Priscila Giavedoni, Florencia Vera-Morandini, Irene Fuertes de Vega, Andrea Combalia, Carolina Fernández-Quiroga, Sebastián Podlipnik, Ximena Wortsman
{"title":"Cross-Sectional Analysis of Subclinical Findings Using High-Frequency Ultrasound in Frontal Fibrosing Alopecia.","authors":"Priscila Giavedoni, Florencia Vera-Morandini, Irene Fuertes de Vega, Andrea Combalia, Carolina Fernández-Quiroga, Sebastián Podlipnik, Ximena Wortsman","doi":"10.1002/jum.16751","DOIUrl":"https://doi.org/10.1002/jum.16751","url":null,"abstract":"<p><strong>Objectives: </strong>Frontal fibrosing alopecia (FFA) has a progressive course; quantifying changes at each visit can be complex. High-frequency ultrasound (HFUS) has been used to assess hair follicle morphology and scalp vascularization. The objectives of the study are to evaluate HFUS characteristics of patients with FFA and, secondarily, to study the usefulness of HFUS in assessing disease activity.</p><p><strong>Methods: </strong>Prospective study between January and June 2018. Patients with confirmed FFA were included. A retrospective analysis of HFUS imaging and its correlation with clinical presentation was performed.</p><p><strong>Results: </strong>Fifteen AFF female patients (median age: 65 years) met the study criteria. A total of 75 ultrasound images were analyzed. The atrophic region exhibited significant dermis thinning (0.7 mm; 0.3-1.2 mm range) compared to healthy sites. Frontal hair growth area showed reduced follicle number and miniaturization. HFUS Doppler ultrasound identified subclinical inflammation in 26.6% of patients.</p><p><strong>Conclusions: </strong>HFUS allows the characterization of FFA by quantitatively assessing dermal atrophy and the miniaturization and shrinkage of hair follicles. In addition, it allows the diagnosis of subclinical inflammation.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484836","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}
Yuning Zhao, Zhengchang Kou, Conn Louie, Rita J Miller, Gregory J Czarnota, Michael L Oelze
{"title":"Toward Real-Time Backscatter Coefficient Estimation Incorporating the U-Net Segmentation and an In Vivo Reference Target.","authors":"Yuning Zhao, Zhengchang Kou, Conn Louie, Rita J Miller, Gregory J Czarnota, Michael L Oelze","doi":"10.1002/jum.16750","DOIUrl":"https://doi.org/10.1002/jum.16750","url":null,"abstract":"<p><p>Quantitative ultrasound using spectral-based techniques, like the backscatter coefficient (BSC), have demonstrated capabilities for tumor characterization and therapy monitoring. The incorporation of an in situ calibration target, that is, a small titanium bead, can provide more consistent BSC estimates. For analyzing tumors, BSC estimation traditionally relies on manual tumor segmentation and calibration bead detection, a time-consuming and skill-dependent task. This study utilizes a U-Net model for automatic BSC estimation by integrating identification of a titanium calibration target embedded in rabbit mammary tumors with automatic segmentation, enabling real-time applications. The U-Net model demonstrated strong segmentation performance, achieving a Dice score of 0.86. Performance metrics demonstrated reliable BSC parameter estimation, with relative errors of 17.87% for effective scatter diameter (ESD) and 9.95% for effective attenuation concentration (EAC) when comparing automated segmentation to manual segmented tumors, highlighting its potential for accurate, real-time tumor diagnostics and therapy monitoring in clinical practice.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484837","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}
Danial Hosseinzadeh, Mohammad Barary, Mostafa Javanian, Ali Alizadeh Khatir, Soheil Ebrahimpour
{"title":"Commentary on \"Explore the Effect of Low-Intensity Focused Ultrasound on Pain Relief in Patients With Diabetic Peripheral Neuropathy\".","authors":"Danial Hosseinzadeh, Mohammad Barary, Mostafa Javanian, Ali Alizadeh Khatir, Soheil Ebrahimpour","doi":"10.1002/jum.16753","DOIUrl":"https://doi.org/10.1002/jum.16753","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475766","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":"Standardizing Safety Practices for Contrast Enhanced Ultrasound in Radiology.","authors":"Stephanie R Wilson, Jordan B Strom","doi":"10.1002/jum.16752","DOIUrl":"https://doi.org/10.1002/jum.16752","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475768","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}
Deniz Esin Tekcan Sanli, Ahmet Necati Sanli, Yildiz Buyukdereli Atadag, Atakan Kurt, Emel Esmerer
{"title":"GPT-4o and Specialized AI in Breast Ultrasound Imaging: A comparative Study on Accuracy, Agreement, Limitations, and Diagnostic Potential.","authors":"Deniz Esin Tekcan Sanli, Ahmet Necati Sanli, Yildiz Buyukdereli Atadag, Atakan Kurt, Emel Esmerer","doi":"10.1002/jum.16749","DOIUrl":"https://doi.org/10.1002/jum.16749","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the ability of ChatGPT and Breast Ultrasound Helper, a special ChatGPT-based subprogram trained on ultrasound image analysis, to analyze and differentiate benign and malignant breast lesions on ultrasound images.</p><p><strong>Methods: </strong>Ultrasound images of histopathologically confirmed breast cancer and fibroadenoma patients were read GPT-4o (the latest ChatGPT version) and Breast Ultrasound Helper (BUH), a tool from the \"Explore\" section of ChatGPT. Both were prompted in English using ACR BI-RADS Breast Ultrasound Lexicon criteria: lesion shape, orientation, margin, internal echo pattern, echogenicity, posterior acoustic features, microcalcifications or hyperechoic foci, perilesional hyperechoic rim, edema or architectural distortion, lesion size, and BI-RADS category. Two experienced radiologists evaluated the images and the responses of the programs in consensus. The outputs, BI-RADS category agreement, and benign/malignant discrimination were statistically compared.</p><p><strong>Results: </strong>A total of 232 ultrasound images were analyzed, of which 133 (57.3%) were malignant and 99 (42.7%) benign. In comparative analysis, BUH showed superior performance overall, with higher kappa values and statistically significant results across multiple features (P .001). However, the overall level of agreement with the radiologists' consensus for all features was similar for BUH (κ: 0.387-0.755) and GPT-4o (κ: 0.317-0.803). On the other hand, BI-RADS category agreement was slightly higher in GPT-4o than in BUH (69.4% versus 65.9%), but BUH was slightly more successful in distinguishing benign lesions from malignant lesions (65.9% versus 67.7%).</p><p><strong>Conclusions: </strong>Although both AI tools show moderate-good performance in ultrasound image analysis, their limited compatibility with radiologists' evaluations and BI-RADS categorization suggests that their clinical application in breast ultrasound interpretation is still early and unreliable.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475767","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":"Ultrasonographic Prevalence of Ring-Down Artifact in the Medial Elbow Joint Gap at the Valgus Position in Asymptomatic High School Baseball Players.","authors":"Yusuke Tsuihiji, Masashi Kawabata, Koki Minegishi, Yuto Sano, Ryuta Hiraoka, Koharu Mogi, Yuto Uchida, Yuto Watanabe, Hiroyoshi Masuma, Hiroyuki Watanabe, Tomonori Kenmoku, Naonobu Takahira","doi":"10.1002/jum.16748","DOIUrl":"10.1002/jum.16748","url":null,"abstract":"<p><strong>Objectives: </strong>Repetitive valgus stress during pitching in baseball can lead to medial elbow instability. Although ring-down artifact (RDA) has been considered an indicator of valgus instability, its pathological significance remains unclear. This study aimed to clarify RDA-positive rates and differences in valgus conditions in the medial elbow joint gap distance of asymptomatic high school baseball players.</p><p><strong>Methods: </strong>Sixty-nine high-school students underwent ultrasonography to visualize the medial elbow joint gap distance. Individuals with linear hyperechoic images in the medial elbow joint gap distance were classified as RDA-positive, while those without were classified as RDA-negative. Measurements were conducted under three conditions: at rest (nongravity condition), with gravity-induced forearm valgus load (gravity condition), and with a ball grip in addition to the gravity condition (ball-grip condition). McNemar's test was conducted to compare changes in RDA-positive rates within each group under the three conditions for the pitching and nonpitching sides. The Student t test was conducted to compare medial elbow joint gap distance in RDA-positive and negative groups under the gravity condition.</p><p><strong>Results: </strong>On the pitching side, RDA-positive rates significantly increased from 51.5% to 83.8% from nongravity condition to gravity condition and significantly decreased to 13.2% in ball-grip condition (P < .01). Similarly, on the nonpitching side, RDA-positive rates significantly increased from 44.1% to 55.9% between nongravity condition and gravity condition and significantly decreased to 14.7% in ball-grip condition (P < .01). RDA-positive rates were significantly higher on the pitching side than on the nonpitching side in gravity condition (P < .01). However, no significant differences were found in quantitative medial elbow joint gap distance between the RDA-positive (4.4 ± 0.9 mm) and RDA-negative groups (4.1 ± 0.9 mm) under gravity condition (P = .39).</p><p><strong>Conclusion: </strong>RDA-positive rates in asymptomatic high school baseball players increased under gravity condition and decreased under ball-grip condition, but no significant difference was observed in quantitative medial elbow joint gap distance between RDA-positive and -negative groups. As such, RDA positivity may not be a specific indicator of valgus instability in gravity condition.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336662","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}
Eric J Super, Marin S Smith, Matthew E Miller, Jay Smith, Xiaoning Yuan
{"title":"Ultrasonographic Assessment of Median Nerve and Carpal Tunnel Variations: Implications for the Interventional Management of Carpal Tunnel Syndrome.","authors":"Eric J Super, Marin S Smith, Matthew E Miller, Jay Smith, Xiaoning Yuan","doi":"10.1002/jum.16733","DOIUrl":"https://doi.org/10.1002/jum.16733","url":null,"abstract":"<p><strong>Objectives: </strong>Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy. Anatomic variations of the median nerve (MN) and carpal tunnel (CT) may predispose patients to CTS or increase procedural complexity and risk during carpal tunnel release (CTR). This study aimed to systematically evaluate the prevalence of 25 MN and CT anatomic variations and measurements using ultrasound (US) in patients referred for electrodiagnostic testing (EDX).</p><p><strong>Methods: </strong>In this cross-sectional observational study, patients underwent diagnostic US exams of the MN (mid-brachium to distal CT), focused on variant anatomy that may predispose to CTS (bifid MN, Gantzer's muscle, lumbrical intrusion) or increase procedural complexity/risk (transligamentous thenar motor branches [TMBs], MN orientation ulnar to the palmaris longus [PL] tendon).</p><p><strong>Results: </strong>Two hundred and twenty patients (mean age: 45.3 ± 13.0 years; 63.6% male; 294 UEs) were evaluated by US. Hundred and eight UEs met EDX criteria for CTS (EDX-CTS). The most common variations identified were lumbrical intrusion (81.3%), Gantzer's muscle (39.5%), and persistent median artery (22.8%), which were not associated with EDX-CTS. US revealed transligamentous (2.4%) and ulnar origin (4.5%) TMBs, which may increase injury risk during CTR. MN location was ulnar to the PL tendon in 70.4% of wrists, which can predispose to injury during landmark-guided CT injections.</p><p><strong>Conclusions: </strong>This study demonstrated that US complements EDX and can systematically identify anatomic variations, including variants at risk during CTS interventions. No differences in the prevalence of variations were detected between patients with and without EDX-CTS. Diagnostic US can support procedural planning, improve safety, and lower injury risk.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326159","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":"Ultrasound-Guided Triamcinolone Injections for Hidradenitis Suppurativa Lesions: A Systematic Review and Meta-Analysis.","authors":"Natalie Hickerson, Thao Kimmy Lam, Hadar Lev-Tov","doi":"10.1002/jum.16746","DOIUrl":"https://doi.org/10.1002/jum.16746","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the role of ultrasound (US) guidance in intralesional triamcinolone (TAC) injections for hidradenitis suppurativa (HS) lesions and assess its impact on injection technique, clinical response rates, and patient-reported outcomes.</p><p><strong>Methods: </strong>We conducted a systematic review of PubMed, Embase, and Cochrane databases from inception through October 2024. Studies that reported outcomes of US-guided TAC injections in patients with HS lesions (nodules, abscesses, or tunnels) were included. Data extraction included study design, lesion type, TAC concentration used, injection technique, clinical outcomes, and adverse events. Meta-analysis was performed to evaluate pooled clinical response rates, complete healing rates, and pain reduction. The protocol was registered on PROSPERO (CRD42024596593).</p><p><strong>Results: </strong>Six studies encompassing 313 patients and 527 lesions were included. The pooled clinical response rate was 80.5% across all lesion types, with highest rates observed for abscesses (96.4%) and nodules (93.4%). Complete clinical healing was achieved in 69.8% of lesions. Meta-analysis of pain outcomes from 3 studies demonstrated a significant reduction in mean pain scores (standardized mean difference: -0.57; 95% CI: [-0.76, -0.37]; P = .0013). Adverse events were rare (5.4%) and no severe complications were reported.</p><p><strong>Conclusions: </strong>US-guided TAC injections are a safe and potentially effective approach to treating HS lesions, particularly for complex or deep lesions. While preliminary data are promising, further randomized controlled studies are needed to directly compare outcomes with non-US-guided injections and to establish standardized protocols for injection technique.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326160","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":"Calibration and Prospective Validation Needed for AI-Assisted Thyroid Nodule Diagnosis.","authors":"Qi Xu, Xiaohui Chen","doi":"10.1002/jum.16744","DOIUrl":"https://doi.org/10.1002/jum.16744","url":null,"abstract":"","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317294","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}