Journal of Ultrasound in Medicine最新文献

Author: Karen Nussbaumer, BS, RDMS, RVT, Academy of Diagnostic and Osteopathic Medicine (ADOM)

Objectives: This study explores the relationship between healthcare access, cancer incidence, and life expectancy across 60 countries. It aims to investigate whether greater access to healthcare—including radiative diagnostic tests (such as x-rays, CT scans) and treatments like chemotherapy—leads to lower cancer rates, or if healthcare access increases cancer risk and contributes to longer survival in high-access countries.

Methods: Cancer incidence and life expectancy data were collected from high-access countries such as Australia, the United States, and New Zealand and compared to low-access countries like Niger, Gambia, and Bhutan. The study analyzes cancer rates and the average age of death in relation to healthcare access, examining whether early detection and treatments lead to longer survival or if cancer rates are higher due to healthcare-related factors.

Results: In high-access countries such as Australia (life expectancy: 84.6 years), cancer rates are significantly higher, with 452.4 cases per 100,000 people. However, patients diagnosed with cancer often live longer, reaching their 60s to 70s, or in cases of less aggressive cancers, living into their 70s and 80s. Despite the availability of early detection and advanced treatments, healthcare access in these countries does not correlate with lower cancer rates; in fact, cancer incidence is higher in countries with more frequent use of diagnostics and treatments. In low-access countries like Niger (life expectancy: 61.5 years) and Gambia, cancer rates are lower, ranging around 78-82 cases per 100,000 people, yet other factors, such as poor living conditions and water quality, contribute to earlier mortality. Cancer patients in these regions tend to die in their 40s or 50s, but the lower cancer rates may also reflect limited diagnostic infrastructure.

Conclusions: This study suggests that access to healthcare does not decrease cancer rates and may even contribute to higher incidence in high-access countries. While patients in these countries often live longer, potentially without the benefit of early access, the frequent use of diagnostics and treatments may play a role in increased cancer rates. Meanwhile, in low-access countries, patients may die earlier from other health challenges unrelated to cancer. These findings call for a reassessment of the role healthcare access plays in cancer prevention and management, particularly in balancing the benefits of detection and treatment with potential risks.

Author: Aylin Tahmasebi, MD, Thomas Jefferson University

Author: Tania Siu Xiao, MD, Thomas Jefferson University

Author: Jesse Civan, MD, Thomas Jefferson University

Author: Flavius Guglielmo, Thomas Jefferson University

Author: John Eisenbrey, PhD, Thomas Jefferson University

Objectives: Liver biopsy remains the definitive method for diagnosing steatohepatitis and fibrosis in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). However, this invasive procedure is costly, prone to sampling errors, and can lead to complications. For this reason, non-invasive imaging techniques, such as FibroScan, MR Elastography (MRE), and MR-based Proton Density Fat Fraction (PDFF) are used as alternative tools. FibroScan provides point-of-care assessments but is limited to a single region of interest (ROI) while MRE and PDFF include an average of multiple measurements to better evaluate liver heterogeneity. This study aims to compare simulated FibroScan interrogation volumes with MRE and PDFF in MASLD patients using ROIs on MRI.

Methods: In this study, data from 118 participants with known MASLD risk who underwent both MRE and MRI PDFF was analyzed, retrospectively. The FatFrac and Greyscale Elastography series were used to outline the ROIs measuring 10×40 mm in segment VIII of the liver (mimicking the acquired ROIs during FibroScan) to obtain simulated controlled attenuation parameter (CAP) scores and liver stiffness measurement (LSM), respectively. MRE and MRI PDFF served as reference standards for fibrosis and steatosis, respectively. The diagnostic accuracy of simulated FibroScan ROIs was assessed, with agreement analyzed using Cohen's kappa test.

Results: Among 118 patients, a strong correlation was observed between simulated FibroScan ROIs and global MRE and PDFF measurements (r = 0.72 and 0.96, respectively; p < 0.0001). However, variability was noted according to fibrosis and steatosis levels. For advanced fibrosis and cirrhosis, FibroScan ROI sensitivity decreased from 91.8% to 83.3%, while specificity and accuracy improved from 75.6% and 85.6% to 95% and 93.2%, respectively. Similarly for steatosis, sensitivity dropped from 89.2% to 88.2%, but specificity and accuracy increased from 86.4% and 87.3% to 99% and 97.5%, respectively. Agreement for LSM ranged from moderate to substantial (0.50–0.75), while for steatosis it ranged from substantial to nearly perfect (0.67–0.89).

Conclusions: This study indicates that simulated FibroScan ROIs within an MR exam provide comparable diagnostic accuracy for assessing fibrosis and steatosis as a global liver evaluation. Nonetheless, the effectiveness of these measurements is influenced by the severity of liver disease.

Author: Jean-Eric Morice, PhD, Department gyneco obstetrique CHU Nord Marseille

Author: Nathalie Frandji, Maternité CHU Nord Marseille France

Author: Georges Haddad, Maternite CHU Tours

Author: Florence Bretelle, Maternité CHU La Timone Marseille France

Objectives: First trimester screening is quite often suspect of retrognatism, generating unnecessary fear. Mandibular articulation's distance is fixed by the skill, so chin position determines the angle between its branches. We wanted to know if an axial mandibular scan could help to discriminate severe ones, the more so only these are interesting to consider at this stage.

Methods: We determined systematically 100 mandibular branches angles for each first trimester screening and compared them with 5 severe retrognatism on profile scan.

Results: As we could expect sharp angle is found as if we had a “retrognatism impression”, between 60 and 70 degrees. In all cases when a severe retrognatism was suspected, thanks to this scan, we could confirm it: the angle couldn’t be measured but there was a mandibular staple form.

Conclusions: As expected and unusual form in staple form of the mandibula confirm a severe retrognatism, the only ones interesting to consider at the first trimester. Much more often when there is a doubt on the profile, a sharp mandibular angle is very helpful to infirm severe retrognatism and avoid fear. We think a regular practice of this mandibular measurement interesting to detect more easily severe forms of retrognatism.