Ultrasound in Medicine and Biology最新文献

{"title":"The Geometric Dependence of Wave Velocity in Carotid Arteries: Phantom and Finite Element Study and Implications for Vascular \"Shear Wave\" Elastography.","authors":"Charles B Capron, Tuhin Roy, Shuvrodeb Adhikary, Murthy N Guddati, Matthew W Urban","doi":"10.1016/j.ultrasmedbio.2025.06.012","DOIUrl":"https://doi.org/10.1016/j.ultrasmedbio.2025.06.012","url":null,"abstract":"<p><strong>Objective: </strong>The intrinsic elasticity and the structural stiffness of blood vessels are widely regarded as important biomarkers for prediction of cardiovascular disease risk, the leading cause of death worldwide. Ultrasound-based shear wave elastography (SWE) has been used to measure these properties in several clinical studies. However, the geometric properties of blood vessels complicate the relationship between wave speed and elasticity in blood vessels compared to bulk tissue. Here we quantify these effects with a semi-analytical finite element (SAFE) model and ultrasound experiments and discuss their implications for the vascular \"shear wave\" (better described as \"guided wave\") elastography literature.</p><p><strong>Methods: </strong>A previously developed SAFE model was employed to simulate wave propagation after insonification with an acoustic radiation force (ARF) in 4,437 combinations of vascular geometry and elasticity. Group velocities were extracted and underwent processing analogous to what a SWE-equipped ultrasound scanner would perform to estimate Young's modulus (E=3ρC_s²), and were compared to the true Young's modulus used in the simulation. Additionally, 23 polyvinyl alcohol cryogel tubes of different geometries and elasticities were constructed and underwent ARF-based SWE and reference inflation-based mechanical testing. Wave speeds were converted to Young's modulus using the same method as in the finite element study and were compared with the Young's modulus obtained from mechanical testing.</p><p><strong>Results: </strong>Both the SAFE simulations and PVA tube ultrasound experiments confirm the dependence of wave speed on vascular geometry which leads to a severe, geometry-dependent underestimation of Young's modulus if geometry is not considered. We identify and discuss 11 recent papers that have used clinical ultrasound systems to measure elasticity in common carotid arteries and argue that geometry (distinct from elasticity) may have contributed to differences in scanner-reported elasticities between groups in some cases.</p>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-Intensity Focused Ultrasound (HIFU) in Pancreatic Cancer-Related Pain: Current Evidence and Future Directions.","authors":"Ying Liu, Minhan Chen, Li Liu, Zhongmin Shen, Bo Wu","doi":"10.1016/j.ultrasmedbio.2025.05.032","DOIUrl":"https://doi.org/10.1016/j.ultrasmedbio.2025.05.032","url":null,"abstract":"<p><p>Pancreatic cancer is a highly malignant gastrointestinal tumor, frequently accompanied by severe cancer-related pain that significantly diminishes patients' quality of life. High-intensity focused ultrasound (HIFU), a non-invasive therapeutic modality, alleviates cancer pain through multiple mechanisms, including the induction of coagulative necrosis through rapid temperature elevation in targeted tissues, disruption of nerve fibers within the tumor microenvironment, and modulation of inflammatory factor release. In combination therapy, HIFU can be integrated with radiotherapy, chemotherapy and immunotherapy to enhance therapeutic efficacy and potentially delay disease progression. However, HIFU treatment is associated with certain adverse effects, including skin burns, pancreatitis, and damage to adjacent organs. Most of these adverse reactions are mild, self-limiting, and do not require specific medical intervention, with no reported fatal cases. Despite its favorable safety profile, meticulous patient selection and optimization of treatment parameters remain crucial. Compared to conventional treatment modalities, HIFU offers several advantages, such as noninvasiveness, repeatability, short recovery time, and precise targeting. However, challenges persist, including limitations in imaging accuracy, treatment zone delineation, and the development of personalized treatment protocols. Future advances that integrate sophisticated imaging guidance and precise energy modulation are expected to further enhance the efficacy of HIFU in alleviating pancreatic cancer related pain, thereby providing a promising therapeutic strategy in clinical practice.</p>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound Radiomics Correlating With Clinical Markers for Enhanced Detection of Placenta Accreta Spectrum.","authors":"Dylan Young, Naimul Khan, Sebastian R Hobson, Dafna Sussman","doi":"10.1016/j.ultrasmedbio.2025.06.018","DOIUrl":"https://doi.org/10.1016/j.ultrasmedbio.2025.06.018","url":null,"abstract":"<p><strong>Objectives: </strong>(i) To develop an accurate and robust ultrasound-based quantitative index for placenta accreta spectrum (PAS) diagnosis by amalgamating texture features from B-mode and color Doppler imaging. (ii) To test the correlation of this index with established sonographic markers for PAS.</p><p><strong>Methods: </strong>In this retrospective study, we collected 2106 texture features extracted from the midsagittal placental view of mid-trimester B-mode and Doppler ultrasound images. These images were acquired during ultrasound examinations conducted between 24 and 34 wk gestation from patients diagnosed with placenta previa and at least one prior uterine surgery risk factor for PAS at a tertiary center in Toronto, Canada. Three distinct models were developed: one using B-mode data (n = 174), another using color Doppler data (n = 98), and a third integrating both modalities (n = 98). Integrated features, derived from weighted z-scores, were employed to generate a quantitative index for detecting PAS. A feature selection pipeline was implemented, combining linear discriminant analysis, extra trees regression and recursive feature elimination. The pipeline identified 15-feature subsets for both B-mode and Doppler models, and a 20-feature subset for the multimodal model, both of which were used for training. The predictive performance of each model (presence/absence of PAS) was assessed using five-fold cross-validation and tested on a separate hold-out test set. Subsequently, the optimized quantitative metrics were examined for any statistically significant correlations with established sonographic clinical markers.</p><p><strong>Results: </strong>The five-fold cross-validation accuracies across the developed B-mode, color Doppler and multimodal models were 88.7% (±5.3), 85.1% (±9.1) and 90% (±6.7), respectively. All eight of the clinical disease markers evaluated from each ultrasound image were determined to be discriminative of the quantitative index generated from B-mode and multimodal models, and six of the eight markers were discriminative of the index generated from Doppler alone.</p><p><strong>Conclusion: </strong>Combined B-mode and Doppler ultrasound-based radiomics can accurately detect PAS in patients with placenta previa and provide a surgical risk factor for PAS using simple and computationally inexpensive operations. The rank correlations between B-mode and color Doppler quantitative indices and their corresponding clinical markers highlight that this multimodal approach captures crucial diagnostic information that may be missed by individual models. All models exhibit notably higher accuracy than projected clinical standards and suggest their potential as aids for clinical decision-making at routine mid-trimester scans.</p>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Flow Turbulence Measured by High-frame-rate Vector Flow Imaging Conduced to Investigating Advanced Carotid Plaque Vulnerability.","authors":"Ya-Chao Zhao, Yi-Ming He, Fei Wang, Ming-Jun Xu, Da Zhang, Dong-Hai Wang, Mei Zhang","doi":"10.1016/j.ultrasmedbio.2025.05.034","DOIUrl":"https://doi.org/10.1016/j.ultrasmedbio.2025.05.034","url":null,"abstract":"<p><strong>Objective: </strong>The high-frame-rate vector flow imaging (V Flow) technique is a simple, practical and feasible quantitative imaging method for detecting hemodynamic parameters of peripheral arteries in healthy people and patients with low carotid stenosis. However, whether V Flow can be used to assess hemodynamic parameters in patients with severe carotid stenosis remains to be illustrated. We sought to investigate the relationship between V Flow-evaluated hemodynamic parameters of advanced carotid stenosis and plaque composition and its value in assessing plaque vulnerability.</p><p><strong>Methods: </strong>Patients undergoing carotid endarterectomy and ultrasound examination were collected, and plaque characteristics were graded on simple semiquantitative scales. Correlations between the turbulence index (Tur) and wall shear stress (WSS) in different parts of plaque and plaque components were analyzed. Receiver operating characteristic curves were used to analyze values of ultrasonic parameters in investigating plaque vulnerability.</p><p><strong>Results: </strong>Tur was more severe in vulnerable plaque than in stable plaque (35.99 ± 26.17 vs 7.82 ± 8.41; p < 0.001). Plaques with severe Tur showed more intraplaque hemorrhage, thrombus, and thinner fibrous cap thickness (p < 0.05 for all). At the upstream sides of carotid stenosis, plaque with a lower mean WSS (meanWSS_upstream) was associated with decreased fibrous tissue (p = 0.022). At the peak of carotid stenosis, meanWSS (meanWSS_peak) was higher in the plaques with intraplaque hemorrhage (p = 0.028) and intraplaque neovascularization (p = 0.037). Plaques with a higher oscillatory shear index of WSS had fewer lipid core (p = 0.029) thinner fibrous cap thicknesses (p = 0.004) and more intraplaque neovascularization (p = 0.032). The areas under the curves of carotid intima-media thickness, total plaque area (TPA), Tur, MeanWSS_upstream, MaxWSS_peak, MeanWSS_peak, model 1, model 5 and model 6 for predicting plaque vulnerability were 0.804 (95% confidence interval [CI], 0.650-0.911), 0.886 (95% CI, 0.748-0.964), 0.843 (95% CI, 0.695-0.937), 0.733 (95% CI, 0.571-0.858), 0.677 (95% CI, 0.514-0.815), 0.672 (95% CI, 0.508-0.811), 0.895 (95% CI, 0.759-0.969), 0.973 (95% CI, 0.867-0.999) and 0.930 (95% CI, 0.805-0.986).</p><p><strong>Conclusion: </strong>V Flow-detected hemodynamic parameters were related to plaque components and plaque vulnerability. V Flow has the potential to be an effective tool for investigating patients with severe carotid plaque.</p>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic Tibial Neuropathy Prediction: Improving interpretability of Various Machine-Learning Models Based on Multimodal-Ultrasound Features Using SHAP Methodology.","authors":"Yanqiu Chen, Zhen Sun, Huohu Zhong, Yuwei Chen, Xiuming Wu, Liyang Su, Zhenhan Lai, Tao Zheng, Guorong Lyu, Qichen Su","doi":"10.1016/j.ultrasmedbio.2025.06.016","DOIUrl":"https://doi.org/10.1016/j.ultrasmedbio.2025.06.016","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop and evaluate eight machine learning models based on multimodal ultrasound to precisely predict of diabetic tibial neuropathy (DTN) in patients. Additionally, the SHapley Additive exPlanations(SHAP)framework was introduced to quantify the importance of each feature variable, providing a precise and noninvasive assessment tool for DTN patients, optimizing clinical management strategies, and enhancing patient prognosis.</p><p><strong>Methods: </strong>A prospective analysis was conducted using multimodal ultrasound and clinical data from 255 suspected DTN patients who visited the Second Affiliated Hospital of Fujian Medical University between January 2024 and November 2024. Key features were selected using Least Absolute Shrinkage and Selection Operator (LASSO) regression. Predictive models were constructed using Extreme Gradient Boosting (XGB), Logistic Regression, Support Vector Machines, k-Nearest Neighbors, Random Forest, Decision Tree, Naïve Bayes, and Neural Network. The SHAP method was employed to refine model interpretability. Furthermore, in order to verify the generalization degree of the model, this study also collected 135 patients from three other tertiary hospitals for external test.</p><p><strong>Results: </strong>LASSO regression identified Echo intensity(EI), Cross-sectional area (CSA), Mean elasticity value(Emean), Superb microvascular imaging(SMI), and History of smoking were key features for DTN prediction. The XGB model achieved an Area Under the Curve (AUC) of 0.94, 0.83 and 0.79 in the training, internal test and external test sets, respectively. SHAP analysis highlighted the ranking significance of EI, CSA, Emean, SMI, and History of smoking. Personalized prediction explanations provided by theSHAP values demonstrated the contribution of each feature to the final prediction, and enhancing model interpretability. Furthermore, decision plots depicted how different features influenced mispredictions, thereby facilitating further model optimization or feature adjustment.</p><p><strong>Conclusion: </strong>This study proposed a DTN prediction model based on machine-learning algorithms applied to multimodal ultrasound data. The results indicated the superior performance of the XGB model and its interpretability was enhanced using SHAP analysis. This cost-effective and user-friendly approach provides potential support for personalized treatment and precision medicine for DTN.</p>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focused Ultrasound Enhances Glymphatic Transport Robustly Across Anesthesia Levels.","authors":"Haijun Xiao, Abhijith Sreejith, Iylan Howson, Alexander Aviles Cruz, Taylor Key, Jeffrey J Iliff, Muna Aryal","doi":"10.1016/j.ultrasmedbio.2025.06.009","DOIUrl":"https://doi.org/10.1016/j.ultrasmedbio.2025.06.009","url":null,"abstract":"<p><strong>Objective: </strong>We recently discovered that low-intensity transcranial focused ultrasound (FUS) can enhance glymphatic influx, the process by which the brain clears metabolic waste, in a rat model. The hypothesis is that ultrasound influences convective forces from arterial pulsations, aiding glymphatic transport. The initial study was conducted under approximately 2.5% isoflurane anesthesia, but it remains unclear how different anesthesia levels affect ultrasonic glymphatic influx as glymphatic function varies with physiological states. Hence, establishing standardized protocols for ultrasonic enhancement of glymphatic influx is crucial for ensuring consistent, reliable results across research labs during preclinical development. We aimed to investigate how different levels of isoflurane anesthesia affect ultrasonic enhancement of glymphatic influx for a model tracer.</p><p><strong>Methods: </strong>FUS (650 kHz, 0.2 MPa, duty cycle 7.7%, brain-wide for 10 min) was applied to rats under anesthesia levels ranging from 1.5% to 3.0%. A model tracer, 1 kDa-IRDye800 was used to assess glymphatic influx in ex-vivo brain.</p><p><strong>Results: </strong>Results demonstrated a significant main effect of FUS treatment (p = 7.70 × 10⁻⁷), indicating that FUS significantly enhanced glymphatic transport acoss all anesthesia levels. Anesthesia level also had a significant effect on glymphatic clearance (p = 7.45 × 10⁻¹¹), consistent with prior reports linking anesthetic depth to cerebrospinal fluid dynamics. However, the interaction between treatment and anesthesia was not statistically significant (p = 0.106), suggesting that the efficacy of FUS was consistent across anesthesia levels.</p><p><strong>Conclusion: </strong>These findings support the robustness of brain-wide FUS-induced glymphatic enhancement and highlight its potential as a modifiable therapeutic tool, independent of anesthetic conditions.</p>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Shear Wave Elastography for Morphofunctional Analysis of Abdominal Muscles: A Scoping Review.","authors":"Sara Cañamero-de León, Mercedes Soto-González, Iria Da Cuña-Carrera, Augusto Gil Pascoal","doi":"10.1016/j.ultrasmedbio.2025.04.016","DOIUrl":"https://doi.org/10.1016/j.ultrasmedbio.2025.04.016","url":null,"abstract":"<p><p>This scoping review evaluates current research on the use of Shear Wave Elastography (SWE) in analyzing abdominal muscles, specifically the transversus abdominis, oblique muscles, and rectus abdominis. SWE is an advanced ultrasound technique that assesses tissue mechanical properties, offering detailed insights into tissue stiffness. Following PRISMA-ScR guidelines, the review included peer-reviewed studies on SWE of abdominal muscles in adults, excluding case studies, reviews, and studies on postmortem subjects or on non-abdominal tissues. A comprehensive search was conducted in PubMed, Medline, SPORTDiscus, Scopus, Web of Science, and Cinahl in April 2024, followed by a rigorous selection process involving two independent reviewers and a third reviewer to resolve discrepancies. Data extraction focused on study design, population characteristics, SWE methodology, and outcomes. The review included 27 studies. Out of these 27 studies, 11 were selected. The stiffness of the transversus abdominis at rest showed great variability, with propagation speeds ranging from 1.45 m/s to 2.3 m/s, being lower in healthy individuals compared to those with pathologies. The resting SWE values for the obliques were more homogeneous: between 1.40 and 1.54 m/s for the internal oblique and from 1.79 to 1.89 m/s for the external oblique in healthy adults, which increased in active individuals. For the rectus abdominis, the resting SWE values ranged from 1.61 m/s in women to 2.07 m/s in active young individuals. Although SWE is a relatively new technique for tissue assessment and there is no standard reference for the values obtained, its use in the study of abdominal musculature is promising, offering a non-invasive view of muscle stiffness. This review has identified several limitations, such as the lack of standardization in methodology, variability in the populations studied, and technical considerations that affect the measurements accuracy.</p>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiparametric ultrasound evaluation of metabolic dysfunction-associated fatty liver disease in minipigs.","authors":"Georges Chabouh, Basile Pradier, Louise Denis, Rached Baida, Vincent Hingot, Arthur Chavignon, Sylvain Bodard, Ludovic Lessage, Aurélie Helbert, Angélique Brzustowski, Dominique Valla, Valerie Duvivier, Edwige Balzac, Tania Baltauss, Philippe Delerive, Valerie Paradis, Catherine Postic, Sebastien Salles, Olivier Couture","doi":"10.1016/j.ultrasmedbio.2025.06.011","DOIUrl":"https://doi.org/10.1016/j.ultrasmedbio.2025.06.011","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to quantitatively assess hepatic steatosis using multiparametric 2-D ultrasound techniques in a choline-deficient high-fat diet minipig model, comparing the results with histological analysis at two time points.</p><p><strong>Methods: </strong>Quantitative ultrasound (QUS) such as attenuation coefficient, backscatter ratio and speed of sound estimation, shear wave elastography and ultrasound localization microscopy, was performed on 17 minipigs. Histological analysis served as the ground truth.</p><p><strong>Results: </strong>The results demonstrate that both the attenuation coefficient and backscatter ratio effectively detected hepatic steatosis, showing significantly higher values in steatotic compared with non-steatotic livers, consistent with findings in human and animal studies. However, speed of sound estimation measurements did not show any significant differences. shear wave elastography measurements were correlated with fibrosis at higher grades. Ultrasound localization microscopy, with its technical challenges, did not reveal significant hemodynamic changes or allow discrimination between steatosis groups.</p><p><strong>Conclusion: </strong>Our study highlights the potential of multiparametric QUS for comprehensive liver assessment, although challenges remain, particularly in ultrasound localization microscopy techniques. Future research should focus on improving motion correction and developing automatic data-processing methods. The combination of QUS parameters could offer a more nuanced understanding of liver disease, paving the way for a non-invasive, multiparametric diagnostic approach akin to magnetic resonance imaging radiomics.</p>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified CEUS LI-RADS With Perfluorobutane in Patients at High-Risk for Hepatocellular Carcinoma: A Systematic Review and Network Meta-Analysis.","authors":"Jifan Chen, Jianing Zhu, Jiaxing Shen, Yuhan Fu, Fei Gao, Jing Wang, Peile Jin, Tao Lin, Yang Sun, Qiu Chen, Ying Zhang, Guowei Wang, Chao Zhang, Jianhua Zhou, Xiang Jing, Pintong Huang","doi":"10.1016/j.ultrasmedbio.2025.05.024","DOIUrl":"https://doi.org/10.1016/j.ultrasmedbio.2025.05.024","url":null,"abstract":"<p><p>Contrast-enhanced Ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) 2017 version is based on pure-blood pool contrast agent, potentially unsuitable for perfluorobutane contrast agent with the Kupffer phase. This article aimed to compare the diagnostic performance of unmodified CEUS LI-RADS and modified CEUS LI-RADS using perfluorobutane for hepatocellular carcinoma by integrating published and original data from three medical centers. Comparison between unmodified and modified CEUS LI-RADS with perfluorobutane involved ranking the diagnostic odds ratio (DOR) and superiority index (SI) using an ANOVA arm-based model. This meta-analysis included nine studies and our original data, encompassing 1505 patients with 1622 lesions. The summarized sensitivity of the modified CEUS LI-RADS was higher than that of the unmodified version (0.77 [0.72-0.81] vs. 0.70 [0.63-0.76]), while specificity was similar for both (0.86 [0.78-0.91] vs. 0.86 [0.77-0.92]). The general diagnostic performance of the modified CEUS LI-RADS was superior to the unmodified version, indicated by a higher DOR (16.98 [11.65-23.43] vs. 12.51 [8.11-18.44], p = 0.02) and SI (1.59 [1.00-3.00] vs. 0.80 [0.33-1.00], p = 0.02). Modified CEUS LI-RADS may be of better diagnostic performance, offering higher sensitivity without compromising specificity.</p>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"UTMD Enhances Targeting of Diclofenac and Doxil® to Boost Tumor Immunotherapy.","authors":"Jie Huang, Qian Hu, XiangMin Zhang, XiaoYing Ni, JinHua Cai","doi":"10.1016/j.ultrasmedbio.2025.06.010","DOIUrl":"https://doi.org/10.1016/j.ultrasmedbio.2025.06.010","url":null,"abstract":"<p><strong>Objective: </strong>The tumor immune microenvironment (TIME) limits antitumor therapy efficacy. Improving TIME enhances immune responses and improves drug effectiveness. The study designed nanobubble-encapsulated diclofenac (DNBs) and used ultrasound-targeted microbubble destruction (UTMD), referred to as DNBs-UTMD, to improve TIME and enhancing the efficacy of Doxil®.</p><p><strong>Methods: </strong>DNBs were characterized using scanning electron microscope and particle size analysis. Encapsulation efficiency and loading capacity were measured via spectro-photometry. Cell activity was evaluated by CCK-8 assays. Lactate concentrations by lactate detection kit, extracellular pH were measured by pH meter, and flow cytometry assessed Doxil® uptake, M2 tumor-associated macrophages (M2), myeloid-derived suppressor cells (MDSCs), CD8+ cells and CD4+ T cells.</p><p><strong>Results: </strong>DNBs had an average size of 331.6 nm, a zeta potential of 15.9 mV, and smooth spherical morphology. Encapsulation efficiency of 12.6% and loading capacity of 24.75%. DNBs-UTMD promoted Doxil® uptake, inhibited lactate secretion, and improved the acidic microenvironment. DNBs-UTMD reduces the proportion of immune-suppressive cells, with M2 of 22% and MDSCs of 5.3%. In addition, combination therapy group of Doxil ® + DNBs-UTMD reduced cell viability to 31%, with CD8+T cells of 51.1% and CD4+T cells of 24.1%, developing a synergistic anti-tumor effect.</p><p><strong>Conclusion: </strong>DNBs-UTMD regulates TIME and alleviates immune suppression (M2 and MDSCs ↓) by improving the acidic tumor microenvironment. DNBs-UTMD also can promote cellular uptake of Doxil® and enhance T cell response (CD8+T cells and CD4+T cells ↑) to exert synergistic therapeutic effects.</p>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}