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Jia W, Jing H, Xia G, Angang D, Wei Z, Pengfei Z, Shujun R, Mengying M, Zhengwei H, Shensheng G. Utility of Ultrasonography for Diagnosing and Differentiating Periapical Granuloma from Radicular Cyst. Acad Radiol 2023; 30:2329-2339. [PMID: 37394410 DOI: 10.1016/j.acra.2023.05.039] [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: 02/17/2023] [Revised: 05/31/2023] [Accepted: 05/31/2023] [Indexed: 07/04/2023]
Abstract
RATIONALE AND OBJECTIVES This study aimed to investigate the reliability and accuracy of high-resolution ultrasonography (US) for diagnosing periapical lesions and differentiating radicular cysts from granulomas. MATERIALS AND METHODS This study included 109 teeth with periapical lesions of endodontic origin from 109 patients scheduled for apical microsurgery. Ultrasonic outcomes were analyzed and categorized after thorough clinical and radiographic examinations using US. B-mode US images reflected the echotexture, echogenicity, and lesion margin, while color Doppler US assessed the presence and features of blood flow of interested areas. Pathological tissue samples were obtained during apical microsurgery and subjected to histopathological examination. Fleiss' κ was used to measure interobserver reliability. Statistical analyses were performed to assess the diagnostic validity and the overall agreement between US and histological findings. The reliability of US compared to histopathological examinations was assessed based on Cohen's κ. RESULTS The percent accuracy of US for diagnosing cysts, granulomas, and cysts with infection based on histopathological findings was 89.9%, 89.0%, and 97.2%, respectively. The sensitivity of US diagnoses was 95.1% for cysts, 84.1% for granulomas, and 80.0% for cysts with infection. The specificity of US diagnoses was 86.8% for cysts, 95.7% for granulomas, and 98.1% for cysts with infection. The reliability for US compared to histopathological examinations was good (κ = 0.779). CONCLUSION The echotexture characteristics of lesions in US images correlated with their histopathological features. US can provide accurate information on the nature of periapical lesions based on the echotexture of their contents and the presence of vascularity. It can help improve clinical diagnosis and avoid overtreatment of patients with apical periodontitis.
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Affiliation(s)
- Wang Jia
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
| | - Huang Jing
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
| | - Gong Xia
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (X.G., A.D.).
| | - Ding Angang
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (X.G., A.D.).
| | - Zhou Wei
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
| | - Zhang Pengfei
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
| | - Ran Shujun
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
| | - Mao Mengying
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
| | - Huang Zhengwei
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
| | - Gu Shensheng
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639, Zhizaoju Road, Shanghai 200011, China (J.W., J.H., W.Z., P.Z., S.R., M.M., Z.H., S.G.).
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Ageeli W, Soha N, Zhang X, Szewcyk-Bieda M, Wilson J, Li C, Nabi G. Preoperative imaging accuracy in size determination of prostate cancer in men undergoing radical prostatectomy for clinically localised disease. Insights Imaging 2023; 14:105. [PMID: 37286770 DOI: 10.1186/s13244-023-01450-5] [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: 11/06/2022] [Accepted: 03/06/2023] [Indexed: 06/09/2023] Open
Abstract
OBJECTIVES To compare the accuracy of pre-surgical prostate size measurements using mpMRI and USWE with imaging-based 3D-printed patient-specific whole-mount moulds facilitated histopathology, and to assess whether size assessment varies between clinically significant and non-significant cancerous lesions including their locations in different zones of the prostate. METHODS The study population included 202 men with clinically localised prostate cancer opting for radical surgery derived from two prospective studies. Protocol-based imaging data was used for measurement of size of prostate cancer in clinically localised disease using MRI (N = 106; USWE (N = 96). Forty-eight men overlapped between two studies and formed the validation cohort. The primary outcome of this study was to assess the accuracy of pre-surgical prostate cancerous size measurements using mpMRI and USWE with imaging-based 3D-printed patient-specific whole-mount moulds facilitated histopathology as a reference standard. Independent-samples T-tests were used for the continuous variables and a nonparametric Mann-Whitney U test for independent samples was applied to examine the distribution and median differences between mpMRI and USWE groups. RESULTS A significant number of men had underestimation of prostate cancer using both mpMRI (82.1%; 87/106) and USWE (64.6%; 62/96). On average, tumour size was underestimated by a median size of 7 mm in mpMRI, and 1 mm in USWE. There were 327 cancerous lesions (153 with mpMRI and 174 for USWE). mpMRI and USWE underestimated the majority of cancerous lesions (108/153; 70.6%) and (88/174; 50.6%), respectively. Validation cohort data confirmed these findings MRI had a nearly 20% higher underestimation rate than USWE (χ2 (1, N = 327) = 13.580, p = 0.001); especially in the mid and apical level of the gland. Clinically non-significant cancers were underestimated in significantly higher numbers in comparison to clinically significant cancers. CONCLUSIONS Size measurement of prostate cancers on preoperative imaging utilising maximum linear extent technique, underestimated the extent of cancer. Further research is needed to confirm our observations using different sequences, methods and approaches for cancer size measurement.
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Affiliation(s)
- Wael Ageeli
- Division of Imaging Sciences and Technology, School of Medicine, University of Dundee, Ninewells Hospital, Dundee, DD1 9SY, UK
- Diagnostic Radiology Department, College of Applied Medical Sciences, Jazan University, Al Maarefah Rd, P.O. Box 114, Jazan, 45142, Saudi Arabia
| | - Nabi Soha
- Division of Imaging Sciences and Technology, School of Medicine, University of Dundee, Ninewells Hospital, Dundee, DD1 9SY, UK
| | - Xinyu Zhang
- Division of Population Health and Genomics, School of Medicine, University of Dundee, Dundee, DD1 9SY, UK
| | | | - Jennifer Wilson
- Department of Pathology, Ninewells Hospital, Dundee, DD1 9SY, UK
| | - Chunhui Li
- School of Science and Engineering, University of Dundee, Dundee, DD1 4HN, UK
| | - Ghulam Nabi
- Division of Imaging Sciences and Technology, School of Medicine, University of Dundee, Ninewells Hospital, Dundee, DD1 9SY, UK.
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Sasikala S, Arun Kumar S, Ezhilarasi M. Improved breast cancer detection using fusion of bimodal sonographic features through binary firefly algorithm. THE IMAGING SCIENCE JOURNAL 2023. [DOI: 10.1080/13682199.2023.2164944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- S. Sasikala
- Department of Electronics & Communication Engineering, Kumaraguru College of Technology, Coimbatore, Tamil Nadu, India
| | - S. Arun Kumar
- Department of Electronics & Communication Engineering, Kumaraguru College of Technology, Coimbatore, Tamil Nadu, India
| | - M. Ezhilarasi
- Department of Electronics & Instrumentation Engineering, Kumaraguru College of Technology, Coimbatore, Tamil Nadu, India
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Shi XQ, Dong Y, Tan X, Yang P, Wang C, Feng W, Lin Y, Qian L. Accuracy of conventional ultrasound, contrast-enhanced ultrasound and dynamic contrast-enhanced magnetic resonance imaging in assessing the size of breast cancer. Clin Hemorheol Microcirc 2022; 82:157-168. [PMID: 35723092 DOI: 10.3233/ch-221456] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study was performed to investigate the accuracy of conventional ultrasound (US), contrast-enhanced US (CEUS), and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in assessing the size of breast cancer. METHODS In total, 49 breast cancer lesions of 48 patients were included in this study. The inclusion criteria were the performance of total mastectomy or breast-conserving surgery for treatment of breast cancer in our hospital from January 2017 to December 2020 with complete pathological results, as well as the performance of conventional US, CEUS, and DCE-MRI examinations with complete results. The exclusion criteria were non-mass breast cancer shown on conventional US or DCE-MRI, including that found on CEUS with no boundary with surrounding tissues and no confirmed tumor scope; a tumor too large to be completely displayed in the US section, thus affecting the measurement results; the presence of two nodules in the same breast that were too close to each other to be distinguished by any of the three imaging methods; and treatment with preoperative chemotherapy. Preoperative conventional US, CEUS, and DCE-MRI examinations were performed. The postoperative pathological results were taken as the gold standard. The lesion size was represented by its maximum diameter. The accuracy, overestimation, and underestimation rates of conventional US, CEUS, and DCE-MRI were compared. RESULTS The maximum lesion diameter on US, CEUS, DCE-MRI and pathology were 1.62±0.63 cm (range, 0.6-3.5 cm), 2.05±0.75 cm (range, 1.0-4.0 cm), 1.99±0.74 cm (range, 0.7-4.2 cm) and 1.92±0.83 cm (range, 0.5-4.0 cm), respectively. The lesion size on US was significantly smaller than that of postoperative pathological tissue (P < 0.05). However, there was no significant difference between the CEUS or DCE-MRI results and the pathological results. The underestimation rate of conventional US (55.1%, 27/49) was significantly higher than that of CEUS (20.4%, 10/49) and DCE-MRI (24.5%, 12/49) (P < 0.001 and P = 0.002, respectively). There was no significant difference in the accuracy of CEUS (36.7%, 18/49) and DCE-MRI (34.7%, 17/49) compared with conventional US (26.5%, 13/49); however, the accuracy of both groups tended to be higher than that of conventional US. The overestimation rate of CEUS (42.9%, 21/49) and DCE-MRI (40.8%, 20/49) was significantly higher than that of conventional US (18.4%, 9/49) (P = 0.001 and P = 0.015, respectively). CONCLUSIONS CEUS and DCE-MRI show similar performance when evaluating the size of breast cancer. However, CEUS is more convenient, has a shorter operation time, and has fewer restrictions on its use. Notably, conventional US is more prone to underestimate the size of lesions, whereas CEUS and DCE-MRI are more prone to overestimate the size.
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Affiliation(s)
- Xian-Quan Shi
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yunyun Dong
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiaoqu Tan
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Peipei Yang
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Chunmei Wang
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wei Feng
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yuxuan Lin
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Linxue Qian
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Nielsen MB, Søgaard SB, Bech Andersen S, Skjoldbye B, Hansen KL, Rafaelsen S, Nørgaard N, Carlsen JF. Highlights of the development in ultrasound during the last 70 years: A historical review. Acta Radiol 2021; 62:1499-1514. [PMID: 34791887 DOI: 10.1177/02841851211050859] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This review looks at highlights of the development in ultrasound, ranging from interventional ultrasound and Doppler to the newest techniques like contrast-enhanced ultrasound and elastography, and gives reference to some of the valuable articles in Acta Radiologica. Ultrasound equipment is now available in any size and for any purpose, ranging from handheld devices to high-end devices, and the scientific societies include ultrasound professionals of all disciplines publishing guidelines and recommendations. Interventional ultrasound is expanding the field of use of ultrasound-guided interventions into nearly all specialties of medicine, from ultrasound guidance in minimally invasive robotic procedures to simple ultrasound-guided punctures performed by general practitioners. Each medical specialty is urged to define minimum requirements for equipment, education, training, and maintenance of skills, also for medical students. The clinical application of contrast-enhanced ultrasound and elastography is a topic often seen in current research settings.
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Affiliation(s)
- Michael Bachmann Nielsen
- Department of Radiology, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stinne Byrholdt Søgaard
- Department of Radiology, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sofie Bech Andersen
- Department of Radiology, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bjørn Skjoldbye
- Department of Radiology, Aleris-Hamlet Hospitals, Copenhagen Denmark
| | - Kristoffer Lindskov Hansen
- Department of Radiology, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Søren Rafaelsen
- Department of Radiology, University Hospital of Southern Denmark, Vejle, Denmark
- Faculty of Health Sciences, Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Nis Nørgaard
- Department of Urology, Herlev Gentofte Hospital, Copenhagen, Denmark
| | - Jonathan F. Carlsen
- Department of Radiology, Rigshospitalet, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Nikolaev AV, de Jong L, Weijers G, Groenhuis V, Mann RM, Siepel FJ, Maris BM, Stramigioli S, Hansen HHG, de Korte CL. Quantitative Evaluation of an Automated Cone-Based Breast Ultrasound Scanner for MRI-3D US Image Fusion. IEEE TRANSACTIONS ON MEDICAL IMAGING 2021; 40:1229-1239. [PMID: 33428568 DOI: 10.1109/tmi.2021.3050525] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Breast cancer is one of the most diagnosed types of cancer worldwide. Volumetric ultrasound breast imaging, combined with MRI can improve lesion detection rate, reduce examination time, and improve lesion diagnosis. However, to our knowledge, there are no 3D US breast imaging systems available that facilitate 3D US - MRI image fusion. In this paper, a novel Automated Cone-based Breast Ultrasound System (ACBUS) is introduced. The system facilitates volumetric ultrasound acquisition of the breast in a prone position without deforming it by the US transducer. Quality of ACBUS images for reconstructions at different voxel sizes (0.25 and 0.50 mm isotropic) was compared to quality of the Automated Breast Volumetric Scanner (ABVS) (Siemens Ultrasound, Issaquah, WA, USA) in terms of signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and resolution using a custom made phantom. The ACBUS image data were registered to MRI image data utilizing surface matching and the registration accuracy was quantified using an internal marker. The technology was also evaluated in vivo. The phantom-based quantitative analysis demonstrated that ACBUS can deliver volumetric breast images with an image quality similar to the images delivered by a currently commercially available Siemens ABVS. We demonstrate on the phantom and in vivo that ACBUS enables adequate MRI-3D US fusion. To our conclusion, ACBUS might be a suitable candidate for a second-look breast US exam, patient follow-up, and US guided biopsy planning.
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Kelly C, Refaee A, Salcudean SE. Integrating photoacoustic tomography into a multimodal automated breast ultrasound scanner. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:JBO-200233RR. [PMID: 33215477 PMCID: PMC7675066 DOI: 10.1117/1.jbo.25.11.116010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 10/26/2020] [Indexed: 05/12/2023]
Abstract
SIGNIFICANCE Photoacoustic tomography (PAT) is a promising emergent modality for the screening and staging of breast cancer. To minimize barriers to clinical translation, it is common to develop PAT systems based upon existing ultrasound hardware, which can entail significant design challenges in terms of light delivery. This often results in inherently non-uniform fluence within the tissue and should be accounted for during image reconstruction. AIM We aim to integrate PAT into an automated breast ultrasound scanner with minimal change to the existing system. APPROACH We designed and implemented an illuminator that directs spatially non-uniform light to the tissue near the acquisition plane of the imaging array. We developed a graphics processing unit-accelerated reconstruction method, which accounts for this illumination geometry by modeling the structure of the light in the sample. We quantified the performance of this system using a custom, modular photoacoustic phantom and graphite rods embedded in chicken breast tissue. RESULTS Our illuminator provides a fluence of 2.5 mJ cm - 2 at the tissue surface, which was sufficient to attain a signal-to-noise ratio (SNR) of 8 dB at 2 cm in chicken breast tissue and image 0.25-mm features at depths of up to 3 cm in a medium with moderate optical scattering. Our reconstruction scheme is 200 × faster than a CPU implementation; it provides a 25% increase in SNR at 2 cm in chicken breast tissue and lowers image error by an average of 31% at imaging depths >1.5 cm compared with a method that does not account for the inhomogeneity of the illumination or the transducer directivity. CONCLUSIONS A fan-shaped illumination geometry is feasible for PAT; however, it is important to account for non-uniform fluence in illumination scenarios such as this. Future work will focus on increasing fluence and further optimizing the ultrasound hardware to improve SNR and overall image quality.
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Affiliation(s)
- Corey Kelly
- University of British Columbia, Department of Electrical and Computer Engineering, Vancouver, British Columbia, Canada
| | - Amir Refaee
- University of British Columbia, Department of Electrical and Computer Engineering, Vancouver, British Columbia, Canada
| | - Septimiu E. Salcudean
- University of British Columbia, Department of Electrical and Computer Engineering, Vancouver, British Columbia, Canada
- Address all correspondence to Septimiu E. Salcudean,
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