Journal of Medical Ultrasonics最新文献

{"title":"Phantom experiment for thoracic spine gap delineation using steering-transmitted ultrasound to assist epidural anesthesia.","authors":"Yusuke Soejima, Eiko Onishi, Masanori Yamauchi, Mototaka Arakawa","doi":"10.1007/s10396-025-01615-3","DOIUrl":"10.1007/s10396-025-01615-3","url":null,"abstract":"<p><strong>Purpose: </strong>Epidural anesthesia under real-time ultrasound guidance has been studied to enhance puncture safety. However, in the thoracic spine, where the anatomy is complex and the interlaminar space is narrow, improved image quality is necessary. Because imaging quality is degraded in bones that are greatly tilted relative to the probe, we aimed to improve the imaging quality by steering the transmitted ultrasonic beam.</p><p><strong>Methods: </strong>We investigated a method to improve bone visibility by selecting appropriate transmit steering angles and receiving aperture ranges for each of the two bones forming the interlaminar space, and by compensating for the directivity of the receiving elements.</p><p><strong>Results: </strong>The proposed method emphasized the delineation of a bone phantom near the gap corresponding to the puncture site. Furthermore, when comparing the contrast ratio in the region of interest of the bone and gap areas, the proposed method showed an improvement of 24.2 dB on the left side and 4.2 dB on the right side compared to the conventional B-mode image.</p><p><strong>Conclusion: </strong>The proposed method was confirmed to emphasize the bones and is expected to improve the image quality of the thoracic spine gap.</p>","PeriodicalId":50130,"journal":{"name":"Journal of Medical Ultrasonics","volume":" ","pages":"259-266"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020483","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":"Intrasheath snapping of the flexor tendons of the index finger in a pediatric patient.","authors":"Marco Becciolini, Giorgio Tamborrini, Andrea Poggetti","doi":"10.1007/s10396-026-01616-w","DOIUrl":"10.1007/s10396-026-01616-w","url":null,"abstract":"","PeriodicalId":50130,"journal":{"name":"Journal of Medical Ultrasonics","volume":" ","pages":"365-367"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146068476","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":"Effect of region of interest settings on diagnostic performance of attenuation imaging in hepatic steatosis.","authors":"Shingo Tanaka, Noboru Ohba, Nagomi Saito, Kanna Tanaka, Yuka Ishimoto, Kayoko Ochi, Kenji Yasui, Minori Fujita, Kiyoshi Abe, Satoshi Takahashi","doi":"10.1007/s10396-025-01612-6","DOIUrl":"10.1007/s10396-025-01612-6","url":null,"abstract":"<p><strong>Purpose: </strong>Attenuation techniques have been developed to quantify liver fat, improving diagnostic accuracy. However, the standardization of measurement methods remains undefined, limiting clinical application. This study evaluated the effect of different region of interest (ROI) settings on the attenuation coefficient (AC) and coefficient of determination (R²) in attenuation imaging (ATI).</p><p><strong>Methods: </strong>We analyzed 5212 ultrasound examinations performed at our institution. Two periods were compared: early [ROI positioned at twice the subcutaneous thickness; double positioning (DP), 2 × 3 cm] and late [ROI placed beneath the multireflection layer; color positioning (CP), 2 × 4 cm]. Additionally, AC and R² were analyzed in 331 patients with stored raw data across four conditions: DP and CP for positioning, and 2 × 3 cm and 2 × 4 cm for size, respectively, using Bland-Altman analysis.</p><p><strong>Results: </strong>The early and late periods included 2881 and 2331 examinations, respectively. Patient characteristics were comparable. Significant differences were observed in the AC (median, 0.58 vs. 0.56 dB/cm/MHz), steatotic liver diagnostic rates based on AC, R² (median, 0.87 vs. 0.93), and proportion of R² ≥ 0.90. Raw data analysis showed slight differences in AC and R² according to ROI position; however, there were significant differences in ROI size (AC: 2 × 3 > 2 × 4; R²: 2 × 4 > 2 × 3).</p><p><strong>Conclusion: </strong>In ATI, the larger ROI improved R², whereas the smaller ROI yielded higher AC values, suggesting that ROI size affects diagnostic reliability. Standardizing ATI protocols is essential, with uniformity in ROI size being a priority.</p>","PeriodicalId":50130,"journal":{"name":"Journal of Medical Ultrasonics","volume":" ","pages":"289-299"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146068444","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":"Recent trends in therapeutic ultrasound: focusing on technologies that utilize non-thermal effects.","authors":"Kenji Yoshida","doi":"10.1007/s10396-026-01670-4","DOIUrl":"10.1007/s10396-026-01670-4","url":null,"abstract":"","PeriodicalId":50130,"journal":{"name":"Journal of Medical Ultrasonics","volume":" ","pages":"257-258"},"PeriodicalIF":2.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425437","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":"Contrast-enhanced ultrasound findings are associated with tumor viability and depth of response in selected patients with unresectable hepatocellular carcinoma treated with immunotherapy-based combination therapy.","authors":"Naoki Matsumoto, Masahiro Ogawa, Aya Konishi, Mai Totsuka, Tomohiro Kaneko, Masayuki Honda, Shuhei Arima, Yukinobu Watanabe, Ryota Masuzaki, Hirofumi Kogure","doi":"10.1007/s10396-026-01665-1","DOIUrl":"https://doi.org/10.1007/s10396-026-01665-1","url":null,"abstract":"<p><strong>Purpose: </strong>Accurate evaluation of tumor viability during immunotherapy for unresectable hepatocellular carcinoma (HCC) remains challenging using contrast-enhanced computed tomography or magnetic resonance imaging (CECT/CEMRI), particularly after treatment-induced vascular changes. This exploratory study investigated whether contrast-enhanced ultrasound (CEUS) detects residual intratumoral perfusion differently from CECT/CEMRI and whether CEUS perfusion patterns are associated with depth of response (DpR) in selected patients receiving immunotherapy-based combination therapy.</p><p><strong>Methods: </strong>Twenty-five patients with unresectable HCC treated with atezolizumab plus bevacizumab, durvalumab plus tremelimumab, or nivolumab plus ipilimumab who underwent both CEUS and CECT/CEMRI within a 3-month interval were retrospectively analyzed. CEUS was performed at a median of 33 days after treatment initiation. Arterial-phase enhancement patterns were classified as hyper-, iso-, or hypoenhancement relative to surrounding liver parenchyma. Tumor response was evaluated using RECIST version 1.1 and modified RECIST. DpR was defined as the maximum percentage reduction in tumor size from baseline.</p><p><strong>Results: </strong>CEUS demonstrated hyperenhancement in 14 lesions compared with six lesions on CECT/CEMRI. Enhancement patterns were discordant in 13 cases, with CEUS demonstrating hyperenhancement in 10 lesions classified as iso- or hypoenhancement on CECT/CEMRI (p = 0.049). Tumor size reduction did not differ significantly among enhancement categories on CECT/CEMRI (p = 0.325), whereas CEUS enhancement patterns were significantly associated with DpR (p = 0.008).</p><p><strong>Conclusion: </strong>In selected patients with unresectable HCC undergoing immunotherapy-based therapy, CEUS detected residual intratumoral perfusion more frequently than CECT/CEMRI and was significantly associated with DpR. CEUS may provide complementary information for exploratory assessment of tumor viability in this setting.</p>","PeriodicalId":50130,"journal":{"name":"Journal of Medical Ultrasonics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354611","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":"One-transmission harmonic imaging with high spatial resolutions using probe consisting of two piezoelectric layer elements.","authors":"Ryo Nagaoka, Shin-Ichiro Umemura, Masaaki Omura, Hideyuki Hasegawa","doi":"10.1007/s10396-026-01661-5","DOIUrl":"https://doi.org/10.1007/s10396-026-01661-5","url":null,"abstract":"<p><strong>Purpose: </strong>Pulse inversion (PI) harmonic imaging has been commonly used because of its contrast and spatial resolution superior to conventional fundamental imaging. However, it requires two transmissions with opposite phases, which reduces the imaging frame rate by half. This study aimed to solve this problem METHOD: An ultrasonic array probe consisting of piezoelectric elements with two polarization-inverted layers, which requires only one transmission to extract the second harmonic components, was developed. Its characteristics, such as electric impedance and its phase, were predicted by solving piezoelectric as well as wave equations, and then compared with measurement. The acoustic pressures produced from the developed probe, when excited at the lower and higher resonant frequencies, were measured using a hydrophone. Finally, imaging of wires in water and phantoms containing wires and a cyst model were performed using the developed probe RESULT: The spatial resolution, especially in the axial direction, was significantly improved with the developed probe consisting of the two piezoelectric layer elements in comparison with the conventional second harmonic imaging (HI) using a band pass filter. It was almost comparable to that of conventional PI imaging despite only one transmission being required CONCLUSION: A probe consisting of two piezoelectric layer elements enabling one-transmission HI was developed. The spatial resolution obtained using the developed probe was slightly worse but almost comparable to that of conventional PI imaging even with only one transmission.</p>","PeriodicalId":50130,"journal":{"name":"Journal of Medical Ultrasonics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340930","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":"Dynamic anatomical ultrasound assessment for breast lesions: a prospective study of diagnostic performance.","authors":"Ayumi Izumori, Yumi Kokubu, Takehiko Sakai, Futoshi Akiyama, Takuji Iwase, Woo Kyung Moon, Takayuki Ueno","doi":"10.1007/s10396-026-01657-1","DOIUrl":"10.1007/s10396-026-01657-1","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether a dynamic ultrasound approach, termed anatomical scanning and interpretation, improves diagnostic performance in differentiating benign from malignant breast lesions compared with conventional static-image BI-RADS assessment.</p><p><strong>Methods: </strong>This prospective study evaluated 102 breast lesions (33 masses, 41 non-masses, and 28 distortions) classified as BI-RADS 3, 4a, or 4b. Fourteen ultrasound technologists underwent dedicated training in dynamic anatomical scanning and interpretation. Each lesion was evaluated using real-time video clips and independently categorized as requiring follow-up or biopsy. A subsequent physician-technologist consensus was performed. With histopathology as the reference standard, performance was assessed using ROC analysis, with AUC comparisons performed using the DeLong test.</p><p><strong>Results: </strong>Among 102 lesions (58 benign, 44 malignant), individual technologist interpretation with dynamic imaging significantly improved diagnostic performance (AUC = 0.748, p = 0.0191) over static BI-RADS assessment (AUC = 0.619). Physician-technologist consensus showed further significant improvement (AUC = 0.865, p < 0.0001). In subgroup analysis, dynamic interpretation outperformed static assessment for masses (AUC = 0.849, p = 0.0036), but not for non-mass lesions (AUC = 0.794) or distortions (AUC = 0.618). In contrast, physician-technologist consensus interpretation demonstrated superior performance compared with static assessment across all lesion types: masses (AUC = 0.879, p < 0.0001), non-mass lesions (AUC = 0.910, p = 0.0005), and distortions (AUC = 0.838, p = 0.0432).</p><p><strong>Conclusion: </strong>Dynamic anatomical scanning and interpretation significantly improve diagnostic performance over conventional static BI-RADS assessment. For non-mass lesions and architectural distortions, anatomical interpretation based on consensus between the physician and the technologist is considered essential to achieve optimal diagnostic accuracy.</p>","PeriodicalId":50130,"journal":{"name":"Journal of Medical Ultrasonics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340960","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":"Cervicovaginal fistula with fetal membrane prolapse following McDonald cerclage: a case report.","authors":"Hitoshi Isohata, Takeshi Hirata, Yu Yamazaki, Hiroyuki Goto, Kyoko Hattori, Daigo Ochiai","doi":"10.1007/s10396-026-01668-y","DOIUrl":"https://doi.org/10.1007/s10396-026-01668-y","url":null,"abstract":"","PeriodicalId":50130,"journal":{"name":"Journal of Medical Ultrasonics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148334249","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":"Attenuation imaging and hepatorenal index composite score for the noninvasive assessment of hepatic steatosis in chronic liver disease: a prospective multicenter study.","authors":"Tamami Abe, Hidekatsu Kuroda, Takashi Nishimura, Masahiro Yoshida, Shunya Kuroiwa, Yudai Fujiwara, Hirohisa Yano, Takayuki Matsumoto, Hiroko Iijima","doi":"10.1007/s10396-026-01655-3","DOIUrl":"https://doi.org/10.1007/s10396-026-01655-3","url":null,"abstract":"<p><strong>Purpose: </strong>The increasing prevalence of steatotic liver disease (SLD) underscores the need for reliable, noninvasive tools to assess hepatic steatosis. Existing methods, such as the controlled attenuation parameter (CAP) under ultrasound, have limitations in accuracy. This study aimed to examine whether combining attenuation imaging (AI) and hepatorenal index (HRI) measurements improves discrimination of steatosis in participants with chronic liver disease (CLD).</p><p><strong>Methods: </strong>This multicenter prospective cohort study enrolled 121 participants with CLD from two centers during 2022-2023. All participants underwent liver biopsy and ultrasound examinations, including AI and HRI measurements using a Philips EPIQ system, and CAP assessment. An AI-HRI composite score was developed using logistic regression and evaluated against individual variables through receive operating characteristic analysis, category-free net reclassification improvement (cf-NRI), and integrated discrimination improvement (IDI). Internal validation was performed using bootstrap sampling.</p><p><strong>Results: </strong>The area under the curve values for discrimination for the AI-HRI composite score, AI, HRI, and CAP were 0.91, 0.87, 0.86, and 0.80, respectively. At a cutoff of -0.083, the sensitivity and specificity were 84.1% and 90.0%, respectively. The cf-NRI and IDI analyses demonstrated improved discrimination compared to other variables (p < 0.01). Bootstrap analysis confirmed the internal validity of the score (C-index: 0.90).</p><p><strong>Conclusions: </strong>The AI-HRI composite score provides superior discrimination of steatosis in participants with CLD, potentially offering a more accurate and reliable tool for clinical assessment. These findings could facilitate improved management and early intervention in SLD.</p>","PeriodicalId":50130,"journal":{"name":"Journal of Medical Ultrasonics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303824","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":"Influence of airway pressure and fibrosis on lung surface shear wave elastography.","authors":"Yuki Kawakami, Kensuke Nakamura, Hironobu Yasui, Keisuke Aoshima, Noboru Sasaki, Nozomu Yokoyama, Mitsuyoshi Takiguchi","doi":"10.1007/s10396-026-01649-1","DOIUrl":"https://doi.org/10.1007/s10396-026-01649-1","url":null,"abstract":"<p><strong>Purpose: </strong>Lung ultrasound is widely used in clinical practice, but B-mode findings often lack disease specificity. Shear wave elastography (SWE) enables quantitative assessment of tissue elasticity and may help overcome this limitation. This study aimed to evaluate whether SWE can be used to detect lung surface changes associated with airway pressure and pulmonary fibrosis.</p><p><strong>Methods: </strong>Ex vivo porcine lungs (n = 3) were used to examine the effects of airway pressure. Airway pressure was adjusted to 10, 20, and 30 cmH₂O, and shear wave speed (SWS) was measured on the lung surface. Pulmonary fibrosis was induced in Sprague-Dawley rats (n = 13) by means of right thoracic irradiation. After 26 weeks, SWE was performed on excised lungs, and histopathological analysis of fibrosis and air proportions was conducted using QuPath-based image analysis. Statistical analyses included Spearman's correlation, Wilcoxon signed-rank test, and multiple regression with isometric log-ratio (ILR) transformation.</p><p><strong>Results: </strong>In porcine lungs, SWS increased with airway pressure and showed a strong positive correlation. In the radiation-induced fibrosis model, irradiated lungs had significantly higher SWS than non-irradiated lungs. Histopathology confirmed increased fibrosis and reduced air without inflammation. Multiple regression showed a significant association between fibrosis and SWS.</p><p><strong>Conclusion: </strong>Lung surface SWE detected changes related to airway pressure and pulmonary fibrosis. SWS increased with both, although other factors, such as lung reduction in air content and tensile stress, can also affect measurements.</p>","PeriodicalId":50130,"journal":{"name":"Journal of Medical Ultrasonics","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260376","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}