Search Results (77)

Background: Ultrasound (U/S) can be used to evaluate skeletal muscle characteristics in clinical and sports settings. Handheld U/S devices have recently emerged as a cheaper and portable alternative to conventional U/S systems. However, further research is warranted on their reliability. We assessed the reliability and inter-device agreement between a handheld U/S device (Clarius L15 HD₃) and a more conventional U/S system (GE LOGIQ e) for measuring the thickness of the rectus femoris (RF) and vastus intermedius (VI). Methods: Cross-sectional images of the RF and VI muscles were obtained in 20 participants by two assessors, and on two separate occasions by one of those assessors, using the Clarius L15 HD₃ and GE LOGIQ e devices. RF and VI thickness measurements were obtained to determine the intra-rater reliability, inter-rater reliability, and inter-device agreement. Results: All intraclass correlation coefficients (ICCs) were above 0.9 for intra-rater reliability (range: 0.94 to 0.97), inter-rater reliability (ICC: 0.97), and inter-device agreement (ICC: 0.98) when comparing the two devices in assessing RF and VI thickness. For the RF, the Bland–Altman plot revealed a mean difference of 0.06 ± 0.07 cm, with limits of agreement ranging from 0.21 to −0.09, whereas for the VI, the Bland–Altman plot showed a mean difference of 0.07 ± 0.10 cm, with limits of agreement ranging from 0.27 to −0.13. Conclusions: The handheld Clarius L15 HD₃ was reliable and demonstrated high agreement with the more conventional GE LOGIQ e for assessing the thickness of the RF and VI in young, healthy adults. Full article

Introduction: In breast conserving surgery (BCS), 15–40% of patients must undergo a second surgery (re-operation) due to post-surgical cancer-positive margins. Efficient intraoperative assessment of lumpectomy margins can reduce this rate. Classical methods like specimen radiography and ultrasound have limitations. The SHIELD study was conducted to prospectively quantify the reduction of the re-operation rate when the Histolog^® Scanner (HLS) confocal microscope is intraoperatively used by surgeons for the margin assessment. Methods: 50 patients undergoing BCS were enrolled and analyzed. Lumpectomy margins were intraoperatively assessed by surgeons with the HLS in addition to standard-of-care techniques. Detected positive margins triggered the excision of additional recuts during the same surgery. Subsequent re-operation and detection rates were compared to historical data and pathology gold standards, respectively. Results: The study population included 32% of patients with pure invasive cancer(s), 18% with pure DCIS and 50% with invasive cancer(s) mixed with DCIS. The overall mean age was 63.56. All population features were statistically similar to the historical control (p > 0.1). Notably, 80.95% sensitivity and 99.53% specificity for breast cancer detection at the margin were intraoperatively achieved by the surgeons using the HLS. The re-operation rate in SHIELD was 10% (5/50) while the historical control was 30% (12/40) corresponding to a 67% reduction (p = 0.016). Notably, 17/21 positive margins were intraoperatively identified with the HLS while 4/21 were detected with standard-of-care techniques. Conclusions: The intraoperative use of the Histolog Scanner confocal microscope provides a significant increase in detection rates of lumpectomy positive margins resulting in a substantial reduction in the re-operation rate, while preserving specimen integrity without impact on histopathology assessment. Full article

Previous work has demonstrated quantitative ultrasound (QUS) analysis techniques for extracting features and texture features from ultrasound radiofrequency data which can be used to distinguish between benign and malignant breast masses. It is desirable that there be good agreement between estimates of such features acquired using different ultrasound devices. Handheld ultrasound imaging systems are of particular interest as they are compact, relatively inexpensive, and highly portable. This study investigated the agreement between QUS parameters and texture features estimated from clinical ultrasound images of breast tumors acquired using two different ultrasound scanners: a traditional cart-based system and a wireless handheld ultrasound system. The 28 patients who participated were divided into two groups (benign and malignant). The reference phantom technique was used to produce functional estimates of the normalized power spectra and backscatter coefficient for each image. Root mean square differences of feature estimates were calculated for each cohort to quantify the level of feature variation attributable to tissue heterogeneity and differences in system imaging parameters. Cross-system statistical testing using the Mann–Whitney U test was performed on benign and malignant patient cohorts to assess the level of feature estimate agreement between systems, and the Bland–Altman method was employed to assess feature sets for systematic bias introduced by differences in imaging method. The range of p-values was 1.03 × 10⁻⁴ to 0.827 for the benign cohort and 3.03 × 10⁻¹⁰ to 0.958 for the malignant cohort. For both cohorts, all five of the primary QUS features (MBF, SS, SI, ASD, AAC) were found to be in agreement at the 5% confidence level. A total of 13 of the 20 QUS texture features (65%) were determined to exhibit statistically significant differences in the sample medians of estimates between systems at the 5% confidence level, with the remaining 7 texture features being in agreement. The results showed a comparable magnitude of feature variation between tissue heterogeneity and system effects, as well as a moderate level of statistical agreement between feature sets. Full article

Photoacoustic (PA) imaging combines optical contrast with ultrasound (US) detection, enabling high-resolution imaging of biological tissues with greater penetration depth than conventional optical techniques. Among its various implementations, photoacoustic microscopy (PAM) achieves micrometer-scale resolution by focusing laser excitation and detecting ultrasonic signals, allowing for the detailed visualization of microvascular structures and fine tissue morphology. Over the last decade, PAM imaging speed has significantly increased by adopting PA scanners that steer optical and acoustic waves. However, these scanners must be placed after focusing optics to co-align the waves on a spot, which creates bent focal lines along the scanning direction and limits the scanning range. To achieve wide-field imaging, various image mosaic algorithms have been applied, but these methods require multiple manual operations, which take more time than the imaging itself. In this study, we developed a wide-field, high-speed scanning acoustic/photoacoustic microscopy (SA/PAM) system equipped with a transparent ultrasound transducer and a moving magnet linear stage, which eliminates the need for complex mosaic algorithms. This system enables wide-field imaging up to 50 × 50 mm² while maintaining high lateral resolution, achieving an imaging speed of 50 Hz in a B-scan image. Through in vivo mouse US/PA imaging, the system demonstrated its capability to visualize blood vessels and organs across the whole body of small animals. These findings suggest that the SA/PAM system is a practical tool for biomedical research, allowing for efficient visualization of vascular networks and anatomical structures in various preclinical studies. Full article

Background and Objectives: Low back pain (LBP) is highly prevalent and often associated with altered muscle function, including in the quadratus lumborum (QL) muscle. While some studies have highlighted the clinical relevance of QL muscle stiffness in LBP, the findings remain inconsistent, and the role of this parameter in relation to clinical severity indicators is not well understood. Considering the high prevalence of myofascial trigger points among patients, objectively and reliably quantifying QL stiffness and its association with other clinical parameters could improve the identification of early stages of the condition before other alterations become apparent. Therefore, this study aimed to explore the association between QL stiffness and multiple indicators of LBP severity. Materials and Methods: A cross-sectional observational study was conducted involving the participation of seventy-six patients suffering from chronic LBP. An ultrasound scanner with shear-wave elastography (SWE) was used to determine the participants’ QL stiffness. Additional information was collected on LBP-associated pain intensity, disability, central sensitization, and quality of life. Results: QL muscle stiffness was negatively correlated with pain intensity (p < 0.01) and central sensitization (p < 0.01), and it was positively correlated with physical quality of life (p < 0.01). Muscle stiffness influenced the variance in pain intensity along with physical quality of life, central sensitization, and chronicity (together explaining 49% of the variance) but did not explain the variance in central sensitization. Conclusions: Assessing QL muscle stiffness in patients with LBP is recommended, as greater muscle softness is linked to higher pain intensity, central sensitization, and poorer physical quality of life. Regression analyses further highlighted that QL stiffness helps explain the variance in pain intensity, physical quality of life, central sensitization, and chronicity, but it did not directly affect the central sensitization variance. Full article

Background: Acne scarring presents a significant esthetic and psychological concern, commonly classified into atrophic and hypertrophic types. Effectively managing these lesions often involves the use of therapeutic strategies such as laser treatments, dermabrasion, and fillers. This study investigates the efficacy of 1550 nm erbium glass laser therapy in the treatment of atrophic acne scars through a quantitative assessment. Material and Methods: Participants with mild to moderate atrophic acne scars received two sessions of fractional erbium glass laser therapy at one-month intervals. Skin density and epidermal thickness were measured using a high-frequency ultrasound device (DUB SkinScanner), while the Antera 3D imaging system facilitated a comprehensive analysis of skin parameters, including texture, volumetric depressions, and pigmentation. Results: The use of this therapy led to significant improvements across multiple parameters. Skin density and epidermal thickness increased. Significant reductions were observed in fold depth, pore volume, and depression volume, indicating enhanced smoothness and minimized scar appearance. Improvements in texture roughness and pigmentation contributed to a visually coherent skin surface. Conclusions: Fractional erbium glass laser therapy effectively ameliorates the appearance of atrophic acne scars by increasing skin density, reducing dermal depressions, and improving texture and pigmentation uniformity. The Antera 3D system and high-frequency ultrasound device demonstrated high efficacy in capturing subtle changes, supporting its value in clinical applications for optimizing treatment parameters. Full article

Background: Cellulite is a cosmetic defect of multifactorial etiology that affects over 90% of women worldwide. Cellulite-induced skin changes are undesirable and negatively affect self-esteem. Despite a plethora of cellulite-reducing treatments, we still lack objective tools to enable accurate diagnosis and treatment efficacy assessment. The aim of this study was to determine whether high-frequency ultrasound can be helpful in assessing cellulite and whether there is an association between ultrasound-derived measurements, parameters ascertained clinically, and cellulite assessment scale scores. Methods: The study group consisted of 114 women with cellulite in their posterior thighs, assessed using the Nürnberger–Müller scale. Two types of ultrasound devices were used in this study: a conventional scanner with a linear transducer and a skin-dedicated scanner equipped with a mechanical transducer. We used high-frequency ultrasonography to determine epidermal thickness, dermal thickness, the surface area of fat protrusions at the dermal subcutaneous junction, and the thickness and stiffness of the subcutaneous tissue (ultrasound elastography). Results: There was a correlation between cellulite severity and subcutaneous tissue thickness (r = 0.63), the surface area of fat protrusions at the dermal subcutaneous junction (r = 0.64), and the elastographic strain ratio (r = 0.51). An association was also demonstrated between thigh circumference and subcutaneous tissue thickness (r = 0.48). There was a significant difference in the assessed parameters between the subgroups identified by cellulite severity scores. Conclusions: Ultrasound-determined surface area of fat protrusions at the dermal subcutaneous junction as well as the thickness and stiffness of the subcutaneous tissue seem useful in cellulite assessment. Thus, ultrasonography has the potential to become a common tool in aesthetic medicine and cosmetology. Full article

Magnetic resonance imaging (MRI) can facilitate accurate organ delineation and optimal dose distributions in high-dose-rate (HDR) MRI-Assisted Radiosurgery (MARS). Its use for this purpose has been limited by the lack of positive-contrast MRI markers that can clearly delineate the lumen of the HDR applicator and precisely show the path of the HDR source on T1- and T2-weighted MRI sequences. We investigated a novel MRI positive-contrast HDR brachytherapy or interventional radiotherapy line marker, C4:S, consisting of C4 (visible on T1-weighted images) complexed with saline. Longitudinal relaxation time (T1) and transverse relaxation time (T2) for C4:S were measured on a 1.5 T MRI scanner. High-density polyethylene (HDPE) tubing filled with C4:S as an HDR brachytherapy line marker was tested for visibility on T1- and T2-weighted MRI sequences in a tissue-equivalent female ultrasound training pelvis phantom. Relaxivity measurements indicated that C4:S solution had good T1-weighted contrast (relative to oil [fat] signal intensity) and good T2-weighted contrast (relative to water signal intensity) at both room temperature (relaxivity ratio > 1; r2/r1 = 1.43) and body temperature (relaxivity ratio > 1; r2/r1 = 1.38). These measurements were verified by the positive visualization of the C4:S (C4/saline 50:50) HDPE tube HDR brachytherapy line marker on both T1- and T2-weighted MRI sequences. Orientation did not affect the relaxivity of the C4:S contrast solution. C4:S encapsulated in HDPE tubing can be visualized as a positive line marker on both T1- and T2-weighted MRI sequences. MRI-guided HDR planning may be possible with these novel line markers for HDR MARS for several types of cancer. Full article

The aim of this retrospective study was to identify myocardial injury after COVID-19 inflammation and explore whether myocardial damage could be a possible cause of the persistent symptoms following COVID-19 infection in previously healthy individuals. This study included 139 patients who were enrolled between January and June 2021, with a mean age of 46.7 ± 15.2 years, of whom 68 were men and 71 were women without known cardiac or pulmonary diseases. All patients underwent clinical work-up, laboratory analysis, cardiac ultrasound, and CMR on a 1.5 T scanner using a recommended protocol for morphological and functional assessment before and after contrast media application with multi-parametric sequences. In 39% of patients, late gadolinium enhancement (LGE) was found as a sign of myocarditis. Fibrinogen was statistically significantly higher in patients with LGE than in those without LGE (4.3 ± 0.23 vs. 3.2 ± 0.14 g/L, p < 0.05, respectively), as well as D-dimer (1.8 ± 0.3 vs. 0.8 ± 0.1 mg/L FEU). Also, troponin was statistically significantly higher in patients with myocardial LGE (13.1 ± 0.4 ng/L) compared to those with normal myocardium (4.9 ± 0.3 ng/L, p < 0.001). We demonstrated chest pain, fatigue, and elevated troponin to be independent predictors for LGE. Septal LGE was shown to be a predictor for arrhythmias. The use of CMR is a potential risk stratification tool in evaluating outcomes following COVID-19 myocarditis. Full article

Increased pressure and shear stress distributions at the limb–socket interface are hypothesised to result from changes in the residual limb shape and volume, which can cause socket fit difficulties. Accurate residual limb volume measurements may aid clinicians in developing strategies to accommodate volume fluctuations. This review primarily aims to analyse the techniques available for measuring the residual lower limb volume that may be used in clinical settings, as documented in the works published over the previous four decades. A comprehensive search of articles in PubMed, ScienceDirect, Web of Science, and Google Scholar identified 904 articles, and further analysis resulted in only 39 articles being chosen to be analysed. Based on the findings, there are nine techniques available to measure the residual limb volume: water displacement, anthropometric measurement, contact probes, optical scanning, spiral X-ray computed tomography (SXCT), magnetic resonance imaging (MRI), ultrasound, laser scanning, and bioimpedance. Considering the variety of techniques for determining residual limb volume, it is critical to choose the ones that best suit clinicians’ objectives, and each technique has potential sources of error that should be avoided by taking precautionary action. A comprehensive study of the measurement techniques is needed since researchers have developed and extensively utilised many new measuring devices, especially handheld 3D laser scanners. Full article

With multimorbidity on the rise, adverse cutaneous drug reactions are becoming a daily challenge in clinical practice. The objective evaluation of the skin lesion is crucial but hardly realized due to missing technology and guidelines. In this study, the novel Dermus SkinScanner-U, an optically guided high-frequency ultrasound imaging device, was evaluated regarding its comparability with the Dermatology Life Quality Index (DLQI) and the pharmacological analysis of the patients’ drug therapy. A total of 40 adult patients were evaluated, all with chronic medication use and skin lesions that led to non-compliance toward the pharmacotherapy. With the ongoing aim of further improving the methodology, the first results, with two detailed patient cases, are presented here. It was concluded that in the cases evaluated, there was a significant correlation between the characteristics of the lesions observed on the optical and ultrasound image, the DLQI score, and the pharmacological analysis. The next steps include increasing the scale of the study to ultimately develop a quality-assured methodology for the correct diagnosis of skin-related adverse drug reactions and to prepare a database with the most frequently observed events. Full article

There have been studies showing attenuation imaging (ATI) with ultrasound as an approach to diagnose liver diseases such as steatosis or cirrhosis. So far, this technique has only been used on a convex probe. The goal of the study was to investigate the feasibility of ATI measurements using the linear array on a canon Aplio i800 scanner on certified phantoms. Three certified liver tissue attenuation phantoms were measured in five different positions using a linear probe. The effects of positioning and depth were explored and compared. The values were compared to the certified expected value for each phantom as well as the different measurement values for each measurement position. The ATI measurements on phantoms showed significant effect for the different probe positions and region of interest (ROI) depths. Values taken in the center with the probe perpendicular to the phantom were closest to certified values. Median values at 2.5–4.5 cm depth for phantoms 1 and 2 and 0.5–2.5 cm for phantom 3 were comparable with certified values. Measurements taken at a depth greater than 6 cm in any position were the least representative of the certified values (p-value < 0.01) and had the widest range throughout the different sessions. ATI measurements can be performed with the linear probe in phantoms; however, careful consideration should be given to depth dependency, as it can significantly affect measurement values. Remaining measurements at various depths within the 0.5–6.0 cm range showed deviation from the certified values of approximately 25%. Full article

Background and Objectives: Pelvic floor muscle training (PFMT) represent the first-line approach to pelvic floor dysfunctions (PFDs). Recently, studies have shown a synergy between the pelvic floor and abdominal muscles, hypothesizing that the anatomical and functional integrity of the abdominal wall plays a role in the prevention of pelvic floor disorders. Some studies have shown a significant correlation between diastasis recti abdominis (DRA) and stress urinary incontinence (SUI). Nevertheless, the evidence reported in the literature is controversial and based on low-quality data. The aim of the study is to clarify whether DRA-specific abdominal rehabilitation is needed in women with SUI after childbirth. Materials and Methods: All consecutive women who had at least one delivery and complained of symptoms of pure SUI that were urodynamically proven were considered for the study. The group of symptomatic patients was compared with a series of consecutive women, identified during the same study period, without any symptoms of SUI. In both groups, we measured the inter-rectal distance (IRD) with an ultrasound scanner above and below the navel. Results: A total of 102 women eligible for the study group and 100 women who did not report any symptoms of SUI were enrolled. The inter-rectal distance above the umbilicus showed no significant difference between the two groups (2.12 ± 0.98 vs. 2.1 ± 0.77; p = 0.94). In contrast, the data from the sub-umbilical measurements showed a significant difference. Surprisingly, the asymptomatic group showed significantly greater (0.98 ± 0.9 vs. 1.33 ± 0.87 p-value: 0.009) IRD compared to the symptomatic group. Conclusions: The study shows that DRA is not a risk factor for SUI in women after childbirth. Therefore, specific abdominal wall rehabilitation after childbirth does not seem to be indicated. Full article

Postpartum uterine involution is necessary for the normal reproduction of dairy cows. The study aimed to investigate the pattern of postpartum uterine involution and the impact of parity on uterine involution in Chinese Holstein dairy cows. The diameter of the uterine cervix, pregnant uterine horn, and non-pregnant uterine horn were monitored using a B-mode veterinary ultrasound scanner at 5, 10, 15, 20, 25, 30, 35, and 40 days, respectively, after parturition in both multiparous and primiparous dairy cows. Meanwhile, the concentrations of hydroxyproline, E2, and IGF-1 were detected using ELISA at 5, 10, 15, 20, 30, and 40 d after parturition in both multiparous and primiparous dairy cows. Furthermore, the duration of uterine involution was compared in the multiparous and primiparous dairy cows. The results demonstrated that the diameter of the uterine cervix and the pregnant uterine horn did not decrease any further at 25 days postpartum for both the multiparous cows and the primiparous cows. Hydroxyproline levels gradually decreased with uterine involution; however, there was no significant variation in IGF-1 concentrations during uterine involution in the dairy cows. Although E2 concentrations of the peripheral plasma displayed an upward trend from day 5 to day 15 in the two groups of postpartum cows, there was no significant difference between the two groups during uterine involution. These results suggest that postpartum uterine involution was around 25 days postpartum in both the primiparous dairy cows and the multiparous Chinese Holstein dairy cows. Parity did not affect uterine involution in the postpartum Chinese Holstein dairy cows. The hydroxyproline levels of the peripheral blood may be an indicator of uterine involution in postpartum cows. Nonetheless, IGF-1 and E2 levels of the periphery blood are not associated with uterine involution in Chinese Holstein dairy cows. Full article

Given that cancer mortality is usually due to a late diagnosis, early detection is crucial to improve the patient’s results and prevent cancer-related death. Imaging technology based on novel nanomaterials has attracted much attention for early-stage cancer diagnosis. In this study, a new block copolymer, poly(ethylene glycol)-poly(l-lactide) diblock copolymer (PEG-PLLA), was synthesized by the ring-opening polymerization method and thoroughly characterized using Fourier transform infrared spectroscopy (FT-IR), proton nuclear magnetic resonance spectroscopy (H-NMR), X-ray diffraction (XRD), and thermogravimetric analysis (TGA). The obtained PEG-PLLA was used to prepare nanoparticles encapsulated with perfluoropentane and salicylic acid by the emulsion-solvent evaporation method, resulting in a new dual-mode nano-image probe (PEG-PLLA@SA·PFP). The zeta potential and mean diameter of the obtained nanoparticles were measured using dynamic light scattering (DLS) with a Malvern Zetersizer Nano. The in vitro biocompatibility of the PEG-PLLA nanoparticles was evaluated with cell migration, hemolysis, and cytotoxicity assays. Ultrasonic imaging was performed using an ultrasonic imaging apparatus, and chemical exchange saturation transfer (CEST) MRI was conducted on a 7.0 T animal scanner. The results of IR and NMR confirmed that the PEG-PLLA was successfully synthesized. The particle size and negative charge of the nanoparticles were 223.8 ± 2.5 nm and −39.6 ± 1.9 mV, respectively. The polydispersity of the diameter was 0.153 ± 0.020. These nanoparticles possessed good stability at 4 °C for about one month. The results of cytotoxicity, cell migration, and hemolysis assays showed that the carrier material was biocompatible. Finally, PEG-PLLA nanoparticles were able to significantly enhance the imaging effect of tumors by the irradiation of ultrasound and saturation by a radiofrequency pulse, respectively. In conclusion, these nanoparticles exhibit promising dual-mode capabilities for US/CEST MR imaging. Full article