Search Results (98)

Soft tissue tumors (STTs) are a heterogeneous group of mesenchymal neoplasms requiring accurate differentiation for optimal patient management. While histopathology remains the gold standard, imaging plays a crucial role in non-invasive assessment. Multiparametric ultrasound (mpUS) has emerged as a promising, cost-effective alternative to MRI, integrating B-mode, color and power Doppler, shear wave elastography (SWE), and contrast-enhanced ultrasound (CEUS) to provide comprehensive morphological, vascular, and biomechanical insights. Each modality offers distinct yet complementary diagnostic value, enhancing accuracy and potentially reducing unnecessary biopsies. This narrative review aims to serve as a practical guide, providing a readily accessible reference for mpUS parameters useful in the differential diagnosis of soft tissue tumors. Full article

Background: Immune checkpoint inhibitors (ICIs) transformed cancer treatment, producing significant survival benefits. However, ICIs can trigger toxicities called immune-related adverse events (irAEs), including inflammatory arthritis (IA) and polymyalgia rheumatica (PMR)-like syndromes. Our study aimed to systematically further characterize musculoskeletal ultrasound (MSKUS) findings in patients with ICI-IA and ICI-PMR, collectively referred to as “MSK-irAEs”, and explore the role of US in guiding treatment. Methods: The authors conducted a comprehensive chart review for patients receiving ICIs undergoing MSKUS at our center’s rheumatology clinics. US examinations were performed and reviewed by two MSKUS-certified rheumatologists. Descriptive statistics were performed to summarize demographic, clinical, and treatment-related variables. US findings were categorized with a novel scoring system: 0—no signs of inflammatory arthropathy or tendinopathy, 1—potential signs of inflammation (grayscale ≥ 2, effusion without power Doppler, synovial hypertrophy in the joint), and 2—active inflammation in joints and/or tendons (characterized by power Doppler) and signs of inflammation. Results: Twenty-three patients were included. The median age was 63 years, 52% were male, and 87% were White. Melanoma was the most common cancer (48%). MSK-irAEs were diagnosed in nineteen (83%), with MSKUS showing inflammation in seventeen (74%). Sixteen (70%) received escalation in MSK-irAE treatment after MSKUS. Four (17%) had erosive disease due to MSK-irAEs, while one had erosive osteoarthritis. Individuals with inflammatory erosive changes experienced prolonged intervals between symptom onset and MSKUS, ranging from 17 to 82 months, suggesting that erosions may reflect chronic, under-recognized inflammation. On MSK-irAE therapy, nine (47%) experienced symptomatic improvement, five (26%) achieved resolution, and in four (21%) cases, it was too early to assess the response. MSKUS detected other causes of MSK symptoms besides MSK-irAEs in several patients, allowing ICI resumption in one. Conclusions: Our study highlights the clinical utility of MSKUS not only as a diagnostic tool but also to guide therapeutic decision-making. Full article

Objectives: To assess the role of musculoskeletal ultrasound (MSUS) in selecting patients with rheumatoid arthritis (RA) in sustained clinical remission, suitable for tapering of biologic therapy (BT), and monitoring for a subclinical relapse. Methods: In this prospective study, seventy-eight patients with RA in sustained Disease Activity for twenty-eight joints (DAS28) clinical remission underwent ultrasound (US) examination of twenty-two joints (bilaterally wrists and metacarpophalangeal and proximal interphalangeal joints). US assessment was performed on gray scale ultrasound (GSUS) and power Doppler US (PDUS) to select patients in imaging remission, defined as a total PD score of synovitis = 0. Group 1 consisted of patients in clinical and imaging remission, in which tapering of BT was done through spacing of the Tumour Necrosis Factor Alpha (TNF-$\alpha$) blocker. Group 2 consisted of patients only in clinical remission (PDUS > 0), who continued standard therapy. Clinical and US assessment was done at months 6 and 12, and the rate of a clinical (defined as DAS28 ≥ 2.6) and an US relapse (PDUS score ≥ 1) was recorded. Results: Thirty-eight patients were in clinical and US remission (group 1) and forty patients only in clinical remission (group 2). At month 6, 26% of patients in group 1 and 10% in group 2 experienced a clinical and an US relapse, whereas 20% and 15% of them, respectively, only an US relapse. At month 12, 26% of patients in group 1 and 20% of patients in group 2 experienced a clinical and an US relapse, whereas 35% and 22% of them, respectively, only an US relapse. Conclusions: Real-world data show that MSUS is a useful tool to identify RA patients in sustained clinical remission appropriate for BT tapering. US monitoring could predict a clinical relapse and the need to re-escalate treatment in patients with subclinical US relapse during BT tapering. Full article

Objective: Transvaginal ultrasonography plays a crucial role in contemporary fertility management, offering insights into uterine and endometrial blood flow. Three-dimensional ultrasonography utilizing power Doppler angiography (3D-CPA) allows precise measurement of endometrial volume and vascular parameters, such as the vascularization index (VI), blood flow index (FI), and vascularization flow index (VFI); variables that indirectly assess endometrial receptivity and integrity. Doppler technology allows for the capture of changes in the uterus induced by hormonal-related fluctuations during the menstrual cycle, revealing a significant correlation between endometrial receptivity and vascularity. Age-related changes in endometrial function are implicated in declining fertility, with limited research exploring this aspect. The aim of this study was to investigate the impact of aging on various ultrasound parameters of the uterus, including endometrial vascularity. Methods: A retrospective cross-sectional study of women who attended the Feto-Maternal Centre from January 2022 to December 2023. Each woman whose menstrual cycle was regular underwent 3D ultrasound with power Doppler as part of the routine assessment of the pelvis. Parameters assessed include the VI, FI, and VFI as well as uterine volume, endometrial volume, and endometrial thickness. The women were grouped based on age, and the variables measured in the follicular and luteal phases were compared between the age groups using SPSS version 30 September 2024. Results: A total of 907 women (427 follicular and 480 luteal phase) were studied: 297 (131 follicular and 166 luteal) were 20–29 years old; 471 (240 follicular and 231 luteal) were aged 30–39; and 139 (56 follicular and 83 luteal) were aged 40–49. Uterine volume, endometrial volume, and thickness increased significantly and steadily with age. VI, VFI, and FI decreased significantly with age in the follicular phase, but in the luteal phase there was no statistically significant difference in any of these indices with age. Conclusions: Uterine volume, endometrial thickness, and endometrial volume increased with age, but the vascular indices decreased with age in the follicular but not in the luteal phase. These age-related changes in endometrial vascularity may partly explain the decrease in age-related fertility. Further research is needed to comprehensively explore the complexities of uterine aging and its implications for female fertility. Full article

Hemodynamic assessment is critical in emergency and critical care for preventing, diagnosing, and managing shock states that significantly affect patient outcomes. Point-of-care ultrasound (POCUS) has become an invaluable, non-invasive, real-time, and reproducible tool for bedside decision-making. Advancements such as Doppler imaging, advanced critical care ultrasonography, and transesophageal echocardiography (TEE) have expanded its utility, enabling rapid and repeatable evaluations, especially in complex mixed shock presentations. This review explores the role of POCUS in hemodynamic monitoring, emphasizing its ability to assess cardiac output, filling pressures, and vascular congestion, facilitating shock classification and guiding fluid management. We highlight an extensive array of POCUS techniques for evaluating right and left cardiac function and review existing literature on their advantages, limitations, and appropriate clinical applications. Beyond assessing volume status, this review discusses the role of POCUS in predicting fluid responsiveness and supporting more individualized, precise management strategies. Ultimately, while POCUS is a powerful tool for rapid, comprehensive hemodynamic assessment in acute settings, its limitations must be acknowledged and thoughtfully integrated into clinical decision-making. Full article

Background: In recent years, musculoskeletal ultrasonography (MSUS) has established itself as a reliable method for evaluating disease activity in combination with clinical examination and laboratory tests. Objectives: In this pilot study, we aimed to evaluate the ultrasound response to treatment with tofacitinib and upadacitinib on tendons and joints in comparison to clinical and laboratory results in patients with RA who have shown inadequate response to conventional synthetic and/or biologic disease-modifying antirheumatic drugs (cs/b DMARDs). Methods: This study presents the MSUS assessment of therapeutic response in RA patients treated with tofacitinib or upadacitinib over a 24-week period. In a prospective, single-center study, patients were treated with upadacitinib 15 mg/daily or tofacitinib 2 × 5 mg/daily or 11 mg/daily, in combination with or without methotrexate or another conventional DMARDs. Disease activity was assessed by DAS28-CRP, CDAI, and SDAI, as well as MSUS. Patients were evaluated at baseline for ultrasound measures and at weeks 2, 4, 8, 12, and 24 for the rest of the indicators. For each patient, we used two ultrasound (US) scores (gray-scale, GS, and power Doppler, PD scores) and the system of European Alliance of Associations for Rheumatology outcome measures in rheumatology (EULAR-OMERACT) US scoring (combined GS and PD). We also calculated the tenosynovitis score (GS and PD) according to OMERACT recommendations. Results: A total of 53 patients were recruited. A total of 25 patients with a mean age of 56 ± 11.6 SD were followed in the upadacitinib group, and 22 patients with a mean age of 56.9 ± 11.3 were followed in the tofacitinib group. At baseline, DAS28-CRP for the upadacitinib group was 5.57 ± 1.24, and for tofacitinib, it was 4.77 ± 1.47. The baseline visit (GS, PD, and combined—US) and tendon US scores (GS and PD) were, respectively, 23 ± 2.96, 15 ± 2.56, 24.08 ± 3.36, 11.04 ± 2.21, and 8.44 ± 1.65 for the upadacitinib group. USGS-J—23 ± 3.55, USPD-J—13.36 ± 2.44, OMERACT composite—23.4 ± 3.84, USGS-T—12.18 ± 2.23, and USPD-T—9.5 ± 1.92 were found in the patients treated with tofacitinib. In both groups of patients, a significant reduction was found in both DAS28-CRP and the described MSUS scores at weeks 8, 12, and 24 (p < 0.05). Conclusions: Upadacitinib managed to produce lower echography scores much faster than tofacitinib; however, the differences in effectiveness evened out at weeks 12 and 24, with all patients being adequately controlled. Full article

Aim: To identify ultrasound (US) predictors of persistence or change in the diagnosis of rheumatoid arthritis (RA) after five years in a cohort of patients with early RA. Patients and Methods: One hundred and twenty patients with early arthritis who met the 2010 ACR/EULAR classification criteria for RA were followed for a period of five years. The US assessment at baseline included a bilateral evaluation of the wrists, second to fifth metacarpophalangeal (MCP) joints, second to fifth proximal interphalangeal (PIP) joints, the IV and VI extensor compartments of the wrists, and the flexor tendons of the second to fifth fingers. This evaluation was conducted using both grayscale ultrasound (GSUS) and power Doppler ultrasound (PDUS). The following scores were recorded for each patient: synovitis score, mini-enthesitis score (including paratenonitis of the finger extensor tendon at the MCP joint, central slip enthesitis at the PIP joint, pseudotenosynovitis, and the A1 pulley of the second finger), finger flexor tenosynovitis score, and tenosynovitis score for the IV and VI wrist extensor compartments. The receiver operating characteristic (ROC) curve was utilized to identify the ultrasound predictors for either maintaining or revising an initial diagnosis of RA. Results: At month 6, 82 (68%) patients were classified as having RA according to 1987 ACR RA criteria, 23 (19.2%) were diagnosed with psoriatic arthritis (PsA), 10 (8.3%) with systemic connective tissue disease (SCTD)–8 (6.7%) patients with Sjogren Syndrome and 2 (1.7%) patients with systemic lupus erythematosus (SLE)–and 5 (4.2%) patients with calcium pyrophosphate deposition disease (CPPD). The most significant predictor of RA in the fifth year was the VI extensor compartment tenosynovitis score, with an AUC of 0.915 and a criterion value > 0, associated with a sensitivity of 82.93% and a specificity of 100% (p < 0.001). The PDUS synovitis score demonstrated the second-best prognostic ability with an AUC of 0.823, a criterion value > 2, a sensitivity of 82.93%, and a specificity of 73.68% (p < 0.001). The mini-enthesitis score showed the best prognostic ability of a PsA diagnosis with an AUC of 0.998, a criterion value > 1, a sensitivity of 95.65%, and a specificity of 100% (p < 0.001). The paratenonitis score, pseudotenosynovitis score, and thickened A1 pulley were also predictive of PsA diagnosis with AUCs of 0.977, 0.955, and 0.919, respectively (p < 0.001 for all). Conclusions: Nearly one-third of the patients who were initially classified as having RA had their diagnosis revised at the end of the fifth year. Ultrasound of joints, tendons, and mini-entheses at baseline may serve as potential imaging predictive biomarkers for persistence or change in diagnosis after 5 years. Full article

Background/Objectives: Lymph node (LN) evaluation is critical in diagnosing, staging, and managing various diseases, particularly lymphoma and metastatic cancer. Although conventional ultrasound (US) is widely used for this purpose, its limitations in reliably differentiating between benign and malignant LNs persist. Ultrasound elastography (US-E), which evaluates tissue stiffness, has emerged as a promising adjunct to improve diagnostic accuracy. This study aims to evaluate the diagnostic performance of conventional US, power Doppler US, and strain elastography (SE) in distinguishing malignant from benign superficial lymph nodes. Methods: In this prospective study, 214 consecutive patients referred for US of enlarged LNs were enrolled. Conventional B-mode US, power Doppler, and SE were performed, and the strain ratio (SR) was calculated as a measure of LN stiffness. Histopathological examination was used as the reference standard. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) analysis, and multivariable logistic regression models were applied to determine the independent predictive role of SR. Results: Among the 214 LNs (one for each patient), 74 (34.6%) were benign and 140 (65.4%) were malignant. The SR showed a significant association with malignancy (p < 0.001). For hematological malignancies, SR demonstrated high sensitivity (79–85%) and specificity (81–96%), with an overall area under the curve (AUC) of 0.91. Multivariable analysis confirmed that SR was an independent predictor of malignancy (continuous and dichotomous), with a 14% gain in predictive accuracy when treated as a continuous variable (p < 0.0001). Conclusions: US-E, particularly SR, is a valuable tool in the differentiation of benign and malignant superficial LNs. SR provides significant diagnostic value, especially in hematological neoplasms like Hodgkin lymphoma, and can serve as an independent predictor of malignancy. This technique, when used in combination with conventional US features, offers enhanced diagnostic performance for LN evaluation. Full article

Anterior cruciate ligament reconstruction with concurrent lateral extra-articular tenodesis enhances rotational stability. However, not many studies describe radiological features following the abovementioned procedure. The purpose of this study was to evaluate the visibility and describe the sonographic morphology of the iliotibial band strip harvested during the modified Lemaire technique and to establish a correlation between these findings and clinical outcomes. Thirty-two consecutive patients underwent primary or revision anterior cruciate ligament reconstruction with the addition of lateral extra-articular tenodesis by the mini-open modified Lemaire technique. All individuals completed the following preoperative and postoperative questionnaires: the KOOS-pain, KOOS-symptoms, KOOS-ADL, KOOS-sport, KOOS-quality, IKDC, Lysholm, and WOMAC. Each patient underwent a postoperative ultrasound examination to evaluate the lateral extra-articular procedure, especially the harvested iliotibial band strip. The most common ultrasound findings of the iliotibial band strip were its hyperechoic appearance (87.1%), location at the level of the femur (58.1%), no surrounding effusion (83.9%), and no power Doppler signal (100%). Effusion seen in sonographic images was correlated with KOOS-symptoms postoperative scores (p = 0.0115). However, there were no correlations between other iliotibial band strip sonographic features and clinical outcomes. The functional score value increased in each patient compared to preoperative measurements. This is the first study that evaluated the sonographic features of the iliotibial band strip after the lateral extra-articular procedure by the mini-open modified Lemaire technique. Our study indicates that ultrasonography is a useful tool in identifying the iliotibial band strip after the mentioned procedure. Effusion observed around the strip on ultrasound was significantly associated with worse KOOS-symptoms scores, suggesting potential clinical relevance. Full article

Background: Ultrasonography is essential for diagnosing endometrial pathologies, such as hyperplasia, polyps, and endometrial cancer. The International Endometrial Tumor Analysis (IETA) group provides guidelines for using ultrasound to assess endometrial thickness, texture, and irregularities, aiding in the diagnosis of these conditions. The aim of this study was to evaluate the utility of various endometrial morphological features, as assessed by gray-scale ultrasound, and endometrial vascular features, as assessed by power Doppler ultrasound, in differentiating benign and malignant endometrial pathologies. A secondary objective was to compare the effectiveness of these ultrasound techniques in assessing myometrial invasion. Methods: A total of 162 women, both pre- and postmenopausal, with or without abnormal vaginal bleeding were enrolled in a prospective study. All participants underwent transvaginal gray-scale and color Doppler ultrasound examinations, conducted by examiners with over 15 years of experience in gynecological ultrasonography. Endometrial morphology and vascularity characteristics were evaluated based on the IETA group criteria, which include parameters such as endometrial uniformity, echogenicity, the three-layer pattern, regularity of the endometrial–myometrial border, Doppler color score, and vascular pattern (single dominant vessel with or without branching, multiple vessels with focal or multifocal origin, scattered vessels, color splashes, and circular flow). Sonographic findings were compared with histopathological results for comprehensive assessment. Results: The mean age of the study population was 56.46 ± 10.84 years, with a range from 36 to 88 years. Approximately 53.08% of the subjects were postmenopausal. The mean endometrial thickness, as measured by transvaginal ultrasonography, was 18.02 ± 10.94 mm with a range of 5 to 64 mm (p = 0.028), and it was found to be a significant predictor of endometrial malignancy. The AUC for the ROC analysis was 0.682 (95% CI: 0.452–0.912), with a cut-off threshold of 26 mm, yielding a sensitivity of 62.5% and a specificity of 89%. Vascularization was absent in 68.4% of patients with polyps. Among the cases with submucosal myomas, 80% exhibited a circular flow pattern. Malignant lesions were identified in 22.84% of the cases. Subjective ultrasound assessment of myometrial invasion, categorized as <50% or ≥50%, corresponded in all cases with the histopathological evaluation, demonstrating the effectiveness of ultrasound in evaluating myometrial invasion in endometrial cancer. Conclusions: In this study, cystic atrophic endometrium was identified as the most prevalent cause of postmenopausal bleeding. The most significant ultrasound parameters for predicting malignancy included heterogeneous endometrial echogenicity, increased endometrial thickness, and the presence of multiple vessels with multifocal origins or scattered vascular patterns. Additionally, color Doppler blood flow mapping was demonstrated to be an effective diagnostic tool for the differential diagnosis of benign intrauterine focal lesions. Full article

Hand gesture recognition (HGR) is a convenient and natural form of human–computer interaction. It is suitable for various applications. Much research has already focused on wearable device-based HGR. By contrast, this paper gives an overview focused on device-free HGR. That means we evaluate HGR systems that do not require the user to wear something like a data glove or hold a device. HGR systems are explored regarding technology, hardware, and algorithms. The interconnectedness of timing and power requirements with hardware, pre-processing algorithm, classification, and technology and how they permit more or less granularity, accuracy, and number of gestures is clearly demonstrated. Sensor modalities evaluated are WIFI, vision, radar, mobile networks, and ultrasound. The pre-processing technologies stereo vision, multiple-input multiple-output (MIMO), spectrogram, phased array, range-doppler-map, range-angle-map, doppler-angle-map, and multilateration are explored. Classification approaches with and without ML are studied. Among those with ML, assessed algorithms range from simple tree structures to transformers. All applications are evaluated taking into account their level of integration. This encompasses determining whether the application presented is suitable for edge integration, their real-time capability, whether continuous learning is implemented, which robustness was achieved, whether ML is applied, and the accuracy level. Our survey aims to provide a thorough understanding of the current state of the art in device-free HGR on edge devices and in general. Finally, on the basis of present-day challenges and opportunities in this field, we outline which further research we suggest for HGR improvement. Our goal is to promote the development of efficient and accurate gesture recognition systems. Full article

Background/Objectives: This study aimed to investigate the effectiveness of etanercept biosimilar 1 under real-world clinical conditions in patients with rheumatoid arthritis (RA), using not only clinical evaluation but also musculoskeletal ultrasound (MSUS). Methods: This multicenter, interventional, open-label, single-arm clinical trial conducted a 24-week follow-up. Patients with RA with moderate to high disease activity received weekly subcutaneous injections of etanercept biosimilar 1 at 50 mg/dose for 24 weeks. The effectiveness was evaluated with clinical indices and MSUS. Results: Twenty-three patients were evaluated during the study period. The primary endpoint involves a change in the Global OMERACT-EULAR Synovitis Score by MSUS in bilateral second–fifth metacarpophalangeal joints from baseline, demonstrating median (IQR) values of 0 (−4, 1), including 4 (1, 9.8) and 2 (0, 5) at baseline and 24 weeks, respectively. The clinical endpoints exhibited a good treatment response, with 15 (68%) and 18 (86%) patients achieving low disease activity or remission at 12 weeks and 24 weeks, respectively. Additionally, MSUS scores improved at both 12 and 24 weeks compared to baseline. The patients who achieved power doppler remission (total power doppler score = 0) at 24 weeks demonstrated a shorter disease duration and no previous use of biological disease-modifying antirheumatic drugs compared to those with no power doppler remission. Conclusions: Etanercept biosimilar 1 exhibited significant improvements not only in clinical indices but also in MSUS assessment, indicating its effectiveness at the structural level. Full article

Background: There have been multiple studies on the use of Doppler ultrasound to define skin inflammation, but the visible vessels of healthy skin have yet to be described. Objective: This study aimed to evaluate the visible vessels of healthy skin using Doppler ultrasound. Methods: Prospective multicenter study using Doppler ultrasound to analyze healthy skin. The color percentage, flow velocity, and maximum vessel diameter were calculated. Results: 943 images from 152 patients were recorded. The most frequently used mode was color Doppler (40.6%), followed by power Doppler (30.4%). Visible vessels were detected in 18.23%; in positive Doppler images, color occupied less than 5%. The malar region exhibited the highest visible vessels. The 22 MHz probe detected smaller vessels with slower flows than the 18 MHz probe. Spectral Doppler showed peak systolic values of less than 10 cm/s and a vessel diameter of less than 1 mm. In most of the participating centers, the operators had less than 10 years of experience in performing skin ultrasound examinations. Sensitivity of the Doppler may vary according to the device. Conclusions: With the used ultrasound equipment, it was uncommon to visualize vessels in healthy skin. When seen, they covered less than 5% of the image with low flow and small size. Full article

Molecular biomarker profiling is an emerging field in maternal-fetal health with the potential to transform early detection and prediction of placental dysfunction. By analysing a range of biomarkers in maternal blood, researchers and clinicians can gain crucial insights into placental health, enabling timely interventions to enhance fetal and maternal outcomes. Placental structural function is vital for fetal growth and development, and disruptions can lead to serious pregnancy complications like preeclampsia. While conventional methods such as ultrasound and Doppler velocimetry offer valuable information on fetal growth and blood flow, they have limitations in predicting placental dysfunction before clinical signs manifest. In contrast, molecular biomarker profiling can provide a more comprehensive assessment by measuring proteins, metabolites, and microRNAs (miRNAs) in maternal blood, reflecting the placenta’s endocrine and metabolic functions. This approach offers a deeper understanding of placental health and function, aiding in early detection and prediction of complications. Challenges in developing molecular biomarker profiling include pinpointing specific molecular changes in the placenta linked to pathologies, timing predictions of conditions before clinical onset, and understanding how placental dysfunction affects maternal metabolism. Validating specific biomarkers and integrating them effectively into clinical practice requires further research. This review underscores the significance of molecular biomarker profiling as a powerful tool for early detection and prediction of placental dysfunction in maternal-fetal health. Through an exploration of biomarker analysis, we delve into how a deeper understanding of placental health can potentially improve outcomes for both mother and baby. Furthermore, we address the critical need to validate the utility of biomarkers and effectively integrate them into clinical practice. Full article

Sonoelastography is a rapid and non-invasive ultrasound-based technique to assess tissue elasticity. Interest in this technique’s application in veterinary medicine is progressively increasing, with preliminary reports also available to assess canine testicular parenchyma abnormalities. Since elastographic techniques are different and it is of paramount importance to standardize procedures, this work aimed to compare two different elastographic techniques, SE and 2D SWE, on the same testes and compare the data with the current literature. Thirty healthy canine testes were included, and complete B-mode, color and power Doppler examinations were performed on each one. SE was performed qualitatively through an elastogram evaluation and semiquantitatively comparing the parenchyma with peripheral skin. 2D SWE was performed and m/s measurements were taken. Each measurement was collected in the cranial, middle and caudal portions, considering the sections above and below the mediastinum separately. The healthy testes appeared to be intermediate in stiffness with differences in the various portions for SE and expressed a mean value from 1.3 m/s to 1.4 m/s for 2D SWE, consistent with the previous literature. Considering the technical specifics of the software for the two elastography methods, both of them are valuable in assessing canine testis stiffness and are potentially clinically appliable. Full article