Dynamic liver volume change in predicting hepatic decompensation and long-term effects of stereotactic body radiation therapy.

BACKGROUND AND AIM: This study aimed to investigate the association between liver volume change and hepatic decompensation and compare the risk of hepatic decompensation in patients with liver cirrhosis (LC) and hepatocellular carcinoma (HCC) who underwent stereotactic body radiation therapy (SBRT). METHODS: A retrospective review of SBRT-treated HCC and compensated LC without HCC patients was conducted. Liver volume was measured using auto-segmentation software on liver dynamic computed tomography scans. The decompensation event was defined as the first occurrence of refractory ascites, esophageal variceal bleeding, hepatic encephalopathy, or spontaneous bacterial peritonitis. We evaluated the association between the rate of liver volume decrease and hepatic decompensation and compared decompensation events between the SBRT and LC cohorts using propensity score matching. RESULTS: A total of 138 patients from the SBRT cohort and 488 from the LC cohort were analyzed. The rate of liver volume decrease was associated with the risk of decompensation events in both cohorts. The 3-year rate of decompensation events was significantly higher in the group with a liver volume decreasing rate > 7%/year compared with the group with a rate < 7%/year. In the propensity score-matched cohort, the 3-year rate of decompensation events after a single session of SBRT was not significantly different from that in the LC cohort. CONCLUSIONS: The rate of liver volume decrease was significantly associated with the risk of hepatic decompensation in both HCC patients who received SBRT and LC patients. A single session of SBRT for HCC did not result in a higher decompensation rate compared with LC.

Stereotactic body radiation therapy as a salvage treatment for single viable hepatocellular carcinoma at the site of incomplete transarterial chemoembolization: a retrospective analysis of 302 patients.

BACKGROUND: To evaluate the clinical outcomes of patients who received stereotactic body radiation therapy (SBRT) for single viable hepatocellular carcinoma (HCC) at the site of incomplete transarterial chemoembolization (TACE). METHODS: Patients treated with SBRT for single viable HCC after incomplete TACE between 2012 and 2017 at Asan Medical Center (Seoul, South Korea) were included. Incomplete TACE was defined as (1) evidence of viable HCC at the site of TACE on follow-up dynamic computed tomography (CT) or magnetic resonance imaging following one or more consecutive TACEs, (2) no definite tumor staining on superselective hepatic angiogram, or (3) no definite iodized oil uptake on post-embolization angiogram or CT. Doses of 10-15 Gy per fraction were given over 3-4 consecutive days. The primary outcome was local control rate at 3 years and secondary outcome included tumor response, overall survival rate, out-of-field intrahepatic recurrence-free survival, distant metastasis-free survival and treatment-related toxicities. Treatment-related adverse events were evaluated according to the common terminology criteria for adverse events, version 4.03. RESULTS: A total of 302 patients were analyzed. The median follow-up duration was 32.9 months (interquartile range [IQR], 23.6-41.7) and the median tumor size was 2.0 cm (range, 0.7-6.9). The local control (LC) and overall survival rates at 3 years were 91.2 and 72.7%, respectively. 95.4% of the tumors reached complete response (CR) during the entire follow-up period (anyCR). The median interval from SBRT to anyCR was 3.4 months (IQR, 1.9-4.7), and 39.9 and 83.3% of the lesions reached CR at 3- and 6-months after SBRT, respectively. Radiation-induced liver disease was observed in 8 (2.6%) patients. No patients experienced gastroduodenal bleeding within the radiation field. CONCLUSION: SBRT could be considered a feasible salvage treatment option for HCC after incomplete TACE.

Role of palliative radiotherapy in bleeding control in patients with unresectable advanced gastric cancer.

BACKGROUND: This study analyzed the clinical results of palliative radiotherapy for bleeding control in patients with unresectable advanced gastric cancer. METHODS: We retrospectively reviewed the medical records of patients who met the following inclusion criteria between January 2002 and June 2018: histologically proven gastric cancer, gastric tumor bleeding confirmed by upper gastrointestinal endoscopy, and palliative radiotherapy performed for hemostasis. The median radiotherapy dose was 30 Gy, with a daily dose ranging from 1.8 to 3 Gy. RESULTS: Sixty-one patients were included in this analysis. The study population was predominantly male (72.1%), with a median age of 62 years (range: 32-92). The median baseline hemoglobin level was 7.1 g/dL, and the most common presenting symptom of gastric tumor bleeding was melena (85.2%). Bleeding control was achieved in 54 (88.5%) patients. The median levels of hemoglobin at 1, 2, and 3 months after completion of radiotherapy were 10.1 g/dL, 10.2 g/dL, and 10.4 g/dL, respectively; these values were significantly different from that before radiotherapy (7.1 g/dL; p < 0.001). The median overall survival was 4.8 months. Among the 54 patients who achieved bleeding control after radiotherapy, 19 (35.2%) experienced re-bleeding during the follow-up period. The median time to re-bleeding was 6.0 months. Multivariate analysis demonstrated that a higher radiation dose (p = 0.007) and additional chemotherapy after radiotherapy (p = 0.004) were significant factors for prolonging the time to re-bleeding. CONCLUSIONS: Tumor bleeding was adequately controlled by radiotherapy in patients with unresectable advanced gastric cancer.

Radiofrequency ablation versus stereotactic body radiation therapy for small (≤ 3 cm) hepatocellular carcinoma: A retrospective comparison analysis.

BACKGROUND AND AIM: We compared the clinical outcomes of radiofrequency ablation (RFA) and stereotactic body radiation therapy (SBRT) in small (≤ 3 cm) hepatocellular carcinoma. METHODS: A total of 266 patients treated with RFA (n = 179) or SBRT (n = 87) were reviewed. Local control rates (LCRs), intrahepatic recurrence-free survival (IHRFS) rates, and overall survival (OS) rates were compared. Inverse probability of treatment weighting (IPTW) was used to adjust for imbalances in baseline characteristics between the two groups. RESULTS: The median follow-up period was 50.3 months, and treatment method (RFA vs SBRT) was not a significant prognostic factor for LCR, OS, and IHRFS in both multivariate and IPTW-adjusted analyses. The 4-year LCRs after RFA and SBRT were 92.7% and 95.0%, respectively. Perivascular location was a significant prognostic factor for LCR in the entire patients and in the RFA group, but not in the SBRT group. The 4-year OS rates in the RFA and SBRT groups were 78.1% and 64.1%, respectively (P = 0.012). After IPTW adjustment, the 4-year LCRs (90.6% vs 96.3%) and OS rates (71.8% vs 70.2%) were not significantly different between the two groups. The rate of grade ≥ 3 adverse events was 0.6% (n = 1) in the RFA group and 1.1% (n = 1) in the SBRT group. CONCLUSIONS: The two treatment methods showed comparable outcomes in terms of LCR, OS rate, and IHRFS rate after IPTW adjustment. SBRT seems to be a viable alternative method for small hepatocellular carcinomas that are not suitable for RFA due to tumor location.

Computational Large Field-of-View RGB-D Integral Imaging System.

The integral imaging system has received considerable research attention because it can be applied to real-time three-dimensional image displays with a continuous view angle without supplementary devices. Most previous approaches place a physical micro-lens array in front of the image, where each lens looks different depending on the viewing angle. A computational integral imaging system with a virtual micro-lens arrays has been proposed in order to provide flexibility for users to change micro-lens arrays and focal length while reducing distortions due to physical mismatches with the lens arrays. However, computational integral imaging methods only represent part of the whole image because the size of virtual lens arrays is much smaller than the given large-scale images when dealing with large-scale images. As a result, the previous approaches produce sub-aperture images with a small field of view and need additional devices for depth information to apply to integral imaging pickup systems. In this paper, we present a single image-based computational RGB-D integral imaging pickup system for a large field of view in real time. The proposed system comprises three steps: deep learning-based automatic depth map estimation from an RGB input image without the help of an additional device, a hierarchical integral imaging system for a large field of view in real time, and post-processing for optimized visualization of the failed pickup area using an inpainting method. Quantitative and qualitative experimental results verify the proposed approach's robustness.

Ambient LED Light Noise Reduction Using Adaptive Differential Equalization in Li-Fi Wireless Link.

For Li-Fi wireless links based on a white light emitting diode, an adaptive differential equalization (ADE) technique that reduces various noises such as interference noise and shot one generated from ambient light sources is pro-posed. The ADE technique reduces noise by taking advantage of the fact that the derivative between adjacent sampling points of signal with digital waveform is very different from that of noise with the random analog waveform. Furthermore, a weighting function that reflects the Poisson characteristics of shot noise is applied to the ADE technique in order to maximize the reduction efficiency of ambient noise. The signal-to-noise ratio of input non-return-to-zero-on-off keying (NRZ-OOK) signal is improved by 7.5 dB at the first-generation forward error correction (FEC) threshold (the bit error rate (BER) of 8 × 10-5) using the optical wireless experimental link. In addition, it is confirmed that it is possible to maintain the transmission performance corresponding to the BER of 1 × 10-5 by using the proposed ADE technique, even when the intensity of the ambient light source increases by 6 dB.

Clinical outcomes of stereotactic body radiation therapy for small hepatocellular carcinoma.

BACKGROUND AND AIM: The purpose of this study was to investigate the long-term oncologic outcomes after stereotactic body radiation therapy (SBRT) for small hepatocellular carcinoma (HCC). METHODS: A total of 290 patients with HCC were registered between March 2007 and July 2013. A dose of 10-15 Gy per fraction was given over three to four consecutive days, resulting in a total dose of 30-60 Gy. Overall and recurrence-free survivals were estimated from the date of the start of SBRT to the date of death, the last follow-up examination, or to the date of tumor recurrence. RESULTS: The median follow-up period of all patients was 38.2 months, and the median tumor size was 1.7 cm. Overall survival (OS) rate at 5 years was 44.9%. Multivariate analyses revealed that age, Child-Pugh class, tumor size, and albumin levels were significant factors for OS. The 5-year local control rate was 91.3%. In multivariate analysis, tumor size and albumin were significantly associated with local tumor control. However, there was a negative correlation between total dose and tumor size in Pearson's correlation analysis (r = -0.111, P = 0.046). CONCLUSIONS: Stereotactic body radiation therapy was an excellent ablative treatment option for patients with small HCC. Tumor size was a significant factor for local tumor control after SBRT, although the total dose was negatively correlated with tumor size. Considering the low OS rates and the high local tumor control rates, the combined SBRT and systemic therapies may be beneficial for improving survival outcomes.

Long-term outcomes of the 2-week schedule of hypofractionated radiotherapy for recurrent hepatocellular carcinoma.

BACKGROUND: The 2-week schedule of hypofractionated radiotherapy as a salvage treatment for hepatocellular carcinoma (HCC) has previously exhibited promising results; this study aimed to assess its long-term clinical outcomes in patients with recurrent HCC ineligible for curative treatments. METHODS: We retrospectively enrolled 77 patients (84 lesions) with HCC who were treated with hypofractionated radiotherapy between December 2008 and July 2013. Primary inclusion criteria were HCC unsuitable for curative treatments and HCC located within 2 cm of a critical normal organ. We administered 3.5-5 Gy/fraction for 2 weeks, resulting in a total dose of 35-50 Gy. RESULTS: The median follow-up period was 33.6 (range, 4.8-78.3) months. The 3- and 5-year overall survival rates were 52.3% and 40.9%, respectively, and local control rates were 79.5% and 72.6% in all treated lesions, respectively. The 5-year local control rate was better in the higher radiation dose group than in the lower radiation dose group (50 Gy: 79.7% vs. < 50 Gy: 66.1%); however, the difference was not statistically significant (P = 0.493). We observed grade ≥ 3 hepatic toxicity in 2 (2.6%) patients and grade 3 gastrointestinal bleeding in 1 (1.3%) patient. However, grade ≥ 4 toxicity was not observed after hypofractionated radiotherapy. CONCLUSIONS: The 2-week schedule of hypofractionated radiotherapy for recurrent HCC exhibited good local control and acceptable treatment-related toxicity during the long-term follow-up period. Thus, this fractionation schedule can be a potential salvage treatment option for recurrent HCC, particularly for tumors located close to a radiosensitive gastrointestinal organ.

Stereotactic body radiation therapy using a respiratory-gated volumetric-modulated arc therapy technique for small hepatocellular carcinoma.

BACKGROUND: Volumetric-modulated arc therapy (VMAT) is a highly sophisticated linear accelerator-based treatment method, and allows dose rate-changing intensity modulation with gantry rotation. We report our clinical experiences with stereotactic body radiation therapy (SBRT) using a respiratory-gated VMAT technique for patients with hepatocellular carcinoma (HCC) when established curative treatments cannot be applied. METHODS: A total of 119 patients (139 lesions) with HCC who were treated with SBRT were registered between March 2012 and July 2013 at our institution. A dose of 10-15 Gy per fraction was applied over 3-4 consecutive days, resulting in a total dose of 30-60 Gy. RESULTS: The median follow-up period was 25.8 months (range, 3.2-36.8 months). The overall 3-year survival rate was 83.8%. The local control rate at 3 years was 97.0% in all treated lesions. Multivariate analysis revealed that the Child-Pugh class before SBRT had significant effects on overall survival (Child-Pugh A: hazard ratio = 0.463; 95% CI, 0.262-0.817; p = 0.008). CONCLUSIONS: SBRT using a respiratory-gated VMAT technique was an excellent ablative treatment modality for patients with HCC. SBRT is a good alternative treatment for patients with small HCCs that are unsuitable for surgical resection or local ablative therapy.

Divide and Conquer-Based 1D CNN Human Activity Recognition Using Test Data Sharpening.

Human Activity Recognition (HAR) aims to identify the actions performed by humans using signals collected from various sensors embedded in mobile devices. In recent years, deep learning techniques have further improved HAR performance on several benchmark datasets. In this paper, we propose one-dimensional Convolutional Neural Network (1D CNN) for HAR that employs a divide and conquer-based classifier learning coupled with test data sharpening. Our approach leverages a two-stage learning of multiple 1D CNN models; we first build a binary classifier for recognizing abstract activities, and then build two multi-class 1D CNN models for recognizing individual activities. We then introduce test data sharpening during prediction phase to further improve the activity recognition accuracy. While there have been numerous researches exploring the benefits of activity signal denoising for HAR, few researches have examined the effect of test data sharpening for HAR. We evaluate the effectiveness of our approach on two popular HAR benchmark datasets, and show that our approach outperforms both the two-stage 1D CNN-only method and other state of the art approaches.

Visual Object Tracking Using Structured Sparse PCA-Based Appearance Representation and Online Learning.

Visual object tracking is a fundamental research area in the field of computer vision and pattern recognition because it can be utilized by various intelligent systems. However, visual object tracking faces various challenging issues because tracking is influenced by illumination change, pose change, partial occlusion and background clutter. Sparse representation-based appearance modeling and dictionary learning that optimize tracking history have been proposed as one possible solution to overcome the problems of visual object tracking. However, there are limitations in representing high dimensional descriptors using the standard sparse representation approach. Therefore, this study proposes a structured sparse principal component analysis to represent the complex appearance descriptors of the target object effectively with a linear combination of a small number of elementary atoms chosen from an over-complete dictionary. Using an online dictionary for learning and updating by selecting similar dictionaries that have high probability makes it possible to track the target object in a variety of environments. Qualitative and quantitative experimental results, including comparison to the current state of the art visual object tracking algorithms, validate that the proposed tracking algorithm performs favorably with changes in the target object and environment for benchmark video sequences.

Radiotherapeutic strategies for hepatocellular carcinoma with portal vein tumour thrombosis in a hepatitis B endemic area.

BACKGROUND & AIMS: This nationwide, multicenter study investigated treatment outcomes as well as the optimal radiotherapeutic strategy in patients with hepatocellular carcinoma (HCC) and portal vein tumour thrombosis (PVTT). METHODS: We retrospectively reviewed the records of 985 patients who received radiotherapy (RT) for PVTT. The median equivalent RT dose was 48.75 Gy. Combined treatment, defined as liver-directed treatments performed within a month of RT, was administered to 657 patients (66.7%). The PVTT and primary tumour were irradiated in 413 patients (41.9%), and PVTT only was targeted in 572 patients (58.1%). RESULTS: The response rate of the PVTT was 51.8%, and RT responders had a significantly longer survival than non-responders (15.2 vs. 6.9 months). Equivalent RT dose and combined treatment predicted response of PVTT. The median overall survival (OS) was 10.2 months. Multivariate analysis revealed the equivalent RT dose ˃45 Gy and combined treatment as significant positive factors for OS. In the propensity score matching analysis, the combined treatment group had better OS than the no combined treatment group, whereas the OS of the PVTT + primary tumour group did not differ significantly from that of the PVTT only group. CONCLUSION: The equivalent RT dose ˃45 Gy, given in combination with other treatments, provided better PVTT control and OS. The optimal RT volume is suggested for either PVTT + primary or PVTT only. Taken together, multimodal treatment with equivalent RT dose higher than 45 Gy is recommended for patients with HCC and PVTT.

Interobserver variability in gross tumor volume delineation for hepatocellular carcinoma : Results of Korean Radiation Oncology Group 1207 study.

PURPOSE: There has been increasing use of external beam radiotherapy for localized treatment of hepatocellular carcinoma (HCC) with both palliative and curative intent. Quality control of target delineation in primary HCC is essential to deliver adequate doses of radiation to the primary tumor while preserving adjacent healthy organs. We analyzed interobserver variability in gross tumor volume (GTV) delineation for HCC. PATIENTS AND METHODS: Twelve radiation oncologists specializing in liver malignancy participated in a multi-institutional contouring dummy-run study of nine HCC cases and independently delineated GTV on the same set of provided computed tomography images. Quantitative analysis was performed using an expectation maximization algorithm for simultaneous truth and performance level estimation (STAPLE) with kappa statistics calculating agreement between physicians. To quantify the interobserver variability of GTV delineations, the ratio of the actual delineated volume to the estimated consensus volume (STAPLE), the ratio of the common and encompassing volumes, and the coefficient of variation were calculated. RESULTS: The median kappa agreement level was 0.71 (range 0.28-0.86). The ratio of the actual delineated volume to the estimated consensus volume ranged from 0.19 to 1.93 (median 0.94) for all cases. The ratio of the common and encompassing volumes ranged from 0.001 to 0.56 (median 0.25). The coefficient of variation for GTV delineation ranged from 8 to 57 % (median 26 %). CONCLUSION: The interobserver variability in target delineation of HCC GTV in this study is noteworthy. Multi-institution studies involving radiotherapy for HCC require appropriate quality assurance programs for target delineation.

Evaluation of quality of life using a tablet PC-based survey in cancer patients treated with radiotherapy: a multi-institutional prospective randomized crossover comparison of paper and tablet PC-based questionnaires (KROG 12-01).

PURPOSE: This study compared a tablet PC questionnaire with a paper method for reliability and patient preferences in the acquisition of patient-reported outcomes (PROs) for patients treated with radiotherapy. By comparing the two modes of PRO administration, we aimed to evaluate the adequacy of using tablet PC questionnaires in future clinical use. METHODS: Patients were randomized in a crossover study design using two different methods for PRO entry. A group of 89 patients answered a paper questionnaire followed by the tablet PC version, whereas 89 patients in another group completed the tablet PC questionnaire followed by the paper version. Surveys were performed four times per patient throughout the course of the radiotherapy. The Korean versions of the M.D. Anderson Symptom Inventory (MDASI-K) and the Brief Fatigue Inventory (BFI-K) were used. The primary endpoint of our current study was an assessment of patient preference for the survey method. The proportions of patients preferring each mode of questionnaire were evaluated. RESULTS: The proportion of patients who preferred the tablet PC version, paper form, or who had no preference was 52.2, 22.1, and 25.7 %, respectively. More than half of the patients preferred the tablet PC to the paper version in all four surveys. Age, gender, educational status, prior experience of using a tablet PC, and the order of paper to tablet PC administration did not impact patient preferences. Inter-class correlation coefficients (ICCs) between the modes were 0.92 for MDASI-K and 0.94 for BFI-K and ranged from 0.91 to 0.96 on both instruments during the four surveys. CONCLUSIONS: A tablet PC-based PRO is an acceptable and reliable method compared with paper-based data collection for Korean patients receiving radiotherapy.

Alpha-fetoprotein normalization as a prognostic surrogate in small hepatocellular carcinoma after stereotactic body radiotherapy: a propensity score matching analysis.

BACKGROUND: To assess the significance of alpha-fetoprotein (AFP) normalization as a prognostic surrogate after stereotactic body radiotherapy (SBRT) for patients with small hepatocellular carcinoma (HCC). METHODS: Patients who underwent SBRT for primary or recurrent HCC were registered and a database thereof was retrospectively reviewed. Among 165 total registered patients, 77 patients were selected who satisfied the following criteria: (1) their AFP levels were > 20 ng/mL before SBRT, and (2) their AFP levels were checked within three months after SBRT. Propensity score based matching analysis was performed to minimize potential confounding bias. AFP normalization was defined as a reduction of AFP level to ≤ 20 ng/mL. Overall survival (OS) and progression-free survival (PFS) curves were estimated by the Kaplan-Meier method. RESULTS: Thirty-seven (48.1 %) patients displayed AFP normalization (normalized group), while 40 (51.9 %) patients comprised the non-normalized group. The OS rates at 3-year were 62.0 % and 44.0 % (p = 0.023), and the PFS rates at 3-year were 27.9 % and 12.0 % (p = 0.019), in the normalized and non-normalized groups, respectively. Local control rates were 97.2 % in the normalized group and 94.7 % in the non-normalized group at three years (p = 0.579). In the propensity score matching cohort (25 pairs), OS and PFS were significantly longer in the normalized group than in the non-normalized group (p = 0.017 and 0.049, respectively). The local control rates were 100 % in both matched groups. CONCLUSIONS: AFP normalization within three months after SBRT is a prognostic surrogate for OS and PFS in patients with small HCC. AFP monitoring should be considered a useful tool for HCC patients with an elevated AFP level before SBRT.

Combined Cisplatin-Based Chemoembolization and Radiation Therapy for Hepatocellular Carcinoma Invading the Main Portal Vein.

PURPOSE: To evaluate the safety and survival outcome of chemoembolization plus radiation therapy (RT) in patients with hepatocellular carcinoma (HCC) with main portal vein (PV) tumor thrombosis. MATERIALS AND METHODS: This retrospective study evaluated 151 patients with HCC and main PV involvement (101 with Child-Pugh class A liver function and 50 with Child-Pugh class B liver function) treated with combined cisplatin-based chemoembolization and RT. Medical records, imaging, and laboratory studies were reviewed, and complications, survival, and mortality rates were determined. RESULTS: After chemoembolization, major complications occurred in 19.9% of patients, with the rate of major complications significantly higher in Child-Pugh class B cases than in Child-Pugh class A cases (32% vs 13.9%; P = .016). The 30-day mortality rate was 0.7%. One hundred forty-seven patients received adjuvant RT an average of 17.4 days after chemoembolization for main PV tumor thrombosis. Adjuvant RT could not be performed in four patients because of intolerance of the initial chemoembolization. There were no major complications after RT. The objective tumor response at 6 months was 25.2%, with a median survival of 12 months (14 mo in Child-Pugh class A cases and 8 mo in Child-Pugh class B cases). Patients with Child-Pugh class B liver function with extrahepatic metastases, no tumor response, and absence of second-line sorafenib treatment had poor survival. CONCLUSIONS: Chemoembolization combined with RT improves survival, with a median survival of 12 months in patients with HCC with main PV involvement.

Comparison of chemoembolization with and without radiation therapy and sorafenib for advanced hepatocellular carcinoma with portal vein tumor thrombosis: a propensity score analysis.

PURPOSE: To compare efficacy of transarterial chemoembolization with and without radiation therapy (RT) versus sorafenib for advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). MATERIALS AND METHODS: This single-center retrospective study involved 557 patients with HCC with PVTT who initially received chemoembolization (1997-2002; n = 295), chemoembolization and RT (2003-2008; n = 196), or sorafenib (2009-2012; n = 66) according to eligibility criteria among an initial population of 617. The three groups were divided into three pairs (chemoembolization vs chemoembolization/RT, chemoembolization vs sorafenib, and chemoembolization/RT vs sorafenib), and time to progression (TTP) and overall survival (OS) were compared by propensity-score analyses. RESULTS: The chemoembolization/RT group had longer median TTP and OS than the chemoembolization-alone and sorafenib groups (P < .001). Multivariate Cox analysis revealed that chemoembolization/RT treatment was an independent predictor of favorable TTP and OS. In the matched cohort, median TTP and OS were significantly longer in the chemoembolization/RT group than the chemoembolization-alone group (102 pairs; TTP, 8.7 mo vs 3.6 mo [P < .001]; OS, 11.4 mo vs 7.4 mo [P = .023]) or the sorafenib group (30 pairs; TTP, 5.1 mo vs 1.6 mo [P < .001]; OS, 8.2 mo vs 3.2 mo [P < .001]), in agreement with the inverse probability of treatment weighted (IPTW) outcomes. In matching analyses, the chemoembolization-alone group had longer median TTP and OS than the sorafenib group (46 pairs; TTP, 3.4 mo vs 1.8 mo [P < .001]; OS, 5.9 mo vs 4.4 mo [P = .003]). There was no significant difference in terms of OS with the IPTW approach (P = .108), but there was one in terms of TTP (P < .001). CONCLUSIONS: Within the limitation of a retrospective study, the present data indicate that transarterial chemoembolization combined with RT could be considered as an alternative to the standard sorafenib in the treatment of patients with advanced-stage HCC with PVTT.

Compressive sensing-based channel bandwidth improvement in optical wireless orthogonal frequency division multiplexing link using visible light emitting diode.

A new technique, which can compensate for the lack of channel bandwidth in an optical wireless orthogonal frequency division multiplexing (OFDM) link based on a light emitting diode (LED), is proposed. It uses an adaptive sampling and an inverse discrete cosine transform in order to convert an OFDM signal into a sparse waveform so that not only is the important data obtained efficiently but the redundancy one is removed. In compressive sensing (CS), a sparse signal that is sampled below the Nyquist/Shannon limit can be reconstructed successively with enough measurement. This means that the CS technique can increase the data rate of visible light communication (VLC) systems based on LEDs. It is observed that the data rate of the proposed CS-based VLC-OFDM link can be made 1.7 times greater than a conventional VLC-OFDM link (from 30.72 Mb/s to 51.2 Mb/s). We see that the error vector magnitude (EVM) of the quadrature phase shift keying (QPSK) symbol is 31% (FEC limit: EVM of 32%) at a compression ratio of 40%.

A case report of testicular sparganosis misdiagnosed as testicular tumor.

Sparganosis is a parasitic infestation of human by plerocercoid larvae. Sparganum is usually reported to be found in the subcutaneous tissues as well as other organs, including scrotum. However, testicular sparganosis is extremely rare, because of strong capsule of tunica albuginea. An urban-living 54-yr-old Korean man presented with left scrotal pain for 6 yr. Both testes look normal physically. Ultrasonography revealed poorly defined, heterogeneous mass with increased echogenicity in the left testis. This case was misdiagnosed as testicular tumor and underwent orchiectomy, but was diagnosed as testicular sparganosis by histopathology. Sparganosis should be included for differential diagnosis of testis tumor in countries where sparganosis is prevalent.

Adaptive total variation minimization-based image enhancement from flash and no-flash pairs.

We present a novel approach for enhancing the quality of an image captured from a pair of flash and no-flash images. The main idea for image enhancement is to generate a new image by combining the ambient light of the no-flash image and the details of the flash image. In this approach, we propose a method based on Adaptive Total Variation Minimization (ATVM) so that it has an efficient image denoising effect by preserving strong gradients of the flash image. Some numerical results are presented to demonstrate the effectiveness of the proposed scheme.