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The Size Differences of Breast Cancer and Benign Tumors Measured by Two-Dimensional Ultrasound and Contrast-Enhanced Ultrasound 用二维超声波和对比增强超声波测量乳腺癌和良性肿瘤的大小差异。
IF 2.1 4区 医学 Q2 ACOUSTICS Pub Date : 2024-11-18 DOI: 10.1002/jum.16621
Hideaki Ishida MD, PhD, Hiroko Naganuma MD, PhD
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引用次数: 0
Quantitative Ultrasound Parameters as Predictors of Chemotherapy Toxicity in Lymphoma 作为淋巴瘤化疗毒性预测指标的定量超声参数:基于超声射频信号评估肌肉质量的新方法
IF 2.1 4区 医学 Q2 ACOUSTICS Pub Date : 2024-11-18 DOI: 10.1002/jum.16618
Yang Sun MD, Jianqiu Huang MD, Jinhua Shao PhD, Jianwen Luo PhD, Qiong He PhD, Ligang Cui MD

Objectives

The aim of this study was to use quantitative ultrasound (QUS) parameters to assess the muscle mass and quality in patients with lymphoma. Additionally, the study aimed to investigate the relationship between these QUS parameters and post-chemotherapy myelosuppression.

Methods

The study cohort comprised 202 patients diagnosed with lymphoma (105 males, 97 females; mean age 57.0 ± 14.9 years). The skeletal muscle index (SMI) and mean skeletal muscle density (SMD) were measured on CT and used as the gold standards to evaluate low skeletal muscle mass and quality. The muscle thickness (MT) of the forearm flexor and extensor muscles was measured in both the relaxed and contracted states, while the normalized non-linear parameter B/A (MusQBOX.NLP) and normalized mean intensity (MusQBOX.NMI) were extracted from retained ultrasound radiofrequency signals. The correlations between the QUS parameters and grip strength were assessed. Models were constructed using these QUS parameters to predict low SMI and SMD, and to evaluate whether these factors were independently associated with post-chemotherapy myelosuppression.

Results

The MT in both the relaxed and contracted states exhibited the strongest correlations with grip strength, while the MusQBOX.NLP and MusQBOX.NMI were only weakly correlated with grip strength. Models incorporating QUS parameters to predict low SMI and SMD achieved high area under the receiver operating characteristic curve values. The MT, MusQBOX.NLP, and MusQBOX.NMI were independent factors associated with post-chemotherapy myelosuppression.

Conclusions

QUS parameters show promise in characterizing muscle strength, mass, and quality. They are also independent factors influencing post-chemotherapy myelosuppression.

研究目的本研究旨在使用定量超声(QUS)参数评估淋巴瘤患者的肌肉质量和品质。此外,研究还旨在探讨这些 QUS 参数与化疗后骨髓抑制之间的关系:研究对象包括 202 名淋巴瘤患者(男性 105 人,女性 97 人;平均年龄 57.0 ± 14.9 岁)。通过 CT 测量骨骼肌指数(SMI)和平均骨骼肌密度(SMD),并将其作为评估低骨骼肌质量和品质的金标准。测量了前臂屈肌和伸肌在放松和收缩状态下的肌肉厚度(MT),同时从保留的超声射频信号中提取了归一化非线性参数B/A(MusQBOX.NLP)和归一化平均强度(MusQBOX.NMI)。评估了 QUS 参数与握力之间的相关性。利用这些 QUS 参数构建了预测低 SMI 和 SMD 的模型,并评估这些因素是否与化疗后骨髓抑制独立相关:结果:放松和收缩状态下的MT与握力的相关性最强,而MusQBOX.NLP和MusQBOX.NMI与握力的相关性较弱。结合 QUS 参数预测低 SMI 和 SMD 的模型达到了较高的接收器操作特征曲线下面积值。MT、MusQBOX.NLP和MusQBOX.NMI是与化疗后骨髓抑制相关的独立因素:结论:QUS 参数在描述肌肉强度、质量和品质方面显示出前景。结论:QUS参数在描述肌肉强度、质量和品质方面显示出前景,它们也是影响化疗后骨髓抑制的独立因素。
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引用次数: 0
Reliability of Semitendinosus and Biceps Femoris Aponeurosis Thickness Using B-Mode Ultrasound 使用 B 型超声波测量半腱肌和股二头肌肌腱厚度的可靠性
IF 2.1 4区 医学 Q2 ACOUSTICS Pub Date : 2024-11-12 DOI: 10.1002/jum.16616
Chrysostomos Sahinis PhD, Eleftherios Kellis PhD

Objectives

The aim of the present study was to assess the reliability of aponeurosis and muscle thickness of the hamstrings using ultrasound (US).

Methods

US images were captured from the semitendinosus (ST) and biceps femoris long head (BFlh) of 30 individuals (15 females), undergoing two testing sessions with a 24-hour interval. Measurements were taken at six sites along the thigh at two knee angles (0° = full extension and 90°) in prone position. Aponeurosis and muscle thickness across the entire length of ST and BFlh were evaluated using computational image segmentation which generated ~360 data points per participant.

Results

The intraclass correlation coefficients ranged from 0.937 to 0.998 while the standard error of measurement varied from 0.88 to 2.72% for superficial aponeurosis, from 1.41 to 2.29% for deep aponeurosis, and from 1.50 to 4.22% for muscle thickness. The minimal detectable change ranged from 2.44 to 7.56% for the superficial aponeurosis, from 3.57 to 6.27% for deep aponeurosis, and from 4.17 to 11.70% for BF and ST muscle thickness.

Conclusions

Evaluation of hamstring aponeurosis and muscle thickness measurements at rest displayed very high reliability and, hence, such measurements can be used to diagnose changes in thickness due to injury or exercise interventions.

目的:本研究旨在利用超声波(US)评估腘绳肌的肌腱和肌肉厚度的可靠性:本研究旨在使用超声波(US)评估腘绳肌的肌腱和肌肉厚度的可靠性:方法:对 30 人(15 名女性)的半腱肌(ST)和股二头肌长头(BFlh)进行超声波图像采集。在俯卧姿势下,沿大腿在两个膝关节角度(0° = 完全伸直和 90°)的六个部位进行测量。采用计算图像分割法对 ST 和 BFlh 整个长度上的肌腱和肌肉厚度进行评估,每位参与者可获得约 360 个数据点:类内相关系数从 0.937 到 0.998 不等,而浅层肌腱的测量标准误差从 0.88 到 2.72% 不等,深层肌腱的测量标准误差从 1.41 到 2.29% 不等,肌肉厚度的测量标准误差从 1.50 到 4.22% 不等。可检测到的最小变化范围为:浅层肌腱从 2.44% 到 7.56%,深层肌腱从 3.57% 到 6.27%,BF 和 ST 肌肉厚度从 4.17% 到 11.70%:对静止状态下的腘绳肌腱和肌肉厚度测量结果的评估显示出极高的可靠性,因此,此类测量结果可用于诊断因损伤或运动干预导致的厚度变化。
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引用次数: 0
Methodology Used in Studies Aimed at Measuring Fetal Soft Tissues by 2D Ultrasound for the Screening of Large for Gestational Age Fetuses 旨在通过二维超声测量胎儿软组织以筛查高龄胎儿的研究中使用的方法:系统回顾。
IF 2.1 4区 医学 Q2 ACOUSTICS Pub Date : 2024-11-11 DOI: 10.1002/jum.16614
Diego Lerma-Puertas PhD, Ana Aguerri MD, Gema Pardina MD, Cristina Paules PhD, David Lerma-Irureta MD, Daniel Oros PhD, Sara Ruiz-Martínez PhD

Management of suspected large for gestational age (LGA) fetuses remains unclear because ultrasound-estimated fetal weight (EFW) is not accurate. This was a systematic review of observational studies on fetal soft tissues measurements used alone or in combination to create a new EFW formula, to improve the screening for LGA fetuses. Studies were scored using a predefined set of independently agreed methodological criteria and an overall quality score was assigned for study design, statistical analysis, and reporting methods. There is a need to standardize methodologies for soft fetal tissue measurements. We propose a set of suggestions for this purpose.

由于超声估测的胎儿体重(EFW)并不准确,因此对疑似巨大胎儿(LGA)的处理仍不明确。本研究对有关胎儿软组织测量的观察性研究进行了系统性回顾,这些研究单独使用或结合使用了新的EFW公式,以改善LGA胎儿的筛查。研究采用预先确定的一套独立商定的方法学标准进行评分,并对研究设计、统计分析和报告方法进行总体质量评分。胎儿软组织测量方法需要标准化。为此,我们提出了一系列建议。
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引用次数: 0
Overview of Therapeutic Ultrasound Applications and Safety Considerations: 2024 Update 治疗超声应用和安全考虑因素概述:2024 年更新。
IF 2.1 4区 医学 Q2 ACOUSTICS Pub Date : 2024-11-11 DOI: 10.1002/jum.16611
Kenneth B. Bader PhD, Frederic Padilla PhD, Kevin J. Haworth PhD, Nicholas Ellens PhD, Diane Dalecki PhD, Douglas L. Miller PhD, Keith A. Wear PhD, Bioeffects Committee of the American Institute of Ultrasound in Medicine

A 2012 review of therapeutic ultrasound was published to educate researchers and physicians on potential applications and concerns for unintended bioeffects (doi: 10.7863/jum.2012.31.4.623). This review serves as an update to the parent article, highlighting advances in therapeutic ultrasound over the past 12 years. In addition to general mechanisms for bioeffects produced by therapeutic ultrasound, current applications, and the pre-clinical and clinical stages are outlined. An overview is provided for image guidance methods to monitor and assess treatment progress. Finally, other topics relevant for the translation of therapeutic ultrasound are discussed, including computational modeling, tissue-mimicking phantoms, and quality assurance protocols.

2012 年发表了一篇关于治疗性超声的综述,向研究人员和医生介绍了超声的潜在应用以及对意外生物效应的担忧(doi: 10.7863/jum.2012.31.4.623)。本综述是对母文的更新,重点介绍了过去 12 年中超声治疗的进展。除了概述治疗性超声产生生物效应的一般机制外,还概述了当前的应用以及临床前和临床阶段。还概述了用于监测和评估治疗进展的图像引导方法。最后,还讨论了与超声治疗转化相关的其他主题,包括计算建模、组织模拟模型和质量保证协议。
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引用次数: 0
Differentiating Closely Resembling Fetal Aortic Arch Abnormalities Using Conventional and Four-Dimensional Echocardiography 利用传统超声心动图和四维超声心动图鉴别近似胎儿主动脉弓畸形:产后结果图解。
IF 2.1 4区 医学 Q2 ACOUSTICS Pub Date : 2024-11-08 DOI: 10.1002/jum.16615
Balaganesh Karmegaraj MD, DM, Sowmya Vijayakumar MD

Double aortic arch with an atretic left aortic arch can resemble like a right aortic arch with an aberrant left subclavian artery or a right aortic arch with mirror image branching. Differentiating these closely resembling fetal aortic arch abnormalities is important for proper prenatal counselling and immediate neonatal evaluation. In this pictorial essay, we describe these three cases and its typical imaging features using conventional and four-dimensional echocardiography.

左主动脉弓闭锁的双主动脉弓可类似于左锁骨下动脉异常的右主动脉弓或右主动脉弓的镜像分支。区分这些近似的胎儿主动脉弓畸形对于正确的产前咨询和即时的新生儿评估非常重要。在这篇图文并茂的文章中,我们将用常规和四维超声心动图描述这三个病例及其典型的影像学特征。
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引用次数: 0
Grading Sonographic Severity of Adenomyosis 子宫腺肌症超声严重程度分级:评估可行性和观察者间可靠性的试点研究
IF 2.1 4区 医学 Q2 ACOUSTICS Pub Date : 2024-11-08 DOI: 10.1002/jum.16612
Lisa M. Trommelen MD, Robert A. De Leeuw MD, PhD, Thierry Van den Bosch MD, PhD, Judith A. F. Huirne MD, PhD

Objectives

The reported prevalence of adenomyosis ranges widely due to different study populations, diagnostic tests and criteria. Categorizing the severity of disease may prove important. This study aims to develop a semi-quantifiable sonographic method to grade the severity of adenomyosis and assess the feasibility and interobserver reliability of this method.

Methods

Cross-sectional pilot study performed at a gynecology outpatient clinic, included 35 premenopausal women with adenomyosis, not taking hormonal medication. Diagnosis required ≥1 direct sonographic feature of adenomyosis. Two-dimensional (2D) grayscale video clips and 3-dimensional (3D) volumes of the uterus of the first 5 patients were evaluated using 6 offline methods to assess feasibility. Feasible methods were analyzed for interobserver (n = 3) reliability (Fleiss kappa or intraclass correlation) and compared with current ultrasound methods (Cohen's weighted kappa and Spearman's rank correlation). Current methods include real-time estimation (mild/moderate/severe) and counting the individual sonographic features.

Results

“eXtended Imaging virtual organ computer-aided analysis (XI VOCAL) counting” (counting affected slices of 20 parallel slices in the 3D volume), “Multiplanar and 3D rendering (MPR) estimation” (grading volume by eyeballing in multiplanar render mode), and “2D-clip estimation” (grading volume in 2D-clips) emerged as feasible methods. “XI VOCAL counting” and “2D-clip estimation” demonstrated good interobserver reliability, whereas “MPR estimation” had poor reliability. Comparison with real-time estimation showed moderate reliability with all methods. “XI VOCAL counting” and “MPR estimation” correlated positively with the number of sonographic features.

Conclusion

“XI VOCAL counting” demonstrated to be feasible with good interobserver reliability to assess the severity of adenomyosis in an objective, systematic, and semi-quantifiable fashion and should be validated with large-scale studies for future use. Future studies should also explore the association between sonographic severity and symptoms of adenomyosis.

目的:由于研究人群、诊断测试和标准不同,子宫腺肌症的报告发病率范围很广。对疾病的严重程度进行分类可能非常重要。本研究旨在开发一种半量化的声像图方法来对子宫腺肌症的严重程度进行分级,并评估该方法的可行性和观察者之间的可靠性:方法:在妇科门诊进行横断面试验研究,纳入 35 名绝经前、未服用激素药物的腺肌症妇女。诊断要求子宫腺肌症的直接声像图特征≥1个。使用 6 种离线方法评估了前 5 名患者子宫的二维(2D)灰度视频片段和三维(3D)体积,以评估其可行性。对可行的方法进行了观察者间(n = 3)可靠性分析(弗莱斯卡帕或类内相关性),并与当前的超声方法进行了比较(科恩加权卡帕和斯皮尔曼等级相关性)。目前的方法包括实时估计(轻度/中度/重度)和计算单个声像图特征:结果:"扩展成像虚拟器官计算机辅助分析(XI VOCAL)计数法"(对三维容积中 20 个平行切片中受影响的切片进行计数)、"多平面和三维渲染(MPR)估算法"(在多平面渲染模式下通过目测对容积进行分级)和 "二维片段估算法"(在二维片段中对容积进行分级)成为可行的方法。"XI VOCAL 计数 "和 "二维剪辑估算 "显示出良好的观察者间可靠性,而 "MPR 估算 "的可靠性较差。与实时估算相比,所有方法的可靠性都处于中等水平。"XI VOCAL计数 "和 "MPR估计 "与声像图特征的数量呈正相关:"XI VOCAL计数法 "以客观、系统和半量化的方式评估子宫腺肌症的严重程度,在观察者之间具有良好的可靠性。今后的研究还应探讨声像图严重程度与子宫腺肌症症状之间的关联。
{"title":"Grading Sonographic Severity of Adenomyosis","authors":"Lisa M. Trommelen MD,&nbsp;Robert A. De Leeuw MD, PhD,&nbsp;Thierry Van den Bosch MD, PhD,&nbsp;Judith A. F. Huirne MD, PhD","doi":"10.1002/jum.16612","DOIUrl":"10.1002/jum.16612","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The reported prevalence of adenomyosis ranges widely due to different study populations, diagnostic tests and criteria. Categorizing the severity of disease may prove important. This study aims to develop a semi-quantifiable sonographic method to grade the severity of adenomyosis and assess the feasibility and interobserver reliability of this method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cross-sectional pilot study performed at a gynecology outpatient clinic, included 35 premenopausal women with adenomyosis, not taking hormonal medication. Diagnosis required ≥1 direct sonographic feature of adenomyosis. Two-dimensional (2D) grayscale video clips and 3-dimensional (3D) volumes of the uterus of the first 5 patients were evaluated using 6 offline methods to assess feasibility. Feasible methods were analyzed for interobserver (n = 3) reliability (Fleiss kappa or intraclass correlation) and compared with current ultrasound methods (Cohen's weighted kappa and Spearman's rank correlation). Current methods include real-time estimation (mild/moderate/severe) and counting the individual sonographic features.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>“eXtended Imaging virtual organ computer-aided analysis (XI VOCAL) counting” (counting affected slices of 20 parallel slices in the 3D volume), “Multiplanar and 3D rendering (MPR) estimation” (grading volume by eyeballing in multiplanar render mode), and “2D-clip estimation” (grading volume in 2D-clips) emerged as feasible methods. “XI VOCAL counting” and “2D-clip estimation” demonstrated good interobserver reliability, whereas “MPR estimation” had poor reliability. Comparison with real-time estimation showed moderate reliability with all methods. “XI VOCAL counting” and “MPR estimation” correlated positively with the number of sonographic features.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>“XI VOCAL counting” demonstrated to be feasible with good interobserver reliability to assess the severity of adenomyosis in an objective, systematic, and semi-quantifiable fashion and should be validated with large-scale studies for future use. Future studies should also explore the association between sonographic severity and symptoms of adenomyosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 3","pages":"495-506"},"PeriodicalIF":2.1,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.16612","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Three-Dimensional Volume Ultrasound Assessment of Cesarean Scar Niche and Cervix in Pregnant Women 孕妇剖宫产瘢痕龛和宫颈的三维容积超声评估:可重复性研究。
IF 2.1 4区 医学 Q2 ACOUSTICS Pub Date : 2024-11-07 DOI: 10.1002/jum.16613
Maria Ivan MBBS, MRCOG, Heba Mahdy MBBCH, DOWH, MRCPI, Amrita Banerjee MBBS, MRCOG, Amos Tetteh MBBS, MRCOG, Natalie Greenwold MD, Davide Casagrandi MD, MSc, MRCOG, Davor Jurkovic MD, FRCOG, Raffaele Napolitano MD, FRCOG, Anna L. David PhD, FRCOG

Objective

To assess the reproducibility of standardized 3-dimensional (3D) ultrasound volume analysis of the dimensions and the position of cesarean birth (CB) scar niche relative to the cervix in pregnant women.

Methods

This prospective single-center study in women with 1 previous CB ≥8 cm cervical dilatation acquired ultrasound volumes between 11 and 24 weeks' gestation in a mid-sagittal plane. Two experienced operators processed the volumes using virtual organ computer-aided analysis. A CB scar niche was defined as an indentation at the scar site of ≥2 mm in depth. Niche and cervix volumes were calculated using manual contouring. Agreement for categorical variables was expressed using intraclass correlation coefficient (ICC). The Bland–Altman method was used to assess numerical variable reproducibility.

Results

To achieve the desired statistical power, 52 participants were included. The intraobserver agreement on niche classification relative to the internal os was 100%, with an interobserver kappa coefficient of 0.98 (95% confidence interval [CI] 0.97–0.99, P < .05).

The intraobserver ICC for niche volume was 0.94 (95% CI 0.90–0.96; P < .001), with a mean difference of −15.32 mm3 (±109.32). The interobserver ICC was 0.78 (95% CI 0.62–0.87; P < .001), with a mean difference of −21.57 mm3 (±202.01). The ICC for niche/cervix volume ratio were 0.94 (95% CI 0.90–0.96; P < .001) and 0.79 (95% CI 0.63–0.87; P < .001) for intra- and interobserver reproducibility, respectively.

Conclusions

This study demonstrates that 3D CB scar sonographic features are highly reproducible in pregnant women with a history of advanced labor CB. The validated protocol can guide future research on the association with subsequent adverse pregnancy outcomes.

目的评估对孕妇剖宫产(CB)瘢痕龛相对于宫颈的尺寸和位置进行标准化三维(3D)超声容积分析的可重复性:这项前瞻性单中心研究的对象是曾有过一次 CB ≥8 厘米宫颈扩张的孕妇,研究人员在妊娠 11 至 24 周期间采集了中矢状面的超声容积。两名经验丰富的操作员使用虚拟器官计算机辅助分析技术处理了这些图像。CB疤痕龛被定义为疤痕部位深度≥2毫米的凹陷。瘢痕龛和宫颈体积通过手动轮廓分析计算得出。分类变量的一致性采用类内相关系数(ICC)表示。Bland-Altman法用于评估数值变量的重现性:为了达到理想的统计能力,共纳入了 52 名参与者。相对于内眦,龛位分类的观察者内一致性为 100%,观察者间卡帕系数为 0.98(95% 置信区间 [CI] 0.97-0.99,P 3(±109.32))。观察者间 ICC 为 0.78(95% 置信区间 [CI] 0.62-0.87;P 3(±202.01))。壁龛/宫颈容积比的 ICC 为 0.94(95% CI 0.90-0.96;P 结论:本研究表明,在有晚期 CB 分娩史的孕妇中,3D CB 疤痕声像图特征具有高度的可重复性。经过验证的方案可指导未来对不良妊娠结局相关性的研究。
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引用次数: 0
Inter-Reader Agreement for Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System Major Features and Final Categorization 对比增强超声肝脏成像报告和数据系统主要特征及最终分类的读片者间一致性:一项前瞻性多中心研究的子分析。
IF 2.1 4区 医学 Q2 ACOUSTICS Pub Date : 2024-10-29 DOI: 10.1002/jum.16608
Cristina M. Kuon Yeng Escalante MD, Tania Siu Xiao MD, Yuko Kono MD, PhD, Fabio Piscaglia MD, Stephanie R. Wilson MD, Alexandra Medellin MD, Shuchi K. Rodgers MD, Virginia Planz MD, Aya Kamaya MD, David T. Fetzer MD, Annalisa Berzigotti MD, Paul S. Sidhu MD, Corinne E. Wessner MS, RDMS, Kristen Bradigan RN, John R. Eisenbrey PhD, Flemming Forsberg PhD, Andrej Lyshchik MD, PhD, CEUS LI-RADS Trial Group

Objectives

Contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) is used to definitively diagnose hepatocellular carcinoma (HCC) in patients at risk. However, the user variability associated with CEUS LI-RADS has not been validated in North American and European patients. This study aims to evaluate the inter-reader agreements of CEUS LI-RADS features for, and final categorization of, HCC in patients at risk.

Methods

This retrospective multicenter clinical study used the database of a previous prospective multinational study, evaluating the accuracy of CEUS LI-RADS for HCC diagnosis in patients at risk. All cases were first evaluated by a site physician performing/supervising the CEUS examination. Randomly selected cases were re-evaluated by a blinded central reader. Final diagnosis was confirmed with the reference standard, which was a composite of imaging tests and histology. Cohen's kappa test was used to evaluate inter-reader agreement.

Results

This study included 150 liver nodules and 58.0% (87/150) were confirmed as HCC, 4.7% (7/150) non-HCC malignancies, 22.7% (34/150) had no confirmed final diagnosis, and 14.7% (22/150) were nonmalignant. Inter-reader agreements were substantial for CEUS LI-RADS categorization (κ = 0.61; 95% confidence interval [CI]: 0.51–0.71) and major features assessment (ranged κ = 0.64–0.78), LR-5 (κ = 0.65; 95% CI: 0.52–0.77), and LR-M (κ = 0.67; 95% CI: 0.44–0.90), while for LR-1 and LR-2 categorization was almost perfect (κ = 0.85; 95% CI: 0.65–1.00).

Conclusion

Our study reported a substantial inter-reader agreement for overall CEUS LI-RADS categorization, especially for LR-5 and LR-M, and major imaging features of HCC, further confirming CEUS LI-RADS as a valuable and reliable tool for diagnosis of HCC.

目的:对比增强超声(CEUS)肝脏成像报告和数据系统(LI-RADS)用于明确诊断高危患者的肝细胞癌(HCC)。然而,与 CEUS LI-RADS 相关的用户变异性尚未在北美和欧洲患者中得到验证。本研究旨在评估高危患者的 CEUS LI-RADS 特征和 HCC 最终分类的读片者之间的一致性:这项回顾性多中心临床研究使用了之前一项前瞻性跨国研究的数据库,评估了 CEUS LI-RADS 诊断高危患者 HCC 的准确性。所有病例均首先由一名负责/监督 CEUS 检查的现场医生进行评估。随机抽取的病例由盲法中央读片员重新评估。最终诊断以影像学检查和组织学检查的综合参考标准进行确认。结果:这项研究包括 150 个肝结节,58.0%(87/150)确诊为 HCC,4.7%(7/150)为非 HCC 恶性肿瘤,22.7%(34/150)未确诊,14.7%(22/150)为非恶性肿瘤。在 CEUS LI-RADS 分类(κ = 0.61;95% 置信区间 [CI]:0.51-0.71)和主要特征评估(范围为 κ = 0.64-0.78)、LR-5(κ = 0.65;95% CI:0.52-0.77)和LR-M(κ = 0.67;95% CI:0.44-0.90),而LR-1和LR-2分类几乎完美(κ = 0.85;95% CI:0.65-1.00):我们的研究报告显示,读片者之间对 CEUS LI-RADS 的整体分类(尤其是 LR-5 和 LR-M)以及 HCC 的主要影像学特征具有很高的一致性,这进一步证实 CEUS LI-RADS 是诊断 HCC 的一种有价值且可靠的工具。
{"title":"Inter-Reader Agreement for Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System Major Features and Final Categorization","authors":"Cristina M. Kuon Yeng Escalante MD,&nbsp;Tania Siu Xiao MD,&nbsp;Yuko Kono MD, PhD,&nbsp;Fabio Piscaglia MD,&nbsp;Stephanie R. Wilson MD,&nbsp;Alexandra Medellin MD,&nbsp;Shuchi K. Rodgers MD,&nbsp;Virginia Planz MD,&nbsp;Aya Kamaya MD,&nbsp;David T. Fetzer MD,&nbsp;Annalisa Berzigotti MD,&nbsp;Paul S. Sidhu MD,&nbsp;Corinne E. Wessner MS, RDMS,&nbsp;Kristen Bradigan RN,&nbsp;John R. Eisenbrey PhD,&nbsp;Flemming Forsberg PhD,&nbsp;Andrej Lyshchik MD, PhD,&nbsp;CEUS LI-RADS Trial Group","doi":"10.1002/jum.16608","DOIUrl":"10.1002/jum.16608","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) is used to definitively diagnose hepatocellular carcinoma (HCC) in patients at risk. However, the user variability associated with CEUS LI-RADS has not been validated in North American and European patients. This study aims to evaluate the inter-reader agreements of CEUS LI-RADS features for, and final categorization of, HCC in patients at risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective multicenter clinical study used the database of a previous prospective multinational study, evaluating the accuracy of CEUS LI-RADS for HCC diagnosis in patients at risk. All cases were first evaluated by a site physician performing/supervising the CEUS examination. Randomly selected cases were re-evaluated by a blinded central reader. Final diagnosis was confirmed with the reference standard, which was a composite of imaging tests and histology. Cohen's kappa test was used to evaluate inter-reader agreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study included 150 liver nodules and 58.0% (87/150) were confirmed as HCC, 4.7% (7/150) non-HCC malignancies, 22.7% (34/150) had no confirmed final diagnosis, and 14.7% (22/150) were nonmalignant. Inter-reader agreements were substantial for CEUS LI-RADS categorization (<i>κ</i> = 0.61; 95% confidence interval [CI]: 0.51–0.71) and major features assessment (ranged <i>κ</i> = 0.64–0.78), LR-5 (<i>κ</i> = 0.65; 95% CI: 0.52–0.77), and LR-M (<i>κ</i> = 0.67; 95% CI: 0.44–0.90), while for LR-1 and LR-2 categorization was almost perfect (<i>κ</i> = 0.85; 95% CI: 0.65–1.00).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study reported a substantial inter-reader agreement for overall CEUS LI-RADS categorization, especially for LR-5 and LR-M, and major imaging features of HCC, further confirming CEUS LI-RADS as a valuable and reliable tool for diagnosis of HCC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 2","pages":"349-357"},"PeriodicalIF":2.1,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predictors of Benignity for Small Endophytic Echogenic Renal Masses 肾脏内生回声性小肿块良性的预测因素
IF 2.1 4区 医学 Q2 ACOUSTICS Pub Date : 2024-10-28 DOI: 10.1002/jum.16610
Anthony F. Chen MD, Mary Le Dinh Getz MD, John P. McGahan MD, FACR, Machelle D. Wilson PhD, Michael C. Larson MD

Objectives

To evaluate for distinguishing demographic and sonographic features of small (<3 cm) endophytic angiomyolipomas (AMLs) that differentiate them from endophytic renal cell carcinomas (RCCs).

Methods

This is a Health Insurance Portablitiy and Accountablity Act (HIPAA)-compliant retrospective review of the demographics and ultrasound features of endophytic renal AMLs compared to a group of endophytic RCCs. AMLs were confirmed by identifying macroscopic fat on computed tomography (CT) or magnetic resonance imaging (MRI), while RCCs were pathologically proven. Statistical analysis was used to compare findings in the 2 groups.

Results

There were a total of 66 patients with 66 AMLs, and 28 patients with 28 RCCs. Of the AMLs, 57 of 66 were in females, while 10 of the 28 RCC cases were in females (P < .0001). The mean AML long and short diameters were 11.0 × 9.3 mm and were statistically significantly smaller (P < .0001) than the diameters of the RCCs (23.4 × 22.1 mm). Likewise, the ratio of the long axis to the short axis measurement was statistically significantly different between the 2 groups (P < .0001). Of the studied sonographic features, statistically different features between AMLs and RCCs included an oval versus a round shape (P < .001), respectively, and the presence versus absence of an echogenic margin, respectively. Location of the mass, mass homogeneity, mass lobulation, and presence of cystic components were not distinguishing features using P < .01 levels.

Conclusion

For an endophytic echogenic mass in a female patient, a small size with an oval shape and an echogenic margin is statistically more likely to be an AML than an RCC, which may be helpful with management decisions.

目的评估肾小球癌的人口统计学特征和超声特征:这是一项符合《健康保险便携性和责任法案》(HIPAA)的回顾性研究,研究对象是内生性肾AML与一组内生性RCC的人口统计学和超声波特征。AML是通过计算机断层扫描(CT)或磁共振成像(MRI)确定宏观脂肪来确诊的,而RCC则是经病理证实的。统计分析用于比较两组患者的检查结果:结果:共有 66 例 AML 患者和 28 例 RCC 患者。在 66 例 AML 患者中,57 例为女性,而在 28 例 RCC 患者中,10 例为女性(P 结 论):就女性患者的内生性回声肿块而言,从统计学角度来看,体积小、呈椭圆形且边缘有回声的肿块更有可能是 AML,而不是 RCC,这可能有助于做出治疗决定。
{"title":"Predictors of Benignity for Small Endophytic Echogenic Renal Masses","authors":"Anthony F. Chen MD,&nbsp;Mary Le Dinh Getz MD,&nbsp;John P. McGahan MD, FACR,&nbsp;Machelle D. Wilson PhD,&nbsp;Michael C. Larson MD","doi":"10.1002/jum.16610","DOIUrl":"10.1002/jum.16610","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate for distinguishing demographic and sonographic features of small (&lt;3 cm) endophytic angiomyolipomas (AMLs) that differentiate them from endophytic renal cell carcinomas (RCCs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a Health Insurance Portablitiy and Accountablity Act (HIPAA)-compliant retrospective review of the demographics and ultrasound features of endophytic renal AMLs compared to a group of endophytic RCCs. AMLs were confirmed by identifying macroscopic fat on computed tomography (CT) or magnetic resonance imaging (MRI), while RCCs were pathologically proven. Statistical analysis was used to compare findings in the 2 groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were a total of 66 patients with 66 AMLs, and 28 patients with 28 RCCs. Of the AMLs, 57 of 66 were in females, while 10 of the 28 RCC cases were in females (<i>P</i> &lt; .0001). The mean AML long and short diameters were 11.0 × 9.3 mm and were statistically significantly smaller (<i>P</i> &lt; .0001) than the diameters of the RCCs (23.4 × 22.1 mm). Likewise, the ratio of the long axis to the short axis measurement was statistically significantly different between the 2 groups (<i>P</i> &lt; .0001). Of the studied sonographic features, statistically different features between AMLs and RCCs included an oval versus a round shape (<i>P</i> &lt; .001), respectively, and the presence versus absence of an echogenic margin, respectively. Location of the mass, mass homogeneity, mass lobulation, and presence of cystic components were not distinguishing features using <i>P</i> &lt; .01 levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>For an endophytic echogenic mass in a female patient, a small size with an oval shape and an echogenic margin is statistically more likely to be an AML than an RCC, which may be helpful with management decisions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 3","pages":"483-492"},"PeriodicalIF":2.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Journal of Ultrasound in Medicine
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