Endoscopic ultrasound-guided, through-the-needle forceps biopsy for diagnosis of pancreatic cystic lesions: a systematic review
ENDOSCOPY INTERNATIONAL OPEN
Authors: Guzman-Calderon, Edson; Martinez-Moreno, Belen; Casellas, Juan A.; de Madaria, Enrique; Ramon Aparicio, Jose
Abstract
Background and study aims Pancreatic cystic lesions (PCL), are a heterogeneous group of cystic lesions. Some patients with PCLs have a significantly higher overall risk of pancreatic cancer and the only test that can differentiate benign and malignnat PCL is fine-needle aspiration plus cytological analysis, but its sensitivity is very low. Through-the-needle direct intracystic biopsy is a technique that allows acquisition of targeted tissue from PCLs and it may improve the diagnostic yield for them. The aim of this study was to review articles about endoscopic ultrasound (EUS)-guided through-the-needle intracystic biopsy for targeted tissue acquisition and diagnosis of PCLs. Methods A systematic review of computerized bibliographic databases was carried out for studies of EUS-guided through-the-needle forceps biopsy (EUS-TTNB) of PCLs. The percentages and their 95 % confidence intervals (CIs) were calculated for all the considered endpoints (technical success, adequate specimens, adverse events (AEs), and overall diagnosis). Results Overall, eight studies with a total of 423 patients were identified. Pooled technical success was 95.6 % of the cases (399/423), (95 % CI, 93.2 %-97.3 %). Technical failure rate was 5.1 % (24 cases). Frequency of adequate specimens was 82.2 %, (95 % CI, 78.5 %-85.8 %). Adverse events were reported in seven of the eight studies. Forty-two total adverse events were reported (10.1 %) (95 % CI, 7.3 %-13.6 %). The overall ability to provide a specific diagnosis with EUS-TTNB for diagnosis of pancreatic cystic lesions was 74.6 % (313 cases), (95 % CI: 70.2 %-78.7 %). The most frequent diagnoses found with EUS-TTNB were mucinous cystic neoplasms (MCN) in 96 cases (30.6 %), IPMN in 80 cases (25.5 %), and serous cystoadenoma neoplasm (SCN) in 48 cases (15.3 %). Conclusions Through-the-needle forceps biopsy appears to be effective and safe, with few AE for diagnosis of pancreatic cystic lesions. This technique had acceptable rates of technical and clinical success and an excellent safety profile. TTNB is associated with a high tissue acquisition yield and provided additional diagnostic yield for mucinous pancreatic lesions. TTNB may be a useful adjunctive tool for EUS-guided assessment of PCLs.
A lossless compression and encryption mechanism for remote monitoring of ECG data using Huffman coding and CBC-AES
FUTURE GENERATION COMPUTER SYSTEMS-THE INTERNATIONAL JOURNAL OF ESCIENCE
Authors: Hameed, Mustafa Emad; Ibrahim, Masrullizam Mat; Abd Manap, Nurulfajar; Mohammed, Ali A.
Abstract
Biomedical signal processing provides a cross-disciplinary international forum through which research on signal and images measurement and analysis of clinical medicine and biological sciences are shared. The broadcast transmission in wireless body area networks raises serious security challenge when employed in biomedical applications. Electrocardiography (ECG) signal is frequently used for diagnosis of cardiovascular diseases. However, the ECG data need a large memory storage device due to continuous heart rate logs and vital parameter storage. Thus, compression schemes are applied to the ECG data before sending them to telemedicine centers for monitoring and analysis. Therefore, a proper compression mechanism cannot only improve the storage efficiency but also help in the rapid data transfer from one device to another due to its compact size. We propose a scheme using buffer blocks, peak detection, compression, and encryption mechanism to enable seamless and secure transmission of ECG signal from the sensor to the monitor. The study will prove that the quality of the reconstructed signals obtained using the proposed scheme, which uses discrete wavelet transform, Huffman coding, and Cipher Block Chaining-Advanced Encryption Standard algorithm approach, is superior to that obtained using unencrypted compression. Furthermore, the proposed system can provide quality-control compressed data, although the data have been encrypted. The experimental results show that the proposed system provides an effective means for assuring data security and compression performance for ECG data storage and transmission. The security of the scheme is applied against known attacks on privacy, such as eavesdropping and passive monitoring attack. (C) 2019 Elsevier B.V. All rights reserved.