Validation of modified fibrosis-4 index for predicting hepatocellular carcinoma in patients with compensated alcoholic liver cirrhosis.

Recently, modified fibrosis-4 index (mFIB-4) and the easy liver fibrosis test (eLIFT) were developed for predicting liver fibrosis in chronic liver disease patients. We evaluated whether the 2 tests can predict hepatocellular carcinoma (HCC) risk in alcoholic liver cirrhosis (ALC) patients.A retrospective cohort of 924 ALC patients was assessed for HCC development. Four non-invasive serum biomarkers, mFIB-4, the eLIFT score, fibrosis-4 index (FIB-4), and aspartate aminotransferase to platelet ratio index (APRI) were tested using time-dependent analysis of areas under receiver operating characteristic curve (AUROC), DeLong, and log-rank tests.During a median 4.8 years of follow-up, HCC occurred in 83 patients (9.0%). For predicting HCC development at 3 years, the mFIB-4 showed a significantly higher AUROC than APRI and eLIFT scores (0.71 vs 0.61 and 0.56, respectively, all P < .05). The AUROCs of the mFIB-4 for HCC development were not significantly different from those of the FIB-4. According to the mFIB-4, the risk of HCC development was significantly stratified by low index (≤4)/high index (>4) (P < .001 by log-rank test).The mFIB-4 showed better predictability of HCC development than APRI and eLIFT scores, and significantly stratified HCC risk in Asian ALC patients.

[Pancreatic Neuroendocrine Tumor Presenting as Acute Pancreatitis].

We report a case of acute pancreatitis secondary to pancreatic neuroendocrine tumor. A 46-year old man presented with upper abdominal pain. The serum amylase and lipase were elevated. Abdominal computed tomography (CT) and magnetic resonance cholangiopancreatography revealed a 1.7 cm sized mass at the pancreas body with a dilatation of the upstream pancreatic duct and mild infiltrations of peripancreatic fat. An endoscopic ultrasound-guided fine needle biopsy was performed for the pancreatic mass, but only necrotic tissue was observed on the pathologic examination. A chest and neck CT scan revealed anterior mediastinal, paratracheal, and cervical lymph node enlargement, which were indicative of metastasis. An ultrasound-guided core needle biopsy was performed for the enlarged neck lymph node, and pathologic examination revealed a metastatic poorly differentiated carcinoma. Immunohistochemical analysis showed positive staining for synaptophysin, chromogranin A, and CD 56, indicative of a neuroendocrine carcinoma.

Detection and restoration of defective lines in the SPOT 4 SWIR band.

This paper presents the categorization and restoration of defective lines developed in pushbroom images. About 100 of the 3000 SPOT 4 SWIR detectors malfunction, which degrades image quality. Conventional methods have difficulties in effectively detecting and restoring defective lines, because they ignore the heterogeneity of the ground surface and the presence of sporadically unstable detectors with gain and offset that vary during a scan. While all defective lines have previously been considered as a single type, here they are categorized into three types according to the variation pattern in the scanning direction: constant defective lines, irregular defective lines, and irrecoverable defective lines. The detection procedure utilizes summed data and standard deviation data that consist of abnormal peaks originating from defective lines and a slowly varying baseline reflecting the surface characteristics within the image. The defective lines are detected by finding abnormal peaks, and classified and restored by using either a moment-matching method or interpolation, depending upon their types. Three SPOT 4 images were used to test and evaluate the performance of the proposed method. From the test results, the constant defective line was the most common type, comprising about 60%, while the irregular defective lines caused serious image degradation because of the difficulty of detecting and classifying them. Commission and omission errors were less than 10% and detection accuracy was higher than 90%. The analysis of signal-to-noise ratio (SNR) showed that the low SNR created by the defective lines was effectively removed. Our method gave a significant improvement of the detection and restoration capability.