Jochen Hampe

The differentiation between benign and malignant biliary strictures remains a significant clinical challenge. Recent studies have suggested that next generation sequencing (NGS) can improve the diagnostic accuracy. However, evidence on its performance in routine clinical practice is limited. Therefore, validation of the diagnostic value of NGS using real‐world clinical data is warranted. We compared the performance of NGS analysis of cholangiocellular carcinoma (CCC)‐associated mutations in endoscopic biopsies with that of histopathology, CA19‐9 and cross‐sectional imaging. NGS showed higher sensitivity for malignancy (65%) compared to histopathology (52%) at similar specificity (96% vs. 100%). The combination of NGS and histopathology further increased sensitivity for malignancy to 78% ( p = 0.03) at similar specificity (96%). Our data provide support for the use of NGS in the diagnostic workup of biliary strictures.

Wearable ultrasound sensing systems are rapidly emerging for precise, continuous, and intuitive biomedical monitoring and human-in-the-loop interaction in healthcare, industry, and rehabilitation. These systems must operate under stringent constraints on size, weight, and power while delivering actionable physiological and functional information. Advances in micromachined transducers, conformable electronics, low-power signal processing, and edge artificial intelligence (AI) have enabled the first generation of wearable prototypes, yet integration of hardware and software at the system-level remains a major barrier to mass deployment. This review maps the technology readiness and architectures of wearable ultrasound systems, and examines critical design trade-offs, including edge versus cloud-based processing and pulse-echo versus coded signal approaches. We identify recurring design principles and argue that modular, scalable, and reusable platforms are key to lowering development barriers and accelerating translation from prototypes to commercial deployment across healthcare, industrial, and consumer domains.

PurposeAssessment of liver steatosis is primarily performed through visual evaluation during ultrasound examinations. A more objective approach relies on quantifying ultrasound attenuation, typically using devices such as the FibroScan® or elastography integrated into high-end ultrasound systems—which offer limited accessibility. By contrast, handheld ultrasound devices (HHUDs) are more affordable and widely available. Using raw ultrasound data to get deeper insights into liver tissue characteristics could turn HHUDs into valuable diagnostic tools. We hypothesized that the frequency-specific attenuation of raw ultrasound data acquired with handheld devices correlates with the controlled attenuation parameter (CAP) obtained through vibration-controlled transient elastography via FibroScan.ApproachIn an exploratory, single-center study, raw data from 395 participants scheduled for CAP measurement were collected using HHUDs. Of these, 304 participants were included in the final analysis; 91 were excluded due to incomplete data. Using the raw data from the HHUDs, a method based on short-time fast Fourier transform was applied to calculate the frequency-specific attenuation. The results were then correlated with the CAP values.ResultsOverall, the attenuation of the radiofrequency data showed a strong linear correlation with CAP values (r=0.672, p<0.001), although the strength of correlation varied significantly across frequencies (r_min = 0.443 at 0.75 MHz, r_max = 0.721 at 3.75 MHz), with the highest correlation, equaling results from studies with high-end ultrasound devices.ConclusionHHUDs capable of acquiring raw data may serve as objective and accessible screening tools for liver steatosis, potentially improving treatment monitoring.

Handheld ultrasound (HHUS) devices are increasingly used in clinical practice due to their portability and cost-effectiveness. However, HHUS image quality remains variable, and a standardized expert-based evaluation protocol is lacking. This study compares the image quality of B-mode recordings of five HHUS models with a high-end reference system (HEUS) using a blinded assessment to identify differences, covariates, offering a standardized evaluation framework. In this blinded, multi-center study, video sequences of the liver, pancreas, and sigmoid colon were recorded in ten volunteers using 5 HHUS devices – Vscan Air, Butterfly iQ+, Philips Lumify, Clarius C3, and Clarius C3 HD3 – and one HEUS (GE Logiq E10). Twenty-two physicians with many years of abdominal ultrasound experience rated blinded clips for 5 image quality parameters. The HEUS consistently received the highest ratings. Image quality differed significantly between HHUS devices. Clarius systems showed the smallest deviation from the reference, followed by Vscan Air and Philips Lumify. All image parameters significantly correlated with the overall impression, without a single dominant factor. The patients’ BMI had no relevant influence. Examiner experience was less impactful than device familiarity and personal preference. The image quality of HEUS remained superior to all tested HHUS devices. Further subdivision of image quality aspects did not provide additional information. Furthermore, we could not identify significant covariates in our setup. These findings could justify simplified setups with reduced questionnaires and requirements for examiners.

Anastomotic failure remains one of the most severe complications in gastrointestinal surgery. Despite continuous advancements in stapler technologies and surgical techniques, it continues to be a leading cause of postoperative morbidity and mortality. It contributes substantially to prolonged hospitalization and increased healthcare expenditures. Currently, diagnosis is based on secondary systemic signs, such as inflammatory response or changes in drain fluid, followed by a multimodal diagnostic approach. However, reliable early detection of local alterations is still lacking. Here, the implantation of a bioresorbable is investigated, intra‐anastomotically placed sensor device. By performing real‐time intra‐anastomotic bioimpedance measurements, ischemia‐related changes are identified at an early, potentially reversible stage, prior to the onset of clinical or systemic manifestations. Furthermore, the sensor device offers the potential for future integration of pattern‐recognition algorithms and the possibility of direct measurement of different markers in the anastomotic microenvironment.

Supplementary Table S9 shows the predictive value of endoscopy history in GERA.

Supplementary Table S1 shows the descriptive characteristics of study populations in GECCO and CORECT.

Supplementary Table S3 shows the comparison on characteristics between GECCO/CORECT study and GERA Europeans-ancestry participants