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Trelsgård AM, Mulabecirovic A, Leiva RA, Nordaas IK, Mjelle AB, Gilja OH, Havre RF. Multiparametric liver assessment in patients successfully treated for hepatitis C: a 4-year follow-up. Scand J Gastroenterol 2024:1-8. [PMID: 39219192 DOI: 10.1080/00365521.2024.2388691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 06/29/2024] [Accepted: 07/31/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Hepatitis C virus (HCV) is a major cause of chronic liver disease, in which liver stiffness increases. Liver stiffness measurements (LSM) are therefore essential in diagnosing liver diseases and predicting disease development. The study objective was to perform a comprehensive prospective assessment of the liver before, after and 4 years after treatment for HCV, including an assessment of the long-term outcome of fibrosis, steatosis and inflammation. METHODS AND FINDINGS Patients eligible for HCV treatment were included prospectively in 2018 (n = 47). Liver stiffness was measured using transient elastography and 2D shear-wave elastography (SWE). Blood tests, B-mode ultrasound (US) and SWE, were performed before, after (end of treatment [EOT]), 3 months after (EOT3) and 4 years after treatment (4Y). At the final visit, we added attenuation imaging and shear-wave dispersion slope (SWDS) measurements to assess steatosis and inflammation. Three months after treatment, the sustained virologic response rate was 93%. The median liver stiffness for baseline, EOT, EOT3 and 4Y was 8.1, 5.9, 5.6 and 6.3 kPa, respectively. There was a significant reduction in liver stiffness from baseline to EOT, and from EOT to EOT3. After 4 years, the mean attenuation coefficient (AC) was 0.58 dB/cm/MHz, and the mean SWDS value was 14.3 (m/s)/kHz. CONCLUSION The treatment for HCV was highly effective. Measurements of liver stiffness decreased significantly after treatment and remained low after 4 years. AC measurements indicated low levels of liver steatosis. Shear-wave dispersion values indicated inflammation of the liver, but the clinical implication is undetermined and should be explored in larger studies.Clinicaltrials.gov: NCT03434470. ABBREVIATIONS AC: attenuation coefficient; APRI: aspartate aminotransferase to platelet ratio index; ATI: attenuation imaging; cACLD: compensated advanced chronic liver disease; CAP: controlled attenuation parameter; FIB-4: Fibrosis-4 Index for liver fibrosis; HCC: hepatocellular carcinoma; LSM: liver stiffness measurement; NAFLD: non-alcoholic fatty liver disease; NASH: non-alcoholic steatohepatitis; SWDS: shear-wave dispersion slope; SWE: shear-wave elastography; US: ultrasound.
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Affiliation(s)
- Audun M Trelsgård
- Department of Medicine, National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Anesa Mulabecirovic
- Department of Medicine, National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
| | | | - Ingrid K Nordaas
- Department of Medicine, National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Anders B Mjelle
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Anaesthesia, Stavanger University Hospital, Stavanger, Norway
| | - Odd Helge Gilja
- Department of Medicine, National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Roald F Havre
- Department of Medicine, National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Gallet J, Sassaroli E, Yuan Q, Aljabal A, Park MA. Quality Assurance of Point and 2D Shear Wave Elastography through the Establishment of Baseline Data Using Phantoms. SENSORS (BASEL, SWITZERLAND) 2024; 24:4961. [PMID: 39124008 PMCID: PMC11314857 DOI: 10.3390/s24154961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 07/09/2024] [Accepted: 07/23/2024] [Indexed: 08/12/2024]
Abstract
Ultrasound elastography has been available on most modern systems; however, the implementation of quality processes tends to be ad hoc. It is essential for a medical physicist to benchmark elastography measurements on each system and track them over time, especially after major software upgrades or repairs. This study aims to establish baseline data using phantoms and monitor them for quality assurance in elastography. In this paper, we utilized two phantoms: a set of cylinders, each with a composite material with varying Young's moduli, and an anthropomorphic abdominal phantom containing a liver modeled to represent early-stage fibrosis. These phantoms were imaged using three ultrasound manufacturers' elastography functions with either point or 2D elastography. The abdominal phantom was also imaged using magnetic resonance elastography (MRE) as it is recognized as the non-invasive gold standard for staging liver fibrosis. The scaling factor was determined based on the data acquired using MR and US elastography from the same vendor. The ultrasound elastography measurements showed inconsistency between different manufacturers, but within the same manufacturer, the measurements showed high repeatability. In conclusion, we have established baseline data for quality assurance procedures and specified the criteria for the acceptable range in liver fibrosis phantoms during routine testing.
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Affiliation(s)
- Jacqueline Gallet
- Department of Radiology, Division of Medical Physics, UT Southwestern Medical Center, Dallas, TX 75390, USA; (Q.Y.); (A.A.)
| | | | - Qing Yuan
- Department of Radiology, Division of Medical Physics, UT Southwestern Medical Center, Dallas, TX 75390, USA; (Q.Y.); (A.A.)
| | - Areej Aljabal
- Department of Radiology, Division of Medical Physics, UT Southwestern Medical Center, Dallas, TX 75390, USA; (Q.Y.); (A.A.)
| | - Mi-Ae Park
- Department of Radiology, Division of Medical Physics, UT Southwestern Medical Center, Dallas, TX 75390, USA; (Q.Y.); (A.A.)
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Cavanagh E, Crawford K, Hong JGS, Fontanarosa D, Edwards C, Wille ML, Hong J, Clifton VL, Kumar S. The Relationship between Placental Shear Wave Elastography and Fetal Weight-A Prospective Study. J Clin Med 2024; 13:4432. [PMID: 39124699 PMCID: PMC11313635 DOI: 10.3390/jcm13154432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 07/23/2024] [Accepted: 07/24/2024] [Indexed: 08/12/2024] Open
Abstract
Background/Objectives: The utility of shear wave elastography (SWE) as an adjunct to ultrasound biometry and Doppler velocimetry for the examination of placental dysfunction and suboptimal fetal growth is unclear. To date, limited data exist correlating the mechanical properties of placentae with fetal growth. This study aimed to investigate the relationship between placental shear wave velocity (SWV) and ultrasound estimated fetal weight (EFW), and to ascertain if placental SWV is a suitable proxy measure of placental function in the surveillance of small-for-gestational-age (SGA) pregnancies. Methods: This prospective, observational cohort study compared the difference in placental SWV between SGA and appropriate-for-gestational-age (AGA) pregnancies. There were 221 women with singleton pregnancies in the study cohort-136 (61.5%) AGA and 85 (38.5%) SGA. Fetal biometry, Doppler velocimetry, the deepest vertical pocket of amniotic fluid, and mean SWV were measured at 2-4-weekly intervals from recruitment to birth. Results: There was no difference in mean placental SWV in SGA pregnancies compared to AGA pregnancies, nor was there any relationship to EFW. Conclusions: Although other studies have shown some correlation between increased placental stiffness and SGA pregnancies, our investigation did not support this. The mechanical properties of placental tissue in SGA pregnancies do not result in placental SWVs that are apparently different from those of AGA controls. As this study did not differentiate between constitutionally or pathologically small fetuses, further studies in growth-restricted cohorts would be of benefit.
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Affiliation(s)
- Erika Cavanagh
- Mater Research Institute, University of Queensland, Level 3, Aubigny Place, Raymond Terrace, South Brisbane, QLD 4101, Australia; (E.C.); (K.C.); (J.G.S.H.); (V.L.C.)
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4000, Australia (C.E.)
- Centre for Biomedical Technologies (CBT), Queensland University of Technology, Brisbane, QLD 4000, Australia
- Mater Centre for Maternal and Fetal Medicine, Mater Mother’s Hospital, South Brisbane, QLD 4101, Australia;
| | - Kylie Crawford
- Mater Research Institute, University of Queensland, Level 3, Aubigny Place, Raymond Terrace, South Brisbane, QLD 4101, Australia; (E.C.); (K.C.); (J.G.S.H.); (V.L.C.)
| | - Jesrine Gek Shan Hong
- Mater Research Institute, University of Queensland, Level 3, Aubigny Place, Raymond Terrace, South Brisbane, QLD 4101, Australia; (E.C.); (K.C.); (J.G.S.H.); (V.L.C.)
- Mater Centre for Maternal and Fetal Medicine, Mater Mother’s Hospital, South Brisbane, QLD 4101, Australia;
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Davide Fontanarosa
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4000, Australia (C.E.)
- Centre for Biomedical Technologies (CBT), Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Christopher Edwards
- School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD 4000, Australia (C.E.)
- Centre for Biomedical Technologies (CBT), Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Marie-Luise Wille
- School of Mechanical, Medical and Process Engineering and ARC Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing, Queensland University of Technology, Brisbane, QLD 4000, Australia;
| | - Jennifer Hong
- Mater Centre for Maternal and Fetal Medicine, Mater Mother’s Hospital, South Brisbane, QLD 4101, Australia;
| | - Vicki L. Clifton
- Mater Research Institute, University of Queensland, Level 3, Aubigny Place, Raymond Terrace, South Brisbane, QLD 4101, Australia; (E.C.); (K.C.); (J.G.S.H.); (V.L.C.)
| | - Sailesh Kumar
- Mater Research Institute, University of Queensland, Level 3, Aubigny Place, Raymond Terrace, South Brisbane, QLD 4101, Australia; (E.C.); (K.C.); (J.G.S.H.); (V.L.C.)
- Mater Centre for Maternal and Fetal Medicine, Mater Mother’s Hospital, South Brisbane, QLD 4101, Australia;
- Faculty of Medicine, The University of Queensland, Herston, QLD 4006, Australia
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Savino A, Loglio A, Neri F, Camagni S, Pasulo L, Lucà MG, Trevisan R, Fagiuoli S, Viganò M. Metabolic-Dysfunction-Associated Steatotic Liver Disease (MASLD) after Liver Transplantation: A Narrative Review of an Emerging Issue. J Clin Med 2024; 13:3871. [PMID: 38999436 PMCID: PMC11242808 DOI: 10.3390/jcm13133871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 06/23/2024] [Accepted: 06/24/2024] [Indexed: 07/14/2024] Open
Abstract
The development of steatotic liver disease after liver transplant (LT) is widely described, and epidemiological data have revealed an increased incidence in recent times. Its evolution runs from simple steatosis to steatohepatitis and, in a small proportion of patients, to significant fibrosis and cirrhosis. Apparently, post-LT steatotic disease has no impact on the recipient's overall survival; however, a higher cardiovascular and malignancy burden has been reported. Many donors' and recipients' risk factors have been associated with this occurrence, although the recipient-related ones seem of greater impact. Particularly, pre- and post-LT metabolic alterations are strictly associated with steatotic graft disease, sharing common pathophysiologic mechanisms that converge on insulin resistance. Other relevant risk factors include genetic variants, sex, age, baseline liver diseases, and immunosuppressive drugs. Diagnostic evaluation relies on liver biopsy, although non-invasive methods are being increasingly used to detect and monitor both steatosis and fibrosis stages. Management requires a multifaceted approach focusing on lifestyle modifications, the optimization of immunosuppressive therapy, and the management of metabolic complications. This review aims to synthesize the current knowledge of post-LT steatotic liver disease, focusing on the recent definition of metabolic-dysfunction-associated steatotic liver disease (MASLD) and its metabolic and multisystemic concerns.
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Affiliation(s)
- Alberto Savino
- Gastroenterology Hepatology and Transplantation Unit, ASST Papa Giovanni XXIII, Piazza OMS 1, 24127 Bergamo, Italy; (A.S.); (S.F.)
- Gastroenterology, Department of Medicine, University of Milan Bicocca, 20126 Milan, Italy
| | - Alessandro Loglio
- Gastroenterology Hepatology and Transplantation Unit, ASST Papa Giovanni XXIII, Piazza OMS 1, 24127 Bergamo, Italy; (A.S.); (S.F.)
| | - Flavia Neri
- Department of Organ Failure and Transplantation, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy
| | - Stefania Camagni
- Department of Organ Failure and Transplantation, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy
| | - Luisa Pasulo
- Gastroenterology Hepatology and Transplantation Unit, ASST Papa Giovanni XXIII, Piazza OMS 1, 24127 Bergamo, Italy; (A.S.); (S.F.)
| | - Maria Grazia Lucà
- Gastroenterology Hepatology and Transplantation Unit, ASST Papa Giovanni XXIII, Piazza OMS 1, 24127 Bergamo, Italy; (A.S.); (S.F.)
| | - Roberto Trevisan
- Endocrine and Diabetology Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy
- Department of Medicine and Surgery, University of Milano Bicocca, 20126 Milan, Italy
| | - Stefano Fagiuoli
- Gastroenterology Hepatology and Transplantation Unit, ASST Papa Giovanni XXIII, Piazza OMS 1, 24127 Bergamo, Italy; (A.S.); (S.F.)
- Gastroenterology, Department of Medicine, University of Milan Bicocca, 20126 Milan, Italy
| | - Mauro Viganò
- Gastroenterology Hepatology and Transplantation Unit, ASST Papa Giovanni XXIII, Piazza OMS 1, 24127 Bergamo, Italy; (A.S.); (S.F.)
- Gastroenterology, Department of Medicine, University of Milan Bicocca, 20126 Milan, Italy
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Stader JM, Recker F, Tonguc T, Ramig O, Thudium M, Matlac D, Mutschler N, Egger EK, Mustea A, Küppers J, Essler M, Jenne J, Strunk HM, Conrad R, Marinova M. Clinical experience with shear wave elastography (SWE) for assessing healthy uterus in a transabdominal approach. Sci Rep 2024; 14:14473. [PMID: 38914622 PMCID: PMC11196258 DOI: 10.1038/s41598-024-65238-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 06/18/2024] [Indexed: 06/26/2024] Open
Abstract
Aim of the study was to evaluate the diagnostic performance and feasibility of transabdominal ultrasound shear wave elastography (SWE) in assessing sonoelastographic features of the uterus. Twenty-seven premenopausal women were enrolled between 2021 and 2022. Transabdominal SWE measured myometrial stiffness in various uterine segments. Additionally, tissue stiffness of the quadriceps femoris muscle and autochthonous back muscle was measured. Statistical analysis employed non-parametric tests, t test, and a robust mixed linear model. Stiffness values of the uterus and the two investigated muscle types exhibited a similar spectrum: 6.38 ± 2.59 kPa (median 5.61 kPa; range 2.76-11.31 kPa) for the uterine myometrium, 7.22 ± 1.24 kPa (6.82 kPa; 5.11-9.39 kPa) for the quadriceps femoris musle, and 7.43 ± 2.73 kPa (7.41 kPa; 3.10-13.73 kPa) for the autochthonous back muscle. A tendency for significant differences in myometrial stiffness was observed concerning the type of labor mode (mean stiffness of 9.17 ± 1.35 kPa after vaginal birth vs. 3.83 ± 1.35 kPa after Caesarian section, p = 0.01). No significant differences in myometrial stiffness were observed concerning age, BMI, previous pregnancies, uterine flexion and menstrual cycle phase. Transabdominal SWE of uterine stiffness seems to be a fast and practicable method in a clinical setting. Uterine stiffness appears to be largely independent of various factors, except for the mode of delivery. However, further studies are needed to validate these results.
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Affiliation(s)
- Judith M Stader
- Department of Nuclear Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Florian Recker
- Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany
| | - Tolga Tonguc
- Department of Diagnostic and Interventional Radiology, Department of Neuroradiology, University Hospital Bonn, Bonn, Germany
| | - Olga Ramig
- Department of Diagnostic and Interventional Radiology, Department of Neuroradiology, University Hospital Bonn, Bonn, Germany
| | - Marcus Thudium
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany
| | - Dieter Matlac
- Department of Gynecology and Gynecological Oncology, University Hospital Bonn, Bonn, Germany
| | - Nikola Mutschler
- Department of Gynecology and Gynecological Oncology, University Hospital Bonn, Bonn, Germany
| | - Eva K Egger
- Department of Gynecology and Gynecological Oncology, University Hospital Bonn, Bonn, Germany
| | - Alexander Mustea
- Department of Gynecology and Gynecological Oncology, University Hospital Bonn, Bonn, Germany
| | - Jim Küppers
- Department of Nuclear Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Markus Essler
- Department of Nuclear Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Jürgen Jenne
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
| | | | - Rupert Conrad
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Muenster, Münster, Germany
| | - Milka Marinova
- Department of Nuclear Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
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Zaniker EJ, Zhang M, Hughes L, La Follette L, Atazhanova T, Trofimchuk A, Babayev E, Duncan FE. Shear wave elastography to assess stiffness of the human ovary and other reproductive tissues across the reproductive lifespan in health and disease†. Biol Reprod 2024; 110:1100-1114. [PMID: 38609185 PMCID: PMC11180622 DOI: 10.1093/biolre/ioae050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/15/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
The ovary is one of the first organs to show overt signs of aging in the human body, and ovarian aging is associated with a loss of gamete quality and quantity. The age-dependent decline in ovarian function contributes to infertility and an altered endocrine milieu, which has ramifications for overall health. The aging ovarian microenvironment becomes fibro-inflammatory and stiff with age, and this has implications for ovarian physiology and pathology, including follicle growth, gamete quality, ovulation dynamics, and ovarian cancer. Thus, developing a non-invasive tool to measure and monitor the stiffness of the human ovary would represent a major advance for female reproductive health and longevity. Shear wave elastography is a quantitative ultrasound imaging method for evaluation of soft tissue stiffness. Shear wave elastography has been used clinically in assessment of liver fibrosis and characterization of tendinopathies and various neoplasms in thyroid, breast, prostate, and lymph nodes as a non-invasive diagnostic and prognostic tool. In this study, we review the underlying principles of shear wave elastography and its current clinical uses outside the reproductive tract as well as its successful application of shear wave elastography to reproductive tissues, including the uterus and cervix. We also describe an emerging use of this technology in evaluation of human ovarian stiffness via transvaginal ultrasound. Establishing ovarian stiffness as a clinical biomarker of ovarian aging may have implications for predicting the ovarian reserve and outcomes of Assisted Reproductive Technologies as well as for the assessment of the efficacy of emerging therapeutics to extend reproductive longevity. This parameter may also have broad relevance in other conditions where ovarian stiffness and fibrosis may be implicated, such as polycystic ovarian syndrome, late off target effects of chemotherapy and radiation, premature ovarian insufficiency, conditions of differences of sexual development, and ovarian cancer. Summary sentence: Shear Wave Elastography is a non-invasive technique to study human tissue stiffness, and here we review its clinical applications and implications for reproductive health and disease.
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Affiliation(s)
- Emily J Zaniker
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Man Zhang
- Department of Radiology, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Lydia Hughes
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Tomiris Atazhanova
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Alexis Trofimchuk
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Elnur Babayev
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Francesca E Duncan
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Center for Reproductive Longevity and Equality, Buck Institute for Research on Aging, Novato, CA, USA
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Almutairi FF. The feasibility of point shear wave elastography (pSWE) in the assessment of pancreas stiffness in diabetic patients and healthy volunteers. PLoS One 2024; 19:e0303098. [PMID: 38857243 PMCID: PMC11164356 DOI: 10.1371/journal.pone.0303098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 04/17/2024] [Indexed: 06/12/2024] Open
Abstract
Type 1 diabetes mellitus (T1DM) is an autoimmune disease characterized by the dysfunctional metabolism of carbohydrates, fats, and proteins caused by impaired insulin secretion and insulin resistance. This study investigated the feasibility of using point shear wave elastography (pSWE) of the pancreas by comparing the shear wave velocity (SWV) measurements of three anatomical areas in patients with T1DM and healthy volunteers. This study included 30 patients with T1DM (9 male, 21 female) and 23 healthy controls (11 men, 12 women). Two experienced certified operators performed the examinations and took the SWV measurements. The mean SWV of the entire pancreas parenchyma differed significantly between patients and controls (1.1 ± 0.29 and 0.74 ± 0.19 m/s, respectively; p ≤ 0.001). Moreover, the SWVs of the pancreatic segments were significantly different in patients and controls; the mean SWV values of the pancreas head, body, and tail (respectively) in patients vs. controls were 0.99 ± 0.36 vs. 0.76 ± 0.26 m/s (p = 0.012), 1.1 ± 0.52 vs. 0.74 ± 0.23 (p ≤ 0.001), and 1.0 ± 0.34 vs. 0.73 ± 0.28 (p ≤ 0.001). This study confirmed the feasibility of quantifying pancreas tissue stiffness with pSWE and revealed that patients with T1DM had higher pancreas tissue stiffness than controls. Further studies are required to determine the potential value of pSWE as a screening tool in patients with prediabetes.
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Affiliation(s)
- Fahad Farhan Almutairi
- Department of Radiologic Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Animal House Unit, King Fahd Medical Research Centre, King Abdulaziz University, Jeddah, Saudi Arabia
- Smart Medical Imaging Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
- Medical Imaging and Artificial Intelligence Research Unit, Center of Modern Mathematical Sciences and its Applications, King Abdulaziz University, Jeddah, Saudi Arabia
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Santos R, Loft MK, Pedersen MRV. Elastography of the Male Pelvic Region-Perspectives on Malignant Lesions. Diagnostics (Basel) 2024; 14:1218. [PMID: 38928634 PMCID: PMC11202996 DOI: 10.3390/diagnostics14121218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 05/31/2024] [Accepted: 06/01/2024] [Indexed: 06/28/2024] Open
Abstract
Ultrasound elastography is widely used to assess tissue stiffness for lesion characterization, including differentiation between benign and malignant lesions. This study focuses on the use of elastography in the male pelvis, including the prostate, testicles, and rectum, by comparing elastography types (shear wave and strain). This article provides a summary of the existing literature on the use of elastography in the male pelvic region and outlines the clinical perspective. Ultrasound elastography is a good technique for evaluating and monitoring lesions in the male pelvic region.
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Affiliation(s)
- Rute Santos
- Medical Imaging and Radiotherapy Department, Coimbra Health School, Polytechnic University of Coimbra, 3045-093 Coimbra, Portugal
- H&TRC—Health & Technology Research Center, Coimbra Health School, Polytechnic University of Coimbra, 3045-093 Coimbra, Portugal
- CIPER-UC, University of Coimbra, 3004-531 Coimbra, Portugal
| | - Martina Kastrup Loft
- Department of Radiology, University Hospital of Southern Denmark, Vejle Hospital, Beriderbakken 4, 7100 Vejle, Denmark; (M.K.L.); (M.R.V.P.)
- Department of Radiology, University Hospital of Southern Denmark, Kolding Hospital, Sygehusvej 24, 6000 Kolding, Denmark
| | - Malene Roland Vils Pedersen
- Department of Radiology, University Hospital of Southern Denmark, Vejle Hospital, Beriderbakken 4, 7100 Vejle, Denmark; (M.K.L.); (M.R.V.P.)
- Department of Radiology, University Hospital of Southern Denmark, Kolding Hospital, Sygehusvej 24, 6000 Kolding, Denmark
- Department of Regional Health, Faculty of Health, University of Southern Denmark, Campusvej 55, 5230 Odense, Denmark
- Discipline of Medical Imaging & Radiation Therapy, School of Medicine, University College Cork, T12 AK54 Cork, Ireland
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Marín-Serrano E, Barbado Cano A, Fernández Martos R, Abadía Barno M, Olveira Martín A, Martín Arranz MD. Protocol for acquisition of images and measurement of transabdominal ultrasound pancreatic two-dimensional shear wave elastography (2D-SWE). GASTROENTEROLOGIA Y HEPATOLOGIA 2024:S0210-5705(24)00156-0. [PMID: 38723774 DOI: 10.1016/j.gastrohep.2024.502198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/24/2024] [Accepted: 02/27/2024] [Indexed: 05/31/2024]
Abstract
INTRODUCTION Transabdominal ultrasound (TU) pancreatic 2D-SWE elastography is a developing technique that needs to be protocolized. OBJECTIVES Establish a protocol for image acquisition and measurement of TU pancreatic - 2D-SWE elastography and estimate the minimum number of measurements to be performed. MATERIALS AND METHODS Ten measurements of pancreatic elasticity were taken in healthy volunteers using TU-2D-SWE, following a strict protocol for image acquisition and measurement. RESULTS The 70% of the participants were women, with an average age, weight, and BMI of 49.5±15.7 years, 65.9±11.9kg, and 24.5±4.2kg/m2, respectively. Measurements were taken from the body (70%), tail (16.7%), and pancreatic head (13.3%). The median mean velocity and elasticity were 1.46±0.25cm/sec and 6.46±2.87KPa, respectively. The ROI depth was 4.12±1cm and the SP-ROI distance was 5.2mm on average. There were no statistically significant differences between the 10 measurements. The reliability analysis of the measurements showed high internal consistency and repeatability. Taking 5-6 measurements ensured high concordance with the ten reference measurements. The measurements were significantly lower when the SP-ROI values were intermediate (0.3-0.6cm). The measurement accuracy was higher when performed at a depth less than 4.8cm. CONCLUSION To measure pancreatic elasticity using TU-2D-SWE, we propose a strict protocol for image acquisition and measurement, taking a minimum of 5 measurements in the best visualized and accessible pancreatic portion, and preferably at a depth of less than 4.8cm.
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Yin Z, Li GY, Zhang Z, Zheng Y, Cao Y. SWENet: A Physics-Informed Deep Neural Network (PINN) for Shear Wave Elastography. IEEE TRANSACTIONS ON MEDICAL IMAGING 2024; 43:1434-1448. [PMID: 38032772 DOI: 10.1109/tmi.2023.3338178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Shear wave elastography (SWE) enables the measurement of elastic properties of soft materials in a non-invasive manner and finds broad applications in various disciplines. The state-of-the-art SWE methods rely on the measurement of local shear wave speeds to infer material parameters and suffer from wave diffraction when applied to soft materials with strong heterogeneity. In the present study, we overcome this challenge by proposing a physics-informed neural network (PINN)-based SWE (SWENet) method. The spatial variation of elastic properties of inhomogeneous materials has been introduced in the governing equations, which are encoded in SWENet as loss functions. Snapshots of wave motions have been used to train neural networks, and during this course, the elastic properties within a region of interest illuminated by shear waves are inferred simultaneously. We performed finite element simulations, tissue-mimicking phantom experiments, and ex vivo experiments to validate the method. Our results show that the shear moduli of soft composites consisting of matrix and inclusions of several millimeters in cross-section dimensions with either regular or irregular geometries can be identified with excellent accuracy. The advantages of the SWENet over conventional SWE methods consist of using more features of the wave motions and enabling seamless integration of multi-source data in the inverse analysis. Given the advantages of SWENet, it may find broad applications where full wave fields get involved to infer heterogeneous mechanical properties, such as identifying small solid tumors with ultrasound SWE, and differentiating gray and white matters of the brain with magnetic resonance elastography.
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Gomez A, Rus G, Saffari N. Reverse time migration and genetic algorithms Combined for Reconstruction in Transluminal Shear Wave Elastography: An In Silico Case Study. ULTRASONICS 2024; 138:107206. [PMID: 38008004 DOI: 10.1016/j.ultras.2023.107206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/14/2023] [Accepted: 11/21/2023] [Indexed: 11/28/2023]
Abstract
A new reconstruction approach that combines Reverse Time Migration (RTM) and Genetic Algorithms (GAs) is proposed for solving the inverse problem associated with transluminal shear wave elastography. The transurethral identification of the first thermal lesion generated by transrectal High Intensity Focused Ultrasound (HIFU) for the treatment of prostate cancer, was used to preliminarily test in silico the combined reconstruction method. The RTM method was optimised by comparing reconstruction images from several cross-correlation techniques, including a new proposed one, and different device configurations in terms of the number and arrangement of emitters and receivers of the conceptual transurethral probe. The best results were obtained for the new proposed cross-correlation method and a device configuration with 3 emitters and 32 receivers. The RTM reconstructions did not completely contour the shape of the HIFU lesion, however, as planned for the combined approach, the areas in the RTM images with high level of correlation were used to narrow down the search space in the GA-based technique. The GA-based technique was set to find the location of the HIFU lesion and the increment in stiffness and viscosity due to thermal damage. Overall, the combined approach achieves lower level of error in the reconstructed values, and in a shorter computational time, compared to the GA-based technique alone. The lowest errors were accomplished for the location of HIFU lesion, followed by the contrast ratio of stiffness between thermally treated tissue and non-treated normal tissue. The homologous ratio of viscosity obtained higher level of error. Further investigation considering diverse scenarios to be reconstructed and with experimental data is required to fully evaluate the feasibility of the combined approach.
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Affiliation(s)
- Antonio Gomez
- UCL Mechanical Engineering, University College London, Roberts Engineering Building, Torrington Place, London, WC1E 7JE, United Kingdom; ibs.GRANADA, Instituto de Investigación Biosanitaria, Avenida de Madrid 15, Granada, 18012, Spain.
| | - Guillermo Rus
- Department of Structural Mechanics, University of Granada, Edificio Politécnico, Campus de Fuentenueva, Granada, 18071, Spain; ibs.GRANADA, Instituto de Investigación Biosanitaria, Avenida de Madrid 15, Granada, 18012, Spain; Excellence Research Unit "Modeling Nature", University of Granada, Campus de Fuentenueva, Granada, 18071, Spain
| | - Nader Saffari
- UCL Mechanical Engineering, University College London, Roberts Engineering Building, Torrington Place, London, WC1E 7JE, United Kingdom
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Vasconcelos L, Kijanka P, Grande JP, Oliveira R, Amador C, Aristizabal S, Sanger NM, Rule AD, Atwell TD, Urban MW. Kidney cortex shear wave motion simulations based on segmented biopsy histology. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 245:108035. [PMID: 38290290 PMCID: PMC10922860 DOI: 10.1016/j.cmpb.2024.108035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/11/2024] [Accepted: 01/14/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND AND OBJECTIVE Biopsy stands as the gold standard for kidney transplant assessment, yet its invasive nature restricts frequent use. Shear wave elastography (SWE) is emerging as a promising alternative for kidney transplant monitoring. A parametric study involving 12 biopsy data sets categorized by standard biopsy scores (3 with normal histology, 3 with interstitial inflammation (i), 3 with interstitial fibrosis (ci), and 3 with tubular atrophy (ct)), was conducted to evaluate the interdependence between microstructural variations triggered by chronic allograft rejection and corresponding alterations in SWE measurements. METHODS Heterogeneous shear wave motion simulations from segmented kidney cortex sections were performed employing the staggered-grid finite difference (SGFD) method. The SGFD method allows the mechanical properties to be defined on a pixel-basis for shear wave motion simulation. Segmentation techniques enabled the isolation of four histological constituents: glomeruli, tubules, interstitium, and fluid. Baseline ex vivo Kelvin-Voigt mechanical properties for each constituent were drawn from established literature. The parametric evaluation was then performed by altering the baseline values individually. Shear wave velocity dispersion curves were measured with the generalized Stockwell transform in conjunction with slant frequency-wavenumber analysis (GST-SFK) algorithm. By fitting the curve within the 100-400 Hz range to the Kelvin-Voigt model, the rheological parameters, shear elasticity (µ1) and viscosity (µ2), were estimated. A time-to-peak algorithm was used to estimate the group velocity. The resultant in silico models emulated the heterogeneity of kidney cortex within the shear wave speed (SWS) reconstructions. RESULTS The presence of inflammation showed considerable spatial composition disparities compared to normal cases, featuring a 23 % increase in interstitial area and a 19 % increase in glomerular area. Concomitantly, there was a reduction of 12 % and 47 % in tubular and fluid areas, respectively. Consequently, mechanical changes induced by inflammation predominate in terms of rheological differentiation, evidenced by increased elasticity and viscosity. Mild tubular atrophy showed significant elevation in group velocity and µ1. Conversely, mild and moderate fibrosis exhibited negligible alterations across all parameters, compatible with relatively limited morphological impact. CONCLUSIONS This proposed model holds promise in enabling patient-specific simulations of the kidney cortex, thus facilitating exploration into how pathologies altering cortical morphology correlates to modifications in SWE-derived rheological measurements. We demonstrated that inflammation caused substantial changes in measured mechanical properties.
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Affiliation(s)
| | - Piotr Kijanka
- Department of Robotics and Mechatronics, AGH University of Krakow, Krakow, Poland
| | - Joseph P Grande
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Rebeca Oliveira
- Department of Earth and Environmental Sciences, University of Minnesota, Minneapolis, MN, USA
| | | | | | - Nicholas M Sanger
- Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Andrew D Rule
- Department of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
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Lin Y, Lu W, Li G, Mao L, Ouyang L, Zhu Z, Chen S, Liang P, Jin H, Gao L, Liang J, Qiu S, Chen F. Non-invasive evaluation of testicular torsion using ultrasound shear wave elastography: an experimental study. Ultrasonography 2024; 43:98-109. [PMID: 38325332 PMCID: PMC10915115 DOI: 10.14366/usg.23171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/09/2023] [Accepted: 11/23/2023] [Indexed: 02/09/2024] Open
Abstract
PURPOSE The goal of this study was to examine changes in testicular stiffness at various intervals after the induction of testicular torsion, as well as to assess the predictive value of testicular stiffness for testicular spermatogenesis after torsion. METHODS Sixty healthy male rabbits were randomly assigned to one of three groups: complete testicular torsion, incomplete testicular torsion, or control. All rabbits underwent preoperative and postoperative scrotal ultrasonography, including shear wave elastography (SWE), at predetermined intervals. Changes in SWE values were analyzed and compared using repeatedmeasures analysis of variance. To assess the diagnostic performance of SWE in determining the degree of spermatogenic function impairment, the areas under the receiver operating characteristic curves (AUCs) were calculated. RESULTS SWE measurements in both central and peripheral zones of the testicular parenchyma affected by torsion demonstrated significant negative correlations with spermatogenesis, with coefficients of r=-0.759 (P<0.001) and r=-0.696 (P<0.001), respectively. The AUCs of SWE measurements in the central or peripheral zones of the torsed testicular parenchyma were 0.886 (sensitivity, 83.3%; specificity, 100%) and 0.824 (sensitivity, 83.3%; specificity, 73.3%) for distinguishing between hypospermatogenesis and spermatogenic arrest, respectively (P=0.451, DeLong test). CONCLUSION Variations in the stiffness of both central and peripheral regions of the testicular parenchyma correlate with the extent and duration of torsion, exhibiting a specific pattern. The "stiff ring sign" is the characteristic SWE finding associated with testicular torsion. SWE appears to aid in the non-invasive determination of the extent of spermatogenic damage in torsed testes.
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Affiliation(s)
- Yunyong Lin
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wenjie Lu
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Guojing Li
- Department of Medical Imaging, The Second Clinical College of Guangzhou Medical University, Guangzhou, China
| | - Lin Mao
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Liangyan Ouyang
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhimin Zhu
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shiyan Chen
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Peixian Liang
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Haowei Jin
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Linlin Gao
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jianjing Liang
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shaodong Qiu
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Fei Chen
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Dai X, Sui X, Chen S, Zhao B, Liu Z, Wang X. The diagnostic performance of salivary gland ultrasound elastography in Sjögren's syndrome and sicca symptoms: a systematic review and meta-analysis. Eur Radiol 2024; 34:1545-1555. [PMID: 37658892 DOI: 10.1007/s00330-023-10166-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/29/2023] [Accepted: 07/19/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE To systematically evaluate the diagnostic performance of ultrasound elastography (USE) in distinguishing primary Sjögren's syndrome (pSS) from healthy/disease controls. METHODS We searched the PubMed, Embase, Web of Science, and Cochrane Library databases for published literature on USE for diagnosing pSS. Bivariate random effects models were used to calculate the pooled sensitivity and specificity of USE. To determine the factors influencing heterogeneity, meta-regression and subgroup analyses were performed to assess country, diagnostic criteria, imaging mechanisms, shear wave elastography techniques, measurement location, control group category, and patient age. Publication bias was assessed using the asymmetry of the Deeks funnel plot. RESULTS Fifteen articles covering 816 patients and 735 control participants were included. USE showed a pooled sensitivity of 0.80 (95% CI: 0.71-0.87) and specificity of 0.87 (95% CI: 0.78-0.92). Meta-regression and subgroup analyses revealed that shear wave elastography techniques, measurement location, and patient age were significant factors that affected study heterogeneity (p < 0.05). Elastography performs better in diagnosing patients aged ≤ 51 years compared to patients aged > 51 years. There was no significant publication bias. CONCLUSION USE demonstrates high accuracy in differentiating between pSS and healthy/disease control groups. CLINICAL RELEVANCE STATEMENT Ultrasound elastography, as a non-invasive and cost-effective technique, can be used to distinguish primary Sjögren's syndrome from disease/healthy control groups by measuring the stiffness of salivary glands. KEY POINTS • Ultrasound elastography is an acceptable technique for the diagnosis of primary Sjögren's syndrome. • The pooled sensitivity and specificity of ultrasound elastography for diagnosing primary Sjögren's syndrome were 0.80 and 0.87, respectively. • In patients aged ≤ 51 years with primary Sjögren's syndrome, ultrasound elastography showed good diagnostic performance.
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Affiliation(s)
- Xinpeng Dai
- Department of Ultrasound, Hebei Medical University Third Affiliated Hospital, No.139 Ziqiang Road, Qiaoxi District, Shijiazhuang, Hebei Province, China
| | - Xin Sui
- Department of Ultrasound, Hebei Medical University Third Affiliated Hospital, No.139 Ziqiang Road, Qiaoxi District, Shijiazhuang, Hebei Province, China.
| | - Simei Chen
- Department of Ultrasound, Hebei Medical University Third Affiliated Hospital, No.139 Ziqiang Road, Qiaoxi District, Shijiazhuang, Hebei Province, China
| | - Bingxin Zhao
- Department of Ultrasound, Hebei Medical University Third Affiliated Hospital, No.139 Ziqiang Road, Qiaoxi District, Shijiazhuang, Hebei Province, China
| | - Zongjie Liu
- Department of Ultrasound, Hebei Medical University Third Affiliated Hospital, No.139 Ziqiang Road, Qiaoxi District, Shijiazhuang, Hebei Province, China
| | - Xiaoyan Wang
- Department of Ultrasound, Hebei General Hospital, NO.348 Heping West Road, Xinhua District, Shijiazhuang, Hebei Province, China
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Ng KH, Wong JHD, Leong SS. Shear wave elastography in chronic kidney disease - the physics and clinical application. Phys Eng Sci Med 2024; 47:17-29. [PMID: 38078996 DOI: 10.1007/s13246-023-01358-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 11/15/2023] [Indexed: 03/26/2024]
Abstract
Chronic kidney disease is a leading public health problem worldwide. The global prevalence of chronic kidney disease is nearly five hundred million people, with almost one million deaths worldwide. Estimated glomerular filtration rate, imaging such as conventional ultrasound, and histopathological findings are necessary as each technique provides specific information which, when taken together, may help to detect and arrest the development of chronic kidney disease, besides managing its adverse outcomes. However, estimated glomerular filtration rate measurements are hampered by substantial error margins while conventional ultrasound involves subjective assessment. Although histopathological assessment is the best tool for evaluating the severity of the renal pathology, it may lead to renal insufficiency and haemorrhage if complications occurred. Ultrasound shear wave elastography, an emerging imaging that quantifies tissue stiffness non-invasively has gained interest recently. This method applies acoustic force pulses to generate shear wave within the tissue that propagate perpendicular to the main ultrasound beam. By measuring the speed of shear wave propagation, the tissue stiffness is estimated. This paper reviews the literature and presents our combined experience and knowledge in renal shear wave elastography research. It discusses and highlights the confounding factors on shear wave elastography, current and future possibilities in ultrasound renal imaging and is not limited to new sophisticated techniques.
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Affiliation(s)
- Kwan Hoong Ng
- Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Faculty of Medicine and Health Sciences, UCSI University, Port Dickson, Negeri Sembilan, Malaysia
| | - Jeannie Hsiu Ding Wong
- Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Sook Sam Leong
- Centre for Medical Imaging Studies, Faculty of Health Sciences, Universiti Teknologi MARA Selangor, Selangor, Malaysia.
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Rössle M, Bettinger D, Sturm L, Reincke M, Thimme R, Schultheiss M. Fibrosis Progression in Patients with Budd-Chiari Syndrome and Transjugular Intrahepatic Portosystemic Shunt (TIPS): A Long-Term Study Using Transient Elastography. Diagnostics (Basel) 2024; 14:344. [PMID: 38337860 PMCID: PMC10855690 DOI: 10.3390/diagnostics14030344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/29/2024] [Accepted: 02/03/2024] [Indexed: 02/12/2024] Open
Abstract
Hepatic vein outflow obstruction causes congestion of the liver, leading to necrosis, fibrosis, and portal hypertension (PH). A transjugular intrahepatic portosystemic shunt (TIPS) reduces congestion and PH by providing artificial outflow. The aim of the study was to investigate fibrosis progression in patients with Budd-Chiari syndrome (BCS) and TIPS using transient elastography (TE). From 2010 to 2022, 25 patients received 80 TEs using FibroScan®, Echosens, Paris, France (3.2 ± 2.1 per patient). TIPS function was assessed via Doppler ultrasound or radiological intervention. At the time of TE examination, 21 patients had patent shunts. Four patients had occluded shunts but normal pressure gradients during the intervention. The first TE measurement performed 9.8 ± 6.8 years after the BCS diagnosis showed stiffness values of 24.6 ± 11.5 kPa. A second or last measurement performed 7.0 ± 2.9 years after the first measurement showed similar stiffness values of 24.1 ± 15.7 kPa (p = 0.943). Except for three patients, the liver stiffness was always >12 kPa, indicating advanced fibrosis. Stiffness values obtained <5 years (n = 8, 23.8 ± 9.2 kPa) or >5 years after the BCS diagnosis (24.9 ± 12.7 kPa) did not differ (p = 0.907). In addition, stiffness was not related to the interval between BCS and TIPS implantation (p = 0.999). One patient received liver transplantation, and two patients died from non-hepatic causes. Most patients developed mild to moderate cirrhosis, possibly during the early phase of the disease. Timing of TIPS did not influence fibrosis progression. This and the release of portal hypertension may argue in favor of a generous TIPS implantation practice in patients with BCS.
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Affiliation(s)
- Martin Rössle
- Department of Medicine II, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; (D.B.); (M.R.); (R.T.); (M.S.)
| | - Dominik Bettinger
- Department of Medicine II, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; (D.B.); (M.R.); (R.T.); (M.S.)
| | - Lukas Sturm
- Department of Medicine II, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; (D.B.); (M.R.); (R.T.); (M.S.)
| | - Marlene Reincke
- Department of Medicine II, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; (D.B.); (M.R.); (R.T.); (M.S.)
| | - Robert Thimme
- Department of Medicine II, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; (D.B.); (M.R.); (R.T.); (M.S.)
| | - Michael Schultheiss
- Department of Medicine II, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; (D.B.); (M.R.); (R.T.); (M.S.)
- Berta-Ottenstein Programme, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
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Almalki YE, Mansour MGED, Ali SA, Basha MAA, Abdelkawi MM, Alduraibi SK, Almushayti ZA, Aldhilan AS, Aboualkheir M, Amin D, Metkees M, Basha AMA, Ebaid NY. Advanced strain elastography is a reliable approach for prostate cancer detection in patients with elevated PSA levels. Sci Rep 2024; 14:2917. [PMID: 38316992 PMCID: PMC10844258 DOI: 10.1038/s41598-024-53440-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 01/31/2024] [Indexed: 02/07/2024] Open
Abstract
This study aimed to examine the validity and reproducibility of strain elastography (SE) for detecting prostate cancer (PCa) in patients with elevated prostate-specific antigen (PSA) levels. The study included 107 patients with elevated PSA levels. All eligible patients underwent transrectal ultrasound (TRUS) with real-time elastography (RTE) to detect suspicious lesions. Two readers independently evaluated the lesions and assigned a strain ratio and elastography score to each lesion. Histopathology was used as a reference standard to estimate the validity of RTE in predicting malignant lesions. An intraclass correlation (ICC) was performed to detect reliability of the strain ratios and elastography scores. TRUS-guided biopsy detected malignancies in 64 (59.8%) patients. TRUS with RTE revealed 122 lesions. The strain ratio index (SRI) cut-off values to diagnose malignancy were 4.05 and 4.35, with sensitivity, specificity, and accuracy of 94.7%, 91.3%, and 93.4%, respectively. An elastography score > 3 was the best cut-off value for detecting malignancy. According to readers, the sensitivity, specificity, and accuracy were 91.3-94.7%, 89.5-93.4%, and 91.3-90.9%, respectively. Excellent inter-reader agreement was recorded for SRI and elastography scores, with ICC of 0.937 and 0.800, respectively. SE proves to be an efficient tool for detecting PCa with high accuracy in patients with elevated PSA levels.
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Affiliation(s)
- Yassir Edrees Almalki
- Division of Radiology, Department of Internal Medicine, Medical College, Najran University, Najran, 61441, Kingdom of Saudi Arabia
| | | | - Susan Adil Ali
- Department of Radiology, Faculty of Medicine, Ain Shams University, Cairo, 11566, Egypt
| | | | | | - Sharifa Khalid Alduraibi
- Department of Radiology, College of Medicine, Qassim University, Buraidah, 52571, Kingdom of Saudi Arabia
| | - Ziyad A Almushayti
- Department of Radiology, College of Medicine, Qassim University, Buraidah, 52571, Kingdom of Saudi Arabia
| | - Asim S Aldhilan
- Department of Radiology, College of Medicine, Qassim University, Buraidah, 52571, Kingdom of Saudi Arabia
| | - Mervat Aboualkheir
- Department of Radiology and Medical Imaging, College of Medicine, Taibah University, Madinah, 42353, Kingdom of Saudi Arabia
| | - Darine Amin
- Department of Biological Anthropology, Medical Research Division, National Research Centre, Giza, 12622, Egypt
| | - Mohamed Metkees
- Department of Biological Anthropology, Medical Research Division, National Research Centre, Giza, 12622, Egypt
| | - Ahmed M A Basha
- Faculty of General Medicine, St. Petersburg State University, Egypt Branch, Cairo, 11646, Egypt
| | - Noha Yahia Ebaid
- Department of Radiology, Faculty of Medicine, Zagazig University, Zagazig, 44519, Egypt
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Ren Q, Yuan M, Wang G. Role of ultrasonography in the evaluation of disease severity and treatment efficacy in adenomyosis. Arch Gynecol Obstet 2024; 309:363-371. [PMID: 37115275 DOI: 10.1007/s00404-023-07034-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 04/01/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Adenomyosis is a benign disorder characterized by the presence of ectopic endometrial glands and stroma within the myometrium. The main clinical manifestations of adenomyosis are dysmenorrhea, menorrhagia, and infertility, which affect patients' quality of life. Recently, with advancements in imaging techniques, magnetic resonance imaging, and ultrasonography have become the main diagnostic tools for adenomyosis. In addition to the diagnosis and differential diagnosis of adenomyosis, ultrasonography can also be used to evaluate the severity of adenomyosis. The emergence of new techniques, such as elastography and contrast-enhanced ultrasonography (CEUS), has significantly improved the accuracy of ultrasound-based diagnosis of adenomyosis. These two imaging tools can also be used for the differential diagnosis of adenomyosis and the evaluation of treatment efficacy after medication or ablation procedure. OBJECTIVE we review the efficacy of ultrasonography as a diagnostic tool for adenomyosis. We also aim to introduce the potential of ultrasound imaging in the evaluation of the severity of this disease, as well as the application of elastography and contrast-enhanced ultrasonography (CEUS) in its diagnosis. RESULTS AND CONCLUSION Our findings reveal the potential value of ultrasonography combined with elastography and/or CEUS as medication guidance and efficacy evaluation tools in the long-term management of adenomyosis.
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Affiliation(s)
- Qianhui Ren
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Jinan, 250000, Shandong, China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Ming Yuan
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Jinan, 250000, Shandong, China
- Gynecology Laboratory, Shandong Provincial Hospital, Jinan, Shandong, China
| | - Guoyun Wang
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Jinan, 250000, Shandong, China.
- Gynecology Laboratory, Shandong Provincial Hospital, Jinan, Shandong, China.
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Zhao S, Wu X, Zhang Y, Zhang C. Role of Shear Wave Elastography in the Diagnosis of Peyronie Disease. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:397-403. [PMID: 37948532 DOI: 10.1002/jum.16372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 10/20/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES The present study aims to explore the role of shear wave elastography (SWE) in the diagnosis of Peyronie disease (PD). METHODS A total of 59 PD patients and 59 age-matched healthy adult men were included in this study. The B-mode ultrasound (US) and SWE were performed for all subjects, and the Young modulus (YM) values of the corresponding regions of the penis in the PD and control groups were recorded and compared. RESULTS The mean age of the included PD patients and age-matched controls was 53.81 years (SD 9.52, range 32-73). On B-mode US evaluation, 41 (69.5%) of 59 included PD patients were found to have penile plaques, and the remaining 18 (30.5%) patients had no evidence of penile plaque. After evaluation using SWE, the YM values in the penile plaque region of these 41 patients with penile dysplasia were found to be significantly higher (60.29 kPa ± 19.95) than those outside the plaque (in the same patient) (21.05 kPa ± 4.58) and in the same penile region of the control group (20.59 kPa ± 4.65) (P < .001). In the remaining 18 PD patients, the results showed that the YM value of the abnormal penile region in the PD patients (56.67 kPa ± 13.52) was significantly higher than the YM value outside the abnormal penile region in the same patients (22.79 kPa ± 4.31) and in the same penile region in the control group (19.87 kPa ± 3.48) (P < .001; P < .001). CONCLUSIONS In conclusion, this study showed that SWE as a non-invasive technique is useful in identifying and differentiating penile plaques in PD patients and is a simple, rapid and complementary method to B-mode US.
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Affiliation(s)
- Sheng Zhao
- The Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xu Wu
- The Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yuyang Zhang
- The Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Chaoxue Zhang
- The Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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Zhu J, Qiu L, Ta D, Hua X, Liu H, Zhang H, Li J, Wang Y, Xi Z, Zheng Y, Shan Y, Liu B, Huang W, Liu W, Hao S, Cui L, Cai J, Zhang W, Zhang C, Chen S, Wei A, Dong F. Chinese Ultrasound Doctors Association Guideline on Operational Standards for 2-D Shear Wave Elastography Examination of Musculoskeletal Tissues. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:175-183. [PMID: 37949764 DOI: 10.1016/j.ultrasmedbio.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/19/2023] [Accepted: 10/13/2023] [Indexed: 11/12/2023]
Abstract
The Ultrasound Physician Branch of the Chinese Medical Doctor Association sought to develop evidence-based recommendations on the operational standards for 2-D shear wave elastography examination of musculoskeletal tissues. A consensus panel of 22 Chinese musculoskeletal ultrasound experts reviewed current scientific evidence and proposed a set of 12 recommendations for 13 key issues, including instruments, operating methods, influencing factors and image interpretation. A final consensus was reached through discussion and voting. On the basis of research evidence and expert opinions, the strength of recommendation for each proposition was assessed using a visual analog scale, while further emphasizing the best available evidence during the question-and-answer session. These expert consensus guidelines encourage facilitation of the standardization of clinical practices for collecting and reporting shear wave elastography data.
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Affiliation(s)
- Jiaan Zhu
- Department of Ultrasound, Peking University People's Hospital, Beijing, China.
| | - Li Qiu
- Department of Medical Ultrasound, West China Hospital of Sichuan University, Chengdu, China
| | - Dean Ta
- Center for Biomedical Engineering, Fudan University, Shanghai, China
| | - Xing Hua
- Department of Ultrasound, First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Hongmei Liu
- Department of Ultrasound, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Huabin Zhang
- Department of Ultrasound, Beijing Tsinghua Changgung Hospital Affiliated with Tsinghua University, Beijing, China
| | - Jia Li
- Department of Ultrasound, Southeast University Zhongda Hospital, Nanjing, China
| | - Yuexiang Wang
- Department of Ultrasound, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhanguo Xi
- Department of Functional Examination, Henan Provincial Orthopedic Hospital Zhengzhou Campus, Zhengzhou, China
| | - Yuanyi Zheng
- Department of Ultrasound, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Yong Shan
- Department of Ultrasound, Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Bingyan Liu
- Department of Ultrasound, Hainan General Hospital, Haikou, China
| | - Weijun Huang
- Department of Interventional Ultrasound, First People's Hospital of Foshan, Foshan, China
| | - Weiyong Liu
- Department of Ultrasound, First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Shaoyun Hao
- Department of Ultrasound, Sun Yat-Sen Memorial Hospital, Guangzhou, China
| | - Ligang Cui
- Department of Ultrasound, Peking University Third Hospital, Beijing, China
| | - Jin Cai
- Department of Ultrasound, Zhejiang Chinese Medical University Affiliated Third Hospital, Hangzhou, China
| | - Wei Zhang
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Chao Zhang
- Department of Medical Ultrasound, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Shuqiang Chen
- Department of Ultrasound, First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - An Wei
- Department of Ultrasound, Hunan Provincial People's Hospital, Changsha, China
| | - Fajin Dong
- Department of Ultrasound, Shenzhen People's Hospital, Shenzhen, China
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Wang Y, Tian XF, Cheng J, Xu XL, Cao JY, Dong Y, Dietrich CF. Normal value of virtual touch imaging quantification elastography in measurements of pancreas. Clin Hemorheol Microcirc 2024; 87:427-436. [PMID: 38393894 DOI: 10.3233/ch-232092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
OBJECTIVE To evaluate pancreatic tissue stiffness and provide a normal reference shear wave velocity (SWV) value of pancreas from healthy adults by Virtual Touch Imaging Quantification (VTIQ) measurements. METHODS Healthy adult volunteers without known history of hepatobiliary or pancreatic diseases were included. VTIQ elastography (Siemens ACUSON Sequoia, 5C-1 transducer) was used. SWV values were measured at the cephalic, corpus and tail of pancreas and replicated different operators' obtained data. Subgroups were classified according to the volunteers' gender, age, body mass index (BMI), depth of measurements and the echogenicity of the pancreas. RESULTS From February 2023 to July 2023, 33 healthy adult volunteers were included. The success rate of VTIQ measurements in cephalic, corpus and tail regions was 90.90 % (30/33), 96.97 % (32/33) and 90.90 % (30/33) respectively. The color elastograms of healthy adult pancreas showed uniform blue or simultaneously blue and green. The average SWV values were 0.97±0.26 m/s for cephalic, 0.91±0.24 m/s for corpus and 0.97±0.25 m/s for pancreatic tail respectively (P = 0.198). The mean SWV values of pancreas did not show significant difference with age, gender or depth (P > 0.05). BMI was an influence factor in the measurements of SWV values of cephalic and tail of pancreas (P < 0.05). Pancreas with hyperechoic parenchyma showed higher mean SWV values (P < 0.05). The intra-observer (ICC = 0.938 [95% CI: 0.869-0.971]) and the inter-observer (ICC = 0.887 [95% CI: 0.760-0.947]) agreements of VTIQ measurements were excellent. CONCLUSIONS The mean SWV value of the pancreas in healthy adults was 0.96±0.20 m/s (range: 0.52-1.74 m/s). VTIQ technique can be used in pancreatic stiffness measurements with good reliability.
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Affiliation(s)
- Ying Wang
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiao-Fan Tian
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Juan Cheng
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xin-Liang Xu
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jia-Ying Cao
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yi Dong
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Christoph F Dietrich
- Department Allgemeine Innere Medizin, Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
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22
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Zhang TY, Yan J, Wu J, Yang W, Zhang S, Xia J, Che X, Li H, Li D, Ying L, Yuan X, Zhou Y, Zhang M, Mou S. Shear wave elastography parameters adds prognostic value to adverse outcome in kidney transplantation recipients. Ren Fail 2023; 45:2235015. [PMID: 37462113 DOI: 10.1080/0886022x.2023.2235015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/05/2023] [Accepted: 07/05/2023] [Indexed: 07/20/2023] Open
Abstract
INTRODUCTION The tissue stiffness of donor kidneys in transplantation may increase due to pathological changes such as glomerulosclerosis and interstitial fibrosis, and those changes associate worse outcomes in kidney transplantation recipients. Ultrasound elastography is a noninvasive imaging examination with the ability to quantitatively reflect tissue stiffness. Aim of this study was to evaluate the prognostic value of ultrasound elastography for adverse kidney outcome in kidney transplantation recipients. METHODS Shear wave elastography (SWE) examinations were performed by two independent operators in kidney transplantation recipients. The primary outcome was a composite of kidney graft deterioration, all-cause re-hospitalization, and all-cause mortality. Survival analysis was calculated by Kaplan-Meier curves with the log-rank test and Cox regression analysis. RESULTS A total of 161 patients (mean age 46 years, 63.4% men) were followed for a median of 20.1 months. 27 patients (16.77%) reached the primary endpoint. The mean and median tissue stiffness at the medulla (hazard ratio: 1.265 and 1.229, respectively), estimated glomerular filtration rate (eGFR), and serum albumin level were associated with the primary outcome in univariate Cox regression. Adding mean or median medulla SWE to a baseline model containing eGFR and albumin significantly improved its discrimination (C-statistics: 0.736 for the baseline, 0.766 and 0.772 for the model added mean and median medulla SWE, respectively). CONCLUSION The medullary tissue stiffness of kidney allograft measured by shear wave elastography may provide incremental prognostic value to adverse outcomes in kidney transplantation recipients. Including SWE parameters in kidney transplantation recipients management could be considered to improve risk stratification.
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Affiliation(s)
- Tian-Yi Zhang
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiayi Yan
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Academy of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jiajia Wu
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenqi Yang
- Department of Ultrasound, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Shijun Zhang
- Department of Ultrasound, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Jia Xia
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiajing Che
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongli Li
- Department of Ultrasound, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Dawei Li
- Department of Urology, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Liang Ying
- Department of Urology, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Xiaodong Yuan
- Department of Urology, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Yin Zhou
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ming Zhang
- Department of Urology, Renji Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Shan Mou
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Academy of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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23
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Wan L, Hu C, Wang F, Xu K, Li F, He B, Wu Z, Luo L, Wen Z. Evaluation of the efficacy of Biejia decoction pill combined with entecavir in the treatment of hepatitis B liver fibrosis/cirrhosis by VCTE. Sci Rep 2023; 13:19616. [PMID: 37949927 PMCID: PMC10638370 DOI: 10.1038/s41598-023-46459-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023] Open
Abstract
The vibration controlled transient elastography (VCTE) technique was used to assess the effectiveness of a Biejia Decoction pill in combination with Entecavir in the treatment of hepatitis B liver fibrosis/cirrhosis. We randomly selected 120 patients to receive entecavir and 119 patients to receive both entecavir and Biejia Decoction Pill, which both with hepatitis B liver fibrosis/cirrhosis visited the Second Affiliated Hospital of Nanchang University between January 2019 and February 2022. The observation group got ETV (entecavir) and Biejia Decoction pills, whereas the control group received only standard ETV antiviral medication. Based on the grading of the VCTE detection value (LSM) initially diagnosed for patients with hepatitis B liver fibrosis/cirrhosis, we divided the patients into two subgroups of liver fibrosis and cirrhosis. In addition, patients with liver fibrosis were divided into mild and moderate subgroups according to their VCTE values. Patients were measured for liver hardness after three, six, nine, and twelve months of treatment with VCTE. Biejia Decoction Pill combined with ETV on HBV liver fibrosis/cirrhosis was evaluated by comparing patients' changes in liver hardness and HBV-DNA negative conversion rates before and after treatment in each group at the same baseline. The LSM (liver elasticity value) of the observation group and the control group after treatment was lower than that before treatment, and the difference was statistically significant (P < 0.0001); The LSM of the observation group after treatment was significantly lower than that of the control group, and the difference was also statistically significant (P = 0.0005 < 0.05). In the subgroup of liver fibrosis, the number of patients with moderate and severe liver fibrosis who completely reversed liver fibrosis after treatment in the treatment group was far more than that in the control group, and the difference between the two groups was statistically significant (χ2 = 4.82 P = 0.028 < 0.05) 。 When the treatment course was more than 9 months, the negative conversion rate of patients in the observation group reached 87.4%, which was higher than that in the control group (70.8%), and the difference was statistically significant (P = 0.002 < 0.05); After 12 months of treatment, the negative conversion rate of patients in the observation group was as high as 95%, which was significantly higher than 76.67% in the control group (P < 0.001). The degree of liver fibrosis was significantly improved when Biejia Decoction Pill was combined with ETV in patients with liver fibrosis/cirrhosis due to hepatitis B. The virological response rate to HBV-DNA increased with the prolongation of treatment, and the Biejia Decoction Pill assists with entecavir in antiviral therapy.
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Affiliation(s)
- Lijun Wan
- Department of Gastroenterology Department, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Donghu District, Nanchang, Jiangxi, China
| | - Chungen Hu
- Department of Gastroenterology Department, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Donghu District, Nanchang, Jiangxi, China
| | - Fenfen Wang
- Department of Gastroenterology Department, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Donghu District, Nanchang, Jiangxi, China
| | - Kedong Xu
- Department of Gastroenterology Department, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Donghu District, Nanchang, Jiangxi, China
| | - Fan Li
- Department of Gastroenterology Department, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Donghu District, Nanchang, Jiangxi, China
| | - Bo He
- Department of Gastroenterology Department, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Donghu District, Nanchang, Jiangxi, China
| | - Zhengqiang Wu
- Department of Gastroenterology Department, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Donghu District, Nanchang, Jiangxi, China
| | - Linfei Luo
- Department of Gastroenterology Department, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Donghu District, Nanchang, Jiangxi, China
| | - Zhili Wen
- Department of Gastroenterology Department, The Second Affiliated Hospital of Nanchang University, 1 Minde Road, Donghu District, Nanchang, Jiangxi, China.
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24
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Ren Q, Dong X, Yuan M, Jiao X, Sun H, Pan Z, Wang X, Tao G, Guoyun W. Application of elastography to diagnose adenomyosis and evaluate the degree of dysmenorrhea: a prospective observational study. Reprod Biol Endocrinol 2023; 21:98. [PMID: 37884924 PMCID: PMC10601167 DOI: 10.1186/s12958-023-01145-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 09/24/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND To determine whether there is a correlation between stiffness measured by strain elastography and the severity of dysmenorrhea and to determine the value of elastography in evaluating severe dysmenorrhea in patients with adenomyosis. METHODS The correlation between tissue stiffness and dysmenorrhea was analyzed by performing elastography on premenopausal women diagnosed with adenomyosis. Expression levels of transforming growth factor-β (TGF-β), α-smooth muscle actin (α-SMA), and protein gene product 9.5 (PGP9.5) were detected by immunohistochemistry; the correlation of TGF-β and α-SMA levels with the tissue stiffness and the degree of fibrosis was further analyzed. Also, the relationship of the PGP9.5 expression level with the tissue stiffness and degree of dysmenorrhea was determined. RESULTS The degree of dysmenorrhea was significantly positively correlated with lesion stiffness in patients with adenomyosis but not with the uterine or lesion volume. The cutoff for the strain ratio was > 1.36 between the adenomyosis and control groups, with an area under the curve (AUC) of 0.987. For severe dysmenorrhea, the cutoff for the strain ratio was > 1.65 in patients with adenomyosis, with an AUC of 0.849. TGF-β, α-SMA, and PGP9.5 expression levels were higher in adenomyotic lesions than in the endometrium of the adenomyosis and control groups. Both TGF-β and α-SMA levels were positively correlated with the tissue stiffness and degree of fibrosis. Additionally, the expression level of PGP9.5 showed a positive correlation with the tissue stiffness and degree of dysmenorrhea. CONCLUSIONS Elastography can be used to evaluate the degree of dysmenorrhea; the greater the tissue stiffness, the greater the degree of dysmenorrhea. In addition, elastography performed well in the diagnosis of adenomyosis and the evaluation of severe dysmenorrhea in patients with adenomyosis.
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Affiliation(s)
- Qianhui Ren
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Shandong University, No. 324 Jingwu Road, Jinan, 250021, Shandong, China
- Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiangyi Dong
- Department of Ultrasonic Medicine, Qilu Hospital of Shandong University, No. 107 Wenhuaxi Road, Jinan, 250012, China
| | - Ming Yuan
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Shandong University, No. 324 Jingwu Road, Jinan, 250021, Shandong, China
- JiNan Key Laboratory of Diagnosis and Treatment of Major Gynaecological Disease, Jinan, Shandong Province, China
- Gynecology Laboratory, Shandong Provincial Hospital, Jinan, Shandong Province, China
- Gynecology Laboratory, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong Province, China
| | - Xue Jiao
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Shandong University, No. 324 Jingwu Road, Jinan, 250021, Shandong, China
- Cheeloo College of Medicine, Shandong University, Jinan, China
- JiNan Key Laboratory of Diagnosis and Treatment of Major Gynaecological Disease, Jinan, Shandong Province, China
- Gynecology Laboratory, Shandong Provincial Hospital, Jinan, Shandong Province, China
- Gynecology Laboratory, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong Province, China
| | - Hao Sun
- Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zangyu Pan
- Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xinyu Wang
- Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Guowei Tao
- Department of Ultrasonic Medicine, Qilu Hospital of Shandong University, No. 107 Wenhuaxi Road, Jinan, 250012, China.
| | - Wang Guoyun
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Shandong University, No. 324 Jingwu Road, Jinan, 250021, Shandong, China.
- JiNan Key Laboratory of Diagnosis and Treatment of Major Gynaecological Disease, Jinan, Shandong Province, China.
- Gynecology Laboratory, Shandong Provincial Hospital, Jinan, Shandong Province, China.
- Gynecology Laboratory, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong Province, China.
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Lin YY, Mao L, Li J, Zhu ZM, Luo YH, Zhou XH, Qiu SD, Chen F. Exploring the anatomical factors influencing testes elasticity via ultrasound shear wave elastography: Preliminary results. Rev Int Androl 2023; 21:100367. [PMID: 37422973 DOI: 10.1016/j.androl.2023.100367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 06/08/2022] [Accepted: 07/18/2022] [Indexed: 07/11/2023]
Abstract
PURPOSE The aim of this study is to evaluate the anatomical factors influencing elasticity values of normal testicular parenchyma using shear wave elastography (SWE). METHODS This study examined 68 healthy male volunteers (117 testes in which standard transverse axis ultrasonography views could be obtained) via conventional scrotal ultrasonography and SWE. Both the mean (EMean) and standard deviation (ESD) elasticity values were acquired. RESULTS In the standard transverse axis view of the rete testis at the mid-lateral edge of the testes, the EMean values in 2mm the testicular parenchyma from the rete testis and the testicular capsule at the same level as the rete testis were all significantly larger than in the central zone (P<0.001, P<0.001, respectively). The EMean value in the testicular parenchyma 2mm from the testicular capsule on the line formed approximately 45° below the horizontal line of the rete testis was significantly larger than in the rete testis approximately 45° above the horizontal line (P<0.001). In two standard transverse axis views, the ESD values in other regions were significantly larger than those in the central zones (all P<0.001). Also, the EMean values in the transmediastinal arteries were larger than those of the surrounding normal testicular parenchyma (P<0.001). CONCLUSION Based on SWE, factors including the testicular capsule, the density of testicular fibrous septa, the depth of the Q-Box™, and the transmediastinal artery may influence the testes elasticity measurement.
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Affiliation(s)
- Yun-Yong Lin
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Lin Mao
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Jin Li
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Zhi-Min Zhu
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Yan-Hua Luo
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Xiao-Hua Zhou
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Shao-Dong Qiu
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China.
| | - Fei Chen
- Department of Ultrasound, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China.
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Qiu Y, Xing Z, Yang Q, Luo Y, Ma B. Diagnostic performance of shear wave elastography in thyroid nodules with indeterminate cytology: A systematic review and meta-analysis. Heliyon 2023; 9:e20654. [PMID: 37842563 PMCID: PMC10570586 DOI: 10.1016/j.heliyon.2023.e20654] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/24/2023] [Accepted: 10/03/2023] [Indexed: 10/17/2023] Open
Abstract
Purpose Thyroid nodules classified as indeterminate in previous fine-needle aspiration cytology often necessitate additional evaluation to determine their histology, while shear wave elastography (SWE) offers an alternative option in this regard. The objective of this study was to assess the diagnostic effectiveness of SWE in evaluating indeterminate nodules. Methods The PubMed, EMBASE, and Web of Science databases were searched from 1st January 1970 to 1st March 2023. The studies were reviewed and the data was extracted by two separate reviewers. A Bayesian bivariate model was utilized to quantitatively synthesize the diagnostic accuracy and yield of the studies in R. Results A total of seven studies, involving indeterminate thyroid nodules undergoing SWE were included, and the overall malignancy rate was 34.1% (307/900). The summarized estimates of sensitivity and specificity were 0.792 (95% credible interval [CI], 0.727-0.850) and 0.845 (95% CI, 0.797-0.887), respectively. The summarized estimate for the diagnostic odds ratio (DOR) was 17.8 (95% CI, 14.0-22.6). Summarized receiver operating characteristic (SROC) plots indicated a trade-off between sensitivity and specificity, and the estimate of AUC was 0.866 (95% CI, 0.834-0.895). The summary estimates for positive and negative likelihood ratios were 4.67 (95% CI, 3.98-5.85) and 0.26 (95% CI, 0.23-0.28), respectively. Conclusions The overall accuracy of SWE remains satisfactory in indeterminate thyroid nodules. However, it should be noted that the available data are still extremely limited, and more studies or guidelines are required to provide further insights.
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Affiliation(s)
- Yuxuan Qiu
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China
- Department of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Zhichao Xing
- Department of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Qianru Yang
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China
| | - Yan Luo
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China
| | - Buyun Ma
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China
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Qiu T, Yang J, Peng C, Xiang H, Huang L, Ling W, Luo Y. Diagnosis of liver fibrosis and liver function reserve through non-invasive multispectral photoacoustic imaging. PHOTOACOUSTICS 2023; 33:100562. [PMID: 38021289 PMCID: PMC10658630 DOI: 10.1016/j.pacs.2023.100562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 10/13/2023]
Abstract
Liver function reserve (LFR) is the sum of remnant functional hepatic cells after liver injury. In the pathologic process of liver fibrosis (LF), LFR is impaired. LFR assessment can help determine the safe scope of liver resection or drug regimen and predict prognosis of patients with liver disease. Here, we used a photoacoustic imaging (PAI) system to assess LF and LFR in rabbit models. We performed PAI, ultrasound elastography and biopsy for 21 rabbits developing none (n = 6) and LF (n = 15). In vivo indocyanine green (ICG) measurements by PAI showed that LF group presented a significantly attenuated ICG clearance compared to control group, indicating LFR impairment of LF. Another finding was a significantly higher collagen photoacoustic signal intensity value was observed in LF both in vivo and in vitro. Our findings demonstrated that PAI was potentially effective to evaluate LFR and collagen accumulation of LF.
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Affiliation(s)
- Tingting Qiu
- Department of Ultrasound, West China Hospital, Sichuan University, 37 Guoxue Alley, Wuhou District, Chengdu 610041, China
| | - Jinge Yang
- School of Optoelectric Engineering, Chongqing University of Posts and Telecommunications, Chongqing 400065, China
| | - Chihan Peng
- Department of Ultrasound, West China Hospital, Sichuan University, 37 Guoxue Alley, Wuhou District, Chengdu 610041, China
| | - Hongjin Xiang
- Department of Ultrasound, West China Hospital, Sichuan University, 37 Guoxue Alley, Wuhou District, Chengdu 610041, China
| | - Lin Huang
- School of Electronic Science and Engineering, University of Electronic Science and Technology of China, No.2006, Xiyuan Ave, West Hi-Tech Zone District, Chengdu 611731, China
| | - Wenwu Ling
- Department of Ultrasound, West China Hospital, Sichuan University, 37 Guoxue Alley, Wuhou District, Chengdu 610041, China
| | - Yan Luo
- Department of Ultrasound, West China Hospital, Sichuan University, 37 Guoxue Alley, Wuhou District, Chengdu 610041, China
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Chen Z, Chen J, Ying TC, Chen H, Wu C, Chen X, Huang Y, Su Z. Development and Deployment of a Novel Diagnostic Tool Based on Conventional Ultrasound for Fibrosis Assessment in Chronic Kidney Disease. Acad Radiol 2023; 30 Suppl 1:S295-S304. [PMID: 36973117 DOI: 10.1016/j.acra.2023.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/30/2023] [Accepted: 02/18/2023] [Indexed: 03/28/2023]
Abstract
RATIONALE AND OBJECTIVES Accurate identification of risk information about fibrosis severity is crucial for clinical decision-making and clinical management of patients with chronic kidney disease (CKD). This study aimed to develop an ultrasound (US)-derived computer-aided diagnosis tool for identifying CKD patients at high risk of developing moderate-severe renal fibrosis, in order to optimize treatment regimens and follow-up strategies. MATERIALS AND METHODS A total of 162 CKD patients undergoing renal biopsies and US examinations were prospectively enrolled and randomly divided into training (n = 114) and validation (n = 48) cohorts. A multivariate logistic regression approach was employed to develop the diagnostic tool named S-CKD for differentiating moderate-severe renal fibrosis from mild one in the training cohort by integrating the significant variables, which were screened out from demographic characteristics and conventional US features via the least absolute shrinkage and selection operator regression algorithm. The S-CKD was then deployed as both an online web-based and an offline document-based, easy-to-use auxiliary device. In both the training and validation cohorts, the S-CKD's diagnostic performance was evaluated through discrimination and calibration. The clinical benefit of using S-CKD was revealed by decision curve analysis (DCA) and clinical impact curves. RESULTS The proposed S-CKD achieved an area under the receiver operating characteristic curve of 0.84 (95% confidence interval (CI): 0.77-0.91) and 0.81 (95% CI: 0.68-0.94) in the training and validation cohorts, respectively, indicating satisfactory diagnosis performance. Results of the calibration curves showed that S-CKD has excellent predictive accuracy (Hosmer-Lemeshow test: training cohort, p = 0.497; validation cohort, p = 0.205). The DCA and clinical impact curves exhibited a high clinical application value of the S-CKD at a wide range of risk probabilities. CONCLUSION The S-CKD tool developed in this study is capable of discriminating between mild and moderate-severe renal fibrosis in patients with CKD and achieving promising clinical benefits, which may aid clinicians in personalizing medical decision-making and follow-up arrangement.
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Affiliation(s)
- Ziman Chen
- Department of Health Technology and Informatics, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Jiaxin Chen
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Tin Cheung Ying
- Department of Health Technology and Informatics, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Hui Chen
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Chaoqun Wu
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Xuehua Chen
- Central Lab, Liver Disease Research Center, The Affiliated Hospital of Yunnan University, Kunming City, Yunnan Province, China
| | - Yongquan Huang
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Zhongzhen Su
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
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Bucci R, Del Signore F, Vignoli M, Felici A, Russo M, Maresca C, Carluccio A. Canine prostatic serum esterase and strain and 2D-shear wave sonoelastography for evaluation of normal prostate in dogs: Preliminary results. Reprod Domest Anim 2023; 58:1311-1319. [PMID: 37501343 DOI: 10.1111/rda.14435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/03/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023]
Abstract
Canine prostatic serum esterase (CPSE) is considered a useful tool to identify prostate disorders in dogs, with increasing interest in ultrasound (US)-based sonoelastography to non-invasively detect prostate disorders. Since no report is available about a possible correlation between these diagnostic tools, we aimed to investigate a possible correlation between strain elastography (SE) and 2D-shear wave elastography (SWE) and CPSE. Twenty-one dogs were included and, on each animal, CPSE was evaluated followed by a complete US examination and SE and 2D-SWE application. Healthy dogs were identified based on the CPSE results. All the dogs included were characterized by normal CPSE values (<52.3 ng/mL) and normal US prostate appearance. The prostate was characterized by intermediate stiffness with SE (pattern III - 84.7% for the left lobe and 79.27% for the right lobe) and softer than the abdominal wall (SR 0.6 for the left lobe and 0.56 for the right lobe), with low values for both m/s and kilopascals (kPa) for 2D-SWE, pointing that the healthy tissue is not hard. 2D-SWE results were, respectively, 13.51 ± 5.55 kPa and 2.31 ± 0.42 m/s for the left lobe and 18.05 ± 6.47 kPa and 2.39 ± 0.43 m/s for the right lobe. The significant difference between the right and left measurements expressed with kPa, not evidenced with m/s, can be considered indicative of m/s as the most reliable measurement to be considered regarding the prostate parenchyma. Even though no linear correlation was detected between CPSE and elastography values, these preliminary results evidence that the healthy prostates were characterized by a similar elastographic pattern, thus pointing that these techniques can be potentially useful to be applied in case of prostatic disorders to improve the accuracy of the final diagnosis in a non-invasive way.
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Affiliation(s)
- Roberta Bucci
- Department of Veterinary Medicine, University of Teramo, Teramo, Italy
| | | | - Massimo Vignoli
- Department of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - Andrea Felici
- Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche "Togo Rosati", Perugia, Italy
| | - Marco Russo
- Department of Veterinary Medicine and Animal Production, University of Naples, Naples, Italy
| | - Carmen Maresca
- Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche "Togo Rosati", Perugia, Italy
| | - Augusto Carluccio
- Department of Veterinary Medicine, University of Teramo, Teramo, Italy
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Li G, Ma S, Zhang F, Jia C, Liu L, Gao F, Shi Q, Wu R, Du L, Li F. The predictive models based on multimodality ultrasonography for the differential diagnosis of thyroid nodules smaller than 10 mm. Br J Radiol 2023; 96:20221120. [PMID: 37427752 PMCID: PMC10461269 DOI: 10.1259/bjr.20221120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 07/11/2023] Open
Abstract
OBJECTIVE The objective of this study was to establish a multimodality ultrasound prediction model based on conventional ultrasound (Con-US), shear wave elastography (SWE), and strain elastography (SE) and contrast-enhanced ultrasound (CEUS) and to explore their diagnostic values for thyroid nodules ≤ 10 mm. METHODS This retrospective study included 198 thyroid nodules (maximum diameter≤10 mm) in 198 thyroid surgery patients who were examined preoperatively with above-mentioned methods. The pathological findings of the thyroid nodules were used as the gold standard, and there were 72 benign nodules and 126 malignant nodules. The multimodal ultrasound prediction models were developed by logistic regression analysis based on the ultrasound image appearances. The diagnostic efficacy of these prediction models was then compared and internally cross-validated in a fivefold manner. RESULTS The specific features on CEUS (enhancement boundary, enhancement direction and decreased nodule area) and the parenchyma-to-nodule strain ratio (PNSR) on SE and SWE ratio were included in the prediction model. The Model one combining American College of Radiology Thyroid Imaging Reporting and Data Systems (ACR TI-RADS) score with PNSR and SWE ratio had the highest sensitivity (92.8%), while the Model three combining TI-RADS score with PNSR, SWE ratio and specific CEUS indicators had the highest specificity, accuracy, and AUC (90.2%,91.4%, and 0.958, respectively). CONCLUSION The multimodality ultrasound predictive models effectively improved the differential diagnosis of thyroid nodules smaller than 10 mm. ADVANCES IN KNOWLEDGE For the differential diagnosis of thyroid nodules ≤ 10 mm, both ultrasound elastography and CEUS could be effective complements to ACR TI-RADS.
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Affiliation(s)
- Gang Li
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sai Ma
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fan Zhang
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chao Jia
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Long Liu
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Feng Gao
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiusheng Shi
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rong Wu
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lianfang Du
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fan Li
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Obrzut M, Atamaniuk V, Ehman RL, Yin M, Cholewa M, Gutkowski K, Domka W, Ozga D, Obrzut B. Evaluation of Spleen Stiffness in Young Healthy Volunteers Using Magnetic Resonance Elastography. Diagnostics (Basel) 2023; 13:2738. [PMID: 37685274 PMCID: PMC10486410 DOI: 10.3390/diagnostics13172738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/16/2023] [Accepted: 08/20/2023] [Indexed: 09/10/2023] Open
Abstract
PURPOSE Magnetic resonance elastography (MRE) has been established as the most accurate noninvasive technique for diagnosing liver fibrosis. Recent publications have suggested that the measurement of splenic stiffness is useful in setting where portal hypertension may be present. The goal of the current study was to compile normative data for MRE-assessed stiffness measurements of the spleen in young adults. MATERIALS AND METHODS A total of 100 healthy young Caucasian volunteers (65 females and 35 males) in the age range of 20 to 32 years were enrolled in this study. The participants reported no history of chronic spleen and liver disease, normal alcohol consumption, and a normal diet. The MRE data were acquired by using a 1.5 T whole-body scanner and a 2D GRE pulse sequence with 60 Hz excitation. Spleen stiffness was calculated as a weighted mean of stiffness values in the regions of interest manually drawn by the radiologist on three to five spleen slices. RESULTS Mean spleen stiffness was 5.09 ± 0.65 kPa for the whole group. Male volunteers had slightly higher splenic stiffness compared to females: 5.28 ± 0.78 vs. 4.98 ± 0.51 kPa, however, this difference was not statistically significant (p = 0.12). Spleen stiffness did not correlate with spleen fat content and liver stiffness but a statistically significant correlation with spleen volume was found. CONCLUSIONS The findings of this study provide normative values for 2D MRE-based measurement of spleen stiffness in young adults, a basis for assessing the value of this biomarker in young patients with portal system pathologies.
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Affiliation(s)
- Marzanna Obrzut
- Institute of Health Sciences, Medical College, University of Rzeszow, Warzywna 1a, 35-310 Rzeszow, Poland; (M.O.)
| | - Vitaliy Atamaniuk
- Department of Biophysics, Institute of Physics, College of Natural Sciences, University of Rzeszow, Prof. Stanisława Pigonia Str. 1, 35-310 Rzeszow, Poland; (V.A.); (M.C.)
| | - Richard L. Ehman
- Department of Radiology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
| | - Meng Yin
- Department of Radiology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
| | - Marian Cholewa
- Department of Biophysics, Institute of Physics, College of Natural Sciences, University of Rzeszow, Prof. Stanisława Pigonia Str. 1, 35-310 Rzeszow, Poland; (V.A.); (M.C.)
| | - Krzysztof Gutkowski
- Institute of Medical Sciences, Medical College, University of Rzeszow, Rejtana 16C, 35-959 Rzeszow, Poland;
| | - Wojciech Domka
- Department of Otolaryngology, Institute of Medical Sciences, Medical College, University of Rzeszow, Rejtana 16C, 35-959 Rzeszow, Poland;
| | - Dorota Ozga
- Institute of Health Sciences, Medical College, University of Rzeszow, Warzywna 1a, 35-310 Rzeszow, Poland; (M.O.)
| | - Bogdan Obrzut
- Department of Obstetrics and Gynecology, Institute of Medical Sciences, Medical College, University of Rzeszow, Rejtana 16C, 35-959 Rzeszow, Poland
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Paratore M, Garcovich M, Ainora ME, Del Vecchio LE, Cuccia G, Riccardi L, Pompili M, Gasbarrini A, Zocco MA. The Role of Transabdominal Ultrasound Elastography in Gastrointestinal Non-Liver Diseases: Current Application and Future Prospectives. Diagnostics (Basel) 2023; 13:2266. [PMID: 37443663 DOI: 10.3390/diagnostics13132266] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/28/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023] Open
Abstract
Ultrasound imaging is the first-line investigation for patients with abdominal symptoms, as it effectively depicts the gastrointestinal tract and enables the diagnosis of multiple pathological conditions. Among different recent ultrasound technological advancements, elastography enables the evaluation of various tissue characteristics, such as neoplastic transformation or fibroinflammatory status. In recent years, ultrasound elastography has been utilized extensively for the study of liver diseases and in numerous other clinical settings, including gastrointestinal diseases. Current guidelines suggest the use of transabdominal ultrasound elastography to characterize bowel wall lesions, to assess gastrointestinal contractility, to diagnose and grade chronic pancreatitis; however, no specific indications are provided. In the present paper, we summarize the evidence concerning the application of different ultrasound elastography modalities in gastrointestinal non-liver diseases.
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Affiliation(s)
- Mattia Paratore
- Medicina Interna e Gastroenterologia, CEMAD Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Matteo Garcovich
- Medicina Interna e Gastroenterologia, CEMAD Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Maria Elena Ainora
- Medicina Interna e Gastroenterologia, CEMAD Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Livio Enrico Del Vecchio
- Medicina Interna e Gastroenterologia, CEMAD Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Giuseppe Cuccia
- Medicina Interna e Gastroenterologia, CEMAD Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Laura Riccardi
- Medicina Interna e Gastroenterologia, CEMAD Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Maurizio Pompili
- Medicina Interna e Gastroenterologia, CEMAD Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
- Medicina Interna e del Trapianto di Fegato, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Antonio Gasbarrini
- Medicina Interna e Gastroenterologia, CEMAD Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
- Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Maria Assunta Zocco
- Medicina Interna e Gastroenterologia, CEMAD Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
- Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy
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Chen Z, Ying TC, Chen J, Wang Y, Wu C, Su Z. Assessment of Renal Fibrosis in Patients With Chronic Kidney Disease Using Shear Wave Elastography and Clinical Features: A Random Forest Approach. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:1665-1671. [PMID: 37105772 DOI: 10.1016/j.ultrasmedbio.2023.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/27/2023] [Accepted: 03/30/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVE Renal fibrosis is the common pathological hallmark of chronic kidney disease (CKD) progression. In this study, a random forest (RF) classifier based on 2-D shear wave elastography (SWE) and clinical features for the differential severity of renal fibrosis in patients with CKD is proposed. METHODS A total of 162 patients diagnosed with CKD who underwent 2-D SWE and renal biopsy were prospectively enrolled from April 2019 to December 2021 and then randomized into training (n = 114) and validation (n = 48) cohorts at a ratio of 7:3. The least absolute shrinkage and selection operator (LASSO) regression and recursive feature elimination for support vector machines (SVM-RFE) algorithm were employed to select renal fibrosis-related features from clinical information and elastosonographic findings. An RF model was subsequently constructed using the aforementioned informative parameters in the training cohort and evaluated in terms of discrimination, calibration and clinical utility in both cohorts. RESULTS The LASSO and SVM-RFE analyses revealed that age, sex, blood urea nitrogen, renal resistive index, hypertension and the 2D-SWE value were independent risk variables associated with renal fibrosis severity. The established RF model incorporating these six variables exhibited fine discrimination in both the derivation (area under the curve [AUC]: 0.84, 95% confidence interval [CI]: 0.76-0.91) and validation (AUC: 0.88, 95% CI: 0.77-0.98) cohorts. Moreover, the calibration curve revealed satisfactory predictive accuracy, and the decision curve analysis revealed a significant clinical net benefit. CONCLUSION The developed RF model, via a combination of the 2-D SWE value and clinical information, indicated satisfactory diagnostic performance and clinical practicality toward differentiating moderate-severe from mild renal fibrosis, which may provide critical insight into risk stratification for patients with CKD.
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Affiliation(s)
- Ziman Chen
- Department of Health Technology and Informatics, Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Tin Cheung Ying
- Department of Health Technology and Informatics, Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Jiaxin Chen
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Yingli Wang
- Ultrasound Department, EDAN Instruments, Inc., Shenzhen, China
| | - Chaoqun Wu
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Zhongzhen Su
- Department of Ultrasound, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
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Santini P, Esposto G, Ainora ME, Lupascu A, Gasbarrini A, Zocco MA, Pola R. Ultrasound Elastography to Assess Age of Deep Vein Thrombosis: A Systematic Review. Diagnostics (Basel) 2023; 13:2075. [PMID: 37370970 DOI: 10.3390/diagnostics13122075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 06/02/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND AND AIMS Deep-vein thrombosis (DVT) is a widely diffused condition, and its accurate staging has major clinical and therapeutic implications. Ultrasound elastography (UE) is a rapidly evolving imaging technique that allows quantification of elastic tissue properties and could play a crucial role in determining thrombus age. The aim of this review is to find clinical evidence regarding the application of UE in the evaluation of DVT and its usefulness in differentiating thrombosis age. METHODS A literature search of clinical studies was performed to identify the ability of UE of discriminate acute, subacute, and chronic DVT. Heterogeneity and publication bias were calculated. In accordance with the study protocol, a qualitative analysis of the evidence was planned. The results were summarized with a comprehensive summary table of study characteristics and baseline characteristics of participant patients. RESULTS Nine studies matched the predetermined eligibility requirements for this systematic review regarding the risk of bias; the greatest criticalities were found within the domains of patient selection and index test. Based on the quality assessment, two publications were excluded from the qualitative synthesis because of the presence of significant applicability concerns. Among the seven studies that were considered eligible for qualitative synthesis, four evaluated strain elastography and three evaluated shear-wave elastography. Despite significant differences concerning study design, thrombus age definitions, and patient characteristics, nearly all studies demonstrated an increase in thrombus stiffness according to DVT age. CONCLUSIONS UE could play a key role in routine ultrasound examination of DVT. The measurement of thrombus stiffness has a high biological plausibility and its use is supported by the finding of a correlation between the stiffness and the progression of the DVT age.
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Affiliation(s)
- Paolo Santini
- Section of Internal Medicine and Thromboembolic Diseases, Department of Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy
| | - Giorgio Esposto
- Section of Internal Medicine and Thromboembolic Diseases, Department of Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy
| | - Maria Elena Ainora
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy
| | - Andrea Lupascu
- Section of Medical Angiology, Department of Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy
| | - Antonio Gasbarrini
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy
| | - Maria Assunta Zocco
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy
| | - Roberto Pola
- Section of Internal Medicine and Thromboembolic Diseases, Department of Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy
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Cheng Q, Huang X, Fan X, Sun J, Zhang J, Tang Q, Deng Y, Bi X. Exploring the prospect of intrinsic wave propagation in evaluating myocardial stiffness among patients with type 2 diabetes. Front Cardiovasc Med 2023; 10:1162500. [PMID: 37378401 PMCID: PMC10291123 DOI: 10.3389/fcvm.2023.1162500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/16/2023] [Indexed: 06/29/2023] Open
Abstract
Background Diabetes predisposes affected individuals to impaired myocardial perfusion and ischemia, leading to cardiac dysfunction. Increased myocardial stiffness is an independent and significant risk factor in diastolic dysfunction. This study sought to estimate myocardial stiffness in Type 2 diabetes (T2DM) patients using the intrinsic wave velocity propagation (IVP) along the longitudinal wall motion during late diastole and evaluate the value of IVP in assessing cardiac function and structure. Methods 87 and 53 participants with and without T2DM (control group) were enrolled. Of the 87 T2DM patients (DM group), 43 were complicated with hypertension (DM + H group), and 44 were not (DM-H group). Ultrasound parameters were measured and analyzed, including color M-mode flow propagation velocity, global longitudinal systolic strain (GLS), and IVP. Results IVP was higher in the DM group than in the control group (1.62 ± 0.25 m/s and 1.40 ± 0.19 m/s, P < 0.001). After stratification for hypertension, IVP in both DM + H (1.71 ± 0.25 m/s) and DM-H (1.53 ± 0.20 m/s) groups were found to be significantly higher than that in the control group (1.40 ± 0.19 m/s); also, the difference of IVP between DM + H and DM-H group reached statistical significance. Moreover, IVP was significantly correlated with flow propagation velocity during early diastole (Pve) (r = -0.580, P < 0.001), flow propagation velocity during late diastole (Pva) (r = 0.271, P < 0.001), GLS (r = 0.330, P < 0.001), interventricular septal thickness at end-diastole (IVSd) (r = 0.321, P < 0.001), blood glucose (r = 0.246, P < 0.003), systolic blood pressure (r = 0.370, P < 0.001) and diastolic blood pressure (r = 0.389, P < 0.001). Conclusions The results indicated the application potential of IVP in assessing the early detection of cardiac function changes noninvasively and sensitively. The correlation with myocardial stiffness warrants further studies to substantiate its potential clinical utility.
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Cao H, Ke B, Lin F, Xue Y, Fang X. Shear Wave Elastography for Assessment of Biopsy-Proven Renal Fibrosis: A Systematic Review and Meta-analysis. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:1037-1048. [PMID: 36746743 DOI: 10.1016/j.ultrasmedbio.2023.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 12/05/2022] [Accepted: 01/02/2023] [Indexed: 05/11/2023]
Abstract
The purpose of this meta-analysis was to evaluate the diagnostic performance of shear wave elastography (SWE) for the staging of renal fibrosis in patients with chronic kidney disease (CKD). Classification of CKD into mild, moderate and severe fibrosis was based on renal biopsy pathology (glomerulosclerosis, tubulointerstitial injury and vascular sclerosis). The Cochrane Library, Medline, PubMed, Web of Science, EMBASE and CNKI databases were searched from January 1, 2009, to April 20, 2022. Pooled sensitivity, specificity, diagnostic odds ratio and area under the receiver operating characteristic curve (AUROC) were calculated using random effects models. A total of 1394 patients from 14 studies were included in the final analysis. For mild, moderate and severe renal fibrosis, SWE had a sensitivity of 0.79 (95% confidence interval [CI]: 0.67-0.88), 0.73 (95% CI: 0.65-0.80) and 0.87 (95% CI: 0.71-0.95); a specificity of 0.82 (95% CI: 0.75-0.87), 72% (95% CI: 0.67-0.77) and 0.83 (95% CI: 0.80-0.86); an AUROC of 0.87 (95% CI: 0.84-0.90), 0.78 (95% CI: 0.75-0.82) and 0.86 (95% CI: 0.82-0.88); and a diagnostic odds ratio of 17 (95% CI: 7-43), 7 (95% CI: 4-12) and 34 (95% CI: 13-88), respectively. Meta-regressions revealed that the publication date, system used and number of valid measurements of SWE were the main causes of heterogeneity. SWE is a good technique for diagnosing mild and severe renal fibrosis, as well as a fair technique for diagnosing moderate fibrosis.
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Affiliation(s)
- Huiling Cao
- Department of Nephrology, Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Ben Ke
- Department of Nephrology, Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Feng Lin
- Department of Neurosurgery, First Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Yuting Xue
- Department of Nephrology, Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Xiangdong Fang
- Department of Nephrology, Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China.
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Chen CT, Gu GX. Physics-Informed Deep-Learning For Elasticity: Forward, Inverse, and Mixed Problems. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023:e2300439. [PMID: 37092567 DOI: 10.1002/advs.202300439] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Indexed: 05/03/2023]
Abstract
Elastography is a medical imaging technique used to measure the elasticity of tissues by comparing ultrasound signals before and after a light compression. The lateral resolution of ultrasound is much inferior to the axial resolution. Current elastography methods generally require both axial and lateral displacement components, making them less effective for clinical applications. Additionally, these methods often rely on the assumption of material incompressibility, which can lead to inaccurate elasticity reconstruction as no materials are truly incompressible. To address these challenges, a new physics-informed deep-learning method for elastography is proposed. This new method integrates a displacement network and an elasticity network to reconstruct the Young's modulus field of a heterogeneous object based on only a measured axial displacement field. It also allows for the removal of the assumption of material incompressibility, enabling the reconstruction of both Young's modulus and Poisson's ratio fields simultaneously. The authors demonstrate that using multiple measurements can mitigate the potential error introduced by the "eggshell" effect, in which the presence of stiff material prevents the generation of strain in soft material. These improvements make this new method a valuable tool for a wide range of applications in medical imaging, materials characterization, and beyond.
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Affiliation(s)
- Chun-Teh Chen
- Department of Materials Science and Engineering, University of California, Berkeley, CA, 94720, USA
| | - Grace X Gu
- Department of Mechanical Engineering, University of California, Berkeley, CA, 94720, USA
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Jung EM, Stroszczynski C, Jung F. Advanced multimodal imaging of solid thyroid lesions with artificial intelligence-optimized B-mode, elastography, and contrast-enhanced ultrasonography parametric and with perfusion imaging: Initial results. Clin Hemorheol Microcirc 2023:CH239102. [PMID: 37092219 PMCID: PMC10357218 DOI: 10.3233/ch-239102] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
Goal of the study was the assessment of AI-assisted diagnosis of solid thyroid foci with multimodal modern ultrasound imaging. 50 patients (26-81 years, 54.7±13.1 years) were included in the study. Multimodal ultrasound imaging by means of B-mode with linear probe (4-12 MHz) with option of automated documentation of findings by means of AI, with supplementary Ultra MicroAngiography (UMA) was used. Macrovascularisation was assessed by dynamic contrast ultrasonography (CEUS) with parametric evaluation and perfusion analysis, and microvascularization was assessed by combined strain and shear wave elastography on a novel high-performance ultrasound system (Resono R9/Mindray) by an experienced examiner with independent reading. The evaluation was performed according to TI-RADS III-V.The volume of the thyroid lobes on both sides averaged 39 ml±5 ml (27 to 69 ml). The 13 cases of histologically confirmed thyroid carcinomas (8 papillary, 2 medullary, 2 microfollicular, 1 anaplastic CA) with a mean size of 15 mm±6 mm (9-21 mm) were correctly evaluated by TI-RADS V on the basis of irregular shape, induration > 2.5 m or > 30kPA and striking wash-out kinetics. Tumor lymph nodes could only be correctly detected preoperatively in one case of medullary carcinoma according to the surgical findings, based on irregular vascularization with UMA in roundish shape with cortex > 4 mm, transverse diameter up to 11 mm. In 25 cases of inhomogeneous nodular goiter an evaluation with TI-RADS III was performed in 31 cases, in 4 cases with incomplete marginal contour, partial marginal vascularization with UMA and partial wash out with indurations up to 2.5 m/s 30 kPA an evaluation with TI-RADS IV and surgical excision for nodular goiter. In 12 cases regressive nodular changes without relevant malignancy criteria resulted in nodular goiter, with focal changes up to 1.5 cm in diameter, classified as requiring control with TI-RADS III. There were no relevant changes in findings in the controls after 6 months. From the AI tool, the 20/25 goiter nodes were assessed as TI-RADS III, 7/12 adenomas, 5 goiter nodes, and 5 adenomas as TI-RADS IV, 5/13 carcinomas as TI-RADS IV, and 8/13 carcinomas as TI-RADS V.Multimodal ultrasound diagnostics supported by AI has a high diagnostic potential for the evaluation of solid thyroid lesions and standardizes the reporting with digital representative image documentation. CEUS perfusion and modern elastography techniques allow targeted follow-up of TI-RADS III findings.
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Affiliation(s)
- E M Jung
- Institute of Diagnostic Radiology and Interdisciplinary Ultrasound Department, University Hospital, Regensburg, Germany
| | - C Stroszczynski
- Institute of Diagnostic Radiology and Interdisciplinary Ultrasound Department, University Hospital, Regensburg, Germany
| | - F Jung
- Institute of Diagnostic Radiology and Interdisciplinary Ultrasound Department, University Hospital, Regensburg, Germany
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Liver stiffness-spleen diameter to platelet ratio score (LSPS model) predicts variceal rebleeding for cirrhotic patients. Eur J Gastroenterol Hepatol 2023; 35:488-496. [PMID: 36719826 DOI: 10.1097/meg.0000000000002518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE The liver stiffness- spleen diameter to platelet ratio score (LSPS model) can identify a high risk of decompensated events in cirrhotic patients. We aimed to evaluate the value of the LSPS model as a risk stratification strategy in the secondary prevention for cirrhotic patients with esophageal and gastric variceal bleeding (EGVB). METHODS Consecutive EGVB patients who underwent liver stiffness measurement by acoustic radiation force impulse, platelet count and ultrasonography were enrolled between January 2013 and December 2019. We calculated the LSPS of all patients and followed up for over 2 years. The primary outcome was rebleeding. Transplant-free survival and overt hepatic encephalopathy (OHE) were the secondary outcomes. RESULTS A total of 131 patients were analyzed. The median value of the LSPS model is 0.1879. We developed risk stratification based on the LSPS model and divided the patients into two groups: the high-LSPS (LSPS > 0.1879) group and the low-LSPS (LSPS ≤ 0.1879) group. Sixty-two (47.33%) patients suffered rebleeding, in which there were 21 (31.92%) patients with low LSPS and 41 (63.08%) patients with high LSPS (hazard ratio 2.883; 95% confidence interval, 1.723-4.822, P < 0.001). For the whole cohort, the rates of transplant-free survival and OHE were consistently similar between the two groups at 2 years. CONCLUSION The LSPS is a reliable, noninvasive method for the detection of a high risk of rebleeding for the secondary prevention of EGVB.
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Platz Batista da Silva N, Scharf G, Lürken L, Verloh N, Schleder S, Stroszczynski C, Jung EM, Haimerl M. Different Ultrasound Shear Wave Elastography Techniques as Novel Imaging-Based Approaches for Quantitative Evaluation of Hepatic Steatosis-Preliminary Findings. Tomography 2023; 9:681-692. [PMID: 36961013 PMCID: PMC10037607 DOI: 10.3390/tomography9020054] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Modern ultrasound (US) shear-wave dispersion (SWD) and attenuation imaging (ATI) can be used to quantify changes in the viscosity and signal attenuation of the liver parenchyma, which are altered in hepatic steatosis. We aimed to evaluate modern shear-wave elastography (SWE), SWD and ATI for the assessment of hepatic steatosis. METHODS We retrospectively analyzed the US data of 15 patients who underwent liver USs and MRIs for the evaluation of parenchymal disease/liver lesions. The USs were performed using a multifrequency convex probe (1-8 MHz). The quantitative US measurements for the SWE (m/s/kPa), the SWD (kPa-m/s/kHz) and the ATI (dB/cm/MHz) were acquired after the mean value of five regions of interest (ROIs) was calculated. The liver MRI (3T) quantification of hepatic steatosis was performed by acquiring proton density fat fraction (PDFF) mapping sequences and placing five ROIs in artifact-free areas of the PDFF scan, measuring the fat-signal fraction. We correlated the SWE, SWD and ATI measurements to the PDFF results. RESULTS Three patients showed mild steatosis, one showed moderate steatosis and eleven showed no steatosis in the PDFF sequences. The calculated SWE cut-off (2.5 m/s, 20.4 kPa) value identified 3/4 of patients correctly (AUC = 0.73, p > 0.05). The SWD cut-off of 18.5 m/s/kHz, which had a significant correlation (r = 0.55, p = 0.034) with the PDFF results (AUC = 0.73), identified four patients correctly (p < 0.001). The ideal ATI (AUC = 0.53 (p < 0.05)) cut-off was 0.59 dB/cm/MHz, which showed a significantly good correlation with the PDFF results (p = 0.024). CONCLUSION Hepatic steatosis can be accurately detected using all the US-elastography techniques applied in this study, although the SWD and the SWE showed to be more sensitive than the PDFF.
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Affiliation(s)
| | - Gregor Scharf
- Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Lukas Lürken
- Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Niklas Verloh
- Department of Diagnostic and Interventional Radiology, Medical Center University of Freiburg, Hugstetter Straße 55, 79106 Freiburg im Breisgau, Germany
| | - Stephan Schleder
- Department of Diagnostic and Interventional Radiology, Merciful Brothers Hospital St. Elisabeth, 94315 Straubing, Germany
| | - Christian Stroszczynski
- Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Ernst Michael Jung
- Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Michael Haimerl
- Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
- Department of Diagnostic and Interventional Radiology, Hospital Wuerzburg Mitte, 97074 Wuerzburg, Germany
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Xia Q, Li M, Xu M, Chen S, Xie X, Chen Y. Measurement of the stiffness of the normal terminal ileum mesentery using shear-wave elastography. Eur J Radiol 2023; 163:110807. [PMID: 37030100 DOI: 10.1016/j.ejrad.2023.110807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVE To investigate the feasibility of using shear-wave elastography (SWE) to measure the stiffness of the normal terminal ileum mesentery, and to establish its normal reference range. METHODS Ninety-five normal subjects and 22 patients with mesentery-related disease were included. The average Young's modulus of the normal terminal ileal mesentery was measured by SWE ultrasound. The thickness and the extent to which mesenteric fat extended around the intestinal circumference of the normal terminal ileum were also recorded. The normal reference range was established and the SWE values of normal and diseased subjects were compared. RESULTS Transabdominal SWE examination of the terminal ileum mesentery was successfully performed on 91 subjects (95.8 %). The mean extent range, thickness, and SWE value of the normal terminal ileum mesentery were 1/4 (1/5-1/3), 6.8 ± 2.4 mm, and 4.3 ± 2.1 kPa, respectively. These parameters did not differ significantly between genders, and across age and body mass index groups (all P > 0.05). The intra- and inter-operator consistencies were excellent for the replicated SWE measurements (0.801 [95 % confidence interval: 0.560-0.916] and 0.751 (95 % confidence interval: 0.388-0.900], respectively). The mean mesenteric elasticity in diseased subjects was 21.9 ± 10.7 kPa, which was significantly higher than that in normal subjects (P < 0.001). The cut-off value for mesenteric elasticity was 9.3 kPa, with a sensitivity of 90 % and a specificity of 100 % (P < 0.001). CONCLUSION SWE can be used to reliably evaluate the stiffness of the terminal ileum mesentery in normal subjects.
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Affiliation(s)
- Qingqing Xia
- Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Manying Li
- Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ming Xu
- Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Shuling Chen
- Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiaoyan Xie
- Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yujun Chen
- Department of Medical Ultrasonics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
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Seppecher L, Bretin E, Millien P, Petrusca L, Brusseau E. Reconstructing the Spatial Distribution of the Relative Shear Modulus in Quasi-static Ultrasound Elastography: Plane Stress Analysis. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:710-722. [PMID: 36639283 DOI: 10.1016/j.ultrasmedbio.2022.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 06/17/2023]
Abstract
Quasi-static ultrasound elastography (QSUE) is an imaging technique that mainly provides axial strain maps of tissues when the latter are subjected to compression. In this article, a method for reconstructing the relative shear modulus distribution within a linear elastic and isotropic medium, in QSUE, is introduced. More specifically, the plane stress inverse problem is considered. The proposed method is based on the variational formulation of the equilibrium equations and on the choice of adapted discretization spaces, and only requires displacement fields in the analyzed media to be determined. Results from plane stress and 3-D numerical simulations, as well as from phantom experiments, showed that the method is able to reconstruct the different regions within a medium, with shear modulus contrasts that unambiguously reveal whether inclusions are stiffer or softer than the surrounding material. More specifically, for the plane stress simulations, inclusion-to-background modulus ratios were found to be very accurately estimated, with an error lower than 3%. For the 3-D simulations, for which the plane stress conditions are no longer satisfied, these ratios were, as expected, less accurate, with an error that remained lower than 10% for two of the three cases analyzed but was around 34% for the last case. Concerning the phantom experiments, a comparison with a shear wave elastography technique from a clinical ultrasound scanner was also made. Overall, the inclusion-to-background shear modulus ratios obtained with our approach were found to be closer to those given by the phantom manufacturer than the ratios provided by the clinical system.
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Affiliation(s)
- Laurent Seppecher
- Institut Camille Jordan, Ecole Centrale de Lyon & UCBL, Lyon, France
| | - Elie Bretin
- Institut Camille Jordan, INSA de Lyon & UCBL, Lyon, France
| | - Pierre Millien
- Institut Langevin, CNRS UMR 7587, ESPCI Paris, PSL Research University, Paris, France
| | - Lorena Petrusca
- Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM Saint-Etienne, CNRS, Inserm, CREATIS UMR 5220, U1294, Lyon, France
| | - Elisabeth Brusseau
- Univ Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM Saint-Etienne, CNRS, Inserm, CREATIS UMR 5220, U1294, Lyon, France.
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Ali M, Bariani MV, Vafaei S, Omran MM, Yang Q, Madueke-Laveaux OS, Al-Hendy A. Prevention of Uterine Fibroids: molecular mechanisms and potential clinical application. JOURNAL OF ENDOMETRIOSIS AND UTERINE DISORDERS 2023; 1:100018. [PMID: 37637856 PMCID: PMC10451784 DOI: 10.1016/j.jeud.2023.100018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Uterine fibroids (UFs; leiomyoma) are the most common benign neoplastic threat to women worldwide, exacting an immense personal burden on female health and a monetary expense to the healthcare system estimated in the hundreds of billions of dollars every year globally. With no long-term non-invasive treatment option currently available to treat UFs, deeper insights regarding tumor etiology are the key for developing newer therapies. Accordingly, in this review, we discuss new mechanistic paradigm to explain UF tumor development through an exquisite model involving developmental reprogramming of myometrial stem cells due to early life endocrine disruptors exposure, inflammation, fibrosis, DNA damage, and eventually tissue stiffness. Further, we propose to utilize shear wave elastography as a potential screening tool for the early identification of women at risk for developing UFs who can benefit from several simple preventive strategies, including the consumption of natural compounds such as vitamin D and green tea as a safe fertility friendly non-hormonal modality to delay or even arrest or reverse UF progression.
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Affiliation(s)
- Mohamed Ali
- Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA Chicago, IL 60637, USA
- Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Maria Victoria Bariani
- Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA Chicago, IL 60637, USA
| | - Somayeh Vafaei
- Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA Chicago, IL 60637, USA
| | - Mervat M. Omran
- Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA Chicago, IL 60637, USA
- Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Qiwei Yang
- Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA Chicago, IL 60637, USA
| | - Obianuju Sandra Madueke-Laveaux
- Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA Chicago, IL 60637, USA
| | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave, Chicago, IL 60637, USA Chicago, IL 60637, USA
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Brunelli AC, Brito LGO, Moro FAS, Jales RM, Yela DA, Benetti-Pinto CL. Ultrasound Elastography for the Diagnosis of Endometriosis and Adenomyosis: A Systematic Review with Meta-analysis. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:699-709. [PMID: 36528440 DOI: 10.1016/j.ultrasmedbio.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 10/05/2022] [Accepted: 11/10/2022] [Indexed: 06/17/2023]
Abstract
Elastography is capable of measuring tissue mechanical properties and elasticity. It is used to help diagnose various diseases, although its use in pelvic endometriosis remains to be established. A systematic review and meta-analysis were conducted to assess transvaginal ultrasound elastography for the diagnosis of different manifestations of endometriosis and adenomyosis. PRISMA guidelines were used for a Medline, PubMed, Embase, BVS/Bireme, Scopus, Cochrane Library and Escudos database search. Studies indexed until March 2021 that evaluated elastography compared with histopathological results (gold standard), ultrasound or magnetic resonance imaging for diagnosis of pelvic endometriosis and adenomyosis were eligible. The Rayyan platform was used to select studies. Sensitivity (S), specificity (Ps), positive and negative predictive values and receiver operating characteristic curves were calculated for elastographic diagnosis of endometriosis. A meta-analysis using Review Manager 5 and Open Meta Analyst was performed. Bias risk in the studies was analyzed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 tool. This systematic review was prospectively registered in the PROSPERO database: CRD42021244555. Among the 163 identified citations, 10 studies were eligible for review (5 for diagnosis of adenomyosis, 2 for endometrioma, 3 for deep intestinal endometriosis and rectovaginal septum [deep pelvic endometriosis], N = 744 women). In deep pelvic endometriosis, lesions diagnosed by elastography were found to correlate with histopathology results. Increased "stiffness" (elastography) was associated with a higher fibrotic component, with S = 78%-100% and Ps = 100%, according to the authors. On elastography, endometriomas were stiffer than hemorrhagic cysts (S = 82%, Ps = 79%) and malignant tumors (S = 86%, Ps = 100%). For these lesions, a meta-analysis could not be performed because the small number of studies and insufficient data. In adenomyosis, meta-analysis and receiver operating characteristic curve analysis revealed that elastography had good sensitivity and specificity. Studies indicated a low bias risk by QUADAS-2. Elastography had high sensitivity and specificity for deep pelvic endometriosis diagnosis, and its findings correlated with histopathology results. For adenomyosis, the meta-analysis confirmed the sensitivity and specificity results of the studies. Given these results, elastography may be a promising imaging test, contributing to non-invasive diagnosis of endometriosis and adenomyosis.
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Affiliation(s)
- Ana Claudia Brunelli
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Luiz Gustavo Oliveira Brito
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Flavia Assad Salum Moro
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Rodrigo Menezes Jales
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Daniela Angerame Yela
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil
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Tokorodani R, Kume T, Daisaki H, Hayashi N, Iwasa H, Yamagami T. Combining 99mTc-GSA single-photon emission-computed tomography and Gd-EOB-DTPA-enhanced magnetic resonance imaging for staging liver fibrosis. Medicine (Baltimore) 2023; 102:e32975. [PMID: 36800578 PMCID: PMC9936016 DOI: 10.1097/md.0000000000032975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
Preoperative assessment of the degree of liver fibrosis is important to determine treatment strategies. In this study, galactosyl human serum albumin single-photon emission-computed tomography and ethoxybenzyl (EOB) contrast-enhanced magnetic resonance imaging (MRI) were used to assess the changes in hepatocyte function after liver fibrosis, and the standardized uptake value (SUV) was combined with gadolinium EOB-diethylenetriaminepentaacetic acid to evaluate its added value for liver fibrosis staging. A total of 484 patients diagnosed with hepatocellular carcinoma who underwent liver resection between January 2010 and August 2018 were included. Resected liver specimens were classified based on pathological findings into nonfibrotic and fibrotic groups (stratified according to the Ludwig scale). Galactosyl human serum albumin-single-photon emission-computed tomography and EOB contrast-enhanced MRI examinations were performed, and the mean SUVs (SUVmean) and contrast enhancement indices (CEIs) were obtained. The diagnostic value of the acquired SUV and CEIs for fibrosis was assessed by calculating the area under the receiver operating characteristic curve (AUC). In the receiver operating characteristic analysis, SUV + CEI showed the highest AUC in both fibrosis groups. In particular, in the comparison between fibrosis groups, SUV + CEI showed significantly higher AUCs than SUV and CEI alone in discriminating between fibrosis (F3 and 4) and no or mild fibrosis (F0 and 2) (AUC: 0.879, vs SUV [P = 0.008], vs. CEI [P = 0.023]), suggesting that the combination of SUV + CEI has greater diagnostic performance than the individual indices. Combining the SUV and CEI provides high accuracy for grading liver fibrosis, especially in differentiating between grades F0 and 2 and F3-4. SUV and gadolinium EOB-diethylenetriaminepentaacetic acid-enhanced MRI can be noninvasive diagnostic methods to guide the selection of clinical treatment options for patients with liver diseases.
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Affiliation(s)
- Ryotaro Tokorodani
- Division of Radiology, Department of Medical Technology, Kochi Medical School Hospital, Nankoku, Japan
- * Correspondence: Ryotaro Tokorodani, Department of Radiology, Kochi Medical School, Kochi University, Nankoku, Kochi 783-8505, Japan (e-mail: )
| | - Toshiaki Kume
- Department of Radiological Technology, Kochi Health Sciences Center, Kochi, Japan
| | - Hiromitu Daisaki
- Department of Gunma Prefectural College of Health Sciences, Maebashi, Japan
| | - Naoya Hayashi
- Division of Radiology, Department of Medical Technology, Kochi Medical School Hospital, Nankoku, Japan
| | - Hitomi Iwasa
- Department of Diagnostic and Interventional Radiology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Takuji Yamagami
- Department of Diagnostic and Interventional Radiology, Kochi Medical School, Kochi University, Nankoku, Japan
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Sebastian JA, Strohm EM, Baranger J, Villemain O, Kolios MC, Simmons CA. Assessing engineered tissues and biomaterials using ultrasound imaging: In vitro and in vivo applications. Biomaterials 2023; 296:122054. [PMID: 36842239 DOI: 10.1016/j.biomaterials.2023.122054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 01/24/2023] [Accepted: 02/11/2023] [Indexed: 02/18/2023]
Abstract
Quantitative assessment of the structural, functional, and mechanical properties of engineered tissues and biomaterials is fundamental to their development for regenerative medicine applications. Ultrasound (US) imaging is a non-invasive, non-destructive, and cost-effective technique capable of longitudinal and quantitative monitoring of tissue structure and function across centimeter to sub-micron length scales. Here we present the fundamentals of US to contextualize its application for the assessment of biomaterials and engineered tissues, both in vivo and in vitro. We review key studies that demonstrate the versatility and broad capabilities of US for clinical and pre-clinical biomaterials research. Finally, we highlight emerging techniques that further extend the applications of US, including for ultrafast imaging of biomaterials and engineered tissues in vivo and functional monitoring of stem cells, organoids, and organ-on-a-chip systems in vitro.
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Affiliation(s)
- Joseph A Sebastian
- Institute of Biomedical Engineering, University of Toronto, Toronto, Canada; Translational Biology and Engineering Program, Ted Rogers Center for Heart Research, Toronto, Canada.
| | - Eric M Strohm
- Translational Biology and Engineering Program, Ted Rogers Center for Heart Research, Toronto, Canada; Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, Canada
| | - Jérôme Baranger
- Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Olivier Villemain
- Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Canada
| | - Michael C Kolios
- Department of Physics, Toronto Metropolitan University, Toronto, Canada; Institute of Biomedical Engineering, Science and Technology (iBEST), A Partnership Between Toronto Metropolitan University and St. Michael's Hospital, Toronto, Canada; Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Craig A Simmons
- Institute of Biomedical Engineering, University of Toronto, Toronto, Canada; Translational Biology and Engineering Program, Ted Rogers Center for Heart Research, Toronto, Canada; Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, Canada.
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A Novel Nomogram Based on Imaging Biomarkers of Shear Wave Elastography, Angio Planewave Ultrasensitive Imaging, and Conventional Ultrasound for Preoperative Prediction of Malignancy in Patients with Breast Lesions. Diagnostics (Basel) 2023; 13:diagnostics13030540. [PMID: 36766645 PMCID: PMC9914566 DOI: 10.3390/diagnostics13030540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/18/2023] [Accepted: 01/28/2023] [Indexed: 02/05/2023] Open
Abstract
Several studies have demonstrated the difficulties in distinguishing malignant lesions of the breast from benign lesions owing to overlapping morphological features on ultrasound. Consequently, we aimed to develop a nomogram based on shear wave elastography (SWE), Angio Planewave Ultrasensitive imaging (Angio PLUS (AP)), and conventional ultrasound imaging biomarkers to predict malignancy in patients with breast lesions. This prospective study included 117 female patients with suspicious lesions of the breast. Features of lesions were extracted from SWE, AP, and conventional ultrasound images. The least absolute shrinkage and selection operator (Lasso) algorithms were used to select breast cancer-related imaging biomarkers, and a nomogram was developed based on six of the 16 imaging biomarkers. This model exhibited good discrimination (area under the receiver operating characteristic curve (AUC): 0.969; 95% confidence interval (CI): 0.928, 0.989) between malignant and benign breast lesions. Moreover, the nomogram also showed demonstrated good calibration and clinical usefulness. In conclusion, our nomogram can be a potentially useful tool for individually-tailored diagnosis of breast tumors in clinical practice.
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Kucukbas GN, Soylu AR. Comparison of fetal and maternal tissue elasticity between euploid and aneuploid pregnancies by shear wave elastography. J Obstet Gynaecol Res 2023; 49:568-576. [PMID: 36404125 DOI: 10.1111/jog.15483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 09/18/2022] [Accepted: 10/19/2022] [Indexed: 11/22/2022]
Abstract
AIM B-mode ultrasonography utilized for fetal screening of common trisomies is referred to as a genetic sonogram and includes determining major abnormalities and soft markers such as hypoplastic nasal bone and increased thickness of the nuchal fold. Elastography is a novel ultrasound technique giving information about tissue stiffness used for diagnosing cancer, transplant rejection, and organ fibrosis. This study aimed to determine via shear wave elastography (SWE) whether euploid and aneuploid fetal soft marker tissues vary in stiffness. METHODS The participants were all singleton pregnancies between 19 and 23 weeks of gestation; 35 euploid and 14 aneuploid fetus pregnancies were enrolled. Fetal bowel, kidney, liver, nasal bone, nuchal fold, placenta, and myometrium were investigated with SWE using acoustic radiation impulse force. Images were analyzed with a novel software calibrated and written by us using MATLAB. Statistical analysis was completed with the SPSS Program. Shapiro-Wilk normality distribution analysis, Student's t-test, and Mann-Whitney U methods were used. RESULTS The mean shear wave speed of fetal nasal bone was significantly lower in aneuploid fetuses. There was no difference between other tissues in mean shear wave velocity. CONCLUSIONS Euploid and aneuploid fetuses have different elastic properties of the nasal bone and this may have a role in differentiating aneuploid fetuses noninvasively.
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Affiliation(s)
- Gokce Naz Kucukbas
- Kocaeli Derince Training and Research Hospital, Department of Obstetrics and Gynecology, Perinatology Division, Karadenizliler Mahallesi İzmit Kadın Doğum ve Çocuk Hastanesi, İzmit/Kocaeli, Turkey.,Perinatology Division, Department of Obstetrics and Gynecology, Van Yuzuncu Yil University, Van, Turkey
| | - Abdullah Ruhi Soylu
- Department of Biophysics, Hacettepe University School of Medicine, Ankara, Turkey
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Bian J, Li J, Liu Y. Diagnostic accuracy of shear wave elastography for endometrial cancer: A meta-analysis. Medicine (Baltimore) 2023; 102:e32700. [PMID: 36705368 PMCID: PMC9875999 DOI: 10.1097/md.0000000000032700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND This meta-analysis aimed to identify the accuracy of shear wave elastography (SWE) in the diagnosis of endometrial cancer (EC). METHODS We searched the PubMed, Cochrane Library, and chinese biomedical literature database from inception to September 30, 2022. Meta-analysis was conducted using STATA version 14.0 and Meta-Disc version 1.4 software. We calculated summary statistics for sensitivity (Sen), specificity (Spe), positive and negative likelihood ratio (LR+/LR-), diagnostic odds ratio (DOR), and receiver operating characteristic (SROC) curves. RESULTS Eight studies that met all the inclusion criteria were included in this meta-analysis. A total of 432 patients with EC and 548 with benign endometrial lesions were assessed. All endometrial lesions were histologically confirmed by SWE. The pooled Sen was 0.91 (95% confidence interval [CI] = 0.83-0.95); the pooled Spe was 0.90 (95% CI = 0.86-0.93); the pooled LR+ was 9.10 (95% CI = 6.20-13.35); the pooled negative LR- was 0.10 (95% CI = 0.05-0.20); the pooled DOR of SWE in the diagnosis of EC was 90.73 (95% CI = 36.62-804.5). The area under the SROC curve was 0.95 (95% CI = 0.93-0.97). No evidence of publication bias was found (t = 0.98, P = .37). CONCLUSION Our meta-analysis indicates that SWE may have high diagnostic accuracy in the differential diagnosis of benign and malignant endometrial lesions. Thus, SWE may be a useful tool for the diagnosis of EC.
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Affiliation(s)
- Jinyi Bian
- The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jingnan Li
- The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yangcheng Liu
- Obstetrics and gynecology department of the First Affiliated Hospital of Dalian Medical University, Dalian, China
- * Correspondence: Yangcheng Liu, Obstetrics and Gynecology Department of the First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Xigang District, Dalian City, Liaoning Province 116011, China (e-mail: )
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Clevert DA, Beyer G, Nieß H, Schlenker B. Ultrasound-New Techniques Are Extending the Applications. DEUTSCHES ARZTEBLATT INTERNATIONAL 2023; 120:41-47. [PMID: 36519209 DOI: 10.3238/arztebl.m2022.0380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 03/16/2022] [Accepted: 11/14/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Sonography is often the first imaging procedure to be used in diagnostic investigation of the abdomen. The aim of this article is to provide a new interdisciplinary overview of recent groundbreaking advances in this modality. METHODS A selective survey of the literature in PubMed was conducted. The literature search was carried out in 2021-2022 and included publications over the period 2004-2022. RESULTS The novel sonographic software techniques can be divided into algorithms that deal with conventional B-scan optimization and new programs that extend the scope of sonographic examination. The latter include elastography, contrast-enhanced sonography, and image fusion in combination with other cross-sectional imaging modalities. Elastography can be used to assess the presence of steatosis, fibrosis, or cirrhosis in patients with liver disease. One study reported diagnostic accuracy of 84-87% for the diagnosis of significant fibrosis (F2), 89-91% for the diagnosis of severe fibrosis (F3), and 92-93% for the diagnosis of liver cirrhosis (F4). Contrast-enhanced sonography is used for evaluation of tumors and trauma. A prospective multicenter study found sensitivity of 95.8% for the characterization of malignant lesions and specificity of 83.1% for benign lesions. Image fusion has the potential to improve the diagnostic assessment of parenchymatous organs, vascular conditions, and the prostate. CONCLUSION With continuous improvement of the B-scan and the development of high-frequency probes and novel investigation techniques, sonography has become established as an increasingly autonomous examination procedure.
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Affiliation(s)
- Dirk-André Clevert
- Department of Radiology, Interdisciplinary Ultrasound-Center, University Hospital of Ludwig-Maximilians-Universität Munich, Germany; Medical Department III,Interdisciplinary Ultrasound-Center, University Hospital of Ludwig-Maximilians-Universität Munich, Germany; Department of General, Visceral and Transplantation Surgery, University Hospital of Ludwig-Maximilians-Universität Munich, Germany; University Hospital of Ludwig-Maximilians-Universität Munich, Germany
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