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He B, Zhou Y, Cao L, Yao B, Gao H, Zhang H. Cervical elastography in predicting spontaneous preterm birth in singleton pregnancy with a short cervix receiving progesterone treatment at 18 to 24 weeks' gestation. J Matern Fetal Neonatal Med 2024; 37:2347954. [PMID: 38714523 DOI: 10.1080/14767058.2024.2347954] [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: 10/24/2023] [Accepted: 04/22/2024] [Indexed: 05/10/2024]
Abstract
BACKGROUND A short cervix in the second trimester is known to increase the risk of preterm birth, which can be reduced with the administration of vaginal progesterone. However, some studies have suggested that a significant number of cases still experience preterm birth despite progesterone treatment. OBJECTIVE This study was aimed to investigate the potential value of transvaginal cervical elasticity measured by E-Cervix as a predictor for spontaneous preterm birth (sPTB) in singleton pregnancies receiving progesterone treatment for a short cervix (CL ≤ 2.5 cm) diagnosed at 18 to 24 weeks' gestation. STUDY DESIGN This prospective study was conducted at a single center premature high-risk clinic from January 2020 to July 2022. Singleton pregnancies with a short cervix at 18 to 24 weeks' gestation were enrolled. Cervical elastography using E-Cervix was performed, and maternal and neonatal demographic characteristics, cervical length (CL), elasticity contrast index (ECI), cervical hardness ratio, mean internal os strain (IOS), and mean external os strain (EOS) were compared before and after progesterone treatment in sPTB and term birth groups. Multivariate logistic regression was used to analyze the association between elasticity parameters and spontaneous preterm birth. The screening performance of CL and optimal cervical elasticity parameters in predicting sPTB was evaluated using receiver-operating characteristic (ROC) curve analysis. RESULTS A total of 228 singleton pregnant women were included in the study, among which 26 (11.4%) had sPTB. There were no significant differences in maternal characteristics and gestational age at enrollment between women with and without sPTB. At the start of progesterone treatment, there were no significant differences in cervical elasticity parameters between the two groups. After two weeks of progesterone treatment, women who had sPTB showed significantly higher levels of ECI, IOS, EOS (p = 0.0108, 0.0001, 0.016), and lower hardness ratio (p = 0.011) compared to those who had a full-term birth. Cervical length did not show significant differences between the two groups, regardless of whether progesterone treatment was administered before or after. Among the post-treatment cervical elasticity parameters, IOS and EOS were associated with a 3.38-fold and 2.29-fold increase in the risk of sPTB before 37 weeks (p = 0.032, 0.047, respectively). The AUROC of the combined model including CL, IOS, and EOS (0.761, 95% CI0.589-0.833) was significantly higher than the AUROC of CL alone (0.618, 95% CI 0.359-0.876). At a fixed false-positive of 13%, the addition of IOS and EOS in the CL model increased sensitivity from 34.6% to 57.6%, PPV from 25.7% to 36.5%, and NPV from 91.1% to 94.1%. CONCLUSION When assessing the risk of sPTB in singleton pregnancies with a short cervix receiving progesterone therapy, relying solely on cervical length is insufficient. It is crucial to also evaluate cervical stiffness, particularly the strain of the internal and external os, using cervical elastography.
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Affiliation(s)
- Biyuan He
- Department of Ultrasound, Shanghai Changning Maternity and Infant Health Hospital, East China Normal University, Shanghai, China
| | - Yuqing Zhou
- Department of Ultrasound, Shanghai Changning Maternity and Infant Health Hospital, East China Normal University, Shanghai, China
| | - Li Cao
- Department of Ultrasound, Shanghai Changning Maternity and Infant Health Hospital, East China Normal University, Shanghai, China
| | - Bingyi Yao
- Department of Obstetrics, Shanghai Changning Maternity and Infant Health Hospital, East China Normal University, Shanghai, China
| | - Haihuan Gao
- Department of Ultrasound, Shanghai Changning Maternity and Infant Health Hospital, East China Normal University, Shanghai, China
| | - Huiping Zhang
- Department of Ultrasound, Shanghai Changning Maternity and Infant Health Hospital, East China Normal University, Shanghai, China
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Tavelli L, Barootchi S. Soft tissue elasticity at teeth and implant sites. A novel outcome measure of the soft tissue phenotype. J Periodontal Res 2024. [PMID: 38837789 DOI: 10.1111/jre.13296] [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: 04/03/2024] [Revised: 05/19/2024] [Accepted: 05/20/2024] [Indexed: 06/07/2024]
Abstract
AIM To assess ultrasonographic tissue elasticity at teeth and implant sites and its variation after peri-implant soft tissue augmentation with a connective tissue graft (CTG). METHODS Twenty-eight patients, each contributing with one clinically healthy dental implant exhibiting a soft tissue dehiscence (PSTD), were included. Implant sites were augmented with CTG and monitored over 12 months. Ultrasonographic strain elastography, expressed as strain ratios (SR1, SR2, and SR3, respectively) was assessed at baseline, 6-, and 12-month, and compared with the corresponding contralateral homologous natural tooth. SR1 assessed the strain/elasticity of the midfacial coronal portion of the soft tissue in comparison to the natural tooth crown/implant-supported crown, SR2 evaluated the strain of the midfacial coronal soft tissue in relation to the one of the alveolar mucosa, while SR3 depicted the strain of the midfacial soft tissue in relation to the interproximal soft tissue on the transverse ultrasound scan. RESULTS SR1 in natural dentition and at implant sites was 0.20 ± 0.08 and 0.30 ± 0.14, respectively (p = .002), indicating that the coronal portion of the soft tissue around teeth is generally more elastic than its counterpart around dental implants. Soft tissue augmentation with CTG promoted an increased stiffness of the midfacial coronal portion of the soft tissue over 12 months (p < .001 for SR1, SR2, and SR3). Strain ratios at the 12-month time points were significantly higher than the values observed at 6 months (p < .001). Regression analysis demonstrated that strain elastography ratios in natural dentition were significantly associated with keratinized gingiva width, and gingival thickness. At implant sites, SR1 was significantly associated with keratinized mucosa width and mucosal thickness (p < .001 for both correlations), SR2 was significantly associated with keratinized mucosa width (p = .013), and SR3 was significantly associated with the surgical technique performed in combination with CTG (p = .022). CONCLUSION Ultrasound strain elastography captures and quantifies tissue elasticity and its changes after soft tissue augmentation. A different baseline tissue elasticity was observed between teeth and dental implants in the most coronal aspect of the soft tissue. The main factors affecting tissue elasticity-related outcomes were the keratinized tissue width, and mucosal thickness.
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Affiliation(s)
- Lorenzo Tavelli
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
- School of Dentistry, Universidad Catolica de Guayaqil, Guayaqil, Ecuador
| | - Shayan Barootchi
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Bergsma S, van Gent M, Dam-Vervloet AJ, Lagerweij MCM, van der Wouden EJ, Nijholt IM, Boomsma MF, Poot L. Image-guided point-shear-wave elastography: a valid and reliable technique for liver fibrotic staging. J Ultrasound 2024; 27:323-328. [PMID: 38281292 DOI: 10.1007/s40477-023-00854-9] [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: 10/23/2023] [Accepted: 11/27/2023] [Indexed: 01/30/2024] Open
Abstract
PURPOSE Despite progressive implementation of image-guided point-shear wave elastography (pSWE) in guidelines as an alternative to transient elastography for the staging of fibrotic liver disease, pSWE is not widely adopted in clinical workflow. More information on reliability and validity of pSWE systems is needed. Therefore, we performed a phantom study to evaluate the validity and reliability of pSWE with ultrasound systems. METHODS Validity and reliability of pSWE measurements from three ultrasound systems were evaluated. Measurements were performed on an elasticity phantom with reference elasticities of 7 ± 1 (low) (median ± interquartile range (IQR)), 14 ± 2 (medium) and 26 ± 3 (high) kPa. Measurements were repeated in tenfold for each reference at 2, 3 and 4 cm depth. Results were considered valid when median elasticity ± IQR was between the uncertainty limits (IQR) for each reference elasticity value and reliable when IQR/median < 0.30. RESULTS pSWE with the systems provided valid results for all reference elasticities and focal depths, except for overestimation of high reference elasticity at 2 and 4 cm depth for one system (41.5 ± 4.3 and 39.0 ± 1.2 kPa, respectively). Measurements were reliable with a maximum IQR/median of 0.13, well below the guideline of IQR/median < 0.30. DISCUSSION The results support the use of pSWE as an alternative to invasive or non-image guided noninvasive techniques for liver fibrotic staging. CONCLUSIONS pSWE with ultrasound systems from different vendors is valid and reliable and can therefore be implemented to optimize clinical workflow by performing imaging and elastography simultaneously.
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Affiliation(s)
- Sietske Bergsma
- Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands.
| | - Margo van Gent
- Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands
- Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Medical Center Leeuwarden, Department of Medical Physics, Leeuwarden, The Netherlands
| | | | | | | | - Ingrid M Nijholt
- Department of Radiology, Isala Hospital, Zwolle, The Netherlands
- Department of Innovation & Science, Isala Hospital, Zwolle, The Netherlands
| | | | - Lieke Poot
- Department of Medical Physics, Isala Hospital, Zwolle, The Netherlands
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Navaeipour F, Hepburn MS, Li J, Metzner KL, Amos SE, Vahala D, Maher S, Choi YS, Kennedy BF. In situ stress estimation in quantitative micro-elastography. BIOMEDICAL OPTICS EXPRESS 2024; 15:3609-3626. [PMID: 38867802 PMCID: PMC11166433 DOI: 10.1364/boe.522002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/20/2024] [Accepted: 04/22/2024] [Indexed: 06/14/2024]
Abstract
In quantitative micro-elastography (QME), a pre-characterized compliant layer with a known stress-strain curve is utilized to map stress at the sample surface. However, differences in the boundary conditions of the compliant layer when it is mechanically characterized and when it is used in QME experiments lead to inconsistent stress estimation and consequently, inaccurate elasticity measurements. Here, we propose a novel in situ stress estimation method using an optical coherence tomography (OCT)-based uniaxial compression testing system integrated with the QME experimental setup. By combining OCT-measured axial strain with axial stress determined using a load cell in the QME experiments, we can estimate in situ stress for the compliant layer, more accurately considering its boundary conditions. Our proposed method shows improved accuracy, with an error below 10%, compared to 85% using the existing QME technique with no lubrication. Furthermore, demonstrations on hydrogels and cells indicate the potential of this approach for improving the characterization of the micro-scale mechanical properties of cells and their interactions with the surrounding biomaterial, which has potential for application in cell mechanobiology.
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Affiliation(s)
- Farzaneh Navaeipour
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia 6009, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, 35, Stirling Highway, Perth, Western Australia 6009, Australia
| | - Matt S. Hepburn
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia 6009, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, 35, Stirling Highway, Perth, Western Australia 6009, Australia
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University in Toruń, Grudziadzka 5, 87-100 Torun, Poland
| | - Jiayue Li
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia 6009, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, 35, Stirling Highway, Perth, Western Australia 6009, Australia
- Australian Research Council Centre for Personalised Therapeutics Technologies, Australia
| | - Kai L. Metzner
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia 6009, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, 35, Stirling Highway, Perth, Western Australia 6009, Australia
| | - Sebastian E. Amos
- School of Human Sciences, The University of Western Australia, 35 Stirling Highway, Perth, Western Australia 6009, Australia
| | - Danielle Vahala
- School of Human Sciences, The University of Western Australia, 35 Stirling Highway, Perth, Western Australia 6009, Australia
| | - Samuel Maher
- School of Human Sciences, The University of Western Australia, 35 Stirling Highway, Perth, Western Australia 6009, Australia
| | - Yu Suk Choi
- School of Human Sciences, The University of Western Australia, 35 Stirling Highway, Perth, Western Australia 6009, Australia
| | - Brendan F. Kennedy
- BRITElab, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands and Centre for Medical Research, The University of Western Australia, Perth, Western Australia 6009, Australia
- Department of Electrical, Electronic and Computer Engineering, School of Engineering, The University of Western Australia, 35, Stirling Highway, Perth, Western Australia 6009, Australia
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University in Toruń, Grudziadzka 5, 87-100 Torun, Poland
- Australian Research Council Centre for Personalised Therapeutics Technologies, Australia
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Zhang LL, Huang S, Wang LY, Wang YY, Lu S, Li R. Endometrial Elasticity is an Ultrasound Marker for Predicting Clinical Pregnancy Outcomes after Embryo Transfer. Reprod Sci 2024:10.1007/s43032-024-01565-0. [PMID: 38769248 DOI: 10.1007/s43032-024-01565-0] [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: 11/06/2023] [Accepted: 04/12/2024] [Indexed: 05/22/2024]
Abstract
Endometrial elasticity is a potential new marker for assessing endometrial receptivity and pregnancy outcomes based on endometrial thickness and type. Currently, little research has been conducted on the elasticity of the endometrium using shear wave elasticity imaging (SWEI). This study aimed to explore whether endometrial elasticity is an ultrasound marker for predicting clinical pregnancy outcomes after embryo transfer. A total of 245 infertile women underwent ultrasonography before embryo transfer at the Peking University Third Hospital. We compared the endometrial elasticity and sub-endometrial blood flow rate using SWEI in the groups with different pregnancy outcomes. Trends in clinical pregnancy outcomes across the quartiles of endometrial elasticity in the fundus of the uterus (E1) were assessed. Logistic regression analysis was performed to obtain odds ratios for clinical pregnancy outcomes based on the quartiles of E1, with or without adjusting for potential confounding variables. Women in the clinical pregnancy group had higher E1 values and sub-endometrial blood flow rates in the uterine fundus than those in the non-pregnancy group. Women in the highest quartile of E1 had the most favorable clinical pregnancy rates. Endometrial elasticity measured using SWEI is a promising ultrasound marker for predicting clinical pregnancy outcomes after embryo transfer.
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Affiliation(s)
- Lin-Lin Zhang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Shuo Huang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Li-Ying Wang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Yuan-Yuan Wang
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, North Garden Rd.49. Haidian District, 100191, Beijing, China
| | - Shan Lu
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, North Garden Rd.49. Haidian District, 100191, Beijing, China
| | - Rong Li
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, North Garden Rd.49. Haidian District, 100191, Beijing, China.
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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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Kuder IM, Rock M, Jones GG, Amis AA, Cegla FB, van Arkel RJ. An Optimization Approach for Creating Application-specific Ultrasound Speckle Tracking Algorithms. ULTRASOUND IN MEDICINE & BIOLOGY 2024:S0301-5629(24)00141-8. [PMID: 38714465 DOI: 10.1016/j.ultrasmedbio.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 03/04/2024] [Accepted: 03/24/2024] [Indexed: 05/09/2024]
Abstract
OBJECTIVE Ultrasound speckle tracking enables in vivo measurement of soft tissue deformation or strain, providing a non-invasive diagnostic tool to quantify tissue health. However, adoption into new fields is challenging since algorithms need to be tuned with gold-standard reference data that are expensive or impractical to acquire. Here, we present a novel optimization approach that only requires repeated measurements, which can be acquired for new applications where reference data might not be readily available or difficult to get hold of. METHODS Soft tissue motion was captured using ultrasound for the medial collateral ligament (MCL) of three quasi-statically loaded porcine stifle joints, and medial ligamentous structures of a dynamically loaded human cadaveric knee joint. Using a training subset, custom speckle tracking algorithms were created for the porcine and human ligaments using surrogate optimization, which aimed to maximize repeatability by minimizing the normalized standard deviation of calculated strain maps for repeat measurements. An unseen test subset was then used to validate the tuned algorithms by comparing the ultrasound strains to digital image correlation (DIC) surface strains (porcine specimens) and length change values of the optically tracked ligament attachments (human specimens). RESULTS After 1500 iterations, the optimization routine based on the porcine and human training data converged to similar values of normalized standard deviations of repeat strain maps (porcine: 0.19, human: 0.26). Ultrasound strains calculated for the independent test sets using the tuned algorithms closely matched the DIC measurements for the porcine quasi-static measurements (R > 0.99, RMSE < 0.59%) and the length change between the tracked ligament attachments for the dynamic human dataset (RMSE < 6.28%). Furthermore, strains in the medial ligamentous structures of the human specimen during flexion showed a strong correlation with anterior/posterior position on the ligaments (R > 0.91). CONCLUSION Adjusting ultrasound speckle tracking algorithms using an optimization routine based on repeatability led to robust and reliable results with low RMSE for the medial ligamentous structures of the knee. This tool may be equally beneficial in other soft-tissue displacement or strain measurement applications and can assist in the development of novel ultrasonic diagnostic tools to assess soft tissue biomechanics.
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Affiliation(s)
- Isabelle M Kuder
- Imperial College London Department of Mechanical Engineering, London, UK
| | | | - Gareth G Jones
- Imperial College London Department of Surgery and Cancer, London, UK
| | - Andrew A Amis
- Imperial College London Department of Mechanical Engineering, London, UK
| | - Frederic B Cegla
- Imperial College London Department of Mechanical Engineering, London, UK
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Alexandrovskaya YM, Kasianenko EM, Sovetsky AA, Matveyev AL, Atyakshin DA, Patsap OI, Ignatiuk MA, Volodkin AV, Zaitsev VY. Optical coherence elastography with osmotically induced strains: Preliminary demonstration for express detection of cartilage degradation. JOURNAL OF BIOPHOTONICS 2024:e202400016. [PMID: 38702959 DOI: 10.1002/jbio.202400016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 04/15/2024] [Accepted: 04/21/2024] [Indexed: 05/06/2024]
Abstract
Optical coherence elastography (OCE) demonstrated impressive abilities for diagnosing tissue types/states using differences in their biomechanics. Usually, OCE visualizes tissue deformation induced by some additional stimulus (e.g., contact compression or auxiliary elastic-wave excitation). We propose a new variant of OCE with osmotically induced straining (OIS-OCE) and demonstrate its application to assess various stages of proteoglycan content degradation in cartilage. The information-bearing signatures in OIS-OCE are the magnitude and rate of strains caused by the application of osmotically active solutions onto the sample surface. OCE examination of the induced strains does not require special tissue preparation, the osmotic stimulation is highly reproducible, and strains are observed in noncontact mode. Several minutes suffice to obtain a conclusion. These features are promising for intraoperative method usage when express assessment of tissue state is required during surgical operations. The "waterfall" images demonstrate the development of cumulative osmotic strains in control and degraded cartilage samples.
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Affiliation(s)
| | - Ekaterina M Kasianenko
- A.V. Gaponov-Grekhov Institute of Applied Physics of the Russian Academy of Sciences, Nizhny Novgorod, Russia
- National Research Center Kurchatov Institute, Moscow, Russia
| | - Alexander A Sovetsky
- A.V. Gaponov-Grekhov Institute of Applied Physics of the Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Alexander L Matveyev
- A.V. Gaponov-Grekhov Institute of Applied Physics of the Russian Academy of Sciences, Nizhny Novgorod, Russia
| | - Dmitry A Atyakshin
- Scientific and Educational Resource Center "Molecular Morphology", RUDN University, Moscow, Russia
| | - Olga I Patsap
- Scientific and Educational Resource Center "Molecular Morphology", RUDN University, Moscow, Russia
| | - Mikhail A Ignatiuk
- Scientific and Educational Resource Center "Molecular Morphology", RUDN University, Moscow, Russia
| | - Artem V Volodkin
- Scientific and Educational Resource Center "Molecular Morphology", RUDN University, Moscow, Russia
| | - Vladimir Y Zaitsev
- A.V. Gaponov-Grekhov Institute of Applied Physics of the Russian Academy of Sciences, Nizhny Novgorod, Russia
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Egorov V, Rosen T, Hill J, Khandelwal M, Kurtenoks V, Francy B, Sarvazyan N. Evaluating the Efficacy of Cervical Tactile Ultrasound Technique as a Predictive Tool for Spontaneous Preterm Birth. OPEN JOURNAL OF OBSTETRICS AND GYNECOLOGY 2024; 14:832-846. [PMID: 38845755 PMCID: PMC11155442 DOI: 10.4236/ojog.2024.145067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
Background Premature cervical softening and shortening may be considered an early mechanical failure that predispose to preterm birth. Purpose This study aims to explore the applicability of an innovative cervical tactile ultrasound approach for predicting spontaneous preterm birth (sPTB). Materials and Methods Eligible participants were women with low-risk singleton pregnancies in their second trimester, enrolled in this prospective observational study. A Cervix Monitor (CM) device was designed with a vaginal probe comprising four tactile sensors and a single ultrasound transducer operating at 5 MHz. The probe enabled the application of controllable pressure to the external cervical surface, facilitating the acquisition of stress-strain data from both anterior and posterior cervical sectors. Gestational age at delivery was recorded and compared against cervical elasticity. Results CM examination data were analyzed for 127 women at 240/7 - 286/7 gestational weeks. sPTB was observed in 6.3% of the cases. The preterm group exhibited a lower average cervical stress-to-strain ratio (elasticity) of 0.70 ± 0.26 kPa/mm compared to the term group's 1.63 ± 0.65 kPa/mm with a p-value of 1.1 × 10-4. Diagnostic accuracy for predicting spontaneous preterm birth based solely on cervical elasticity data was found to be 95.0% (95% CI, 88.5 - 100.0). Conclusion These findings suggest that measuring cervical elasticity with the designed tactile ultrasound probe has the potential to predict spontaneous preterm birth in a cost-effective manner.
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Affiliation(s)
| | - Todd Rosen
- Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Jennifer Hill
- Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Meena Khandelwal
- Department of Maternal-Fetal Medicine, Cooper Medical School of Rowan University, Camden, New Jersey, USA
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Liu Z, Zhong Y, Maemichi T, Zhou Q, Okunuki T, Li Y, Kazuki W, Kumai T. Acute Effects of Local High-Frequency Percussive Massage on Deep Fascial and Muscular Stiffness and Joint Range of Motion in Young Adult Men. J Sport Rehabil 2024; 33:252-258. [PMID: 38508160 DOI: 10.1123/jsr.2022-0455] [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: 12/25/2022] [Revised: 01/29/2024] [Accepted: 02/04/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Local high-frequency percussive (HFP) massage has recently found widespread application in physical therapy. Although HFP massage reportedly improves range of motion (ROM), the mechanism underlying its action has not yet been proven. This study aimed to clarify whether a 5-minute percussive massage regimen affects muscular or connective tissues, such as the deep fascia and deep intermuscular fascia and the change in joint ROM. METHOD The study sample was calculated using G*Power analysis program, and this study enrolled 15 healthy men who underwent 5-minute HFP massage to the medial gastrocnemius muscle. Shear-wave elastography was used to measure tissue stiffness in the deep fascia, muscle, and deep intermuscular fascia through shear-wave velocity as well as the ROM of the volunteers' ankle joint dorsiflexion before and after the HFP massage. A value of P < .05 was used to declare statistical significance, and post hoc was used to calculate the effect size using G*Power. RESULTS Shear-wave velocity revealed a significant change in the deep fascia (P = .003; shear-wave velocity: -0.7 m/s) and significant increase in ROM of ankle dorsiflexion (P = .002; increase in ROM: 3.0°) after 5 minutes of HFP massage. However, the muscle and deep intermuscular fascia did not exhibit any significant changes. CONCLUSIONS HFP massage for 5 minutes modified the stiffness of the deep fascia and concurrently improved the ankle joint-dorsiflexion ROM. This method can be used as an intervention to decrease stiffness of the deep fascia and increase the ROM efficiently.
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Affiliation(s)
- Zijian Liu
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Yicheng Zhong
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Toshihiro Maemichi
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
- Institute of Life Innovation Studies, Toyo University, Tokyo, Japan
| | - Qianhui Zhou
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Takumi Okunuki
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
- Institute of Life Innovation Studies, Toyo University, Tokyo, Japan
- Research Organization of Science and Technology, Ritsumeikan University/Research Fellow of Japan Society for the Promotion of Science, Japan
| | - Yanshu Li
- Graduate School of Human Sciences, Waseda University, Saitama, Japan
| | - Wakamiya Kazuki
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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11
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García-Mejido JA, García-Jimenez R, Fernández-Conde C, García-Pombo S, Fernández-Palacín F, Sainz-Bueno JA. The Application of Shear Wave Elastography to Determine the Elasticity of the Levator Ani Muscle and Vaginal Tissue in Patients With Pelvic Organ Prolapse. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:913-921. [PMID: 38284137 DOI: 10.1002/jum.16422] [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: 11/20/2023] [Revised: 01/08/2024] [Accepted: 01/15/2024] [Indexed: 01/30/2024]
Abstract
OBJECTIVES The changes of the extracellular matrix of the connective tissue have significantly contributed to the incidence of pelvic organ prolapse (POP). It seems reasonable that sonoelastography could be a useful tool to evaluate the elasticity of pelvic floor tissue in patients with POP and compare it to those without POP. The main aim of this pilot study was to determine if there are differences in the elasticity of the levator ani muscle (LAM) and vaginal tissue between patients with and without POP. METHODS Prospective observation study, including 60 patients (30 with POP and 30 without POP). Sonoelastography was performed to evaluate the elasticity (in kilopascals, kPa) of the following regions of interest: vagina at the level of middle third of the urethra; vagina at the level of the bladder trigone; vagina in the anterior and posterior fornix; vagina at the level of middle third of the anorectal canal; posterior third of the LAM. RESULTS A total of 60 patients completed the study (30 with POP, 30 without POP). In the POP group, 18/30 (60%) had an anterior vaginal wall prolapse, 3/30 (10%) a uterine prolapse, 15/30 (50%) a rectocele, and 6/30 (20%) a enterocele. Patients with POP had higher elasticity in all anatomical study areas, with statistically significant differences in the anterior fornix (13.6 vs 11.2 kPa; P: .012). A multiple regression (controlling age, menopausal stage, and parity) allowed to detect statistically significant differences in the elasticity of the middle third of the urethra (P: .03) and the middle third of the anorectal canal (P: .019). CONCLUSION It is possible to evaluate the elasticity of the LAM and vaginal tissue using sonoelastography, detecting a higher elasticity in patients with POP than in those without POP.
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Affiliation(s)
- José Antonio García-Mejido
- Department of Obstetrics and Gynecology, Valme University Hospital, Seville, Spain
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Seville, Seville, Spain
| | | | | | - Sara García-Pombo
- Department of Obstetrics and Gynecology, Valme University Hospital, Seville, Spain
| | | | - José Antonio Sainz-Bueno
- Department of Obstetrics and Gynecology, Valme University Hospital, Seville, Spain
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Seville, Seville, Spain
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12
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Chen X, Li X, Turco S, van Sloun RJG, Mischi M. Ultrasound Viscoelastography by Acoustic Radiation Force: A State-of-the-Art Review. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2024; 71:536-557. [PMID: 38526897 DOI: 10.1109/tuffc.2024.3381529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Ultrasound elastography (USE) is a promising tool for tissue characterization as several diseases result in alterations of tissue structure and composition, which manifest as changes in tissue mechanical properties. By imaging the tissue response to an applied mechanical excitation, USE mimics the manual palpation performed by clinicians to sense the tissue elasticity for diagnostic purposes. Next to elasticity, viscosity has recently been investigated as an additional, relevant, diagnostic biomarker. Moreover, since biological tissues are inherently viscoelastic, accounting for viscosity in the tissue characterization process enhances the accuracy of the elasticity estimation. Recently, methods exploiting different acquisition and processing techniques have been proposed to perform ultrasound viscoelastography. After introducing the physics describing viscoelasticity, a comprehensive overview of the currently available USE acquisition techniques is provided, followed by a structured review of the existing viscoelasticity estimators classified according to the employed processing technique. These estimators are further reviewed from a clinical usage perspective, and current outstanding challenges are discussed.
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13
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Israelsen M, Rungratanawanich W, Thiele M, Liangpunsakul S. Non-invasive tests for alcohol-associated liver disease. Hepatology 2024:01515467-990000000-00841. [PMID: 38607723 DOI: 10.1097/hep.0000000000000885] [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] [Received: 02/24/2024] [Accepted: 03/23/2024] [Indexed: 04/14/2024]
Abstract
Alcohol consumption is a global phenomenon and a major contributor to alcohol-associated liver disease (ALD). Detecting individuals at risk of ALD has been challenging, with only a small fraction of patients being identified at early stages compared to other chronic liver diseases. In response to this challenge, non-invasive tests (NITs) have become essential tools for the detection of ALD, offering opportunities for early identification and intervention to mitigate the disease burden. Noninvasive alcohol consumption biomarkers are crucial in estimating individuals' recent alcohol intake, providing valuable insights into their drinking patterns. Various NITs have been investigated for the initial screening of asymptomatic individuals at risk of ALD, as well as for identifying specific stages of the disease. These NITs are applied in 2 main clinical scenarios: population-based stratification for identifying and predicting liver-related symptoms and diagnosing and prognosticating compensated cirrhosis or advanced chronic liver disease in secondary or tertiary care settings. Moreover, NITs play a significant role in the prognostic assessment of patients with various manifestations of ALD, including alcohol-associated hepatitis (AH), decompensated cirrhosis, and metabolic-associated and ALD. These tests guide appropriate treatment decisions and predict outcomes. In this review, various NITs for the early detection and monitoring of alcohol consumption were discussed. Additionally, the evaluation of NITs for screening and predicting ALD and liver complications was addressed comprehensively. Future perspectives of NITs for ALD were explored, alongside a thorough discussion of the opportunities and challenges associated with NITs for ALD screening.
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Affiliation(s)
- Mads Israelsen
- Department of Gastroenterology and Hepatology, Fibrosis Fatty Liver and Steatohepatitis Research Centre, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Wiramon Rungratanawanich
- Section of Molecular Pharmacology and Toxicology, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland, USA
| | - Maja Thiele
- Department of Gastroenterology and Hepatology, Fibrosis Fatty Liver and Steatohepatitis Research Centre, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Suthat Liangpunsakul
- Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Roudebush Veterans Administration Medical Center, Indianapolis, Indiana, USA
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14
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Billy J, Bensamoun SF, Mercier J, Durand S. Applications of ultrasound elastography to hand and upper limb disorders. HAND SURGERY & REHABILITATION 2024; 43:101636. [PMID: 38215880 DOI: 10.1016/j.hansur.2024.101636] [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: 11/15/2023] [Revised: 12/22/2023] [Accepted: 12/24/2023] [Indexed: 01/14/2024]
Abstract
Ultrasound elastography is a recently developed method for accurate measurement of soft tissue stiffness in addition to the clinician's subjective evaluation. The present review briefly describes the ultrasound elastography techniques and outlines clinical applications for tendon, muscle, nerve, skin and other soft tissues of the hand and upper limb. Strain elastography provides a qualitative evaluation of the stiffness, and shear-wave elastography generates quantitative elastograms superimposed on a B-mode image. The stiffness in degenerative tendinopathy and/or tendon injury was significantly lower than in a normal tendon in several studies. Elastography is also a reliable method to evaluate functional muscle activity, compared to conventional surface electromyography. The median nerve is consistently stiffer in patients with carpal tunnel syndrome than in healthy subjects, on whatever ultrasound elastography technique. Elastography distinguishes normal skin from scars and can be used to evaluate scar severity and treatment. Elastography has huge clinical applications in musculoskeletal tissues. Continued development of systems and increased training of clinicians will expand our knowledge of elastography and its clinical applications in the future.
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Affiliation(s)
- Jessica Billy
- Department of Hand Surgery, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
| | - Sabine F Bensamoun
- Sorbonne University, Université de Technologie de Compiègne, CNRS UMR 7338, Biomechanics and Bioengineering, Compiègne, France
| | - Julie Mercier
- Department of Hand Surgery, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland
| | - Sébastien Durand
- Department of Hand Surgery, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland.
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15
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Marmin A, Dufour N, Facca S, Catheline S, Chatelin S, Nahas A. Full-field noise-correlation elastography for in-plane mechanical anisotropy imaging. BIOMEDICAL OPTICS EXPRESS 2024; 15:2622-2635. [PMID: 38633096 PMCID: PMC11019699 DOI: 10.1364/boe.516166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/04/2024] [Accepted: 03/05/2024] [Indexed: 04/19/2024]
Abstract
Elastography contrast imaging has great potential for the detection and characterization of abnormalities in soft biological tissues to help physicians in diagnosis. Transient shear-waves elastography has notably shown promising results for a range of clinical applications. In biological soft tissues such as muscle, high mechanical anisotropy implies different stiffness estimations depending on the direction of the measurement. In this study, we propose the evolution of a noise-correlation elastography approach for in-plane anisotropy mapping. This method is shown to retrieve anisotropy from simulation images before being validated on agarose anisotropic tissue-mimicking phantoms, and the first results on in-vivo biological fibrous tissues are presented.
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Affiliation(s)
- Agathe Marmin
- Université de
Strasbourg, CNRS, ICube, UMR 7357, 67000 Strasbourg,
France
| | - Nina Dufour
- Université de
Strasbourg, CNRS, ICube, UMR 7357, 67000 Strasbourg,
France
| | - Sybille Facca
- Université de
Strasbourg, CNRS, ICube, UMR 7357, 67000 Strasbourg,
France
- Department of Hand Surgery, SOS hand,
University Hospital of Strasbourg, FMTS, 1
avenue Molière, 67000 Strasbourg, France
| | - Stefan Catheline
- LabTAU, Inserm, Centre Léon Bérard, Université Lyon 1, Univ Lyon, F-69003 Lyon, France
| | - Simon Chatelin
- Université de
Strasbourg, CNRS, ICube, UMR 7357, 67000 Strasbourg,
France
- RoDIn, Inserm ERL1328, 1 place de l’Hôpital, 67000 Strasbourg, France
| | - Amir Nahas
- Université de
Strasbourg, CNRS, ICube, UMR 7357, 67000 Strasbourg,
France
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16
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Poudrel AS, Bouffandeau A, Demeet OL, Rosi G, Nguyen VH, Haiat G. Characterization of the concentration of agar-based soft tissue mimicking phantoms by impact analysis. J Mech Behav Biomed Mater 2024; 152:106465. [PMID: 38377641 DOI: 10.1016/j.jmbbm.2024.106465] [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: 06/24/2023] [Revised: 01/14/2024] [Accepted: 02/13/2024] [Indexed: 02/22/2024]
Abstract
In various medical fields, a change of soft tissue stiffness is associated with its physio-pathological evolution. While elastography is extensively employed to assess soft tissue stiffness in vivo, its application requires a complex and expensive technology. The aim of this study is to determine whether an easy-to-use method based on impact analysis can be employed to determine the concentration of agar-based soft tissue mimicking phantoms. Impact analysis was performed on soft tissue mimicking phantoms made of agar gel with a mass concentration ranging from 1% to 5%. An indicator Δt is derived from the temporal variation of the impact force signal between the hammer and a small beam in contact with the sample. The results show a non-linear decrease of Δt as a function of the agar concentration (and thus of the sample stiffness). The value of Δt provides an estimation of the agar concentration with an error of 0.11%. This sensitivity of the impact analysis based method to the agar concentration is of the same order of magnitude than results obtained with elastography techniques. This study opens new paths towards the development of impact analysis for a fast, easy and relatively inexpensive clinical evaluation of soft tissue elastic properties.
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Affiliation(s)
- Anne-Sophie Poudrel
- CNRS, Univ Paris Est Creteil, Univ Gustave Eiffel, UMR 8208, MSME, F-94010 Créteil, France
| | - Arthur Bouffandeau
- CNRS, Univ Paris Est Creteil, Univ Gustave Eiffel, UMR 8208, MSME, F-94010 Créteil, France
| | - Oriane Le Demeet
- CNRS, Univ Paris Est Creteil, Univ Gustave Eiffel, UMR 8208, MSME, F-94010 Créteil, France
| | - Giuseppe Rosi
- Univ Paris Est Creteil, Univ Gustave Eiffel, CNRS, UMR 8208, MSME, F-94010 Créteil, France
| | - Vu-Hieu Nguyen
- Univ Paris Est Creteil, Univ Gustave Eiffel, CNRS, UMR 8208, MSME, F-94010 Créteil, France
| | - Guillaume Haiat
- CNRS, Univ Paris Est Creteil, Univ Gustave Eiffel, UMR 8208, MSME, F-94010 Créteil, France.
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17
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Hendriks GAGM, Chen C, Mann R, Hansen HHG, de Korte CL. Automated 3-D Ultrasound Elastography of the Breast: An In Vivo Validation Study. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:358-363. [PMID: 38103946 DOI: 10.1016/j.ultrasmedbio.2023.11.006] [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: 04/12/2023] [Revised: 10/23/2023] [Accepted: 11/09/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE Studies have indicated that adding 2-D quasi-static elastography to B-mode ultrasound imaging improved the specificity for malignant lesion detection, as malignant lesions are often stiffer (increased strain ratio) compared with benign lesions. This method is limited by its user dependency and so unsuitable for breast screening. To overcome this limitation, we implemented quasi-static elastography in an automated breast volume scanner (ABVS), which is an operator-independent 3-D ultrasound system and is especially useful for screening women with dense breasts. The study aim was to investigate if 3-D quasi-static elastography implemented in a clinically used ABVS can discriminate between benign and malignant breast lesions. METHODS Volumetric breast ultrasound radiofrequency data sets of 82 patients were acquired before and after automated transducer lifting. Lesions were annotated and strain was calculated using an in-house-developed strain algorithm. Two strain ratio types were calculated per lesion: using axial and maximal principal strain (i.e., strain in dominant direction). RESULTS Forty-four lesions were detected: 9 carcinomas, 23 cysts and 12 other benign lesions. A significant difference was found between malignant (median: 1.7, range: [1.0-3.2]) and benign (1.0, [0.6-1.9]) using maximal principal strain ratios. Axial strain ratio did not reveal a significant difference between benign (0.6, [-12.7 to 4.9]) and malignant lesions (0.8, [-3.5 to 5.1]). CONCLUSION Three-dimensional strain imaging was successfully implemented on a clinically used ABVS to obtain, visualize and analyze in vivo strain images in three dimensions. Results revealed that maximal principal strain ratios are significantly increased in malignant compared with benign lesions.
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Affiliation(s)
- Gijs A G M Hendriks
- Medical Ultrasound Imaging Center, Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Chuan Chen
- Medical Ultrasound Imaging Center, Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ritse Mann
- Breast Imaging Group, Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hendrik H G Hansen
- Medical Ultrasound Imaging Center, Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Chris L de Korte
- Medical Ultrasound Imaging Center, Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands; Physics and Fluids Group, Faculty of Science and Technology, University of Twente, Enschede, The Netherlands.
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18
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Dai F, Li Y, Zhu Y, Li B, Shi Q, Chen Y, Ta D. B-mode ultrasound to elastography synthesis using multiscale learning. ULTRASONICS 2024; 138:107268. [PMID: 38402836 DOI: 10.1016/j.ultras.2024.107268] [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: 09/04/2023] [Revised: 02/03/2024] [Accepted: 02/09/2024] [Indexed: 02/27/2024]
Abstract
Elastography is a promising diagnostic tool that measures the hardness of tissues, and it has been used in clinics for detecting lesion progress, such as benign and malignant tumors. However, due to the high cost of examination and limited availability of elastic ultrasound devices, elastography is not widely used in primary medical facilities in rural areas. To address this issue, a deep learning approach called the multiscale elastic image synthesis network (MEIS-Net) was proposed, which utilized the multiscale learning to synthesize elastic images from ultrasound data instead of traditional ultrasound elastography in virtue of elastic deformation. The method integrates multi-scale features of the prostate in an innovative way and enhances the elastic synthesis effect through a fusion module. The module obtains B-mode ultrasound and elastography feature maps, which are used to generate local and global elastic ultrasound images through their correspondence. Finally, the two-channel images are synthesized into output elastic images. To evaluate the approach, quantitative assessments and diagnostic tests were conducted, comparing the results of MEIS-Net with several deep learning-based methods. The experiments showed that MEIS-Net was effective in synthesizing elastic images from B-mode ultrasound data acquired from two different devices, with a structural similarity index of 0.74 ± 0.04. This outperformed other methods such as Pix2Pix (0.69 ± 0.09), CycleGAN (0.11 ± 0.27), and StarGANv2 (0.02 ± 0.01). Furthermore, the diagnostic tests demonstrated that the classification performance of the synthetic elastic image was comparable to that of real elastic images, with only a 3 % decrease in the area under the curve (AUC), indicating the clinical effectiveness of the proposed method.
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Affiliation(s)
- Fei Dai
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai 200433, China
| | - Yifang Li
- Academy for Engineering and Technology, Fudan University, Shanghai 200433, China
| | - Yunkai Zhu
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
| | - Boyi Li
- Academy for Engineering and Technology, Fudan University, Shanghai 200433, China
| | - Qinzhen Shi
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai 200433, China
| | - Yaqing Chen
- Department of Ultrasound, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China.
| | - Dean Ta
- Center for Biomedical Engineering, School of Information Science and Technology, Fudan University, Shanghai 200433, China.
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19
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Bosio G, Destrempes F, Yazdani L, Roy Cardinal MH, Cloutier G. Resonance, Velocity, Dispersion, and Attenuation of Ultrasound-Induced Shear Wave Propagation in Blood Clot In Vitro Models. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:535-551. [PMID: 38108551 DOI: 10.1002/jum.16387] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 11/24/2023] [Accepted: 11/25/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE Improve the characterization of mechanical properties of blood clots. Parameters derived from shear wave (SW) velocity and SW amplitude spectra were determined for gel phantoms and in vitro blood clots. METHODS Homogeneous phantoms and phantoms with gel or blood clot inclusions of different diameters and mechanical properties were analyzed. SW amplitude spectra were used to observe resonant peaks. Parameters derived from those resonant peaks were related to mimicked blood clot properties. Three regions of interest were tested to analyze where resonances occurred the most. For blood experiments, 20 samples from different pigs were analyzed over time during a 110-minute coagulation period using the Young modulus, SW frequency dispersion, and SW attenuation. RESULTS The mechanical resonance was manifested by an increase in the number of SW spectral peaks as the inclusion diameter was reduced (P < .001). In blood clot inclusions, the Young modulus increased over time during coagulation (P < .001). Descriptive spectral parameters (frequency peak, bandwidth, and distance between resonant peaks) were linearly correlated with clot elasticity values (P < .001) with R2 = .77 for the frequency peak, .60 for the bandwidth, and .48 for the distance between peaks. The SW dispersion and SW attenuation reflecting the viscous behavior of blood clots decreased over time (P < .001), mainly in the early stage of coagulation (first minutes). CONCLUSION The confined soft inclusion configuration favored SW mechanical resonances potentially challenging the computation of spectral-based parameters, such as the SW attenuation. The impact of resonances can be reduced by properly selecting the region of interest for data analysis.
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Affiliation(s)
- Guillaume Bosio
- Institute of Biomedical Engineering, University of Montreal, Montreal, Quebec, Canada
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - François Destrempes
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Ladan Yazdani
- Institute of Biomedical Engineering, University of Montreal, Montreal, Quebec, Canada
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Marie-Hélène Roy Cardinal
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
| | - Guy Cloutier
- Institute of Biomedical Engineering, University of Montreal, Montreal, Quebec, Canada
- Laboratory of Biorheology and Medical Ultrasonics, University of Montreal Hospital Research Center (CRCHUM), Montreal, Quebec, Canada
- Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Montreal, Quebec, Canada
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20
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Eshaghinia SS, Taghvaeipour A, Aghdam MM, Rivaz H. On the soft tissue ultrasound elastography using FEM based inversion approach. Proc Inst Mech Eng H 2024; 238:271-287. [PMID: 38240143 DOI: 10.1177/09544119231224674] [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: 03/16/2024]
Abstract
Elastography is a medical imaging modality that enables visualization of tissue stiffness. It involves quasi-static or harmonic mechanical stimulation of the tissue to generate a displacement field which is used as input in an inversion algorithm to reconstruct tissue elastic modulus. This paper considers quasi-static stimulation and presents a novel inversion technique for elastic modulus reconstruction. The technique follows an inverse finite element framework. Reconstructed elastic modulus maps produced in this technique do not depend on the initial guess, while it is computationally less involved than iterative reconstruction approaches. The method was first evaluated using simulated data (in-silico) where modulus reconstruction's sensitivity to displacement noise and elastic modulus was assessed. To demonstrate the method's performance, displacement fields of two tissue mimicking phantoms determined using three different motion tracking techniques were used as input to the developed elastography method to reconstruct the distribution of relative elastic modulus of the inclusion to background tissue. In the next stage, the relative elastic modulus of three clinical cases pertaining to liver cancer patient were determined. The obtained results demonstrate reasonably high elastic modulus reconstruction accuracy in comparison with similar direct methods. Also it is associated with reduced computational cost in comparison with iterative techniques, which suffer from convergence and uniqueness issues, following the same formulation concept. Moreover, in comparison with other methods which need initial guess, the presented method does not require initial guess while it is easy to understand and implement.
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Affiliation(s)
- Seyed Shahab Eshaghinia
- Mechanical Engineering Department, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Afshin Taghvaeipour
- Mechanical Engineering Department, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Mohammad Mohammadi Aghdam
- Mechanical Engineering Department, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Hassan Rivaz
- Department of Electrical and Computer Engineering, Concordia University, Montreal, QC, Canada
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21
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Pradhan DR, Saxena S, Kant R, Kumar M, Saran S. Shear wave elastography of tibial nerve in patients with diabetic peripheral neuropathy-A cross-sectional study. Skeletal Radiol 2024; 53:547-554. [PMID: 37698625 DOI: 10.1007/s00256-023-04448-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 08/31/2023] [Accepted: 08/31/2023] [Indexed: 09/13/2023]
Abstract
OBJECTIVE To explore the role of shear wave elastography of the tibial nerve as a potential ultrasonographic method for the diagnosis of tibial neuropathy in patients with type 2 diabetes. MATERIALS AND METHODS This cross-sectional study included 50 subjects each in case (patients with diabetic tibial neuropathy diagnosed on the basis of clinical features and nerve conduction study) and control groups (non-diabetic non-neuropathic healthy volunteers). The exclusion criteria included the presence of type 1 diabetes, a known history of neuropathy from other causes except for type 2 diabetes, or a history of leg or ankle fracture. Cross-sectional area and shear wave velocity values of the tibial nerve were measured in both groups. Demographic details and body mass index were obtained in both groups and additionally, the duration of type 2 diabetes and HbA1c values in the case group were also noted. Wilcoxon Mann-Whitney U test was used to compare these variables in study groups. ROC curve analysis provided additional findings. RESULTS Tibial nerve stiffness was significantly higher in the case group (p-value < 0.001). The study groups did not significantly differ in the Cross-sectional area of the tibial nerve (p-value 0.57). The case group exhibited a higher frequency of loss of the fascicular pattern of the tibial nerve (40% vs 18%, p-value 0.027). Duration of diabetes mellitus and HbA1c values did not significantly affect Shear wave velocity values in the case group. At the cut-off value of Shear wave velocity of 3.13 m/s, sensitivity and specificity to diagnose diabetic peripheral neuropathy were 94% and 88% respectively. CONCLUSION Increased nerve stiffness is seen in patients with diabetic peripheral neuropathy. Shear wave elastography might prove as a novel noninvasive technology for screening/early diagnosis of diabetic peripheral neuropathy.
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Affiliation(s)
- Dhiri Ranjan Pradhan
- Department of Diagnostic and Interventional Radiology, AIIMS Rishikesh, Rishikesh, India
| | - Sudhir Saxena
- Department of Diagnostic and Interventional Radiology, AIIMS Rishikesh, Rishikesh, India
| | - Ravi Kant
- Department of Internal Medicine, AIIMS Rishikesh, Rishikesh, India
| | | | - Sonal Saran
- Department of Diagnostic and Interventional Radiology, AIIMS Rishikesh, Rishikesh, India.
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22
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Filipov T, Teutsch B, Szabó A, Forintos A, Ács J, Váradi A, Hegyi P, Szarvas T, Ács N, Nyirády P, Deák PÁ. Investigating the role of ultrasound-based shear wave elastography in kidney transplanted patients: correlation between non-invasive fibrosis detection, kidney dysfunction and biopsy results-a systematic review and meta-analysis. J Nephrol 2024:10.1007/s40620-023-01856-w. [PMID: 38427308 DOI: 10.1007/s40620-023-01856-w] [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: 09/12/2023] [Accepted: 11/28/2023] [Indexed: 03/02/2024]
Abstract
INTRODUCTION Interstitial fibrosis and tubular atrophy are leading causes of renal allograft failure. Shear wave elastography could be a promising noninvasive method for providing information on the state of the kidney, with specific regard to fibrosis but currently available data in the literature are controversial. Our study aimed to analyze the correlation between shear wave elastography and various kidney dysfunction measures. METHODS This review was registered on PROSPERO (CRD42021283152). We systematically searched three major databases (MEDLINE, Embase, and CENTRAL) for articles concerning renal transplant recipients, shear wave elastography, fibrosis, and kidney dysfunction. Meta-analytical calculations for pooled Pearson and Spearman correlation coefficients (r) were interpreted with 95% confidence intervals (CIs). Heterogeneity was tested with Cochran's Q test. I2 statistic and 95% CI were reported as a measurement of between-study heterogeneity. Study quality was assessed with the QUADAS2 tool. RESULTS In total, 16 studies were included in our meta-analysis. Results showed a moderate correlation between kidney stiffness and interstitial fibrosis and tubular atrophy, graded according to BANFF classification, on biopsy findings for pooled Pearson (r = 0.48; CI: 0.20, 0.69; I2 = 84%) and Spearman correlations (r = 0.57; CI: 0.35, 0.72; I2 = 74%). When compared to kidney dysfunction parameters, we found a moderate correlation between shear wave elastography and resistive index (r = 0.34 CI: 0.13, 0.51; I2 = 67%) and between shear wave elastography and estimated Glomerular Filtration Rate (eGFR) (r = -0.65; CI: - 0.81, - 0.40; I2 = 73%). All our outcomes had marked heterogeneity. CONCLUSION Our results showed a moderate correlation between kidney stiffness measured by shear wave elastography and biopsy results. While noninvasive assessment of kidney fibrosis after transplantation is an important clinical goal, there is insufficient evidence to support the use of elastography over the performance of a kidney biopsy.
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Affiliation(s)
- Teodóra Filipov
- Department of Interventional Radiology, Heart and Vascular Center, Faculty of Medicine, Semmelweis University, Határőr ut 18, 1122, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Brigitta Teutsch
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School University of Pécs, Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Anett Szabó
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Urology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Attila Forintos
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Júlia Ács
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Urology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Alex Váradi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Laboratory Medicine, Medical School, University of Pécs, Pécs, Hungary
- Department of Metagenomics, University of Debrecen, Debrecen, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School University of Pécs, Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Tibor Szarvas
- Department of Urology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
| | - Nándor Ács
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Nyirády
- Department of Urology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Pál Ákos Deák
- Department of Interventional Radiology, Heart and Vascular Center, Faculty of Medicine, Semmelweis University, Határőr ut 18, 1122, Budapest, Hungary.
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Wolf M, Darwish O, Neji R, Eder M, Sunder-Plassmann G, Heinz G, Robinson SD, Schmid AI, Moser EV, Sinkus R, Meyerspeer M. Magnetic resonance elastography resolving all gross anatomical segments of the kidney during controlled hydration. Front Physiol 2024; 15:1327407. [PMID: 38384795 PMCID: PMC10880033 DOI: 10.3389/fphys.2024.1327407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/24/2024] [Indexed: 02/23/2024] Open
Abstract
Introduction: Magnetic resonance elastography (MRE) is a non-invasive method to quantify biomechanical properties of human tissues. It has potential in diagnosis and monitoring of kidney disease, if established in clinical practice. The interplay of flow and volume changes in renal vessels, tubule, urinary collection system and interstitium is complex, but physiological ranges of in vivo viscoelastic properties during fasting and hydration have never been investigated in all gross anatomical segments simultaneously. Method: Ten healthy volunteers underwent two imaging sessions, one following a 12-hour fasting period and the second after a drinking challenge of >10 mL per kg body weight (60-75 min before the second examination). High-resolution renal MRE was performed using a novel driver with rotating eccentric mass placed at the posterior-lateral wall to couple waves (50 Hz) to the kidney. The biomechanical parameters, shear wave speed (cs in m/s), storage modulus (Gd in kPa), loss modulus (Gl in kPa), phase angle ( Υ = 2 π atan G l G d ) and attenuation (α in 1/mm) were derived. Accurate separation of gross anatomical segments was applied in post-processing (whole kidney, cortex, medulla, sinus, vessel). Results: High-quality shear waves coupled into all gross anatomical segments of the kidney (mean shear wave displacement: 163 ± 47 μm, mean contamination of second upper harmonics <23%, curl/divergence: 4.3 ± 0.8). Regardless of the hydration state, median Gd of the cortex and medulla (0.68 ± 0.11 kPa) was significantly higher than that of the sinus and vessels (0.48 ± 0.06 kPa), and consistently, significant differences were found in cs, Υ , and Gl (all p < 0.001). The viscoelastic parameters of cortex and medulla were not significantly different. After hydration sinus exhibited a small but significant reduction in median Gd by -0.02 ± 0.04 kPa (p = 0.01), and, consequently, the cortico-sinusoidal-difference in Gd increased by 0.04 ± 0.07 kPa (p = 0.05). Only upon hydration, the attenuation in vessels became lower (0.084 ± 0.013 1/mm) and differed significantly from the whole kidney (0.095 ± 0.007 1/mm, p = 0.01). Conclusion: High-resolution renal MRE with an innovative driver and well-defined 3D segmentation can resolve all renal segments, especially when including the sinus in the analysis. Even after a prolonged hydration period the approach is sensitive to small hydration-related changes in the sinus and in the cortico-sinusoidal-difference.
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Affiliation(s)
- Marcos Wolf
- High Field MR Center, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Omar Darwish
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- MR Research Collaborations, Siemens Healthcare Limited, Frimley, United Kingdom
| | - Radhouene Neji
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
| | - Michael Eder
- Department of Medicine III, Division of Nephrology and Dialysis, General Hospital and Medical University of Vienna, Vienna, Austria
| | - Gere Sunder-Plassmann
- Department of Medicine III, Division of Nephrology and Dialysis, General Hospital and Medical University of Vienna, Vienna, Austria
| | - Gertraud Heinz
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum St. Pölten, Sankt Pölten, Austria
| | - Simon Daniel Robinson
- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
- Centre of Advanced Imaging, University of Queensland, Brisbane, QLD, Australia
| | - Albrecht Ingo Schmid
- High Field MR Center, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Ewald V. Moser
- High Field MR Center, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Ralph Sinkus
- Institut National de La Santé et de La Recherche Médicale, U1148, Laboratory for Vascular Translational Science, Paris, France
| | - Martin Meyerspeer
- High Field MR Center, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
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24
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Grinbaum E, Shulman I, Rozen N, Rubin G. Finger flexor rigidity in the healthy population. Sci Rep 2024; 14:2965. [PMID: 38316861 PMCID: PMC10844215 DOI: 10.1038/s41598-024-52971-y] [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: 03/25/2023] [Accepted: 01/25/2024] [Indexed: 02/07/2024] Open
Abstract
The involvement of the hand flexors in trigger finger is not clear. This study aimed to examine the rigidity of the flexor tendon in the first pulley territory in the hand by using ultrasound in a healthy population, as well as to create a reference scale of rigidity for the flexor tendons to compare those values in trigger fingers. We tested 35 healthy volunteers using a linear ultrasound transducer and the color Doppler method. Rigidity levels below the first pulley were examined and compared between the different fingers of the hand and the relationship between rigidity and sex and the three different age groups was evaluated. In the healthy population, the rigidity of the flexor tendons of the hand in the territory of the first pulley varied between 233.1 and 962.8 kPa, with an average of 486.42 kPa and standard deviation of 114.85. We showed that the flexors in the dominant hand were more rigid, there was a difference between the rigidity of the flexor tendons of the thumb and the other fingers of the same hand, and the ring finger of the dominant hand had stiffer flexor tendons than the fingers of the other hand in the male population. We created a value scale for the rigidity of the flexor tendons of the fingers. This base scale can be compared between different pathologies, including trigger finger. The study and all experimental protocols were approved by the local ethical committee.
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Affiliation(s)
- Erez Grinbaum
- Orthopedic Department, Emek Medical Center, Afula, Israel
| | - Igor Shulman
- Orthopedic Department, Emek Medical Center, Afula, Israel
| | - Nimrod Rozen
- Orthopedic Department, Emek Medical Center, Afula, Israel
- Faculty of Medicine, Technion, Haifa, Israel
| | - Guy Rubin
- Orthopedic Department, Emek Medical Center, Afula, Israel.
- Faculty of Medicine, Technion, Haifa, Israel.
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25
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Ngo HHP, Andrade RJ, Lancelot J, Loumeaud A, Cornu C, Nordez A, Chatelin S, Gennisson JL. Unravelling anisotropic nonlinear shear elasticity in muscles: Towards a non-invasive assessment of stress in living organisms. J Mech Behav Biomed Mater 2024; 150:106325. [PMID: 38150816 DOI: 10.1016/j.jmbbm.2023.106325] [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: 09/01/2023] [Revised: 12/08/2023] [Accepted: 12/11/2023] [Indexed: 12/29/2023]
Abstract
Acoustoelasticity theory describes propagation of shear waves in uniaxially stressed medium and allows the retrieval of nonlinear elastic coefficients of tissues. In transverse isotropic medium such as muscles the theory leads to 9 different configurations of propagating shear waves (stress axis vs. fibers axis vs. shear wave polarization axis vs. shear wave propagation axis). In this work we propose to use 4 configurations to quantify these nonlinear parameters ex vivo and in vivo. Ex vivo experiments combining ultrasound shear wave elastography and mechanical testing were conducted on iliopsoas pig muscles to quantify three third-order nonlinear coefficients A, H and K that are possibly linked to the architectural structure of muscles. In vivo experiments were performed with human volunteers on biceps brachii during a stretching exercise on an ergometer. A combination of the third order nonlinear elastic parameters was assessed. The knowledge of this nonlinear elastic parameters paves the way to quantify in vivo the local forces produced by muscle during exercise, contraction or movements.
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Affiliation(s)
- Ha Hien Phuong Ngo
- Laboratoire d'imagerie biomédicale multimodale (BioMaps), University Paris-Saclay, CEA, CNRS UMR 9011, Inserm UMR 1281, Orsay, F-91401, France
| | - Ricardo J Andrade
- Mouvement Interactions Performance (MIP), University of Nantes, UR 4334, F-44000, Nantes, France
| | - Juliette Lancelot
- Mouvement Interactions Performance (MIP), University of Nantes, UR 4334, F-44000, Nantes, France
| | - Aude Loumeaud
- Engineering Science, Computer Science and Imaging Laboratory (ICube), University of Strasbourg, CNRS UMR 7357, Strasbourg, F-67000, France
| | - Corentin Cornu
- Laboratoire d'imagerie biomédicale multimodale (BioMaps), University Paris-Saclay, CEA, CNRS UMR 9011, Inserm UMR 1281, Orsay, F-91401, France
| | - Antoine Nordez
- Mouvement Interactions Performance (MIP), University of Nantes, UR 4334, F-44000, Nantes, France; Institut Universitaire de France (IUF), France
| | - Simon Chatelin
- Engineering Science, Computer Science and Imaging Laboratory (ICube), University of Strasbourg, CNRS UMR 7357, Strasbourg, F-67000, France
| | - Jean-Luc Gennisson
- Laboratoire d'imagerie biomédicale multimodale (BioMaps), University Paris-Saclay, CEA, CNRS UMR 9011, Inserm UMR 1281, Orsay, F-91401, France.
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26
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Cormack JM, Chao YH, Archer BT, Kim K, Spratt KS, Hamilton MF. Focused Shear Wave Beam Propagation in Tissue-Mimicking Phantoms. IEEE Trans Biomed Eng 2024; 71:621-630. [PMID: 37665711 PMCID: PMC10951862 DOI: 10.1109/tbme.2023.3311688] [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] [Indexed: 09/06/2023]
Abstract
OBJECTIVE Ultrasound transient elastography (TE) technologies for liver stiffness measurement (LSM) utilize vibration of small, flat pistons, which generate shear waves that lack directivity. The most common cause for LSM failure in practice is insufficient shear wave signal at the needed depths. We propose to increase shear wave amplitude by focusing the waves into a directional beam. Here, we demonstrate the generation and propagation of focused shear wave beams (fSWBs) in gelatin. METHODS Directional fSWBs are generated by vibration at 200-400 Hz of a concave piston embedded near the surface of gelatin phantoms and measured with high-frame-rate ultrasound imaging. Five phantoms with a range of stiffnesses are employed. Shear wave speeds assessed by fSWBs are compared with those by radiation-force-based methods (2D SWE). fSWB amplitudes are compared to predictions using an analytical model. RESULTS fSWB-derived shear wave speeds are in good agreement with 2D SWE. The amplitudes of fSWBs are localized to the LSM region and are significantly greater than unfocused shear waves. Overall agreement with theory is observed, with some discrepancies in the theoretical source condition. CONCLUSION Focusing shear waves can increase the signal in the LSM region for TE. Challenges for translation include coupling piston vibration with the patient skin and increased attenuation in vivo compared to the phantoms employed here. SIGNIFICANCE Fibrosis is the most predictive measure of patient outcome in non-alcoholic fatty liver disease. Increased shear wave amplitude in the LSM region can reduce fibrosis assessment failure rates by TE, thus reducing the need for invasive methods like biopsy.
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27
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Song A, Li T, Ding X, Wu M, Wang R. TSE-GAN: strain elastography using generative adversarial network for thyroid disease diagnosis. Front Bioeng Biotechnol 2024; 12:1330713. [PMID: 38361791 PMCID: PMC10867782 DOI: 10.3389/fbioe.2024.1330713] [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: 10/31/2023] [Accepted: 01/15/2024] [Indexed: 02/17/2024] Open
Abstract
Over the past 35 years, studies conducted worldwide have revealed a threefold increase in the incidence of thyroid cancer. Strain elastography is a new imaging technique to identify benign and malignant thyroid nodules due to its sensitivity to tissue stiffness. However, there are certain limitations of this technique, particularly in terms of standardization of the compression process, evaluation of results and several assumptions used in commercial strain elastography modes for the purpose of simplifying imaging analysis. In this work, we propose a novel conditional generative adversarial network (TSE-GAN) for automatically generating thyroid strain elastograms, which adopts a global-to-local architecture to improve the ability of extracting multi-scale features and develops an adaptive deformable U-net structure in the sub-generator to apply effective deformation. Furthermore, we introduce a Lab-based loss function to induce the networks to generate realistic thyroid elastograms that conform to the probability distribution of the target domain. Qualitative and quantitative assessments are conducted on a clinical dataset provided by Shanghai Sixth People's Hospital. Experimental results demonstrate that thyroid elastograms generated by the proposed TSE-GAN outperform state-of-the-art image translation methods in meeting the needs of clinical diagnostic applications and providing practical value.
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Affiliation(s)
- Anping Song
- School of Computer Engineering and Science, Shanghai University, Shanghai, China
| | - Tianyi Li
- School of Computer Engineering and Science, Shanghai University, Shanghai, China
| | - Xuehai Ding
- School of Computer Engineering and Science, Shanghai University, Shanghai, China
| | - Mingye Wu
- Department of Medical Ultrasonics, Shanghai University of Traditional Chinese Medicine Affiliated Shuguang Hospital, Shanghai, China
| | - Ren Wang
- Department of Ultrasound Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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28
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Xie Y, Huang Y, Stevenson HCS, Yin L, Zhang K, Islam ZH, Marcum WA, Johnston C, Hoyt N, Kent EW, Wang B, Hossack JA. A Quantitative Method for the Evaluation of Deep Vein Thrombosis in a Murine Model Using Three-Dimensional Ultrasound Imaging. Biomedicines 2024; 12:200. [PMID: 38255304 PMCID: PMC11154521 DOI: 10.3390/biomedicines12010200] [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: 12/23/2023] [Revised: 01/13/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024] Open
Abstract
Deep vein thrombosis (DVT) is a life-threatening condition that can lead to its sequelae pulmonary embolism (PE) or post-thrombotic syndrome (PTS). Murine models of DVT are frequently used in early-stage disease research and to assess potential therapies. This creates the need for the reliable and easy quantification of blood clots. In this paper, we present a novel high-frequency 3D ultrasound approach for the quantitative evaluation of the volume of DVT in an in vitro model and an in vivo murine model. The proposed method involves the use of a high-resolution ultrasound acquisition system and semiautomatic segmentation of the clot. The measured 3D volume of blood clots was validated to be correlated with in vitro blood clot weights with an R2 of 0.89. Additionally, the method was confirmed with an R2 of 0.91 in the in vivo mouse model with a cylindrical volume from macroscopic measurement. We anticipate that the proposed method will be useful in pharmacological or therapeutic studies in murine models of DVT.
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Affiliation(s)
- Yanjun Xie
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22908, USA; (Y.X.); (Y.H.); (H.C.S.S.)
| | - Yi Huang
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22908, USA; (Y.X.); (Y.H.); (H.C.S.S.)
| | - Hugo C. S. Stevenson
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22908, USA; (Y.X.); (Y.H.); (H.C.S.S.)
| | - Li Yin
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA 22908, USA; (L.Y.); (K.Z.); (Z.H.I.); (W.A.M.); (C.J.); (N.H.); (E.W.K.); (B.W.)
| | - Kaijie Zhang
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA 22908, USA; (L.Y.); (K.Z.); (Z.H.I.); (W.A.M.); (C.J.); (N.H.); (E.W.K.); (B.W.)
| | - Zain Husain Islam
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA 22908, USA; (L.Y.); (K.Z.); (Z.H.I.); (W.A.M.); (C.J.); (N.H.); (E.W.K.); (B.W.)
| | - William Aaron Marcum
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA 22908, USA; (L.Y.); (K.Z.); (Z.H.I.); (W.A.M.); (C.J.); (N.H.); (E.W.K.); (B.W.)
| | - Campbell Johnston
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA 22908, USA; (L.Y.); (K.Z.); (Z.H.I.); (W.A.M.); (C.J.); (N.H.); (E.W.K.); (B.W.)
| | - Nicholas Hoyt
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA 22908, USA; (L.Y.); (K.Z.); (Z.H.I.); (W.A.M.); (C.J.); (N.H.); (E.W.K.); (B.W.)
| | - Eric William Kent
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA 22908, USA; (L.Y.); (K.Z.); (Z.H.I.); (W.A.M.); (C.J.); (N.H.); (E.W.K.); (B.W.)
| | - Bowen Wang
- Department of Surgery, School of Medicine, University of Virginia, Charlottesville, VA 22908, USA; (L.Y.); (K.Z.); (Z.H.I.); (W.A.M.); (C.J.); (N.H.); (E.W.K.); (B.W.)
| | - John A. Hossack
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22908, USA; (Y.X.); (Y.H.); (H.C.S.S.)
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29
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Lin X, Chen J, Sun C. High-accuracy optical coherence elastography digital volume correlation methods to measure depth regions with low correlation. JOURNAL OF BIOPHOTONICS 2024; 17:e202300094. [PMID: 37774123 DOI: 10.1002/jbio.202300094] [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: 03/22/2023] [Revised: 09/17/2023] [Accepted: 09/27/2023] [Indexed: 10/01/2023]
Abstract
The decreasing correlation of optical coherence tomography (OCT) images with depth is an unavoidable problem for the depth measurement of the digital volume correlation (DVC) based optical coherence elastography (OCE) method. We propose an OCE-DVC method to characterize biological tissue deformation in deeper regions. The method proposes a strategy based on reliability layer guided displacement tracking to achieve the OCE-DVC method for the deformation measurement in deep regions of OCT images. Parallel computing solves the computational burden associated with the OCE-DVC method. The layer-by-layer adaptive data reading methods are used to guarantee the parallel computing of high-resolution OCT images. The proposed method shown in this study nearly doubles the depth of quantitative characterization of displacement and strain. At this depth, the standard deviation of displacement and strain measurements is reduced by nearly 78%. Under nonuniform deformation field, OCE-DVC method tracked the displacement with large strain gradient in depth region.
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Affiliation(s)
- Xianglong Lin
- Department of Mechanics, School of Mechanical Engineering, Tianjin University, Tianjin, China
- Tianjin Key Laboratory of Modern Engineering Mechanics, Tianjin University, Tianjin, China
| | - Jinlong Chen
- Department of Mechanics, School of Mechanical Engineering, Tianjin University, Tianjin, China
- Tianjin Key Laboratory of Modern Engineering Mechanics, Tianjin University, Tianjin, China
| | - Cuiru Sun
- Department of Mechanics, School of Mechanical Engineering, Tianjin University, Tianjin, China
- Tianjin Key Laboratory of Modern Engineering Mechanics, Tianjin University, Tianjin, China
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30
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Harinesan N, Silsby M, Simon NG. Carpal tunnel syndrome. HANDBOOK OF CLINICAL NEUROLOGY 2024; 201:61-88. [PMID: 38697747 DOI: 10.1016/b978-0-323-90108-6.00005-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Median neuropathy at the wrist, commonly referred to as carpal tunnel syndrome (CTS), is the most common entrapment neuropathy. It is caused by chronic compression of the median nerve at the wrist within the space-limited carpal tunnel. Risk factors that contribute to the etiology of compression include female gender, obesity, work-related factors, and underlying medical conditions, such as hypothyroidism, pregnancy, and amyloidosis. The diagnosis is made on clinical grounds, although these can be confounded by anatomical variations. Electrodiagnostic studies, which are specific and sensitive in diagnosing CTS, support the diagnosis; however, a subgroup may present with normal results. The advent of imaging techniques, including ultrasound and MRI, further assists the diagnostic process. The management of CTS is divided into the nonsurgical approaches that include hand therapy, splinting and corticosteroid injection, and surgical decompression of the carpal tunnel. Although several surgical techniques have been developed, no one method is more effective than the other. Each of these management approaches are effective at providing symptom relief and are utilized at different severities of the condition. There is, however, a lack of consensus on standardized diagnostic criteria, as well as when and to whom to refer patients for surgery.
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Affiliation(s)
- Nimalan Harinesan
- Westmead Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Matthew Silsby
- Westmead Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Neil G Simon
- Northern Beaches Clinical School, Macquarie University, Sydney, NSW, Australia.
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31
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Hanitsch LG, Steiner S, Schumann M, Wittke K, Kedor C, Scheibenbogen C, Fischer A. Portal hypertension in common variable immunodeficiency disorders - a single center analysis on clinical and immunological parameter in 196 patients. Front Immunol 2023; 14:1268207. [PMID: 38187397 PMCID: PMC10769488 DOI: 10.3389/fimmu.2023.1268207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/20/2023] [Indexed: 01/09/2024] Open
Abstract
Background Liver manifestations and in particular portal hypertension (PH) contribute significantly to morbidity and mortality of patients with common variable immunodeficiency disorders (CVID). Screening strategies and early detection are limited due to the lack of specific diagnostic tools. Methods We evaluated clinical, immunological, histological, and imaging parameters in CVID patients with clinical manifestation of portal hypertension (CVID+PH). Results Portal hypertension was present in 5.6% of CVID patients and was associated with high clinical burden and increased mortality (18%). Longitudinal data on clinical and immunological parameters in patients before and during clinically manifest portal hypertension revealed a growing splenomegaly and increasing gamma-glutamyl transferase (GGT) and soluble interleukin 2 receptor (SIL-2R) levels with decreasing platelets over time. While ultrasound of the liver failed to detect signs of portal hypertension in most affected patients, transient elastography was elevated in all patients. All CVID+PH patients had reduced naïve CD45RA+CD4+ T-cells (mean of 6,2%). The frequency of severe B-lymphocytopenia (Euroclass B-) was higher in CVID+PH patients. The main histological findings included lymphocytic infiltration, nodular regenerative hyperplasia-like changes (NRH-LC), and porto(-septal) fibrosis. Conclusion CVID patients with lower naïve CD45RA+CD4+ T-cells or severely reduced B-cells might be at higher risk for portal hypertension. The combination of biochemical (increasing sIL-2R, GGT, and decreasing platelets) and imaging parameters (increasing splenomegaly) should raise suspicion of the beginning of portal hypertension.
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Affiliation(s)
- Leif G. Hanitsch
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Berlin, Germany
| | - Sophie Steiner
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Michael Schumann
- Department of Gastroenterology, Infectiology and Rheumatology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Kirsten Wittke
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Claudia Kedor
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Carmen Scheibenbogen
- Institute of Medical Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Center for Regenerative Therapies (BCRT), Berlin, Germany
| | - Andreas Fischer
- Department of Internal Medicine and Gastroenterology, Caritas-Klinik Maria Heimsuchung Berlin-Pankow, Berlin, Germany
- Department of Hepatology and Gastroenterology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
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Arıkan B, Dedeoğlu N, Keskinrüzgar A. Ultrasonographic evaluation of the masseter muscle in patients with temporomandibular joint degeneration. Imaging Sci Dent 2023; 53:355-363. [PMID: 38174042 PMCID: PMC10761293 DOI: 10.5624/isd.20230134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/08/2023] [Accepted: 08/12/2023] [Indexed: 01/05/2024] Open
Abstract
Purpose Sonographic elastography can be used to evaluate the hardness of muscle tissue through the application of compression. Strain elastography gauges hardness through the comparison of echo sets before and after compression. This study utilized ultrasonography to measure the thickness and hardness of the masseter muscle in individuals with temporomandibular joint (TMJ) osteoarthritis. Materials and Methods This study included 40 patients who presented with joint pain and were diagnosed with TMJ osteoarthritis via diagnostic cone-beam computed tomography, along with 40 healthy individuals. The thickness and hardness of each individual's masseter muscle were evaluated both at rest and at maximum bite using ultrasonography. The Mann-Whitney U test and the chi-square test were employed for statistical analysis, with the significance level set at P<0.05. Results The mean thickness of the resting masseter muscle was 0.91 cm in patients with osteoarthritis, versus 1.00 cm in healthy individuals. The mean thickness of the masseter muscle at maximum bite was 1.28 cm in osteoarthritis patients and 1.36 cm in healthy individuals. The mean masseter elasticity index ratio at maximum bite was 4.51 in patients with osteoarthritis and 3.16 in healthy controls. Significant differences were observed between patients with osteoarthritis and healthy controls in both the masseter muscle thickness and the masseter elasticity index ratio, at rest and at maximum bite (P<0.05). Conclusion The thickness of the masseter muscle in patients with TMJ osteoarthritis was less than that in healthy controls. Additionally, the hardness of the masseter muscle was greater in patients with TMJ osteoarthritis.
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Affiliation(s)
- Büşra Arıkan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inonu University, Malatya, Turkey
| | - Numan Dedeoğlu
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inonu University, Malatya, Turkey
| | - Aydın Keskinrüzgar
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Adıyaman University, Adıyaman, Turkey
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Shingare A, Maldar AN, Chauhan PH, Wadhwani R. Use of ultrasound elastography in differentiating benign from malignant thyroid nodules: a prospective study. J Diabetes Metab Disord 2023; 22:1245-1253. [PMID: 37975077 PMCID: PMC10638165 DOI: 10.1007/s40200-023-01239-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/15/2023] [Indexed: 11/19/2023]
Abstract
Purpose Elastography is a real-time non-invasive ultrasonography modality wherein the tissue stiffness is evaluated by calculating the degree of tissue distortion in response to an external force. This study was undertaken to assess the diagnostic value of elastography in differentiating benign from malignant thyroid nodules. Methodology In this prospective comparative study, a total of 52 thyroid nodules from 44 euthyroid patients undergoing fine needle aspiration cytology were assessed. Elastography was performed by a single experienced sonologist, wherein the nodules were graded as per elastography scoring (ES), and the strain ratio (SR) for each nodule was computed. Final histopathology findings of the patients undergoing surgery were compared to elastography findings, and measures of diagnostic accuracy to differentiate between benign and malignant nodules were determined for ES and SR. Results Thirty (68.2%) females and 14 (31.8%) males, with a mean age of 45.18 ± 11.23 years, were assessed. Fourteen (31.8%) patients underwent thyroidectomy, and histopathology was reported for 18 (34.6%) nodules. In all, nine (17.3%) nodules were malignant, and 43 (82.7%) nodules were considered benign. ES demonstrated a sensitivity of 88.9%, specificity of 88.3%, PPV of 61.5%, NPV of 97.4%, and accuracy of 88.5% to identify benign thyroid nodules. The mean SR for benign nodules was significantly lower as compared to malignant nodules (2.72 ± 0.62 vs. 4.52 ± 0.75, P < 0.0001). The optimal cut-point value for SR to differentiate benign and malignant thyroid nodules was determined to be 3.8, with the sensitivity, specificity, PPV, NPV, and accuracy being 88.9%, 95.4%, 80%, 94.6%, and 94.2%, respectively. Conclusion Ultrasound elastography (ES and SR) demonstrated good diagnostic efficacy to differentiate benign thyroid nodules from the malignant ones, and can be a good supplementary tool to gray-scale ultrasonography. It can also help in reducing the rates of unnecessary fine needle-aspiration biopsy.
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Affiliation(s)
- Awesh Shingare
- Department of Endocrinology, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India
| | - Aasim N. Maldar
- Department of Endocrinology, P. D. Hinduja Hospital and Medical Research Centre, Mumbai, India
| | - Phulrenu H. Chauhan
- Department of Endocrinology, P. D. Hinduja Hospital and Medical Research Centre, Mumbai, India
| | - Raju Wadhwani
- Department of Radiology, P. D. Hinduja Hospital and Medical Research Centre, Mumbai, India
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Bracco C, Gloria A, Contri A. Ultrasound-Based Technologies for the Evaluation of Testicles in the Dog: Keystones and Breakthroughs. Vet Sci 2023; 10:683. [PMID: 38133235 PMCID: PMC10747277 DOI: 10.3390/vetsci10120683] [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: 07/10/2023] [Revised: 11/11/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023] Open
Abstract
Ultrasonography is a valuable diagnostic tool extensively used in the andrology of human and domestic animals, including dogs. This review aims to provide an overview of various technologies based on ultrasound, from the basic B-Mode ultrasonography to the more recent advancements, such as contrast-enhanced ultrasonography (CEUS) and ultrasound elastography (UEl), all of which are utilized in the evaluation of canine testicles. The review outlines the principles behind each of these technologies and discusses their application in assessing normal and abnormal testicular conditions. B-mode canine testicular ultrasonography primarily focuses on detecting focal lesions but has limitations in terms of objectivity. Other technologies, including Doppler ultrasonography, B-Flow, and CEUS, allow for the characterization of vascular patterns, which could be further measured using specific applications like spectral Doppler or quantitative CEUS. Additionally, ultrasound elastography enables the assessment of parenchyma stiffness both qualitatively and quantitatively. These ultrasound-based technologies play a crucial role in andrology by providing valuable information for evaluating testicular function and integrity, aiding in the identification of pathological conditions that may impact the health and quality of life of male dogs.
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Affiliation(s)
| | - Alessia Gloria
- Department of Veterinary Medicine, University of Teramo, Località Piano d’Accio, 64100 Teramo, Italy; (C.B.); (A.C.)
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Zaed I, Della Pepa GM, Cannizzaro D, Menna G, Cardia A. Applicability and efficacy of ultrasound elastography in neurosurgery: a systematic review of the literature. J Neurosurg Sci 2023; 67:750-757. [PMID: 36239425 DOI: 10.23736/s0390-5616.22.05866-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
INTRODUCTION Neurosurgery is one of the fields in which intraoperative imaging is paramount. One of these main imaging tools that have been acquiring the interest of the neurosurgical community is Ultrasound elastography (USE), which is an imaging technology sensitive to tissue stiffness. Here we present a systematic review of the use of USE in neurosurgery. EVIDENCE ACQUISITION A systematic review of the literature has been performed, according to the PRISMA guideline, for the last 30 years on 3 different databases (MEDLINE, Scopus, and Cochrane), to gather all the studies on the use of ultrasound elastography for neurosurgical pathologies, including both clinical and laboratory studies. EVIDENCE SYNTHESIS A total of 15 articles met the inclusion criteria. USE has widely and safely been used especially for oncological lesions (meningiomas and gliomas) and focal cortical dysplasia. However, there are also encouraging laboratory studies about its application for the management of traumatic brain injury, and ischemic stroke. CONCLUSIONS This systematic review showed that, despite the lack of strong evidence, USE is a valid intraoperative tool, especially in oncological neurosurgery.
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Affiliation(s)
- Ismail Zaed
- Department of Neurosurgery, ASST Ovest Milanese, Legnano Hospital, Milan, Italy -
| | - Giuseppe M Della Pepa
- Institute of Neurosurgery, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Delia Cannizzaro
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Department of Neurosurgery, IRCCS Humanitas Clinic, Rozzano, Milan, Italy
| | - Grazia Menna
- Institute of Neurosurgery, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
| | - Andrea Cardia
- Department of Neurosurgery, Neurocenter of Southern Switzerland, EOC, Lugano, Switzerland
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Izak Ghasemian S, Reuter F, Fan Y, Rose G, Ohl CD. Shear wave generation from non-spherical bubble collapse in a tissue phantom. SOFT MATTER 2023. [PMID: 37990644 DOI: 10.1039/d3sm01077e] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Abstract
Elastography is a non-invasive technique to detect tissue anomalies via the local elastic modulus using shear waves. Commonly shear waves are produced via acoustic focusing or the use of mechanical external sources, shear waves may result also naturally from cavitation bubbles during medical intervention, for example from thermal ablation. Here, we measure the shear wave emitted from a well-controlled single laser-induced cavitation bubble oscillating near a rigid boundary. The bubbles are generated in a transparent tissue-mimicking hydrogel embedded with tracer particles. High-speed imaging of the tracer particles and the bubble shape allow quantifying the shear wave and relate it to the bubble dynamics. It is found that different stages of the bubble dynamics contribute to the shear wave generation and the mechanism of shear wave emission, its direction and the efficiency of energy converted into the shear wave depend crucially on the bubble to wall stand-off distance.
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Affiliation(s)
- Saber Izak Ghasemian
- Institute of Physics, Otto-von-Guericke Universität, Magdeburg, Germany.
- Research Campus STIMULATE, Otto-von-Guericke Universität, Magdeburg, Germany
| | - Fabian Reuter
- Institute of Physics, Otto-von-Guericke Universität, Magdeburg, Germany.
| | - Yuzhe Fan
- Research Campus STIMULATE, Otto-von-Guericke Universität, Magdeburg, Germany
| | - Georg Rose
- Research Campus STIMULATE, Otto-von-Guericke Universität, Magdeburg, Germany
- Institute of Medical Engineering, Otto-von-Guericke Universität, Magdeburg, Germany
| | - Claus-Dieter Ohl
- Institute of Physics, Otto-von-Guericke Universität, Magdeburg, Germany.
- Research Campus STIMULATE, Otto-von-Guericke Universität, Magdeburg, Germany
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Petersen M, Klemenz B, Schenke SA. [Elastography in thyroid nodules]. Laryngorhinootologie 2023; 102:839-849. [PMID: 37918385 DOI: 10.1055/a-2144-4176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
BACKGROUND Elastography is an imaging method to examine the elasticity of tissue. In the meantime, various elastography methods have been developed, which are subdivided according to the type of stimulus applied. In principle, a distinction should be made between strain elastography (SE) and shear wave elastography (SWE). Both methods provide another means of assessing thyroid disease in addition to conventional B-mode sonography. OBJECTIVE The aim is to provide an overview of elastography techniques including physical basics and their importance in the clarification algorithm of thyroid nodules. MATERIALS AND METHODS International guidelines and recent publications on elastography were selectively assessed. RESULTS Elastography provides additional information compared to conventional B-mode sonography. The change in shear stiffness is the essential physical mechanism for tissue contrast in all elastograms. In addition to the qualitative assessment of elasticity in SE, quantification is possible with SWE. In the international literature, elastography was analyzed as a single method or in comparison or combination with conventional B-mode sonography and especially with standardization using a risk stratification system (RSS, TIRADS). The results are quite controversial. In nodules with unclear findings on fine-needle biopsy (Bethesda III/IV), the combination of morphologic criteria and elastography improved diagnostic accuracy. In particular, the high negative predictive value of soft nodules represents a relevant added value. This strength of the method can play an important role in the clarification of nodules with intermediate malignancy risk or of unclear FNB results. Elastography has previously only been incorporated into French-TIRADS. Although the procedure is mentioned in the EU-TIRADS as a complementary method, integration has not been described. Limitations of the method are idealized basic assumptions, dependence of manufacturer and examiner, and artifacts. CONCLUSION Elastography can be a useful adjunct to standard diagnostic procedures in the evaluation of thyroid nodules, especially in nodules with intermediate risk of malignancy and unclear results on fine needle aspiration.
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Affiliation(s)
- Manuela Petersen
- Arbeitsbereich Gefäßchirurgie, Klinik für Allgemein-, Viszeral-, Gefäß- und Transplantationschirurgie, Universitätsklinikum Magdeburg A.ö.R., Magdeburg, Germany
| | - Burkhard Klemenz
- Klinik für Nuklearmedizin, Bundeswehrkrankenhaus Ulm, Ulm, Deutschland
| | - Simone A Schenke
- Klinik und Institut für Nuklearmedizin, Klinikum Bayreuth GmbH, Bayreuth, Germany
- Bereich Nuklearmedizin, Universitätsklinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg
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Aspromonte N, Fumarulo I, Petrucci L, Biferali B, Liguori A, Gasbarrini A, Massetti M, Miele L. The Liver in Heart Failure: From Biomarkers to Clinical Risk. Int J Mol Sci 2023; 24:15665. [PMID: 37958649 PMCID: PMC10649397 DOI: 10.3390/ijms242115665] [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: 09/20/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
Heart failure (HF) is a clinical syndrome due to heart dysfunction, but in which other organs are also involved, resulting in a complex multisystemic disease, burdened with high mortality and morbidity. This article focuses on the mutual relationship between the heart and liver in HF patients. Any cause of right heart failure can cause hepatic congestion, with important prognostic significance. We have analyzed the pathophysiology underlying this double interaction. Moreover, we have explored several biomarkers and non-invasive tests (i.e., liver stiffness measurement, LSM) potentially able to provide important support in the management of this complex disease. Cardiac biomarkers have been studied extensively in cardiology as a non-invasive diagnostic and monitoring tool for HF. However, their usefulness in assessing liver congestion in HF patients is still being researched. On the other hand, several prognostic scores based on liver biomarkers in patients with HF have been proposed in recent years, recognizing the important burden that liver involvement has in HF. We also discuss the usefulness of a liver stiffness measurement (LSM), which has been recently proposed as a reliable and non-invasive method for assessing liver congestion in HF patients, with therapeutic and prognostic intentions. Lastly, the relationship between LSM and biomarkers of liver congestion is not clearly defined; more research is necessary to establish the clinical value of biomarkers in assessing liver congestion in HF patients and their relationship with LSM.
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Affiliation(s)
- Nadia Aspromonte
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, 00168 Rome, Italy; (I.F.); (M.M.)
- Department of Cardiovascular and Thoracic Sciences, A. Gemelli University Policlinic Foundation IRCCS, 00168 Rome, Italy
| | - Isabella Fumarulo
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, 00168 Rome, Italy; (I.F.); (M.M.)
- Department of Cardiovascular and Thoracic Sciences, A. Gemelli University Policlinic Foundation IRCCS, 00168 Rome, Italy
| | - Lucrezia Petrucci
- Department of Translational Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Rome, Italy; (L.P.); (B.B.); (A.L.); (A.G.); (L.M.)
- Department of Medical and Surgical Sciences, A. Gemelli University Policlinic Foundation IRCCS, 00168 Rome, Italy
| | - Bianca Biferali
- Department of Translational Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Rome, Italy; (L.P.); (B.B.); (A.L.); (A.G.); (L.M.)
- Department of Medical and Surgical Sciences, A. Gemelli University Policlinic Foundation IRCCS, 00168 Rome, Italy
| | - Antonio Liguori
- Department of Translational Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Rome, Italy; (L.P.); (B.B.); (A.L.); (A.G.); (L.M.)
- Department of Medical and Surgical Sciences, A. Gemelli University Policlinic Foundation IRCCS, 00168 Rome, Italy
| | - Antonio Gasbarrini
- Department of Translational Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Rome, Italy; (L.P.); (B.B.); (A.L.); (A.G.); (L.M.)
- Department of Medical and Surgical Sciences, A. Gemelli University Policlinic Foundation IRCCS, 00168 Rome, Italy
| | - Massimo Massetti
- Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, 00168 Rome, Italy; (I.F.); (M.M.)
- Department of Cardiovascular and Thoracic Sciences, A. Gemelli University Policlinic Foundation IRCCS, 00168 Rome, Italy
| | - Luca Miele
- Department of Translational Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Rome, Italy; (L.P.); (B.B.); (A.L.); (A.G.); (L.M.)
- Department of Medical and Surgical Sciences, A. Gemelli University Policlinic Foundation IRCCS, 00168 Rome, Italy
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Zandi A, Shojaeian F, Abbasvandi F, Faranoush M, Anbiaee R, Hoseinpour P, Gilani A, Saghafi M, Zandi A, Hoseinyazdi M, Davari Z, Miraghaie SH, Tayebi M, Taheri MS, Ardestani SMS, Sheikhi Mobarakeh Z, Nikshoar MR, Enjavi MH, Kordehlachin Y, Mousavi-kiasary SMS, Mamdouh A, Akbari ME, Yunesian M, Abdolahad M. A human pilot study on positive electrostatic charge effects in solid tumors of the late-stage metastatic patients. Front Med (Lausanne) 2023; 10:1195026. [PMID: 37915327 PMCID: PMC10616960 DOI: 10.3389/fmed.2023.1195026] [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: 03/27/2023] [Accepted: 09/25/2023] [Indexed: 11/03/2023] Open
Abstract
Background Correlative interactions between electrical charges and cancer cells involve important unknown factors in cancer diagnosis and treatment. We previously reported the intrinsic suppressive effects of pure positive electrostatic charges (PEC) on the proliferation and metabolism of invasive cancer cells without any effect on normal cells in cell lines and animal models. The proposed mechanism was the suppression of pro-caspases 3 and 9 with an increase in Bax/Bcl2 ratio in exposed malignant cells and perturbation induced in the KRAS pathway of malignant cells by electrostatic charges due to the phosphate molecule electrostatic charge as the trigger of the pathway. This study aimed to examine PECs as a complementary treatment for patients with different types of solid metastatic tumors, who showed resistance to chemotherapy and radiotherapy. Methods In this study, solid metastatic tumors of the end-stage patients (n = 41) with various types of cancers were locally exposed to PEC for at least one course of 12 days. The patient's signs and symptoms, the changes in their tumor size, and serum markers were followed up from 30 days before positive electrostatic charge treating (PECT) until 6 months after the study. Results Entirely, 36 patients completed the related follow-ups. Significant reduction in tumor sizes and cancer-associated enzymes as well as improvement in cancer-related signs and symptoms and patients' lifestyles, without any side effects on other tissues or metabolisms of the body, were observed in more than 80% of the candidates. Conclusion PECT induced significant cancer remission in combination with other therapies. Therefore, this non-ionizing radiation would be a beneficial complementary therapy, with no observable side effects of ionizing radiotherapy, such as post-radiation inflammation.
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Affiliation(s)
- Ashkan Zandi
- Nano Electronic Centre of Excellence, Nanobioelectronic Devices Laboratory, Cancer Electronics Research Group, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran, Iran
- Nano Electronic Centre of Excellence, Nanoelectronics and Thin Film Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran, Iran
| | - Fatemeh Shojaeian
- Nano Electronic Centre of Excellence, Nanobioelectronic Devices Laboratory, Cancer Electronics Research Group, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran, Iran
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereshteh Abbasvandi
- Department of ATMP, Breast Cancer Research Centre, Motamed Cancer Institute, ACECR, Tehran, Iran
- Cancer Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Faranoush
- Pediatric Growth and Development Research Centre, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
- Cardio-Oncology Research Centre, Rajaie Cardiovascular Medical and Research Centre, Iran University of Medical Sciences, Tehran, Iran
| | - Robab Anbiaee
- Department of Radiation Oncology, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parisa Hoseinpour
- Nano Electronic Centre of Excellence, Nanobioelectronic Devices Laboratory, Cancer Electronics Research Group, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran, Iran
- SEPAS Pathology Laboratory, Tehran, Iran
| | - Ali Gilani
- Nano Electronic Centre of Excellence, Nanobioelectronic Devices Laboratory, Cancer Electronics Research Group, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran, Iran
| | - Mohammad Saghafi
- Nano Electronic Centre of Excellence, Nanobioelectronic Devices Laboratory, Cancer Electronics Research Group, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran, Iran
| | - Afsoon Zandi
- Department of Otolaryngology, Head and Neck Surgery, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Meisam Hoseinyazdi
- Medical Imaging Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Davari
- Nano Electronic Centre of Excellence, Nanobioelectronic Devices Laboratory, Cancer Electronics Research Group, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran, Iran
| | - Seyyed Hossein Miraghaie
- Nano Electronic Centre of Excellence, Nanobioelectronic Devices Laboratory, Cancer Electronics Research Group, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran, Iran
| | - Mahtab Tayebi
- Department of ATMP, Breast Cancer Research Centre, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Morteza Sanei Taheri
- Department of Radiology, Shohada Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S. Mehdi Samimi Ardestani
- Department of Psychiatry, Behavioural Sciences Research Centre, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Sheikhi Mobarakeh
- Department of Quality of Life, Breast Cancer Research Centre, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Mohammad Reza Nikshoar
- Department of Gastroenterology Surgery, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Hossein Enjavi
- Nano Electronic Centre of Excellence, Nanobioelectronic Devices Laboratory, Cancer Electronics Research Group, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran, Iran
- Nano Electronic Centre of Excellence, Nanoelectronics and Thin Film Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran, Iran
| | - Yasin Kordehlachin
- Nano Electronic Centre of Excellence, Nanobioelectronic Devices Laboratory, Cancer Electronics Research Group, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran, Iran
| | - S. M. Sadegh Mousavi-kiasary
- Nano Electronic Centre of Excellence, Nanobioelectronic Devices Laboratory, Cancer Electronics Research Group, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran, Iran
| | - Amir Mamdouh
- Nano Electronic Centre of Excellence, Nanobioelectronic Devices Laboratory, Cancer Electronics Research Group, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran, Iran
| | | | - Masud Yunesian
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Abdolahad
- Nano Electronic Centre of Excellence, Nanobioelectronic Devices Laboratory, Cancer Electronics Research Group, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran, Iran
- Nano Electronic Centre of Excellence, Nanoelectronics and Thin Film Laboratory, School of Electrical and Computer Engineering, Faculty of Engineering, University of Tehran, Tehran, Iran
- Imam-Khomeini Hospital, Tehran University of Medical Sciences, Cancer Institute, Tehran, Iran
- UT&TUMS Cancer Electrotechnique Research Centre, YAS Hospital, Tehran, Iran
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Qi WH, Jin K, Cao LL, Peng M, He NA, Zhan XL, Yang Y, Guo YY, Cui XW, Jiang F. Diagnostic performance of a new two-dimensional shear wave elastography expression using siemens ultrasound system combined with ACR TI-RADS for classification of benign and malignant thyroid nodules: A prospective multi-center study. Heliyon 2023; 9:e20472. [PMID: 37790965 PMCID: PMC10543209 DOI: 10.1016/j.heliyon.2023.e20472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/19/2023] [Accepted: 09/26/2023] [Indexed: 10/05/2023] Open
Abstract
Objective The present study aimed to evaluate the efficacy of a new two-dimensional shear wave elastography (2D-SWE) method using a Siemens ultrasound system and its combination with the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) for the differential diagnosis of benign and malignant thyroid nodules. Methods Conventional ultrasound images and 2D-SWE (E-whole-mean and E-stiffest-mean) were prospectively analyzed in 593 thyroid nodules from 543 patients. Nodules were divided into diameter (D) ≤10 mm and D > 10 mm groups and graded using ACR TI-RADS. The receiver operating characteristic curve was plotted using pathological findings as the gold standard. Diagnostic performance was compared among 2D-SWE, ACR TI-RADS, and their combination. Results The area under the curve (AUC) for E-whole-mean was higher than that for E-stiffest-mean (0.858 vs. 0.790, P < 0.001), which indicated that it was the better 2D-SWE parameter for differentiating malignant nodules from benign nodules with an optimal cut-off point of 11.36 kPa. In the all-sizes group, the AUC for E-whole-mean was higher than that for ACR TI-RADS (0.858 vs. 0.808, P < 0.001). The combination of E-whole-mean and ACR TI-RADS resulted in a higher AUC (0.929 vs. 0.858 vs. 0.808, P < 0.001), sensitivity (87.0% vs. 80.3% vs. 85.2%), specificity (85.1% vs. 74.0% vs. 73.6%), accuracy (86.3% vs. 78.1% vs. 81.1%), positive predictive value (91.5% vs. 85.1% vs. 85.6%), and negative predictive value (78.0% vs. 67.0% vs. 72.9%) compared to E-whole-mean or ACR TI-RADS alone. The AUC for the combination of 2D-SWE and ACR TI-RADS was superior to that for E-whole-mean or ACR TI-RADS alone in both D ≤ 10 mm and D > 10 mm groups (P < 0.001). Conclusion As the better 2D-SWE parameter, E-whole-mean had a higher diagnostic power than ACR TI-RADS and enhanced the diagnostic performance of ACR TI-RADS when identifying benign and malignant thyroid nodules. The combination of E-whole-mean and ACR TI-RADS improved the diagnostic performance compared to using ACR TI-RADS alone, providing a new and reliable method for the clinical diagnosis of thyroid nodules.
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Affiliation(s)
- Wei-Hong Qi
- Department of Medical Ultrasound, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, PR China
| | - Kun Jin
- Department of Medical Ultrasound, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, PR China
| | - Liu-Liu Cao
- Department of Medical Ultrasound, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, PR China
| | - Mei Peng
- Department of Medical Ultrasound, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, PR China
| | - Nian-An He
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, PR China
| | - Xiao-Lin Zhan
- Department of Medical Ultrasound, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230012, PR China
| | - Yang Yang
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, PR China
| | - Yun-Yun Guo
- Department of Medical Ultrasound, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, PR China
| | - Xin-Wu Cui
- Department of Medical Ultrasound, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, PR China
| | - Fan Jiang
- Department of Medical Ultrasound, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, PR China
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Adler RS. Musculoskeletal ultrasound: a technical and historical perspective. J Ultrason 2023; 23:e172-e187. [PMID: 38020513 PMCID: PMC10668930 DOI: 10.15557/jou.2023.0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 08/21/2023] [Indexed: 12/01/2023] Open
Abstract
During the past four decades, musculoskeletal ultrasound has become popular as an imaging modality due to its low cost, accessibility, and lack of ionizing radiation. The development of ultrasound technology was possible in large part due to concomitant advances in both solid-state electronics and signal processing. The invention of the transistor and digital computer in the late 1940s was integral in its development. Moore's prediction that the number of microprocessors on a chip would grow exponentially, resulting in progressive miniaturization in chip design and therefore increased computational power, added to these capabilities. The development of musculoskeletal ultrasound has paralleled technical advances in diagnostic ultrasound. The appearance of a large variety of transducer capabilities and rapid image processing along with the ability to assess vascularity and tissue properties has expanded and continues to expand the role of musculoskeletal ultrasound. It should also be noted that these developments have in large part been due to a number of individuals who had the insight to see the potential applications of this developing technology to a host of relevant clinical musculoskeletal problems. Exquisite high-resolution images of both deep and small superficial musculoskeletal anatomy, assessment of vascularity on a capillary level and tissue mechanical properties can be obtained. Ultrasound has also been recognized as the method of choice to perform a large variety of interventional procedures. A brief review of these technical developments, the timeline over which these improvements occurred, and the impact on musculoskeletal ultrasound is presented below.
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Affiliation(s)
- Ronald Steven Adler
- Department of Radiology, New York University, Grossman School of Medicine, Langone Orthopedic Center, New York, USA
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Shintani S, Inatomi O, Hiroe K, Tomozawa Y, Inoue A, Kimura H, Nishida A, Tsuji Y, Watanabe Y, Andoh A. The diagnostic accuracy of endoscopic ultrasound-shear wave elastography in multiple pancreatic regions for chronic pancreatitis based on the Rosemont criteria. J Med Ultrason (2001) 2023; 50:485-492. [PMID: 37584779 DOI: 10.1007/s10396-023-01350-7] [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: 05/13/2023] [Accepted: 07/12/2023] [Indexed: 08/17/2023]
Abstract
PURPOSE Although endoscopic ultrasound (EUS) has been widely used for diagnosing chronic pancreatitis (CP), the assessment of fibrosis using the Rosemont criteria (RC) is generally subjective. Shear wave elastography using EUS (EUS-SWE) has been advocated as an objective approach to evaluating pancreatic fibrosis; however, it is unknown which pancreatic region should be selected for measurement. This study aims to compare the diagnostic accuracy in diagnosing CP by measurement site. METHODS Fifty patients with CP or suspected CP who underwent EUS-SWE were retrospectively analyzed. As per the RC, they were classified into two groups: CP and non-CP. Pancreatic stiffness was evaluated by measuring the velocities of the shear wave (Vs) in addition to determining the relevant cutoff value of Vs for diagnosing CP. The correlation between Vs and RC, and the RC factors affecting pancreatic stiffness were evaluated. RESULTS In the CP group, the Vs were notably higher in all regions (P < 0.001). The Vs for diagnostic accuracy of CP were highest in the body [area under the curve (AUC): 0.87]. A significant correlation was seen between the number of RC and Vs in all regions, with the correlation coefficient being highest in the pancreatic body (rs = 0.55). Multivariate analysis revealed that lobularity with honeycombing was an independent factor for pancreatic stiffness (P = 0.02). CONCLUSION The pancreatic body is a suitable region for assessing pancreatic stiffness using EUS-SWE. Additionally, quantifying Vs is a valuable objective indicator for diagnosing CP.
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Affiliation(s)
- Shuhei Shintani
- Department of Medicine, Shiga University of Medical Science, Seta Tsukinowa, Otsu, Shiga, 520-2192, Japan
| | - Osamu Inatomi
- Department of Medicine, Shiga University of Medical Science, Seta Tsukinowa, Otsu, Shiga, 520-2192, Japan.
| | - Kosuke Hiroe
- Department of Medicine, Shiga University of Medical Science, Seta Tsukinowa, Otsu, Shiga, 520-2192, Japan
| | - Yuki Tomozawa
- Department of Radiology, Shiga University of Medical Science, Otsu, Japan
| | - Akitoshi Inoue
- Department of Radiology, Shiga University of Medical Science, Otsu, Japan
| | - Hidenori Kimura
- Department of Endoscopy, Shiga University of Medical Science, Otsu, Japan
| | - Atsushi Nishida
- Department of Medicine, Shiga University of Medical Science, Seta Tsukinowa, Otsu, Shiga, 520-2192, Japan
| | - Yoshihisa Tsuji
- Department of General Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Yoshiyuki Watanabe
- Department of Radiology, Shiga University of Medical Science, Otsu, Japan
| | - Akira Andoh
- Department of Medicine, Shiga University of Medical Science, Seta Tsukinowa, Otsu, Shiga, 520-2192, Japan
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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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Vogel-Minea CM, Bader W, Blohmer JU, Duda V, Eichler C, Fallenberg EM, Farrokh A, Golatta M, Gruber I, Hackelöer BJ, Heil J, Madjar H, Marzotko E, Merz E, Müller-Schimpfle M, Mundinger A, Ohlinger R, Peisker U, Schäfer FK, Schulz-Wendtland R, Solbach C, Warm M, Watermann D, Wojcinski S, Dudwiesus H, Hahn M. Best Practice Guideline - DEGUM Recommendations on Breast Ultrasound. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2023; 44:520-536. [PMID: 37072031 DOI: 10.1055/a-2020-9904] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Alongside mammography, breast ultrasound is an important and well-established method in assessment of breast lesions. With the "Best Practice Guideline", the DEGUM Breast Ultrasound (in German, "Mammasonografie") working group, intends to describe the additional and optional application modalities for the diagnostic confirmation of breast findings and to express DEGUM recommendations in this Part II, in addition to the current dignity criteria and assessment categories published in Part I, in order to facilitate the differential diagnosis of ambiguous lesions.The present "Best Practice Guideline" has set itself the goal of meeting the requirements for quality assurance and ensuring quality-controlled performance of breast ultrasound. The most important aspects of quality assurance are explained in this Part II of the Best Practice Guideline.
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Affiliation(s)
- Claudia Maria Vogel-Minea
- Brustzentrum, Diagnostische und Interventionelle Senologie, Rottal-Inn Kliniken Eggenfelden, Eggenfelden, Germany
| | - Werner Bader
- Zentrum für Frauenheilkunde, Brustzentrum, Universitätsklinikum OWL der Universität Bielefeld, Campus Klinikum Bielefeld, Bielefeld, Germany
| | - Jens-Uwe Blohmer
- Klinik für Gynäkologie mit Brustzentrum, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Volker Duda
- Senologische Diagnostik, Universitätsklinikum Gießen und Marburg, Marburg, Germany
| | - Christian Eichler
- Klinik für Brusterkrankungen, St Franziskus-Hospital Münster GmbH, Münster, Germany
| | - Eva Maria Fallenberg
- Department of Diagnostic and Interventional Radiology, Technical University of Munich Hospital Rechts der Isar, Munich, Germany
| | - André Farrokh
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Michael Golatta
- Sektion Senologie, Universitäts-Frauenklinik Heidelberg, Heidelberg, Germany
- Brustzentrum Heidelberg, Klinik St. Elisabeth, Heidelberg, Germany
| | - Ines Gruber
- Frauenklinik, Department für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen, Germany
| | | | - Jörg Heil
- Sektion Senologie, Universitäts-Frauenklinik Heidelberg, Heidelberg, Germany
- Brustzentrum Heidelberg, Klinik St. Elisabeth, Heidelberg, Germany
| | - Helmut Madjar
- Gynäkologie und Senologie, Praxis für Gynäkologie, Wiesbaden, Germany
| | - Ellen Marzotko
- Mammadiagnostik, Frauenheilkunde und Geburtshilfe, Praxis, Erfurt, Germany
| | - Eberhard Merz
- Frauenheilkunde, Zentrum für Ultraschall und Pränatalmedizin, Frankfurt, Germany
| | - Markus Müller-Schimpfle
- DKG-Brustzentrum, Klinik für Radiologie, Neuroradiologie und Nuklearmedizin, varisano Klinikum Frankfurt Höchst, Frankfurt am Main, Germany
| | - Alexander Mundinger
- Brustzentrum Osnabrück - Bildgebende und interventionelle Mamma Diagnostik, Franziskus Hospital Harderberg, Niels Stensen Kliniken, Georgsmarienhütte, Germany
| | - Ralf Ohlinger
- Interdisziplinäres Brustzentrum, Universitätsmedizin Greifswald, Klinik für Frauenheilkunde und Geburtshilfe, Greifswald, Germany
| | - Uwe Peisker
- BrustCentrum Aachen-Kreis Heinsberg, Hermann-Josef Krankenhaus, Akademisches Lehrkrankenhaus der RWTH-Aachen, Erkelenz, Germany
| | - Fritz Kw Schäfer
- Bereich Mammadiagnostik und Interventionen, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | | | - Christine Solbach
- Senologie, Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Frankfurt, Frankfurt, Germany
| | - Mathias Warm
- Brustzentrum, Krankenhaus Holweide, Kliniken der Stadt Köln, Koeln, Germany
| | - Dirk Watermann
- Frauenklinik, Evangelisches Diakoniekrankenhaus, Freiburg, Germany
| | - Sebastian Wojcinski
- Zentrum für Frauenheilkunde, Brustzentrum, Universitätsklinikum OWL Bielefeld, Bielefeld, Germany
| | | | - Markus Hahn
- Frauenklinik, Department für Frauengesundheit, Universität Tübingen, Tübingen, Germany
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Tang S, Weiner B, Taraballi F, Haase C, Stetco E, Mehta SM, Shajudeen P, Hogan M, De Rosa E, Horner PJ, Grande-Allen KJ, Shi Z, Karmonik C, Tasciotti E, Righetti R. Assessment of spinal cord injury using ultrasound elastography in a rabbit model in vivo. Sci Rep 2023; 13:15323. [PMID: 37714920 PMCID: PMC10504274 DOI: 10.1038/s41598-023-41172-8] [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: 02/19/2023] [Accepted: 08/23/2023] [Indexed: 09/17/2023] Open
Abstract
The effect of the mechanical micro-environment on spinal cord injury (SCI) and treatment effectiveness remains unclear. Currently, there are limited imaging methods that can directly assess the localized mechanical behavior of spinal cords in vivo. In this study, we apply new ultrasound elastography (USE) techniques to assess SCI in vivo at the site of the injury and at the time of one week post injury, in a rabbit animal model. Eleven rabbits underwent laminectomy procedures. Among them, spinal cords of five rabbits were injured during the procedure. The other six rabbits were used as control. Two neurological statuses were achieved: non-paralysis and paralysis. Ultrasound data were collected one week post-surgery and processed to compute strain ratios. Histologic analysis, mechanical testing, magnetic resonance imaging (MRI), computerized tomography and MRI diffusion tensor imaging (DTI) were performed to validate USE results. Strain ratios computed via USE were found to be significantly different in paralyzed versus non-paralyzed rabbits. The myelomalacia histologic score and spinal cord Young's modulus evaluated in selected animals were in good qualitative agreement with USE assessment. It is feasible to use USE to assess changes in the spinal cord of the presented animal model. In the future, with more experimental data available, USE may provide new quantitative tools for improving SCI diagnosis and prognosis.
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Affiliation(s)
- Songyuan Tang
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, TX, USA
| | - Bradley Weiner
- Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, TX, USA
| | - Francesca Taraballi
- Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, TX, USA
- Department of Orthopedics and Sports Medicine, Center for Musculoskeletal Regeneration, Houston Methodist Hospital, Houston, TX, USA
| | - Candice Haase
- Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, TX, USA
- Department of Orthopedics and Sports Medicine, Center for Musculoskeletal Regeneration, Houston Methodist Hospital, Houston, TX, USA
| | - Eliana Stetco
- Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, TX, USA
- Department of Orthopedics and Sports Medicine, Center for Musculoskeletal Regeneration, Houston Methodist Hospital, Houston, TX, USA
| | | | - Peer Shajudeen
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, TX, USA
| | - Matthew Hogan
- Department of Neurosurgery, Center for Neuroregeneration, Houston Methodist Research Institute, Houston, TX, USA
| | - Enrica De Rosa
- Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, TX, USA
- Department of Orthopedics and Sports Medicine, Center for Musculoskeletal Regeneration, Houston Methodist Hospital, Houston, TX, USA
| | - Philip J Horner
- Department of Neurosurgery, Center for Neuroregeneration, Houston Methodist Research Institute, Houston, TX, USA
| | | | - Zhaoyue Shi
- Translational Imaging Center, Houston Methodist Research Institute, Houston, TX, USA
| | - Christof Karmonik
- Translational Imaging Center, Houston Methodist Research Institute, Houston, TX, USA
| | - Ennio Tasciotti
- Department of Human Sciences and Promotion of Quality of Life, San Raffaele Roma Open University and IRCCS San Raffaele Pisana, 00166, Rome, Italy
| | - Raffaella Righetti
- Department of Electrical and Computer Engineering, Texas A&M University, College Station, TX, USA.
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Miller T, Bello UM, Tsang CSL, Winser SJ, Ying MTC, Pang MYC. Using ultrasound elastography to assess non-invasive, non-pharmacological interventions for musculoskeletal stiffness: a systematic review and meta-analysis. Disabil Rehabil 2023:1-15. [PMID: 37668241 DOI: 10.1080/09638288.2023.2252744] [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: 02/23/2022] [Revised: 08/13/2023] [Accepted: 08/22/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE To evaluate the current evidence regarding the use of ultrasound elastography for assessing non-invasive, non-pharmacological interventions for eliciting changes in musculoskeletal stiffness. METHODS A systematic search of MEDLINE, CINAHL, EMBASE, and Web of Science databases was performed in accordance with Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Information on measurement and intervention procedures was extracted. Bias was assessed using Cochrane Risk of Bias or Risk of Bias In Non-randomised Studies of Interventions (ROBINS-I) tools for studies with true or quasi-experimental designs, respectively. Analyses were conducted for adequately powered subgroups based on intervention type, measurement site, and population assessed. RESULTS Twenty-one studies were included in the review. Overall risk of bias was low for true experimental studies and moderate for quasi-experimental studies. Subgroup analyses indicated a large overall effect for interventions involving manual physiotherapy and taping/splinting for reducing masseter muscle stiffness in patients with masticatory muscle disorders (g = 1.488, 95% CI = 0.320-2.655, p = 0.013). Analyses for other intervention types and patient groups were underpowered. CONCLUSION Ultrasound elastography demonstrates clinical applicability for assessing non-invasive, non-pharmacological interventions for musculoskeletal stiffness. However, the comparative efficacy of these interventions for modulating tissue stiffness remains inconclusive.
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Affiliation(s)
- Tiev Miller
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Umar M Bello
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
- Department of Physiotherapy and Paramedicine, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Charlotte S L Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Stanley J Winser
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Michael T C Ying
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, China
| | - Marco Y C Pang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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Hu X, Sun C, Ren X, Ge S, Xie C, Li X, Zhu Y, Ding H. Contrast-enhanced Ultrasound Combined With Elastography for the Evaluation of Muscle-invasive Bladder Cancer in Rats. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:1999-2011. [PMID: 36896871 DOI: 10.1002/jum.16216] [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: 08/17/2022] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES By comparing with the control group, we evaluated the usefulness of contrast-enhanced ultrasound (CEUS) combined with elastography for the assessment of muscle invasion by bladder cancer (MIBC) in a Sprague-Dawley (SD) rat model. METHODS In the experimental group, 40 SD rats developed in situ bladder cancer (BLCA) in response to N-methyl-N-nitrosourea treatment, whereas 40 SD rats were included in the control group for comparison. We compared PI, Emean , microvessel density (MVD), and collagen fiber content (CFC) between the two groups. In the experimental group, Bland-Altman test was used to assess the relationships between various parameters. The largest Youden value was used as the cut-off point, and binomial logistic regression analysis was performed to analyze the PI and Emean . Receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic power of parameters, individually and in combination. RESULTS The PI, Emean , MVD, and CFC were significantly lower in the control group than in the experimental group (P < .05). The PI, Emean , MVD, and CFC were significantly higher for MIBC than for non-muscle-invasive bladder cancer (P < .05). There were significant correlations between PI and MVD, and between Emean and CFC. The diagnostic efficiency analysis showed PI had the highest sensitivity, CFC had the highest specificity, and PI + Emean had the highest diagnostic efficacy. CONCLUSION CEUS and elastography can distinguish lesions from normal tissue. PI, MVD, Emean , and CFC were useful for the detection of BLCA myometrial invasion. The comprehensive utilization of PI and Emean improved diagnostic accuracy and have clinical application.
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Affiliation(s)
- Xing Hu
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
| | - Chuanyu Sun
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xinping Ren
- Department of Ultrasound, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Shengyang Ge
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
| | - Chunmei Xie
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiangyu Li
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yingfeng Zhu
- Department of Pathology, Huashan Hospital, Fudan University, Shanghai, China
| | - Hong Ding
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
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Febo E, Del Signore F, Bernabò N, Paolini A, Simeoni F, De Bonis A, Rosto M, Canal S, Vignoli M. Ultrasonography and Sonoelastography Characteristics of Benign vs. Malignant Mesenteric Lymph Nodes in Cats: An Update. Animals (Basel) 2023; 13:2664. [PMID: 37627454 PMCID: PMC10451840 DOI: 10.3390/ani13162664] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/11/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
(1) Background: Strain elastography (SE) is an ultrasound-based technique able to non-invasively assess tissue elasticity, with malignant tissues being stiffer than normal tissues. The purpose of the study was to evaluate the diagnostic performance of SE to differentiate feline mesenteric benign and malignant lymph nodes (LNs) using a multivariate approach including both SE results and B-mode ultrasound and color Doppler findings. (2) Methods: Feline enlarged mesenteric LNs were evaluated using B-mode ultrasound, color Doppler ultrasonography, and SE. Short-to-long axis ratios, borders, echogenicity, hilum, vascular flow distribution, elastographic patterns, and strain ratios were recorded. Histological and/or cytological diagnosis was available for each LN. (3) Results: A total of 88 LNs were included, 46 (52.3%) benign and 42 (47.7%) malignant; in the benign group, 40 LNs had a diagnosis of reactive hyperplasia (group A) and 6 eosinophilic sclerosing lymphadenitis (group B), while in the malignant group 42 had a diagnosis of lymphoma (group C). The principal component analysis approach showed evidence that by combining B-mode- and color Doppler-based scores with SE scores, the three groups of LNs can be accurately distinguished. (4) Conclusions: Our results demonstrate that a multivariate sonographic approach combining B-mode ultrasound, color Doppler ultrasonography, and SE can accurately distinguish benign from malignant LNs, thus helping in the clinical advice of feline patients.
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Affiliation(s)
| | - Francesca Del Signore
- Department of Veterinary Medicine, University of Teramo, Località Piano D’ Accio, 64100 Teramo, Italy; (E.F.); (N.B.); (F.S.); (A.D.B.); (M.R.); (S.C.); (M.V.)
| | | | - Andrea Paolini
- Department of Veterinary Medicine, University of Teramo, Località Piano D’ Accio, 64100 Teramo, Italy; (E.F.); (N.B.); (F.S.); (A.D.B.); (M.R.); (S.C.); (M.V.)
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49
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Saharkhiz N, Kamimura HAS, Konofagou EE. The impact of amplitude modulation frequency in harmonic motion imaging on inclusion characterization. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:1768-1779. [PMID: 37202245 PMCID: PMC10392769 DOI: 10.1016/j.ultrasmedbio.2023.03.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 03/28/2023] [Accepted: 03/30/2023] [Indexed: 05/20/2023]
Abstract
OBJECTIVE Ultrasound elasticity imaging techniques aim to provide a non-invasive characterization of tissue mechanical properties to detect pathological changes and monitor disease progression. Harmonic motion imaging (HMI) is an ultrasound-based elasticity imaging technique that utilizes an oscillatory acoustic radiation force to induce localized displacements and estimate relative tissue stiffness. Previous studies have applied a low amplitude modulation (AM) frequency of 25 or 50 Hz in HMI to assess the mechanical properties of different tissue types. In this study, we investigate the dependence of AM frequency in HMI and whether the frequency can be adjusted based on the size and mechanical properties of the underlying medium for enhanced image contrast and inclusion detection. METHODS A tissue-mimicking phantom with embedded inclusions at different sizes and stiffnesses was imaged within a range of AM frequencies from 25 to 250 Hz at 25-Hz step size. DISCUSSION The AM frequency at which the maximum contrast and CNR are achieved depends on the size and stiffness of the inclusions. A general trend shows that contrast and CNR peak at higher frequencies for smaller inclusions. In addition, for some inclusions with the same size but different stiffnesses, the optimized AM frequency increases with the stiffness of the inclusion. Nevertheless, there is a shift between the frequencies at which the contrast peaks and those with maximum CNR. Finally, in agreement with the phantom findings, imaging an ex-vivo human specimen with a 2.7-cm breast tumor at a range of AM frequencies showed that the highest contrast and CNR are achieved at the AM frequency of 50 Hz. CONCLUSION These findings indicate that the AM frequency can be optimized in different applications of HMI, especially in the clinic, for improved detection and characterization of tumors with different geometries and mechanical properties.
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Affiliation(s)
- Niloufar Saharkhiz
- Department of Biomedical Engineering, Columbia University, New York, NY 10027, USA
| | - Hermes A S Kamimura
- Department of Biomedical Engineering, Columbia University, New York, NY 10027, USA
| | - Elisa E Konofagou
- Department of Biomedical Engineering, Columbia University, New York, NY 10027, USA; Department of Radiology, Columbia University, New York, NY 10027, USA.
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Rogowska JO, Durko Ł, Malecka-Wojciesko E. The Latest Advancements in Diagnostic Role of Endosonography of Pancreatic Lesions. J Clin Med 2023; 12:4630. [PMID: 37510744 PMCID: PMC10380545 DOI: 10.3390/jcm12144630] [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: 05/18/2023] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
Endosonography, a minimally invasive imaging technique, has revolutionized the diagnosis and management of pancreatic diseases. This comprehensive review highlights the latest advancements in endosonography of the pancreas, focusing on key technological developments, procedural techniques, clinical applications and additional techniques, which include real-time elastography endoscopic ultrasound, contrast-enhanced-EUS, EUS-guided fine-needle aspiration or EUS-guided fine-needle biopsy. EUS is well established for T-staging and N-staging of pancreaticobiliary malignancies, for pancreatic cyst discovery, for identifying subepithelial lesions (SEL), for differentiation of benign pancreaticobiliary disorders or for acquisition of tissue by EUS-guided fine-needle aspiration or EUS-guided fine-needle biopsy. This review briefly describes principles and application of EUS and its related techniques.
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Affiliation(s)
| | - Łukasz Durko
- Department of Digestive Tract Diseases, Medical University of Lodz, 90-647 Lodz, Poland
| | - Ewa Malecka-Wojciesko
- Department of Digestive Tract Diseases, Medical University of Lodz, 90-647 Lodz, Poland
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