Journal of Ultrasound in Medicine最新文献

{"title":"Quantitative Ultrasound Parameters as Predictors of Chemotherapy Toxicity in Lymphoma","authors":"Yang Sun MD,&nbsp;Jianqiu Huang MD,&nbsp;Jinhua Shao PhD,&nbsp;Jianwen Luo PhD,&nbsp;Qiong He PhD,&nbsp;Ligang Cui MD","doi":"10.1002/jum.16618","DOIUrl":"10.1002/jum.16618","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>QUS parameters show promise in characterizing muscle strength, mass, and quality. They are also independent factors influencing post-chemotherapy myelosuppression.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 3","pages":"545-555"},"PeriodicalIF":2.1,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647492","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":"Reliability of Semitendinosus and Biceps Femoris Aponeurosis Thickness Using B-Mode Ultrasound","authors":"Chrysostomos Sahinis PhD,&nbsp;Eleftherios Kellis PhD","doi":"10.1002/jum.16616","DOIUrl":"10.1002/jum.16616","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of the present study was to assess the reliability of aponeurosis and muscle thickness of the hamstrings using ultrasound (US).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 3","pages":"521-534"},"PeriodicalIF":2.1,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.16616","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622518","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}

{"title":"Methodology Used in Studies Aimed at Measuring Fetal Soft Tissues by 2D Ultrasound for the Screening of Large for Gestational Age Fetuses","authors":"Diego Lerma-Puertas PhD,&nbsp;Ana Aguerri MD,&nbsp;Gema Pardina MD,&nbsp;Cristina Paules PhD,&nbsp;David Lerma-Irureta MD,&nbsp;Daniel Oros PhD,&nbsp;Sara Ruiz-Martínez PhD","doi":"10.1002/jum.16614","DOIUrl":"10.1002/jum.16614","url":null,"abstract":"<p>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.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 3","pages":"365-379"},"PeriodicalIF":2.1,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622285","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":"Overview of Therapeutic Ultrasound Applications and Safety Considerations: 2024 Update","authors":"Kenneth B. Bader PhD,&nbsp;Frederic Padilla PhD,&nbsp;Kevin J. Haworth PhD,&nbsp;Nicholas Ellens PhD,&nbsp;Diane Dalecki PhD,&nbsp;Douglas L. Miller PhD,&nbsp;Keith A. Wear PhD,&nbsp;Bioeffects Committee of the American Institute of Ultrasound in Medicine","doi":"10.1002/jum.16611","DOIUrl":"10.1002/jum.16611","url":null,"abstract":"<p>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.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 3","pages":"381-433"},"PeriodicalIF":2.1,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.16611","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622422","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}

{"title":"Differentiating Closely Resembling Fetal Aortic Arch Abnormalities Using Conventional and Four-Dimensional Echocardiography","authors":"Balaganesh Karmegaraj MD, DM,&nbsp;Sowmya Vijayakumar MD","doi":"10.1002/jum.16615","DOIUrl":"10.1002/jum.16615","url":null,"abstract":"<p>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.</p>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 3","pages":"581-588"},"PeriodicalIF":2.1,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605687","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":"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}

{"title":"Three-Dimensional Volume Ultrasound Assessment of Cesarean Scar Niche and Cervix in Pregnant Women","authors":"Maria Ivan MBBS, MRCOG,&nbsp;Heba Mahdy MBBCH, DOWH, MRCPI,&nbsp;Amrita Banerjee MBBS, MRCOG,&nbsp;Amos Tetteh MBBS, MRCOG,&nbsp;Natalie Greenwold MD,&nbsp;Davide Casagrandi MD, MSc, MRCOG,&nbsp;Davor Jurkovic MD, FRCOG,&nbsp;Raffaele Napolitano MD, FRCOG,&nbsp;Anna L. David PhD, FRCOG","doi":"10.1002/jum.16613","DOIUrl":"10.1002/jum.16613","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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, <i>P</i> &lt; .05).</p>\u0000 \u0000 <p>The intraobserver ICC for niche volume was 0.94 (95% CI 0.90–0.96; <i>P</i> &lt; .001), with a mean difference of −15.32 mm³ (±109.32). The interobserver ICC was 0.78 (95% CI 0.62–0.87; <i>P</i> &lt; .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; <i>P</i> &lt; .001) and 0.79 (95% CI 0.63–0.87; <i>P</i> &lt; .001) for intra- and interobserver reproducibility, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 3","pages":"509-519"},"PeriodicalIF":2.1,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.16613","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605689","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}

{"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}

{"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}

{"title":"A Wearable, Steerable, Transcranial Low-Intensity Focused Ultrasound System","authors":"Christopher R. Bawiec PhD,&nbsp;Peter J. Hollender PhD,&nbsp;Sarah B. Ornellas BA,&nbsp;Jessica N. Schachtner BA,&nbsp;Jacob F. Dahill-Fuchel BA,&nbsp;Soren D. Konecky PhD,&nbsp;John J. B. Allen PhD","doi":"10.1002/jum.16600","DOIUrl":"10.1002/jum.16600","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Transcranial low-intensity focused ultrasound (LIFU) offers unique opportunities for precisely neuromodulating small and/or deep targets within the human brain, which may be useful for treating psychiatric and neurological disorders. This article presents a novel ultrasound system that delivers focused ultrasound through the forehead to anterior brain targets and evaluates its safety and usability in a volunteer study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The ultrasound system and workflow are described, including neuronavigation, LIFU planning, and ultrasound delivery components. Its capabilities are analyzed through simulations and experiments in water to establish its safe steering range. A cohort of 20 healthy volunteers received a LIFU protocol aimed at the anterior medial prefrontal cortex (amPFC), using imaging and questionnaires to screen for adverse effects. Additional development after the study also analyzes the effect of the skull and sinus cavities on delivered ultrasound energy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Simulations and hydrophone readings agreed with &lt;5% error, and the safe steering range was found to encompass a 1.8 cm × 2.5 cm × 2 cm volume centered at a depth 5 cm from the surface of the skin. There were no adverse effects evident on qualitative assessments, nor any signs of damage in susceptibility-weighted imaging scans. All participants tolerated the treatment well. The interface effectively enabled the users to complete the workflow with all participants. In particular, the amPFC of every participant was within the steering limits of the system. A post hoc analysis showed that “virtual fitting” could aid in steering the beams around subjects' sinuses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The presented system safely delivered LIFU through the forehead while targeting the amPFC in all volunteers, and was well-tolerated. With the capabilities validated here and positive results of the study, this technology appears well-suited to explore LIFU's efficacy in clinical neuromodulation contexts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 2","pages":"239-261"},"PeriodicalIF":2.1,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502994","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}