Ultrasound in Medicine and Biology最新文献

{"title":"Sonosensitizers for Sonodynamic Therapy: Current Progress and Future Perspectives","authors":"Ting Wang ,&nbsp;Meng Du ,&nbsp;Zhiyi Chen","doi":"10.1016/j.ultrasmedbio.2025.01.011","DOIUrl":"10.1016/j.ultrasmedbio.2025.01.011","url":null,"abstract":"<div><div>Sonodynamic therapy (SDT) is a novel non-invasive treatment method that combines low-intensity ultrasound and sonosensitizers. Compared with photodynamic therapy, SDT has the advantages of deeper tissue penetration, higher accuracy and fewer adverse reactions. Sonosensitizers are essential for the efficacy of SDT. Sonosensitizers have the advantages of clear structure, easy monitoring, evaluation of drug metabolism and clinical transformation, etc. Notably, biochemical techniques can be used in the field of sonosensitizers and SDT to overcome inherent barriers and achieve sustainable innovation. This article first summarizes the molecular mechanism of SDT, focusing on organic sonosensitizers, inorganic nano-sonosensitizers and multi-functional drug delivery systems with targeting, penetration and imaging functions after a series of modifications. This review provides ideas and references for the design of sonosensitizers and SDT and promotes their future transformation into clinical applications.</div></div>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":"51 5","pages":"Pages 727-734"},"PeriodicalIF":2.4,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256961","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":"Low-Intensity Ultrasound Facilitation of Intranasal Drug Delivery to Olfactory Bulb and Trigeminal Nerves","authors":"Meng-Ting Lin ,&nbsp;Tsai-Yun Chan ,&nbsp;Wei-Hao Liao ,&nbsp;Chueh-Hung Wu ,&nbsp;Tai-Horng Young ,&nbsp;Wen-Shiang Chen","doi":"10.1016/j.ultrasmedbio.2025.01.003","DOIUrl":"10.1016/j.ultrasmedbio.2025.01.003","url":null,"abstract":"<div><h3>Objective</h3><div>Nasal-to-brain (NtoB) delivery is a noninvasive approach that uses the nasal cavity as a pathway to transport therapeutic agents directly to the brain. This approach bypasses systemic circulation and avoids the blood-brain barrier (BBB). Transcranial ultrasound, coupled with microbubbles (MB), is a technique used to oscillate and generate acoustic cavitation to open the capillary tight junctions of BBB temporarily. Its efficacy in facilitating NtoB delivery has been demonstrated in vivo. However, while opening the BBB, sonication with MB poses the risk of cerebral microhemorrhage or brain tissue damage due to sonication-induced physical injury. This study aimed to assess the effectiveness of low-intensity ultrasound treatment to facilitate NtoB delivery in a mouse model without using MB.</div></div><div><h3>Methods</h3><div>In this study, 10-kDa dextran was administered intranasally (IN), and transcranial planar US was applied to the entire mouse brain without MB assistance. Ex-vivo whole brain imaging via fluorescence macroscopy, brain slice analysis with fluorescence microscope, and quantification of dextran concentration in distinct brain regions were conducted to compare the IN-only, IN combined with US (IN+US), and sham groups. For the trigeminal nerves (TN), fluorescence macroscopy, microscopy, and TN concentration quantification were performed to compare the three groups.</div></div><div><h3>Results</h3><div>Whole brain imaging revealed that US facilitated the IN delivery of dextran to the olfactory bulb (OB) in the IN+US group compared with that in the IN-only and sham groups; however, this difference was not observed after a 24 h follow-up. Conversely, brain slice images showed that the tracer was delivered to the OB, cerebral cortex, striatum and brainstem in the IN+US group, but this finding was not observed in the IN-only group at the 4 h mark. The quantification of fluorescence intensity at two follow-up time points revealed no significant difference between the IN and IN+US groups in these specific regions. Dextran concentration analysis for distinct brain areas and TN showed that ultrasound significantly increased the tracer concentration delivered to the OB and TN in the IN+US group at the 4 h mark compared with that in the IN-only and sham groups; however, this effect was not sustained at 24 h. Confocal microscopy indicated that the dextran tracer accumulated in the perivascular space along the microvascular structures.</div></div><div><h3>Conclusion</h3><div>We demonstrated the efficacy of low-intensity ultrasound without using MB, in enhancing nose-to-OB and nose-to-TN drug delivery, and proposed the potential for future clinical application. Thus, we showed that this approach was safe, without evidence of microhemorrhage or brain tissue damage.</div></div>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":"51 5","pages":"Pages 788-796"},"PeriodicalIF":2.4,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081819","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":"Application of B+M-Mode Ultrasound in Evaluating Dysphagia in Elderly Stroke Patients","authors":"Jiaying Shuai ,&nbsp;Linping Pian ,&nbsp;Li Tian ,&nbsp;Linying Wang ,&nbsp;Miaomiao Deng ,&nbsp;Chen Cheng","doi":"10.1016/j.ultrasmedbio.2024.10.001","DOIUrl":"10.1016/j.ultrasmedbio.2024.10.001","url":null,"abstract":"<div><h3>Objective</h3><div>The purpose of this study was to evaluate and compare the swallow-related muscles and bones movement patterns during swallowing quantitatively by B+M-mode ultrasound, and to investigate its application value in dysphagia.</div></div><div><h3>Methods</h3><div>Sixty elderly stroke patients with dysphagia (patient group) and sixty healthy elderly individuals (control group) were enrolled in this study. M-mode ultrasound was utilized to measure the radial displacement and duration of tongue and geniohyoid muscle movements. B-mode ultrasound was employed to assess hyoid bone displacement and the distance of hyoid-larynx approximation. Ultrasound parameters were compared between the two groups. Logistic regression was used to identify the optimal parameters with independent predictive value. The predictive efficacy of each parameter for dysphagia was evaluated using ROC curve analysis.</div></div><div><h3>Results</h3><div>Both intraindividual and interindividual variations were observed in the B+M-mode imaging traces during the three swallows. Significant differences were found in the average radial displacement and duration of tongue and geniohyoid muscle movements, hyoid bone displacement, and hyoid-larynx approximation distance between the two groups (all <em>p</em> &lt; 0.001). The radial displacement of the tongue and geniohyoid muscle, hyoid bone displacement, and hyoid-larynx approximation distance were lower in the patient group compared to the control group, while the duration of tongue and geniohyoid muscle movements was higher in the patient group. Logistic regression selected the radial displacement of the tongue, the duration of geniohyoid muscle movement, and the hyoid-larynx approximation distance as significant predictors. The combined model demonstrated excellent predictive performance with an AUC of 0.994 and good model fit (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The B+M-mode ultrasound offers a rapid and safe technique for the preliminary evaluation of swallowing movements. It can serve as a quantitative and noninvasive method for the clinical screening of dysphagia.</div></div>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":"51 2","pages":"Pages 273-279"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607159","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":"Dyssynchronous Fetal Heart Failure in Maternal Diabetes: Evaluation with Speckle Tracking Echocardiography and Novel M-Mode Software","authors":"Theresa M. Kühle ,&nbsp;Angela Burgmair ,&nbsp;Georg Schummers ,&nbsp;Mareike Möllers ,&nbsp;Kathrin Oelmeier ,&nbsp;Chiara De Santis ,&nbsp;Helen Ann Köster ,&nbsp;Ute Möllmann ,&nbsp;Daniela Willy ,&nbsp;Janina Braun ,&nbsp;Felix Albert ,&nbsp;Ralf Schmitz","doi":"10.1016/j.ultrasmedbio.2024.10.004","DOIUrl":"10.1016/j.ultrasmedbio.2024.10.004","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to investigate dyssynchronous heart failure in fetuses of mothers with diabetes mellitus (FDM) and fetal controls (FC) using two-dimensional speckle tracking echocardiography (2D-STE) and novel M-mode prototype software (PS).</div></div><div><h3>Methods</h3><div>In this cohort study 174 fetuses were analyzed, 87 in the FDM-cohort and 87 gestational age-matched fetuses in the FC-cohort. A subgroup of 38 fetuses formed the final case group, with a high median frame rate of approximately 160 frames/s. Using 2D Cardiac Performance Analysis software (TOMTEC, Unterschleissheim, Germany) we measured global longitudinal strain (GLS). TOMTEC PS detected annular displacement by assessing an artificial M-mode on the previously generated tracking. Dyssynchrony (DYS) was calculated as the inter- and intraventricular difference in time to peak GLS or annular displacement.</div></div><div><h3>Results</h3><div>Greater DYS was observed in all basal myocardial measurement sites and software between FDM-cohort compared to FC-cohort and no significant correlation was found between DYS measurements and gestational age. Intraventricular DYS between the basal segments was statistically significant (all <em>p</em> ≤ 0.036, Wald test of univariate regression models). The PS performed best in DYS measurements identifying right ventricular DYS as potentially predicting FDM (FDM: median, 18.5 (interquartile range [IQR], 13.9–25.0) ms vs. FC: median, 2.7 [IQR, 1.5–3.5] ms; <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Increased intraventricular DYS demonstrated an impact of maternal diabetes mellitus on fetal hearts independent of gestational age. The prototype M-mode method identified cardiac dysfunction with higher accuracy than the conventional analysis. High-quality echocardiographic image acquisition is imperative for clinical application of 2D-STE and related advanced technologies.</div></div>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":"51 2","pages":"Pages 302-311"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Rim-like Enhancement on Pre-ablation Contrast-enhanced Ultrasound of Colorectal Liver Metastasis and Early Intrahepatic Progression After Thermal Ablation: A Preliminary Study","authors":"Jia Lin ,&nbsp;Huahui Liu ,&nbsp;Shuang Liang ,&nbsp;Liping Luo ,&nbsp;Sainan Guan ,&nbsp;Shanshan Wu ,&nbsp;Ying Liu ,&nbsp;Shuxian Xu ,&nbsp;Ronghua Yan ,&nbsp;Erjiao Xu","doi":"10.1016/j.ultrasmedbio.2024.10.015","DOIUrl":"10.1016/j.ultrasmedbio.2024.10.015","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the relationship between the rim-like enhancement pattern on pre-ablation contrast-enhanced ultrasound (CEUS) of colorectal liver metastasis (CRLM) and the therapeutic efficacy of percutaneous microwave ablation (MWA).</div></div><div><h3>Methods</h3><div>Patients with CRLM underwent MWA and were evaluated using CEUS before ablation in our hospital between February 2020 and February 2023 were enrolled in this retrospective study. The enhancement patterns of CRLM were assessed by two radiologists and classified as rim-like enhancement and non-rim-like enhancement patterns. The therapeutic outcomes, including cumulative intrahepatic progression rate and early intrahepatic progression rate, were followed up and analyzed.</div></div><div><h3>Results</h3><div>Overall, 50 patients with 121 nodules were enrolled. Rim-like enhancement pattern was observed in 18 patients (18/50, 36.0%). The cumulative intrahepatic progression rate was significantly higher in the rim-like enhancement group than the rate in the non-rim-like enhancement group (<em>p</em> = 0.022). The early intrahepatic progression rate in the rim-like enhancement group was also significantly higher than the rate in the non-rim-like enhancement group (12/17, 70.6% vs. 6/24, 25.0%, <em>p</em> = 0.005). The multivariable analysis demonstrated that the rim-like enhancement pattern of CRLM was a significant risk factor associated with early intrahepatic progression after MWA (<em>p</em> = 0.013).</div></div><div><h3>Conclusion</h3><div>Rim-like enhancement pattern on pre-ablation CEUS of CRLM was associated with a higher risk of intrahepatic progression after MWA.</div></div>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":"51 2","pages":"Pages 358-363"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631401","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":"Assessing Intensive Care Unit Acquired Weakness: An Observational Study Using Quantitative Ultrasound Shear Wave Elastography of the Rectus Femoris and Vastus Intermedius","authors":"Sishu Yin ,&nbsp;Shiying Zheng ,&nbsp;Jie Li ,&nbsp;Kaifan Chen ,&nbsp;Hong Yang ,&nbsp;Ping Wang","doi":"10.1016/j.ultrasmedbio.2024.07.011","DOIUrl":"10.1016/j.ultrasmedbio.2024.07.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Intensive care unit-acquired weakness (ICUAW) is associated with unfavorable outcomes. The current diagnostic tools for ICUAW are invasive, yield delayed results, and lack precision. This study explored the potential of shear wave elastography (SWE), an innovative ultrasound technique, to evaluate the quality changes in the lower extremity muscles of ICU patients, potentially aiding the early detection of ICUAW.</div></div><div><h3>Materials and Methods</h3><div>We included adult patients diagnosed with ICUAW (average Medical Research Council score &lt; 48) from December 2020 to October 2021. ICU patients were continuously monitored twice daily. Using ultrasonography, we measured the thickness (TH), cross-sectional area (CSA), pennation angle (PA), and SWE (SWE-values) modulus of the bilateral rectus femoris (RF) and vastus intermedius (VI). The diagnostic performance of each parameter was evaluated using sensitivity, specificity, and area under the receiver operating characteristic curve.</div></div><div><h3>Results</h3><div>Ultrasound quantification assessments were performed in 47 patients, 24 with ICUAW and 23 without ICUAW. Notably, PA decreased (RF: 11.33%, VI: 10.51%), while muscle rigidity increased (RF: 22.39%, VI: 22.50%) in ICUAW patients compared with non-ICUAW patients. The sensitivity and specificity for PA in the RF were 79.17% and 91.30%, respectively, and those for PA in VI were 79.17% and 78.26%, respectively. The use of both combinations yielded 91.67% and 73.91% sensitivity and specificity, respectively. Employing the PA of RF and SWE-values of RF together, we observed a diagnostic prediction sensitivity of 91.67% and a specificity of 60.87%.</div></div><div><h3>Conclusions</h3><div>ICUAW patients exhibited increased rigidity of the lower extremity muscles during their hospital stay. Ultrasonic SWE emerged as a reliable and objective tool, offering significant diagnostic value for ICUAW.</div></div>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":"51 2","pages":"Pages 235-241"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound Strain Imaging for Characterizing Atherosclerotic Plaque in the Carotid Arteries of Asymptomatic Subjects","authors":"Hendrik H.G. Hansen ,&nbsp;Alies H.M. Bekkers ,&nbsp;Inge C.L. van den Munckhof ,&nbsp;Eveline van der Kolk ,&nbsp;Frederick J.A. Meijer ,&nbsp;Marinette van der Graaf ,&nbsp;Joost H.W. Rutten ,&nbsp;Chris L. de Korte","doi":"10.1016/j.ultrasmedbio.2024.10.009","DOIUrl":"10.1016/j.ultrasmedbio.2024.10.009","url":null,"abstract":"<div><h3>Objective</h3><div>The rupture of vulnerable plaques in the carotid artery is a leading cause of strokes. While magnetic resonance imaging (MRI) is the standard for quantifying plaque composition, its high costs and lengthy procedure times limit large-scale use. Compound ultrasound strain imaging (CUSI) ultrasound offers a non-invasively alternative by assessing tissue deformation/strain within the arterial wall. Previous studies have demonstrated the relationship between strain values and plaque composition, primarily focusing on longitudinal acquisitions, which only image the proximal and distal parts of the wall. This study examines CUSI in transverse imaging planes, which enables visualization of the entire cross-section of the vessel wall. CUSI has already been validated on a symptomatic population. Therefore, the aim is to determine whether CUSI can differentiate plaque composition in asymptomatic individuals with an increased cardiovascular risk profile, validated by MRI.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 42 plaques in 28 participants. Ultrasound data were acquired with a Samsung Medison Accuvix V10 with an L5-13IS transducer and RF-interface. An experienced neuroradiologist classified plaques with MRI using the Siemens 3.0T MAGNETOM Skyra MRI (Erlangen, Germany) with a dedicated coil. Strain differences were compared across four plaque categories (calcified, lipid, hemorrhagic, fibrous/aspecific) and for vulnerable versus stable plaques.</div></div><div><h3>Results</h3><div>A difference in strain values was found between lipid and calcified plaques (Kruskal–Wallis test, <em>p</em> &lt; 0.05). Additionally, vulnerable plaques exhibited higher strain values than stable plaques (independent samples test, <em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>CUSI values differ between lipid and calcified and between stable and vulnerable plaques. Minor differences were found between the other plaque types.</div></div>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":"51 2","pages":"Pages 321-329"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcranial MRI-guided Histotripsy Targeting Using MR-thermometry and MR-ARFI","authors":"Dinank Gupta ,&nbsp;Tarana P. Kaovasia ,&nbsp;Mahmoud Komaiha ,&nbsp;Jon-Fredrik Nielsen ,&nbsp;Steven P. Allen ,&nbsp;Timothy L. Hall ,&nbsp;Douglas C. Noll ,&nbsp;Zhen Xu","doi":"10.1016/j.ultrasmedbio.2024.10.010","DOIUrl":"10.1016/j.ultrasmedbio.2024.10.010","url":null,"abstract":"<div><h3>Objective</h3><div>Transcranial magnetic resonance imaging (MRI)-guided histotripsy has been demonstrated to treat various locations in <em>in vivo</em> swine brain through a human skull. To ensure that the histotripsy treatment is delivered to the intended target location, accurate pre-treatment targeting is necessary. In this work, we investigate the feasibility of MR-thermometry and MR-acoustic radiation force imaging (MR-ARFI) to perform pre-treatment targeting of histotripsy in <em>ex vivo</em> bovine brain through a human skull.</div></div><div><h3>Methods</h3><div>A 700 kHz, 128-element MR-compatible histotripsy array was used to generate histotripsy and tone-burst sonications. The array's electronic drivers were modified to also generate low-amplitude tone-burst sonications to perform MR-thermometry and MR-ARFI–based targeting. Twelve <em>ex vivo</em> bovine brains were treated with histotripsy at 35 MPa, 75 MPa and through a skull at 36 MPa. Before treating the tissue, both MR-ARFI and MR-thermometry were used to estimate the lesion location. Finally, the location of the histotripsy lesion was compared with the focus estimated by MR-thermometry and MR-ARFI.</div></div><div><h3>Results</h3><div>MR-thermometry and MR-ARFI were able to successfully perform pre-treatment targeting of histotripsy using the modified histotripsy array driver. Histotripsy focus was estimated with mean absolute errors along the transverse/longitudinal axis of 2.06/2.95 mm and 2.13/2.51 mm for MR-ARFI and MR-thermometry, respectively. The presence of the human skull reduced the pressure at the focal region, but it did not compromise the targeting accuracy of either of the two methods with a mean absolute error of 1.10/2.91 mm and 1.29/2.91 mm for MR-ARFI and MR-thermometry, respectively.</div></div><div><h3>Conclusion</h3><div>This study demonstrated that transcranial histotripsy pre-treatment targeting is feasible with MR-thermometry and MR-ARFI.</div></div>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":"51 2","pages":"Pages 330-335"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Study on Automatic O-RADS Classification of Sonograms of Ovarian Adnexal Lesions Based on Deep Convolutional Neural Networks","authors":"Tao Liu,&nbsp;Kuo Miao,&nbsp;Gaoqiang Tan,&nbsp;Hanqi Bu,&nbsp;Xiaohui Shao,&nbsp;Siming Wang,&nbsp;Xiaoqiu Dong","doi":"10.1016/j.ultrasmedbio.2024.11.009","DOIUrl":"10.1016/j.ultrasmedbio.2024.11.009","url":null,"abstract":"<div><h3>Objective</h3><div>This study explored a new method for automatic O-RADS classification of sonograms based on a deep convolutional neural network (DCNN).</div></div><div><h3>Methods</h3><div>A development dataset (DD) of 2,455 2D grayscale sonograms of 870 ovarian adnexal lesions and an intertemporal validation dataset (IVD) of 426 sonograms of 280 lesions were collected and classified according to O-RADS v2022 (categories 2–5) by three senior sonographers. Classification results verified by a two-tailed z-test to be consistent with the O-RADS v2022 malignancy rate indicated the diagnostic performance was comparable to that of a previous study and were used for training; otherwise, the classification was repeated by two different sonographers. The DD was used to develop three DCNN models (ResNet34, DenseNet121, and ConvNeXt-Tiny) that employed transfer learning techniques. Model performance was assessed for accuracy, precision, and F1 score, among others. The optimal model was selected and validated over time using the IVD and to analyze whether the efficiency of O-RADS classification was improved with the assistance of this model for three sonographers with different years of experience.</div></div><div><h3>Results</h3><div>The proportion of malignant tumors in the DD and IVD in each O-RADS-defined risk category was verified using a two-tailed z-test. Malignant lesions (O-RADS categories 4 and 5) were diagnosed in the DD and IVD with sensitivities of 0.949 and 0.962 and specificities of 0.892 and 0.842, respectively. ResNet34, DenseNet121, and ConvNeXt-Tiny had overall accuracies of 0.737, 0.752, and 0.878, respectively, for sonogram prediction in the DD. The ConvNeXt-Tiny model's accuracy for sonogram prediction in the IVD was 0.859, with no significant difference between test sets. The modeling aid significantly reduced O-RADS classification time for three sonographers (Cohen's d = 5.75).</div></div><div><h3>Conclusion</h3><div>ConvNeXt-Tiny showed robust and stable performance in classifying O-RADS 2–5, improving sonologists' classification efficacy.</div></div>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":"51 2","pages":"Pages 387-395"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741188","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":"Automatic Segmentation of Quadriceps Femoris Cross-Sectional Area in Ultrasound Images: Development and Validation of Convolutional Neural Networks in People With Anterior Cruciate Ligament Injury and Surgery","authors":"Beyza Tayfur ,&nbsp;Paul Ritsche ,&nbsp;Olivia Sunderlik ,&nbsp;Madison Wheeler ,&nbsp;Eric Ramirez ,&nbsp;Jacob Leuteneker ,&nbsp;Oliver Faude ,&nbsp;Martino V. Franchi ,&nbsp;Alexa K. Johnson ,&nbsp;Riann Palmieri-Smith","doi":"10.1016/j.ultrasmedbio.2024.11.004","DOIUrl":"10.1016/j.ultrasmedbio.2024.11.004","url":null,"abstract":"<div><h3>Objective</h3><div>Deep learning approaches such as DeepACSA enable automated segmentation of muscle ultrasound cross-sectional area (CSA). Although they provide fast and accurate results, most are developed using data from healthy populations. The changes in muscle size and quality following anterior cruciate ligament (ACL) injury challenges the validity of these automated approaches in the ACL population. Quadriceps muscle CSA is an important outcome following ACL injury; therefore, our aim was to validate DeepACSA, a convolutional neural network (CNN) approach for ACL injury.</div></div><div><h3>Methods</h3><div>Quadriceps panoramic CSA ultrasound images (vastus lateralis [VL] <em>n =</em> 430, rectus femoris [RF] <em>n =</em> 349, and vastus medialis [VM] <em>n =</em> 723) from 124 participants with an ACL injury (age 22.8 ± 7.9 y, 61 females) were used to train CNN models. For VL and RF, combined models included extra images from healthy participants (<em>n =</em> 153, age 38.2, range 13–78) that the DeepACSA was developed from. All models were tested on unseen external validation images (<em>n =</em> 100) from ACL-injured participants. Model predicted CSA results were compared to manual segmentation results.</div></div><div><h3>Results</h3><div>All models showed good comparability (ICC &gt; 0.81, &lt; 14.1% standard error of measurement, mean differences of &lt;1.56 cm²) to manual segmentation. Removal of the erroneous predictions resulted in excellent comparability (ICC &gt; 0.94, &lt; 7.40% standard error of measurement, mean differences of &lt;0.57 cm²). Erroneous predictions were 17% for combined VL, 11% for combined RF, and 20% for ACL-only VM models.</div></div><div><h3>Conclusion</h3><div>The new CNN models provided can be used in ACL-injured populations to measure CSA of VL, RF, and VM muscles automatically. The models yield high comparability to manual segmentation results and reduce the burden of manual segmentation.</div></div>","PeriodicalId":49399,"journal":{"name":"Ultrasound in Medicine and Biology","volume":"51 2","pages":"Pages 364-372"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711663","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}