Hypervascular lesions of the pancreas: Think before you act.

Background: The "classic" CT appearance of pancreatic neuroendocrine tumors (PNETs) is a solid, hypervascular lesion; however, non-PNET diagnoses may appear similar. In addition, some PNETs have a "non-classic" appearance.

Methods: Demographic, imaging, endoscopic ultrasound-fine needle aspiration (EUS/FNA) results, and pathology data were analyzed for patients who underwent pancreatectomy for suspected or confirmed diagnosis of PNET from our institutional database.

Clinical triage decision vs risk scores in predicting the need for endotherapy in upper gastrointestinal bleeding.

Background: Acute upper gastrointestinal hemorrhage (UGIH) is a common reason for hospitalization with substantial associated morbidity, mortality, and cost. Differentiation of high- and low-risk patients using established risk scoring systems has been advocated. The aim of this study was to determine whether these scoring systems are more accurate than an emergency physician's clinical decision making in predicting the need for endoscopic intervention in acute UGIH.

Characterization of pancreatic cancer and intra-abdominal lymph node malignancy using spectrum analysis of endoscopic ultrasound imaging.

This study assessed the ability of spectral analysis of endoscopic ultrasound (EUS) RF signals acquired in humans in vivo to distinguish between (1) benign and malignant intraabdominal and mediastinal lymph nodes and (2) pancreatic cancer, chronic pancreatitis, and normal pancreas. Mean midband fit, slope, intercept, and correlation coefficient from a linear regression of the calibrated RF power spectra were computed over regions of interest defined by the endoscopist. Linear discriminant analysis was then performed to develop a classification of the resulting spectral parameters.

In vivo characterization of pancreatic and lymph node tissue by using EUS spectrum analysis: a validation study.

Background: Quantitative spectral analysis of the radiofrequency (RF) signals that underlie grayscale EUS images can be used to provide additional, objective information about tissue state.

Objective: Our purpose was to validate RF spectral analysis as a method to distinguish between (1) benign and malignant lymph nodes and (2) normal pancreas, chronic pancreatitis, and pancreatic cancer.

Design And Setting: A prospective validation study of eligible patients was conducted to compare with pilot study RF data.

Artificial neural network as a predictive instrument in patients with acute nonvariceal upper gastrointestinal hemorrhage.

Background & Aims: Triage of patients with acute upper gastrointestinal hemorrhage (UGIH) has traditionally required urgent upper endoscopy. The aim of this study is to evaluate the use of artificial neural network for nonendoscopic triage.

Methods: A cohort of 387 patients was used to train (n = 194) and internally validate (n = 193) the neural network, which was then externally validated in 200 patients and compared with the clinical and complete Rockall score.

EUS spectrum analysis for in vivo characterization of pancreatic and lymph node tissue: a pilot study.

Background: EUS is limited by variability in the examiner's subjective interpretation of B-scan images to differentiate among normal, inflammatory, and malignant tissue. By using information otherwise discarded by conventional EUS systems, quantitative spectral analysis of the raw radiofrequency (RF) signals underlying EUS images enables tissue to be characterized more objectively.

Objective: Our purpose was to determine the feasibility of using spectral analysis of EUS data for characterization of pancreatic tissue and lymph nodes.

Endoscopic Doppler US probe for the diagnosis of gastric varices (with videos).

Background: Gastric varices may appear similar to enlarged gastric folds and submucosal neoplasms at endoscopy. A simple endoscopic method to diagnose variceal blood flow without formal EUS could be clinically useful.

Objective: To demonstrate the use of Doppler US (DOP-US) in the diagnosis of gastric varices.