To evaluate the ultrasonographic features of male breast nodules classified as Breast Imaging Reporting and Data System category 4. A retrospective analysis of 79 breast nodules from 77 male patients, classified as Breast Imaging Reporting and Data System category 4 after ultrasonography, was conducted. The ultrasonographic features of benign and malignant nodules were evaluated and compared. Independent risk factors for malignancy were identified by logistic regression analysis. In addition, we conducted a subgroup analysis comparing the ultrasonographic features of gynecomastia and malignant nodules in male breasts. Differences were found in age of onset, calcifications, aspect ratio greater than 1/2, Adler grading of blood flow, and axillary lymph nodes. The presence of calcifications was an independent risk factor for malignancy in males. The results of the comparison between gynecomastia and breast cancer were essentially consistent with the former. However, the differences in calcifications were not as significant as those observed in the former. We identified differences in age of onset, calcification, aspect ratio greater than 1/2, blood flow, and axillary lymph nodes between benign and malignant male breast nodules classified as Breast Imaging Reporting and Data System category 4, with calcification being an independent risk factor for malignancy. These features can help determine the nature of the nodules and guide biopsy decisions.

The European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) has been publishing guidelines, position papers and also technical reviews. In addition, comments have been published for illustration of such papers including recently the role of ultrasound in cutaneous neoplasms but also in the hepatobiliary system, pancreas, lung and other organs. In the current paper, we aim to summarize the typical sonographic findings of the most commonly benign cutaneous lesions.

Rotator cuff tears are a major cause of shoulder pain and restricted mobility, with the supraspinatus tendon being particularly susceptible to injury due to its biomechanical properties and vascular perfusion characteristics. Failure to achieve an accurate diagnosis and initiate timely treatment following a rotator cuff injury can result in progressive worsening of the condition, potentially leading to severe complications. In this report, we present a case of post-traumatic supraspinatus tendon injury. By comparing musculoskeletal ultrasound, contrast-enhanced ultrasound, and ultra resolution microscopy (URM) imaging, we demonstrate that URM, as an advanced imaging modality with high resolution, real-time dynamic capabilities, and quantitative analytical potential, offers distinct advantages in detecting rotator cuff injuries. Specifically, URM improves the detection rate, delineates injury boundaries with greater accuracy, and assesses the extent of inflammatory adhesions surrounding the affected site.

To evaluate the effectiveness of two large language models, ChatGPT-4 and Claude 3, in improving the accuracy of question responses by senior sonologist and junior sonologist. A senior and a junior sonologist were given a practice exam. After answering the questions, they reviewed the responses and explanations provided by ChatGPT-4 and Claude 3. The accuracy and scores before and after incorporating the models' input were analyzed to compare their effectiveness. No statistically significant differences were found between the two models' responses scores for each section (all p>0.05). For junior sonologist, both ChatGPT-4 (p=0.039) and Claude 3 (p=0.039) significantly improved scores in basic knowledge. The responses provided by ChatGPT-4 also significantly improved scores in relevant professional knowledge (p=0.038), though their explanations did not (p=0.077). For all exam sections, both models' responses and explanations significantly improved scores (all p<0.05). For senior sonologist, both ChatGPT-4's responses (p=0.022) and explanations (p=0.034) improved scores in basic knowledge, as did Claude 3's explanations (p=0.003). Across all sections, Claude 3's explanations significantly improved scores (p=0.041). ChatGPT-4 and Claude 3 significantly improved sonologist' examination performance, particularly in basic knowledge.

The aim of this study was to compare the measurement of periodontal pocket by ultrasound in comparison with gold standard measurements ex-vivo. A total of 12 hemi-jaws were included in the study. Ultrasound measurements of the sulcus were performed and then, sulcus depth was measured by manual probing. The reading of the ultrasound images was carried using ImageJ software. Reference points are made allowing the measurement of this sulcular space. To assess the hypothesis of normality of the data, a Kolmogorov-Smirnov test was performed for each of the samples due to the size of their population (>50). To complete this test, Lin's concordance test was also applied. A total of 348 manual probing and 348 ultrasound imagines measurements were performed. The Lin concordance and correlation coefficients and their 95% confidence intervals obtained were 0.855 (95% CI [0.822; 0.855]). These data allow us to demonstrate the equivalence between the measurement of the depth of the periodontal pocket by ultrasound imaging and the measurement by manual probing. This study shows that the use of an ultrasound probe for periodontal imaging was comparable to the current gold standard for measuring the sulcus area. These promising results must be confirmed by measurements in humans.

Caudal epidural injection is used for lumbosacral radicular pain but there is a risk of vascular injection. An ultrasound-guided catheter-over-needle technique was proposed to reduce this risk. This study compared the incidence of vascular injections between the catheter-over-needle and Tuohy needle methods for caudal epidural injections. This prospective, randomized clinical trial included patients aged ≥19 years with degenerative lumbar disease accompanied by radicular pain who were unresponsive to non-invasive treatments and scheduled for caudal epidural injection. The participants were randomized into two groups: catheter-over-needle and Tuohy needle groups. Under ultrasound guidance, the contrast medium was injected and observed in real time using fluoroscopy. An independent physician assessed the vascular injection rates. The incidence of vascular injection was significantly lower in the catheter-over-needle group (15.7%) than in the Tuohy needle group (37.5%; p=0.014). Chronic pain lasting >12 months was a significant risk factor for vascular injection (p=0.035). However, no statistically significant association was found between sacral opening depth and vascular injection, although the sacral opening depth was shorter in patients who received intravascular injections. The catheter-over-needle technique significantly reduces the risk of vascular injection. The depth of the sacral opening may also influence vascular injection.

This study aims to explore the potential of machine learning as a non-invasive automated tool for skin tumor differentiation. Data were included from 156 lesions, collected retrospectively from September 2021 toFebruary 2024. Univariate and multivariate analyses of traditional clinical features were performed to establish a logistic regression model. Ultrasound-based radiomics features are extracted from grayscale images after delineating regions of interest(ROIs). Independent samples t-tests, Mann-Whitney U tests, and Least Absolute Shrinkage and Selection Operator (LASSO)regression were employed to select ultrasound-based radiomics features. Subsequently, five machine learning methods wereused to construct radiomics models based on the selected features. Model performance was evaluated using receiver operatingcharacteristic (ROC) curves and the Delong test. Age, poorly defined margins, and irregular shape were identified asindependent risk factors for malignant skin tumors. The multilayer perception (MLP) model achieved the best performance,with area under the curve (AUC) values of 0.963 and 0.912, respectively. The results of DeLong's test revealed a statisticallysignificant discrepancy in efficacy between the MLP and clinical models (Z=2.611, p=0.009). Machine learning based skin tumor models may serve as a potential non-invasive method to improve diagnostic efficiency.

Ultrasound (US) can be performed at the point of care by the treating physician, is safe, well tolerated and, therefore, canbe repeated as often as clinically required and shortens the time to decision. An invaluable advantage of US is that the imagingis real-time and pathophysiological phenomena can be visualized dynamically. In addition, the multiparametric capabilities ofUS facilitate the evaluation of intestinal, peri-intestinal and some of the extra-intestinal manifestations of inflammatory boweldiseases (IBD).In the current series of papers a synopsis of recommendations for ultrasound in IBD guidelines, ultrasound parameters ininflammatory bowel disease including activities scores, the value of contrast enhanced ultrasound (CEUS), small intestinalcontrast ultrasound (SICUS) and elastography, perineal ultrasound (PNUS), endoscopic ultrasound (EUS) including endorectal ultrasound (ERUS) and interventional ultrasound (INVUS) have been discussed and illustrated.This review discusses advantages, accuracy and limitations of ultrasound techniques for the diagnosis of intestinal, periintestinal and extra-intestinal complications of MC and CU and for monitoring treatment response.

To investigate the multimodal ultrasonography (US) features of extramedullary plasmacytomas (EMPs) in patientswith multiple myeloma (MM). Nine patients with MM who were diagnosed EMPs and underwentmultimodal ultrasonography were enrolled in this study. Clinical information and multimodal US results were retrospectivelyanalyzed. The multimodal US with a standardized sonographic protocol including US, color Doppler flow imaging (CDFI),microvascular US, ultrasound elastography (UE) and contrast-enhanced ultrasound (CEUS) was performed on the enrolledpatients. This study included both males (4 of 9) and females (5 of 9), with ages ranging from 48 to 72 years. Thenine lesions were located in the skin/muscle (7 of 9) and pleura (2 of 9). On US images, all lesions showed inhomogeneoussolid hypoechogenicity without calcification. Vascularity was abundant (hypervascularization). CEUS images confirmed thisvascular pattern (9 of 9) and presented hyperenhancement with enlarged range. On elastographic images, the lesions presentedwith high elastic score (3-4). An inhomogeneous hypoechoic soft tissue or visceral mass occurring in MM withincreased vascularity, low elasticity, and hyperenhancement along with enlarged range can indicate the diagnosis of EMP onmultimodal US images.

The objective was to assess chemotherapy-induced cardiotoxicity by comparing changes in myocardial work indices(MWI) using echocardiographic myocardial work (MW). A comprehensive search was performedin PubMed, Embase, and the Cochrane Library, covering literature up to June 2024. A total of 13 non-randomizedexperimental studies (n=1,373) assessed changes in MWI of cancer patients treated with anthracyclines, trastuzumab/pertuzumab, or immune checkpoint inhibitors. After chemotherapy, adecrease was observed in the left ventricular ejection fraction(LVEF) (Pooled standard mean difference [SMD] = -0.75, 95% CI: -1.18, -0.31, p=0.001, I 2= 95.9%), global longitudinalstrain (GLS) (Pooled SMD = -2.38, 95% CI: -3.10, -1.66, p<0.001, I 2= 97.9%), global work index (Pooled SMD = -1.27, 95%CI: -1.68, -0.86, p<0.001, I2= 95.0%), global constructive work (GCW) (Pooled SMD = -1.55, 95% CI: -2.10, -0.99, p<0.001,I 2= 96.9%), and global work efficiency (Pooled SMD = -1.66, 95% CI: -2.39, -0.94, p<0.001, I2= 98.2%). Conversely, globalwasted work (GWW) increased (Pooled SMD = 1.17, 95% CI: 0.44, 1.89, p=0.002, I 2= 98.2%). Post-chemotherapy, GCWand GLS were below normal ranges, GWW exceeded normal values, and LVEF remained within normal limits across allsubgroups. Echocardiographic MWI provides a non-invasive method for assessing cardiotoxicity induced byanthracyclines, trastuzumab / pertuzumab, or immune checkpoint inhibitors.