Uncommon evolutions and complications of common benign liver lesions

Frequently encountered on abdominal imaging studies, the majority of common benign liver lesions are asymptomatic, confidently diagnosed by imaging, and do not require further workup, follow-up, or treatment. The increasing use of multimodality liver imaging, has allowed the recognition of uncommon evolutions of common benign liver lesions such as size changes, fibrotic regression, and content and vascularization changes, and their complications such as rupture, hemorrhage, thrombosis, extrinsic compression, and malignancy. The purpose of this pictorial review is to describe and illustrate the incidence and diagnostic features of these uncommon evolutions and complications on cross-sectional imaging, mainly on computed tomography and magnetic resonance imaging, with emphasis on those imaging clues which are helpful in the differential diagnosis or indicate the need for treatment

Imaging features of histological subtypes of hepatocellular carcinoma: Implication for LI-RADS

Background & Aims: The histopathological subtypes of hepatocellular carcinoma (HCC) are associated with distinct clinical features and prognoses. This study aims to report Liver Imaging Reporting and Data System (LI-RADS)-defined imaging features of different HCC subtypes in a cohort of resected tumours and to assess the influence of HCC subtypes on computed tomography (CT)/magnetic resonance imaging (MRI) LI-RADS categorisation in the subgroup of high-risk patients.Methods: This retrospective institutional review board-approved study included patients with resected HCCs and available histopathological classification. Three radiologists independently reviewed preoperative CT and MRI exams. The readers evaluated the presence of imaging features according to LI-RADS v2018 definitions and provided a LI-RADS category in patients at high risk of HCC. Differences in LI-RADS features and categorisations were assessed for not otherwise specified (NOS-HCC), steatohepatitic (SH-HCC), and macrotrabecular-massive (MTM-HCC) types of HCCs.Results: Two hundred and seventy-seven patients (median age 64.0 years, 215 [77.6%] men) were analysed, which involved 295 HCCs. There were 197 (66.7%) NOS-HCCs, 62 (21.0%) SH-HCCs, 23 (7.8%) MTM-HCCs, and 13 (4.5%) other rare subtypes. The following features were more frequent in MTM-HCC: elevated alpha-foetoprotein serum levels (p <0.001), tumour-in-vein (p <0.001 on CT, p <= 0.052 on MRI), presence of at least 1 LR-M feature (p <= 0.010 on CT), infiltrative appearance (p <= 0.032 on CT), necrosis or severe ischaemia (p <= 0.038 on CT), and larger size (p <= 0.006 on CT, p <= 0.011 on MRI). SH-HCC was associated with fat in mass (p <0.001 on CT, p <= 0.002 on MRI). The distribution of the LI-RADS major features and categories in high-risk patients did not significantly differ among the 3 main HCC subtypes.Conclusions: The distribution of LI-RADS major features and categories is not different among the HCC subtypes. Nevertheless, careful analysis of tumour-in-vein, LR-M, and ancillary features as well as clinico-biological data can provide information for the non-invasive diagnosis of HCC subtypes.Lay summary: In high-risk patients, the overall distribution of LI-RADS major features and categories is not different among the histological subtypes of hepatocellular carcinoma, but tumour-in-vein, presence of LR-M features, and ancillary features can provide information for the non-invasive diagnosis of hepatocellular carcinoma subtypes. (C) 2021 The Authors. Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL)

Use of polyethylene glycol coatings for optical fibre humidity sensing

Humidity induced change in the refractive index and thickness of the polyethylene glycol (PEG) coatings are in situ investigated for a range from 10 to 95%, using an optical waveguide spectroscopic technique. It is experimentally demonstrated that, upon humidity change, the optical and swelling characteristics of the PEG coatings can be employed to build a plastic fibre optic humidity sensor. The sensing mechanism is based on the humidity induced change in the refractive index of the PEG film, which is directly coated onto a polished segment of a plastic optical fibre with dip-coating method. It is observed that PEG, which is a highly hydrophilic material, shows no monotonic linear response to humidity but gives different characteristics for various ranges of humidity levels both in index of refraction and in thickness. It undergoes a physical phase change from a semi-crystal line structure to a gel one at around 80% relative humidity. At this phase change point, a drastic decrease occurs in the index of refraction as well as a drastic increase in the swelling of the PEG film. In addition, PEG coatings are hydrogenated in a vacuum chamber. It is observed that the hydrogen has a preventing effect on the humidity induced phase change in PEG coatings. Finally, the possibility of using PEG coatings in construction of a real plastic fibre optic humidity sensor is discussed. (C) 2008 The Optical Society of Japan

Set up of a methodology for participatory plant breeding in bread wheat in France

In Organic Agriculture, cultivation environments and agronomic practices are very diverse. This diversity can be handled with decentralized selection based on the knowledge of farmers and scientists. A collaborative work between associations from Réseau Semences Paysannes and the DEAP team from INRA du Moulon set up an innovative breeding approach on farm based on decentralization and participation of farmers. This approach makes it possible to (i) create new population varieties of bread wheat locally adapted (genetic innovation) (ii) set up an organizational scheme based on decentralization and co construction between actors (societal innovation) and (iii) develop experimental designs, create statistical and data management tools which stimulate these genetic and societal innovations

Individual participant data meta-analysis of LR-5 in LI-RADS version 2018 versus revised LI-RADS for hepatocellular carcinoma diagnosis

Background A simplification of the Liver Imaging Reporting and Data System (LI-RADS) version 2018 (v2018), revised LI-RADS (rLI-RADS), has been proposed for imaging-based diagnosis of hepatocellular carcinoma (HCC). Single-site data suggest that rLI-RADS category 5 (rLR-5) improves sensitivity while maintaining positive predictive value (PPV) of the LI-RADS v2018 category 5 (LR-5), which indicates definite HCC. Purpose To compare the diagnostic performance of LI-RADS v2018 and rLI-RADS in a multicenter data set of patients at risk for HCC by performing an individual patient data meta-analysis. Materials and Methods Multiple databases were searched for studies published from January 2014 to January 2022 that evaluated the diagnostic performance of any version of LI-RADS at CT or MRI for diagnosing HCC. An individual patient data meta-analysis method was applied to observations from the identified studies. Quality Assessment of Diagnostic Accuracy Studies version 2 was applied to determine study risk of bias. Observations were categorized according to major features and either LI-RADS v2018 or rLI-RADS assignments. Diagnostic accuracies of category 5 for each system were calculated using generalized linear mixed models and compared using the likelihood ratio test for sensitivity and the Wald test for PPV. Results Twenty-four studies, including 3840 patients and 4727 observations, were analyzed. The median observation size was 19 mm (IQR, 11–30 mm). rLR-5 showed higher sensitivity compared with LR-5 (70.6% [95% CI: 60.7, 78.9] vs 61.3% [95% CI: 45.9, 74.7]; P < .001), with similar PPV (90.7% vs 92.3%; P = .55). In studies with low risk of bias (n = 4; 1031 observations), rLR-5 also achieved a higher sensitivity than LR-5 (72.3% [95% CI: 63.9, 80.1] vs 66.9% [95% CI: 58.2, 74.5]; P = .02), with similar PPV (83.1% vs 88.7%; P = .47). Conclusion rLR-5 achieved a higher sensitivity for identifying HCC than LR-5 while maintaining a comparable PPV at 90% or more, matching the results presented in the original rLI-RADS study

Accuracy of citrulline, I-FABP and d-lactate in the diagnosis of acute mesenteric ischemia

Data availability: Research data are not shared.Supplementary Information oi available online at: https://www.nature.com/articles/s41598-021-98012-w#Sec14 .Early diagnosis of acute mesenteric ischemia (AMI) remains a clinical challenge, and no biomarker has been consistently validated. We aimed to assess the accuracy of three promising circulating biomarkers for diagnosing AMI—citrulline, intestinal fatty acid-binding protein (I-FABP), and D-lactate. A cross-sectional diagnostic study enrolled AMI patients admitted to the intestinal stroke center and controls with acute abdominal pain of another origin. We included 129 patients—50 AMI and 79 controls. Plasma citrulline concentrations were significantly lower in AMI patients compared to the controls [15.3 μmol/L (12.0–26.0) vs. 23.3 μmol/L (18.3–29.8), p = 0.001]. However, the area under the receiver operating curves (AUROC) for the diagnosis of AMI by Citrulline was low: 0.68 (95% confidence interval = 0.58–0.78). No statistical difference was found in plasma I-FABP and plasma D-lactate concentrations between the AMI and control groups, with an AUROC of 0.44, and 0.40, respectively. In this large cross-sectional study, citrulline, I-FABP, and D-lactate failed to differentiate patients with AMI from patients with acute abdominal pain of another origin. Further research should focus on the discovery of new biomarkers.Grants from MSD-Avenir and APHP funded the SURVIBIO study; Alexandre Nuzzo received Ph.D. Grants from “Fondation de l'Avenir” and the French Gastroenterology Society (SNFGE)

Comparison of the accuracy of AASLD and LI-RADS criteria for the non-invasive diagnosis of HCC smaller than 3 cm

BACKGROUND &amp; AIMS: Non-invasive imaging is crucial for the early diagnosis and successful treatment of hepatocellular carcinoma (HCC). Terminology and criteria for interpreting and reporting imaging results must be standardized to optimize diagnosis. The aim of this study was to prospectively compare the diagnostic accuracy of the American Association for the Study of Liver Diseases (AASLD) and the 2014 version of Liver Imaging Reporting and Data System (LI-RADS®) criteria for the non-invasive diagnosis of small HCC, and to evaluate the diagnostic value of ancillary features used in the LI-RADS criteria. METHODS: Between April 2009 and April 2012, patients with cirrhosis and one to three 10-30 mm nodules were enrolled and underwent computed tomography (CT) and magnetic resonance (MR) imaging. The diagnostic accuracy of both the AASLD and the LI-RADS criteria were determined based on their sensitivity, specificity, positive (PPV) and negative predictive values (NPV). RESULTS: A total of 595 nodules were included (559 [341 HCC, 61%] with MR imaging and 529 [332 HCC, 63%] with CT). Overall, no (0%) LR-1 and LR-2, 44 (33%) and 47 (41%) LR-3, 50 (53%) and 54 (55%) LR-4, 244 (94%) and 222 (91%) LR-5 and 4 (67%) and 9 (82%) LR-5V were HCC on MR imaging and CT, respectively. The sensitivity, specificity, PPV/NPV of the AASLD score was 72.5%, 87.6%, 90.2%, and 66.9% for MR imaging, and 71.4%, 77.7%, 84.3%, 61.7% for CT, respectively. For the combination of LR-5V and LR-5 nodules these measures were 72.5%, 89.9%, 91.9% and 67.5% on MRI and 66.9%, 88.3%, 90.9% and 63.3% on CT, respectively. For the combination of LR-5V, LR-5 and LR-4 nodules they were 87.1%, 69.1%, 81.6% and 77.3% on MRI and 85.8%, 66%, 81% on 73.5% on CT, respectively. CONCLUSION: The 2014 version of the LI-RADS is no more accurate than the AASLD score for the non-invasive diagnosis of small HCC in high-risk patients, but it provides important and complementary information on the probability of having HCC in high-risk patients, allowing for possible changes in the management of these patients. LAY SUMMARY: The 2014 version of Liver Imaging Reporting and Data System criteria does not outperform the American Association for the Study of Liver Diseases criteria for the non-invasive diagnosis of hepatocellular carcinoma (HCC) smaller than 3 cm. Liver Imaging Reporting and Data System offers a nodule-based evaluation of the risk of HCC, allowing possible changes in management in these patients. The added value of ancillary features appears limited for the non-invasive diagnosis of small HCC