Search Results (3,274)

Non-melanoma skin cancers (NMSCs), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are highly prevalent and a significant cause of morbidity. Image-guided superficial radiation therapy (IGSRT) uses integrated high-resolution dermal ultrasound to improve lesion visualization, but it is unknown whether efficacy varies by histology. This large retrospective cohort study was conducted to determine the effect of tumor histology on freedom from recurrence in 20,069 biopsy-proven NMSC lesions treated with IGSRT, including 9928 BCCs (49.5%), 5294 SCCs (26.4%), 4648 SCCIS cases (23.2%), and 199 lesions with ≥2 NMSCs (1.0%). Freedom from recurrence at 2, 4, and 6 years was 99.60%, 99.45%, and 99.45% in BCC; 99.58%, 99.49%, and 99.49% in SCC; and 99.96%, 99.80%, and 99.80% in SCCIS. Freedom from recurrence at 2, 4, and 6 years following IGSRT did not differ significantly comparing BCC vs. non-BCC or SCC vs. non-SCC but were slightly lower among SCCIS vs. non-SCCIS (p = 0.002). There were no significant differences in freedom from recurrence when stratifying lesions by histologic subtype. This study demonstrates that there is no significant effect of histology on freedom from recurrence in IGSRT-treated NMSC except in SCCIS. These findings support IGSRT as a first-line therapeutic option for NMSC regardless of histology. Full article

Background: As the first sentinel lymph nodes (SLN) in lung cancer are most likely to harbor metastasis, their non-invasive identification could have a significant role in future treatments. We investigated the feasibility of adding an SLN procedure to a diagnostic navigation bronchoscopy. Methods: Thirty-one patients were included for injection of ^99mTc-nanocolloid and an iodinated contrast agent intra-/peritumorally and assessment of tracer dissipation via SPECT and CBCT imaging. Injections were performed endobronchially using a multi-modal catheter (Pioneer Plus), combining radial ultrasound and an angulated retractable needle to place injections under fluoroscopy and real-time ultrasound. Results: The injection of an imaging tracer was feasible in all cases using the catheter. Ultrasound visualized 29/30 tumors, and tracer injection was performed in 100% of patients. An SLN was subsequently identified in 10 out of 31 cases (32.3%) via SPECT/CT imaging. Iodinated contrast agent injection under CBCT imaging prior to ^99mTc nanocolloid injection visualized dissipation pathways and enabled needle relocation for subsequent ^99mTc-nanocolloid injection. Conclusions: Performing imaging tracer injections with a multi-modal catheter provided safe and local depot placement immediately following diagnostic navigation bronchoscopy. SPECT/CT imaging using ^99mTc-nanocolloid showed inconsistent results for SLN identification. Full article

Head and neck masses are a significant diagnostic challenge and differential diagnoses range from inflammatory, infectious, and neoplastic conditions. Timely, accurate evaluation is essential for optimal patient outcomes. This review highlights a systematic approach to diagnosing head and neck masses through comprehensive history, physical examination, and a variety of diagnostic tools. Imaging modalities such as computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound are integral in diagnosis. Fine-needle aspiration (FNA) biopsy is a minimally invasive option for a preliminary diagnosis. However, in cases where it may be inconclusive or when extensive tissue sampling is needed to confirm a diagnosis, open tissue biopsy is considered. Collaboration among a multidisciplinary team (surgeons, radiologists, and pathologists) is vital in developing an effective individualized treatment plan. Early detection and accurate diagnosis of head and neck masses are critical for achieving favorable clinical outcomes. Full article

Background/Objectives: Magnetic nanoparticles (MNPs) have gained attention in theranostics for their ability to combine diagnostic imaging and therapeutic capabilities in a single platform, enhancing targeted treatment and monitoring. Surface coatings are essential for stabilizing MNPs, improving biocompatibility, and preventing oxidation that could compromise their functionality. Natural rubber latex (NRL) offers a promising coating alternative due to its biocompatibility and stability-enhancing properties. While NRL-coated MNPs have shown potential in applications such as magnetic resonance imaging, their effectiveness in theranostics, particularly magnetic hyperthermia (MH) and photoacoustic imaging (PAI), remains underexplored. Methods: In this study, iron oxide nanoparticles were synthesized via coprecipitation, using NRL as the coating agent. The samples were labeled by NRL amount used during synthesis: NRL-100 for 100 μL and NRL-400 for 400 μL. Results: Characterization results showed that NRL-100 and NRL-400 samples exhibited improved stability with zeta potentials of −27 mV and −30 mV, respectively and higher saturation magnetization values of 79 emu/g and 88 emu/g of Fe₃O₄. Building on these findings, we evaluated the performance of these nanoparticles in biomedical applications, including magnetomotive ultrasound (MMUS), PAI, and MH. NRL-100 and NRL-400 samples showed greater displacements and higher contrast in MMUS than uncoated samples (5, 8, and 9 µm) at 0.5 wt%. In addition, NRL-coated samples demonstrated an improved signal-to-noise ratio (SNR) in PAI. SNR values were 24.72 (0.51), 31.44 (0.44), and 33.81 (0.46) dB for the phantoms containing uncoated MNPs, NRL-100, and NRL-400, respectively. Calorimetric measurements for MH confirmed the potential of NRL-coated MNPs as efficient heat-generating agents, showing values of 43 and 40 W/g for NRL-100 and NRL-400, respectively. Conclusions: Overall, NRL-coated MNPs showed great promise as contrast agents in MMUS and PAI imaging, as well as in MH applications. Full article

Purpose: Elastography increased the diagnostic accuracy of liver fibrosis. However, several challenges persist, including the widespread utilization of equipment, difficulties in measuring certain cases, and the influence of viscosity factors. A rough surface and a blunted hepatic margin have long been acknowledged as valuable characteristics indicative of hepatic fibrosis. The objective of this study was to conduct an image analysis and quantitative assessment of the contour of the sagittal section of the left lobe of the liver. Methods: Between February and October 2020, 486 consecutive outpatients underwent ultrasound examinations at our hospital. A total of 214 images were manually annotated by delineating the liver contour to create annotation images. U-Net was employed for liver segmentation, with the dataset divided into training (n = 128), testing (n = 42), and validation (n = 44) subsets. Additionally, 43 Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) cases with pathology data from between 2015 and 2020 were included. Segmentation was performed using the program developed in the first step. Subsequently, shape analysis was conducted using ImageJ. Results: Liver segmentation exhibited high accuracy, as indicated by Dice loss of 0.044, Intersection over Union of 0.935, and an F score of 0.966. The accuracy of the classification of the liver surface as smooth or rough via ResNet 50 was 84.6%. Image analysis showed MinFeret and Minor correlated with liver fibrosis stage (p = 0.046, 0.036, respectively). Sensitivity, specificity, and AUROC of Minor for ≥F3 were 0.571, 0.862, and 0.722, respectively, and F4 were 1, 0.600, and 0.825, respectively. Conclusion: Deep learning segmentation of the sagittal cross-sectional contour of the left lobe of the liver demonstrated commendable accuracy. The roughness of the liver surface was correctly judged by artificial intelligence. Image analysis showed the thickness of the left lobe inversely correlated with liver fibrosis stage. Full article

The present work proposes a method for the synthesis of a nanoparticle with a superparamagnetic Fe₃O₄ core coated with SiO₂-NH₂ by ultrasound-assisted coprecipitation. Additionally, the nanoparticle is functionalized with a microinflammation biomarker peptide, and its effects on the viability of monkey kidney endothelial cells and the Vero cell line were evaluated. The main physicochemical properties of the nanoparticles were characterized by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), a vibrating sample magnetometer (VSM), a field emission scanning electron, Scanning Electron Microscopy (SEM), and High-Resolution Transmission Electron Microscopy (HR-TEM). The results showed that the nanoparticles are spherical, with sizes smaller than 10 nm, with high thermal stability and superparamagnetic properties. They also demonstrated cell viability rates exceeding 85% through Magnetic Resonance Imaging (MRI). The results indicate the potential of these nanoparticles to be used as a contrast agent in magnetic resonance to detect mild brain lesions. Full article

Background: Guyon’s canal syndrome is a pathological condition caused by compression of the ulnar nerve at the level of the wrist. It is less frequent than other compression syndromes of the upper limb (cubital and carpal tunnel), and different causative agents, including vascular lesions, are described. Among these, aneurysm of the ulnar artery is described in the literature as an infrequent aetiology. Case Presentation: We report the case of a 25-year-old young man with Guyon’s canal syndrome caused by an aneurysm of the ulnar artery, who underwent surgical decompression of the Guyon’s canal without intervening on the aneurysm. The postoperative course was free of complications, and the patient reported satisfaction, with reduced symptoms. Clinical examination and ultrasound imaging showed mass reduction of the aneurysm in the postoperative period, which appears to be an evolution hitherto undocumented in the literature. Conclusions: Many treatments are available for Guyon’s canal syndrome. Past medical and surgical treatments, duration and severity of symptoms, causes, and pathogenesis are important for therapeutic choice. Surgical treatment based on ligament section and lysis of the Guyon’s canal downstream, without any action on the aneurysm and with ulnar artery preservation, determined a reduction in terms of volume, relief of the symptoms, and patient satisfaction. With this case we describe a surgical therapeutic option for the treatment of Guyon’s canal syndrome caused by an aneurysm of the ulnar artery, in which surgery is limited to canal decompression and consequential aneurism mass reduction with concomitant relief of symptoms. Full article

Background/Objectives: This study investigated patient pain descriptors for transvaginal ultrasound (TVS) diagnostic evaluation of endometriosis for uterosacral ligaments (USLs), including correlation between USL thickness and site-specific tenderness (SST). It further investigated if SST could positively assist diagnosing endometriosis on TVS. Methods: TVS images and SST pain descriptors were collected from 42 patients. SST was evaluated by applying sonopalpation during TVS. The images were presented to six observers for diagnosis based on established USL criteria. Following this, they were given the SST pain scores and asked to reevaluate their diagnosis to assess if the pain scores impacted their decision. Results: An independent t-test showed that the patients with an endometriosis history had higher pain scores overall (7.2 ± 0.59) compared to the patients with no history (0.34 ± 0.12), t (40) = 8.8673. Spearman’s correlation showed a strong correlation to the pain scale score for clinical symptoms (r = 0.74), endometriosis diagnosis (r = 0.78), USL thickness (r = 0.74), and when USL nodules were identified (r = 0.70). Paired t-tests showed that the observers demonstrated a higher ability to correctly identify endometriosis with the pain scale information (33 ± 8.83) as opposed to not having this information (29.67 ± 6.31), which was a statistically significant change of 3.33, t (5) = 2.7735. Conclusions: Patients with an endometriosis history have significantly higher pain scores on TVS compared to patients with no endometriosis history. A strong correlation was shown between SST pain scores and patient symptoms, USL thickness, and USL nodules. Inclusion of SST alongside TVS imaging shows promise, with these results demonstrating a higher ability to diagnose endometriosis with additional SST pain scale information. Full article

Background/Objectives: Systematic quality review of ultrasound exams is recommended to ensure accurate diagnosis. Our primary objectives were to develop a quantitative method for quality review of estimated fetal weight (EFW) and to assess the accuracy of EFW for an entire practice and for individual personnel. A secondary objective was to evaluate the accuracy of fetal sex determination. Methods: This is a retrospective cohort study. Eligible ultrasound exams included singleton pregnancies with live birth and known birth weight (BW). A published method was used to predict BW from EFW for exams with ultrasound-to-delivery intervals of up to 12 weeks. Mean error and median absolute error (AE) were compared between different personnel. Image audits were performed for exams with AE > 30% and exams with reported fetal sex different than newborn sex. Results: We analyzed 1938 exams from 890 patients. In the last exam before birth, the median AE was 5.9%, and the predicted BW was within ±20% of the actual BW in 97.2% of patients. AE was >30% in 28 exams (1.4%); image audit found correct caliper placement in all 28. Only two patients (0.2%) had AE > 30% on the last exam before birth. One sonographer systematically over-measured head and abdominal circumferences, leading to EFWs that were overestimated. Reported fetal sex differed from newborn sex in seven exams (0.4%) and five patients (0.6%). Images in four of these patients were annotated with the correct fetal sex, but a clerical error was made in the report. In one patient, an unclear image was labeled “probably female”, but the newborn was male. Conclusions: The accuracy of EFW in this practice was similar to literature reports. The quantitative analysis identified a sonographer with outlier measurements. Time-consuming image audits could be focused on a small number of exams with large errors. We suggest some enhancements to ultrasound reporting software that may help to reduce clerical errors. We provide tools to help other practices perform similar quality reviews. Full article

Speckle noise is a granular interference that degrades image quality in coherent imaging systems, including underwater sonar, Synthetic Aperture Radar (SAR), and medical ultrasound. This study aims to enhance speckle noise reduction through advanced deep learning techniques. We introduce the Deep Gradient-Guidance Network (DGGNet), which features an architecture comprising one encoder and two decoders—one dedicated to image recovery and the other to gradient preservation. Our approach integrates a gradient map and fractional-order total variation into the loss function to guide training. The gradient map provides structural guidance for edge preservation and directs the denoising branch to focus on sharp regions, thereby preventing over-smoothing. The fractional-order total variation mitigates detail ambiguity and excessive smoothing, ensuring rich textures and detailed information are retained. Extensive experiments yield an average Peak Signal-to-Noise Ratio (PSNR) of 31.52 dB and a Structural Similarity Index (SSIM) of 0.863 across various benchmark datasets, including McMaster, Kodak24, BSD68, Set12, and Urban100. DGGNet outperforms existing methods, such as RIDNet, which achieved a PSNR of 31.42 dB and an SSIM of 0.853, thereby establishing new benchmarks in speckle noise reduction. Full article

This article describes a technique for gluteal augmentation using cross-linked hyaluronic acid (HA) filler, with a focus on long-term patient follow-up. The rising demand for buttock enhancement driven by esthetic preferences has led to the exploration of minimally invasive alternatives to traditional surgical methods. Ultrasound imaging was utilised to evaluate the presence and distribution of HA filler over time. The patients reported satisfactory aesthetic improvements, with mild transient side effects. The findings highlight the technique’s effectiveness in achieving enhanced gluteal contour with a minimal volume of filler, demonstrating both safety and durability in the long term. This innovative approach may serve as a valuable option in aesthetic practises focused on body contouring. Full article

Prostate cancer (PCa) is a clinically heterogeneous disease. Predicting clinically significant PCa with low–intermediate prostate-specific antigen (PSA), which often includes aggressive cancers, is imperative. This study evaluated the predictive accuracy of deep learning analysis using multimodal medical data focused on clinically significant PCa in patients with PSA ≤ 20 ng/mL. Our cohort study included 178 consecutive patients who underwent ultrasound-guided prostate biopsy. Deep learning analyses were applied to predict clinically significant PCa. We generated receiver operating characteristic curves and calculated the corresponding area under the curve (AUC) to assess the prediction. The AUC of the integrated medical data using our multimodal deep learning approach was 0.878 (95% confidence interval [CI]: 0.772–0.984) in all patients without PSA restriction. Despite the reduced predictive ability of PSA when restricted to PSA ≤ 20 ng/mL (n = 122), the AUC was 0.862 (95% CI: 0.723–1.000), complemented by imaging data. In addition, we assessed clinical presentations and images belonging to representative false-negative and false-positive cases. Our multimodal deep learning approach assists physicians in determining treatment strategies by predicting clinically significant PCa in patients with PSA ≤ 20 ng/mL before biopsy, contributing to personalized medical workflows for PCa management. Full article

Background/Objectives: Genicular artery embolization (GAE) has demonstrated potential as a treatment for knee osteoarthritis by targeting inflammation and pain, although current evidence remains limited. This study used imaging biomarkers to objectively assess synovitis and possible ischemic complications following GAE. Methods: This was a prospective, single-center trial including participants with mild-to-moderate knee osteoarthritis. Ultrasound, contrast-enhanced (CE), and non-CE-MRI were performed two days before and one and six months after GAE. Ultrasound biomarkers included synovial hypertrophy, effusion, and Doppler activity. A combined effusion-synovitis score was assessed on non-CE-MRI, while CE-MRI allowed differentiation between synovium and effusion and was used to calculate whole-joint and local synovitis scores. The post-GAE MRIs were reviewed for ischemic complications. Results: Seventeen participants (aged 43–71) were treated. Significant reductions were observed in ultrasound-assessed synovial hypertrophy and Doppler activity, as well as in CE-MRI local and whole-joint synovitis scores. While reductions in effusion were noted in both ultrasound and MRI, these changes did not reach statistical significance. At one month, MRI revealed three cases of nonspecific osteonecrosis-like areas, which resolved completely by six months. Conclusions: This study demonstrated a reduction in synovitis and no permanent ischemic complication following GAE in knee osteoarthritis. Larger studies with longer follow-up are needed to confirm the long-term efficacy and safety of the procedure. Full article

The predictive brain hypothesis suggests that perception can be interpreted as the process of minimizing the error between predicted perception tokens generated via an internal world model and actual sensory input tokens. When implementing working examples of this hypothesis in the context of in-air sonar, significant difficulties arise due to the sparse nature of the reflection model that governs ultrasonic sensing. Despite these challenges, creating consistent world models using sonar data is crucial for implementing predictive processing of ultrasound data in robotics. In an effort to enable robust robot behavior using ultrasound as the sole exteroceptive sensor modality, this paper introduces EchoPT (Echo-Predicting Pretrained Transformer), a pretrained transformer architecture designed to predict 2D sonar images from previous sensory data and robot ego-motion information. We detail the transformer architecture that drives EchoPT and compare the performance of our model to several state-of-the-art techniques. In addition to presenting and evaluating our EchoPT model, we demonstrate the effectiveness of this predictive perception approach in two robotic tasks. Full article

Objective: To evaluate the accuracy of the O-RADS system in differentiating between benign and malignant adnexal masses, as assessed by inexperienced gynecologists. Methods: Ten gynecologic residents attended a 20 h training course on the O-RADS system conducted by experienced examiners. Following the training, the residents performed ultrasound examinations on patients admitted with adnexal masses under supervision, recording the data in a database that included videos and still images. The senior author later accessed this ultrasound database and presented the cases offline to ten residents for O-RADS rating, with the raters being blinded to the final diagnosis. The efficacy of the O-RADS system by the residents and inter-observer variability were assessed. Results: A total of 201 adnexal masses meeting the inclusion criteria were evaluated, consisting of 136 (67.7%) benign masses and 65 (32.3%) malignant masses. The diagnostic performance of the O-RADS system showed a sensitivity of 90.8% (95% CI: 82.2–96.2%) and a specificity of 86.8% (95% CI: 80.4–91.8%). Inter-observer variability in scoring was analyzed using multi-rater Fleiss Kappa analysis, yielding Kappa indices of 0.642 (95% CI: 0.641–0.643). The false positive rate was primarily due to the misclassification of solid components in classic benign masses as O-RADS-4 or O-RADS-5. Conclusions: The O-RADS system demonstrates high diagnostic performance in distinguishing benign from malignant adnexal masses, even when used by inexperienced examiners. However, the false positive rate remains relatively high, mainly due to the over-interpretation of solid-appearing components in classic benign lesions. Despite this, inter-observer variability among non-expert raters was substantial. Incorporating O-RADS system training into residency programs is beneficial for inexperienced practitioners. This study could be an educational model for gynecologic residency training for other systems of sonographic features. Full article