Contrast-enhanced ultrasound in the diagnosis of nodules in liver cirrhosis

Contrast-enhanced ultrasound(CEUS)using microbubble contrast agents are useful for the diagnosis of the nodules in liver cirrhosis.CEUS can be used as a problem-solving method for indeterminate nodules on computed tomography(CT)or magnetic resonance imaging(MRI)or as an initial diagnostic test for small newly detected liver nodules.CEUS has unique advantages over CT and MRI including no renal excretion of contrast,real-time imaging capability,and purely intravascular contrast.Hepatocellular carcinoma(HCC)is characterized by arterial-phase hypervascularity and later washout(negative enhancement).Benign nodules such as regenerative nodules or dysplastic nodules are usually isoechoic or slightly hypoechoic in the arterial phase and isoechoic in the late phase.However,there are occasional HCC lesions with atypical enhancement including hypovascular HCC and hypervascular HCC without washout.Cholangiocarcinomas are infrequently detected during HCC surveillance and mostly show rimlike or diffuse hypervascularity followed by rapid washout.Hemangiomas are often found at HCC surveillance and are easily diagnosed by CEUS.CEUS can be effectively used in the diagnostic work-up of small nodules detected at HCC surveillance.CEUS is also useful to differentiate malignant and benign venous thrombosis and to guide and monitor the local ablation therapy for HCC.

Germline BRCA2 variants in advanced pancreatic acinar cell carcinoma:A case report and review of literature

BACKGROUND Pancreatic acinar cell carcinoma(PACC)is a rare tumor.Up to 45%of PACCs have alterations in the DNA damage repair pathway and 23%harbor rearrangements in the BRAF or RAF1 genes.We present a PACC case with a germline BRCA2 likely pathogenic variant(LPV)to highlight the impact of genomic testing on treatment decisions and patient outcomes.In our larger case series,we provide clinic-based information on additional 10 PACC patients treated in our center.CASE SUMMARY A 70-year-old male was diagnosed with advanced PACC.At presentation,he was cachectic with severe arthralgia despite prednisolone and a skin rash that was later confirmed to be panniculitis.He was treated with modified FOLFIRINOX(mFFX)with the knowledge of the germline BRCA2 LPV.Following 11 cycles of mFFX,a computed tomography(CT)scan demonstrated significant tumor response in the pancreatic primary and hepatic metastases,totaling 70%from baseline as per Response Evaluation Criteria in Solid Tumors.Resolution of the skin panniculitis was also noted.We identified two additional PACCs with druggable targets in our case series.Our data contribute to practical evidence for the value of germline and somatic profiling in the management of rare diseases like PACC.CONCLUSION This patient and others in our larger case series highlight the importance of genomic testing in PACC with potential utility in personalized treatment.

Impact of tin-oxide nanoparticles on improving the carrier transport in the Ag/p-GaN interface of InGaN/GaN micro-light-emitting diodes by originating inhomogeneous Schottky barrier height

The ffect of tin-oxide(SnO)nanoparticles,which are obtained by indium-tin-oxide(ITO)treatment,on the p-GaN surface of GaN-based flip-chip blue micro-light-emitting diode(μ-LED)arrays is investigated.A thin Ag layer is deposited on the ITO-treated p-GaN surface by sputtering.SnO nanoparticles originate from inho-mogencous Schottly barrier heights(SBHs)at Ag/p-GaN contact.Therefore,efective SBH is reduced,which causes carrier transport into theμ-LED to enhance.10 nm thick ITO-treatedμ-LEDs show better optoelectronic characteristics among fabricated u-LEDs owing to improved ohmic contact and highly reflective p-type reflectors.Basically,SnO nanoparticles help to make good ohmic contact,which results in improved carrier transport intoμ-LEDs and thus results in increased optoelectronic performances.

Diagnosing non-hepatocellular carcinoma malignancies on CT/MRI and contrast enhanced ultrasound: the Liver Imaging Reporting and Data System approach

The Liver Imaging Reporting and Data System(LI-RADS)provides a stepwise algorithmic approach that is proven to be highly accurate in diagnosing hepatocellular carcinoma(HCC)in patients at risk.An essential and early step in the algorithm is the diagnosis of malignancies other than HCC,such as cholangiocarcinoma and combined tumors,by application of LR-M features and criteria.The LR-M category captures most non-HCC malignancies and some atypical HCCs.The exclusion of non-HCC malignancies is important for maintaining the high specificity of the LR-5,definite HCC category.This review provides an overview of the approach to diagnosing non-HCC malignancies using LI-RADS CT/MRI and contrast enhanced ultrasound algorithms.