Contrast-enhanced Mode Research Articles

Multimode ultrasonic technique is recommended for the differential diagnosis of thyroid cancer.

BackgroundB-mode ultrasound is one of the most commonly used imaging techniques for evaluating thyroid nodules due to its noninvasive property and excellent performance in terms of discriminating between benign and malignant nodules. However, the accuracy of differential diagnosis strongly depends on the experience of ultrasonographers. In addition to B-mode ultrasound, the elastic mode and contrast-enhanced mode have shown complimentary value in the diagnosis of thyroid nodules. The combination of multiple modes in ultrasonic techniques may effectively undermine diagnostic subjectiveness and improve accuracy. In this study, we evaluated the diagnostic value of combining the three ultrasonic modes for differentiating thyroid cancers.MethodsIn this retrospective study, we analyzed a total of 196 thyroid nodules with suspected malignancies from 185 patients who gave informed consent. Xi’an Jiaotong University granted ethical approval (No. 2018200) to carry out the study within its facilities. All the patients received ultrasonic examinations with the B mode, elastic mode and contrast-enhanced mode, followed by histopathological confirmation by fine-need aspiration or surgery. A predictive multivariate logistic regression model was selected to integrate the variety of data obtained from the three modes.ResultsThe combination of three ultrasonic techniques for differentiating malignant from benign thyroid nodules showed the highest diagnostic accuracy of 0.985 compared to the B mode alone (0.841) and the two-mode combination. The accuracy of the B mode combined with the elastic technique was 0.954, and the accuracy of the B mode combined with the contrast-enhanced technique was 0.960.DiscussionMultimode ultrasonic techniques should be recommended to patients with suspected malignant thyroid nodules in routine clinical practice.

Diagnosed values of fine needle aspiration combined with contrast-enhanced ultrasonography in the diagnosis of early thyroid microcarcinoma

Objective To analyze the role of thyroid imaging reporting and data system(TI-RADS), contrast-enhanced ultrasound(CEUS), fine needle aspiration cytology (FNAC) and tumor proliferation related genes in the early diagnosis of thyroid micro-papillary carcinoma(PTMC) and risk assessment of early metastasis. Methods From May 2018 to May 2019, a total of 140 patients with Thyroid micronodules for surgical resection and pathological diagnosis of benign or malignant into the Seventh People′s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine for the retrospective study.There were 90 cases in benign group and 50 cases in malignant group.The levels of TI-RADS, CEUS enhancement mode, peak intensity (PI) and cyclin D1 (CCND1), cell nuclear Proliferating Antigen (PCNA) and vascular endothelial growth factor (VEGF) were compared between malignant and benign groups, VEGF) mRNA expression level.The positive rate of FNAC, TNM stage, capsule invasion and lymph node metastasis were evaluated. Results The percentage of class four and more by TI-RADS grade in malignant group was significantly more than benign group((92.0% (46/50) vs.5.6% (5/90), χ2=103.718, P<0.001), more early low enhancement by CEUS(86.0%(43/50) VS.6.7%(6/90), χ2=91.328, P<0.001) and PI value higher than benign group, too((6.79±1.88) VS.(5.32±1.46), t=4.968, P=0.008). The positive rate of FNAC in malignant group was 92.0% (46/50). FNAC was positive in 42 cases of TNM stage, 9 cases of capsule invasion and 6 cases of lymph node metastasis.The pathological positive rate after resection was 50 cases of TNM stage, 10 cases of capsule invasion and 6 cases of lymph node metastasis.The expression of CCND1, PCNA and VEGF mRNA in malignant group was significantly higher than that in benign group((0.5624±0.134) VS.(0.213±0.097), t=15.639, P<0.001; (0.453±0.126) VS.(0.186±0.056), t=20.253, P<0.001; (0.633±0.159) VS.(0.252±0.097), t=31.265, P<0.001). Conclusion Ultrasound-guided FNAC is used to determine TNM staging, capsule invasion and lymph node metastasis, CCND1, PCNA and VEGF expression level, contrast-enhanced mode and peak intensity value measured by quantitative evaluation software have good accuracy for early diagnosis of PTMC, and are consistent with the pathological results of hand surgery. Key words: Thyroid micro-papillary carcinoma; Thyroid Imaging Reporting and Data System; Contrast-enhanced ultrasound; Fine needle aspiration cytology

Comparison of comfort between cone beam breast computed tomography and digital mammography

PurposeTo compare the comfort levels of cone beam breast computed tomography (CBBCT) and digital mammography. Materials and methodsOn 409 patients, CBBCT was performed within 1 week after conventional mammography. Patients evaluated their comfort by using an 11-point numerical rating scale (NRS-11) after completing the two examinations. The lower the score was, the more comfortable the examination modality was. The data was divided into different groups according to CBBCT scan mode (non-contrast mode, contrast-enhanced mode), age (≤44, 45∼59 and ≥60), body mass index (BMI) (<18.5 kg/m2, 18.5∼23.9 kg/m2, 24∼27.9 kg/m2 and ≥28 kg/m2), and breast density (fatty-breast, dense-breast) to evaluate the performance of CBBCT comfort in different groups and to analyse the influencing factor of patient comfort. The paired rank sum test was used to compare the comfort between CBBCT and mammography. ResultsOverall, the comfort of CBBCT was better than mammography (P < 0.05). CBBCT was more comfortable than mammography in both non-contrast and contrast-enhanced groups (P < 0.05). CBBCT was more comfortable than mammography in the ≤44, 45∼59 age groups (P < 0.05). There was no significant difference in the ≥60 age group (P = 0.5433). CBBCT was more comfortable than mammography in the BMI groups of 18.5∼23.9 kg/m2, 24∼27.9 kg/m2and ≥28 kg/m2 (P < 0.05). There was no significant difference in the <18.5 kg/m2 group (P = 0.43). CBBCT was more comfortable than mammography in both the fatty-breast and dense-breast groups (P < 0.05). ConclusionThe comfort of CBBCT was better than mammography.

Value of conventional ultrasound combined with contrast-enhanced ultrasound in differential diagnosis of thyroid TI-RADS 3-5 nodules

Objective To evaluate the diagnostic value of gray-scale ultrasound combined with contrast-enhanced ultrasound (CEUS) in thyroid imaging and reporting system (TI-RADS) 3-5 nodules of American College of Radiology (ACR). Methods The 208 patients(216 nodules) who underwent thyroid contrast-enhanced ultrasound examination from April 2014 to December 2016 were retrospectively analyzed. The ACR TI-RADS classification and contrast-enhanced mode of thyroid ultrasound were evaluated. The benign and malignant thyroid lesions were constructed through the analysis of contrast-enhanced mode of thyroid benign and malignant lesions in the past literature and the preliminary study of our group. Prediction model of gray scale combined with contrast-enhanced ultrasound for lesions were established. Besides, the sensitivity, specificity and accuracy of gray scale ultrasound combined with contrast-enhanced ultrasound prediction model for differential diagnosis of benign and malignant thyroid lesions were calculated based on the results of puncture biopsy or surgical pathology as the gold standard. Results Compared with pathological results, the positive predictive value, negative predictive value, accuracy, sensitivity and specificity of gray scale combined with contrast-enhanced ultrasound in evaluating thyroid nodules were 90.8%, 93.3%, 91.2%, 98.8% and 62.2%, respectively. Conclusions Gray-scale ultrasound combined with contrast-enhanced ultrasound can provide clinical value in differential diagnosis of benign and malignant TI-RADS 3-5 thyroid nodules. Key words: Contrast-enhanced ultrasound; Thyroid nodule; Thyroid imaging reporting and data system

Feasibility and safety of retrograde ureterography combined with ultrasound-guided percutaneous nephrolithotomy for renal calculi complicated with hydronephrosis

Objective To investigate the feasibility and safety of retrograde ureterography combined with ultrasound-guided percutaneous nephrolithotomy for renal calculi complicated with hydronephrosis. Methods From April 2016 to July 2016, 5 patients with renal calculi complicated with hydronephrosis were selected. B-mode ultrasound imaging was compared with contrast-enhanced mode with simultaneous retrograde injection of optison via an ipsilateral ureteral catheter. Results Five patients (four males and one female) with renal stones underwent percutaneous nephrolithotomy (PCNL) with retrograde ultrasound contrast injection during the study period. Mean body mass index was(28.3±5.6)kg/m2 and mean stone size was(24.5±12.0)mm. Under B-mode ultrasound, all patients demonstrated non-dilated renal collecting systems that appeared as hyperechoic areas, where it was difficult to identify a target calix for puncture.Retrograde contrast injection facilitated delineation of all renal calices initially difficult to visualize under B-mode ultrasound. Renal puncture was then performed effectively in all cases with a mean puncture time of(55.4±44.8)seconds. All PCNL procedures were completed without intraoperative complications and no adverse events related to ultrasound contrast injection occurred. Conclusions Retrograde ultrasound contrast injection as an aide for renal puncture during PCNL is a feasible technique. By improving visualization of the collecting system, it facilitates needle placement in challenging patients without hydronephrosis. Future larger scale stu-dies comparing its use to standard ultrasound-guided technique will be required to validate this concept. Key words: Kidney Calculi; Nephrostomy, Percutaneous; Lithotripsy; Urography

Feasibility of Retrograde Ureteral Contrast Injection to Guide Ultrasonographic Percutaneous Renal Access in the Nondilated Collecting System.

Ultrasound-guided percutaneous nephrolithotomy (PCNL) has become increasingly utilized. Patients with nondilated collecting systems represent a challenge: the target calix is often difficult to visualize. Here we report pilot study results for retrograde ultrasound contrast injection to aid in percutaneous renal access during ultrasound-guided PCNL. From April to July 2016, consecutive patients over the age of 18 years with nondilated collecting systems on preoperative imaging who presented for PCNL were enrolled. B-mode ultrasound imaging was compared with contrast-enhanced mode with simultaneous retrograde injection of Optison™ via an ipsilateral ureteral catheter. Five patients (four males and one female) with renal stones underwent PCNL with retrograde ultrasound contrast injection during the study period. Mean body mass index was 28.3 ± 5.6 kg/m2 and mean stone size was 24.5 ± 12.0 mm. Under B-mode ultrasound, all patients demonstrated nondilated renal collecting systems that appeared as hyperechoic areas, where it was difficult to identify a target calix for puncture. Retrograde contrast injection facilitated delineation of all renal calices initially difficult to visualize under B-mode ultrasound. Renal puncture was then performed effectively in all cases with a mean puncture time of 55.4 ± 44.8 seconds. All PCNL procedures were completed without intraoperative complications and no adverse events related to ultrasound contrast injection occurred. Retrograde ultrasound contrast injection as an aide for renal puncture during PCNL is a feasible technique. By improving visualization of the collecting system, it facilitates needle placement in challenging patients without hydronephrosis. Future larger scale studies comparing its use to standard ultrasound-guided technique will be required to validate this concept.

Effects of automatic tube potential selection on radiation dose index, image quality, and lesion detectability in pediatric abdominopelvic CT and CTA: a phantom study.

To assess the effect of automatic tube potential selection (ATPS) on radiation dose, image quality, and lesion detectability in paediatric abdominopelvic CT and CT angiography (CTA). A paediatric modular phantom with contrast inserts was examined with routine pitch (1.4) and high pitch (3.0) using a standard abdominopelvic protocol with fixed 120 kVp, and ATPS with variable kVp in non-contrast, contrast-enhanced, and CTA mode. The volume CT dose index (CTDIvol), contrast-to-noise ratio (CNR) and lesion detectability index (d') were compared between the standard protocol and ATPS examinations. CTDIvol was reduced in all routine pitch ATPS examinations, with dose reductions of 27-52 % in CTA mode (P < 0.0001), 15-33 % in contrast-enhanced mode (P = 0.0003) and 8-14 % in non-contrast mode (P = 0.03). Iodine and soft tissue insert CNR and d' were improved or maintained in all ATPS examinations. kVp and dose were reduced in 25 % of high pitch ATPS examinations and in none of the full phantom examinations obtained after a single full phantom localizer. ATPS reduces radiation dose while maintaining image quality and lesion detectability in routine pitch paediatric abdominopelvic CT and CTA, but technical factors such as pitch and imaging range must be considered to optimize ATPS benefits. ATPS automatically individualizes CT scan technique for each patient. ATPS lowers radiation dose in routine pitch pediatric abdominopelvic CT and CTA. There is no loss of image quality or lesion detectability with ATPS. Pitch and scan range impact the effectiveness of ATPS dose reduction.

Real-time single-shot three-dimensional and contrast-enhanced optical coherence imaging using phase coherent photorefractive quantum wells

We demonstrate two real-time optical coherence imaging acquisition modes using all-optical phase coherent photorefractive ZnSe quantum wells as dynamic holographic films. These films use the coherence of excitons for time-gating which provides depth information of an object according to the brightness profile of its holographic image. This quality allows depth-resolved imaging of moving particles with a resolution of a few micrometers in a single-shot three-dimensional mode. In a complementary contrast-enhanced mode moving particles are imaged by the local enhancement of a static reference hologram, enabling optical coherence imaging at a large depth-of-field.