Journal of Ultrasound最新文献

{"title":"Point-of-care ultrasonography in High-Care Internal Medicine.","authors":"Francesco Cei, Lucia Colavolpe, Riccardo Capra, Aldo Fici, Emanuela Laurita, Stefania Marengo, Michela Provisione, Nicola Mumoli","doi":"10.1007/s40477-026-01217-w","DOIUrl":"https://doi.org/10.1007/s40477-026-01217-w","url":null,"abstract":"<p><strong>Background: </strong>Internal Medicine wards have progressively evolved into high-complexity clinical environments, increasingly managing patients with acute respiratory failure, hemodynamic instability, and multi-organ dysfunction. Within this scenario, point-of-care ultrasonography (POCUS) has emerged as a bedside imaging modality capable of supporting rapid diagnostic reasoning and real-time clinical decision-making.</p><p><strong>Objectives: </strong>This narrative review aims to critically analyze the role of POCUS in High-Care Medical Areas of Internal Medicine, focusing on diagnostic applications, clinical monitoring, and ultrasound-guided procedures, while addressing limitations and training requirements.</p><p><strong>Methods: </strong>A narrative review of the literature was conducted, integrating evidence from international guidelines, observational studies, randomized trials, and expert consensus documents regarding the use of POCUS in acutely ill medical patients. Emphasis was placed on multimodal ultrasound approaches consistent with the holistic clinical framework of Internal Medicine.</p><p><strong>Results: </strong>POCUS facilitates early identification of time-dependent conditions such as pulmonary embolism, acute coronary syndromes, acute heart failure, acute respiratory distress syndrome, and septic shock. Lung ultrasound, focused cardiac ultrasound, vascular, and abdominal ultrasound can be integrated to improve diagnostic accuracy and etiological characterization of shock and respiratory failure. Serial POCUS examinations enable dynamic monitoring of disease progression, treatment response, and fluid responsiveness. Furthermore, ultrasound guidance significantly improves the safety and effectiveness of bedside invasive procedures.</p><p><strong>Conclusion: </strong>POCUS represents a cornerstone of modern High-Care Internal Medicine, enhancing bedside diagnostic integration, clinical monitoring, and procedural safety. Its effectiveness depends on structured training, awareness of limitations, and appropriate clinical governance. Although evidence of direct mortality reduction remains limited, POCUS consistently improves diagnostic confidence, appropriateness of care, and patient-centered decision-making.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ultrasound and contrast-enhanced ultrasound characteristics of IgG4-related cholangitis: compared with cholangiocarcinoma.","authors":"Qingyang Kong, Lili Wu, Jie Ren, Kai Li, Yinglin Long","doi":"10.1007/s40477-026-01218-9","DOIUrl":"https://doi.org/10.1007/s40477-026-01218-9","url":null,"abstract":"<p><strong>Background: </strong>IgG4-related cholangitis (IgG4-SC) is often difficult to differentiate from cholangiocarcinoma (CCA) due to similar clinical and imaging presentations, yet their management and prognosis differ drastically. Accurate non-invasive distinction remains a significant clinical challenge.</p><p><strong>Aim: </strong>This study aimed to identify and compare the characteristic features of IgG4-SC and CCA on conventional ultrasound (US) and contrast-enhanced ultrasound (CEUS) to establish reliable imaging discriminators.</p><p><strong>Methods: </strong>We retrospectively analyzed clinical and imaging data from 14 patients with IgG4-SC and 26 with CCA. Two blinded physicians independently reviewed US and CEUS images to assess lesion characteristics, bile duct lumen visibility, wall thickening, and enhancement patterns. Statistical comparisons were performed using appropriate tests.</p><p><strong>Results: </strong>On conventional US, a preserved bile duct lumen within the thickened segment was significantly more frequent in IgG4-SC (10/14, 71.4%) than in CCA (1/26, 3.8%; P < 0.001). Concomitant lesions in other organs were also more common in IgG4-SC (50% vs. 3.8%, P = 0.001). On CEUS, arterial-phase hyper-enhancement was observed in 95.8% of CCA lesions but only in 50.0% of IgG4-SC lesions (P = 0.009), with the latter showing more variable (hypo-/iso-) enhancement.</p><p><strong>Conclusion: </strong>The combination of a preserved bile duct lumen on conventional US and a lower frequency of arterial hyper-enhancement on CEUS provides key imaging clues to differentiate IgG4-SC from CCA. These features, alongside assessment for other organ involvement, may improve diagnostic confidence and guide appropriate clinical management. However, given the exploratory nature of this small-sample study, these findings require validation in larger prospective cohorts.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: CEUS in the evaluation of focal salivary gland lesions: a systematic review.","authors":"Alessio Frisone, Giuseppe Balice, Matteo Serroni, Gianmaria D'Addazio, Antonella Berardicurti, Andrea Boccatonda","doi":"10.1007/s40477-026-01213-0","DOIUrl":"https://doi.org/10.1007/s40477-026-01213-0","url":null,"abstract":"","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colour Doppler and contrast-enhanced ultrasound diagnosis of a delayed intrahepatic pseudoaneurysm after liver biopsy: a case report and literature review.","authors":"Leonardo Sacco, Antonella Marra, Chiara Lillo, Silvio Maresca, Michelangelo Nasuto, Simone Mammone, Agnese Favale, Veronica Nassisi, Fulvia Terracciano","doi":"10.1007/s40477-026-01215-y","DOIUrl":"https://doi.org/10.1007/s40477-026-01215-y","url":null,"abstract":"<p><p>Percutaneous liver biopsy is widely performed and generally safe; however, rare vascular complications may occur. We report a 43-year-old man with a history of allogeneic haematopoietic stem cell transplantation undergoing ultrasound evaluation for multiple hepatic and splenic lesions detected during investigation of persistent fever. After a non-diagnostic biopsy, follow-up ultrasound three weeks later demonstrated vascular features within a left-lobe lesion selected for repeat sampling. Contrast-enhanced ultrasound (CEUS) showed rapid and persistent arterial enhancement. Colour Doppler revealed turbulent bidirectional flow with a \"yin-yang\" pattern, and pulsed-wave Doppler demonstrated a characteristic \"to-and-fro\" waveform consistent with pseudoaneurysm. CT angiography confirmed a pseudoaneurysm arising from a peripheral intrahepatic branch of the left hepatic artery. The patient remained asymptomatic, haemodynamically stable and without laboratory evidence of bleeding. Selective endovascular embolisation was performed. This case highlights how combined CEUS and Doppler may detect delayed, clinically silent vascular complications after liver biopsy.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148834617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic breast ultrasound with knowledge-guided path planning and vision feedback.","authors":"Mohammadali Afshar Kazemi, Hosein Esmaeili, Reza Radfar, Nazanin Pilevari","doi":"10.1007/s40477-026-01214-z","DOIUrl":"https://doi.org/10.1007/s40477-026-01214-z","url":null,"abstract":"<p><strong>Aims: </strong>Standardizing robotic breast ultrasound remains challenging in practice, particularly during near-lesion approach, where small nonlinearities can degrade imaging consistency and needle guidance.</p><p><strong>Methods: </strong>This study uses publicly available datasets to derive skill-informed motion primitives for an ontology-guided path-planning framework and to define a representative breast ultrasound workspace with lesion-oriented linear trajectories. BUSI-derived lesion information is used to generate image-informed scan paths in the imaging plane, while JIGSAWS kinematic sequences are used to initialize motion primitives and neuro-fuzzy inverse-kinematics rules. The proposed robotic ultrasound scan controller maps Cartesian targets to joint commands, and its parameters are subsequently refined using an ant colony optimization for continuous domains (ACOR) strategy. Performance is evaluated in terms of joint-angle error, forward-kinematics path tracking, motion smoothness measured by mean absolute jerk, and needle-heading alignment relative to the planned trajectory.</p><p><strong>Results: </strong>Among the untuned variants, the controller initialized by data-driven clustering showed the strongest generalization across the evaluation workspace. ACOR-based refinement further reduced path-tracking error and markedly improved motion smoothness. Orientation alignment also improved relative to the baseline, although performance remained variable across test segments and the predefined success threshold was not achieved in all cases.</p><p><strong>Conclusion: </strong>The proposed knowledge-driven robotic ultrasound framework integrates ontology-guided linear path planning, neuro-fuzzy inverse kinematics, and metaheuristic parameter refinement to achieve accurate and smoother tracking in representative breast-imaging tasks. In the present proof-of-concept study, the image-based component is used primarily for lesion-informed trajectory generation and evaluation rather than full real-time visual servoing. These findings support the feasibility of standardized robotic ultrasound workflows and motivate future integration of explicit orientation costs, force regulation, and real-time image feedback.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-cost gelatin phantom for ultrasound-guided core-needle biopsy training: a pictorial essay.","authors":"Camilla Culcasi, Lucia Zanchi, Lorena Quagliozzi, Francesca Moro, Federica Pozzati, Valentina Chiappa, Daniela Fischerova, Antonia Carla Testa, Anna Fagotti, Floriana Mascilini","doi":"10.1007/s40477-026-01185-1","DOIUrl":"https://doi.org/10.1007/s40477-026-01185-1","url":null,"abstract":"<p><p>Core-needle (tru-cut) biopsy is increasingly used in gynecologic oncology for tissue acquisition and molecular assessment. Adequate operator training is essential, but hands-on opportunities and affordable pelvic simulation models remain limited. This pictorial essay describes a step-by-step approach for pelvic ultrasound-guided core-needle biopsy using a low-cost gelatin-based phantom adapted from a previously published model. The phantom incorporates target lesions and optional simulated bowel loops to increase procedural complexity. The accompanying images and instructional video demonstrate phantom preparation, probe handling, needle-beam alignment, lesion targeting, and simulated biopsy using transvaginal/transrectal and transabdominal approaches. This reproducible, inexpensive model may facilitate simulation-based training and improve familiarity with biopsy equipment and needle-tip visualization before supervised clinical practice.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging role of ultrasound in food technology: principles, applications, and future prospects.","authors":"Antara Roy, Bimal Krishna Banik","doi":"10.1007/s40477-026-01199-9","DOIUrl":"https://doi.org/10.1007/s40477-026-01199-9","url":null,"abstract":"<p><p>Ultrasound technology has developed to be a versatile and sustainable technology in new food processing and preservation methods. Ultrasound, which is based on the principles of acoustic cavitation and mechanical vibrations, can improve mass and heat transfer, ramping up processing times and improve the quality of products. The main application of low intensity ultrasound is the analytical and quality checks in food systems while high intensity ultrasound is more common in food systems for emulsification, extraction, homogenization, drying, freezing and microbial inactivation. As it is a nonthermal approach, ultrasound is safe for food systems to follow nutritional and sensory characteristics, making it a green processing technology versus conventional methods. Advances in ultrasonic equipment design and combined use with other elegant technologies like pulsed electric fields, high pressure processing and nanotechnology have led to a broader industrial application. Although the advantages are promising, aspects of scalability, energy efficiency, and uniform energy distribution are important areas for research moving forward. This review provides various applications, fundamental principles of ultrasound in food science with a focus on improving energy efficiency, product safety and sustainability.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chorionic bumps in early pregnancy and their link to miscarriage.","authors":"Melanie Norton, Jude Hamilton","doi":"10.1007/s40477-026-01209-w","DOIUrl":"https://doi.org/10.1007/s40477-026-01209-w","url":null,"abstract":"<p><strong>Introduction: </strong>Chorionic bumps are a rare first‑trimester ultrasound finding with uncertain prognostic significance.</p><p><strong>Objective: </strong>To estimate the risk of miscarriage in pregnancies with a chorionic bump compared with the institutional baseline miscarriage rate in our Early Pregnancy Unit (EPU).</p><p><strong>Methods: </strong>Retrospective cohort of consecutive pregnancies with a sonographically confirmed chorionic bump (January 2020-May 2025). Outcomes were benchmarked against the EPU's baseline miscarriage rate derived from all attendances during the study period. Prespecified secondary analyses explored whether maternal age, subchorionic haematoma (SCH), or bump size predicted outcome.</p><p><strong>Results: </strong>Among 151 pregnancies with a chorionic bump, 81 miscarried (53.6%). This was substantially higher than the EPU baseline of 14.2% (2,295 miscarriages among 16,115 patients), corresponding to a near‑sevenfold increase in odds (OR 6.99; z = 9.72; p < 0.0001). Bump size and the presence of SCH were not associated with outcome. Increasing maternal age had a modest effect (OR 1.09 per year, p = 0.014). Outcomes following IVF conception were similar to, or slightly better than, spontaneous conception.</p><p><strong>Conclusion: </strong>The presence of a chorionic bump is a clinically important prognostic marker of miscarriage, independent of bump size or SCH.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated breast ultrasound (ABUS) meets artificial intelligence: a new accurate classification tool for BIRADS 3-4 breast lesions.","authors":"Marco Moschetta, Alessia Spitaleri, Federico Cofone, Fabio Panarelli, Corrado Caiazzo, Amato Antonio Stabile Ianora, Michele Telegrafo","doi":"10.1007/s40477-026-01212-1","DOIUrl":"https://doi.org/10.1007/s40477-026-01212-1","url":null,"abstract":"<p><strong>Purpose: </strong>Breast ultrasound (US) has often interpretation challenges (BIRADS 3-BIRADS 4 lesions), leading to a high demand for core needle biopsies (CNB). In this context, a computer-aided diagnostic (CAD) tool based on a machine-learning artificial intelligence, applied to images obtained with an automated breast ultrasound system (ABUS), could potentially provide more accurate diagnoses by instantly and automatically assessing the US lesion features and their level of suspicion. The aim of this study is to evaluate the diagnostic accuracy of a CAD applied to ABUS images for BIRADS 3-4 lesions.</p><p><strong>Materials and methods: </strong>Fifty-four patients underwent ABUS, performed with three scans per side, reconstructing images in the axial, coronal, and sagittal planes. Two expert radiologists draw a region of interest (ROI) on the lesion to be assessed by CAD tool, reaching a consensus regarding the images. Only breast lesions classified as BIRADS 3-4 were included, for a total of 68 (32 BIRADS 3, 36 BIRADS 4). CAD results were compared with the histological findings from CNBs in all cases, calculating sensitivity (SE), specificity (SP), accuracy (AC), positive predictive value (PPV), and negative predictive value (NPV).</p><p><strong>Results: </strong>Histology identified 40 positive lesions and 28 negative lesions. The CAD classified 38 suspicious lesions, with 6 false positives, 22 true negatives, and 2 false negatives. The values for SE, SP, AC, PPV, and NPV were 95, 79, 88, 86, and 92%, respectively.</p><p><strong>Conclusions: </strong>The proposed CAD system is accurate in characterizing BIRADS 3-4 breast lesions diagnosed by ABUS and, therefore, could be applied in the clinical practice in order to assist radiologists in evaluating US images and reducing the number of the required CNBs.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated breast ultrasound (ABUS) versus handheld ultrasound (HHUS) for the preoperative assessment of tumor size in invasive breast cancer.","authors":"Michele Telegrafo, Fabio Panarelli, Federico Cofone, Alessia Spitaleri, Corrado Caiazzo, Amato Antonio Stabile Ianora, Marco Moschetta","doi":"10.1007/s40477-026-01211-2","DOIUrl":"https://doi.org/10.1007/s40477-026-01211-2","url":null,"abstract":"<p><strong>Purpose: </strong>Accurate preoperative assessment of tumor size (T parameter) is crucial for surgical planning in breast cancer. This study aimed to compare the diagnostic performance of automated breast ultrasound (ABUS) and conventional handheld ultrasound (HHUS) in evaluating tumor size, using histopathology as the reference standard.</p><p><strong>Methods: </strong>Between September 2025 and March 2026, 43 patients with 46 invasive breast carcinoma lesions underwent preoperative evaluation with both HHUS and ABUS. Tumor diameters were measured by two experienced radiologists. Measurements obtained with each imaging modality were compared with histological findings. Statistical analysis included analysis of variance (ANOVA), paired Student's t-tests, and inter-observer agreement using Cohen's kappa coefficient.</p><p><strong>Results: </strong>Mean tumor diameters were 12.82 mm for ABUS, 12.50 mm for HHUS, and 12.74 mm for histology. No statistically significant differences were observed between ABUS and HHUS measurements (p = 0.07), nor between either imaging modality and histology (ABUS vs. histology: p = 0.15; HHUS vs. histology: p = 0.86). Inter-observer agreement was excellent (κ = 0.88). Measurements obtained with ABUS showed a closer overlap with histological findings.</p><p><strong>Conclusion: </strong>Both ABUS and HHUS provide accurate preoperative assessment of tumor size in invasive breast cancer. However, ABUS demonstrates advantages in reproducibility, operator independence, and three-dimensional visualization, supporting its role as a valuable tool for surgical planning.</p>","PeriodicalId":51528,"journal":{"name":"Journal of Ultrasound","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}