The general expressions of the average dissipative and dipole forces acting on a A-configuration three-level atom in an arbitrary light field are derived by means of the optical Bloch equations based on the atomic den...The general expressions of the average dissipative and dipole forces acting on a A-configuration three-level atom in an arbitrary light field are derived by means of the optical Bloch equations based on the atomic density matrix elements, and the general properties of the average dissipative and dipole forces on a three-level atom in the linearly-polarized high-order Bessel beams （HBBs） are analysed. We find a resonant property （with two resonant peaks） of the dissipative force and a non-resonant property （with two pairs of non-resonant peaks） of the dipole force on the three-level atom, which are completely different from those on the two-level atom. Meanwhile we find a saturation effect of the average dissipative force in the HBB, which comes from the saturation of the upper-level population. Our study shows that the general expressions of the average dissipative and dipole forces on the three-level atom will be simplified to those of the two-level atom under the approximation of large detuning. Finally, we study the axial and azimuthal Doppler cooling of atoms in ID optical molasses composed of two counter-propagating HBBs and discuss the azimuthal influence of the HBB on the Doppler cooling limit. We also find that the Doppler limit of atoms in the molasses HBB is slightly below the conventional Doppler limit of hГ/（2kB） due to the orbital angular momentum lh of the HBB.展开更多
This article presents illustrations of an extended model of the electron to visualize how it spins and radiates in the external magnetic field. A time-varying magnetic field B produces a rotational induced electric fi...This article presents illustrations of an extended model of the electron to visualize how it spins and radiates in the external magnetic field. A time-varying magnetic field B produces a rotational induced electric field E which rotates (spins) the electron about its axis. In time-constant magnetic field: the electron radiates the cyclotron radiation. In time-varying magnetic field: synchrotron radiation is generated. The couplings between spin, acceleration and radiation will be discussed.展开更多
In this article the electron is conceived as an extended particle, consisting of a negatively charged core (-q<sub>0</sub>) which is surrounded by a cloud of electric dipoles (-q, +q). The article presents...In this article the electron is conceived as an extended particle, consisting of a negatively charged core (-q<sub>0</sub>) which is surrounded by a cloud of electric dipoles (-q, +q). The article presents the illustrations that show how and why the electron spins and radiates in an external electric field. In the appendices, Bremsstrahlung & Cerenkov radiations, and the processes of Emission & Absorption of photons will be discussed.展开更多
AIM: To evaluate cut-off values and performance of acoustic radiation force impulse imaging (ARFI) using transient elastography [FibroScan■ (FS)] as a reference. METHODS: Six hundred and six patients were enrolled in...AIM: To evaluate cut-off values and performance of acoustic radiation force impulse imaging (ARFI) using transient elastography [FibroScan■ (FS)] as a reference. METHODS: Six hundred and six patients were enrolled in this study.All patients underwent liver stiffness measurement with FS (FS-LS) and ARFI (with shear wave velocity quantification; ARFI-SWV) and the performance of ARFI in comparison to FS was determined. Sixtyeight patients underwent liver biopsy. RESULTS: Significantly higher success rates for the determination of liver stiffness were found using ARFI as compared to FS [604/606 (99.7%) vs 482/606 (79.5%); P < 0.001]. ARFI-SWV correlated significantly with FS-LS (r = 0.920, P < 0.001). ARFI-SWV increased significantly with the stage of fibrosis (1.09 ± 0.13 m/s for patients with no significant fibrosis (FS-LS < 7.6 kPa); 1.46 ± 0.27 m/s for patients with significant liver fibrosis (7.6 < FS-LS ≤ 13.0 kPa); and 2.55 ± 0.77 m/s for patients with liver cirrhosis (FS-LS > 13.0 kPa)). ARFI-SWV cut-off values were identified for no significant fibrosis (1.29 m/s; sensitivity 91.4% and specificity 92.6%) and for liver cirrhosis (1.60 m/s; sensitivity 92.3% and specificity 96.5%). The optimal cut-off value for predicting liver fibrosis (F ≥ 2) was 1.32 m/s (sensitivity 87.0% and specificity 80.0%) and for liver cirrhosis (F4) 1.62 m/s (sensitivity 100% and specificity 85.7%), for patients who underwent liver biopsy. An excellent inter-and intraobserver reproducibility was observed for ARFI-SWV determinations. CONCLUSION: An ARFI-SWV cut-off value of 1.29 m/s seems to be optimal for patients with no significant liver fibrosis and 1.60 m/s for patients with liver cirrhosis.展开更多
Infection with hepatitis B virus is an important healthproblem worldwide:it affects more than 350 millionpeople and is a leading cause of liver-related morbidity,accounting for 1 million deaths annually.Hepatic fibros...Infection with hepatitis B virus is an important healthproblem worldwide:it affects more than 350 millionpeople and is a leading cause of liver-related morbidity,accounting for 1 million deaths annually.Hepatic fibrosis is a consequence of the accumulation of extracellular matrix components in the liver.An accurate diagnosis of liver fibrosis is essential for the management of chronic liver disease.Liver biopsy has been considered the gold standard for diagnosing disease,grading necroinflammatory activity,and staging fibrosis.However,liver biopsy is unsuitable for repeated evaluations because it is invasive and can cause major complications,including death.Several noninvasive evaluations have been introduced for the assessment of liver fibrosis:serum biomarkers,combined indices or scores,and imaging techniques including transient elastography,acoustic radiation force impulse,real-time tissue elastography,and magnetic resonance elastography.Here,we review the recent progress of noninvasive assessment of liver fibrosis in patients with chronic hepatitis B.Most noninvasive evaluations for liver fibrosis have been validated first in patients with chronic hepatitis C,and later in those with chronic hepatitis B.The establishment of a noninvasive assessment of liver fibrosis is urgently needed to aid in the management of this leading cause of chronic liver disease.展开更多
AIM:To investigate whether a noninvasive measurement of tissue strain has a potential usefulness for management of nonalcoholic steatohepatitis(NASH).METHODS:In total 26 patients,23 NASHs and 3 normal controls were en...AIM:To investigate whether a noninvasive measurement of tissue strain has a potential usefulness for management of nonalcoholic steatohepatitis(NASH).METHODS:In total 26 patients,23 NASHs and 3 normal controls were enrolled in this study.NASH was staged based on Brunt criterion.At a region of interest(ROI),a shear wave was evoked by implementing an acoustic radiation force impulse(ARFI),and the propagation velocity was quantif ied.RESULTS:Shear wave velocity(SWV) could be reproducibly quantified at all ROIs in all subjects except for 4 NASH cases,in which a reliable SWV value was not calculated at several ROIs.An average SWV of 1.34 ± 0.26 m/s in fibrous stage 0-1 was significantly slower than 2.20 ± 0.74 m/s and 2.90 ± 1.01 m/s in stages 3 and 4,respectively,but was not significantly different from 1.79 ± 0.78 m/s in stage 2.When a cutoff value was set at 1.47 m/s,receiver operating characteristic analysis showed significance to dissociate stages 3 and 4 from stage 0-1(P=0.0092) with sensitivity,specificity and area under curve of 100%,75% and 94.2%,respectively.In addition,the correlation between SWV and hyaluronic acid was significant(P<0.0001),while a tendency toward negative correlation was observed with serum albumin(P=0.053).CONCLUSION:The clinical implementation of ARFI provides noninvasive repeated evaluations of liver stiffness at an arbitrary position,which has the potential to shed new light on NASH management.展开更多
Chronic hepatitis B(CHB)infection is a major public health problem associated with significant morbidity and mortality worldwide.Twenty-three percent of patients with CHB progress naturally to liver cirrhosis,which wa...Chronic hepatitis B(CHB)infection is a major public health problem associated with significant morbidity and mortality worldwide.Twenty-three percent of patients with CHB progress naturally to liver cirrhosis,which was earlier thought to be irreversible.However,it is now known that cirrhosis can in fact be reversed by treatment with oral anti-nucleotide drugs.Thus,early and accurate diagnosis of cirrhosis is important to allow an appropriate treatment strategy to be chosen and to predict the prognosis of patients with CHB.Liver biopsy is the reference standard for assessment of liver fibrosis.However,the method is invasive,and is associated with pain and complications that can be fatal.In addition,intra-and inter-observer variability compromises the accuracy of liver biopsy data.Only small tissue samples are obtained and fibrosis is heterogeneous in such samples.This confounds the two types of observer variability mentioned above.Such limitations have encouraged development of non-invasive methods for assessment of fibrosis.These include measurements of serum biomarkers of fibrosis;and assessment of liver stiffness via transient elastography,acoustic radiation force impulse imaging,real-time elastography,or magnetic resonance elastography.Although significant advances have been made,most work to date has addressed the diagnostic utility of these techniques in the context of cirrhosis caused by chronic hepatitis C infection.In the present review,we examine the advantages afforded by use of non-invasive methods to diagnose cirrhosis in patients with CHB infections and the utility of such methods in clinical practice.展开更多
AIM: To investigate the combined diagnostic accuracy of acoustic radiation force impulse(ARFI), aspartate aminotransferase to platelet ratio index(APRI) and Forns index for a non-invasive assessment of liver fibrosis ...AIM: To investigate the combined diagnostic accuracy of acoustic radiation force impulse(ARFI), aspartate aminotransferase to platelet ratio index(APRI) and Forns index for a non-invasive assessment of liver fibrosis in patients with chronic hepatitis B(CHB). METHODS: In this prospective study, 206 patients had CHB with liver fibrosis stages F0-F4 classified by METAVIR and 40 were healthy volunteers were measured by ARFI, APRI and Forns index separately or combined as indicated. RESULTS: ARFI, APRI or Forns index demonstrated a significant correlation with the histological stage(all P < 0.001). According to the AUROC of ARFI and APRI for evaluating fibrotic stages more than F2, ARFI showed an enhanced diagnostic accuracy than APRI(P < 0.05). The combined measurement of ARFI and APRI exhibited better accuracy than ARFI alone when evaluating ≥ F2 fibrotic stage(Z = 2.77, P = 0.006). Combination of ARFI, APRI and Forns index did not obviously improve the diagnostic accuracy compared to the combination of ARFI and APRI(Z = 0.958, P = 0.338). CONCLUSION: ARFI + APRI showed enhanced diagnostic accuracy than ARFI or APRI alone for significant liver fibrosis and ARFI + APRI + Forns index shows the same effect with ARFI + APRI.展开更多
AIM: To explore the value of liver fibrosis assessment by acoustic radiation force impulse (ARFI) and the AST/PLT ratio index (APRI) in chronic hepatitis C patients.
Progressive hepatic fibrosis can lead to cirrhosis,so its early detection is fundamental.Staging fibrosis is also critical for prognosis and management.The gold standard for these aims is liver biopsy,but it has sever...Progressive hepatic fibrosis can lead to cirrhosis,so its early detection is fundamental.Staging fibrosis is also critical for prognosis and management.The gold standard for these aims is liver biopsy,but it has several drawbacks,as it is invasive,expensive,has poor acceptance,is prone to inter observer variability and sampling errors,has poor repeatability,and has a risk of complications and mortality.Therefore,non-invasive imaging tests have been developed.This review mainly focuses on the role of transient elastography,acoustic radiation force impulse imaging,and magnetic resonance-based methods for the noninvasive diagnosis of cirrhosis.展开更多
AIM:To find out if by combining 2 ultrasound based elastographic methods:acoustic radiation force impulse(ARFI)elastography and transient elastography(TE),we can improve the prediction of fibrosis in patients with chr...AIM:To find out if by combining 2 ultrasound based elastographic methods:acoustic radiation force impulse(ARFI)elastography and transient elastography(TE),we can improve the prediction of fibrosis in patients with chronic hepatitis C.METHODS:Our study included 197 patients with chronic hepatitis C.In each patient,we performed,in the same session,liver stiffness(LS)measurements by means of TE and ARFI,respectively,and liver biopsy(LB),assessed according to the Metavir score.10 LS measurements were performed both by TE and ARFI;median values were calculated and expressed in kilopascals(kPa)and meters/second(m/s),respectively.Only TE and ARFI measurements with IQR<30%andSR≥60%were considered reliable.RESULTS:On LB 13(6.6%)patients had F0,32(16.2%) had F1,52(26.4%)had F2,47(23.9%)had F3,and 53(26.9%)had F4.A direct,strong correlation was found between TE measurements and fibrosis(r=0.741),between ARFI and fibrosis(r=0.730)and also between TE and ARFI(r=0.675).For predicting significant fibrosis(F≥2),for a cutoff of 6.7 kPa,TE had 77.5% sensitivity(Se)and 86.5%specificity(Sp)[area under the receiver operating characteristic curve(AUROC)0.87] and for a cutoff of 1.2 m/s,ARFI had 76.9%Se and 86.7%Sp(AUROC 0.84).For predicting cirrhosis(F=4),for a cutoff of 12.2 kPa,TE had 96.2%Se and 89.6% Sp(AUROC 0.97)and for a cutoff of 1.8 m/s,ARFI had 90.4%Se and 85.6%Sp(AUROC 0.91).When both elastographic methods were taken into consideration,for predicting significant fibrosis(F≥2),(TE≥6.7 kPa and ARFI≥1.2 m/s)we obtained 60.5%Se,93.3% Sp,96.8%positive predictive value(PPV),41.4%negative predictive value(NPV)and 68%accuracy,while for predicting cirrhosis(TE≥12.2 kPa and ARFI≥1.8 m/s) we obtained 84.9%Se,94.4%Sp,84.9%PPV,94.4% NPV and 91.8%accuracy.CONCLUSION:TE used in combination with ARFI is highly specific for predicting significant fibrosis;therefore when the two methods are concordant,liver biopsy can be avoided.展开更多
AIM: To assess whether acoustic radiation force impulse (ARFI) elastography can differentiate normal from pathological thyroid parenchyma. METHODS: We evaluated 136 subjects (mean age 45.8 ± 15.6 years, 106 women...AIM: To assess whether acoustic radiation force impulse (ARFI) elastography can differentiate normal from pathological thyroid parenchyma. METHODS: We evaluated 136 subjects (mean age 45.8 ± 15.6 years, 106 women and 30 men): 44 (32.3%) without thyroid pathology, 48 (35.3%) with Basedow-Graves’ disease (GD), 37 (27.2%) with chronic autoimmune thyroiditis (CAT; diagnosed by specific tests), 4 (2.9%) with diffuse thyroid goiter and 3 (2.2%) cases with thyroid pathology induced by amiodarone. In all patients, 10 elastographic measurements were made in the right thyroid lobe and 10 in the left thyroid lobe, using a 1-4.5 MHZ convex probe and a 4-9 MHz linear probe, respectively. Median values were calculated for thyroid stiffness and expressed in meters/second (m/s). RESULTS: Thyroid stiffness (TS) assessed by means of ARFI in healthy subjects (2 ± 0.40 m/s) was significantly lower than in GD (2.67 ± 0.53 m/s) (P < 0.0001) and CAT patients (2.43 ± 0.58 m/s) (P = 0.0002), but the differences were not significant between GD vs CAT patients (P = 0.053). The optimal cut-off value for the prediction of diffuse thyroid pathology was 2.36 m/s. For this cut-off value, TS had 62.5% sensitivity, 79.5% specificity, 87.6% predictive positive value, 55.5% negative predictive value and 72.7% accuracy for the presence of diffuse thyroid gland pathology (AUROC = 0.804). There were no significant differences between the TS values obtained with linear vs convex probes and when 5 vs 10 measurements were taken in each lobe (median values). CONCLUSION: ARFI seems to be a useful method for the assessment of diffuse thyroid gland pathology.展开更多
Elastographic techniques are new ultrasound-based imaging techniques developed to estimate tissue deformability/stiffness. Several ultrasound elastographic approaches have been developed, such as static elastography, ...Elastographic techniques are new ultrasound-based imaging techniques developed to estimate tissue deformability/stiffness. Several ultrasound elastographic approaches have been developed, such as static elastography, transient elastography and acoustic radiation force imaging methods, which include point shear wave and shear wave imaging elastography. The application of these methods in clinical practice aims at estimating the mechanical tissues properties. One of the main settings for the application of these tools has been liver stiffness assessment in chronic liver disease, which has been studied mainly using transient elastography. Another field of application for these techniques is the assessment of focal lesions, detected by ultrasound in organs such as pancreas, prostate, breast, thyroid, lymph nodes. Considering the frequency and importance of the detection of focal liver lesions through routine ultrasound, some studies have also aimed to assess the role that elestography can play in studying the stiffness of different types of liver lesions, in order to predict their nature and thus offer valuable non-invasive methods for the diagnosis of liver masses.展开更多
BACKGROUND: Acoustic radiation force impulse (ARFI) imaging is a new elastography method for the evaluation of tissue stiffness. This study aims to evaluate the performance of ARFI in noninvasive assessment of the tis...BACKGROUND: Acoustic radiation force impulse (ARFI) imaging is a new elastography method for the evaluation of tissue stiffness. This study aims to evaluate the performance of ARFI in noninvasive assessment of the tissue stiffness of focal liver lesion (FLL) and to explore its potential value in the differential diagnosis of FLL. METHODS: ARFI was performed in 140 patients with 154 FLLs, which included 28 hemangiomas (ANGIs), 14 focal nodular hyperplasias (FNHs), 61 hepatocellular carcinomas (HCCs), 39 metastases and 12 cholangiocellular carcinomas (CCCs). Virtual touch tissue quantification (VTTQ) values were obtained, analyzed and compared. The area under the receiver operating characteristic curve (AUROC) and optimal cut-off values were obtained using a receiver operating characteristic (ROC) curve analysis to assess diagnostic performance. All cases were definitively diagnosed using histopathology, CT, MRI or contrast-enhanced ultrasound. RESULTS: The VTTQ median values of ANGI, FNH, HCC metastasis and CCC were 1.30, 1.80, 2.52, 3.08 and 3.89 m/s respectively. A significant increase in the VTTQ values of different lesions was observed: ANGI【FNH【HCC【metastasis 【CCC (P【0.001). The AUROC (95% CI) of VTTQ values was 0.94 (0.90-0.98) for ANGI, 0.91 (0.87-0.96) for malignant lesions and 0.87 (0.79-0.94) for CCC. The sensitivity and specificity for ANGI (86.5%, 89.3%, respectively), malignancy (81.3% 92.9%, respectively), and CCC (91.7%, 72.5%, respectively) were associated with VTTQ cut-off values of 1.76, 2.22 and 3.00 m/s respectively.CONCLUSIONS: ARFI can accurately and objectively assess the elasticity of lesions by obtaining the shear wave elastic value of FLL with VTTQ. Therefore, ARFI is a novel, simple, noninvasive and useful diagnostic method for the characterization of FLL.展开更多
AIM: To evaluate the assessment of primary biliary cirrhosis degree by acoustic radiation force impulse imaging (ARFI) and hepatic fibrosis indicators. METHODS: One hundred and twenty patients who developed liver cirr...AIM: To evaluate the assessment of primary biliary cirrhosis degree by acoustic radiation force impulse imaging (ARFI) and hepatic fibrosis indicators. METHODS: One hundred and twenty patients who developed liver cirrhosis secondary to primary biliary cirrhosis were selected as the observation group, with the degree of patient liver cirrhosis graded by Child-Pugh (CP) score. Sixty healthy individuals were selected as the control group. The four indicators of hepatic fibrosis were detected in all research objects, including hyaluronic acid (HA), laminin (LN), type III collagen (PC III), and type IV collagen (IV-C). The liver parenchyma hardness value (LS) was then measured by ARFI technique. LS and the four indicators of liver fibrosis (HA, LN, PC III, and IV-C) were observed in different grade CP scores. The diagnostic value of LS and the four indicators of liver fibrosis in determining liver cirrhosis degree with PBC, whether used alone or in combination, were analyzed by receiver operating characteristic (ROC) curve. RESULTS: LS and the four indicators of liver fibrosis within the three classes (A, B, and C) of CP scores in the observation group were higher than in the control group, with C class > B class > A class; the differences were statistically significant (P < 0.01). Although AUC values of LS within the three classes of CP scores were higher than in the four indicators of liver fibrosis, sensitivity and specificity were unstable. The ROC curves of LS combined with the four indicators of liver fibrosis revealed that: AUC and sensitivity in all indicators combined in the A class of CP score were higher than in LS alone, albeit with slightly decreased specificity; AUC and specificity in all indicators combined in the B class of CP score were higher than in LS alone, with unchanged sensitivity; AUC values (0.967), sensitivity (97.4%), and specificity (90%) of all indicators combined in the C class of CP score were higher than in LS alone (0.936, 92.1%, 83.3%). CONCLUSION: The diagnostic value of PBC cirrhosis degree in liver cirrhosis degree assessment by ARFI combined with the four indicators of serum liver fibrosis is of satisfactory effectiveness and has important clinical application value.展开更多
Progressive fibrosis is encountered in almost all chronicliver diseases. Its clinical signs are diagnostic in advanced cirrhosis, but compensated liver cirrhosis is harder to diagnose. Liver biopsy is still considered...Progressive fibrosis is encountered in almost all chronicliver diseases. Its clinical signs are diagnostic in advanced cirrhosis, but compensated liver cirrhosis is harder to diagnose. Liver biopsy is still considered the reference method for staging the severity of fibrosis, but due to its drawbacks(inter and intra-observer variability, sampling errors, unequal distribution of fibrosis in the liver, and risk of complications and even death), non-invasive methods were developed to assess fibrosis(serologic and elastographic). Elastographic methods can be ultrasound-based or magnetic resonance imaging-based. All ultrasoundbased elastographic methods are valuable for the early diagnosis of cirrhosis, especially transient elastography(TE) and acoustic radiation force impulse(ARFI) elastography, which have similar sensitivities and specificities, although ARFI has better feasibility. TE is a promising method for predicting portal hypertension in cirrhotic patients, but it cannot replace upper digestive endoscopy. The diagnostic accuracy of using ARFI in the liver to predict portal hypertension in cirrhotic patients is debatable, with controversial results in published studies. The accuracy of ARFI elastography may be significantly increased if spleen stiffness is assessed, either alone or in combination with liver stiffness and other parameters. Two-dimensional shearwave elastography, the Elast PQ technique and strain elastography all need to be evaluated as predictors of portal hypertension.展开更多
A modified Monte Carlo model of speckle tracking of shear wave propagation in scattering media is proposed. The established Monte Carlo model mainly concerns the variations of optical electric field and speckle. The t...A modified Monte Carlo model of speckle tracking of shear wave propagation in scattering media is proposed. The established Monte Carlo model mainly concerns the variations of optical electric field and speckle. The two- dimensional intensity distribution and the time evolution of speckles in different probe locations are obtained. The fluctuation of speckle intensity tracks the acoustic-radiation-force shear wave propagation, and especially the reduction of speckle intensity implies attenuation of shear wave. Then, the shear wave velocity is estimated quantitatively on the basis of the time-to-peak algorithm and linear regression processing. The results reveal that a smaller sampling interval yields higher estimation precision and the shear wave velocity is estimated more efficiently by using speckle intensity difference than by using speckle contrast difference according to the estimation error. Hence, the shear wave velocity is estimated to be 2.25 m/s with relatively high accuracy for the estimation error reaches the minimum （0.071）.展开更多
Shell structures have increasingly widespread applications in biomedical ultrasound fields such as contrast agents and drug delivery,which requires the precise prediction of the acoustic radiation force under various ...Shell structures have increasingly widespread applications in biomedical ultrasound fields such as contrast agents and drug delivery,which requires the precise prediction of the acoustic radiation force under various circumstances to improve the system efficiency.The acoustic radiation force exerted by a zero-order quasi-Bessel-Gauss beam on an elastic spherical shell near an impedance boundary is theoretically and numerically studied in this study.By means of the finite series method and the image theory,a zero-order quasi-Bessel-Gauss beam is expanded in terms of spherical harmonic functions,and the exact solution of the acoustic radiation force is derived based on the acoustic scattering theory.The acoustic radiation force function,which represents the radiation force per unit energy density and per unit cross-sectional surface,is especially investigated.Some simulated results for a polymethyl methacrylate shell and an aluminum shell are provided to illustrate the behavior of acoustic radiation force in this case.The simulated results show the oscillatory property and the negative radiation force caused by the impedance boundary.An appropriate relative thickness of the shell can generate sharp peaks for a polymethyl methacrylate shell.Strong radiation force can be obtained at small half-cone angles and the beam waist only affects the results at high frequencies.Considering that the quasi-Bessel-Gauss beam possesses both the energy focusing property and the non-diffracting advantage,this study is expected to be useful in the development of acoustic tweezers,contrast agent micro-shells,and drug delivery applications.展开更多
BACKGROUND Acoustic radiation force impulse(ARFI)is used to measure liver fibrosis and predict outcomes.The performance of elastography in assessment of fibrosis is poorer in hepatitis B virus(HBV)than in other etiolo...BACKGROUND Acoustic radiation force impulse(ARFI)is used to measure liver fibrosis and predict outcomes.The performance of elastography in assessment of fibrosis is poorer in hepatitis B virus(HBV)than in other etiologies of chronic liver disease.AIM To evaluate the performance of ARFI in long-term outcome prediction among different etiologies of chronic liver disease.METHODS Consecutive patients who received an ARFI study between 2011 and 2018 were enrolled.After excluding dual infection,alcoholism,autoimmune hepatitis,and others with incomplete data,this retrospective cohort were divided into hepatitis B(HBV,n=1064),hepatitis C(HCV,n=507),and non-HBV,non-HCV(NBNC,n=391)groups.The indexed cases were linked to cancer registration(1987-2020)and national mortality databases.The differences in morbidity and mortality among the groups were analyzed.RESULTS At the enrollment,the HBV group showed more males(77.5%),a higher prevalence of prediagnosed hepatocellular carcinoma(HCC),and a lower prevalence of comorbidities than the other groups(P<0.001).The HCV group was older and had a lower platelet count and higher ARFI score than the other groups(P<0.001).The NBNC group showed a higher body mass index and platelet count,a higher prevalence of pre-diagnosed non-HCC cancers(P<0.001),especially breast cancer,and a lower prevalence of cirrhosis.Male gender,ARFI score,and HBV were independent predictors of HCC.The 5-year risk of HCC was 5.9%and 9.8%for those ARFI-graded with severe fibrosis and cirrhosis.ARFI alone had an area under the receiver operating characteristic curve(AUROC)of 0.742 for prediction of HCC in 5 years.AUROC increased to 0.828 after adding etiology,gender,age,and platelet score.No difference was found in mortality rate among the groups.CONCLUSION The HBV group showed a higher prevalence of HCC but lower comorbidity that made mortality similar among the groups.Those patients with ARFI-graded severe fibrosis or cirrhosis should receive regular surveillance.展开更多
基金supported by the National Natural Science Foundation of China (Grant Nos 10434060 and 10674047)the Natural Science Foundation of the Jiangsu Higher Institutions of China (Grant No 06KJB510020)the Natural Science Foundation of Jiangsu University of China (Grant No 07JDG027)
文摘The general expressions of the average dissipative and dipole forces acting on a A-configuration three-level atom in an arbitrary light field are derived by means of the optical Bloch equations based on the atomic density matrix elements, and the general properties of the average dissipative and dipole forces on a three-level atom in the linearly-polarized high-order Bessel beams （HBBs） are analysed. We find a resonant property （with two resonant peaks） of the dissipative force and a non-resonant property （with two pairs of non-resonant peaks） of the dipole force on the three-level atom, which are completely different from those on the two-level atom. Meanwhile we find a saturation effect of the average dissipative force in the HBB, which comes from the saturation of the upper-level population. Our study shows that the general expressions of the average dissipative and dipole forces on the three-level atom will be simplified to those of the two-level atom under the approximation of large detuning. Finally, we study the axial and azimuthal Doppler cooling of atoms in ID optical molasses composed of two counter-propagating HBBs and discuss the azimuthal influence of the HBB on the Doppler cooling limit. We also find that the Doppler limit of atoms in the molasses HBB is slightly below the conventional Doppler limit of hГ/（2kB） due to the orbital angular momentum lh of the HBB.
文摘This article presents illustrations of an extended model of the electron to visualize how it spins and radiates in the external magnetic field. A time-varying magnetic field B produces a rotational induced electric field E which rotates (spins) the electron about its axis. In time-constant magnetic field: the electron radiates the cyclotron radiation. In time-varying magnetic field: synchrotron radiation is generated. The couplings between spin, acceleration and radiation will be discussed.
文摘In this article the electron is conceived as an extended particle, consisting of a negatively charged core (-q<sub>0</sub>) which is surrounded by a cloud of electric dipoles (-q, +q). The article presents the illustrations that show how and why the electron spins and radiates in an external electric field. In the appendices, Bremsstrahlung & Cerenkov radiations, and the processes of Emission & Absorption of photons will be discussed.
文摘AIM: To evaluate cut-off values and performance of acoustic radiation force impulse imaging (ARFI) using transient elastography [FibroScan■ (FS)] as a reference. METHODS: Six hundred and six patients were enrolled in this study.All patients underwent liver stiffness measurement with FS (FS-LS) and ARFI (with shear wave velocity quantification; ARFI-SWV) and the performance of ARFI in comparison to FS was determined. Sixtyeight patients underwent liver biopsy. RESULTS: Significantly higher success rates for the determination of liver stiffness were found using ARFI as compared to FS [604/606 (99.7%) vs 482/606 (79.5%); P < 0.001]. ARFI-SWV correlated significantly with FS-LS (r = 0.920, P < 0.001). ARFI-SWV increased significantly with the stage of fibrosis (1.09 ± 0.13 m/s for patients with no significant fibrosis (FS-LS < 7.6 kPa); 1.46 ± 0.27 m/s for patients with significant liver fibrosis (7.6 < FS-LS ≤ 13.0 kPa); and 2.55 ± 0.77 m/s for patients with liver cirrhosis (FS-LS > 13.0 kPa)). ARFI-SWV cut-off values were identified for no significant fibrosis (1.29 m/s; sensitivity 91.4% and specificity 92.6%) and for liver cirrhosis (1.60 m/s; sensitivity 92.3% and specificity 96.5%). The optimal cut-off value for predicting liver fibrosis (F ≥ 2) was 1.32 m/s (sensitivity 87.0% and specificity 80.0%) and for liver cirrhosis (F4) 1.62 m/s (sensitivity 100% and specificity 85.7%), for patients who underwent liver biopsy. An excellent inter-and intraobserver reproducibility was observed for ARFI-SWV determinations. CONCLUSION: An ARFI-SWV cut-off value of 1.29 m/s seems to be optimal for patients with no significant liver fibrosis and 1.60 m/s for patients with liver cirrhosis.
文摘Infection with hepatitis B virus is an important healthproblem worldwide:it affects more than 350 millionpeople and is a leading cause of liver-related morbidity,accounting for 1 million deaths annually.Hepatic fibrosis is a consequence of the accumulation of extracellular matrix components in the liver.An accurate diagnosis of liver fibrosis is essential for the management of chronic liver disease.Liver biopsy has been considered the gold standard for diagnosing disease,grading necroinflammatory activity,and staging fibrosis.However,liver biopsy is unsuitable for repeated evaluations because it is invasive and can cause major complications,including death.Several noninvasive evaluations have been introduced for the assessment of liver fibrosis:serum biomarkers,combined indices or scores,and imaging techniques including transient elastography,acoustic radiation force impulse,real-time tissue elastography,and magnetic resonance elastography.Here,we review the recent progress of noninvasive assessment of liver fibrosis in patients with chronic hepatitis B.Most noninvasive evaluations for liver fibrosis have been validated first in patients with chronic hepatitis C,and later in those with chronic hepatitis B.The establishment of a noninvasive assessment of liver fibrosis is urgently needed to aid in the management of this leading cause of chronic liver disease.
文摘AIM:To investigate whether a noninvasive measurement of tissue strain has a potential usefulness for management of nonalcoholic steatohepatitis(NASH).METHODS:In total 26 patients,23 NASHs and 3 normal controls were enrolled in this study.NASH was staged based on Brunt criterion.At a region of interest(ROI),a shear wave was evoked by implementing an acoustic radiation force impulse(ARFI),and the propagation velocity was quantif ied.RESULTS:Shear wave velocity(SWV) could be reproducibly quantified at all ROIs in all subjects except for 4 NASH cases,in which a reliable SWV value was not calculated at several ROIs.An average SWV of 1.34 ± 0.26 m/s in fibrous stage 0-1 was significantly slower than 2.20 ± 0.74 m/s and 2.90 ± 1.01 m/s in stages 3 and 4,respectively,but was not significantly different from 1.79 ± 0.78 m/s in stage 2.When a cutoff value was set at 1.47 m/s,receiver operating characteristic analysis showed significance to dissociate stages 3 and 4 from stage 0-1(P=0.0092) with sensitivity,specificity and area under curve of 100%,75% and 94.2%,respectively.In addition,the correlation between SWV and hyaluronic acid was significant(P<0.0001),while a tendency toward negative correlation was observed with serum albumin(P=0.053).CONCLUSION:The clinical implementation of ARFI provides noninvasive repeated evaluations of liver stiffness at an arbitrary position,which has the potential to shed new light on NASH management.
基金Supported by A grant of the South Korea Healthcare technology R and D projectMinistry of Health and Welfare+1 种基金South KoreaNo.HI10C2020
文摘Chronic hepatitis B(CHB)infection is a major public health problem associated with significant morbidity and mortality worldwide.Twenty-three percent of patients with CHB progress naturally to liver cirrhosis,which was earlier thought to be irreversible.However,it is now known that cirrhosis can in fact be reversed by treatment with oral anti-nucleotide drugs.Thus,early and accurate diagnosis of cirrhosis is important to allow an appropriate treatment strategy to be chosen and to predict the prognosis of patients with CHB.Liver biopsy is the reference standard for assessment of liver fibrosis.However,the method is invasive,and is associated with pain and complications that can be fatal.In addition,intra-and inter-observer variability compromises the accuracy of liver biopsy data.Only small tissue samples are obtained and fibrosis is heterogeneous in such samples.This confounds the two types of observer variability mentioned above.Such limitations have encouraged development of non-invasive methods for assessment of fibrosis.These include measurements of serum biomarkers of fibrosis;and assessment of liver stiffness via transient elastography,acoustic radiation force impulse imaging,real-time elastography,or magnetic resonance elastography.Although significant advances have been made,most work to date has addressed the diagnostic utility of these techniques in the context of cirrhosis caused by chronic hepatitis C infection.In the present review,we examine the advantages afforded by use of non-invasive methods to diagnose cirrhosis in patients with CHB infections and the utility of such methods in clinical practice.
基金Shenzhen Municipal Science and Technology Innovation Fund,Nos.CXZZ20130322170220544 and JCYJ20140411112047885
文摘AIM: To investigate the combined diagnostic accuracy of acoustic radiation force impulse(ARFI), aspartate aminotransferase to platelet ratio index(APRI) and Forns index for a non-invasive assessment of liver fibrosis in patients with chronic hepatitis B(CHB). METHODS: In this prospective study, 206 patients had CHB with liver fibrosis stages F0-F4 classified by METAVIR and 40 were healthy volunteers were measured by ARFI, APRI and Forns index separately or combined as indicated. RESULTS: ARFI, APRI or Forns index demonstrated a significant correlation with the histological stage(all P < 0.001). According to the AUROC of ARFI and APRI for evaluating fibrotic stages more than F2, ARFI showed an enhanced diagnostic accuracy than APRI(P < 0.05). The combined measurement of ARFI and APRI exhibited better accuracy than ARFI alone when evaluating ≥ F2 fibrotic stage(Z = 2.77, P = 0.006). Combination of ARFI, APRI and Forns index did not obviously improve the diagnostic accuracy compared to the combination of ARFI and APRI(Z = 0.958, P = 0.338). CONCLUSION: ARFI + APRI showed enhanced diagnostic accuracy than ARFI or APRI alone for significant liver fibrosis and ARFI + APRI + Forns index shows the same effect with ARFI + APRI.
文摘AIM: To explore the value of liver fibrosis assessment by acoustic radiation force impulse (ARFI) and the AST/PLT ratio index (APRI) in chronic hepatitis C patients.
文摘Progressive hepatic fibrosis can lead to cirrhosis,so its early detection is fundamental.Staging fibrosis is also critical for prognosis and management.The gold standard for these aims is liver biopsy,but it has several drawbacks,as it is invasive,expensive,has poor acceptance,is prone to inter observer variability and sampling errors,has poor repeatability,and has a risk of complications and mortality.Therefore,non-invasive imaging tests have been developed.This review mainly focuses on the role of transient elastography,acoustic radiation force impulse imaging,and magnetic resonance-based methods for the noninvasive diagnosis of cirrhosis.
文摘AIM:To find out if by combining 2 ultrasound based elastographic methods:acoustic radiation force impulse(ARFI)elastography and transient elastography(TE),we can improve the prediction of fibrosis in patients with chronic hepatitis C.METHODS:Our study included 197 patients with chronic hepatitis C.In each patient,we performed,in the same session,liver stiffness(LS)measurements by means of TE and ARFI,respectively,and liver biopsy(LB),assessed according to the Metavir score.10 LS measurements were performed both by TE and ARFI;median values were calculated and expressed in kilopascals(kPa)and meters/second(m/s),respectively.Only TE and ARFI measurements with IQR<30%andSR≥60%were considered reliable.RESULTS:On LB 13(6.6%)patients had F0,32(16.2%) had F1,52(26.4%)had F2,47(23.9%)had F3,and 53(26.9%)had F4.A direct,strong correlation was found between TE measurements and fibrosis(r=0.741),between ARFI and fibrosis(r=0.730)and also between TE and ARFI(r=0.675).For predicting significant fibrosis(F≥2),for a cutoff of 6.7 kPa,TE had 77.5% sensitivity(Se)and 86.5%specificity(Sp)[area under the receiver operating characteristic curve(AUROC)0.87] and for a cutoff of 1.2 m/s,ARFI had 76.9%Se and 86.7%Sp(AUROC 0.84).For predicting cirrhosis(F=4),for a cutoff of 12.2 kPa,TE had 96.2%Se and 89.6% Sp(AUROC 0.97)and for a cutoff of 1.8 m/s,ARFI had 90.4%Se and 85.6%Sp(AUROC 0.91).When both elastographic methods were taken into consideration,for predicting significant fibrosis(F≥2),(TE≥6.7 kPa and ARFI≥1.2 m/s)we obtained 60.5%Se,93.3% Sp,96.8%positive predictive value(PPV),41.4%negative predictive value(NPV)and 68%accuracy,while for predicting cirrhosis(TE≥12.2 kPa and ARFI≥1.8 m/s) we obtained 84.9%Se,94.4%Sp,84.9%PPV,94.4% NPV and 91.8%accuracy.CONCLUSION:TE used in combination with ARFI is highly specific for predicting significant fibrosis;therefore when the two methods are concordant,liver biopsy can be avoided.
文摘AIM: To assess whether acoustic radiation force impulse (ARFI) elastography can differentiate normal from pathological thyroid parenchyma. METHODS: We evaluated 136 subjects (mean age 45.8 ± 15.6 years, 106 women and 30 men): 44 (32.3%) without thyroid pathology, 48 (35.3%) with Basedow-Graves’ disease (GD), 37 (27.2%) with chronic autoimmune thyroiditis (CAT; diagnosed by specific tests), 4 (2.9%) with diffuse thyroid goiter and 3 (2.2%) cases with thyroid pathology induced by amiodarone. In all patients, 10 elastographic measurements were made in the right thyroid lobe and 10 in the left thyroid lobe, using a 1-4.5 MHZ convex probe and a 4-9 MHz linear probe, respectively. Median values were calculated for thyroid stiffness and expressed in meters/second (m/s). RESULTS: Thyroid stiffness (TS) assessed by means of ARFI in healthy subjects (2 ± 0.40 m/s) was significantly lower than in GD (2.67 ± 0.53 m/s) (P < 0.0001) and CAT patients (2.43 ± 0.58 m/s) (P = 0.0002), but the differences were not significant between GD vs CAT patients (P = 0.053). The optimal cut-off value for the prediction of diffuse thyroid pathology was 2.36 m/s. For this cut-off value, TS had 62.5% sensitivity, 79.5% specificity, 87.6% predictive positive value, 55.5% negative predictive value and 72.7% accuracy for the presence of diffuse thyroid gland pathology (AUROC = 0.804). There were no significant differences between the TS values obtained with linear vs convex probes and when 5 vs 10 measurements were taken in each lobe (median values). CONCLUSION: ARFI seems to be a useful method for the assessment of diffuse thyroid gland pathology.
文摘Elastographic techniques are new ultrasound-based imaging techniques developed to estimate tissue deformability/stiffness. Several ultrasound elastographic approaches have been developed, such as static elastography, transient elastography and acoustic radiation force imaging methods, which include point shear wave and shear wave imaging elastography. The application of these methods in clinical practice aims at estimating the mechanical tissues properties. One of the main settings for the application of these tools has been liver stiffness assessment in chronic liver disease, which has been studied mainly using transient elastography. Another field of application for these techniques is the assessment of focal lesions, detected by ultrasound in organs such as pancreas, prostate, breast, thyroid, lymph nodes. Considering the frequency and importance of the detection of focal liver lesions through routine ultrasound, some studies have also aimed to assess the role that elestography can play in studying the stiffness of different types of liver lesions, in order to predict their nature and thus offer valuable non-invasive methods for the diagnosis of liver masses.
文摘BACKGROUND: Acoustic radiation force impulse (ARFI) imaging is a new elastography method for the evaluation of tissue stiffness. This study aims to evaluate the performance of ARFI in noninvasive assessment of the tissue stiffness of focal liver lesion (FLL) and to explore its potential value in the differential diagnosis of FLL. METHODS: ARFI was performed in 140 patients with 154 FLLs, which included 28 hemangiomas (ANGIs), 14 focal nodular hyperplasias (FNHs), 61 hepatocellular carcinomas (HCCs), 39 metastases and 12 cholangiocellular carcinomas (CCCs). Virtual touch tissue quantification (VTTQ) values were obtained, analyzed and compared. The area under the receiver operating characteristic curve (AUROC) and optimal cut-off values were obtained using a receiver operating characteristic (ROC) curve analysis to assess diagnostic performance. All cases were definitively diagnosed using histopathology, CT, MRI or contrast-enhanced ultrasound. RESULTS: The VTTQ median values of ANGI, FNH, HCC metastasis and CCC were 1.30, 1.80, 2.52, 3.08 and 3.89 m/s respectively. A significant increase in the VTTQ values of different lesions was observed: ANGI【FNH【HCC【metastasis 【CCC (P【0.001). The AUROC (95% CI) of VTTQ values was 0.94 (0.90-0.98) for ANGI, 0.91 (0.87-0.96) for malignant lesions and 0.87 (0.79-0.94) for CCC. The sensitivity and specificity for ANGI (86.5%, 89.3%, respectively), malignancy (81.3% 92.9%, respectively), and CCC (91.7%, 72.5%, respectively) were associated with VTTQ cut-off values of 1.76, 2.22 and 3.00 m/s respectively.CONCLUSIONS: ARFI can accurately and objectively assess the elasticity of lesions by obtaining the shear wave elastic value of FLL with VTTQ. Therefore, ARFI is a novel, simple, noninvasive and useful diagnostic method for the characterization of FLL.
文摘AIM: To evaluate the assessment of primary biliary cirrhosis degree by acoustic radiation force impulse imaging (ARFI) and hepatic fibrosis indicators. METHODS: One hundred and twenty patients who developed liver cirrhosis secondary to primary biliary cirrhosis were selected as the observation group, with the degree of patient liver cirrhosis graded by Child-Pugh (CP) score. Sixty healthy individuals were selected as the control group. The four indicators of hepatic fibrosis were detected in all research objects, including hyaluronic acid (HA), laminin (LN), type III collagen (PC III), and type IV collagen (IV-C). The liver parenchyma hardness value (LS) was then measured by ARFI technique. LS and the four indicators of liver fibrosis (HA, LN, PC III, and IV-C) were observed in different grade CP scores. The diagnostic value of LS and the four indicators of liver fibrosis in determining liver cirrhosis degree with PBC, whether used alone or in combination, were analyzed by receiver operating characteristic (ROC) curve. RESULTS: LS and the four indicators of liver fibrosis within the three classes (A, B, and C) of CP scores in the observation group were higher than in the control group, with C class > B class > A class; the differences were statistically significant (P < 0.01). Although AUC values of LS within the three classes of CP scores were higher than in the four indicators of liver fibrosis, sensitivity and specificity were unstable. The ROC curves of LS combined with the four indicators of liver fibrosis revealed that: AUC and sensitivity in all indicators combined in the A class of CP score were higher than in LS alone, albeit with slightly decreased specificity; AUC and specificity in all indicators combined in the B class of CP score were higher than in LS alone, with unchanged sensitivity; AUC values (0.967), sensitivity (97.4%), and specificity (90%) of all indicators combined in the C class of CP score were higher than in LS alone (0.936, 92.1%, 83.3%). CONCLUSION: The diagnostic value of PBC cirrhosis degree in liver cirrhosis degree assessment by ARFI combined with the four indicators of serum liver fibrosis is of satisfactory effectiveness and has important clinical application value.
基金Supported by MEXT-Supported Program for the Strategic Research Foundation at Private Universities of the Japanese Governmentthe Ministry of Health,Labor,and Welfare of the Japanese Government
文摘AIM: To investigate the factors other than fibrosis stage correlating with acoustic radiation force impulse (ARFI) elastograpy in chronic hepatitis C.
文摘Progressive fibrosis is encountered in almost all chronicliver diseases. Its clinical signs are diagnostic in advanced cirrhosis, but compensated liver cirrhosis is harder to diagnose. Liver biopsy is still considered the reference method for staging the severity of fibrosis, but due to its drawbacks(inter and intra-observer variability, sampling errors, unequal distribution of fibrosis in the liver, and risk of complications and even death), non-invasive methods were developed to assess fibrosis(serologic and elastographic). Elastographic methods can be ultrasound-based or magnetic resonance imaging-based. All ultrasoundbased elastographic methods are valuable for the early diagnosis of cirrhosis, especially transient elastography(TE) and acoustic radiation force impulse(ARFI) elastography, which have similar sensitivities and specificities, although ARFI has better feasibility. TE is a promising method for predicting portal hypertension in cirrhotic patients, but it cannot replace upper digestive endoscopy. The diagnostic accuracy of using ARFI in the liver to predict portal hypertension in cirrhotic patients is debatable, with controversial results in published studies. The accuracy of ARFI elastography may be significantly increased if spleen stiffness is assessed, either alone or in combination with liver stiffness and other parameters. Two-dimensional shearwave elastography, the Elast PQ technique and strain elastography all need to be evaluated as predictors of portal hypertension.
基金Supported by the National Key Scientific Instrument and Equipment Development Projects of China under Grant No 81127901the National Natural Science Foundation of China under Grant Nos 61372017 and 30970828
文摘A modified Monte Carlo model of speckle tracking of shear wave propagation in scattering media is proposed. The established Monte Carlo model mainly concerns the variations of optical electric field and speckle. The two- dimensional intensity distribution and the time evolution of speckles in different probe locations are obtained. The fluctuation of speckle intensity tracks the acoustic-radiation-force shear wave propagation, and especially the reduction of speckle intensity implies attenuation of shear wave. Then, the shear wave velocity is estimated quantitatively on the basis of the time-to-peak algorithm and linear regression processing. The results reveal that a smaller sampling interval yields higher estimation precision and the shear wave velocity is estimated more efficiently by using speckle intensity difference than by using speckle contrast difference according to the estimation error. Hence, the shear wave velocity is estimated to be 2.25 m/s with relatively high accuracy for the estimation error reaches the minimum （0.071）.
基金Project supported by the National Natural Science Foundation of China(Grant Nos.81527901,11604361,and 91630309)。
文摘Shell structures have increasingly widespread applications in biomedical ultrasound fields such as contrast agents and drug delivery,which requires the precise prediction of the acoustic radiation force under various circumstances to improve the system efficiency.The acoustic radiation force exerted by a zero-order quasi-Bessel-Gauss beam on an elastic spherical shell near an impedance boundary is theoretically and numerically studied in this study.By means of the finite series method and the image theory,a zero-order quasi-Bessel-Gauss beam is expanded in terms of spherical harmonic functions,and the exact solution of the acoustic radiation force is derived based on the acoustic scattering theory.The acoustic radiation force function,which represents the radiation force per unit energy density and per unit cross-sectional surface,is especially investigated.Some simulated results for a polymethyl methacrylate shell and an aluminum shell are provided to illustrate the behavior of acoustic radiation force in this case.The simulated results show the oscillatory property and the negative radiation force caused by the impedance boundary.An appropriate relative thickness of the shell can generate sharp peaks for a polymethyl methacrylate shell.Strong radiation force can be obtained at small half-cone angles and the beam waist only affects the results at high frequencies.Considering that the quasi-Bessel-Gauss beam possesses both the energy focusing property and the non-diffracting advantage,this study is expected to be useful in the development of acoustic tweezers,contrast agent micro-shells,and drug delivery applications.
基金Supported by the Chang Gung Memorial Hospital and PAII Inc.(a United States subsidiary company of Ping An Insurance Group),No.SMRPG3I0011.
文摘BACKGROUND Acoustic radiation force impulse(ARFI)is used to measure liver fibrosis and predict outcomes.The performance of elastography in assessment of fibrosis is poorer in hepatitis B virus(HBV)than in other etiologies of chronic liver disease.AIM To evaluate the performance of ARFI in long-term outcome prediction among different etiologies of chronic liver disease.METHODS Consecutive patients who received an ARFI study between 2011 and 2018 were enrolled.After excluding dual infection,alcoholism,autoimmune hepatitis,and others with incomplete data,this retrospective cohort were divided into hepatitis B(HBV,n=1064),hepatitis C(HCV,n=507),and non-HBV,non-HCV(NBNC,n=391)groups.The indexed cases were linked to cancer registration(1987-2020)and national mortality databases.The differences in morbidity and mortality among the groups were analyzed.RESULTS At the enrollment,the HBV group showed more males(77.5%),a higher prevalence of prediagnosed hepatocellular carcinoma(HCC),and a lower prevalence of comorbidities than the other groups(P<0.001).The HCV group was older and had a lower platelet count and higher ARFI score than the other groups(P<0.001).The NBNC group showed a higher body mass index and platelet count,a higher prevalence of pre-diagnosed non-HCC cancers(P<0.001),especially breast cancer,and a lower prevalence of cirrhosis.Male gender,ARFI score,and HBV were independent predictors of HCC.The 5-year risk of HCC was 5.9%and 9.8%for those ARFI-graded with severe fibrosis and cirrhosis.ARFI alone had an area under the receiver operating characteristic curve(AUROC)of 0.742 for prediction of HCC in 5 years.AUROC increased to 0.828 after adding etiology,gender,age,and platelet score.No difference was found in mortality rate among the groups.CONCLUSION The HBV group showed a higher prevalence of HCC but lower comorbidity that made mortality similar among the groups.Those patients with ARFI-graded severe fibrosis or cirrhosis should receive regular surveillance.
