Felix Bende - Academia.edu (original) (raw)

Papers by Felix Bende

Research paper thumbnail of Liver Elastography: Basic Principles, Evaluation Technique, and Confounding Factors

Elastography - Applications in Clinical Medicine [Working Title], Mar 1, 2022

Ultrasound-based elastography techniques have received considerable attention in the last years f... more Ultrasound-based elastography techniques have received considerable attention in the last years for the noninvasive assessment of tissue mechanical properties. These techniques have the advantage of detecting tissue elasticity changes occurring in various pathological conditions and are able to provide qualitative and quantitative information that serves diagnostic and prognostic purposes. For liver applications and especially for the noninvasive assessment of liver fibrosis, ultrasound-based elastography has shown promising results. Several ultrasound elastography techniques using different excitation methods have been developed. In general, these techniques are classified into strain elastography, which is a semi-quantitative method that uses internal or external compression for tissue stimulation, and shear wave elastography, which measures the ultrasound-generated shear wave speed at different locations in the tissue. All liver elastography techniques have a standardized examination technique, with the patient in a supine position, while the measurements are performed through the right liver lobe. There are also some confounding factors that need to be taken into account when performing liver elastography such as a higher level of aminotransferases, infiltrative liver disease, liver congestion, cholestasis. This chapter briefly introduces the basic principles of liver elastography and discusses some important clinical aspects of elastography, such as the examination technique and the limitations.

Research paper thumbnail of Válvulas de Ahmed em doentes com Polineuropatia Amiloidótica Familiar

Objetivo: Avaliar os resultados clínicos dos doentes com glaucoma secundário à Polineuropatia Ami... more Objetivo: Avaliar os resultados clínicos dos doentes com glaucoma secundário à Polineuropatia Amiloidótica Familiar (PAF) submetidos a implante de válvula de Ahmed no Serviço de Oftalmologia do CHP entre Novembro de 2010 e Fevereiro de 2015. Material e Métodos: Estudo retrospetivo de 37 doentes (47 olhos) com o follow-up mínimo de 6 meses. Definiu-se sucesso cirúrgico relativo como pressão intraocular (PIO) ≥6 mmHg e ≤21 mmHg ou redução de 20% da PIO, com ou sem medicação ou reoperação. Sucesso cirúrgico absoluto foi definido como a obtenção dos mesmos resultados, mas sem recurso a medicação ou cirurgia adicional. Foram analisadas variáveis demográficas, PIO no 1º dia, 1ª e 2ª semanas, 1º, 2º, 3º e 6º meses, 1º ano e à data da última consulta, acuidade visual pré e 1 mês após cirurgia, número de anti-glaucomatosos pré e pós cirurgia, entre outras. Resultados: A PIO pré-operatória média foi de 27,53±7,48 e a pós-operatória foi de 15,29±4,37 (6º mês), p<0,01. A média de fármacos di...

Research paper thumbnail of Evolution of Echocardiographic Abnormalities Identified in Previously Healthy Individuals Recovering from COVID-19

Journal of Personalized Medicine, 2022

Research paper thumbnail of The BISAP score, NLR, CRP, or BUN: Which marker best predicts the outcome of acute pancreatitis?

Medicine, 2021

Abstract Acute pancreatitis is a common disease, and the mortality rate can be high. Thus, a risk... more Abstract Acute pancreatitis is a common disease, and the mortality rate can be high. Thus, a risk assessment should be performed early to optimize treatment. We compared simple prognostic markers with the bedside index for severity in acute pancreatitis (BISAP) scoring system to identify the best predictors of severity and mortality. This retrospective study stratified disease severity based on the revised Atlanta criteria. The accuracies of the markers for predicting severe AP (SAP) were assessed using receiver operating characteristic curves. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated for each marker. Multivariate logistic regression analyses were used to identify independent predictors of SAP and mortality. The area under the curve (AUC) for the BISAP score was classified as fair for predicting SAP. The neutrophil-to-lymphocyte ratio at 48 hours (NLR48 h) and the C-reactive protein level at 48 hours (CRP48 h) had the best AUCs and were independently associated with SAP. When both criteria were met, the AUC was 0.89, sensitivity was 68%, and specificity was 92%. CRP48 h and hematocrit at 48 hours were independently associated with mortality. NLR48 h and CRP48 h were independently associated with SAP but not superior to the BISAP score at admission. Assessing NLR48 h and CRP48H together was most suitable for predicting SAP. The CRP level was a good predictive marker for mortality.

Research paper thumbnail of Conference Abstract Scientific Meeting of Victor Babes University of Medicine and Pharmacy Doctoral School and Romanian Academy of Medical Sciences, December 2016, Timisoara, Romania Which Are the Best Cut-Off Values for Predicting Different Stages of Liver Fibrosis for 2D-SWE.GE in Daily Practice?

Research paper thumbnail of Quantification of Liver Fibrosis, Steatosis, and Viscosity Using Multiparametric Ultrasound in Patients with Non-Alcoholic Liver Disease: A “Real-Life” Cohort Study

Diagnostics

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide. Thi... more Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide. This study aimed to evaluate the performance of four ultrasound-based techniques for the non-invasive multiparametric (MPUS) assessment of liver fibrosis (LF), steatosis (HS), and inflammation in patients with NAFLD. We included 215 consecutive adult patients with NAFLD (mean age: 54.9 ± 11.7; 54.5% were male), in whom LF, HS, and viscosity were evaluated in the same session using four new ultrasound-based techniques embedded on the Aixplorer MACH 30 system: ShearWave Elastography (2D-SWE.PLUS), Sound Speed Plane-wave UltraSound (SSp.PLUS), Attenuation Plane-wave UltraSound (Att.PLUS), and Viscosity Plane-wave UltraSound (Vi.PLUS). Transient Elastography (TE) with Controlled Attenuation Parameter (CAP) (FibroScan) were considered as control. All elastographic measurements were performed according to guidelines. Valid liver stiffness measurements (LSM) were obtained in 98.6% of patients by T...

Research paper thumbnail of Is There a Place for Elastography in the Diagnosis of Hepatocellular Carcinoma?

Journal of Clinical Medicine

Background and Aims: Elastography can provide information regarding tissue stiffness (TS). This s... more Background and Aims: Elastography can provide information regarding tissue stiffness (TS). This study aimed to analyze the elastographic features of hepatocellular carcinoma (HCC) and the factors that influence intratumoral elastographic variability in patients with liver cirrhosis. Methods: This prospective study included 115 patients with liver cirrhosis and hepatocellular carcinoma evaluated between June 2016–November 2019. A total of 88 HCC nodules visualized in conventional abdominal ultrasound (US) met the inclusion criteria and underwent elastographic evaluation. Elastographic measurements (EM) were performed in HCC and liver parenchyma using VTQ (Virtual Touch Quantification), a point shear wave elastography (pSWE) technique. In all patients, we performed contrast-enhanced ultrasound (CEUS), and the final diagnosis of HCC was established by contrast-enhanced-CT or contrast-enhanced-MRI. Results: The mean VTQ values in HCCs were 2.16 ± 0.75 m/s. TS was significantly lower in ...

Research paper thumbnail of An intra- and interobserver correlation of shear wave elastography in a phantom model

Poster: "ECR 2015 / C-2156 / An intra- and interobserver correlation of shear wave elastogr... more Poster: "ECR 2015 / C-2156 / An intra- and interobserver correlation of shear wave elastography in a phantom model" by: "A. Popescu, O. Gradinaru Tascau, I. Sporea, R. Sirli, M. Danila, M. Popescu, T. V. Moga, F. B. Bende, S. Bota; Timisoara/RO"

Research paper thumbnail of Comparative study between two 2D-Shear Waves Elastography techniques for the non-invasive assessment of liver fibrosis in patients with chronic hepatitis C virus (HCV) infection

Medical ultrasonography, 2021

AIMS We aimed to compare the diagnostic performance of two 2D-Shear Wave Elastography (2D-SWE) te... more AIMS We aimed to compare the diagnostic performance of two 2D-Shear Wave Elastography (2D-SWE) techniques for the non-invasive assessment of liver fibrosis in patients with chronic hepatitis C virus (HCV) infection using Transient Elas-tography (TE) as reference. MATERIAL AND METHODS We enrolled 208 consecutive patients with chronic HCV infection, in which liver stiffness (LS) was evaluated in the same session using two 2D-SWE techniques: 2D-SWE.GE and 2D-SWE.SSI using TE as the method of reference. LS measurements were considered failures when no value was obtained after 10 attempts. RESULTS Valid LSMs were obtained in 95.6% (199/208) of cases by 2D-SWE.GE, 92.7% (193/208) of cases by 2D-SWE.SSI, and in 94.7% (197/208) of cases by TE (p>0.05). The mean LS values by 2D-SWE.GE were significantly lower than those obtained by 2D-SWE.SSI: 10.3±3.8 kPa vs. 15±10.4 kPa (p<0.0001). 2D-SWE.GE LSMs correlated better with TE than 2D-SWE.SSI (r=0.75, p<0.0001 vs. r=0.57, p<0.0001, ...

Research paper thumbnail of Mo1380 - The Value of Elastpq to Rule in and Rule Out HCV Liver Cirrhosis

Research paper thumbnail of Poster SessionAssessing Liver Stiffness by 2D-Shear Wave Elastography in a Healthy Cohort

Research paper thumbnail of Spleen and Liver Stiffness for Predicting High-Risk Varices in Patients with Compensated Liver Cirrhosis

Ultrasound in Medicine & Biology

Research paper thumbnail of Comparative Study Between the Diagnostic Performance of Point and 2-D Shear-Wave Elastography for the Non-invasive Assessment of Liver Fibrosis in Patients With Chronic Hepatitis C Using Transient Elastography as Reference

Ultrasound in medicine & biology, 2020

The study compared the diagnostic performance of two shear-wave elastography techniques, elastogr... more The study compared the diagnostic performance of two shear-wave elastography techniques, elastography point quantification (ElastPQ) and 2-D shear-wave elastography by General Electric (2-D-SWE.GE), for the non-invasive assessment of liver fibrosis in a cohort of patients with chronic hepatitis C virus (HCV) infection, using transient elastography (TE) as the reference method. There was no significant difference between the feasibility rates of TE, ElastPQ and 2-D-SWE.GE (p = 0.507). A good correlation was found between the liver stiffness (LS) values obtained using the two elastographic methods (r = 0.78). The mean LS values obtained using the ElastPQ technique were significantly higher than those obtained using 2-D-SWE.GE (12.1 ± 7.3 kPa vs. 10.4 ± 4.0 kPa, p < 0.0001). Pairwise comparisons of receiver operator characteristics curves between 2-D-SWE.GE and ElastPQ have shown that there are no significant differences in their performance for staging F ≥ 2 fibrosis (p = 0.89), F ...

Research paper thumbnail of Tu1556 - The Value of Ultrasound Based Elastographic Methods for Ruling Out the Presence of Esophageal Varices in Liver Cirrhotic Patients

Research paper thumbnail of Ultrasound-Guided Attenuation Parameter (UGAP) for the quantification of liver steatosis using the Controlled Attenuation Parameter (CAP) as the reference method

Medical Ultrasonography

Aim: Nonalcoholic Fatty Liver Disease (NAFLD) is increasing in frequency in daily practice and ev... more Aim: Nonalcoholic Fatty Liver Disease (NAFLD) is increasing in frequency in daily practice and evaluation of liver steatosis, fibrosis and inflammation severity are essential for prognosis assessment. The aim was to evaluate the usefulnessof a new liver steatosis quantification system - Ultrasound-Guided Attenuation Parameter (UGAP) from General Electric Healthcare, using Controlled Attenuation Parameter (CAP) as the reference method.Material and method: 179 consecutive subjects, in whom liver steatosis was assessed in the same session using UGAP, implemented on LOGIQ E10 system (GE Healthcare), and CAP (FibroScan, EchoSens). To discriminate between steatosis stages by CAP, we used the cut-offs recommended by the manufacturer: S1 (mild) – 230 dB/m, S2 (moderate) – 275 dB/m, S3 (severe) – 300 dB/m.Results: We classified our cohort by means of CAP into the following groups: S0 (no steatosis): 48/176 (27.2%), S1 (mild): 56/176 (31.6%), S2 (moderate): 14/176 (7.3%) and S3 (severe): 59/1...

Research paper thumbnail of Day-4 Lille Score Is a Good Prognostic Factor and Early Predictor in Assessing Therapy Response in Patients with Liver Cirrhosis and Severe Alcoholic Hepatitis

Journal of Clinical Medicine

Lille score at Day 7 (LM7) helps to predict the outcome of patients with severe alcoholic hepatit... more Lille score at Day 7 (LM7) helps to predict the outcome of patients with severe alcoholic hepatitis (sAH) undergoing corticotherapy. Several scores such as Maddrey’s discriminant function (MDF), MELD, ABIC, and GAHS are used for a 28-day mortality prognosis. Our study aimed to evaluate if the assessment of the Lille score at 4 days (LM4) is as useful as the Lille score at Day 7 (LM7) to predict response to corticosteroids and 28-day mortality and evaluate the utility of severity scores at admission for predicting the prognosis of patients with liver cirrhosis (LC) and severe alcoholic hepatitis (sAH). A retrospective study was performed, and all consecutive patients with AH and MDF > 32 without contraindications to corticosteroids were included. Prognostic scores were evaluated at admission, and 28-day mortality was assessed. Response to corticotherapy was assessed by LM4 and LM7. Results: A total of 55/103 patients with sAH (51.5%) had MDF > 32 and received corticosteroids. T...

Research paper thumbnail of The Performance of a 2-Dimensional Shear-Wave Elastography Technique for Predicting Different Stages of Liver Fibrosis Using Transient Elastography as the Control Method

Ultrasound Quarterly

The aim was to evaluate the performance of 2-dimensional (2D) shear-wave elastography from genera... more The aim was to evaluate the performance of 2-dimensional (2D) shear-wave elastography from general electric (2D SWE-GE), implemented on the new LOGIQ S8 system, for the noninvasive assessment of liver fibrosis, and to identify liver stiffness (LS) cutoff values for predicting different stages of fibrosis using transient elastography (TE) as the control method. We included 179 consecutive subjects, with or without chronic hepatopathies, in whom LS was evaluated in the same session using 2 elastographic techniques: TE (FibroScan, EchoSens) and 2D SWE-GE (LOGIQ S8; GE Healthcare, Chalfont St Giles, United Kingdom). Reliable LS measurements were defined for TE: the median value of 10 measurements with a success rate of 60% or greater and an interquartile range/median ratio (IQR/M) < 0.30; for 2D SWE-GE: the median value of 10 measurements acquired in a homogenous area and IQR/M < 0.30. To discriminate between fibrosis stages by TE, we used the following cutoffs: F2-7; F3-9.5 and F4-12 kPa. Reliable LS measurements were obtained in 97.2% subjects by 2D SWE-GE and in 98.3% by TE (P = 0.72), so that 171 subjects were included for the final analysis. A good correlation was found between the LS values obtained by the 2 methods (r = 0.72, P < 0.0001). The best 2D SWE-GE cutoff value for F ≥ 2 was 6.9 kPa (areas under receiver operating characteristic [AUROC], 0.93; sensitivity, 85.8%; specificity, 90.2%), for F of 3 or greater, it was 8.2 kPa (AUROC, 0.93; sensitivity, 87.5%; specificity, 86.8%) and for F value of 4, it was 9.3 kPa (AUROC, 0.91; sensitivity, 85.7%; specificity, 81.2%). In conclusion, the best 2D SWE-GE (S8) cutoff values for predicting F2, F ≥ 3 and F = 4 were 6.9, 8.2, and 9.3 kPa.

Research paper thumbnail of Associations between the Severity of the Post-Acute COVID-19 Syndrome and Echocardiographic Abnormalities in Previously Healthy Outpatients Following Infection with SARS-CoV-2

Biology

The COVID-19 pandemic affected over 130 million individuals during more than one year. Due to the... more The COVID-19 pandemic affected over 130 million individuals during more than one year. Due to the overload of health-care services, a great number of people were treated as outpatients, many of them subsequently developing post-acute COVID-19 syndrome. Our study was conducted on 150 subjects without a history of cardiovascular diseases, treated as outpatients for a mild/moderate form of COVID-19 4 to 12 weeks prior to study inclusion, and who were diagnosed with post-acute COVID-19 and attended a cardiology evaluation with transthoracic echocardiography (TTE) for persisting symptoms. We detected various cardiac abnormalities in 38 subjects (25.33%), including pulmonary hypertension (9.33%), impaired left ventricular performance (8.66%), diastolic dysfunction (14%) and/or evidence of pericarditis (10%). We highlighted statistically significant correlations between the intensity of symptoms and quality of life scores with the severity of initial pulmonary injury, the number of weeks s...

Research paper thumbnail of Impact of the COVID-19 Pandemic on Health-Related Quality of Life, Anxiety, and Training Among Young Gastroenterologists in Romania

Frontiers in Psychology

The novel COVID-19 infection has spread all over the world and is still generating a lot of issue... more The novel COVID-19 infection has spread all over the world and is still generating a lot of issues at different levels. There is a lack of control in disease early diagnosis and rapid evolution, which impacts both the medical and the economic system. Young gastroenterologists should adapt to overcome current difficulties and continue their life and general training. This is a multi-center national study, which aims to assess the general perspective of young gastroenterologists (residents and young specialists) from six university centers in Romania regarding their current training and the psychological effect the pandemic has on their life and job. An online survey with 58 items was distributed using Google Forms, and quality of life and anxiety were assessed. The validated instruments 15D (for assessing the health-related quality of life) and endler multidimensional anxiety scales (EMAS—for assessing anxiety) were used. All analyses were performed using SPSS 25. Of the 174 gastroen...

Research paper thumbnail of Assessing Baveno VI Criteria Using Liver Stiffness Measured with a 2D-Shear Wave Elastography Technique

Diagnostics

The present study evaluates the performance of Baveno VI criteria, using liver stiffness (LS) ass... more The present study evaluates the performance of Baveno VI criteria, using liver stiffness (LS) assessed with a 2D-SWE elastography technique, for predicting high-risk varices (HRV) in patients with compensated advanced chronic liver disease (cACLD). A secondary aim was to determine whether the use of spleen stiffness measurements (SSMs), as additional criteria, increases the performance of the 2D-SWE Baveno VI criteria. Data were collected from 208 subjects with cACLD, who underwent abdominal ultrasound, liver and spleen stiffness measurements, and upper digestive endoscopy. HRV were defined as grade 1 esophageal varices (EV) with red wale marks, grade 2/3 EV, and gastric varices. A total of 35.6% (74/208) of the included subjects had HRV. The optimal LS cut-off value for predicting HRV was 12 kPa (AUROC-0.80). Using both LS cut-off value < 12 kPa and a platelet cut-off value > 150 × 109 cells/L as criteria to exclude HRV, 52/208 (25%) subjects were selected, 88.5% (46/52) were...

Research paper thumbnail of Liver Elastography: Basic Principles, Evaluation Technique, and Confounding Factors

Elastography - Applications in Clinical Medicine [Working Title], Mar 1, 2022

Ultrasound-based elastography techniques have received considerable attention in the last years f... more Ultrasound-based elastography techniques have received considerable attention in the last years for the noninvasive assessment of tissue mechanical properties. These techniques have the advantage of detecting tissue elasticity changes occurring in various pathological conditions and are able to provide qualitative and quantitative information that serves diagnostic and prognostic purposes. For liver applications and especially for the noninvasive assessment of liver fibrosis, ultrasound-based elastography has shown promising results. Several ultrasound elastography techniques using different excitation methods have been developed. In general, these techniques are classified into strain elastography, which is a semi-quantitative method that uses internal or external compression for tissue stimulation, and shear wave elastography, which measures the ultrasound-generated shear wave speed at different locations in the tissue. All liver elastography techniques have a standardized examination technique, with the patient in a supine position, while the measurements are performed through the right liver lobe. There are also some confounding factors that need to be taken into account when performing liver elastography such as a higher level of aminotransferases, infiltrative liver disease, liver congestion, cholestasis. This chapter briefly introduces the basic principles of liver elastography and discusses some important clinical aspects of elastography, such as the examination technique and the limitations.

Research paper thumbnail of Válvulas de Ahmed em doentes com Polineuropatia Amiloidótica Familiar

Objetivo: Avaliar os resultados clínicos dos doentes com glaucoma secundário à Polineuropatia Ami... more Objetivo: Avaliar os resultados clínicos dos doentes com glaucoma secundário à Polineuropatia Amiloidótica Familiar (PAF) submetidos a implante de válvula de Ahmed no Serviço de Oftalmologia do CHP entre Novembro de 2010 e Fevereiro de 2015. Material e Métodos: Estudo retrospetivo de 37 doentes (47 olhos) com o follow-up mínimo de 6 meses. Definiu-se sucesso cirúrgico relativo como pressão intraocular (PIO) ≥6 mmHg e ≤21 mmHg ou redução de 20% da PIO, com ou sem medicação ou reoperação. Sucesso cirúrgico absoluto foi definido como a obtenção dos mesmos resultados, mas sem recurso a medicação ou cirurgia adicional. Foram analisadas variáveis demográficas, PIO no 1º dia, 1ª e 2ª semanas, 1º, 2º, 3º e 6º meses, 1º ano e à data da última consulta, acuidade visual pré e 1 mês após cirurgia, número de anti-glaucomatosos pré e pós cirurgia, entre outras. Resultados: A PIO pré-operatória média foi de 27,53±7,48 e a pós-operatória foi de 15,29±4,37 (6º mês), p<0,01. A média de fármacos di...

Research paper thumbnail of Evolution of Echocardiographic Abnormalities Identified in Previously Healthy Individuals Recovering from COVID-19

Journal of Personalized Medicine, 2022

Research paper thumbnail of The BISAP score, NLR, CRP, or BUN: Which marker best predicts the outcome of acute pancreatitis?

Medicine, 2021

Abstract Acute pancreatitis is a common disease, and the mortality rate can be high. Thus, a risk... more Abstract Acute pancreatitis is a common disease, and the mortality rate can be high. Thus, a risk assessment should be performed early to optimize treatment. We compared simple prognostic markers with the bedside index for severity in acute pancreatitis (BISAP) scoring system to identify the best predictors of severity and mortality. This retrospective study stratified disease severity based on the revised Atlanta criteria. The accuracies of the markers for predicting severe AP (SAP) were assessed using receiver operating characteristic curves. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated for each marker. Multivariate logistic regression analyses were used to identify independent predictors of SAP and mortality. The area under the curve (AUC) for the BISAP score was classified as fair for predicting SAP. The neutrophil-to-lymphocyte ratio at 48 hours (NLR48 h) and the C-reactive protein level at 48 hours (CRP48 h) had the best AUCs and were independently associated with SAP. When both criteria were met, the AUC was 0.89, sensitivity was 68%, and specificity was 92%. CRP48 h and hematocrit at 48 hours were independently associated with mortality. NLR48 h and CRP48 h were independently associated with SAP but not superior to the BISAP score at admission. Assessing NLR48 h and CRP48H together was most suitable for predicting SAP. The CRP level was a good predictive marker for mortality.

Research paper thumbnail of Conference Abstract Scientific Meeting of Victor Babes University of Medicine and Pharmacy Doctoral School and Romanian Academy of Medical Sciences, December 2016, Timisoara, Romania Which Are the Best Cut-Off Values for Predicting Different Stages of Liver Fibrosis for 2D-SWE.GE in Daily Practice?

Research paper thumbnail of Quantification of Liver Fibrosis, Steatosis, and Viscosity Using Multiparametric Ultrasound in Patients with Non-Alcoholic Liver Disease: A “Real-Life” Cohort Study

Diagnostics

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide. Thi... more Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide. This study aimed to evaluate the performance of four ultrasound-based techniques for the non-invasive multiparametric (MPUS) assessment of liver fibrosis (LF), steatosis (HS), and inflammation in patients with NAFLD. We included 215 consecutive adult patients with NAFLD (mean age: 54.9 ± 11.7; 54.5% were male), in whom LF, HS, and viscosity were evaluated in the same session using four new ultrasound-based techniques embedded on the Aixplorer MACH 30 system: ShearWave Elastography (2D-SWE.PLUS), Sound Speed Plane-wave UltraSound (SSp.PLUS), Attenuation Plane-wave UltraSound (Att.PLUS), and Viscosity Plane-wave UltraSound (Vi.PLUS). Transient Elastography (TE) with Controlled Attenuation Parameter (CAP) (FibroScan) were considered as control. All elastographic measurements were performed according to guidelines. Valid liver stiffness measurements (LSM) were obtained in 98.6% of patients by T...

Research paper thumbnail of Is There a Place for Elastography in the Diagnosis of Hepatocellular Carcinoma?

Journal of Clinical Medicine

Background and Aims: Elastography can provide information regarding tissue stiffness (TS). This s... more Background and Aims: Elastography can provide information regarding tissue stiffness (TS). This study aimed to analyze the elastographic features of hepatocellular carcinoma (HCC) and the factors that influence intratumoral elastographic variability in patients with liver cirrhosis. Methods: This prospective study included 115 patients with liver cirrhosis and hepatocellular carcinoma evaluated between June 2016–November 2019. A total of 88 HCC nodules visualized in conventional abdominal ultrasound (US) met the inclusion criteria and underwent elastographic evaluation. Elastographic measurements (EM) were performed in HCC and liver parenchyma using VTQ (Virtual Touch Quantification), a point shear wave elastography (pSWE) technique. In all patients, we performed contrast-enhanced ultrasound (CEUS), and the final diagnosis of HCC was established by contrast-enhanced-CT or contrast-enhanced-MRI. Results: The mean VTQ values in HCCs were 2.16 ± 0.75 m/s. TS was significantly lower in ...

Research paper thumbnail of An intra- and interobserver correlation of shear wave elastography in a phantom model

Poster: "ECR 2015 / C-2156 / An intra- and interobserver correlation of shear wave elastogr... more Poster: "ECR 2015 / C-2156 / An intra- and interobserver correlation of shear wave elastography in a phantom model" by: "A. Popescu, O. Gradinaru Tascau, I. Sporea, R. Sirli, M. Danila, M. Popescu, T. V. Moga, F. B. Bende, S. Bota; Timisoara/RO"

Research paper thumbnail of Comparative study between two 2D-Shear Waves Elastography techniques for the non-invasive assessment of liver fibrosis in patients with chronic hepatitis C virus (HCV) infection

Medical ultrasonography, 2021

AIMS We aimed to compare the diagnostic performance of two 2D-Shear Wave Elastography (2D-SWE) te... more AIMS We aimed to compare the diagnostic performance of two 2D-Shear Wave Elastography (2D-SWE) techniques for the non-invasive assessment of liver fibrosis in patients with chronic hepatitis C virus (HCV) infection using Transient Elas-tography (TE) as reference. MATERIAL AND METHODS We enrolled 208 consecutive patients with chronic HCV infection, in which liver stiffness (LS) was evaluated in the same session using two 2D-SWE techniques: 2D-SWE.GE and 2D-SWE.SSI using TE as the method of reference. LS measurements were considered failures when no value was obtained after 10 attempts. RESULTS Valid LSMs were obtained in 95.6% (199/208) of cases by 2D-SWE.GE, 92.7% (193/208) of cases by 2D-SWE.SSI, and in 94.7% (197/208) of cases by TE (p>0.05). The mean LS values by 2D-SWE.GE were significantly lower than those obtained by 2D-SWE.SSI: 10.3±3.8 kPa vs. 15±10.4 kPa (p<0.0001). 2D-SWE.GE LSMs correlated better with TE than 2D-SWE.SSI (r=0.75, p<0.0001 vs. r=0.57, p<0.0001, ...

Research paper thumbnail of Mo1380 - The Value of Elastpq to Rule in and Rule Out HCV Liver Cirrhosis

Research paper thumbnail of Poster SessionAssessing Liver Stiffness by 2D-Shear Wave Elastography in a Healthy Cohort

Research paper thumbnail of Spleen and Liver Stiffness for Predicting High-Risk Varices in Patients with Compensated Liver Cirrhosis

Ultrasound in Medicine & Biology

Research paper thumbnail of Comparative Study Between the Diagnostic Performance of Point and 2-D Shear-Wave Elastography for the Non-invasive Assessment of Liver Fibrosis in Patients With Chronic Hepatitis C Using Transient Elastography as Reference

Ultrasound in medicine & biology, 2020

The study compared the diagnostic performance of two shear-wave elastography techniques, elastogr... more The study compared the diagnostic performance of two shear-wave elastography techniques, elastography point quantification (ElastPQ) and 2-D shear-wave elastography by General Electric (2-D-SWE.GE), for the non-invasive assessment of liver fibrosis in a cohort of patients with chronic hepatitis C virus (HCV) infection, using transient elastography (TE) as the reference method. There was no significant difference between the feasibility rates of TE, ElastPQ and 2-D-SWE.GE (p = 0.507). A good correlation was found between the liver stiffness (LS) values obtained using the two elastographic methods (r = 0.78). The mean LS values obtained using the ElastPQ technique were significantly higher than those obtained using 2-D-SWE.GE (12.1 ± 7.3 kPa vs. 10.4 ± 4.0 kPa, p < 0.0001). Pairwise comparisons of receiver operator characteristics curves between 2-D-SWE.GE and ElastPQ have shown that there are no significant differences in their performance for staging F ≥ 2 fibrosis (p = 0.89), F ...

Research paper thumbnail of Tu1556 - The Value of Ultrasound Based Elastographic Methods for Ruling Out the Presence of Esophageal Varices in Liver Cirrhotic Patients

Research paper thumbnail of Ultrasound-Guided Attenuation Parameter (UGAP) for the quantification of liver steatosis using the Controlled Attenuation Parameter (CAP) as the reference method

Medical Ultrasonography

Aim: Nonalcoholic Fatty Liver Disease (NAFLD) is increasing in frequency in daily practice and ev... more Aim: Nonalcoholic Fatty Liver Disease (NAFLD) is increasing in frequency in daily practice and evaluation of liver steatosis, fibrosis and inflammation severity are essential for prognosis assessment. The aim was to evaluate the usefulnessof a new liver steatosis quantification system - Ultrasound-Guided Attenuation Parameter (UGAP) from General Electric Healthcare, using Controlled Attenuation Parameter (CAP) as the reference method.Material and method: 179 consecutive subjects, in whom liver steatosis was assessed in the same session using UGAP, implemented on LOGIQ E10 system (GE Healthcare), and CAP (FibroScan, EchoSens). To discriminate between steatosis stages by CAP, we used the cut-offs recommended by the manufacturer: S1 (mild) – 230 dB/m, S2 (moderate) – 275 dB/m, S3 (severe) – 300 dB/m.Results: We classified our cohort by means of CAP into the following groups: S0 (no steatosis): 48/176 (27.2%), S1 (mild): 56/176 (31.6%), S2 (moderate): 14/176 (7.3%) and S3 (severe): 59/1...

Research paper thumbnail of Day-4 Lille Score Is a Good Prognostic Factor and Early Predictor in Assessing Therapy Response in Patients with Liver Cirrhosis and Severe Alcoholic Hepatitis

Journal of Clinical Medicine

Lille score at Day 7 (LM7) helps to predict the outcome of patients with severe alcoholic hepatit... more Lille score at Day 7 (LM7) helps to predict the outcome of patients with severe alcoholic hepatitis (sAH) undergoing corticotherapy. Several scores such as Maddrey’s discriminant function (MDF), MELD, ABIC, and GAHS are used for a 28-day mortality prognosis. Our study aimed to evaluate if the assessment of the Lille score at 4 days (LM4) is as useful as the Lille score at Day 7 (LM7) to predict response to corticosteroids and 28-day mortality and evaluate the utility of severity scores at admission for predicting the prognosis of patients with liver cirrhosis (LC) and severe alcoholic hepatitis (sAH). A retrospective study was performed, and all consecutive patients with AH and MDF > 32 without contraindications to corticosteroids were included. Prognostic scores were evaluated at admission, and 28-day mortality was assessed. Response to corticotherapy was assessed by LM4 and LM7. Results: A total of 55/103 patients with sAH (51.5%) had MDF > 32 and received corticosteroids. T...

Research paper thumbnail of The Performance of a 2-Dimensional Shear-Wave Elastography Technique for Predicting Different Stages of Liver Fibrosis Using Transient Elastography as the Control Method

Ultrasound Quarterly

The aim was to evaluate the performance of 2-dimensional (2D) shear-wave elastography from genera... more The aim was to evaluate the performance of 2-dimensional (2D) shear-wave elastography from general electric (2D SWE-GE), implemented on the new LOGIQ S8 system, for the noninvasive assessment of liver fibrosis, and to identify liver stiffness (LS) cutoff values for predicting different stages of fibrosis using transient elastography (TE) as the control method. We included 179 consecutive subjects, with or without chronic hepatopathies, in whom LS was evaluated in the same session using 2 elastographic techniques: TE (FibroScan, EchoSens) and 2D SWE-GE (LOGIQ S8; GE Healthcare, Chalfont St Giles, United Kingdom). Reliable LS measurements were defined for TE: the median value of 10 measurements with a success rate of 60% or greater and an interquartile range/median ratio (IQR/M) < 0.30; for 2D SWE-GE: the median value of 10 measurements acquired in a homogenous area and IQR/M < 0.30. To discriminate between fibrosis stages by TE, we used the following cutoffs: F2-7; F3-9.5 and F4-12 kPa. Reliable LS measurements were obtained in 97.2% subjects by 2D SWE-GE and in 98.3% by TE (P = 0.72), so that 171 subjects were included for the final analysis. A good correlation was found between the LS values obtained by the 2 methods (r = 0.72, P < 0.0001). The best 2D SWE-GE cutoff value for F ≥ 2 was 6.9 kPa (areas under receiver operating characteristic [AUROC], 0.93; sensitivity, 85.8%; specificity, 90.2%), for F of 3 or greater, it was 8.2 kPa (AUROC, 0.93; sensitivity, 87.5%; specificity, 86.8%) and for F value of 4, it was 9.3 kPa (AUROC, 0.91; sensitivity, 85.7%; specificity, 81.2%). In conclusion, the best 2D SWE-GE (S8) cutoff values for predicting F2, F ≥ 3 and F = 4 were 6.9, 8.2, and 9.3 kPa.

Research paper thumbnail of Associations between the Severity of the Post-Acute COVID-19 Syndrome and Echocardiographic Abnormalities in Previously Healthy Outpatients Following Infection with SARS-CoV-2

Biology

The COVID-19 pandemic affected over 130 million individuals during more than one year. Due to the... more The COVID-19 pandemic affected over 130 million individuals during more than one year. Due to the overload of health-care services, a great number of people were treated as outpatients, many of them subsequently developing post-acute COVID-19 syndrome. Our study was conducted on 150 subjects without a history of cardiovascular diseases, treated as outpatients for a mild/moderate form of COVID-19 4 to 12 weeks prior to study inclusion, and who were diagnosed with post-acute COVID-19 and attended a cardiology evaluation with transthoracic echocardiography (TTE) for persisting symptoms. We detected various cardiac abnormalities in 38 subjects (25.33%), including pulmonary hypertension (9.33%), impaired left ventricular performance (8.66%), diastolic dysfunction (14%) and/or evidence of pericarditis (10%). We highlighted statistically significant correlations between the intensity of symptoms and quality of life scores with the severity of initial pulmonary injury, the number of weeks s...

Research paper thumbnail of Impact of the COVID-19 Pandemic on Health-Related Quality of Life, Anxiety, and Training Among Young Gastroenterologists in Romania

Frontiers in Psychology

The novel COVID-19 infection has spread all over the world and is still generating a lot of issue... more The novel COVID-19 infection has spread all over the world and is still generating a lot of issues at different levels. There is a lack of control in disease early diagnosis and rapid evolution, which impacts both the medical and the economic system. Young gastroenterologists should adapt to overcome current difficulties and continue their life and general training. This is a multi-center national study, which aims to assess the general perspective of young gastroenterologists (residents and young specialists) from six university centers in Romania regarding their current training and the psychological effect the pandemic has on their life and job. An online survey with 58 items was distributed using Google Forms, and quality of life and anxiety were assessed. The validated instruments 15D (for assessing the health-related quality of life) and endler multidimensional anxiety scales (EMAS—for assessing anxiety) were used. All analyses were performed using SPSS 25. Of the 174 gastroen...

Research paper thumbnail of Assessing Baveno VI Criteria Using Liver Stiffness Measured with a 2D-Shear Wave Elastography Technique

Diagnostics

The present study evaluates the performance of Baveno VI criteria, using liver stiffness (LS) ass... more The present study evaluates the performance of Baveno VI criteria, using liver stiffness (LS) assessed with a 2D-SWE elastography technique, for predicting high-risk varices (HRV) in patients with compensated advanced chronic liver disease (cACLD). A secondary aim was to determine whether the use of spleen stiffness measurements (SSMs), as additional criteria, increases the performance of the 2D-SWE Baveno VI criteria. Data were collected from 208 subjects with cACLD, who underwent abdominal ultrasound, liver and spleen stiffness measurements, and upper digestive endoscopy. HRV were defined as grade 1 esophageal varices (EV) with red wale marks, grade 2/3 EV, and gastric varices. A total of 35.6% (74/208) of the included subjects had HRV. The optimal LS cut-off value for predicting HRV was 12 kPa (AUROC-0.80). Using both LS cut-off value < 12 kPa and a platelet cut-off value > 150 × 109 cells/L as criteria to exclude HRV, 52/208 (25%) subjects were selected, 88.5% (46/52) were...