WFUMB Ultrasound Open最新文献

The diagnostic value of Bosniak classification based on contrast enhanced ultrasound (CEUS) on complex cystic renal mass (CRM) was compared among different observers. From 2012 to 2022, 212 complex CRMs, confirmed by pathology or at least 1-year imaging follow-up, were enrolled. The CEUS images of CRM were retrospectively analyzed by two reviewers with different experience in kidney CEUS examination, and each lesion was given the categorizations according the Bosniak ver. 2015 and ver. 2019, respectively. There was good inter-observer agreement (k = 0.689; p < 0.05) for Bosniak ver. 2019. With Bosniak ver. 2019, senior and junior reviewer correctly classified 44 (83.02%), 40 (75.47%) benign lesions as low grade (Ⅰ ∼ ⅡF), and 94 (94.95%), 80 (80.81%) malignant tumors as high grade (Ⅲ or Ⅳ), respectively. Meanwhile, the combination of Bosniak 2019 and senior reviewer demonstrated the highest area under the receiver operating characteristic curve (Az: 0.875, all p < 0.05) than other groups, with the highest specificity (81.10%) and sensitivity (93.90%) among all the groups (95% CI, 0.807–0.943; p < 0.05), respectively. Overall, the senior reviewer combined with Bosniak ver. 2019 was the best choice for the diagnosis of complex CRM.

Purpose

Echocardiography is dependent on highly specialized healthcare professionals. Teleoperated examinations could provide higher availability of specialized care for patients living in rural areas. The objective of this study was to evaluate the feasibility of a teleoperated robotic echocardiography system.

Methods

Twenty-three healthy volunteers underwent teleoperated echocardiography, compared to standard bedside echocardiography. Examination time, image quality, ability to assess cardiac structures, measurements of left ventricular fractional shortening and blood flow velocities were compared. Image quality was rated on a scale from 0 to 3.

Results

Approximately 90% of robotically acquired images were rated as medium quality or better and approximately 80% of cardiac structures were evaluated as assessable by at least one evaluator. Mean image quality was lower for robotic (1.6 ± 0.3) compared to standard clinical examinations (2.5 ± 0.4) (p = 0.001). Left ventricular fractional shortening from the robotic examinations was 2.2%, p = 0.160 (absolute value) lower compared to the reference and showed a variation coefficient of 19%. The calculated Doppler insonation angles deviated from the reference by more than 25° for three of four blood flow velocity measurements. The teleoperated examinations had a mean examination time of 26.4 min and were 1.9 times longer compared to the reference (p = 0.001).

Conclusion

This feasibility study of teleoperated echocardiography shows promising results for the presented system. Clinically satisfactory imaging, particularly measurements of dimension and velocities, requires further development of the system.

Background & aims

Differentiation between predominantly inflammatory or fibrous strictures is particularly important to decide the optimal therapy in patients with refractory symptoms in Crohn's disease. The purpose of this research was to evaluate the accuracy of color Doppler US and Shear Wave Elastography in differentiating the degree of inflammation or fibrosis in ileal strictures in patients with Crohn's disease by comparing with resected bowel samples.

Materials and methods

Preoperative ultrasound examination, including SWE, was performed in 30 consecutive patients with Crohn's disease undergoing elective bowel resection. Ultrasound variables, Shear Wave Elastography quantitative analysis and visual elastographic color map, were prospectively evaluated. Histopathology grading of acute inflammation using the acute inflammatory score and the degree of fibrostenosis was performed.

Results

In pathology analysis there were 21 segments with severe fibrosis. The mean Shear Wave Elastography value of the stenotic bowel wall was significantly higher in severe fibrosis (3.56 ± 1.4 m/s) than in mild fibrosis (1.89 ± 0.75 m/s) (P = 0.004). Using 2.5 m/s as the cut-off value to discriminate between mild and severe fibrosis, the sensitivity and specificity was 76.2% and 100% with an area under the curve (AUC) of 0.889. The sensitivity and specificity of the visual assessment of the elastographic color map in differentiating severe from mild fibrosis was 82.4% and 88.9%.

Conclusions

this study suggests that Shear Wave Elastography is accurate for detecting severe intestinal fibrosis in Crohn's disease patients. This information may be useful in the treatment strategy for CD.

Placenta accreta spectrum (PAS) is a serious complication of pregnancy. Preoperative diagnosis improves outcome for both mother and infant therefore it is critical that obstetric imagers are aware of the signs of the disease and know how to avoid pitfalls in diagnosis. This article reviews and illustrates the sonographic signs that are most helpful in detection of PAS and provides tips on avoiding pitfalls in diagnosis.

This study aimed to use Artificial Intelligence (AI) Deep Learning (DL) techniques to predict female breast cancer detected by ultrasound based on clinical data and Breast Imaging Reporting and Data System (BI-RADS) Ultrasound (US) descriptors. We retrospectively gathered data on clinical information and BI-RADS US descriptors of breast lesions from 1051 female patients, forming a comprehensive dataset. Two datasets (A and B) were derived by selecting different variables. A BI-RADS DL-based Network (BD-Net) was developed and trained on Dataset A and B, and its performance was evaluated on an external test set. Radiologists also classified Dataset B and the external test set using BI-RADS US. Performance in predicting the probability of malignancy was evaluated by calculating the Area Under Curve (AUC), accuracy, sensitivity, and specificity. BD-Net achieved an accuracy of 92.5% (95%CI, 90.5–94.2) in predicting breast cancer with a sensitivity of 93.0% (95%CI, 90.3–95.4), a specificity of 92.1% (95%CI, 89.7–94.6), and an AUC of 0.97 (95%CI, 0.96–0.98) on the training data set of dataset A. On the external dataset, the BD-Net showed a sensitivity of 93.8% (95%CI, 87.5–98.8), a specificity of 91.0% (95%CI, 85.0–96.0), and an AUC of 0.92 (95%CI, 0.88–0.97) for predicting breast cancer. The radiologists predicted breast cancer on Dataset B and the external test set with AUC values between 0.75 (95%CI, 0.75–0.79) and 0.82 (95%CI, 0.77–0.87). These results indicate that the BD-Net is effective for predicting ultrasound-detected female breast cancer.

Background

Handheld ultrasound devices are increasingly used by medical professionals for bedside ultrasound-guided interventions. Especially for vascular access procedures, the width of the imaging plane, known as the slice thickness or elevational beam width is a prominent source for misinterpretation. A wide slice thickness can lead to the interpretation that 2 objects (i.e. needle and vessel) are on the same plane while in fact they are not and thereby negatively influencing the performance of in-plane ultrasound-guided interventions. Therefore, the beam profiles of three popular handheld US devices are tested and compared to a conventional US device.

Methods

The GE VScan, Philips Lumify and Butterfly IQ ​+ ​are tested using a slice phantom to determine the slice thickness. For comparison, a Philips Affiniti machine was investigated. Both linear and curved array settings were analyzed. In a slice phantom, a diffuse scattering plane at an angle of exactly 45° is scanned. For each imaging depth, the vertical height of the imaged rectangle corresponds to the slice thickness at that depth.

Main results

For the linear array transducers, the focus depth ranges from 1.5 to 3.5 cm. At the focus depth, all transducers have a reasonable slice thickness of approximately 1 mm. More superficially, the slice thickness varies between 1 and 4 mm. The curved array probes have larger focus depths, ranging from 2.7 to 7.3 cm. The slice thickness at focus depth varies between 1.4 and 3.8 mm, but at 2 cm depth is even more than 5 mm.

Conclusions

The slice thickness of handheld ultrasound transducers varies between the different devices, and can be suboptimal for superficial in-plane ultrasound-guided interventions. The larger slice thickness of the curved array settings may complicate in-plane guidance. Handheld ultrasound users should be aware of the beam characteristics of their devices to optimize guidance for interventions.

[Objective]

To evaluate the diagnostic value of sonoelastography to distinguish endometrial cancer from benign endometrial lesions.

[Methods]

A cross-sectional study was conducted and included 31 subjects with abnormal uterine bleeding who required endometrial sampling. Sonoelastography assessment was done qualitatively and quantitatively using Tsukuba elasticity score and strain ratio, respectively. Results were compared between those with endometrial cancer and those with benign endometrial lesions (hyperplasia and polyp) using Kruskal-Wallis test and Mann-Whitney U test. Diagnostic accuracies of Tsukuba elasticity score and strain ratio in differentiating endometrial cancer from benign endometrial lesions were determined with cut-off values derived from ROC analysis.

[Discussion]

Both the Tsukuba elasticity score and strain ratio value were significantly higher among patients with endometrial cancer (n = 15; mean age: 55.07 ± 8.53 years) compared to those with benign endometrial lesions (n = 16; mean age: 41.63 ± 8.02 years) (P < 0.0001). A Tsukuba elasticity score of ≥3 showed the highest diagnostic accuracy at 93.5%(95%CI: 79.3%–98.2%), with sensitivity of 86.7%(95%CI: 62.1%–96.3%), specificity of 100%(95%CI: 80.6%–100%), PPV of 100%(95%CI: 77.2%–100%), NPV of 88.9%(95%CI: 67.2%–96.9%), positive LR of undefined indicating high value and negative LR of 0.10(95%CI: 0.05–0.40). A Strain ratio value of ≥2 showed the highest diagnostic accuracy at 93.5%(95%CI: 79.3%–98.2%), with sensitivity of 93.3%(95%CI: 70.2%–98.8%), specificity of 93.8%(95%CI: 71.7%–98.9%), PPV of 93.3% (95%CI: 70.2%–98.8%), NPV of 93.8%(95%CI: 71.7%–98.9%), positive LR 14.9(95%CI: 2.1–107.1), and negative LR of 0.07(95%CI: 0.01–0.51).

[Conclusion]

The results indicate that sonoelastography can distinguish endometrial cancer from benign endometrial lesions.