Echo Pattern Research Articles

Radio-Histopathological Spectrum of Ovarian Specimens Following Cystectomy

Ovarian cysts can be benign or malignant and requires accurate diagnosis for efficient treatment. Objective: To characterize the radiological and histopathological spectrum of ovarian specimens following cystectomy. Methods: This retrospective study was conducted at Pakistan Atomic Energy Commission General Hospital, Islamabad from 1st April 2022 to 31st December 2022.Eighty patient’s samples from cystectomy patients who were suffering from ovarian cysts were included. Each patient underwent radiological examination before ovarian cystectomy through laparoscopic surgery except two cases of urgent laparotomy. Gross histopathological specimen examination was conducted. The data were analysed using SPSS version 26.0, wherein p value <. 0.05 was considered as significant. Results: The mean age of the patients enrolled in this study was 35.5±5.9 years. Hemorrhagic cysts were having a reticular pattern of internal echoes with soli appearing area with concave margins and no internal flow, while endometrioma cysts were having homogenous low level internal echoes with non-solid component and tiny echogenic foci in the walls. While within the neoplastic cysts 4/8 werehaving cystic external surface and 1/8 presented with ovarian mass.The surface epithelial tumor presented of 2 cases with carcinoma detection on histopathology slides while in the germ cell tumor 1 cases each of strumaovarii, dysgerminoma and mixed germ cell tumor was observed. Conclusions: Surface epithelial tumors were the most common category of ovarian tumors and majority of the cysts were benign cystadenomas. Radiological imaging provides a precise non-invasive tool for categorizing various ovarian cysts and histopathological findings further confirms the exact category of tumors.

Semi-analytical Monte Carlo simulation of underwater target echoes from a small UAV-based oceanic lidar

Small unmanned airborne oceanic lidars are becoming increasingly popular for ocean surveys. They typically weigh less than 10 kg and can be mounted on commonly used commercial drones, making them easier to use than traditional large oceanic lidars, which typically weigh up to 80 kg and can only be carried on manned aircraft. Unmanned airborne oceanic lidars typically fly at lower altitudes and use higher laser emission frequencies, making them suitable for detecting underwater targets. However, most of the existing LiDAR underwater echo simulation models are designed for flat terrain and assume that the target fills the LiDAR receiving field of view, and there are few studies on the echoes of suspended targets smaller than the field of view range. Therefore, we combined ray tracing and semi-analytical Monte Carlo to model the laser echo energy of the underwater target. The study investigated the energy change of the target echo in the direction of deviation from the laser outgoing direction, and the impact of absorption and scattering coefficients on it. The difference in echo energy between different fields of view for extended and non-extended targets and the effect of water quality on it were explored. The echo waveforms of the target under different tilt angles were simulated, and it was found that the target echo pattern will be tilted with the change of tilt angle and offset position.

Low echogenicity of Hashimoto's disease could be useful in detecting early phase of thyroid lymphomas, especially diffuse large B cell lymphomas

BackgroundHashimoto's disease, characterized by low echogenicity on ultrasonography, is associated with thyroid lymphomas. Most thyroid lymphomas are diffuse large B cell lymphomas (DLBCLs) and mucosa-associated lymphoid tissue (MALT) lymphomas. DLBCLs have a worse prognosis than MALT lymphomas. This study aimed to evaluate the early signs, especially the low echogenicity, of Hashimoto's disease and thyroid lymphomas. MethodsThis retrospective cohort study was conducted at Noguchi Thyroid Clinic and Hospital Foundation. A total of 9008 cases were operated on between 2008 and 2016, of which 162 had operated with suspected thyroid lymphoma, because of low echogenicity and aspiration biopsy cytology. The final diagnosis revealed 28 Hashimoto's disease, 134 thyroid lymphomas (91 MALT lymphomas and 43 DLBCLs). The primary outcomes were clinicopathological characteristics including low echogenicity of the thyroid. Early signs of thyroid lymphomas, especially DLBCLs were also investigated. ResultsAge, echo pattern, echogenicity anti-thyroid peroxidase antibody (TPOAb) and lactate dehydrogenase (LDH) were significantly different between Hashimoto's disease and thyroid lymphomas. Echogenicity, echo pattern and age were significant early signs of thyroid lymphomas. Age, echogenicity, soluble interleukin-2 receptor (IL2R), lactate dehydrogenase (LDH), and the neutrophil-to-lymphocyte ratio were significantly different between MALT lymphomas and DLBCLs. Echogenicity, and IL2R were significant early signs of DLBCL. The ROC analysis of low echogenicity for thyroid lymphomas compared to Hashimoto's disease revealed that Area Under the Curve (AUC) was 0.80 and the ROC analysis for DLBCL compared to Hashimoto's disease and MALT lymphoma revealed that the AUC was 0.73. ConclusionsLow echogenicity of Hashimoto's disease could be a useful early sign of thyroid lymphomas, especially DLBCL. Data availabilityThe data that supports the findings of this study are available in the supplementary material of this article.

Association of clinicopathologic and sonographic features with stromal tumor-infiltrating lymphocytes in triple-negative breast cancer

BackgroundIncreased level of stromal tumor-infiltrating lymphocytes (sTILs) are associated with therapeutic outcomes and prognosis in triple-negative breast cancer (TNBC). This study aimed to investigate the associations of clinicopathologic and sonographic features with sTILs level in TNBC.MethodsThis study included invasive TNBC patients with postoperative evaluation of sTILs after surgical resection. Tumor shape, margin, orientation, echo pattern, posterior features, calcification, and vascularity were retrospectively evaluated. The patients were categorized into high-sTILs (≥ 20%) and low-sTILs (< 20%) level groups. Chi-square or Fisher’s exact tests were used to assess the association of clinicopathologic and sonographic features with sTILs level.ResultsThe 171 patients (mean ± SD age, 54.7 ± 10.3 years [range, 22‒87 years]) included 58.5% (100/171) with low-sTILs level and 41.5% (71/171) with high-sTILs level. The TNBC tumors with high-sTILs level were more likely to be no special type invasive carcinoma (p = 0.008), higher histologic grade (p = 0.029), higher Ki-67 proliferation rate (all p < 0.05), and lower frequency of associated DCIS component (p = 0.026). In addition, the TNBC tumors with high-sTILs level were more likely to be an oval or round shape (p = 0.001), parallel orientation (p = 0.011), circumscribed or micro-lobulated margins (p < 0.001), complex cystic and solid echo patterns (p = 0.001), posterior enhancement (p = 0.002), and less likely to have a heterogeneous pattern (p = 0.001) and no posterior features (p = 0.002).ConclusionsThis preliminary study showed that preoperative sonographic characteristics could be helpful in distinguishing high-sTILs from low-sTILs in TNBC patients.

Stripe‐Like Echoes Scattered From Nighttime F‐Region Field‐Aligned Irregularities at Low‐Latitudes

AbstractThe unusual stripe‐like scattered echoes were observed by the Hainan Coherent Scatter Phased Array Radar (HCOPAR) in the nigh of 9 Sep. 2017. There were parallel stripes with the interval of ∼33 min appearing from 12:57 to 17:50 UT. While the emergence of the scattered echoes, the Hainan Digisonde has observed the Spread‐F, and the Total Electron Content (TEC) maps recorded by the Global Navigation Satellite System (GNSS) in China show that there was no Equatorial Plasma Bubble (EPB), but the Medium‐Scale Traveling Ionospheric Disturbance (MSTID) traveled southwestward. The spatial and temporal distributions of the stripe‐like echoes and the MSTID show great consistency, indicating that the F‐region Field‐Aligned Irregularities were generated in the wave peaks and troughs of the MSTID. The MSTID has decayed greatly while reaching the HCOPAR, and the echo pattern is determined by the wave features of the MSTID.

Role of Endoscopic Ultrasound in Diagnosis of Submucosal Lesions of Gastrointestinal Tract

The study aimed to understand the magnitude of submucosal lesions as part of the referral to the endoscopic ultrasound (EUS) unit in one year and know the percent of the different types and sites of submucosal lesions of GIT in Theodore Bilharz Research Institute as tertiary referral center draining Egyptian community. Within one year, all patients referred to the EUS unit at Theodore Bilharz Research Institute (TBRI) for assessment to assess the percent of submucosal lesions cases as part of the total referral and know the different types seen and their common sites as compared to the international literature. Patients diagnosed to have submucosal lesion will be subjected to; full clinical history, thorough physical examination, laboratory investigations, BUS for more characterization (site, size, location, echo pattern, etc.) and BUS-guided fine-needle aspiration (FNA) for histopathological examination. The work comprised 36 patients; 16 females and 20 males. Their ages ranged from 21 to 75 years. All patients had preliminary upper endoscopy or colonoscopy. According to the indication of upper preliminary endoscopy or colonoscopy, 12 (33.3%) were complaining of melena, 5 (13.8%) hematemesis, 1 (2.7%) bleeding per rectum, 7 (19.4%) upper abdominal pain, 2 (5.5%) dysphagia, finally, 8 (22.2%) vomiting. According to the site of the submucosal lesion, 24 (66.6%) were gastric, 6 (16.6%) esophageal, 4 (11.1%) duodenal, 1 gastro-esophageal (2.8%), and 1 (2.8%) rectal. 34 cases (94%) were covered by normal overlying mucosa while 2 cases (6%) had superficial ulcerations. It was concluded that EUS criteria, can be used without FNA and histopathologic examination to reduce the cost of differentiation between malignant and benign lesions. All homogenous lesions were benign. Lesion size of 4.5 cm is a cut off; &gt; 4.5 cm were malignant whereas &lt; 4.5 cm were benign. All submucosal lesions without areas of breakdown were benign. Those infiltrating all layers are malignant. EUS guided fine needle aspiration (FNA) and histopathological examination should be done for some submucosal masses to put a definite diagnosis. EUS with colored Doppler is necessary in differentiating cystic from vascular lesions.

The 3D localization of subsurface pipes from Ground Penetrating Radar images using edge detection and point cloud segmentation

This research introduces an innovative algorithm using Ground Penetrating Radar (GPR) for inspecting underground infrastructure non-destructively, surpassing R-CNN methods by combining signal processing with computer vision techniques including hyperbola correlation, point cloud segmentation and noise reduction based on linearity, density and echo patterns. Utilizing on-vehicle multi-channel GPR and without training, it maps pipes in 3D with high precision on both experimental fields and real roads. The method demonstrated remarkable accuracy, with an average error of 0.1175 m in locating pipes, outperforming deep learning methods requiring numerous training data. The ablation study and sensitivity analysis on hyperparameters further prove the improvement from the proposed method and its robustness. These outcomes offer notable improvements in infrastructure monitoring, highlighting the potential for automated underground utility detection.

Arterial Distension Monitoring Scheme Using FPGA-Based Inference Machine in Ultrasound Scanner Circuit System.

This paper presents an arterial distension monitoring scheme using a field-programmable gate array (FPGA)-based inference machine in an ultrasound scanner circuit system. An arterial distension monitoring requires a precise positioning of an ultrasound probe on an artery as a prerequisite. The proposed arterial distension monitoring scheme is based on a finite state machine that incorporates sequential support vector machines (SVMs) to assist in both coarse and fine adjustments of probe position. The SVMs sequentially perform recognitions of ultrasonic A-mode echo pattern for a human carotid artery. By employing sequential SVMs in combination with convolution and average pooling, the number of features for the inference machine is significantly reduced, resulting in less utilization of hardware resources in FPGA. The proposed arterial distension monitoring scheme was implemented in an FPGA (Artix7) with a resource utilization percentage less than 9.3%. To demonstrate the proposed scheme, we implemented a customized ultrasound scanner consisting of a single-element transducer, an FPGA, and analog interface circuits with discrete chips. In measurements, we set virtual coordinates on a human neck for 9 human subjects. The achieved accuracy of probe positioning inference is 88%, and the Pearson coefficient (r) of arterial distension estimation is 0.838.

Use superb microvascular imaging to diagnose and predict metastatic cervical lymph nodes in patients with papillary thyroid carcinoma

PurposePapillary thyroid carcinoma (PTC) with metastatic lymph nodes (LNs) is closely associated with disease recurrence. This study accessed the value of superb microvascular imaging (SMI) in the diagnosis and prediction of metastatic cervical LNs in patients with PTC.MethodsA total of 183 cervical LNs (103 metastatic and 80 reactive) from 116 patients with PTC were analysed. Metastatic cervical LNs were confirmed by pathology or/and cytology; reactive cervical LNs were confirmed by pathology or clinical features. The characteristic of conventional ultrasound (US) was extracted using univariate and multivariate analyses. The diagnostic performance of US and SMI were compared using the area under the receiver operating curve (AUC) with corresponding sensitivity and specificity. A nomogram was developed to predict metastatic LNs in patients with PTC, based on multivariate analyses.ResultsL/S < 2, ill-defined border, absence of hilum, isoechoic or hyperechoic, heterogeneous internal echo, peripheral or mixed vascular pattern on color Doppler flow imaging (CDFI) and SMI, and a larger SMI vascular index appeared more frequently in metastatic LNs in the training datasets than in reactive LNs (P < 0.05). The diagnostic sensitivity, specificity and accuracy of SMI vs US are 94.4% and 87.3%, 79.3% and 69.3%, and 87.6% and 79.1%, respectively; SMI combined with US exhibited a higher AUC [0.926 (0.877–0.975)] than US only [0.829 (0.759–0.900)]. L/S < 2, peripheral or mixed vascular type on CDFI, and peripheral or mixed vascular types on SMI were independent predictors of metastatic LNs with PTC. The nomogram based on these three parameters exhibited excellent discrimination, with an AUC of 0.926.ConclusionSMI was superior to US in diagnosing metastatic LNs in PTC. US combined with SMI significantly improved the diagnostic accuracy of metastatic cervical LNs with PTC. SMI is efficacious for differentiating and predicting metastatic cervical LNs.

Axillary lymph node metastasis in pure mucinous carcinoma of breast: clinicopathologic and ultrasonographic features

BackgroundThe purpose of this research is to study the sonographic and clinicopathologic characteristics that associate with axillary lymph node metastasis (ALNM) for pure mucinous carcinoma of breast (PMBC).MethodsA total of 176 patients diagnosed as PMBC after surgery were included. According to the status of axillary lymph nodes, all patients were classified into ALNM group (n = 15) and non-ALNM group (n = 161). The clinical factors (patient age, tumor size, location), molecular biomarkers (ER, PR, HER2 and Ki-67) and sonographic features (shape, orientation, margin, echo pattern, posterior acoustic pattern and vascularity) between two groups were analyzed to unclose the clinicopathologic and ultrasonographic characteristics in PMBC with ALNM.ResultsThe incidence of axillary lymph node metastasis was 8.5% in this study. Tumors located in the outer side of the breast (upper outer quadrant and lower outer quadrant) were more likely to have lymphatic metastasis, and the difference between the two group was significantly (86.7% vs. 60.3%, P = 0.043). ALNM not associated with age (P = 0.437). Although tumor size not associated with ALNM(P = 0.418), the tumor size in ALNM group (32.3 ± 32.7 mm) was bigger than non-ALNM group (25.2 ± 12.8 mm). All the tumors expressed progesterone receptor (PR) positively, and 90% of all expressed estrogen receptor (ER) positively, human epidermal growth factor receptor 2 (HER2) were positive in two cases of non-ALNM group. Ki-67 high expression was observed in 36 tumors in our study (20.5%), and it was higher in ALNM group than non-ALNM group (33.3% vs. 19.3%), but the difference wasn’t significantly (P = 0.338).ConclusionsTumor location is a significant factor for ALNM in PMBC. Outer side location is more easily for ALNM. With the bigger size and/or Ki-67 higher expression status, the lymphatic metastasis seems more likely to present.

Pregnancy Rates in Frozen-Thawed Embryos Derived from Donor Oocytes According To the Mid-Luteal Phase Endometrial Echo Pattern

Background: Previous studies have found a lower live delivered pregnancy rate (LDPR) when women have a triple-line (TL) endometrial echo pattern in mid-luteal phase in natural cycles, but not specifically when a donor oocyte was used. Objective: To determine if failure of progression of a triple line (TL) sonographic endometrial echo pattern despite supplemental progesterone (P) support in the luteal phase is associated with a LDPR following frozen embryo transfer (FET) where the embryos were derived from donor oocytes. Study Design/Materials and Methods: A retrospective review was performed over a twenty-year period of all FET cycles performed in women ≤ age 42 and women ≥ age 43 when the oocyte source was a fresh donor oocyte. All women were on the same regimen of maximum P where 100 mg of P in oil plus vaginal P once there was adequate endometrial thickness. All FETs occurred on day three. The live delivered pregnancy rates were determined and compared according to whether a TL echo pattern, isoechogenic (IE), or homogenic hyperechogenic (HH) was found on the seventh day of taking P. Results: No matter what age, the TL pattern was uncommon (&lt;5%). Women aged &gt; 43 showed a non-significant trend of about a 33% reduction in LDPRs if they continued with a TL pattern into mid-luteal phase. Conclusion: Identifying a TL mid-luteal echo pattern may help to identify a potential correctable reason for failure to conceive following transfer of embryos derived from younger donors in a small minority of women aged &gt; 43.

FPre-Operative Ultrasound Diagnostics of Mirizzi Syndrome

Background. Mirizzi syndrome (MS) is one of the most severe complications of the gastrointestinal tract and the most complex pathological process in biliary surgery in general. The issue of ultrasound diagnostics (USD) of MS in patients with gallstone disease (GLC) at the preoperative stage for planning the scope of surgical intervention and warning the patient about possible complications is acute. The goal. Determine the sensitivity of preoperative ultrasound in the diagnosis of MS and finding the most significant echo pattern of MS during ultrasound. Materials and Methods. The results of 9126 cholecystectomies performed in the Kharkiv Clinical Hospital on railway transport No. 2 for the period from 1997 to 2023 were analyzed, while MS was suspected in 159 (1.7%) patients by ultrasound. Out of 159 in whom signs of MS were detected by ultrasound, MS was reliably confirmed intraoperatively in 116 (72,9%) patients, and no SM was detected in 43 (27,1%) patients. MS I type was detected in 98 (84.49%) patients, MS II type – 18 (15.51%). Among them there were 87 (75) women, 29 (25) men, the age of the patients ranged from 37 to 80 years (on average – 66.4 years). To analyze the sensitivity of certain echo characteristics during preoperative ultrasound in case of suspicion of SM, the diagnostic sensitivity index (DS) was used. Results. It was established that the most sensitive echocardiogram is the absence of a clear border between the back wall of the gallbladder and the hepaticocholedochus, the frequency is 75.40%. The next sign of sensitivity, which was confirmed intraoperatively, is a shrunken gall bladder, the DS indicator is 54.55%. It was also established that the combination of such echo features as: a shrunken gallbladder and the absence of a clear border between the back wall of the gallbladder and hepatic choledochal, which was detected in 25, in 23 of them, MS was confirmed intraoperatively, the DS rate was 92%. Conclusions. Ultrasound allows with a high (72,9%) degree of probability to establish the presence of SM at the preoperative stage. A reliable ultrasound sign of the presence of SM is the visualization of the common wall between the gallbladder and the hepaticocholedochus – DS 75.40%. With a combination of echo signs: shrunken gallbladder and deformation of the wall of the hepaticocholedochus in the place of attachment of the gallbladder, it is possible to assume MS with a high percentage of reliability (92%) with the help of ultrasound at the preoperative stage. The received information about the high probability of the presence of MS before the operation allows you to correctly plan possible options for the volume and tactics of surgical intervention.

m B C C f : Multilevel Breast Cancer Classification Framework Using Radiomic Features

Breast cancer characterization remains a significant and challenging issue in contemporary medicine. Accurately distinguishing between malignant and benign breast lesions is crucial for effective diagnosis and treatment. The anatomical structure of malignant breast ultrasound images is more chaotic than that of benign images due to disease pathologies. However, texture-based analysis alone often fails to identify the extent of chaoticness in malignant breast ultrasound images due to their vague appearance with normal echo patterns, leading to missed diagnoses and increased mortality rates. To address this issue, we proposed an angular feature-based multilevel breast cancer classification framework mBCCf that aims to improve the accuracy and efficiency of classification. The proposed framework mimics the radiologist interpretation procedure by identifying the chaoticness on the periphery of the breast lesion in a breast ultrasound image (level-1). If the lesion contains an acute angle in any part of the periphery, it can be characterized as malignant or otherwise benign. However, solely relying on level-1 analysis may result in misclassification, especially when benign lesions exhibit echo patterns that resemble malignant ones. To overcome this limitation and to make the proposed system highly sensitive, advanced texture-based analysis (using combined shape, texture, and angular features) is performed (level-2). Finally, the performance of the proposed system is evaluated using a cross-dataset (consisting of 1293 breast ultrasound images) and compared with the different individual feature extraction techniques. Encouragingly, our system demonstrated an accuracy of 96.99% for classifying malignant and benign tumors, which is also validated using statistical analysis. The implications of our research lie in its potential to significantly improve breast cancer diagnosis by providing a reliable, efficient, and sensitive tool for radiologists.

Association between Thyroid Function indices and Thyroid Autoantibodies with Thyroid Ultrasonography Outcomes in Children and Adolescents

Objectives: Thyroid Ultrasonography (US) is recommended as a valuable tool for evaluating the status and function of the thyroid gland. The objective of this study was to compare and analyze the thyroid ultrasonography outcomes in children and adolescents who have normal thyroid function and thyroid antibodies.&#x0D; Methods: A cross-sectional study was conducted on a group of 233 selected females aged 9 to 14 years old. Blood samples were obtained from the subjects and analyzed for thyroid hormones and thyroid autoantibodies. Additionally, a thyroid ultrasound was performed to provide an in-depth evaluation.&#x0D; Results: Of all the participants, 25% displayed hypoechogenicity. Individuals with reduced echogenicity had higher median levels of thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPO-Ab), and thyroglobulin antibody (Tg-Ab) compared to those with normal echogenicity. Moreover, those with hypoechogenicity had significantly higher thyroid volume (TVol), iodine status, and thyroglobulin levels than their counterparts with normal echogenicity. Hypoechogenicity was also significantly associated with higher levels of TPO-Ab, Tg-Ab, and TSH. Logistic regression analysis revealed that high TSH and TPO-Ab levels were associated with a higher risk of irregular echo patterns and thyroid autoantibodies.&#x0D; Conclusion: The results revealed that irregular thyroid patterns in the ultrasonography were useful for assessing thyroid structure and dysfunction. Moreover, elevated TPOAb, Tg-Ab, and TSH concentrations in the serum may indicate thyroid malfunction. Ultrasound can help to identify early thyroid dysfunction along with the standard thyroid assessment biomarkers.

Sonographic and clinicopathologic features of metaplastic breast carcinoma and infiltrating ductal carcinoma: a comparative single-center cohort study.

The rarity of metaplastic breast carcinoma (MBC) has resulted in limited sonographic data. Given the inferior prognosis of MBC compared to invasive ductal carcinoma (IDC), accurate preoperative differentiation between the two is imperative for effective treatment planning and prognostic prediction. The objective of this study was to assess the diagnostic accuracy of MBC and differentiate it from IDC by analyzing sonographic and clinicopathologic features. In this retrospective cohort study, 197 women comprising 200 IDC lesions were enrolled between January 2012 and December 2021 and 20 women comprising 20 pure MBC lesions were enrolled between January 2019 and December 2019. A comparison was made between the sonographic and clinicopathologic characteristics of MBC and IDC. The results indicated that patients with MBC had a higher proportion of tumor grade 3 (95.0% vs. 32.5%; P<0.001), high Ki-67 expression (100.0% vs. 75.0%; P<0.001), and the triple-negative subtype (90.0% vs. 13.0%; P<0.001) as compared to those with IDC. On ultrasound (US) findings, MBC lesions tended to have a larger size (≥5 cm: 45.0% vs. 1.5%; P<0.001), regular shape (45.0% vs. 1.5%, P<0.001), circumscribed margin (40.0% vs. 0.5%, P<0.001), a complex cystic and solid echo pattern (50.0% vs. 3.5%; P<0.001), and posterior acoustic enhancement (95.0% vs. 14.5%; P<0.001). Additionally, MBC was more likely to be misinterpreted as a benign lesion by sonographers than was IDC (30.0% vs. 4.5%; P<0.001). Multilayer perceptron analysis revealed posterior acoustic enhancement, circumscribed margins, and size as distinguishing factors between these two tumor types. The estimated rates of local recurrence, distant metastasis, and 5-year overall survival in 19 cases with MBC were found to be 10.5%, 31.6%, and 65.0%, respectively. MBC typically presents as a large breast mass with more benign US features in older women, findings which may facilitate its accurate diagnosis and differentiation from other breast masses.

The Role of Ultrasound Features in Predicting the Breast Cancer Response to Neoadjuvant Chemotherapy.

Background Neoadjuvant chemotherapy (NACT) has become the standard of care for locally advanced breast cancer. This study investigates whether baseline ultrasound features can predict complete pathological response (pCR) after NACT. Methods This retrospective study was approved by the Institutional Review Board of King Abdulaziz University Hospital, Jeddah, Saudi Arabia, with a waiver of informed consent. Records of female patients aged over 18 years with locally advanced breast cancer treated with NACT from 2018 to 2020 were reviewed. Baseline ultrasound parameters were assessed, including posterior effect, echo pattern, margin, and maximum lesion diameter. Tumor grade and immunophenotype were documented from the core biopsy. pCR was defined as the absence of invasive residual disease in the breast and axilla. Univariate and multivariate analyses assessed the association between ultrasound features and pathological response. Results A total of 110breast cancer cases were analyzed: 36 (32.7%) were estrogen receptor (ER)-positive/human epidermal growth factor 2 (HER-2) negative, 49 (44.5%) were HER-2 positive, and 25 (22.7%) were triple-negative (TN). A pCR was achieved in 20 (18%) of cancers. Lesion diameter was significantly different between pCR and non-pCR groups, 28.5 ± 12 mm versus 39 ± 18 mm, respectively, with an area under the curve (AUC) of 0.7, a confidence interval (CI) of 0.55-0.81, and a p-value of 0.01. No significant association was observed between ultrasound features, tumor grade, and immunophenotype with pCR. Conclusion Ultrasound features could not predict pCR. A smaller tumor diameter was the only significant factor associated with pCR. Further prospective studies combining imaging features from different modalities are needed to explore the potential of varying imaging features in predicting post-NACT pathological response more comprehensively.

Prospective assessment of breast lesions AI classification model based on ultrasound dynamic videos and ACR BI-RADS characteristics.

AI-assisted ultrasound diagnosis is considered a fast and accurate new method that can reduce the subjective and experience-dependent nature of handheld ultrasound. In order to meet clinical diagnostic needs better, we first proposed a breast lesions AI classification model based on ultrasound dynamic videos and ACR BI-RADS characteristics (hereafter, Auto BI-RADS). In this study, we prospectively verify its performance. In this study, the model development was based on retrospective data including 480 ultrasound dynamic videos equivalent to 18122 static images of pathologically proven breast lesions from 420 patients. A total of 292 breast lesions ultrasound dynamic videos from the internal and external hospital were prospectively tested by Auto BI-RADS. The performance of Auto BI-RADS was compared with both experienced and junior radiologists using the DeLong method, Kappa test, and McNemar test. The Auto BI-RADS achieved an accuracy, sensitivity, and specificity of 0.87, 0.93, and 0.81, respectively. The consistency of the BI-RADS category between Auto BI-RADS and the experienced group (Kappa:0.82) was higher than that of the juniors (Kappa:0.60). The consistency rates between Auto BI-RADS and the experienced group were higher than those between Auto BI-RADS and the junior group for shape (93% vs. 80%; P = .01), orientation (90% vs. 84%; P = .02), margin (84% vs. 71%; P = .01), echo pattern (69% vs. 56%; P = .001) and posterior features (76% vs. 71%; P = .0046), While the difference of calcification was not significantly different. In this study, we aimed to prospectively verify a novel AI tool based on ultrasound dynamic videos and ACR BI-RADS characteristics. The prospective assessment suggested that the AI tool not only meets the clinical needs better but also reaches the diagnostic efficiency of experienced radiologists.

Jejunal gastrointestinal stromal tumor that developed in a patient with neurofibromatosis type 1: a case report

BackgroundNeurofibromatosis type 1 (NF1) is known to be associated with the frequent occurrence of unique gastrointestinal stromal tumors (GISTs), preferably occurring in the small intestine, with no mutations in the c-kit proto-oncogene or platelet-derived growth factor receptor-alpha (PDGFRA), with a high tendency for multifocal development, indolent nature, with low proliferation activity and favorable prognosis.Case presentationA woman in her forties visited her local doctor complaining of menstrual pain; a large mass was detected in her lower abdomen, and she was referred to our hospital. The patient had hundreds of skin warts and café au lait spots. The patient’s mother had been diagnosed with type 1 neurofibromatosis. The patient met the diagnostic criteria for NF1 and was diagnosed with NF1. Ultrasonography showed a large heterogeneous cystic mass with various echo patterns, solid compartments and multiple septations. Magnetic resonance imaging showed a multilocular cystic mass with liquid content exhibiting various intensities, including that of blood. A small round solid mass was also observed close to the cystic tumor. Contrast-enhanced computed tomography showed that the round solid mass showed strong enhancement in the early phase, unlike the cystic tumor component. Open laparotomy revealed a multicystic exophytic tumor measuring 11.5 cm originating from the jejunal wall, 20 cm distal to the duodenojejunal flexure. A solid tumor measuring 2.1 cm was also found on the anal side of the large tumor. We resected the short segment of the jejunum, including the two lesions. Microscopic findings revealed that the cystic and solid tumors consisted of spindle-shaped tumor cells showing little atypia with a fascicular or bundle arrangement. Nuclear mitosis was scarce. Immunostaining of the tumor cells showed positive staining for KIT and DOG1 and negative staining for S100 and desmin. The NF1 patient was diagnosed with multiple GISTs accompanied by intratumoral hemorrhagic denaturation arising from the jejunum. The TNM staging was pT4N0M0, stage IIIA.ConclusionWe report a case of GISTs associated with NF1 that showed a jejunal origin, multifocal development and few mitotic figures. The recurrence risk, survival prognosis and need for adjuvant chemotherapy, particularly in cases where the initial GIST exhibits a very indolent pathology in NF1-related GISTs, remain to be elucidated.

Investigating the impact of biomimetic pinna shape variations on clutter echoes received from natural environments

Bat species navigating dense vegetation based on biosonar have to obtain the necessary sensory information from “clutter echoes”, i.e., echoes that are superpositions of contributions from many reflecting facets (e.g., leaves) and hence have highly unpredictable waveforms. Prior results have suggested that pinna motions could aid in direction-finding tasks based on deterministic echo patterns. This raises the question whether varying pinna shapes could also have a function significance for challenging biosonar tasks performed on clutter echoes. As a first, task-independent step to test this hypothesis it has been investigated whether different pinna shapes have a consistent effect on clutter echoes despite the random nature of these signals. This was accomplished using a dedicated laboratory setup that produced large amounts of uncorrelated clutter echo data by agitating an artificial foliage with fans between echoes. Deep learning methods were then applied to identify the pinna shape that received a given clutter echo. A two-dimensional convolutional neural network operating on spectrograms achieved 90% validation accuracy in this task. This finding demonstrates that even small pinna deformations can impart consistent effects on the clutter echoes. Ongoing research is directed at analyzing the nature of the signal properties that the successful classifications were based on.

Improving the Completion of Weather Radar Missing Data with Deep Learning

Weather radars commonly suffer from the data-missing problem that limits their data quality and applications. Traditional methods for the completion of weather radar missing data, which are based on radar physics and statistics, have shown defects in various aspects. Several deep learning (DL) models have been designed and applied to weather radar completion tasks but have been limited by low accuracy. This study proposes a dilated and self-attentional UNet (DSA-UNet) model to improve the completion of weather radar missing data. The model is trained and evaluated on a radar dataset built with random sector masking from the Yizhuang radar observations during the warm seasons from 2017 to 2019, which is further analyzed with two cases from the dataset. The performance of the DSA-UNet model is compared to two traditional statistical methods and a DL model. The evaluation methods consist of three quantitative metrics and three diagrams. The results show that the DL models can produce less biased and more accurate radar reflectivity values for data-missing areas than traditional statistical methods. Compared to the other DL model, the DSA-UNet model can not only produce a completion closer to the observation, especially for extreme values, but also improve the detection and reconstruction of local-scale radar echo patterns. Our study provides an effective solution for improving the completion of weather radar missing data, which is indispensable in radar quantitative applications.