Journal of Ultrasound in Medicine最新文献

{"title":"Sample Size of Trials Investigating the Impact of Point-of-Care Ultrasound-Guided Strategies on Patient Outcomes: A Systematic Review.","authors":"William Beaubien-Souligny, Michel Gouin, Karel Huard","doi":"10.1002/jum.70001","DOIUrl":"https://doi.org/10.1002/jum.70001","url":null,"abstract":"<p><p>Point-of-care ultrasound (POCUS) is increasingly utilized for bedside diagnosis and management in diverse clinical contexts. However, the design of randomized controlled trials (RCTs) evaluating the impact of POCUS-guided strategies on clinical outcomes presents significant challenges. This study aims to explore the assumptions underlying sample size estimation in POCUS-guided trials and assess the adequacy of sample sizes in published trials through a systematic review. We performed a sample size analysis considering varying rates of POCUS-induced management changes and plausible effect sizes on binary and continuous patient-centered outcomes. Additionally, a systematic review of PubMed was conducted to identify RCTs comparing POCUS-guided management to usual care, extracting data on planned and actual sample sizes and justifications for sample size decisions. Sample size estimations revealed a substantial dependence on the proportion of participants experiencing management changes due to POCUS findings. For example, achieving adequate power in a trial with a moderate effect size requires over 1000 participants if POCUS alters management in 50% of cases. Our review included 25 RCTs, with a median sample size of 206 participants (interquartile range 122-250). Only 68% of trials reported sample size justifications, and 41% failed to meet planned recruitment targets, primarily due to recruitment challenges and other logistical barriers. Most trials investigating POCUS-guided strategies are underpowered, underscoring the need for realistic sample size estimations that consider the rate of POCUS-induced management changes and anticipated effect sizes. Future trials should incorporate pilot phases and innovative designs to optimize feasibility and power.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707943","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}

{"title":"Shear Wave Elastography and Magnetic Resonance Imaging in Predicting Breast Cancer Response to Neoadjuvant Chemotherapy.","authors":"Lixia Xu, Chengqiang Jin, Yanxia Jia","doi":"10.1002/jum.70008","DOIUrl":"https://doi.org/10.1002/jum.70008","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698912","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}

{"title":"AI in Breast Ultrasound: Purpose, Current Boundaries, and Future Directions.","authors":"Deniz Esin Tekcan Sanli, Ahmet Necati Sanli","doi":"10.1002/jum.70009","DOIUrl":"https://doi.org/10.1002/jum.70009","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690656","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}

{"title":"Evaluation of Hepatic Steatosis and Fibrosis in Steatotic Liver Disease Ultrasound-Derived Fat Fraction (UDFF) and Auto pSWE by Using Deep Abdominal Transducer (DAX) and Liver Biopsy Correlation.","authors":"Ahmet Burak Kale, Mustafa Faraşat, Gökhan Pekindil, Semin Ayhan, Serdar Tarhan, Tahir Buran","doi":"10.1002/jum.70005","DOIUrl":"https://doi.org/10.1002/jum.70005","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the diagnostic performance of ultrasound-derived fat fraction (UDFF) in detecting and grading hepatosteatosis using liver histology as the reference, and to assess the effectiveness of point shear wave elastography (pSWE), UDFF, and auto-pSWE in diagnosing steatohepatitis and detecting fibrosis in metabolic dysfunction-associated steatotic liver disease (MASLD).</p><p><strong>Methods: </strong>In this prospective study, patients underwent liver biopsy following UDFF and pSWE measurements using deep abdominal transducer (DAX) and conventional abdominal probes by 2 operators. Imaging findings were compared with histopathology to assess diagnostic performance. Associations between nonalcoholic fatty liver disease activity score (NAS), fibrosis stage, and imaging parameters were also evaluated.</p><p><strong>Results: </strong>A total of 121 patients were included. The median age was 50 years, and 57 (41%) were male. Histology confirmed steatotic liver disease in 43 cases. Excellent interobserver agreement was observed for UDFF (ICC = 0.974), pSWE (ICC = 0.958), and auto-pSWE (ICC = 0.960). UDFF showed a stepwise increase with steatosis grade and was moderately correlated with histological fat content (r = 0.676 for Sonographer 1, r = 0.638 for Sonographer 2; P < .001). For detecting S ≥ 1 steatosis, the optimal UDFF thresholds were ≥8.4% (Area Under the Curve (AUC) = 0.968; Se = 92.5%, Sp = 93.2%) for Sonographer 1 and ≥8.6% (AUC = 0.951; Se = 90.0%, Sp = 86.3%) for Sonographer 2. For moderate steatosis (S ≥ 2), the cutoffs were ≥10.4% (AUC = 0.932; Se = 100%, Sp = 79.6%) and ≥10.6% (AUC = 0.925; Se = 100%, Sp = 76.5%), and for severe steatosis (S = 3), ≥18.3% (AUC = 0.961; Se = 100%, Sp = 77.4%) and ≥18.7% (AUC = 0.949; Se = 100%, Sp = 77.4%) for Sonographer 1 and 2, respectively. UDFF positively correlated with body mass index and subcutaneous fat thickness, and negatively with both pSWE and auto-pSWE. A strong correlation was observed between pSWE and auto-pSWE for both observers. A weak positive correlation was found between NAS and auto-pSWE in MASLD cases. The optimal thresholds to detect fibrosis (≥F1) were 5.05 and 4.95 kPa for Sonographer 1, and 5.05 and 4.85 kPa for Sonographer 2, for pSWE and auto-pSWE measurements, respectively.</p><p><strong>Conclusion: </strong>DAX-derived UDFF and auto-pSWE are reproducible, noninvasive biomarkers with strong diagnostic value in assessing steatosis and fibrosis in MASLD.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690657","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}

{"title":"Exploring the Early Cardiovascular Dynamics in TOF Fetuses.","authors":"Kui Zhang, Sen Wang, Chengqiang Jin","doi":"10.1002/jum.70004","DOIUrl":"https://doi.org/10.1002/jum.70004","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690658","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}

{"title":"Refining the Use of CEUS in Adnexal Tumors: Diagnostic Parameters and Opportunities for Analytical Advancement.","authors":"Alvaro Martino Netto, Victor Arthur Ohannesian, Pedro Henrique Machado Carani, Guilherme Ciconelli Del Guerra, Miguel José Francisco Neto","doi":"10.1002/jum.70006","DOIUrl":"https://doi.org/10.1002/jum.70006","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667939","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}

{"title":"Lung Ultrasound in Pediatric and Neonatal Pre-Hospital Care: An Observational Study.","authors":"Judit Becerra-Hervás, Anna Solé-Ribalta, Mònica Girona-Alarcón, Roi Campos, Elena Fresán, Nuria Millán, Carme Alejandre, Elisabeth Esteban","doi":"10.1002/jum.16754","DOIUrl":"https://doi.org/10.1002/jum.16754","url":null,"abstract":"<p><strong>Objectives: </strong>The use of point-of-care ultrasound, particularly lung ultrasound (LUS), has grown in pediatric and neonatal intensive care units and also in pre-hospital settings. However, its application in pre-hospital care of pediatric population remains understudied. The objective of the study is to analyze the utility of the LUS in a Paediatric and Neonatal Transport Unit.</p><p><strong>Methods: </strong>This is a prospective observational study conducted in a specialized Paediatric and Neonatal advanced life support Transport Unit in Catalonia, Spain, between March 2021 and September 2023. Patients who underwent bedside LUS during stabilization or transfer for medical reasons were included. Epidemiologic variables, clinical data, transport-related data, and LUS-related data were recorded and analyzed.</p><p><strong>Results: </strong>During the study period, 2452 patients were transferred. In 89 (3.6%) LUS was performed. Seventy LUS were performed for respiratory distress or cyanosis, 50 of these were in neonatal patients in which transient tachypnea and meconium aspiration were the most frequent diagnoses. LUS was also used during hemodynamic assessment of unstable patients and during cardiac arrest resuscitation. Exactly 87.1% of LUS results were confirmed at the receiving hospital. LUS findings led to a change in patient management in 32 (35.9%) patients.</p><p><strong>Conclusions: </strong>The rational use of lung ultrasound performed by a pediatric and neonatal transport team can help in diagnostic orientation, management assessment, and improve patient safety.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642873","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}

{"title":"Yesterday's Pollution, Today's Technology: Can Ultrasound Detect Tissue Microplastics?","authors":"Ahmad Jasem Abdulsalam","doi":"10.1002/jum.70002","DOIUrl":"https://doi.org/10.1002/jum.70002","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642875","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}

{"title":"Super-Resolution Ultrasound Imaging of Renal Microcirculation in a Murine Model of Renal Fibrosis.","authors":"Yan Xu, Yi Luo, Mingyu Chen, Qinghai Peng, Chengcheng Niu","doi":"10.1002/jum.70003","DOIUrl":"https://doi.org/10.1002/jum.70003","url":null,"abstract":"<p><strong>Objectives: </strong>Peripheral kidney microvascular damage and chronic perfusion dysfunction in kidney fibrosis are demonstrated in most chronic kidney diseases. There is an urgent clinical need to develop an in vivo, noninvasive, and quantitative diagnostic tool to monitor the renal microcirculation. The present study aims to investigate the feasibility of super-resolution ultrasound (SRU) imaging in the visualization and quantification of renal microvascular and microcirculation in mice of unilateral ureteral obstruction (UUO).</p><p><strong>Methods: </strong>The SRU for renal micro-vessels imaging in healthy mice was performed and compared with conventional power Doppler ultrasound (US) and micro-computed tomography (CT). Renal fibrosis was prepared in vivo using UUO. B-mode, conventional power Doppler US, and SRU imaging were performed on the sham kidneys and UUO models at 3, 7, and 14 days. Then these kidneys were followed by histopathologic analysis and comparisons with SRU quantification parameters.</p><p><strong>Results: </strong>SRU helped to evaluate the function and structure of vessels in progressive renal disease via quantifying the renal microvascular. The quantitative parameters of SRU based on total blood flow of the kidney were calculated in the sham group, 3, 7, and 14 days after UUO. Renal cortical vessel density (r = 0.881), vessel curvature (r = -0.506), cortical perfusion index (PI) (r = 0.668) showed correlations with pathologically derived vessel density labeled with the expression of CD31. Vessel density (r = -0.615) and cortical curvature (r = -0.842), cortical PI (r = -0.508) also showed correlations with Masson's trichrome stain. Vessel curvature (r = -0.591) showed correlations with the expression of Col-1.</p><p><strong>Conclusion: </strong>SRU imaging provides the noninvasive, dynamic, and longitudinal monitoring of vessel functionality and can provide quantification of renal microvascular changes in a murine model of renal fibrosis.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642874","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}

{"title":"Color Doppler Ultrasound Pattern of Cutaneous Exosomes at High and Ultra-High Frequency.","authors":"Ximena Wortsman, Natacha Quezada","doi":"10.1002/jum.70000","DOIUrl":"https://doi.org/10.1002/jum.70000","url":null,"abstract":"<p><p>Exosomes are extracellular vesicles that play a crucial role in intercellular communication and are becoming an increasingly popular worldwide aesthetic procedure. To date, the ultrasound changes in the cutaneous layers generated by exosomes have not been reported. We present 3 cases that were ultrasonographically studied before and 3 months after the last exosome procedure, using high (24 MHz) and ultra-high (71 MHz) frequencies. The exosome regions were compared with the contralateral (non-treated) areas and adjacent tissues before and after application. Hyperechoic islets in the upper hypodermis and an increase in dermal vascularity were detected in these cases, forming a consistent pattern in the 3 cases at the exosome regions. This may be related to a mild degree of inflammation and neoangiogenesis in the treated regions. In 1 patient with alopecia, there was evidence of hair follicle growth at the exosome area. Further investigations are needed to examine the persistence of these changes over time and the impact of local trauma on the ultrasonographic abnormalities resulting from the application of these agents. The capability to identify ultrasonographic patterns in cutaneous exosomes may help discriminate them from abnormalities present in dermatologic diseases, particularly when patients do not provide a clear history, and monitor anatomical changes more objectively.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608701","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}