Query: Liver data statistics

title: Clinical validation of ultrasound backscatter statistics for the assessment of liver fibrosis
abstract: Deposition of fibrous tissue in the liver changes with the progression of liver cirrhosis. Ultrasound backscatter imaging may describe the scatterer distribution in the liver, and reflect the severity of liver cirrhosis. However, it is known that the backscatter statistics are often subject to ultrasound imaging settings, region of interest (ROI) for analysis and hepatic steatosis. This study aims to establish a standard imaging procedure and a discriminant model for assessment of liver fibrosis regardless of the degrees of liver fatty changes.  201 patients received elective liver resection were prospectively enrolled in the study. Ultrasound radio frequency (RF) data of right liver lobe through an intercostal space with the maximum imaging depth of 8cm were collected using the Terason t3000 (tm) (convex array) system pre operatively from each patient. Since significant inter ROI variation was found when the ROI is less than 10 cm2, all the ROI's were selected such that the ROI area covered as much as possible the liver parenchyma and was larger than 10 cm2. The liver tissue was examined and determined by an experienced pathologist the degrees of liver fibrosis and fatty changes. Among the 201 patients, there were 36 F0, 51 F1, 26 F2, 22 F3 and 66 F4 patients while 62 with mild steatosis (5 30% and 26 with severe steatosis 30% A FDA cleared backscatter analysis tool (AmCAD USTM) was used to calculate the statistics and a stepwise logistic regression model was established to differentiate significant liver fibrosis F2) Results Three backscatter statistics, including the 95th percentile of the Nakagami (m) statistic, and the 75th and 95th percentiles of the histogram (h) statistics, were selected into the logistic model. Regardless of the liver fatty changes, the Receiver Operating Characteristic (ROC) curve analysis showed a significant discriminant power of the model for evaluation of liver fibrosis stage 0 versus stage 1 4, AUC 0.77 (p value  The liver fibrosis in human results in variation of the scatterer distributions in medical ultrasound imaging. Following a standard imaging procedure, a discriminant model is established and shown to be able to distinguish significantly different degrees of liver fibrosis regardless of the presence of steatosis.

title: Cancer statistics in China, 2015
abstract: With increasing incidence and mortality, cancer is the leading cause of death in China and is a major public health problem. Because of China's massive population (1.37 billion) previous national incidence and mortality estimates have been limited to small samples of the population using data from the 1990s or based on a specific year. With high quality data from an additional number of population based registries now available through the National Central Cancer Registry of China, the authors analyzed data from 72 local, population based cancer registries (2009 2011) representing 6.5% of the population, to estimate the number of new cases and cancer deaths for 2015. Data from 22 registries were used for trend analyses (2000 2011) The results indicated that an estimated 4292,000 new cancer cases and 2814,000 cancer deaths would occur in China in 2015, with lung cancer being the most common incident cancer and the leading cause of cancer death. Stomach, esophageal, and liver cancers were also commonly diagnosed and were identified as leading causes of cancer death. Residents of rural areas had significantly higher age standardized (Segi population) incidence and mortality rates for all cancers combined than urban residents (213.6 per 100,000 vs 191.5 per 100,000 for incidence; 149.0 per 100,000 vs 109.5 per 100,000 for mortality, respectively) For all cancers combined, the incidence rates were stable during 2000 through 2011 for males +0.2% per year; P .1) whereas they increased significantly +2.2% per year; P .05) among females. In contrast, the mortality rates since 2006 have decreased significantly for both males 1.4% per year; P .05) and females 1.1% per year; P .05) Many of the estimated cancer cases and deaths can be prevented through reducing the prevalence of risk factors, while increasing the effectiveness of clinical care delivery, particularly for those living in rural areas and in disadvantaged populations.

title: The Incidence Rate of Liver Cancer in Saudi Arabia: An Observational Descriptive Epidemiological Analysis of Data from the Saudi Cancer Registry (2004 2014)
abstract: This study describes the epidemiological pattern of liver cancer in all regions of Saudi Arabia. It explores the frequency of cases diagnosed, the age specific incidence rate (AIR) the crude incidence rate (CIR) and the age standardised incidence rate (ASIR) stratified by age group, year of diagnosis, and region.  A retrospective descriptive epidemiological analysis of all liver cancer cases documented in the Saudi Cancer Registry (SCR) between 2004 and 2014 was performed. The data were analysed using descriptive statistics, t test, Kruskal Wallis, and sex ratio with the Statistical Package for the Social Sciences version 20.0 (SPSS) Results A total of 4723 liver cancer cases were registered in the SCR between January 2004 and December 2014. The highest overall ASIR of liver cancer among Saudi males was observed in the regions of Riyadh, Najran, and Tabuk at 10.4, 7.7, and 7.0 per 100,000 males, respectively. Furthermore, Riyadh, Eastern Region, and Tabuk recorded the highest overall ASIR among Saudi females at 4.9, 2.8, and 2.6 per 100,000 females, respectively. Jazan had the lowest overall ASIR (1.7 per 100,000 males) of liver cancer among male Saudis, while the Northern region and Baha had the lowest overall ASIR (0.6 and 0.9 per 100,000 females, respectively) of liver cancer among female Saudis. However, the overall ASIR of liver cancer was statistically higher in males than females (P value <0.05) and the overall male to female ratio in ASIR of liver cancer in Saudi Arabia was 2.4 per 100,000.  There was a slight increase in the CIRs and ASIRs of liver cancer in Saudi Arabia between 2004 and 2014. Riyadh, Najran, and Tabuk were the areas most affected by liver cancer among Saudi males, and Riyadh, Eastern Region, and Tabuk among female Saudis. The areas least affected by liver cancer were observed in Jazan among Saudi males, and the Northern region and Baha among Saudi females. The rates of liver cancer in Saudi Arabia were significantly higher among males compared with female Saudis.

title: Integrative Analysis of scRNA seq and GWAS Data Pinpoints Periportal Hepatocytes as the Relevant Liver Cell Types for Blood Lipids.
abstract: Liver, a heterogeneous tissue consisting of various cell types, is known to be relevant for blood lipid traits. By integrating summary statistics from genome wide association studies (GWAS) of lipid traits and single cell transcriptome data of the liver, we sought to identify specific cell types in the liver that were most relevant for blood lipid levels. We conducted differential expression analyses for forty cell types from human and mouse livers in order to construct the cell type specifically expressed gene sets, which we refer to as CT SEGS. Under the assumption that CT SEGS represented specific functions of each cell type, we applied stratified linkage disequilibrium score regression (LDSC) to determine which cell types were most relevant for complex traits and diseases. We first confirmed the validity of this method (of delineating functionally relevant cell types) by identifying the immune cell types as relevant for autoimmune diseases. We further showed that lipid GWAS signals were enriched in the human and mouse periportal hepatocytes. Our results provide important information to facilitate future cellular studies of the metabolic mechanism affecting blood lipid levels.

title: The interreader agreement and validation of contrast enhanced ultrasound liver imaging reporting and data system.
abstract: This study explored the interreader agreement and diagnostic performance of contrast enhanced ultrasound liver imaging reporting and data system (CEUS LI RADS) METHODS Between January 2014 and December 2017, 1366 patients at risk for hepatocellular carcinoma (HCC) who underwent CEUS were included in this retrospective study. Four ultrasound physicians rated the HCC likelihood of focal liver lesions (FLLs) using CEUS LI RADS v2017. Interreader agreement on CEUS LI RADS categories and major features (arterial phase hyperenhancement (APHE) washout appearance) were assessed using weighted kappa statistics (k) Diagnostic performance was described by sensitivity, specificity, PPV and NPV, +LR, LR.  The interreader agreement (k) for CEUS LI RADS categories, APHE, and washout appearance ranged from 0.61 to 0.73, 0.65 to 0.83, and 0.58 to 0.71, respectively. Interreader agreement for LI RADS categories and APHE were almost substantial between FLLs <2 cm, =2 cm, <5 cm; interreader agreement for major features were fair to substantial for FLLs =5 cm. The accuracy, PPV and LR for HCC and malignancy in FLLs <2 cm, =2 cm, <5 cm, =5 cm were high, with values of 84.7% to 91.9% 90.2% to 94.2% and 2.2 to 8.0, respectively. CEUS LI RADS had the highest specificity for HCC (90.2% and malignancy (90.9% diagnosis for FLLs <2 cm and <5 cm, respectively; specificity was lowest for HCC (54.7% and malignancy (68.3% diagnosis for FLLs =5 cm.  LI RADS is a good standardized categorization system for high risk patients, and the combination of two or three LR M features may improve the true negative classification of HCC diagnosis.

title: Effect of ultrasound frequency on the Nakagami statistics of human liver tissues
abstract: The analysis of the backscattered statistics using the Nakagami parameter is an emerging ultrasound technique for assessing hepatic steatosis and fibrosis. Previous studies indicated that the echo amplitude distribution of a normal liver follows the Rayleigh distribution (the Nakagami parameter m is close to 1) However, using different frequencies may change the backscattered statistics of normal livers. This study explored the frequency dependence of the backscattered statistics in human livers and then discussed the sources of ultrasound scattering in the liver. A total of 30 healthy participants were enrolled to undergo a standard care ultrasound examination on the liver, which is a natural model containing diffuse and coherent scatterers. The liver of each volunteer was scanned from the right intercostal view to obtain image raw data at different central frequencies ranging from 2 to 3.5 MHz. Phantoms with diffuse scatterers only were also made to perform ultrasound scanning using the same protocol for comparisons with clinical data. The Nakagami parameter frequency correlation was evaluated using Pearson correlation analysis. The median and interquartile range of the Nakagami parameter obtained from livers was 1.00 (0.98 1.05) for 2 MHz, 0.93 (0.89 0.98) for 2.3 MHz, 0.87 (0.84 0.92) for 2.5 MHz, 0.82 (0.77 0.88) for 3.3 MHz, and 0.81 (0.76 0.88) for 3.5 MHz. The Nakagami parameter decreased with the increasing central frequency (r 0.67, p 0.0001) However, the effect of ultrasound frequency on the statistical distribution of the backscattered envelopes was not found in the phantom results (r 0.147, p 0.0727) The current results demonstrated that the backscattered statistics of normal livers is frequency dependent. Moreover, the coherent scatterers may be the primary factor to dominate the frequency dependence of the backscattered statistics in a liver.

title: Chemometric tools for the authentication of cod liver oil based on nuclear magnetic resonance and infrared spectroscopy data
abstract: Cod liver oil is a popular dietary supplement marketed as a rich source of omega 3 fatty acids as well as vitamins A and D. Due to its high market price, cod liver oil is vulnerable to adulteration with lower priced vegetable oils. In this study, 1H and 13C nuclear magnetic resonance spectroscopy, Fourier transform infrared spectroscopy, and gas chromatography (coupled to a flame ionization detector) were used in combination with multivariate statistics to determine cod liver oil adulteration with common vegetable oils (sunflower and canola oils) Artificial neural networks (ANN) were able to differentiate adulteration levels based on infrared spectra with a detection limit of 0.22% and a root mean square error of prediction (RMSEP) of 0.86% ANN models using 1H NMR and 13C NMR data yielded detection limits of 3.0% and 1.8% and RMSEPs of 2.7% and 1.1% respectively. In comparison, the ANN model based on fatty acid profiles determined by gas chromatography achieved a detection limit of 0.81% and an RMSEP of 1.1% The approach of using spectroscopic techniques in combination with multivariate statistics can be regarded as a promising tool for the authentication of cod liver oil and may pave the way for a holistic quality assessment of fish oils.

title: ACR Ultrasound Liver Reporting and Data System: Multicenter Assessment of Clinical Performance at 1 Year.
abstract: The aim of this study was to evaluate the clinical performance of the ACR's Ultrasound Liver Reporting and Data System (US LI RADS(tm) for detecting hepatocellular carcinoma (HCC) in patients at high risk for HCC.  In this retrospective, multicenter study, 2,050 patients at high risk for HCC (1,078 men and 972 women; mean age, 57.7 years) at five sites in the United States had undergone screening liver ultrasound from January 2017 to February 2018, and US LI RADS observation categories and visualization scores were assigned on a clinical basis. Ultrasound reports and patient records were retrospectively reviewed and follow up imaging studies and/or pathologic reports recorded. Descriptive statistics were generated, and multivariate logistic regression analysis was used to analyze the relationship of clinical and reader based predictors of limited visualization. Diagnostic performance data were calculated in the subset of patients with confirmatory testing.  The most common indications for HCC screening were cirrhosis (n 1,054 [51.4% noncirrhotic hepatitis B virus (n 555 [27.1% and noncirrhotic hepatitis C virus (n 234 [11.4% US LI RADS observation categories assigned were US 1 (negative) in 90.4% (n 1,854) US 2 (subthreshold) in 4.6% (n 95) and US 3 (positive) in 4.9% (n 101) Visualization scores were A (no or minimal limitations) in 76.8% (n 1,575) B (moderate limitations) in 18.9% (n 388) and C (severe limitations) in 4.2% (n 87) Confirmatory tests including multiphase contrast enhanced CT or MRI (n 331) or histopathology (n 18) were available for 349 patients (17.0% The sensitivity of US LI RADS in this subset of patients was 82.4% specificity was 74.2% positive predictive value was 35.3% and negative predictive value was 96.1% CONCLUSIONS Approximately 90% of US LI RADS screening examinations were negative, 5% subthreshold, and 5% positive. Visualization scores were diagnostically acceptable in the vast majority >95% of examinations. US LI RADS emphasized sensitivity and negative predictive value, key characteristics of a screening test.

title: Analysis of Data from the Oxygen Persufflation in Liver Transplantation (OPAL) Study to Determine the Role of Factors Affecting the Hepatic Microcirculation and Early Allograft Dysfunction
abstract: Adequate microcirculatory perfusion is essential for the provision of oxygen to the liver following transplantation. Data from the Oxygen Persufflation in Liver Transplantation (OPAL) study (ISRCTN00167887) were analyzed from liver transplants performed at a single center to determine the role of factors affecting the hepatic microcirculation and early allograft dysfunction (EAD)  Retrospective data from 116 patients from the Oxygen Persufflation as Adjunction in Liver Transplantation (OPAL) study who underwent liver transplantation at a single center were analyzed. Oxygen saturation of hemoglobin (SO2) relative capillary hemoglobin concentration (rHb) relative tissue blood flow (rBF) using laser Doppler flow measurements, and the Oxygen to See (O2C) spectrometry were measured and with post transplant allograft function were analyzed using univariate and multivariate logistic regression statistics.  Livers donors had a median donor risk index of 1.8. Most liver transplant recipients were men (60.3% with a median age of 54 years (IQR, 23 68 years) Mean post transplant 3 month survival was 90.5% The EAD rate was 22.4% the median SO2 was 78% (IQR, 29.5 95.8% the median rHb was 55.6 AU (IQR, 16.8 74.8 AU) and the median rBF was 110.1 AU (IQR, 35.8 406.8 AU) Multivariate logistic regression analysis showed that tissue SO2 (p=0.01) body mass index (BMI) of the transplant recipient (p=0.002) serum alanine transaminase (ALT) of the donor (p=0.02) and portal blood flow (p=0.01) were predictive factors for EAD.  Non invasive investigations of the liver microcirculation and hemoglobin oxygenation were shown to be predictive factors for EAD following liver transplantation.

title: Liver Imaging Reporting and Data System: Discordance Between Computed Tomography and Gadoxetate Enhanced Magnetic Resonance Imaging for Detection of Hepatocellular Carcinoma Major Features
abstract: The goal of this study was to compare agreement between computed tomography (CT) and magnetic resonance imaging (MRI) in the evaluation of the major Liver Imaging Reporting and Data System (LI RADS) features used in assessment of hepatocellular carcinoma: arterial phase hyperenhancement (APHE) portal venous phase washout (WO) capsule appearance (capsule) and largest diameter (diameter)  Patients with liver protocol CT and gadoxetate enhanced MRI within 1 month of each other and at least 1 discrete untreated liver lesion were included. Two readers independently reviewed hepatic arterial phase and portal venous phase of each lesion on both CT and MRI, presented at random. The APHE, WO, capsule, and diameter were assessed for each lesion on CT and MRI. The LI RADS category was assigned based on the recorded major features. Interobserver agreements between the readers for both imaging modalities and for each of the major features were assessed using &kgr; statistics. Agreement between CT and MRI for each reader and for each feature was assessed using &kgr; statistics. Agreement was interpreted based on &kgr; as follows: 0.20 or less, slight agreement; 0.21 to 0.40, fair agreement; 0.41 to 0.60, moderate agreement; 0.61 to 0.80, substantial agreement; and 0.81 to 1.00, almost perfect agreement. Intraclass correlation coefficient was used to assess concordance of diameter measurements.  There were 42 patients (mean age, 62.2 7.0 years; 33 men [78.6% with 50 lesions. On CT, the interobserver agreement between the readers was almost perfect for APHE &kgr; 0.85) WO &kgr; 0.83) and capsule &kgr; 0.86) On MRI, the interobserver agreement between the readers was almost perfect for APHE &kgr; 0.86) and WO &kgr; 0.83) and moderate for capsule &kgr; 0.59) Intraclass correlation coefficient for diameter measurement was 0.99 for CT and 0.98 for MRI. For reader 1, the agreement between CT and MRI was fair for APHE &kgr; 0.39) and capsule &kgr; 0.26) and moderate for WO &kgr; 0.49) For reader 2, the agreement between CT and MRI was moderate for APHE &kgr; 0.43) and capsule &kgr; 0.43) and fair &kgr; 0.38) for WO. Agreement between readers for final LI RADS category was substantial for CT &kgr; 0.79) and moderate for MRI &kgr; 0.60) Agreement for final LI RADS categories between MRI and CT was fair for both reader 1 &kgr; 0.33) and reader 2 &kgr; 0.39) Conclusions Interobserver agreement for the major LI RADS features varies from moderate to almost perfect, for both CT and MRI. However, the agreement between CT and MRI for each of the major LI RADS features is poor, ranging from fair to moderate. This poor agreement contributes to substantial differences between final LI RADS category assigned on CT versus MRI.