multiple regression analysis confirmed the correlations of both PSWE and TE with fibrosis stage and GGT but not with any other *** following AUC values were found:0.80(0.71-0.87)for PSWE and

关键词： Chronic viral hepatitis Liver biopsy Liver fibrosi

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Performance of liver stiffness measurements by transient elastography in chronic hepatitis

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World Journal of Gastroenterology 2013年第1期19卷 49-56页

作者： Giovanna Ferraioli Carmine Tinelli Barbara Dal Bello Mabel Zicchetti Raffaella Lissandrin Gaetano filice carlo filice Elisabetta Above Giorgio Barbarini Enrico Brunetti Willy Calderon Marta Di Gregorio Roberto Gulminetti Paolo Lanzarini Serena Ludovisi Laura Maiocchi Antonello Malfitano Giuseppe Michelone Lorenzo Minoli Mario Mondelli Stefano Novati Savino FA Patruno Alessandro Perretti Gianluigi Poma Paolo Sacchi Domenico Zanaboni Marco Zaramella Ultrasound Unit Department of Infectious DiseasesFondazione IRCCS Policlinico San MatteoMedical School University of Pavia27100 PaviaItaly Clinical Epidemiology and Biometric Unit Fondazione IRCCS Policlinico San Matteo27100 PaviaItaly Department of Pathology Fondazione IRCCS Policlinico San Matteo27100 PaviaItaly Department of Infectious Diseases Fondazione IRCCS Policlinico San MatteoMedical School University of Pavia27100 PaviaItaly Department of Infectious Diseases Fondazione IRCCS Policlinico San Matteo27100 PaviaItaly

AIM:To compare results of liver stiffness measurements by transient elastography(TE) obtained in our patients population with that used in a recently published ***:This was a single center cross-sectional *** patients with chronic viral hepatitis scheduled for liver biopsy at the outpatient ward of our Infectious Diseases Department were *** was carried out by using FibroScan(Echosens,Paris,France).Liver biopsy was performed on the same day as TE,as day case *** was staged according to the Metavir scoring *** diagnostic performance of TE was assessed by using receiver operating characteristic(ROC) curves and the area under the ROC curve ***:Two hundred and fifty-two patients met the inclusion ***(2%) patients were excluded due to unreliable TE ***,246(171 men and 75 women) patients were *** hundred and ninety-five(79.3%) patients had chronic hepatitis C,41(16.7%) had chronic hepatitis B,and 10(4.0%) were coinfected with human immunodeficiency *** curve analysis identified optimal cut-off value of TE as high as 6.9 kPa forF ≥ 2;7.9 kPa forF ≥ 3;9.6 kPa for F = 4 in all patients(n = 246),and as high as 6.9 kPa for F ≥ 2;7.3 kPa for F ≥ 3;9.3 kPa for F = 4 in patients with hepatitis C(n = 195).Cut-off values of TE obtained by maximizing only the specificity were as high as 6.9 kPa for F ≥ 2;9.6 kPa for F ≥ 3;12.2 kPa for F = 4 in all patients(n = 246),and as high as 7.0 kPa forF ≥ 2;9.3 kPa forF ≥ 3;12.3 kPa forF = 4 in patients with hepatitis C(n = 195).CONCLUSION:The cut-off values of TE obtained in this single center study are comparable to that obtained in a recently published meta-analysis that included up to 40 studies.

关键词： Chronic viral hepatitis Hepatitis C Liver Liver biopsy Liver fibrosis Elastography Transient elastography FibroScan Ultrasound

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Microwave ablation of liver tumors:initial clinical experience

Microwave ablation of liver tumors:initial clinical experien...

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2009年世界肿瘤介入学术大会

作者： Maria Franca Melonil Anita Andreanol Elena Meneghell Sergio Lazzaroni carlo filice Sandro Sironil Univerisity of Milan-Bicocca Italy Clusone Hospital Bergamo Italy Univeristy of Pavia Italy

＜正＞Aim:To present our initial clinical experience with microwave（MW） percutaneous devices for liver tumor ablation. MW ablation is an emerging technique due to its efficacious heating of tissue without the electrical conductivity dependence that is characteristic of radiofrequency（RF） *** has theoretical advantages over RF such as rapid tissue heating that reduces the problem of heat sinking,higher tissue temperatures and no grounding pads,which eliminates the risk of skin burns.

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肝局灶性病变非侵入性影像评估意大利指南：发展和结论(全译)

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中华超声影像学杂志 2014年第2期23卷 172-183页

作者： carlo filice Fabrizio Calliada Salvatore De Masi Letizia Sampaolo Cristina Morciano Alfonso Mele Maria Franc Meloni Chiara Sileo Mara Scabini Paolo Ricci Vito Cantisani Giovanna Ferraioli Ultrasound Unit Infectious Diseases Department University of Pavia Institute of Radiology IRCCS Fondazione Policlinico S.Matteo University of Pavia Dipartimento diPrevenzione ASL 6 Livorno National Institute of Health (Istituto Superioredi Sanita ) Rome Institute of Radiology S. Gerardo Hospital Monza Department of Radiology Umberto I Hospital University of RomaItaly

简介成像技术的进步极大改善了肝局灶性病变（FLLs）的非侵入性检测和成像。由于良性FLLs的发病率极高，因此病变成像极其重要。相对而言，包括原发性肝癌和转移癌在内的肝癌是最常见的肿瘤疾病。

关键词：肝局灶性病变影像评估意大利原发性肝癌指南人性非侵入性检测成像技术

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Can semi-quantitative evaluation of uncertain (type II) time-intensity curves improve diagnosis in breast DCE-MRI?

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Journal of Biomedical Science and Engineering 2013年第3期6卷 418-425页

作者： Roberta Fusco Salvatore filice Vincenza Granata Ylenia Mandato Annamaria Porto Massimiliano D’Aiuto Massimo Rinaldo Maurizio Di Bonito Mario Sansone carlo Sansone Antonio Rotondo Antonella Petrillo Petrillo Department of Breast Surgery and Oncology National Cancer Institute of Naples “Pascale Foundation” Naples Italy Department of Diagnostic and Laboratory Pathology National Cancer Institute of Naples “Pascale Foundation” Naples Italy Department of Diagnostic Imaging National Cancer Institute of Naples “Pascale Foundation” Naples Italy Department of Diagnostic Imaging Second University of Naples (SUN) Naples Italy Department of Electrical Engineering and Information Technology University “Federico II” of Naples Naples Italy

Objective/Background: Qualitative assessment of uncertain (type II) time-intensity curves (TICs) in breast DCE-MRI is problematic and operator dependent. The aim of this work is to evaluate if a semi-quantitative assessment of uncertain TICs could improve overall diagnostic performance. Methods: In this study 49 lesions from 44 patients were retrospectively analysed. Per each lesion one region-of-interest (ROI)- averaged TIC was qualitatively evaluated by two radiologists in consensus: all the ROIs resulted in type II (uncertain) TIC. The same TICs were semi-quantitatively re-classified on the basis of the difference between the signal intensities of the last-time-point and of the peak: this difference was classified according to two different cut-off ranges (±5% and ±3%). All patients were cytological or histological biopsy proven. Fisher test and McNemar test were performed to evaluate if results were statistically significant (p < 0.05). Results: Using ±5% cut-off 16 TICs were reclassified as type III and 12 as type I while 21 were reclassified again as type II. Using ±3% 22 TICs were reclassified as type III and 16 as type I while 11 were reclassified again as type II. The semi-quantitative classification was compared to the histological-cytological results: the sensitivity, specificity, positive and negative predictive values obtained with ±3% were 77%, 91%, 91% and 78% respectively while using ±5% were 58%, 96%, 94% and 68% respectively. Using the ±5% cut-off 26/28 (93%) TICs were correctly reclassified while using the ±3% cut-off 34/38 (90%) TICs were correctly reclassified (p < 0.05). Conclusions: Semi-quantitative methods in kinetic curve assessment on DCE-MRI could improve classification of qualitatively uncertain TICs, leading to a more accurate classification of suspicious breast lesions.

关键词： Breast Cancer Dynamic Contrast Enhanced-MRI Time Intensity Curve Tracer Kinetics Semi-Quantitative Analysis

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