1
|
Masud AA, Liu J. Ultrasonic surface acoustic wave elastography: A review of basic theories, technical developments, and medical applications. Med Phys 2024. [PMID: 38597908 DOI: 10.1002/mp.17063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 02/19/2024] [Accepted: 03/18/2024] [Indexed: 04/11/2024] Open
Abstract
Physiological and pathological changes in tissues often cause changes in tissue mechanical properties, making tissue elastography an effective modality in medical imaging. Among the existing elastography methods, ultrasound elastography is of great interest due to the inherent advantages of ultrasound imaging technology, such as low cost, portability, safety, and wide availability. However, most current ultrasound elastography methods are based on the bulk shear wave; they can image deep tissues but cannot image superficial tissues. To address this challenge, ultrasonic elastography methods based on surface acoustic waves have been proposed. In this paper, we present a comprehensive review of ultrasound-based surface acoustic wave elastography techniques, including their theoretical foundations, technical implementations, and existing medical applications. The goal is to provide a concise summary of the state-of-the-art of this field, hoping to offer a reliable reference for the further development of these techniques and foster the expansion of their medical applications.
Collapse
Affiliation(s)
- Abdullah Al Masud
- Biomedical Acoustics Research Laboratory, Department of Mechanical Engineering, Texas Tech University, Lubbock, Texas, USA
| | - Jingfei Liu
- Biomedical Acoustics Research Laboratory, Department of Mechanical Engineering, Texas Tech University, Lubbock, Texas, USA
| |
Collapse
|
2
|
Li J, Wu Y, Tian Z, Shu L, Wu S, Wu Z. Application Value of Ultrasound Elastography Combined With Contrast-Enhanced Ultrasound (CEUS) Quantitative Analysis in Differentiation of Nodular Fibrocystic Changes of the Breast From Invasive Ductal Carcinoma. Ultrason Imaging 2024; 46:102-109. [PMID: 38098206 DOI: 10.1177/01617346231217087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
This study aimed to compare the value of ultrasound elastography combined with contrast-enhanced ultrasound (CEUS) quantitative analysis in the differentiation of nodular fibrocystic breast change (FBC) from breast invasive ductal carcinoma (BIDC). We selected 50 patients each with nodular FBC and BIDC, who were admitted to the Affiliated Hospital of Zunyi Medical University from January 2018 to December 2021. Their ultrasonic elastic images and CEUS videos were collected, their ultrasound elastography scores and the ratio of strain rate (SR) of the lesions were determined, and the exported DICOM format videos of CEUS were quantitatively analyzed using VueBox software to obtain quantitative perfusion parameters. The differences between the ultrasound elastography score and SR while comparing nodular FBC and BIDC cases were statistically significant (p < .05). The sensitivity, specificity, and accuracy of ultrasound elastography scores in the differential diagnoses of nodular FBC and BIDC were 74%, 88%, and 81%, respectively. Additionally, the sensitivity, specificity, and accuracy of SR in the differential diagnosis of nodular FBC and BIDC were 94%, 78%, and 86%, respectively. Statistically significant differences were observed in the CEUS quantitative perfusion parameters PE, AUC (WiAUC, WoAUC, WiWoAUC), and WiPI in both nodular FBC and BIDC according to the VueBox software (p < .05). The sensitivity, specificity, and accuracy of CEUS quantitative analysis in the differential diagnoses of nodular FBC and BIDC were 66%, 82%, and 74%, respectively. Using the pathological findings as the gold standard, ROC curves were established, and the area under the curve (AUC) of the CEUS quantitative analysis, elasticity score, SR, and ultrasound elastography combined with CEUS quantitative analysis were 0.731, 0.838, and 0.892, as well as 0.945, respectively. Ultrasound elasticity scoring, SR and CEUS quantitative analysis have certain application value for differentiating nodular FBC cases from BIDC; however, ultrasound elasticity imaging combined with CEUS quantitative analysis can help in improving the differential diagnostic efficacy of nodular FBC cases from BIDC.
Collapse
Affiliation(s)
- Jiajia Li
- Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Yunfeng Wu
- Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Zhaoyu Tian
- Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Linfeng Shu
- Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Siru Wu
- Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| | - Zuohui Wu
- Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
| |
Collapse
|
3
|
Wang C, Zhou Y, Ruan R. Application of Acoustic Radiation Force Pulse Imaging Technology in the Evaluation of the Efficacy of Calf Intermuscular Vein Thrombosis. Discov Med 2024; 36:591-597. [PMID: 38531799 DOI: 10.24976/discov.med.202436182.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
BACKGROUND The continuous advancement in ultrasound technology has given rise to Acoustic Radiation Force Impulse (ARFI) elastography, which boasts non-invasiveness, ease of operation, rapid inspection, and high accuracy. It has been successfully employed in detecting tissue hardness across various diseases. This study aims to investigate the application of acoustic radiation force pulse imaging technology in evaluating the efficacy of calf intermuscular vein thrombosis. METHODS This study is retrospective in nature, involving a total of 120 patients diagnosed with calf intermuscular venous thrombosis (MCVT) who were admitted to our hospital. These patients were selected retrospectively as the subjects for our research. They were subsequently divided into two groups: the control group and the observation group. The control group received standard nursing care and simple pressure therapy, while the observation group underwent anticoagulant drug treatment. The shear wave elastic hardness of both groups was measured, with the recording of ultrasonic elasticity scores and the average elastic modulus value (E-mean, in kPa). Furthermore, a comparison was made between the two groups regarding thrombus disappearance time, blood flow patency, and the clinical treatment effect. RESULTS At the 1, 3, and 6-month marks of the treatment period, the ultrasonic elasticity scores in the observation group were consistently higher compared to those in the control group. Additionally, the shear wave elastic hardness in the observation group was consistently lower than that in the control group, and these differences were found to be statistically significant (p < 0.05). The total effective rates for the control and observation groups were 83.33% and 95.00%, respectively. Notably, the clinical total effective rate in the observation group was significantly higher than that in the control group, and this difference was statistically significant (p < 0.05). The thrombus disappearance time in the observation group was significantly shorter than that in the control group, and the blood flow rate was significantly higher than in the control group, with both differences being statistically significant (p < 0.05). CONCLUSION ARFI plays a crucial role in assessing the efficacy of MCVT by effectively revealing the hardness and location of the patient's thrombus tissue. This technology aids doctors in gaining a more precise understanding of the deep vein thrombosis condition. Notably, ARFI is characterized by high safety levels and exhibits positive effects due to its painless and non-invasive nature.
Collapse
Affiliation(s)
- Chengfang Wang
- Department of Ultrasound, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 325000 Wenzhou, Zhejiang, China
| | - Yijia Zhou
- Department of Ultrasound, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 325000 Wenzhou, Zhejiang, China
| | - Ruhui Ruan
- Department of Ultrasound, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 325000 Wenzhou, Zhejiang, China
| |
Collapse
|
4
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
5
|
Slomka G, Schleip R, Frei P, Kurpiers N, Krämer M, Bauermeister K, Bauermeister W. The Influence of Mobility Training on the Myofascial Structures of the Back and Extremities. J Clin Med 2024; 13:329. [PMID: 38256463 PMCID: PMC10816048 DOI: 10.3390/jcm13020329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/13/2023] [Accepted: 01/02/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND The subject of the study was the effect of a multicomponent program (Mobility Routine) on muscular and fascial stiffness, flexibility, subjective well-being, and body perception. METHODS The assumption was that high physical stress affects myofascial structures and joint range of motion. The assessment of myofascial stiffness employed a Shear Wave Elastography. The joint flexibility, pressure pain threshold, and subjective experiences with regard to tension, pain, and general discomfort were documented. RESULTS In the CT group, a greater increase in stiffness was measured in fewer measurement areas compared to the MR group. MR demonstrated superior gains in flexibility compared to CT. Both groups experienced significant reductions in pain, tension, and discomfort. In conclusion, repetitive motion patterns akin to CT lead to increased myofascial stiffness, whereas MR yields more balanced stiffness development, compensates for asymmetries, and improves body awareness. CONCLUSIONS Hence, this study highlights the advantages of mobility training over Crosstrainer exercises and provides valuable insights for the recommendation of training regimens aiming at the enhancement of musculoskeletal functionality and overall well-being.
Collapse
Affiliation(s)
- Gunda Slomka
- Institute of Sport Science, University of Hildesheim, Universitätsplatz 1, 31141 Hildesheim, Germany; (G.S.); (P.F.); (N.K.)
| | - Robert Schleip
- Conservative and Rehabilitative Orthopedics, Department Sport and Health Sciences, Technical University of Munich, Campus D, Georg-Bauchle-Ring 60/62, 80992 München, Germany;
- Department of Medical Professions, Diploma Hochschule, 37242 Bad Sooden-Allen, Germany
| | - Peter Frei
- Institute of Sport Science, University of Hildesheim, Universitätsplatz 1, 31141 Hildesheim, Germany; (G.S.); (P.F.); (N.K.)
| | - Nicolas Kurpiers
- Institute of Sport Science, University of Hildesheim, Universitätsplatz 1, 31141 Hildesheim, Germany; (G.S.); (P.F.); (N.K.)
| | - Michael Krämer
- Institute for Materials Technology, Technical University Darmstadt, Grafenstrasse 2, 64283 Darmstadt, Germany;
| | - Katharina Bauermeister
- Conservative and Rehabilitative Orthopedics, Department Sport and Health Sciences, Technical University of Munich, Campus D, Georg-Bauchle-Ring 60/62, 80992 München, Germany;
| | - Wolfgang Bauermeister
- Department of Sports, Physical and Rehabilitative Medicine, Kharkiv National Medical University, 4 Nauky Avenue, 61022 Kharkiv, Ukraine;
| |
Collapse
|
6
|
Liu Y, Saharkhiz N, Hossain MM, Konofagou EE. Optimization of the Tracking Beam Sequence in Harmonic Motion Imaging. IEEE Trans Ultrason Ferroelectr Freq Control 2024; 71:102-116. [PMID: 37917522 PMCID: PMC10871064 DOI: 10.1109/tuffc.2023.3329729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Harmonic motion imaging (HMI) is an ultrasound elastography technique that estimates the viscoelastic properties of tissues by inducing localized oscillatory motion using focused ultrasound (FUS). The resulting displacement, assumed to be inversely proportional to the tissue local stiffness, is estimated using an imaging array based on RF speckle tracking. In conventional HMI, this is accomplished with plane-wave (PW) imaging, which inherently suffers from low lateral resolution. Coherent PW compounding (PWC) leverages spatial and temporal resolution using synthetic focusing in transmit. In this study, we introduced focused imaging with parallel tracking in HMI and compared parallel tracking of various transmit F-numbers (F/2.6, 3, 4, and 5) qualitatively and quantitatively with PW and PWC imaging at various compounded angle ranges (6°, 12°, and 18°). An in silico model of a 56-kPa spherical inclusion (diameter: 3.6 mm) embedded in a 5.3-kPa background and a 5.3-kPa elastic phantom with cylindrical inclusions (Young's moduli: 22-56 kPa, diameters: 2.0-8.6 mm) were imaged to assess different tracking beam sequences. Speckle biasing in displacement estimation associated with parallel tracking was also investigated and concluded to be negligible in HMI. Parallel tracking in receive (Rx) resulted in 2%-7% and 8%-12% increase compared to PW imaging ( ) in HMI contrast and contrast-to-noise ratio in silico and phantoms. Focused imaging with parallel tracking in Rx was concluded to be most robust among PW and PWC imaging for displacement estimation, and its preclinical feasibility was demonstrated in postsurgical human cancerous breast tissue specimens and in vivo murine models of breast cancer.
Collapse
|
7
|
Ashikuzzaman M, Peng B, Jiang J, Rivaz H. Alternating direction method of multipliers for displacement estimation in ultrasound strain elastography. Med Phys 2023. [PMID: 38159299 DOI: 10.1002/mp.16921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Ultrasound strain imaging, which delineates mechanical properties to detect tissue abnormalities, involves estimating the time delay between two radio-frequency (RF) frames collected before and after tissue deformation. The existing regularized optimization-based time-delay estimation (TDE) techniques suffer from at least one of the following drawbacks: (1) The regularizer is not aligned with the tissue deformation physics due to taking only the first-order displacement derivative into account; (2) The L2-norm of the displacement derivatives, which oversmooths the estimated time-delay, is utilized as the regularizer; (3) The modulus function defined mathematically should be approximated by a smooth function to facilitate the optimization of L1-norm. PURPOSE Our purpose is to develop a novel TDE technique that resolves the aforementioned shortcomings of the existing algorithms. METHODS Herein, we propose employing the alternating direction method of multipliers (ADMM) for optimizing a novel cost function consisting of L2-norm data fidelity term and L1-norm first- and second-order spatial continuity terms. ADMM empowers the proposed algorithm to use different techniques for optimizing different parts of the cost function and obtain high-contrast strain images with smooth backgrounds and sharp boundaries. We name our technique ADMM for totaL variaTion RegUlarIzation in ultrasound STrain imaging (ALTRUIST). ALTRUIST's efficacy is quantified using absolute error (AE), Structural SIMilarity (SSIM), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and strain ratio (SR) with respect to GLUE, OVERWIND, and L1-SOUL, three recently published energy-based techniques, and UMEN-Net, a state-of-the-art deep learning-based algorithm. Analysis of variance (ANOVA)-led multiple comparison tests and paired t-tests at 5% overall significance level were conducted to assess the statistical significance of our findings. The Bonferroni correction was taken into account in all statistical tests. Two simulated layer phantoms, three simulated resolution phantoms, one hard-inclusion simulated phantom, one multi-inclusion simulated phantom, one experimental breast phantom, and three in vivo liver cancer datasets have been used for validation experiments. We have published the ALTRUIST code at http://code.sonography.ai. RESULTS ALTRUIST substantially outperforms the four state-of-the-art benchmarks in all validation experiments, both qualitatively and quantitatively. ALTRUIST yields up to573 % ∗ ${573\%}^{*}$ ,41 % ∗ ${41\%}^{*}$ , and51 % ∗ ${51\%}^{*}$ SNR improvements and443 % ∗ ${443\%}^{*}$ ,53 % ∗ ${53\%}^{*}$ , and15 % ∗ ${15\%}^{*}$ CNR improvements over L1-SOUL, its closest competitor, for simulated, phantom, and in vivo liver cancer datasets, respectively, where the asterisk (*) indicates statistical significance. In addition, ANOVA-led multiple comparison tests and paired t-tests indicate that ALTRUIST generally achieves statistically significant improvements over GLUE, UMEN-Net, OVERWIND, and L1-SOUL in terms of AE, SSIM map, SNR, and CNR. CONCLUSIONS A novel ultrasonic displacement tracking algorithm named ALTRUIST has been developed. The principal novelty of ALTRUIST is incorporating ADMM for optimizing an L1-norm regularization-based cost function. ALTRUIST exhibits promising performance in simulation, phantom, and in vivo experiments.
Collapse
Affiliation(s)
- Md Ashikuzzaman
- Department of Electrical and Computer Engineering, Concordia University, Montreal, Québec, Canada
| | - Bo Peng
- School of Computer Science and Software Engineering, Southwest Petroleum University, Chengdu, China
| | - Jingfeng Jiang
- Department of Biomedical Engineering, Michigan Technological University, Houghton, Michigan, USA
| | - Hassan Rivaz
- Department of Electrical and Computer Engineering, Concordia University, Montreal, Québec, Canada
| |
Collapse
|
8
|
Marčun Varda N, Golob Jančič S, Močnik M. Obesity and Body Composition in Relation to Liver and Kidney Ultrasound Elastography in Paediatric Patients with Either Hypertension or Chronic Kidney Disease. Children (Basel) 2023; 11:18. [PMID: 38255333 PMCID: PMC10814102 DOI: 10.3390/children11010018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/15/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024]
Abstract
(1) Background: Ultrasound elastography is a novel ultrasound technique for evaluating tissue elasticity. One of the key factors influencing the measurement in children is excess weight. This study aimed to evaluate the effect of body composition, namely, fat mass, on liver and kidney ultrasound elastography in paediatric patients. (2) Methods: 114 participants, in whom bioimpedance, along with liver and kidney ultrasound elastography, were performed, were included (37 patients with chronic kidney disease, 46 patients with hypertension, and 31 healthy subjects). (3) Results: Bioimpedance analysis showed a significant correlation between liver elastography parameters and the phase angle (p = 0.002), fat-free mass (p = 0.001), body cell mass (p = 0.001), total body water (p = 0.001), extracellular water (p = 0.006), and, to lesser extent, fat mass (p = 0.041). On the contrary, kidney elastography parameters strongly correlated only with fat mass (p < 0.001 for both kidneys). (4) Conclusions: Liver and kidney stiffness increased in overweight participants and showed significant correlation with fat mass, particularly in the case of kidney elastography.
Collapse
Affiliation(s)
- Nataša Marčun Varda
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (S.G.J.); (M.M.)
- Medical Faculty, University of Maribor, Taborska 8, 2000 Maribor, Slovenia
| | - Sonja Golob Jančič
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (S.G.J.); (M.M.)
| | - Mirjam Močnik
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (S.G.J.); (M.M.)
| |
Collapse
|
9
|
Almutawakel S, Halleck F, Dürr M, Grittner U, Schrezenmeier E, Budde K, Althoff CE, Hamm B, Sack I, Fischer T, Marticorena Garcia SR. Shear Wave Elastography for Assessing Liver Stiffness in HCV-Infected Kidney Transplant Recipients after Direct-Acting Antiviral Treatment: A Comparative Study with Magnetic Resonance Elastography. J Clin Med 2023; 12:7547. [PMID: 38137615 PMCID: PMC10743898 DOI: 10.3390/jcm12247547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/22/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open
Abstract
Hepatitis C virus (HCV) infection can lead to hepatic fibrosis. The advent of direct-acting antivirals (DAAs) has substantially improved sustained virological response (SVR) rates. In this context, kidney transplant recipients (KTRs) are of particular interest due to their higher HCV infection rates and uncertain renal excretion and bioavailability of DAAs. We investigated liver stiffness after DAA treatment in 15 HCV-infected KTRs using ultrasound shear wave elastography (SWE) in comparison with magnetic resonance elastography (MRE). KTRs were treated with DAAs (daclatasvir and sofosbuvir) for three months and underwent SWE at baseline, end of therapy (EOT), and 3 (EOT+3) and 12 months (EOT+12) after EOT. Fourteen patients achieved SVR12. Shear wave speed (SWS)-as a surrogate parameter for tissue stiffness-was substantially lower at all three post-therapeutic timepoints compared with baseline (EOT: -0.42 m/s, p < 0.01; CI = -0.75--0.09, EOT+3: -0.43 m/s, p < 0.01; CI = -0.75--0.11, and EOT+12: -0.52 m/s, p < 0.001; CI = -0.84--0.19), suggesting liver regeneration after viral eradication and end of inflammation. Baseline SWS correlated positively with histopathological fibrosis scores (r = 0.48; CI = -0.11-0.85). Longitudinal results correlated moderately with APRI (r = 0.41; CI = 0.12-0.64) but not with FIB-4 scores (r = 0.12; CI = -0.19-0.41). Although higher on average, SWE-derived measurements correlated strongly with MRE (r = 0.64). In conclusion, SWE is suitable for non-invasive therapy monitoring in KTRs with HCV infection.
Collapse
Affiliation(s)
- Salma Almutawakel
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (S.A.)
| | - Fabian Halleck
- Department of Nephrology and Medical Intensive Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Michael Dürr
- Department of Nephrology and Medical Intensive Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Ulrike Grittner
- Institute of Biometry and Clinical Epidemiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Eva Schrezenmeier
- Department of Nephrology and Medical Intensive Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Klemens Budde
- Department of Nephrology and Medical Intensive Care, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany
| | - Christian E. Althoff
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (S.A.)
| | - Bernd Hamm
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (S.A.)
| | - Ingolf Sack
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (S.A.)
| | - Thomas Fischer
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (S.A.)
| | - Stephan R. Marticorena Garcia
- Department of Radiology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (S.A.)
| |
Collapse
|
10
|
Li X, Ruff C, Rafailidis V, Grozinger G, Cokkinos D, Kirksey L, Levitin A, Gadani S, Partovi S. Noninvasive and invasive imaging of lower-extremity acute and chronic venous thrombotic disease. Vasc Med 2023; 28:592-603. [PMID: 37792749 DOI: 10.1177/1358863x231198069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
The spectrum of venous thromboembolic (VTE) disease encompasses both acute deep venous thrombosis (DVT) and chronic postthrombotic changes (CPC). A large percentage of acute DVT patients experience recurrent VTE despite adequate anticoagulation, and may progress to CPC. Further, the role of iliocaval venous obstruction (ICVO) in lower-extremity VTE has been increasingly recognized in recent years. Imaging continues to play an important role in both acute and chronic venous disease. Venous duplex ultrasound remains the gold standard for diagnosing acute VTE. However, imaging of CPC is more complex and may involve computed tomography, magnetic resonance, contrast-enhanced ultrasound, or intravascular ultrasound. In this narrative review, we aim to discuss the full spectrum of venous disease imaging for both acute and chronic venous thrombotic disease.
Collapse
Affiliation(s)
- Xin Li
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Christer Ruff
- Department of Diagnostic and Interventional Radiology, University of Tubingen, Tubingen, Germany
- Department of Diagnostic and Interventional Neuroradiology, University of Tubingen, Tubingen, Germany
| | - Vasileios Rafailidis
- Department of Clinical Radiology, AHEPA University Hospital of Thessaloniki, Thessaloniki, Greece
| | - Gerd Grozinger
- Department of Diagnostic and Interventional Radiology, University of Tubingen, Tubingen, Germany
| | | | - Levester Kirksey
- Department of Vascular Surgery, The Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Abraham Levitin
- Division of Interventional Radiology, The Cleveland Clinic Imaging Institute, Cleveland, OH, USA
| | - Sameer Gadani
- Division of Interventional Radiology, The Cleveland Clinic Imaging Institute, Cleveland, OH, USA
| | - Sasan Partovi
- Division of Interventional Radiology, The Cleveland Clinic Imaging Institute, Cleveland, OH, USA
| |
Collapse
|
11
|
Abstract
As a sign of chronic kidney disease (CKD) progression, renal fibrosis is an irreversible and alarming pathological change. The accurate diagnosis of renal fibrosis depends on the widely used renal biopsy, but this diagnostic modality is invasive and can easily lead to sampling error. With the development of imaging techniques, an increasing number of noninvasive imaging techniques, such as multipara meter magnetic resonance imaging (MRI) and ultrasound elastography, have gained attention in assessing kidney fibrosis. Depending on their ability to detect changes in tissue stiffness and diffusion of water molecules, ultrasound elastography and some MRI techniques can indirectly assess the degree of fibrosis. The worsening of renal tissue oxygenation and perfusion measured by blood oxygenation level-dependent MRI and arterial spin labeling MRI separately is also an indirect reflection of renal fibrosis. Objective and quantitative indices of fibrosis may be available in the future by using novel techniques, such as photoacoustic imaging and fluorescence microscopy. However, these imaging techniques are susceptible to interference or may not be convenient. Due to the lack of sufficient specificity and sensitivity, these imaging techniques are neither widely accepted nor proposed by clinicians. These obstructions must be overcome by conducting technology research and more prospective studies. In this review, we emphasize the recent advancement of these noninvasive imaging techniques and provide clinicians a continuously updated perspective on the assessment of kidney fibrosis.
Collapse
Affiliation(s)
- Buchun Jiang
- Department of Nephrology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, China
| | - Fei Liu
- Department of Nephrology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, China
| | - Haidong Fu
- Department of Nephrology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, China,CONTACT Haidong Fu
| | - Jianhua Mao
- Department of Nephrology, The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, Hangzhou, China,Jianhua Mao The Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children’s Regional Medical Center, 3333 Bingsheng Rd, Hangzhou, Zhejiang310052, China
| |
Collapse
|
12
|
Dong J, Zhao X, Wang Y, Zhang M, Wang W, Liu Y. Evaluation on Diagnostic Value of Ultrasonic Elastography Parameters and Serum Testosterone in the Diagnosis of Prostate Cancer. ARCH ESP UROL 2023; 76:674-679. [PMID: 38053422 DOI: 10.56434/j.arch.esp.urol.20237609.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
OBJECTIVE To explore the clinical diagnostic value of ultrasound elastography (UE) combined with serum testosterone (T) detection in prostate cancer (PCa). METHOD A total of 155 patients with suspected PCa admitted to Affiliated Qingdao Third People's Hospital from January 2020 to January 2022 were included in this study. All the patients underwent UE detection and serum T examination and were divided into positive and negative groups based on histopathological examination results. The detection rates of UE detection, serum T detection and combined detection of the two were compared. T test, nonparametric test and binary logistic regression were used for statistical analysis. The diagnostic efficiencies of single and combined detection were analysed using the receiver operating characteristic (ROC) curve. RESULT After the pathological confirmation, 71 cases were classified under the positive group and 84 cases in the negative group. The positive group had significantly higher elastic strain ratio and elastic-image compression index level and a significantly lower serum T level than the negative group (p < 0.05). Elastic strain ratio, elastic image compression index and serum T level were all risk factors for PCa (p < 0.05). ROC analysis showed that the sensitivity of combined detection was significantly higher than that of single detection. CONCLUSIONS Offering a certain clinical application value, the application of combined UE and serum T detection in the clinical diagnosis of PCa can compensate for the shortcomings of single diagnosis, improve diagnostic sensitivity and accuracy and provide a new direction for the clinical diagnosis of PCa.
Collapse
Affiliation(s)
- Junxiu Dong
- Ultrasound Medicine Department, Affiliated Qingdao Third People's Hospital, Qingdao University, 266041 Qingdao, Shandong, China
| | - Xianhui Zhao
- Ultrasound Medicine Department, Affiliated Qingdao Third People's Hospital, Qingdao University, 266041 Qingdao, Shandong, China
| | - Yan Wang
- Emergency Center, Affiliated Qingdao Central Hospital of Qingdao University, Qingdao Cancer Hospital, 266000 Qingdao, Shandong, China
| | - Min Zhang
- Department of Health Management, Jinan Zhangqiu District People's Hospital, 250200 Jinan, Shandong, China
| | - Weiling Wang
- Department of Ultrasound, Jinan Zhangqiu District People's Hospital, 250200 Jinan, Shandong, China
| | - Yun Liu
- Ultrasound Medicine Department, Affiliated Qingdao Third People's Hospital, Qingdao University, 266041 Qingdao, Shandong, China
| |
Collapse
|
13
|
Pavlides M, Mózes FE, Akhtar S, Wonders K, Cobbold J, Tunnicliffe EM, Allison M, Godfrey EM, Aithal GP, Francis S, Romero-Gomez M, Castell J, Fernandez-Lizaranzu I, Aller R, González RS, Agustin S, Pericàs JM, Boursier J, Aube C, Ratziu V, Wagner M, Petta S, Antonucci M, Bugianesi E, Faletti R, Miele L, Geier A, Schattenberg JM, Tilman E, Ekstedt M, Lundberg P, Berzigotti A, Huber AT, Papatheodoridis G, Yki-Järvinen H, Porthan K, Schneider MJ, Hockings P, Shumbayawonda E, Banerjee R, Pepin K, Kalutkiewicz M, Ehman RL, Trylesinksi A, Coxson HO, Martic M, Yunis C, Tuthill T, Bossuyt PM, Anstee QM, Neubauer S, Harrison S. Liver Investigation: Testing Marker Utility in Steatohepatitis (LITMUS): Assessment & validation of imaging modality performance across the NAFLD spectrum in a prospectively recruited cohort study (the LITMUS imaging study): Study protocol. Contemp Clin Trials 2023; 134:107352. [PMID: 37802221 DOI: 10.1016/j.cct.2023.107352] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/29/2023] [Accepted: 10/01/2023] [Indexed: 10/08/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the liver manifestation of the metabolic syndrome with global prevalence reaching epidemic levels. Despite the high disease burden in the population only a small proportion of those with NAFLD will develop progressive liver disease, for which there is currently no approved pharmacotherapy. Identifying those who are at risk of progressive NAFLD currently requires a liver biopsy which is problematic. Firstly, liver biopsy is invasive and therefore not appropriate for use in a condition like NAFLD that affects a large proportion of the population. Secondly, biopsy is limited by sampling and observer dependent variability which can lead to misclassification of disease severity. Non-invasive biomarkers are therefore needed to replace liver biopsy in the assessment of NAFLD. Our study addresses this unmet need. The LITMUS Imaging Study is a prospectively recruited multi-centre cohort study evaluating magnetic resonance imaging and elastography, and ultrasound elastography against liver histology as the reference standard. Imaging biomarkers and biopsy are acquired within a 100-day window. The study employs standardised processes for imaging data collection and analysis as well as a real time central monitoring and quality control process for all the data submitted for analysis. It is anticipated that the high-quality data generated from this study will underpin changes in clinical practice for the benefit of people with NAFLD. Study Registration: clinicaltrials.gov: NCT05479721.
Collapse
Affiliation(s)
- Michael Pavlides
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK; Translational Gastroenterology Unit, University of Oxford, Oxford, UK; Oxford NIHR Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust and the University of Oxford, Oxford, UK.
| | - Ferenc E Mózes
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Salma Akhtar
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Kristy Wonders
- Translational & Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom; Newcastle NIHR Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Jeremy Cobbold
- Translational Gastroenterology Unit, University of Oxford, Oxford, UK; Oxford NIHR Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust and the University of Oxford, Oxford, UK
| | - Elizabeth M Tunnicliffe
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK; Oxford NIHR Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust and the University of Oxford, Oxford, UK
| | - Michael Allison
- Liver Unit, Department of Medicine, Cambridge NIHR Biomedical Research Centre, Cambridge University NHS Foundation Trust, UK
| | - Edmund M Godfrey
- Department of Radiology, Cambridge University NHS Foundation Trust, Cambridge, UK
| | - Guruprasad P Aithal
- NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | - Susan Francis
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, UK
| | - Manuel Romero-Gomez
- Digestive Diseases Unit, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Javier Castell
- Radiodiagnosis Clinical Management Unit, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | - Rocio Aller
- Department of Gastroenterology, Clinic University Hospital, Medical School, University of Valladolid, CIBERINFEC, Valladolid, Spain
| | - Rebeca Sigüenza González
- Department of Radiology, Clinic University Hospital, Medical School, University of Valladolid, Valladolid, Spain
| | - Salvador Agustin
- Liver Unit, Vall d'Hebron Institut de Recerca, Vall d'Hebron Barcelona Hospital, Centros de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
| | - Juan M Pericàs
- Liver Unit, Vall d'Hebron Institut de Recerca, Vall d'Hebron Barcelona Hospital, Centros de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
| | - Jerome Boursier
- Centre Hospitalier Universitaire d'Angers, Angers, France; & Laboratoire HIFIH UPRES EA3859, Université d'Angers, Angers, France
| | - Christophe Aube
- Department of Radiology, Centre Hospitalier Universitaire d'Angers, Angers, France; & Laboratoire HIFIH UPRES EA3859, Université d'Angers, Angers, France
| | - Vlad Ratziu
- Sorbonne Université, Institute of Cardiometabolism and Nutrition, Pitié-Salpêtrière Hospital, Paris, France
| | - Mathilde Wagner
- Radiology department, AP-HP.6, GH Pitié Salpêtrière - Charles Foix Sorbonne Université, Paris, France
| | - Salvatore Petta
- Section of Gastroenterology, PROMISE, University of Palermo, Italy
| | - Michela Antonucci
- Section of Radiology - Di.Bi.Me.F., University of Palermo, Palermo, Italy
| | - Elisabetta Bugianesi
- Division of Gastroenterology, Department of Medical Sciences, University of Torino, Torino, Italy
| | - Riccardo Faletti
- Department of Diagnostic and Interventional Radiology, University of Turin, Turin, Italy
| | - Luca Miele
- Department of Translational Medicine and Surgery, Medical School, Università Cattolica del S. Cuore and Fondazione Pol. Gemelli IRCCS Hospital, Rome, Italy
| | - Andreas Geier
- Department of Hepatology, University of Würzburg, Würzburg, Germany
| | - Jörn M Schattenberg
- Metabolic Liver Research Program, I. Department of Medicine, University Medical Centre, Mainz, Germany
| | - Emrich Tilman
- Department of Diagnostic and Interventional Radiology, University Medical Center of Johannes-Gutenberg-University, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Mattias Ekstedt
- Department of Health, Medicine and Caring Sciences, and Centre for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Peter Lundberg
- Department of Radiation Physics, and Centre for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Annalisa Berzigotti
- Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Adrian T Huber
- Department of Diagnostic, Interventional and Paediatric Radiology (DIPR), Bern University Hospital, University of Bern, Bern, Switzerland
| | - George Papatheodoridis
- Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, General Hospital of Athens "Laiko", Athens, Greece
| | - Hannele Yki-Järvinen
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kimmo Porthan
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | | | | | | | | | | | | | - Aldo Trylesinksi
- ADVANZPHARMA, Capital House, 1st Floor, 85 King William Street, London EC4N 7BL, United Kingdom
| | | | - Miljen Martic
- Novartis AG, Translational Medicine, Clinical and Precision Medicine Imaging, Basel, Switzerland
| | - Carla Yunis
- Clinical Development and Operations, Pfizer Inc., Lake Mary, FL, USA
| | - Theresa Tuthill
- Clinical Development and Operations, Pfizer Inc., Lake Mary, FL, USA
| | - Patrick M Bossuyt
- Department of Epidemiology & Data Science, Amsterdam Public Health, Amsterdam University Medical Centres, University of Amsterdam, the Netherlands
| | - Quentin M Anstee
- Translational & Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom; Newcastle NIHR Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK; Oxford NIHR Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust and the University of Oxford, Oxford, UK
| | - Stephen Harrison
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| |
Collapse
|
14
|
Velázquez Saornil J, Sánchez Milá Z, Campón Chekroun A, Barragán Casas JM, Frutos Llanes R, Rodríguez Sanz D. Effectiveness of Dry Needling and Ischaemic Trigger Point Compression of the Levator Scapulae in Patients with Chronic Neck Pain: A Short-Term Randomized Clinical Trial. J Clin Med 2023; 12:6136. [PMID: 37834780 PMCID: PMC10573879 DOI: 10.3390/jcm12196136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/07/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Chronic neck pain (CNP) may be associated with latent myofascial trigger points (MTrPs) in the levator scapulae (LS), which can be treated with ischemic compression (IC) and dry needling (DN). Variables and elastography changes are evaluated to compare the short-term efficacy of two treatments with DN. METHODS A randomized clinical trial is conducted with 80 participants in two groups: the DN group (n = 40) and IC group (n = 40). The duration is 12 weeks, and mechanical heterogeneity index, pressure pain threshold (PPT), and pain intensity are measured at baseline, immediately after, 48 h after, and one week after treatment. RESULTS Statistically significant changes were immediately observed between the two groups: PPT decreased in the DN group (p = 0.05), while it increased in the IC group. At 48 h and one week after treatment, these values increased in the DN group and remained higher than in the IC group. The heterogeneity index improved in both groups but more significantly in the DN group than in the IC group. CONCLUSIONS In subjects with CNP who had latent plus hyperalgesic MTrPs in the LS muscle, DN outperformed IC in PPT, pain intensity, and mechanical heterogeneity index at 48 h and one week after initiating therapy.
Collapse
Affiliation(s)
- Jorge Velázquez Saornil
- NEUMUSK Group Research, Department of Physiotherapy, Facultad de Ciencias de la Salud, Universidad Católica de Ávila, 05005 Ávila, Spain; (Z.S.M.); (J.M.B.C.); (R.F.L.)
| | - Zacarías Sánchez Milá
- NEUMUSK Group Research, Department of Physiotherapy, Facultad de Ciencias de la Salud, Universidad Católica de Ávila, 05005 Ávila, Spain; (Z.S.M.); (J.M.B.C.); (R.F.L.)
| | | | - José Manuel Barragán Casas
- NEUMUSK Group Research, Department of Physiotherapy, Facultad de Ciencias de la Salud, Universidad Católica de Ávila, 05005 Ávila, Spain; (Z.S.M.); (J.M.B.C.); (R.F.L.)
| | - Raúl Frutos Llanes
- NEUMUSK Group Research, Department of Physiotherapy, Facultad de Ciencias de la Salud, Universidad Católica de Ávila, 05005 Ávila, Spain; (Z.S.M.); (J.M.B.C.); (R.F.L.)
| | - David Rodríguez Sanz
- Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, 28005 Madrid, Spain;
| |
Collapse
|
15
|
Xu X, Chen Y, Cai W, Huang J, Yao X, Zhao Q, Li H, Liang W, Zhang H. A Multivariable Model Based on Ultrasound Imaging Features of Gastrocnemius Muscle to Identify Patients With Sarcopenia. J Ultrasound Med 2023; 42:2045-2055. [PMID: 36929858 DOI: 10.1002/jum.16223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/22/2023] [Accepted: 03/05/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES Low skeletal muscle mass, strength, or somatic function are used to diagnose sarcopenia; however, effective assessment methods are still lacking. Therefore, we evaluated the effectiveness of ultrasound in identifying patients with sarcopenia. METHODS This study included 167 patients, 78 with sarcopenia and 89 healthy participants, from two hospitals. We evaluated clinical factors and five ultrasound imaging features, of which three ultrasound imaging features were used to create the model. In both the training and validation datasets, the sarcopenia detection performances of chosen ultrasonic characteristics and the constructed model were evaluated using receiver operating characteristic (ROC) curves. The predictive performance was evaluated by area under the ROC (AUROC), calibration, and decision curves. RESULTS There were statistically significant differences in muscle thickness (MT) of gastrocnemius medialis muscle (GM), flaky myosteatosis echo (FE), pennation angle (PA), average shear wave velocity (SWV) in the relaxed state (RASWV), and average SWV in the passive stretched state (PASWV) between sarcopenic and normal subjects. PA, RASWV, and PASWV were effective predictors of sarcopenia. The AUROC (95% confidence interval) for these three parameters were 0.930 (0.882-0.978), 0.865 (0.791-0.940), and 0.849 (0.770-0.928), respectively, in the training set, and 0.873 (0.777-0.969), 0.936 (0.878-0.993), and 0.826 (0.716-0.935), respectively, in the validation set. The combined model had better detection power. Finally, the calibration curve showed that the combined model had good prediction accuracy. CONCLUSION Our model can be used to identify sarcopenia in primary medical institutions, which is valuable for the early recognition and management of sarcopenia patients.
Collapse
Affiliation(s)
- Xuanshou Xu
- Department of Ultrasound, Zhuhai People's Hospital, Zhuhai Hospital Affiliated to Jinan University, Zhuhai, China
- Department of Ultrasound Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuansen Chen
- Department of Ultrasound, The Third People's Hospital of Longgang District, Shenzhen, China
| | - Wenwen Cai
- Department of Ultrasound, Zhuhai People's Hospital, Zhuhai Hospital Affiliated to Jinan University, Zhuhai, China
| | - Jing Huang
- Department of Ultrasound, Zhuhai People's Hospital, Zhuhai Hospital Affiliated to Jinan University, Zhuhai, China
| | - Xiaohong Yao
- Department of Ultrasound, The Third People's Hospital of Longgang District, Shenzhen, China
| | - Qin Zhao
- Department of Ultrasound, Zhuhai People's Hospital, Zhuhai Hospital Affiliated to Jinan University, Zhuhai, China
| | - Hong Li
- Department of Ultrasound, Zhuhai People's Hospital, Zhuhai Hospital Affiliated to Jinan University, Zhuhai, China
| | - Weixiang Liang
- Department of Ultrasound Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Heng Zhang
- Department of Ultrasound, Zhuhai People's Hospital, Zhuhai Hospital Affiliated to Jinan University, Zhuhai, China
| |
Collapse
|
16
|
Deng M, Ye X, Ma J, Xia Y, Zhang Q, Jiang B, Wu J, Wen Q, Zheng Y, Yin Y, Tong R, Zhou G, Yao H, Li X, Herth FJF, Hou G, Wang C. Ultrasonic Elastography-guided Pleural Biopsy for the Diagnosis of Pleural Effusion: A Multicenter Prospective Study of Diagnostic Test Performance. Ann Am Thorac Soc 2023; 20:1242-1249. [PMID: 37098021 DOI: 10.1513/annalsats.202212-1047oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/25/2023] [Indexed: 04/26/2023] Open
Abstract
Rationale: The diagnostic yield of traditional ultrasound-guided pleural biopsy remains unsatisfactory, particularly when the pleural thickness is ⩽5 mm and/or no pleural nodules are detected. Pleural ultrasound elastography (UE) has a better diagnostic yield than traditional ultrasound for malignant pleural effusion (MPE). However, studies on UE-guided pleural biopsies are lacking. Objectives: To evaluate the feasibility and safety of UE-guided pleural biopsy. Methods: In this multicenter prospective single-arm trial, patients with pleural effusion whose pleural thickness was ⩽5 mm with no pleural nodules were enrolled between July 2019 and August 2021. The diagnostic yield of UE-guided pleural biopsy for pleural effusion and its sensitivity for detecting MPE were evaluated. Results: Ninety-eight patients (mean age, 62.4 ± 13.2 yr; 65 men) were prospectively enrolled. The diagnostic yield of UE-guided pleural biopsy for making any diagnosis was 92.9% (91/98), and its sensitivity for MPE was 88.7% (55/62). In addition, its sensitivity for pleural tuberculosis was 69.6% (16/23). The rate of postoperative chest pain was acceptable, and there was no pneumothorax. Conclusions: UE-guided pleural biopsy is a novel technique for diagnosing MPE with good diagnostic yield and sensitivity. Clinical trial registered with https://www.chictr.org.cn (ChiCTR2000033572).
Collapse
Affiliation(s)
- Mingming Deng
- National Center for Respiratory Medicine
- National Clinical Research Center for Respiratory Diseases
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, and
| | - Xianwei Ye
- Department of Pulmonary and Critical Care Medicine and
| | | | - Yang Xia
- Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, and
| | - Qin Zhang
- National Center for Respiratory Medicine
| | - Bin Jiang
- Department of Ultrasound, The First Hospital of China Medical University, Shenyang, China
| | - Jie Wu
- Department of Ultrasound, Guizhou Provincial People's Hospital, Guiyang, China
| | - Qing Wen
- Department of Ultrasound in Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, China
| | - Yujin Zheng
- Department of Ultrasound, China-Japan Friendship Hospital, Beijing, China
| | - Yan Yin
- Institute of Respiratory Disease and
| | - Run Tong
- National Center for Respiratory Medicine
| | - Guowu Zhou
- National Center for Respiratory Medicine
| | - Hongmei Yao
- Department of Pulmonary and Critical Care Medicine and
| | - Xuelian Li
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China; and
| | - Felix J F Herth
- Department of Pneumology and Critical Care Medicine, Thoraxklinik University of Heidelberg, Heidelberg, Germany
| | - Gang Hou
- National Center for Respiratory Medicine
| | - Chen Wang
- National Center for Respiratory Medicine
| |
Collapse
|
17
|
Taru MG, Lupsor-Platon M. Exploring Opportunities to Enhance the Screening and Surveillance of Hepatocellular Carcinoma in Non-Alcoholic Fatty Liver Disease (NAFLD) through Risk Stratification Algorithms Incorporating Ultrasound Elastography. Cancers (Basel) 2023; 15:4097. [PMID: 37627125 PMCID: PMC10452922 DOI: 10.3390/cancers15164097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD), with its progressive form, non-alcoholic steatohepatitis (NASH), has emerged as a significant public health concern, affecting over 30% of the global population. Hepatocellular carcinoma (HCC), a complication associated with both cirrhotic and non-cirrhotic NAFLD, has shown a significant increase in incidence. A substantial proportion of NAFLD-related HCC occurs in non-cirrhotic livers, highlighting the need for improved risk stratification and surveillance strategies. This comprehensive review explores the potential role of liver ultrasound elastography as a risk assessment tool for HCC development in NAFLD and highlights the importance of effective screening tools for early, cost-effective detection and improved management of NAFLD-related HCC. The integration of non-invasive tools and algorithms into risk stratification strategies could have the capacity to enhance NAFLD-related HCC screening and surveillance effectiveness. Alongside exploring the potential advancement of non-invasive tools and algorithms for effectively stratifying HCC risk in NAFLD, we offer essential perspectives that could enable readers to improve the personalized assessment of NAFLD-related HCC risk through a more methodical screening approach.
Collapse
Affiliation(s)
- Madalina-Gabriela Taru
- Hepatology Department, Regional Institute of Gastroenterology and Hepatology “Octavian Fodor”, 400162 Cluj-Napoca, Romania;
- “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Monica Lupsor-Platon
- “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Medical Imaging Department, Regional Institute of Gastroenterology and Hepatology “Octavian Fodor”, 400162 Cluj-Napoca, Romania
| |
Collapse
|
18
|
Lai DKH, Cheng ESW, Mao YJ, Zheng Y, Yao KY, Ni M, Zhang YQ, Wong DWC, Cheung JCW. Sonoelastography for Testicular Tumor Identification: A Systematic Review and Meta-Analysis of Diagnostic Test Accuracy. Cancers (Basel) 2023; 15:3770. [PMID: 37568585 PMCID: PMC10417060 DOI: 10.3390/cancers15153770] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
The objective of this review was to summarize the applications of sonoelastography in testicular tumor identification and inquire about their test performances. Two authors independently searched English journal articles and full conference papers from CINAHL, Embase, IEEE Xplore®, PubMed, Scopus, and Web of Science from inception and organized them into a PIRO (patient, index test, reference test, outcome) framework. Eleven studies (n = 11) were eligible for data synthesis, nine of which (n = 9) utilized strain elastography and two (n = 2) employed shear-wave elastography. Meta-analyses were performed on the distinction between neoplasm (tumor) and non-neoplasm (non-tumor) from four study arms and between malignancy and benignity from seven study arms. The pooled sensitivity of classifying malignancy and benignity was 86.0% (95%CI, 79.7% to 90.6%). There was substantial heterogeneity in the classification of neoplasm and non-neoplasm and in the specificity of classifying malignancy and benignity, which could not be addressed by the subgroup analysis of sonoelastography techniques. Heterogeneity might be associated with the high risk of bias and applicability concern, including a wide spectrum of testicular pathologies and verification bias in the reference tests. Key technical obstacles in the index test were manual compression in strain elastography, qualitative observation of non-standardized color codes, and locating the Regions of Interest (ROI), in addition to decisions in feature extractions. Future research may focus on multiparametric sonoelastography using deep learning models and ensemble learning. A decision model on the benefits-risks of surgical exploration (reference test) could also be developed to direct the test-and-treat strategy for testicular tumors.
Collapse
Affiliation(s)
- Derek Ka-Hei Lai
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ethan Shiu-Wang Cheng
- Department of Electronic and Information Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ye-Jiao Mao
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yi Zheng
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ke-Yu Yao
- Department of Materials, Imperial College, London SW7 2AZ, UK
| | - Ming Ni
- Department of Orthopaedics, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, China
- Laboratory of Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Ying-Qi Zhang
- Department of Orthopaedics, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200065, China
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong, China
| |
Collapse
|
19
|
Lin MT, Yang SM, Wu HW, Chen YH, Wu CH. Utility of Ultrasound Elastography to Evaluate Poststroke Spasticity and Therapeutic Efficacy: A Narrative Review. J Med Ultrasound 2023; 31:171-177. [PMID: 38025006 PMCID: PMC10668905 DOI: 10.4103/jmu.jmu_106_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 11/11/2022] [Indexed: 12/01/2023] Open
Abstract
Poststroke spasticity (PSS) is a common complication that affects function and daily self-care. Conservative PSS treatments include traditional rehabilitation, botulinum toxin injection, and extracorporeal shock wave therapy. Currently, the Modified Ashworth Scale and Modified Tardieu Scale are widely used tools to clinically evaluate spasticity, but the best tool for PSS assessment remained controversial. Ultrasound elastography (UE), including shear wave and strain image as the emerging method to evaluate soft tissue elasticity, became popular in clinical applications. Spastic biceps and gastrocnemius muscles were reported to be significantly stiffer compared to nonparetic muscles or healthy control using shear wave or strain elastography. More studies investigated the utility, reliability, and validity of UE in patients with PSS, but the contemporary consensus for the utility of UE in the measurement and therapeutic follow-up of PSS remained lacking. Therefore, this narrative review aimed to appraise the literature on the shear wave and strain elastography on PSS and summarize the roles of UE in assessing the therapeutic efficacy of different PSS interventions.
Collapse
Affiliation(s)
- Meng-Ting Lin
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shu-Mei Yang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Hao-Wei Wu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Yen-Hua Chen
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Chueh-Hung Wu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| |
Collapse
|
20
|
Zhang Q, Deng MM, Li XL, Lu Y, Hou G. Thoracic ultrasound-guided real-time pleural biopsy in the diagnosis of pleural diseases: a systematic review and meta-analysis. Expert Rev Respir Med 2023; 17:805-813. [PMID: 37787485 DOI: 10.1080/17476348.2023.2266377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/29/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND Real-time thoracic ultrasound-guided pleural biopsy (TUSPB) is an important diagnostic method for pleural diseases. Traditional two-dimensional thoracic ultrasound, as well as newly developed contrast-enhanced ultrasound (CEUS) and ultrasound elastography (UE), are all used as guidance tools for pleural biopsies. Herein, we aimed to determine the diagnostic yield of real-time TUSPB for pleural diseases to better inform the decision-making process. METHODS A literature search of the MEDLINE/PubMed, Embase, and Cochrane Library databases was performed up to June 2023. A binary random-effects model was applied to determine the pooled diagnostic yield. RESULTS Fifteen studies comprising 1553 patients with pleural diseases were included and analyzed. The overall diagnostic yield of TUSPB for pleural diseases was 85.58% (95% confidence interval [CI]: 81.57-89.58%). The sensitivity was 77.56% for pleural malignancy and 80.13% for tuberculous pleurisy. The sub-analysis result revealed that CEUS-guided pleural biopsy provided a pooled diagnostic yield of 98.24%, which was higher than that of conventional TUSPB (78.97%; p < 0.01). The overall proportion of adverse events for TUSPB was 6.68% (95% CI: 5.31-8.04%). CONCLUSION Conventional TUSPB has good pooled diagnostic yields and high safety. CEUS and UE are promising guidance tools for pleural biopsy with the potential to increase diagnostic yield.
Collapse
Affiliation(s)
- Qin Zhang
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, P.R. China
| | - Ming-Ming Deng
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, P.R. China
| | - Xue-Lian Li
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, P.R. China
| | - Ye Lu
- Department of Respiratory and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, P.R. China
| | - Gang Hou
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, P.R. China
| |
Collapse
|
21
|
Obrecht M, Zurbruegg S, Accart N, Lambert C, Doelemeyer A, Ledermann B, Beckmann N. Magnetic resonance imaging and ultrasound elastography in the context of preclinical pharmacological research: significance for the 3R principles. Front Pharmacol 2023; 14:1177421. [PMID: 37448960 PMCID: PMC10337591 DOI: 10.3389/fphar.2023.1177421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/16/2023] [Indexed: 07/18/2023] Open
Abstract
The 3Rs principles-reduction, refinement, replacement-are at the core of preclinical research within drug discovery, which still relies to a great extent on the availability of models of disease in animals. Minimizing their distress, reducing their number as well as searching for means to replace them in experimental studies are constant objectives in this area. Due to its non-invasive character in vivo imaging supports these efforts by enabling repeated longitudinal assessments in each animal which serves as its own control, thereby enabling to reduce considerably the animal utilization in the experiments. The repetitive monitoring of pathology progression and the effects of therapy becomes feasible by assessment of quantitative biomarkers. Moreover, imaging has translational prospects by facilitating the comparison of studies performed in small rodents and humans. Also, learnings from the clinic may be potentially back-translated to preclinical settings and therefore contribute to refining animal investigations. By concentrating on activities around the application of magnetic resonance imaging (MRI) and ultrasound elastography to small rodent models of disease, we aim to illustrate how in vivo imaging contributes primarily to reduction and refinement in the context of pharmacological research.
Collapse
Affiliation(s)
- Michael Obrecht
- Diseases of Aging and Regenerative Medicines, Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Stefan Zurbruegg
- Neurosciences Department, Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Nathalie Accart
- Diseases of Aging and Regenerative Medicines, Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Christian Lambert
- Diseases of Aging and Regenerative Medicines, Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Arno Doelemeyer
- Diseases of Aging and Regenerative Medicines, Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Birgit Ledermann
- 3Rs Leader, Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Nicolau Beckmann
- Diseases of Aging and Regenerative Medicines, Novartis Institutes for BioMedical Research, Basel, Switzerland
| |
Collapse
|
22
|
Santini P, Esposto G, Ainora ME, Lupascu A, Gasbarrini A, Zocco MA, Pola R. Ultrasound Elastography to Assess Age of Deep Vein Thrombosis: A Systematic Review. Diagnostics (Basel) 2023; 13:2075. [PMID: 37370970 DOI: 10.3390/diagnostics13122075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 06/02/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND AND AIMS Deep-vein thrombosis (DVT) is a widely diffused condition, and its accurate staging has major clinical and therapeutic implications. Ultrasound elastography (UE) is a rapidly evolving imaging technique that allows quantification of elastic tissue properties and could play a crucial role in determining thrombus age. The aim of this review is to find clinical evidence regarding the application of UE in the evaluation of DVT and its usefulness in differentiating thrombosis age. METHODS A literature search of clinical studies was performed to identify the ability of UE of discriminate acute, subacute, and chronic DVT. Heterogeneity and publication bias were calculated. In accordance with the study protocol, a qualitative analysis of the evidence was planned. The results were summarized with a comprehensive summary table of study characteristics and baseline characteristics of participant patients. RESULTS Nine studies matched the predetermined eligibility requirements for this systematic review regarding the risk of bias; the greatest criticalities were found within the domains of patient selection and index test. Based on the quality assessment, two publications were excluded from the qualitative synthesis because of the presence of significant applicability concerns. Among the seven studies that were considered eligible for qualitative synthesis, four evaluated strain elastography and three evaluated shear-wave elastography. Despite significant differences concerning study design, thrombus age definitions, and patient characteristics, nearly all studies demonstrated an increase in thrombus stiffness according to DVT age. CONCLUSIONS UE could play a key role in routine ultrasound examination of DVT. The measurement of thrombus stiffness has a high biological plausibility and its use is supported by the finding of a correlation between the stiffness and the progression of the DVT age.
Collapse
Affiliation(s)
- Paolo Santini
- Section of Internal Medicine and Thromboembolic Diseases, Department of Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy
| | - Giorgio Esposto
- Section of Internal Medicine and Thromboembolic Diseases, Department of Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy
| | - Maria Elena Ainora
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy
| | - Andrea Lupascu
- Section of Medical Angiology, Department of Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy
| | - Antonio Gasbarrini
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy
| | - Maria Assunta Zocco
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy
| | - Roberto Pola
- Section of Internal Medicine and Thromboembolic Diseases, Department of Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Rome, 00168 Rome, Italy
| |
Collapse
|
23
|
Bracco MI, Broda M, Lorenzen US, Florkow MC, Somphone O, Avril S, Biancolini ME, Rouet L. Fast strain mapping in abdominal aortic aneurysm wall reveals heterogeneous patterns. Front Physiol 2023; 14:1163204. [PMID: 37362444 PMCID: PMC10285457 DOI: 10.3389/fphys.2023.1163204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/17/2023] [Indexed: 06/28/2023] Open
Abstract
Abdominal aortic aneurysm patients are regularly monitored to assess aneurysm development and risk of rupture. A preventive surgical procedure is recommended when the maximum aortic antero-posterior diameter, periodically assessed on two-dimensional abdominal ultrasound scans, reaches 5.5 mm. Although the maximum diameter criterion has limited ability to predict aneurysm rupture, no clinically relevant tool that could complement the current guidelines has emerged so far. In vivo cyclic strains in the aneurysm wall are related to the wall response to blood pressure pulse, and therefore, they can be linked to wall mechanical properties, which in turn contribute to determining the risk of rupture. This work aimed to enable biomechanical estimations in the aneurysm wall by providing a fast and semi-automatic method to post-process dynamic clinical ultrasound sequences and by mapping the cross-sectional strains on the B-mode image. Specifically, the Sparse Demons algorithm was employed to track the wall motion throughout multiple cardiac cycles. Then, the cyclic strains were mapped by means of radial basis function interpolation and differentiation. We applied our method to two-dimensional sequences from eight patients. The automatic part of the analysis took under 1.5 min per cardiac cycle. The tracking method was validated against simulated ultrasound sequences, and a maximum root mean square error of 0.22 mm was found. The strain was calculated both with our method and with the established finite-element method, and a very good agreement was found, with mean differences of one order of magnitude smaller than the image spatial resolution. Most patients exhibited a strain pattern that suggests interaction with the spine. To conclude, our method is a promising tool for investigating abdominal aortic aneurysm wall biomechanics as it can provide a fast and accurate measurement of the cyclic wall strains from clinical ultrasound sequences.
Collapse
Affiliation(s)
- Marta Irene Bracco
- Mines Saint-Étienne, University Jean Monnet, INSERM, Sainbiose, Saint-Étienne, France
- Philips Research Paris, Suresnes, France
| | - Magdalena Broda
- Department of Vascular Surgery, Rigshospitalet, Copenhagen, Denmark
| | | | | | | | - Stephane Avril
- Mines Saint-Étienne, University Jean Monnet, INSERM, Sainbiose, Saint-Étienne, France
| | | | | |
Collapse
|
24
|
Akbulut UE, Isik IA, Atalay A, Özkan MB. The usefulness of transabdominal ultrasound elastography in Helicobacter pylori gastritis in children. J Ultrason 2023; 23:e61-e65. [PMID: 37520749 PMCID: PMC10379834 DOI: 10.15557/jou.2023.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/31/2023] [Indexed: 08/01/2023] Open
Abstract
Background Helicobacter pylori can colonize the submucosal layer as well as the mucosa in the stomach. Inflammation and erosions cause both mucosal and submucosal thickening in patients with Helicobacter pylori gastritis. Elastography is a method for measuring the elasticity and hardness of tissues by visualization of their response to the applied force. Hard tissues respond to applied compression differently compared to soft tissues. Hard tissues displace as a whole without deforming as opposed to soft tissues. In this study, we investigated the diagnostic performance of transabdominal ultrasound elastography in detecting Helicobacter pylori gastritis in children. Methods Nineteen children (group 1) with Helicobacter pylori gastritis, 33 children (group 2) with Helicobacter pylori (-) gastritis and 37 healthy children (group 3) were included the study. These groups were compared in terms of their strain index values. Ultrasonographic examinations were performed with a single transducer at 1.8-6.2 MHz frequency range. Results Both group 1 and 2 had significantly higher strain index values compared to the control group (2.7, 2.2 and 1.4 respectively). Additionally, the mean strain index value was significantly higher in group 1 compared to group 2. Conclusion Transabdominal ultrasound elastography has diagnostic value in differentiating Helicobacter pylori (+) gastritis from Helicobacter pylori (-) gastritis as well as in the diagnosis of gastritis in children.
Collapse
Affiliation(s)
- Ulas Emre Akbulut
- University of Health Sciences, Antalya Education and Research Hospital, Department of Pediatric Gastroenterogy, Hepatology and Nutrition, University of Health Sciences, Antalya Education and Research Hospital, Antalya, Turkey
| | - Ishak Abdurrahman Isik
- University of Health Sciences, Antalya Education and Research Hospital, Department of Pediatric Gastroenterogy, Hepatology and Nutrition, University of Health Sciences, Antalya Education and Research Hospital, Antalya, Turkey
| | - Atike Atalay
- University of Health Sciences, Antalya Education and Research Hospital, Department of Pediatric Gastroenterogy, Hepatology and Nutrition, University of Health Sciences, Antalya Education and Research Hospital, Antalya, Turkey
| | - Mehmet Burak Özkan
- Department of Pediatric Radiology, University of Health Sciences, Antalya Education and Research Hospital, Antalya, Turkey
| |
Collapse
|
25
|
Chen W, Lu W, Yuan Y, Li L, Deng H, Ye X. The role of ultrasound quantitative parameters in the assessment of acute radiodermatitis after breast-conserving surgery. J Radiat Res 2023:7153713. [PMID: 37154691 DOI: 10.1093/jrr/rrad029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/14/2022] [Indexed: 05/10/2023]
Abstract
This study aimed to assess the severity of acute radiodermatitis (ARD) by ultrasound quantitative parameters and to try to identify the influencing factors of skin toxicity. A total of 55 patients who underwent radiotherapy after unilateral breast-conserving surgery (BCS) were included in the study. The irradiated side of the breast was used as the research object and the quantitative ultrasound parameters (skin thickness, shear wave elasticity) were evaluated before radiotherapy, every week during radiotherapy. Two weeks after radiotherapy, the patients were divided into two groups, according to the World Health Organization scoring standard: mild (0-2 grade) and severe (3-4 grade). The differences in the parameters between the groups and the changes during radiotherapy were compared, and the relationship between these parameters and the severity of ARD was analyzed. In addition, some clinical factors that may affect ARD were also included in our study. Ninety-eight percent of patients developed different degrees of ARD, and Group 2 accounted for ~31%. At the end of 5 weeks of radiotherapy, the difference in thickness between the two groups was statistically significant (P < 0.05). There was no significant change in the elastic modulus of breast skin between the two groups (P > 0.05). Body mass index >25 kg/m2, breast thickness ≥18 mm, skin basic elastic modulus <23 kPa and skin thickness increment >0.3 mm were considered to be associated with severe skin reactions (P < 0.05). Ultrasound can be a useful tool for the non-invasive and objective assessment of skin changes during radiotherapy, documenting quantitative changes in the skin of breast cancer patients following BCS undergoing radiotherapy.
Collapse
Affiliation(s)
- Wenqin Chen
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Wenjuan Lu
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Ya Yuan
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Lu Li
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Hongyan Deng
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| | - Xinhua Ye
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu 210029, China
| |
Collapse
|
26
|
Ellis MD, Gurari N, Gerritsen NTA, Lee SM, Wang A, Dewald JPA. Shear wave ultrasound elastography of the biceps brachii can be used as a precise proxy for passive elbow torque in individuals with hemiparetic stroke. Physiol Rep 2023; 11:e15691. [PMID: 37208978 DOI: 10.14814/phy2.15691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 05/21/2023] Open
Abstract
Muscle tissue is prone to changes in composition and architecture following stroke. Changes in muscle tissue of the extremities are thought to increase resistance to muscle elongation or joint torque under passive conditions. These effects likely compound neuromuscular impairments, exacerbating movement function. Unfortunately, conventional rehabilitation is devoid of precise measures and relies on subjective assessments of passive joint torques. Shear wave ultrasound elastography, a tool to measure muscle mechanical properties, may be readily available for use in the rehabilitation setting as a precise measure, albeit at the muscle-tissue level. To support this postulation, we evaluated the criterion validity of shear wave ultrasound elastography of the biceps brachii; we investigated its relationship with a laboratory-based criterion measure for quantifying elbow joint torque in individuals with moderate to severe chronic stroke. Additionally, we evaluated construct validity, with the specific sub-type of hypothesis testing of known groups, by testing the difference between arms. Measurements were performed under passive conditions at seven positions spanning the arc of elbow joint flexion-extension in both arms of nine individuals with hemiparetic stroke. Surface electromyography was utilized for threshold-based confirmation of muscle quiescence. A moderate relationship between the shear wave velocity and elbow joint torque was identified, and both metrics were greater in the paretic arm. Data supports the progression toward a clinical application of shear wave ultrasound elastography in evaluating altered muscle mechanical properties in stroke, while acknowledging that undetectable muscle activation or hypertonicity may contribute to the measurement. Shear wave ultrasound elastography may augment the conventional method of manually testing joint mobility by providing a high-resolution precise value. Tissue-level measurement may also assist in identifying new therapeutic targets for patient-specific impairment-based interventions.
Collapse
Affiliation(s)
- Michael D Ellis
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois, USA
| | - Netta Gurari
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois, USA
- Department of Mechanical Engineering, Northwestern University, Evanston, Illinois, USA
| | - Ninette T A Gerritsen
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois, USA
- Mechanical, Maritime and Materials Engineering (3mE), Delft University of Technology, Delft, Netherlands
| | - Sabrina M Lee
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois, USA
| | - Amy Wang
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois, USA
| | - Julius P A Dewald
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, Illinois, USA
- Mechanical, Maritime and Materials Engineering (3mE), Delft University of Technology, Delft, Netherlands
- Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois, USA
- Department of Biomedical Engineering, Northwestern University, Chicago, Illinois, USA
| |
Collapse
|
27
|
Peng L, Yu L, Jia J, Gan Y, Ding A, Xiong P, Zhao Y, Yao Y. The effect of thickness and elastic modulus of the anterior talofibular ligament on anterior ankle joint stiffness: A subject-specific finite element study. Front Bioeng Biotechnol 2023; 11:1175347. [PMID: 37180042 PMCID: PMC10166853 DOI: 10.3389/fbioe.2023.1175347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/10/2023] [Indexed: 05/15/2023] Open
Abstract
Ankle sprain is a frequent type of sports injury leading to lateral ligament injury. The anterior talofibular ligament (ATFL) is a primary ligamentous stabilizer of the ankle joint and typically the most vulnerable ligament injured in a lateral ankle sprain (LAS). This study aimed to quantitively investigate the effect of the thickness and elastic modulus of ATFL on anterior ankle joint stiffness (AAJS) by developing nine subject-specific finite element (FE) models under acute injury, chronic injury, and control conditions of ATFL. A 120 N forward force was applied at the posterior calcaneus leading to an anterior translation of the calcaneus and talus to simulate the anterior drawer test (ADT). In the results, the ratio of the forward force to the talar displacement was used to assess the AAJS, which increased by 5.85% in the acute group and decreased by 19.78% in the chronic group, compared to those of the control group. An empirical equation described the relationship between AAJS, thickness, and elastic modulus (R-square 0.98). The equation proposed in this study provided an approach to quantify AAJS and revealed the effect of the thickness and the elastic modulus of ATFL on ankle stability, which may shed light on the potential diagnosis of lateral ligament injury.
Collapse
Affiliation(s)
- Linjing Peng
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
- Engineering Research Center of Digital Medicine of the Ministry of Education, Shanghai Jiao Tong University, Shanghai, China
| | - Lu Yu
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
- Engineering Research Center of Digital Medicine of the Ministry of Education, Shanghai Jiao Tong University, Shanghai, China
| | - Jingyi Jia
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
- Engineering Research Center of Digital Medicine of the Ministry of Education, Shanghai Jiao Tong University, Shanghai, China
| | - Yaokai Gan
- Engineering Research Center of Digital Medicine of the Ministry of Education, Shanghai Jiao Tong University, Shanghai, China
- Department of Orthopedics, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Angang Ding
- Department of Ultrasound, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ping Xiong
- Department of Ultrasound, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yichen Zhao
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yifei Yao
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
- Engineering Research Center of Digital Medicine of the Ministry of Education, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
28
|
Chang D, Wang Q. Diagnostic value of ultrasound elastography and conventional ultrasound for thyroid nodules: a meta-analysis. Quant Imaging Med Surg 2023; 13:1300-1311. [PMID: 36915345 PMCID: PMC10006152 DOI: 10.21037/qims-22-505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 12/11/2022] [Indexed: 02/25/2023]
Abstract
Background Thyroid nodular disease is a common disorder. Ultrasonography has emerged as a powerful tool for the diagnosis of thyroid disease owing to its high operational simplicity, non-invasiveness and reproducibility. This study aimed to systematically evaluate the value of ultrasound elastography and conventional ultrasound for the diagnosis of thyroid nodules. Methods The PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Wanfang and VIP databases were searched systematically. RevMan 5.3 software was used to draw a risk bias map, and Stata 16.0 was used to plot a sensitivity and specificity forest map. A summary receiver operating characteristics (SROC) curve was plotted, and the area under the curve (AUC) was calculated. Meta-regression was used to explore the sources of heterogeneity. Results The sensitivity of conventional ultrasonography for detecting thyroid nodules was 0.55 [95% confidence interval (CI): 0.45-0.65], the specificity was 0.90 (95% CI: 0.87-0.93), the positive likelihood ratio was 5.8 (95% CI: 3.8-8.9), the negative likelihood ratio was 0.49 (95% CI: 0.39-0.6), and the AUC was 0.86 (95% CI: 0.82-0.88). The sensitivity of ultrasonic elastography for detecting thyroid nodules was 0.67 (95% CI: 0.60-0.73), the specificity was 0.93 (95% CI: 0.90-0.95), the positive likelihood ratio was 9.1 (95% CI: 6.3-13.3), the negative likelihood ratio was 0.36 (95% CI: 0.29-0.44), and the AUC was 0.89 (95% CI: 0.86-0.91). The sensitivity of conventional ultrasound combined with ultrasonic elastography for detecting thyroid nodules was 0.88 (95% CI: 0.84-0.90), the specificity of the combined approach was 0.96 (95% CI: 0.93-0.98), the positive likelihood ratio was 23.3 (95% CI: 12.4-43.6), the negative likelihood ratio was 0.13 (95% CI: 0.10-0.17), and the AUC was 0.92 (95% CI: 0.90-0.94). Age, region, research type, conventional ultrasound evaluation criteria and elastography evaluation criteria had specific effects on sensitivity and specificity when detecting thyroid nodules. Conclusions Conventional ultrasound can be used as a routine examination technique for the differential diagnosis of benign and malignant thyroid nodules, while ultrasound elastography can improve the sensitivity and specificity of the diagnosis. The diagnostic value of conventional ultrasound combined with ultrasound elastography is higher than that of a single diagnostic method.
Collapse
Affiliation(s)
- Donghua Chang
- Department of General Surgery, Zhejiang Jinhua Guangfu Tumor Hospital, Jinhua, China
| | - Qin Wang
- Department of Ultrasonic Imaging, Zhejiang Jinhua Guangfu Tumor Hospital, Jinhua, China
| |
Collapse
|
29
|
Taru MG, Neamti L, Taru V, Procopciuc LM, Procopet B, Lupsor-Platon M. How to Identify Advanced Fibrosis in Adult Patients with Non-Alcoholic Fatty Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH) Using Ultrasound Elastography-A Review of the Literature and Proposed Multistep Approach. Diagnostics (Basel) 2023; 13:diagnostics13040788. [PMID: 36832276 PMCID: PMC9955630 DOI: 10.3390/diagnostics13040788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD), and its progressive form, non-alcoholic steatohepatitis (NASH), represent, nowadays, real challenges for the healthcare system. Liver fibrosis is the most important prognostic factor for NAFLD, and advanced fibrosis is associated with higher liver-related mortality rates. Therefore, the key issues in NAFLD are the differentiation of NASH from simple steatosis and identification of advanced hepatic fibrosis. We critically reviewed the ultrasound (US) elastography techniques for the quantitative characterization of fibrosis, steatosis, and inflammation in NAFLD and NASH, with a specific focus on how to differentiate advanced fibrosis in adult patients. Vibration-controlled transient elastography (VCTE) is still the most utilized and validated elastography method for liver fibrosis assessment. The recently developed point shear wave elastography (pSWE) and two-dimensional shear wave elastography (2D-SWE) techniques that use multiparametric approaches could bring essential improvements to diagnosis and risk stratification.
Collapse
Affiliation(s)
- Madalina-Gabriela Taru
- Hepatology Department, Regional Institute of Gastroenterology and Hepatology “Octavian Fodor”, 400162 Cluj-Napoca, Romania
- Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
| | - Lidia Neamti
- Hepatology Department, Regional Institute of Gastroenterology and Hepatology “Octavian Fodor”, 400162 Cluj-Napoca, Romania
- Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Vlad Taru
- Hepatology Department, Regional Institute of Gastroenterology and Hepatology “Octavian Fodor”, 400162 Cluj-Napoca, Romania
- Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Division of Gastroenterology and Hepatology, Department of Medicine III, Medical University of Vienna, 1090 Vienna, Austria
- Christian Doppler Lab for Portal Hypertension and Liver Fibrosis, Medical University of Vienna, 1090 Vienna, Austria
| | - Lucia Maria Procopciuc
- Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Bogdan Procopet
- Hepatology Department, Regional Institute of Gastroenterology and Hepatology “Octavian Fodor”, 400162 Cluj-Napoca, Romania
- Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Monica Lupsor-Platon
- Faculty of Medicine, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Medical Imaging Department, Regional Institute of Gastroenterology and Hepatology “Octavian Fodor”, 400162 Cluj-Napoca, Romania
- Correspondence:
| |
Collapse
|
30
|
Wang F, Wang H. Diagnostic value of ultrasound elastography in triple negative breast cancer: A meta-analysis. Medicine (Baltimore) 2023; 102:e32879. [PMID: 36820576 PMCID: PMC9907922 DOI: 10.1097/md.0000000000032879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND The purpose of this study was to determine the value of ultrasound elastic imaging (UE) in the differential diagnosis of the 3 negative breast cancer (TNBC) and non-TNBC. METHODS We searched the PubMed, Cochrane Library, and CBM databases from inception to July 20, 2022 and used STATA version 14.0 and Meta-Disc version 1.4 software. We computed summary statistics for sensitivity (Sen), specificity, positive and negative likelihood ratio (LR+/LR-), diagnostic odds ratio, and summary receiver operating characteristic curves. Cochran Q-statistic and I2 test were used to assess potential heterogeneity between studies. Sen analysis was carried out to evaluate the effect of a single study on overall estimation. We also conducted a meta regression analysis to investigate potential sources of heterogeneity. RESULTS Nine studies that fulfilled all the criteria for acceptance were incorporated into the meta-analysis. TNBC 317 and non-TNBC 1055 cases were evaluated. All breast tumors were histologically confirmed. The pooled Sen was 0.78 (95% confidence interval [CI] = 0.58-0.90); the pooled specificity was 0.86 (95%CI = 0.78-0.91). The pooled LR+ was 5.46 (95%CI = 3.07-9.73); the pooled negative LR- was 0.26 (95%CI = 0.12-0.55). The pooled diagnostic odds ratio of UE was 21.00 (95% CI = 6.14-71.78). The area under the summary receiver operating characteristic curve was 0.89 (SE = 0.0378). No evidence was found to reveal bias (t = 0.10, P = .92). CONCLUSION Our meta-analysis showed that UE could have high diagnostic accuracy in distinguishing TNBC and non-TNBC.
Collapse
Affiliation(s)
- Fei Wang
- Breast surgery Department of the First Affiliated Hospital of Dalian Medical University, Liaoning Province, China
| | - Hongjiang Wang
- Breast surgery Department of the First Affiliated Hospital of Dalian Medical University, Liaoning Province, China
- * Correspondence: Hongjiang Wang, Breast Surgery Department of the First Affiliated Hospital of Dalian Medical University, No. 222 Zhongshan Road, Xigang District, Dalian City, Liaoning Province 116001, China (e-mail: )
| |
Collapse
|
31
|
Furuichi Y. Comparison between splenic dispersion slope and splenic shear wave speed on ultrasound elastography for predicting esophageal varices. Hepatol Res 2023; 53:88-90. [PMID: 36735242 DOI: 10.1111/hepr.13862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Yoshihiro Furuichi
- Department of Clinical Laboratory and Endoscopy, Tokyo Women's Medical University Adachi Medical Center, Tokyo, Japan
| |
Collapse
|
32
|
Cerrito L, Mignini I, Ainora ME, Mosoni C, Gasbarrini A, Zocco MA. Hepatocellular Carcinoma in Patients with Nonalcoholic Fatty Liver Disease: The Prognostic Role of Liver Stiffness Measurement. Cancers (Basel) 2023; 15. [PMID: 36765595 DOI: 10.3390/cancers15030637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD), which is nowadays the most common etiology of chronic liver disease, is associated with an increased risk of hepatocellular carcinoma (HCC), with or without cirrhosis. Owing to the high prevalence of NAFLD worldwide, it becomes crucial to develop adequate strategies for surveillance of HCC and new prediction models aiming at stratifying NAFLD population for HCC risk. To this purpose, several noninvasive tests (NITs) have been proposed in the several last years, including clinical parameters, serum biomarkers, and imaging techniques. Most of these tools are focused on the assessment of liver fibrosis. Both ultrasound (US) elastography (especially transient elastography) and magnetic resonance (MR) elastography have been evaluated to estimate HCC risk in NAFLD patients. Recently, the American Association for the Study of Liver Diseases (AASLD) and the European Association for the Study of the Liver (EASL) include these techniques among the recommended NITs for the assessment of liver fibrosis. The aim of this review is to summarize the most recent data on the role of US and MR elastography in HCC risk stratification in patients with NAFLD.
Collapse
|
33
|
Li J, Wang SR, Li QL, Zhu T, Zhu PS, Chen M, Cui XW. Diagnostic value of multiple ultrasound diagnostic techniques for axillary lymph node metastases in breast cancer: A systematic analysis and network meta-analysis. Front Oncol 2023; 12:1043185. [PMID: 36686798 PMCID: PMC9853394 DOI: 10.3389/fonc.2022.1043185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/25/2022] [Indexed: 01/09/2023] Open
Abstract
Background Early diagnosis of axillary lymph node metastasis is very important for the recurrence and prognosis of breast cancer. Currently, Lymph node biopsy is one of the important methods to detect lymph node metastasis in breast cancer, however, its invasiveness might bring complications to patients. Therefore, this study investigated the diagnostic performance of multiple ultrasound diagnostic methods for axillary lymph node metastasis of breast cancer. Materials and methods In this study, we searched PubMed, Web of Science, CNKI and Wan Fang databases, conducted Bayesian network meta-analysis (NMA) on the studies that met the inclusion criteria, and evaluated the consistency of five different ultrasound imaging techniques in axillary lymph node metastasis of breast cancer. Funnel graph was used to evaluate whether it had publication bias. The diagnostic performance of each ultrasound imaging method was ranked using SUCRA. Results A total of 22 papers were included, US+CEUS showed the highest SUCRA values in terms of sensitivity (SEN) (0.874), specificity (SPE) (0.911), positive predictive value (PPV) (0.972), negative predictive value (NPV) (0.872) and accuracy (ACC) (0.990). Conclusion In axillary lymph node metastasis of breast cancer, the US+CEUS combined diagnostic method showed the highest SUCRA value among the five ultrasound diagnostic methods. This study provides a theoretical basis for preoperative noninvasive evaluation of axillary lymph node metastases in breast cancer patients and clinical treatment decisions. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022351977.
Collapse
Affiliation(s)
- Jun Li
- Department of Medical Ultrasound, the First Affiliated Hospital of Medical College, Shihezi University, Xinjiang, China,NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases (First Affiliated Hospital, School of Medicine, Shihezi University), Shihezi, Xinjiang, China,*Correspondence: Jun Li, ; Xin-Wu Cui,
| | - Si-Rui Wang
- Department of Medical Ultrasound, the First Affiliated Hospital of Medical College, Shihezi University, Xinjiang, China,NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases (First Affiliated Hospital, School of Medicine, Shihezi University), Shihezi, Xinjiang, China
| | - Qiao-Li Li
- Department of Medical Ultrasound, the First Affiliated Hospital of Medical College, Shihezi University, Xinjiang, China,NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases (First Affiliated Hospital, School of Medicine, Shihezi University), Shihezi, Xinjiang, China
| | - Tong Zhu
- School of Medicine, Shihezi University, Shihezi, China
| | - Pei-Shan Zhu
- Department of Medical Ultrasound, the First Affiliated Hospital of Medical College, Shihezi University, Xinjiang, China,NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases (First Affiliated Hospital, School of Medicine, Shihezi University), Shihezi, Xinjiang, China
| | - Ming Chen
- Department of Medical Ultrasound, the First Affiliated Hospital of Medical College, Shihezi University, Xinjiang, China
| | - Xin-Wu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,*Correspondence: Jun Li, ; Xin-Wu Cui,
| |
Collapse
|
34
|
Accurso G, Vetrugno L, Pierucci P. Editorial: New advances in bedside assessment and monitoring of acute respiratory failure patients. Front Med (Lausanne) 2023; 10:1154289. [PMID: 36936218 PMCID: PMC10018187 DOI: 10.3389/fmed.2023.1154289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 02/14/2023] [Indexed: 03/06/2023] Open
Affiliation(s)
- Giuseppe Accurso
- Department of Anaesthesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, Palermo, Italy
- *Correspondence: Giuseppe Accurso
| | - Luigi Vetrugno
- Department of Medical, Oral and Biotechnological Sciences University of Chieti-Pescara, Chieti, Italy
| | - Paola Pierucci
- Cardiothoracic Department, Respiratory and Critical Care Unit Bari Policlinico University Hospital, Bari, Italy
- Section of Respiratory Diseases, Department of Basic Medical Science Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy
| |
Collapse
|
35
|
Liu L, Li G, Jia C, Du L, Shi Q, Wu R. Preoperative strain ultrasound elastography can predict occult central cervical lymph node metastasis in papillary thyroid cancer: a single-center retrospective study. Front Oncol 2023; 13:1141855. [PMID: 37124540 PMCID: PMC10130523 DOI: 10.3389/fonc.2023.1141855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/29/2023] [Indexed: 05/02/2023] Open
Abstract
Objective To determine whether preoperative ultrasound elastography can predict occult central cervical lymph node metastasis (CCLNM) in patients with papillary thyroid cancer. Methods This retrospective study included 541 papillary thyroid cancer patients with clinically negative lymph nodes prior to surgery between July 2019 and December 2021. Based on whether CCLNM was present on postoperative pathology, patients were categorized as CCLNM (+) or CCLNM (-). Preoperative clinical data, conventional ultrasound features, and ultrasound elastography indices were compared between the groups. Univariate and multivariate logistic regression analysis were performed to identify the independent predictors of occult CCLNM. Results A total of 36.60% (198/541) patients had confirmed CCLNM, while 63.40% (343/541) did not. Tumor location, bilaterality, multifocality, echogenicity, margin, shape, vascularity, capsule contact, extrathyroidal extension, aspect ratio, and shear wave elasticity parameters were comparable between the groups (all P > 0.05). Univariate analysis showed statistically significant differences between the two groups in age, sex, tumor size, calcification, capsule invasion, and strain rates ratio in strain ultrasound elastography (all P < 0.05). In multivariate logistic regression analysis, the independent predictors of occult CCLNM were age (OR = 0.975, 95% CI = 0.959-0.991, P = 0.002), sex (OR = 1.886, 95% CI = 1.220-2.915, P = 0.004), tumor size (OR = 1.054, 95% CI = 1.014-1.097, P = 0.008), and strain rates ratio (OR = 1.178, 95% CI = 1.065-1.304, P = 0.002). Conclusion Preoperative strain ultrasound elastography can predict presence of occult CCLNM in papillary thyroid cancer patients and help clinicians select the appropriate treatment strategy.
Collapse
Affiliation(s)
- Long Liu
- Department of Ultrasound, Shanghai General Hospital of Nanjing Medical University, Shanghai, China
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Gang Li
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chao Jia
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lianfang Du
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiusheng Shi
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rong Wu
- Department of Ultrasound, Shanghai General Hospital of Nanjing Medical University, Shanghai, China
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Rong Wu,
| |
Collapse
|
36
|
Hasegawa Y, Niimi M, Hara T, Sakurai Y, Soshi S, Udaka J, Abo M. Shear Wave Velocity to Evaluate the Effect of Botulinum Toxin on Post-Stroke Spasticity of the Lower Limb. Toxins (Basel) 2022; 15. [PMID: 36668834 DOI: 10.3390/toxins15010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 12/11/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
(1) Background: The evaluation of muscles with spasticity using ultrasound elastography has attracted attention recently, and the shear wave velocity (SWV) technique can measure the mechanical properties of tissues objectively and quantitatively. The purpose of this study was to evaluate the effect of using SWV to assess the effect of Botulinum toxin type A (BoNT-A) treatment in adult patients with post-stroke lower limb spasticity. (2) Methods: We assessed the modified Ashworth Scale, the modified Tardieu Scale, and SWV at rest and after stretching before and at 1 month after BoNT-A treatment in 10 adult participants with post-stroke lower limb spasticity. (3) Results: Significant changes in SWV of the ankle joint in maximum dorsiflexion to the extent possible (SWV stretched) were observed after BoNT-A treatment. SWV stretched was positively correlated with joint range of motion. Participants whose joint range of motion did not improve (i.e., gastrocnemius medialis muscle (GCM) extension distance did not change) had significantly more reductions in SWV stretched after BoNT-A treatment. (4) Conclusions: Our results suggest that the SWV measurements may serve as a quantitative assessment to determine the effect of the BoNT-A treatment in adult stroke patients. SWV measurements to assess GCM spasticity should consider the effects of tension, material properties and activation level of muscles. The challenge is to measure SWV with matching limb positions in patients without contractures.
Collapse
|
37
|
Vatovec R, Kozinc Ž, Voglar M. The Effects of Isometric Fatigue on Trunk Muscle Stiffness: Implications for Shear-Wave Elastography Measurements. Sensors (Basel) 2022; 22:9476. [PMID: 36502176 PMCID: PMC9735660 DOI: 10.3390/s22239476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 11/24/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
Muscle stiffness has been implicated as a possible factor in low back pain risk. There are few studies on the effects of isometric fatigue on the shear modulus of trunk muscles. This study aimed to investigate the effects of trunk isometric fatigue on the passive and active (during low and high-level contractions) shear moduli of the erector spinae (ES) and superficial and deep multifidus (MF) muscles. We assessed passive and active shear modulus using shear-wave elastography in healthy young participants (n = 22; 11 males, 11 females), before and after an isometric trunk extension fatigue protocol. Maximal voluntary force decreased from 771.2 ± 249.8 N before fatigue to 707.3 ± 204.1 N after fatigue (-8.64%; p = 0.003). Passive shear modulus was significantly decreased after fatigue in the MF muscle (p = 0.006-0.022; Cohen's d = 0.40-46), but not the ES muscle (p = 0.867). Active shear modulus during low-level contraction was not affected by fatigue (p = 0.697-0.701), while it was decreased during high-level contraction for both muscles (p = 0.011; d = 0.29-0.34). Sex-specific analysis indicated the decrease in ES shear modulus was significant in males (p = 0.015; d = 0.31), but not in females (p = 0.140). Conversely, the shear modulus in superficial MF had a statistically significant decrease in females (p = 0.002; d = 0.74) but not in males (p = 0.368). These results have important implications for further investigations of the mechanistic interaction between physical workloads, sex, muscle stiffness (and other variables affecting trunk stability and neuromuscular control), and the development/persistence of low back pain.
Collapse
Affiliation(s)
- Rok Vatovec
- Department of Physiotherapy, Faculty of Health Sciences, University of Primorska Polje 42, SI-6310 Izola, Slovenia
| | - Žiga Kozinc
- Department of Kinesiology, Faculty of Health Sciences, University of Primorska Polje 42, SI-6310 Izola, Slovenia
- Andrej Marušič Institute, University of Primorska, Muzejski trg 2, SI-6000 Koper, Slovenia
| | - Matej Voglar
- Department of Physiotherapy, Faculty of Health Sciences, University of Primorska Polje 42, SI-6310 Izola, Slovenia
| |
Collapse
|
38
|
Nielsen J, Kjær MS, Rasmussen A, Chiranth D, Willemoe GL, Henriksen BM, Borgwardt L, Grand MK, Borgwardt L, Christensen VB. Noninvasive Prediction of Advanced Fibrosis in Pediatric Liver Disease-Discriminatory Performance of 2D Shear Wave Elastography, Transient Elastography and Magnetic Resonance Elastography in Comparison to Histopathology. Diagnostics (Basel) 2022; 12:diagnostics12112785. [PMID: 36428845 PMCID: PMC9689483 DOI: 10.3390/diagnostics12112785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Elastography can be measured with different imaging techniques and is increasingly used for noninvasive assessment of hepatic fibrosis. Little is known about the performance, and interrelation of different elastographic techniques, in prediction of hepatic fibrosis in pediatric liver disease. Objectives: We aimed to determine the discriminatory value for advanced fibrosis (Metavir F3-4) and evaluate the applicability of 2D shear wave ultrasound elastography (USe), Transient Elastography (TE) and Magnetic Resonance elastography (MRe) in pediatric liver disease. Methods: In patients with pediatric liver disease aged 0−19 years, USe, TE and MRe were compared with histopathological fibrosis stage. Multivariate logistic regression models for advanced fibrosis were considered. Discriminative performance was assessed by the area under the receiver operating characteristic curve and the Brier Score. Primary analyses included complete cases. Multiple imputation was used as sensitivity analysis. Results: In 93 histologically evaluated patients USe, TE and MRe were performed 89, 93 and 61 times respectively. With increased liver stiffness values, significantly increased odds for presenting F3-4 were seen in individual models for ALT < 470 U/L, whereas the effect for ALT > 470 U/L was non-significant. Area under the curve and Brier Score for discrimination of advanced fibrosis were 0.798 (0.661−0.935) and 0.115 (0.064−0.166); 0.862 (0.758−0.966) and 0.118 (0.065−0.171); 0.896 (0.798−0.994) and 0.098 (0.049−0.148) for USe, TE and MRe respectively. No significant increase in discriminatory ability was found when combining elastographic modalities. Conclusions: In pediatric liver disease, USe, TE and MRe had a good discriminatory ability for assessment of advanced liver fibrosis, although TE and MRe performed best. In most children with pediatric liver disease, TE is a reliable and easily applicable measure.
Collapse
Affiliation(s)
- Jon Nielsen
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
- Correspondence: ; Tel.: +45-23839149
| | - Mette Skalshøi Kjær
- Department of Medical Gastroenterology and Hepatology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Allan Rasmussen
- Department of Surgical Gastroenterology and Transplantation, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Deepthi Chiranth
- Department of Pathology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Gro Linno Willemoe
- Department of Pathology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Birthe Merete Henriksen
- Department of Diagnostic Radiology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Lotte Borgwardt
- Department of Diagnostic Radiology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Mia Klinten Grand
- Department of Biostatistics, Faculty of Health Sciences, Institute of Public Health, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Lise Borgwardt
- Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Vibeke Brix Christensen
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| |
Collapse
|
39
|
Gao Y, Zhao Y, Choi S, Chaurasia A, Ding H, Haroon A, Wan S, Adeleke S. Evaluating Different Quantitative Shear Wave Parameters of Ultrasound Elastography in the Diagnosis of Lymph Node Malignancies: A Systematic Review and Meta-Analysis. Cancers (Basel) 2022; 14. [PMID: 36428661 DOI: 10.3390/cancers14225568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/08/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022] Open
Abstract
Shear wave elastography (SWE) has shown promise in distinguishing lymph node malignancies. However, the diagnostic accuracies of various SWE parameters that quantify tissue stiffness are yet to be demonstrated. To evaluate the pooled diagnostic accuracy of different SWE parameters for differentiating lymph node malignancies, we conducted a systematic screening of four databases using the PRISMA guidelines. Lymph node biopsy was adopted as the reference standard. Emax (maximum stiffness), Emean (mean stiffness), Emin (minimum stiffness), and Esd (standard deviation) SWE parameters were subjected to separate meta-analyses. A sub-group analysis comparing the use of Emax in cervical (including thyroid) and axillary lymph node malignancies was also conducted. Sixteen studies were included in this meta-analysis. Emax and Esd demonstrated the highest pooled sensitivity (0.78 (95% CI: 0.69-0.87); 0.78 (95% CI: 0.68-0.87)), while Emean demonstrated the highest pooled specificity (0.93 (95% CI: 0.88-0.98)). From the sub-group analysis, the diagnostic performance did not differ significantly in cervical and axillary LN malignancies. In conclusion, SWE is a promising adjunct imaging technique to conventional ultrasonography in the diagnosis of lymph node malignancy. SWE parameters of Emax and Esd have been identified as better choices of parameters for screening clinical purposes.
Collapse
|
40
|
Hossain MM, Konofagou EE. Imaging of Single Transducer-Harmonic Motion Imaging-Derived Displacements at Several Oscillation Frequencies Simultaneously. IEEE Trans Med Imaging 2022; 41:3099-3115. [PMID: 35635828 PMCID: PMC9865352 DOI: 10.1109/tmi.2022.3178897] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Mapping of mechanical properties, dependent on the frequency of motion, is relevant in diagnosis, monitoring treatment response, or intra-operative surgical resection planning. While shear wave speeds at different frequencies have been described elsewhere, the effect of frequency on the "on-axis" acoustic radiation force (ARF)-induced displacement has not been previously investigated. Instead of generating single transducer-harmonic motion imaging (ST-HMI)-derived peak-to-peak displacement (P2PD) image at a particular frequency, a novel multi-frequency excitation pulse is proposed to generate P2PD images at 100-1000 Hz simultaneously. The performance of the proposed excitation pulse is compared with the ARFI by imaging 16 different inclusions (Young's moduli of 6, 9, 36, 70 kPa and diameters of 1.6, 2.5, 6.5, and 10.4 mm) embedded in an 18 kPa background. Depending on inclusion size and stiffness, the maximum CNR and contrast were achieved at different frequencies and were always higher than ARFI. The frequency, at which maximum CNR and contrast were achieved, increased with stiffness for fixed inclusion's size and decreased with size for fixed stiffness. In vivo feasibility is tested by imaging a 4T1 breast cancer mouse tumor on Day 6, 12, and 19 post-injection of tumor cells. Similar to phantoms, the CNR of ST-HMI images was higher than ARFI and increased with frequency for the tumor on Day 6. Besides, P2PD at 100-1000 Hz indicated that the tumor became stiffer with respect to the neighboring non-cancerous tissue over time. These results indicate the importance of using a multi-frequency excitation pulse to simultaneously generate displacement at multiple frequencies to better delineate inclusions or tumors.
Collapse
|
41
|
Dong B, Weng Z, Lyu G, Yang X, Wang H. The diagnostic performance of ultrasound elastography for biliary atresia: A meta-analysis. Front Public Health 2022; 10:973125. [PMID: 36388297 PMCID: PMC9643747 DOI: 10.3389/fpubh.2022.973125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 10/07/2022] [Indexed: 01/25/2023] Open
Abstract
Background Biliary atresia (BA) is a severe inflammatory obliterative cholangiopathy of infancy that requires early diagnosis and prompt surgical intervention. In this study, we aimed to obtain comprehensive evidence on the diagnostic performance of liver stiffness measurement by ultrasound elastography in the detection of BA through a meta-analysis. Methods The PubMed, EMBASE, Cochrane Library, and Web of Science databases were searched for studies that investigated the diagnostic performance of ultrasound elastography in the detection of BA up to January 10, 2022. In this study, in order to summarize the diagnostic performance of ultrasound elastography, the summary receiver operating characteristic (SROC) modeling was constructed. Heterogeneity was estimated with the I 2 statistic. Multiple subgroup analyses were also performed. Results Fourteen studies from eleven articles, including 774 BA patients, 850 non-BA patients, and 173 controls were included in the present meta-analysis. The summary sensitivity and specificity of ultrasound elastography for liver stiffness were 85% [95% confidence interval (CI): 79-89%] and 82% (95% CI: 73-88%) with the I 2 value of 82.90 and 84.33%, respectively. The area under the SROC curve (AUROC) using ultrasound elastography for diagnosing BA was 0.90 (95% CI: 0.87-0.92). In addition, a subgroup analysis of 9 two-dimensional shear wave elastography studies was also performed. Subgroup analysis revealed that the summary sensitivity and specificity were 85% (95% CI: 77-91%) and 79% (95% CI: 71-86%), respectively, and the summary AUROC was 0.89 (95% CI: 0.86-0.92). Conclusions Ultrasound elastography exhibits good diagnostic accuracy for BA and can be served as a non-invasive tool to facilitate the differential diagnosis of BA.
Collapse
Affiliation(s)
- Bingtian Dong
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Zongjie Weng
- Department of Medical Ultrasonics, Fujian Provincial Maternity and Children's Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Guorong Lyu
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China,Collaborative Innovation Center for Maternal and Infant Health Service Application Technology, Quanzhou Medical College, Quanzhou, China,*Correspondence: Guorong Lyu
| | - Xiaocen Yang
- Department of Ultrasound, Chenggong Hospital, Xiamen University, Xiamen, China
| | - Huaming Wang
- Department of Ultrasound, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| |
Collapse
|
42
|
Sprague AL, Couppé C, Pohlig RT, Cortes DC, Silbernagel KG. Relationships between tendon structure and clinical impairments in patients with patellar tendinopathy. J Orthop Res 2022; 40:2320-2329. [PMID: 34996130 PMCID: PMC9259765 DOI: 10.1002/jor.25262] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 12/17/2021] [Accepted: 01/05/2022] [Indexed: 02/04/2023]
Abstract
The clinical relevance of altered tendon structure in patellar tendinopathy is contested since structural change persists after symptom resolution. The purpose of this study was to explore the relationships between tendon structure and clinical impairments in patellar tendinopathy. In this retrospective, secondary analysis of individuals with patellar tendinopathy (n = 41), tendon structure (thickness, cross-sectional area [CSA], shear modulus, and viscosity), symptom severity, lower extremity function (counter-movement jump [CMJ] height), and quadriceps muscle performance (knee extension force and central activation ratio [CAR]) were recorded for the symptomatic limb. Relationships among structure, symptom severity, lower extremity function, and quadriceps muscle performance were examined using sequential regression models. Adjusting for age, sex, body mass index, and pain levels, there were significant positive relationships for thickness (p < 0.001, β = 0.718) and viscosity (p = 0.006, β = 0.496) with CMJ height. There were significant negative relationships between CSA with both CMJ height (p = 0.001, β = -0.538) and CAR (p = 0.04, β = -0.517). This is the first study to demonstrate relationships between tendon structure and lower extremity function or quadriceps muscle performance in patients with patellar tendinopathy. Clinical significance: Since structural changes persist after symptom resolution, addressing these changes may assist in restoring lower extremity function and quadriceps muscle performance.
Collapse
Affiliation(s)
- Andrew L. Sprague
- Department of Physical Therapy, University of Delaware,
Newark, DE, USA
- Department of Biomechanics and Movement Science, University
of Delaware, Newark, DE, USA
- Department of Physical Therapy, University of Pittsburgh,
Pittsburgh, PA, USA
| | - Christian Couppé
- Department of Orthopaedic Surgery M, Faculty of Health and
Medical Sciences, Institute of Sports Medicine Copenhagen, Bispebjerg Hospital and
Center for Healthy Aging, University of Copenhagen, Copenhagen, DK
- Department of Physical and Occupational Therapy, Bispebjerg
Hospital, Copenhagen, DK
- IOC Research Center Copenhagen Center for Injury Prevention
and Protection of Athlete Health, Bispebjerg Hospital, Copenhagen, DK
| | - Ryan T. Pohlig
- Biostatistic Core Facility, College of Health Sciences,
University of Delaware, Newark, DE, USA
| | - Daniel C. Cortes
- Department of Mechanical Engineering, Penn State
University, State College, PA, USA
| | - Karin Grävare Silbernagel
- Department of Physical Therapy, University of Delaware,
Newark, DE, USA
- Department of Biomechanics and Movement Science, University
of Delaware, Newark, DE, USA
- Department of Biomedical Engineering, University of
Delaware, Newark, DE, USA
| |
Collapse
|
43
|
Meyer T, Tzschätzsch H, Wellge B, Sack I, Kröncke T, Martl A. Valsalva Maneuver Decreases Liver and Spleen Stiffness Measured by Time-Harmonic Ultrasound Elastography. Front Bioeng Biotechnol 2022; 10:886363. [PMID: 35711644 PMCID: PMC9195299 DOI: 10.3389/fbioe.2022.886363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/04/2022] [Indexed: 11/26/2022] Open
Abstract
Ultrasound elastography quantitatively measures tissue stiffness and is widely used in clinical practice to diagnose various diseases including liver fibrosis and portal hypertension. The stiffness of soft organs has been shown to be sensitive to blood flow and pressure-related diseases such as portal hypertension. Because of the intricate coupling between tissue stiffness of abdominal organs and perfusion-related factors such as vascular stiffness or blood volume, simple breathing maneuvers have altered the results of liver elastography, while other organs such as the spleen are understudied. Therefore, we investigated the effect of a standardized Valsalva maneuver on liver stiffness and, for the first time, on spleen stiffness using time-harmonic elastography (THE). THE acquires full-field-of-view stiffness maps based on shear wave speed (SWS), covers deep tissues, and is potentially sensitive to SWS changes induced by altered abdominal pressure in the hepatosplenic system. SWS of the liver and the spleen was measured in 17 healthy volunteers under baseline conditions and during the Valsalva maneuver. With the Valsalva maneuver, SWS in the liver decreased by 2.2% (from a median of 1.36 m/s to 1.32 m/s; p = 0.021), while SWS in the spleen decreased by 5.2% (from a median of 1.63 m/s to 1.51 m/s; p = 0.00059). Furthermore, we observed that the decrease was more pronounced the higher the baseline SWS values were. In conclusion, the results confirm our hypothesis that the Valsalva maneuver decreases liver and spleen stiffness, showing that THE is sensitive to perfusion pressure-related changes in tissue stiffness. With its extensive organ coverage and high penetration depth, THE may facilitate translation of pressure-sensitive ultrasound elastography into clinical routine.
Collapse
Affiliation(s)
- Tom Meyer
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Heiko Tzschätzsch
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Brunhilde Wellge
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ingolf Sack
- Department of Radiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Kröncke
- Department of Diagnostic and Interventional Radiology and Neuroradiology, Universitätsklinikum Augsburg, Augsburg, Germany
| | - Alma Martl
- Department of Diagnostic and Interventional Radiology and Neuroradiology, Universitätsklinikum Augsburg, Augsburg, Germany
| |
Collapse
|
44
|
Hossain MM, Gallippi CM. Quantitative Estimation of Mechanical Anisotropy Using Acoustic Radiation Force (ARF)-Induced Peak Displacements (PD): In Silico and Experimental Demonstration. IEEE Trans Med Imaging 2022; 41:1468-1481. [PMID: 34995184 PMCID: PMC9208382 DOI: 10.1109/tmi.2022.3141084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Elastic degree of anisotropy (DoA) is a diagnostically relevant biomarker in muscle, kidney, breast, and other organs. Previously, elastic DoA was qualitatively assessed as the ratio of peak displacements (PD) achieved with the long-axis of a spatially asymmetric Acoustic Radiation Force Impulse (ARFI) excitation point spread function (PSF) aligned along versus across the axis of symmetry (AoS) in transversely isotropic materials. However, to better enable longitudinal and cross-sectional analyses, a quantitative measure of elastic DoA is desirable. In this study, qualitative ARFI PD ratios are converted to quantitative DoA, measured as the ratio of longitudinal over transverse shear elastic moduli, using a model empirically derived from Field II and finite element method (FEM) simulations. In silico, the median absolute percent error (MAPE) in ARFI-derived shear moduli ratio (SMR) was 1.75%, and predicted SMRs were robust to variations in transverse shear modulus, Young's moduli ratio, speed of sound, attenuation, density, and ARFI excitation PSF dimension. Further, ARFI-derived SMRs distinguished two materials when the true SMRs of the compared materials differed by as little as 10%. Experimentally, ARFI-derived SMRs linearly correlated with the corresponding ratios measured by Shear Wave Elasticity Imaging (SWEI) in excised pig skeletal muscle ( [Formula: see text], MAPE = 13%) and in pig kidney, in vivo ( [Formula: see text], MAPE = 5.3%). These results demonstrate the feasibility of using the ARFI PD to quantify elastic DoA in biological tissues.
Collapse
|
45
|
Zhou B, Yang X, Curran WJ, Liu T. Artificial Intelligence in Quantitative Ultrasound Imaging: A Survey. J Ultrasound Med 2022; 41:1329-1342. [PMID: 34467542 DOI: 10.1002/jum.15819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 08/01/2021] [Accepted: 08/16/2021] [Indexed: 06/13/2023]
Abstract
Quantitative ultrasound (QUS) imaging is a safe, reliable, inexpensive, and real-time technique to extract physically descriptive parameters for assessing pathologies. Compared with other major imaging modalities such as computed tomography and magnetic resonance imaging, QUS suffers from several major drawbacks: poor image quality and inter- and intra-observer variability. Therefore, there is a great need to develop automated methods to improve the image quality of QUS. In recent years, there has been increasing interest in artificial intelligence (AI) applications in medical imaging, and a large number of research studies in AI in QUS have been conducted. The purpose of this review is to describe and categorize recent research into AI applications in QUS. We first introduce the AI workflow and then discuss the various AI applications in QUS. Finally, challenges and future potential AI applications in QUS are discussed.
Collapse
Affiliation(s)
- Boran Zhou
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Xiaofeng Yang
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Walter J Curran
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Tian Liu
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA
| |
Collapse
|
46
|
deSouza NM, Oprea-Lager DE, Fournier LS. Editorial: Quantitative Imaging for Clinical Decisions. Front Oncol 2022; 12:858372. [PMID: 35311084 PMCID: PMC8929672 DOI: 10.3389/fonc.2022.858372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Nandita Maria deSouza
- Division of Radiotherapy and Imaging, The Institute of Cancer Research and Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Daniela Elena Oprea-Lager
- Department of Radiology & Nuclear Medicine, Cancer Centre Amsterdam, Amsterdam University Medical Centers, VU University, Amsterdam, Netherlands
| | - Laure S Fournier
- Université de Paris, PARCC, INSERM, Radiology Department, AP-HP, Hopital Europeen Georges Pompidou, Paris, France
| |
Collapse
|
47
|
Li L, Zhang A, Chen D, Taragin BH, Luo X. Preliminary study of sound touch elastography in diffuse thyroid disease in children. Front Pediatr 2022; 10:964413. [PMID: 36275048 PMCID: PMC9582431 DOI: 10.3389/fped.2022.964413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/13/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the use of sound touch elastography (STE) in conjunction with conventional ultrasound in the differential diagnosis of diffuse thyroid disease (DTD) and normal thyroid in children. METHODS Studies performed on 62 children with DTD and 30 normal volunteers were reviewed. Standard gray scale ultrasound, Doppler ultrasound and STE of the examinees, and the serum test results of children with DTD were collected, analyzed and compared. RESULTS The STE-Mean values in the Graves' disease (GD) group, Hashimoto's thyroiditis (HT) group, and normal control group, respectively, were 19.35 ± 5.00 kPa, 19.43 ± 6.06 kPa, and 11.24 ± 1.99 kPa. With an area under the ROC curve (AUC) of 0.945, STE-Mean values differentiated DTD from normal children. The peak systolic velocity (PSV) of the superior thyroid artery separated DTD from normal children and AUC from children with GD and HT, respectively, and was 0.992 and 0.864. The PSV of superior thyroid artery revealed a somewhat favorable connection with FT3 and FT4. CONCLUSION The STE results revealed that thyroid stiffness was higher in children with DTD than in normal children, but further differentiation into GD and HT subgroups lacked specificity, and the superior thyroid artery flow velocity might be a good supplement to distinguish both.
Collapse
Affiliation(s)
- Lin Li
- Department of Ultrasonography, Suining Central Hospital, Suining, China
| | - Aimei Zhang
- Department of Ultrasonography, Suining Central Hospital, Suining, China
| | - Dan Chen
- Department of Ultrasonography, Suining Central Hospital, Suining, China
| | - Benjamin H Taragin
- Department of Radiology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Xiaoyong Luo
- Department of Ultrasonography, Suining Central Hospital, Suining, China
| |
Collapse
|
48
|
Wang TJ, Stecco A. Fascial thickness and stiffness in hypermobile Ehlers-Danlos syndrome. Am J Med Genet C Semin Med Genet 2021; 187:446-452. [PMID: 34741592 DOI: 10.1002/ajmg.c.31948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/23/2021] [Accepted: 10/16/2021] [Indexed: 11/05/2022]
Abstract
There is a high prevalence of myofascial pain in people with hypermobile Ehlers-Danlos Syndrome (hEDS). The fascial origin of pain may correspond to changes in the extracellular matrix. The objective of this study was to investigate structural changes in fascia in hEDS. A series of 65 patients were examined prospectively-26 with hEDS, and 39 subjects with chronic neck, knee, or back pain without hEDS. The deep fascia of the sternocleidomastoid, iliotibial tract, and iliac fascia were examined with B-mode ultrasound and strain elastography, and the thicknesses were measured. Stiffness (strain index) was measured semi-quantitatively using elastography comparing fascia to muscle. Differences between groups were compared using one-way analysis of variance. hEDS subjects had a higher mean thickness in the deep fascia of the sternocleidomastoid compared with non-hEDS subjects. There was no significant difference in thickness of the iliac fascia and iliotibial tract between groups. Non-hEDS subjects with pain had a higher strain index (more softening of the fascia with relative stiffening of the muscle) compared with hEDS subjects and non-hEDS subjects without back or knee pain. In myofascial pain, softening of the fascia may occur from increase in extracellular matrix content and relative increase in stiffness of the muscle; this change is not as pronounced in hEDS.
Collapse
Affiliation(s)
- Tina J Wang
- Department of Physical Medicine & Rehabilitation, Loma Linda University School of Medicine, Upland, California, USA
| | - Antonio Stecco
- Department of Rehabilitation Medicine, New York University Grossman School of Medicine, New York, New York, USA
| |
Collapse
|
49
|
Rosen DP, Husmann DA, Mynderse LA, Kelly TF, Alizad A, Fatemi M. Detrusor overactivity assessment using ultrasound bladder vibrometry. Physiol Meas 2021; 42:10.1088/1361-6579/ac2c5c. [PMID: 34598174 PMCID: PMC8609921 DOI: 10.1088/1361-6579/ac2c5c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 10/01/2021] [Indexed: 11/12/2022]
Abstract
Objective. Detrusor overactivity (DO) is a urodynamic observation characterized by fluctuations in detrusor pressure (Pdet) of the bladder. Although detecting DO is important for the management of bladder symptoms, the invasive nature of urodynamic studies (UDS) makes it a source of discomfort and morbidity for patients. Ultrasound bladder vibrometry (UBV) could provide a direct and noninvasive means of detecting DO, due to its sensitivity to changes in elasticity and load in the bladder wall. In this study, we investigated the feasibility and applying UBV toward detecting DO.Approach. UBV and urodynamic study (UDS) measurements were collected in 76 neurogenic bladder patients (23 with DO). Timestamped group velocity squared (cg2) data series were collected from UBV measurements. ConcurrentPdetdata series were identically analyzed for comparison and validation. A processing approach is developed to separate transient fluctuations in the data series from the larger trend of the data and a DO index is proposed for characterizing the transient peaks observed in the data.Main Results.Applying the DO index as a classifier for DO produced sensitivities and specificities of 0.70 and 0.75 forcg2data series and 0.70 and 0.83 forPdetdata series respectively.Significance. It was found that DO can be feasibly detected from data series of timestamped UBV measurements. Collectively, these initial results are promising, and further refinement to the UBV measurement process is likely to improve and clarify its capabilities for noninvasive detection of DO.
Collapse
Affiliation(s)
- David P. Rosen
- Department of Physiology and Biomedical Engineering, Mayo
Clinic College of Medicine & Science, Rochester, MN, USA
| | - Douglas A. Husmann
- Department of Urology, Mayo Clinic College of Medicine
& Science, Rochester, MN, USA
| | - Lance A. Mynderse
- Department of Urology, Mayo Clinic College of Medicine
& Science, Rochester, MN, USA
| | - Troy F. Kelly
- Department of Physiology and Biomedical Engineering, Mayo
Clinic College of Medicine & Science, Rochester, MN, USA
| | - Azra Alizad
- Department of Physiology and Biomedical Engineering, Mayo
Clinic College of Medicine & Science, Rochester, MN, USA
- Department of Radiology, Mayo Clinic College of Medicine
& Science, Rochester, MN, USA
| | - Mostafa Fatemi
- Department of Physiology and Biomedical Engineering, Mayo
Clinic College of Medicine & Science, Rochester, MN, USA
| |
Collapse
|
50
|
Zhang Q, Agyekum EA, Zhu L, Yan L, Zhang L, Wang X, Yin L, Qian X. Clinical Value of Three Combined Ultrasonography Modalities in Predicting the Risk of Metastasis to Axillary Lymph Nodes in Breast Invasive Ductal Carcinoma. Front Oncol 2021; 11:715097. [PMID: 34631542 PMCID: PMC8493283 DOI: 10.3389/fonc.2021.715097] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/07/2021] [Indexed: 12/07/2022] Open
Abstract
Objective The present study aimed to assess the clinical value of conventional ultrasound (C-US), ultrasound elastography (UE), percutaneous contrast-enhanced ultrasound (P-CUES), and the combination of these three ultrasonography modalities for evaluating the risk of axillary lymph node (ALN) metastasis in breast invasive ductal carcinoma (IDC). Methods This retrospective analysis included 120 patients with pathologically confirmed IDC who underwent sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). Based on the gold standard of postoperative pathology, ALN pathology results were evaluated and compared with findings obtained using C-US, UE, P-CUES, and the three modalities combined. Results (1) There was a statistically significant difference between the histological grade of the tumor and the pathological condition of ALNs. (2) The difference between C-US parameters and UE score were statistically significant. The accuracy of P-CEUS localization of SLNs was 100% (96/96) when compared with localization guided by methylene blue. The difference in the distribution of the four SLN enhancement patterns was statistically significant. (3) The sensitivity, specificity, positive predictive value, and negative predictive value of C-US and UE were 75%, 71%, 58%, and 89%, and 71%, 72%, 50%, and 86%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of P-CUES were 91%, 82%, 78%, 92%, respectively. When all three modalities were combined, the sensitivity, specificity, positive predictive value, and negative predictive value were 94%, 89%, 86%, and 95%, respectively. In the detection of ALN metastasis, there was a good correlation between histopathological results and evaluations based on the three combined ultrasonography modalities (kappa: 0.82, p<0.001). Conclusions When compared to C-US, UE, or P-CEUS alone, the combination of the three ultrasonography modalities was found to be superior in distinguishing metastatic and non-metastatic ALNs. This combined strategy may aid physicians in determining the most appropriate approach to ALN surgery as well as the prognosis of breast IDC.
Collapse
Affiliation(s)
- Qing Zhang
- Department of Ultrasound, Jiangsu University Affiliated People's Hospital, Zhenjiang, China
| | | | - Linna Zhu
- Department of Ultrasound, Jiangsu University Affiliated People's Hospital, Zhenjiang, China
| | - Lingling Yan
- Department of Ultrasound, Jiangsu University Affiliated People's Hospital, Zhenjiang, China
| | - Lei Zhang
- Department of Ultrasound, Jiangsu University Affiliated People's Hospital, Zhenjiang, China
| | - Xian Wang
- Department of Ultrasound, Jiangsu University Affiliated People's Hospital, Zhenjiang, China
| | - Liang Yin
- Department of Breast Surgery, Jiangsu University Affiliated People's Hospital, Zhenjiang, China
| | - Xiaoqin Qian
- Department of Ultrasound, Jiangsu University Affiliated People's Hospital, Zhenjiang, China
| |
Collapse
|