Diagnostic Accuracy of CEUS LI-RADS for the Characterization of Liver Nodules 20 mm or Smaller in Patients at Risk for Hepatocellular Carcinoma.

Background: American College of Radiology contrast agent–enhanced US Liver Imaging Reporting and Data System (CEUS LI-RADS) was developed to improve the accuracy of hepatocellular carcinoma (HCC) diagnosis at contrast agent2enhanced US. However, to the knowledge of the authors, the diagnostic accuracy of the system in characterization of liver nodules 20 mm or smaller has not been fully evaluated. Purpose: To evaluate the diagnostic accuracy of CEUS LI-RADS in diagnosing HCC in liver nodules 20 mm or smaller in patients at risk for HCC. Materials and Methods: Between January 2015 and February 2018, consecutive patients at risk for HCC presenting with untreated liver nodules 20 mm or less were enrolled in this retrospective double-reader study. Each nodule was categorized according to the CEUS LI-RADS and World Federation for Ultrasound in Medicine and Biology (WFUMB)–European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) criteria. Diagnostic performance of CEUS LI-RADS and WFUMB-EFSUMB characterization was evaluated by using tissue histologic analysis, multiphase contrast-enhanced CT and MRI, and imaging follow-up as reference standard and compared by using McNemar test. Results: The study included 175 nodules (mean diameter, 16.1 mm 6 3.4) in 172 patients (mean age, 51.8 years 6 10.6; 136 men). The sensitivity of CEUS LR-5 versus WFUMB-EFSUMB criteria in diagnosing HCC was 73.3% (95% confidence inter-val [CI]: 63.8%, 81.5%) versus 88.6% (95% CI: 80.9%, 94%), respectively (P, .001). The specificity of CEUS LR-5 versus WFUMB-EFSUMB criteria was 97.1% (95% CI: 90.1%, 99.7%) versus 87.1% (95% CI: 77%, 94%), respectively (P = .02). No malignant lesions were found in CEUS LR-1 and LR-2 categories. Only two nodules (of 41; 5%, both HCC) were malignant in CEUS LR-3 category. The incidences of HCC in CEUS LR-4, LR-5, and LR-M were 48% (11 of 23), 98% (77 of 79), and 75% (15 of 20), respectively. Two of 175 (1.1%) histologic analysis2confirmed intrahepatic cholangiocarcinomas were categorized as CEUS LR-M by CEUS LI-RADS and misdiagnosed as HCC by WFUMB-EFSUMB criteria. Conclusion: The contrast-enhanced US Liver Imaging Reporting and Data System (CEUS LI-RADS) algorithm was an effective tool for characterization of small (≤20 mm) liver nodules in patients at risk for hepatocellular carcinoma (HCC). Compared with World Federation for Ultrasound in Medicine and Biology2European Federation of Societies for Ultrasound in Medicine and Biology criteria, CEUS LR-5 demonstrated higher specificity for diagnosing small HCCs with lower sensitivity

Five-dimensional generalized f(R)f(R) gravity with curvature-matter coupling

The generalized $f(R)$ gravity with curvature-matter coupling in five-dimensional (5D) spacetime can be established by assuming a hypersurface-orthogonal spacelike Killing vector field of 5D spacetime, and it can be reduced to the 4D formulism of FRW universe. This theory is quite general and can give the corresponding results to the Einstein gravity, $f(R)$ gravity with both no-coupling and non-minimal coupling in 5D spacetime as special cases, that is, we would give the some new results besides previous ones given by Ref.\cite{60}. Furthermore, in order to get some insight into the effects of this theory on the 4D spacetime, by considering a specific type of models with $f_{1}(R)=f_{2}(R)=\alpha R^{m}$ and $B(L_{m})=L_{m}=-\rho$, we not only discuss the constraints on the model parameters $m$, $n$, but also illustrate the evolutionary trajectories of the scale factor $a(t)$, the deceleration parameter $q(t)$ and the scalar field $\epsilon(t)$, $\phi(t)$ in the reduced 4D spacetime. The research results show that this type of $f(R)$ gravity models given by us could explain the current accelerated expansion of our universe without introducing dark energy.Comment: arXiv admin note: text overlap with arXiv:0912.4581, arXiv:gr-qc/0411066 by other author

Observation of forbidden phonons and dark excitons by resonance Raman scattering in few-layer WS2_2

The optical properties of the two-dimensional (2D) crystals are dominated by tightly bound electron-hole pairs (excitons) and lattice vibration modes (phonons). The exciton-phonon interaction is fundamentally important to understand the optical properties of 2D materials and thus help develop emerging 2D crystal based optoelectronic devices. Here, we presented the excitonic resonant Raman scattering (RRS) spectra of few-layer WS$_2$ excited by 11 lasers lines covered all of A, B and C exciton transition energies at different sample temperatures from 4 to 300 K. As a result, we are not only able to probe the forbidden phonon modes unobserved in ordinary Raman scattering, but also can determine the bright and dark state fine structures of 1s A exciton. In particular, we also observed the quantum interference between low-energy discrete phonon and exciton continuum under resonant excitation. Our works pave a way to understand the exciton-phonon coupling and many-body effects in 2D materials.Comment: 14 pages, 11 figure