Elastic Mean Research Articles

The income elasticity of household energy demand: a quantile regression analysis

ABSTRACTThis article examines variation in the income elasticity of household energy demand across the energy expenditure distribution using expenditure data from the five most recent Household Budget Surveys (HBSs) in Ireland: the 1987, 1994/1995, 1999/2000, 2004/2005 and 2009/2010 HBS. The analysis uses a two-stage instrumental variable quantile regression approach and is based on each HBS cross section, as well as the overall pooled observations. The estimated elasticities are compared across low- and high-energy-consumption scenarios and to a benchmark elasticity estimated using two-stage least squares. The results provide evidence that there is significant variation in the income elasticities across the energy expenditure distribution and that care must be taken when using the constant mean elasticity for policy purposes. More specifically, any examination of the future impact of a change in income support policy measures on energy consumption should recognize the substantial context-dependent variation in the income elasticity.

Shear wave elastography in the diagnosis of breast non-mass lesions: factors associated with false negative and false positive results

To investigate factors related to false shear wave elastography (SWE) results for breast non-mass lesions (NMLs) detected by B-mode US. This retrospective study enrolled 152 NMLs detected by B-mode US and later pathologically confirmed (79 malignant, 73 benign). All lesions underwent B-mode US and SWE. Quantitative (mean elasticity [E mean]) and qualitative (maximum stiffness colour) SWE parameters were assessed, and 'E mean > 85.1 kPa' or 'stiff colour (green to red)' determined malignancy. Final SWE results were matched to pathology results. Multivariate logistic regression analysis identified factors associated with false SWE results for diagnosis of breast NMLs. Associated calcifications (E mean: odds ratio [OR] = 7.60, P < 0.01; maximum stiffness colour: OR = 6.30, P = 0.02), in situ cancer compared to invasive cancer (maximum stiffness colour: OR = 5.29, P = 0.02), and lesion size (E mean: OR = 0.90, P < 0.01; maximum stiffness colour: OR = 0.91, P = 0.01) were significantly associated with false negative SWE results for malignant NMLs. Distance from the nipple (E mean: OR = 0.84, P = 0.03; maximum stiffness colour: OR = 0.93, P = 0.04) was significantly associated with false positive SWE results for benign NMLs. Presence of associated calcifications, absence of the invasive component, and smaller lesion size for malignant NMLs and shorter distance from the nipple for benign NMLs are factors significantly associated with false SWE results. • Calcification and size are associated with false negative SWE in malignant NMLs. • In situ cancer is associated with false negative SWE in malignant NMLs. • Distance from the nipple is associated with false positive SWE in benign NMLs. • These factors need consideration when performing SWE on breast NMLs.

Assessment of extent of skin involvement in scleroderma using shear wave elastography

Introduction: Scleroderma (systemic sclerosis [SSc]) is a rare autoimmune disease which manifests as fibrosis in the skin and other internal organs. Conventionally, the modified Rodnan skin score (MRSS) has been used to quantify the extent of skin fibrosis (resulting in skin tightness) in SSc. This technique, although widely validated, is limited by the requirement of a trained, experienced assessor. Recent literature suggests that utilization of the objective ultrasound-based assessment of skin fibrosis utilizing shear wave elastography (SWE) may be a more robust technique to detect early skin tightness in SSc. Methods: We evaluated the use of SWE (assessed by an experienced radiologist) in 24 patients with SSc compared with 16 healthy controls. Results: Our patients were predominantly females, with median disease duration of 1.5 years and median MRSS of 17. There was minimal intraobserver variation in the assessment of SWE. Patients with SSc had higher SWE values (mean elasticity [Emean]) compared to healthy controls at most assessed sites for the MRSS. The Emeancorrelated significantly at all sites with the MRSS scores. At the sites where MRSS was scored as 0 (normal), the Emeanin patients with SSc was higher when compared with similarly clinical normal skin in patients with SSc, suggesting potential early involvement of these areas of the skin with fibrosis. Conclusion: SWE is a promising tool to objectively assess skin fibrosis in SSc and may be useful in detecting early, subclinical skin involvement in this disease.

Elastography of Neck Masses

Elasticity (hardness) is a mechanical tissue characteristic that prevents tissue displacement under pressure. It varies in different types of tissue (fat, collagen and so forth) and in the same tissue in different pathologic states (inflammatory, malignant). During the past few years, sonographic elastography, magnetic resonance elastography and some other techniques have performed digital measurements of tissue hardness. http://www.eusjournal.com/article.asp?issn=2303-9027;year=2014;volume=3;issue=1;spage=58;epage=62;aulast=Okasha - ref1 Two techniques of elastography have evolved 1) Strain elastography (SE) 2) Shear Wave elastography (SWE) US elastography Strain scoring (patterns) system for Lymph Nodes(LN) and Thyroid masses Score 1: The entire LN is red or green, i.e., soft. Score 2: 80% or more of the cross-sectional area of the LN is red or green, i.e., soft. Score 3: 50% or more and less than 80% is red or green. Score 4: 50% or more and less than 80% is blue; and Score 5: 80% or more of the cross-sectional area of the LN is blue i.e., hard. Shear Wave Elastography SWE provides quantitative elastic information on the basis of the acoustic pulse of a US probe that stimulates tissues, thereby producing a real-time elastogram. Sonographic elastography in the neck can be primarily used to evaluate pathologies involving Lymph nodes (LN), thyroid nodules and salivary gland nodules http://www.eusjournal.com/article.asp?issn=2303-9027;year=2014;volume=3;issue=1;spage=58;epage=62;aulast=Okasha - ref4. Differentiation between reactive and metastatic lymphadenopathy is vital and one of the differentiating criteria is hardness (elasticity) of the mass. LYMPH NODES LNs that have sonographic criteria suggestive of benign nature and had elastography score of 1 hence biopsy is not indicated and the diagnoses is based on follow-up with the minimum period of 12 months. In LNs with score 2, if clinical or sonographic suspicion existed the LN was subjected to histopathological examination, but in case of low suspicion a follow-up policy can be adopted to avoid unnecessary invasive procedures. All LNs with score 3 and 4 are subjected to histopathological examination either by biopsy or FNAC. Thyroid Nodules Using strain criteria in a study by Rago differentiating benign nodules from malignant ones was a mean elasticity index of 65 kPa on SWE. The sensitivity and the specificity for malignancy were 51.9% and 97% in the case of gray-scale US and 81.5% and 97.0% in the case of the combination of gray-scale US and SWE. SWE: Sebag et al.in a study of 146 thyroid nodules form 93 patients, the cut-off point for discriminating benign nodules from malignant ones was a mean elasticity index of 65 kPa on SWE. The sensitivity and specificity for malignancy were 81.5% and 97.0% in a combination of gray-scale US and SWE, respectively While elastography is a promising technique in some organs such as the breast and the liver there have been conflicting results of its additional value in predicting thyroid malignancy and Lymp Node charachterisation

Real-Time Sonoelastography of Parotid Gland Tumors.

We sought to determine the performance of real-time sonoelastography in the differential diagnosis of parotid gland tumors. Between April, 2014, and June, 2015, 54 parotid gland masses were examined by ultrasound and strain sonoelastography in 46 patients. Real-time sonoelastography using the elasticity score (E-index), which gives an absolute value between 0 (softest) and 6 (hardest), was performed. Demographic characteristics, histopathologic examination, and difference in elasticity scores between benign and malignant masses were evaluated. The mean age of the patients was 60.01 ± 2.97 years, and 56.52% of the patients were male (n = 26). Among the 54 parotid gland masses, 44 (81.5%) were benign and 10 (18.5%) were malignant tumors, 63% (n = 34) of the lesions being on the right side. The diagnoses as benign tumors consisted of Warthin tumor (n = 18, 33.3%), pleomorphic adenoma (n = 8, 14.8%) and other benign tumors (n = 18, 33.3%). The mean elasticity score and the size of all tumors were 2.87 ± 0.96 and 23.68 ± 12.38 mm, respectively. The mean elasticity score for benign tumors was 2.75 ± 0.95, and for malignant tumors it was 3.44 ± 0.85 (P = .034). According to our results, real-time strain sonoelastography seems to have additional value over routine sonographic evaluation of parotid gland tumors in the differential diagnosis of benign and malignant parotid masses. However, with a small sample of malignant cases and appreciable overlap of the stiffness of benign and malignant masses, caution must be applied because the findings may not be representative of all patients with a parotid gland tumor.

Shear-Wave Elastography for the Differential Diagnosis of Breast Papillary Lesions.

ObjectiveTo evaluate the diagnostic performance of shear-wave elastography (SWE) for the differential diagnosis of breast papillary lesions.MethodsThis study was an institutional review board-approved retrospective study, with a waiver of informed consent. A total of 79 breast papillary lesions in 71 consecutive women underwent ultrasound and SWE prior to biopsy. Ultrasound features and quantitative SWE parameters were recorded for each lesion. All lesions were surgically excised or excised using an ultrasound-guided vacuum-assisted method. The diagnostic performances of the quantitative SWE parameters were compared using the area under the receiver operating characteristic curve (AUC).ResultsOf the 79 lesions, six (7.6%) were malignant and 12 (15.2%) were atypical. Orientation, margin, and the final BI-RADS ultrasound assessments were significantly different for the papillary lesions (p < 0.05). All qualitative SWE parameters were significantly different (p < 0.05). The AUC values for SWE parameters of benign and atypical or malignant papillary lesions ranged from 0.707 to 0.757 (sensitivity, 44.4–94.4%; specificity, 42.6–88.5%). The maximum elasticity and the mean elasticity showed the highest AUC (0.757) to differentiate papillary lesions.ConclusionSWE provides additional information for the differential diagnosis of breast papillary lesions. Quantitative SWE features were helpful to differentiate breast papillary lesions.

Correlating Tumor Stiffness with Immunohistochemical Subtypes of Breast Cancers: Prognostic Value of Comb-Push Ultrasound Shear Elastography for Differentiating Luminal Subtypes.

PurposeThe purpose of our study is to correlate quantitatively measured tumor stiffness with immunohistochemical (IHC) subtypes of breast cancer. Additionally, the influence of prognostic histologic features (cancer grade, size, lymph node status, and histological type and grade) to the tumor elasticity and IHC profile relationship will be investigated.MethodsUnder an institutional review board (IRB) approved protocol, B-mode ultrasound (US) and comb-push ultrasound shear elastography (CUSE) were performed on 157 female patients with suspicious breast lesions. Out of 157 patients 83 breast cancer patients confirmed by pathology were included in this study. The association between CUSE mean stiffness values and the aforementioned prognostic features of the breast cancer tumors were investigated.ResultsOur results demonstrate that the most statistically significant difference (p = 0.0074) with mean elasticity is tumor size. When considering large tumors (size ≥ 8mm), thus minimizing the statistical significance of tumor size, a significant difference (p< 0.05) with mean elasticity is obtained between luminal A of histological grade I and luminal B (Ki-67 > 20%) subtypes.ConclusionTumor size is an independent factor influencing mean elasticity. The Ki-67 proliferation index and histological grade were dependent factors influencing mean elasticity for the differentiation between luminal subtypes. Future studies on a larger group of patients may broaden the clinical significance of these findings.

Limits to Substitution Between Ecosystem Services and Manufactured Goods and Implications for Social Discounting

This paper examines implications of limits to substitution for estimating substitutability between ecosystem services and manufactured goods and for social discounting. Based on a model that accounts for a subsistence requirement in the consumption of ecosystem services, we provide empirical evidence on substitution elasticities. We find an initial mean elasticity of substitution of two, which declines over time towards complementarity. We subsequently extend the theory of dual discounting by introducing a subsistence requirement. The relative price of ecosystem services is non-constant and grows without bound as the consumption of ecosystem services declines towards the subsistence level. An application suggests that the initial discount rate for ecosystem services is more than a percentage-point lower as compared to manufactured goods. This difference increases by a further half percentage-point over a 300-year time horizon. The results underscore the importance of considering limited substitutability in long-term public project appraisal.

Diagnostic Performance of Shear Wave Elastography Parameters Alone and in Combination with Conventional B-Mode Ultrasound Parameters for the Characterization of Thyroid Nodules: A Prospective, Dual-Center Study

The aims of our study were to determine whether shear wave elastography (SWE) can improve the conventional B-mode differentiation of thyroid lesions, determine the most accurate SWE parameter for differentiation and assess the influence of microcalcifications and chronic autoimmune thyroiditis on SWE values. We examined 119 patients with 169 thyroid nodules who prospectively underwent B-mode ultrasound and SWE using the same ultrasound machine. The parameters assessed using SWE were: mean elasticity within the entire lesion (SWE-whole) and mean (SWE-mean) and maximum (SWE-max) elasticity for a 2-mm-diameter region of interest in the stiffest portion of the lesion, excluding microcalcifications. The discriminant powers of a generalized estimating equation model including B-mode parameters only and a generalized estimation equation model including both B-mode and SWE parameters were assessed and compared using the area under the receiver operating characteristic curve, in association with pathologic verification. In total, 50 and 119 malignant and benign lesions were detected. In generalized estimated equation regression, the B-mode parameters associated with higher odds ratios (ORs) for malignant lesions were microcalcifications (OR = 4.3), hypo-echogenicity (OR = 3.13) and irregular margins (OR = 10.82). SWE-max was the only SWE independent parameter in differentiating between malignant and benign tumors (OR = 2.95). The area under the curve for the B-mode model was 0.85, whereas that for the model combining B-mode and SWE parameters was 0.87. There was no significant difference in mean SWE values between patients with and without chronic autoimmune thyroiditis. The results of the present study suggest that SWE is a valuable tool for the characterization of thyroid nodules, with SWE-max being a significant parameter in differentiating benign and malignant lesions, independent of conventional B-mode parameters. The combination of SWE parameters and conventional B-mode parameters does not significantly improve the diagnosis of malignant thyroid nodules. The presence of microcalcifications can influence the SWE-whole value, whereas the presence of chronic autoimmune thyroiditis may not.

Does Shear Wave Elastography (SWE) parameters improve the differentiation the character of the thyroid lesions

The aims of study were to determine whether shear wave elastography (SWE) can improve the B-mode differentiation of thyroid lesions, determine the most accurate SWE parameter for differentiation, and assess the influence of microcalcifications (MCs) and chronic autoimmune thyroiditis (CAT) on SWE values. We examined 119 patients with 169 thyroid nodules who prospectively underwent B-mode US and SWE using the same US machine. The following parameters were assessed using SWE: mean elasticity within the entire lesion (SWE-whole) and the mean (SWE-mean) and maximum elasticities (SWE-max) for a 2-mm region of interest (ROI) in the stiffest portion of the lesion, excluding MCs. The discriminant powers of a GEE model including B-mode only and both B-mode and SWE parameters were assessed and compared using the area under the ROC curve (AUC), in association with pathological verifications. In total, 50 and 119 malignant and benign lesions were detected. Multivariate logistic regression analysis for B-mode parameters revealed that MCs [odds ratio (OR), 4.3, hypoechogenicity (OR, 3.13, and irregular margins (OR, 10.82) were associated with a higher OR for malignancy, while that for SWE parameters revealed that SWE-max was an independent parameter for the same (OR, 2.95). The AUC for the B-mode model was 0.85, while that for the model combining B-mode and SWE parameters was 0.87. There was no significant difference in the mean SWE values between patients with and without CAT.

Stiffness at shear-wave elastography and patient presentation predicts upgrade at surgery following an ultrasound-guided core biopsy diagnosis of ductal carcinoma in situ

The aim of this study is to establish predictors of invasion in lesions yielding an ultrasound-guided biopsy diagnosis of ductal carcinoma in situ (DCIS). Patients subjected to ultrasound-guided core biopsy yielding DCIS were studied. At shear-wave elastography (SWE) a threshold of 50kPa was used for mean elasticity (Emean) to dichotomise the elasticity data between invasive and non-invasive masses. Data recorded included the mammographic and ultrasound features, the referral source, and grade of DCIS in the biopsy. The chi-square test was used to detect statistical significance. Of 57 lesions, 24 (42%) had invasion at excision. Symptomatic patients and patients with stiff lesions were more likely to have invasion than patients presenting through screening and with soft lesions (58% [14 of 24] versus 30% [10 of 33], p=0.03) and (51% [20 of 39] versus 22% [4 of 18], p=0.04). No other factors showed a relationship with invasion. Combining the two predictors of invasion improved risk stratification with symptomatic and stiff lesions having a risk of invasion of 67% (12 of 18) and soft lesions presenting at screening having only a 17% (2 of 12) risk of invasion (p=0.02). Stiffness on SWE and the referral source of the patient are predictors of occult invasion in women with an ultrasound-guided core biopsy diagnosis of DCIS.

Marketing's Impact on Firm Value: Generalizations from a Meta-Analysis

The interest in the value relevance of marketing investments has given rise to numerous studies on the marketing–finance interface. This study integrates extant research findings and establishes empirical generalizations on marketing's impact on firm value. Specifically, the authors conduct a meta-analysis of prior econometric elasticity estimates of the stock market impact of marketing actions and marketing assets. Analyses based on 488 elasticities drawn from 83 studies reveal a mean elasticity of .04 for advertising expenditure variables and of .54 for marketing asset variables. Among marketing assets, customer-related assets show a higher mean elasticity of .72, compared with .33 for brand-related assets. Further analyses show that advertising elasticities are lower in more concentrated industries and that marketing asset elasticities are higher during recession times. Researchers should also be aware that characteristics of the research design (e.g., the type of firm value metric used, the omission of control variables, or not accounting for endogeneity) may affect the estimation results.

Testicular microlithiasis and preliminary experience of acoustic radiation force impulse imaging

BackgroundElastography of the testis can be used as a part of multiparametric examination of the scrotum.PurposeTo determine the testicular stiffness using acoustic radiation force impulse imaging (ARFI) technique in men with testicular microlithiasis (TML).Material and MethodsIn 2013, 12 patients with diagnosed testicular microlithiasis in 2008 (mean age, 51 years; age range, 25–76 years) underwent a 5-year follow-up B-mode ultrasonography with three ARFI elastography measurements of each testis. We used a Siemens Acuson S3000 machine.ResultsNo malignancy was found at the 5-year follow-up B-mode and elastography in 2013. However, we found an increase in TML; in the previous ultrasonography in 2008, eight men had bilateral TML, whereas in 2013, 10 men were diagnosed with bilateral TML. The mean elasticity of testicles with TML was 0.82 m/s (interquartile range [IQR], 0.72–0.88 m/s; range, 65–1.08 m/s).ConclusionElastography velocity of testis with TML seems to be in the same velocity range as in men with normal testis tissue.

WE‐AB‐202‐09: Feasibility and Quantitative Analysis of 4DCT‐Based High Precision Lung Elastography

Purpose:The purpose of this project is to derive high precision elastography measurements from 4DCT lung scans to facilitate the implementation of elastography in a radiotherapy context.Methods:4DCT scans of the lungs were acquired, and breathing stages were subsequently registered to each other using an optical flow DIR algorithm. The displacement of each voxel gleaned from the registration was taken to be the ground‐truth deformation. These vectors, along with the 4DCT source datasets, were used to generate a GPU‐based biomechanical simulation that acted as a forward model to solve the inverse elasticity problem. The lung surface displacements were applied as boundary constraints for the model‐guided lung tissue elastography, while the inner voxels were allowed to deform according to the linear elastic forces within the model. A biomechanically‐based anisotropic convergence magnification technique was applied to the inner voxels in order to amplify the subtleties of the interior deformation. Solving the inverse elasticity problem was accomplished by modifying the tissue elasticity and iteratively deforming the biomechanical model. Convergence occurred when each voxel was within 0.5 mm of the ground‐truth deformation and 1 kPa of the ground‐truth elasticity distribution. To analyze the feasibility of the model‐guided approach, we present the results for regions of low ventilation, specifically, the apex.Results:The maximum apical boundary expansion was observed to be between 2 and 6 mm. Simulating this expansion within an apical lung model, it was observed that 100% of voxels converged within 0.5 mm of ground‐truth deformation, while 91.8% converged within 1 kPa of the ground‐truth elasticity distribution. A mean elasticity error of 0.6 kPa illustrates the high precision of our technique.Conclusion:By utilizing 4DCT lung data coupled with a biomechanical model, high precision lung elastography can be accurately performed, even in low ventilation regions of the lungs.This material is based upon work supported by the National Science Foundation Graduate Research Fellowship under Grant No. DGE‐1144087.

Do regional trade agreements really boost trade? Evidence from agricultural products

We evaluate the impact on trade of regional trade agreements (RTAs) using a panel data approach at the detailed product level which exploits exports to third destinations and imports from third origins as benchmarks. This method is robust to both endogeneity and heterogeneity across agreements and across products, and allows differentiation between the impacts of tariff provisions and non-tariff provisions. The analysis covers agricultural and food products for 74 country pairs linked by an agreement entered into force during the period 1998–2009. Our estimate of the mean elasticity of substitution across imports at product level is slightly below four. Counterfactual simulations suggest that RTAs have increased partners’ bilateral agricultural and food exports by 30–40 % on average, with marked heterogeneity across agreements. Also, RTAs are found to increase the probability of exporting a given product to a partner country although this impact is small. Finally, we found non-tariff provisions have no measurable trade impact.

Prediction of invasive breast cancer using shear-wave elastography in patients with biopsy-confirmed ductal carcinoma in situ.

To investigate whether mass stiffness measured by shear-wave elastography (SWE) can predict the histological upgrade of ductal carcinoma in situ (DCIS) confirmed through ultrasound (US)-guided core needle biopsy (CNB). The institutional review board approved this study and informed consent was waived. A database search revealed 120 biopsy-confirmed DCIS in patients who underwent B-mode US and SWE prior to surgery. Clinicopathologic results, B-mode findings, size on US, and mean and maximum elasticity values on SWE were recorded. Associations between upgrade to invasive cancer and B-mode US findings, SWE information, and clinical variables were assessed using univariate, multivariate logistic regression, and multiple linear regression analysis. The overall upgrade rate was 41.7% (50/120). Mean stiffness value (P = .014) and mass size (P = .001) were significantly correlated with histological upgrade. The optimal cut-off value of mean stiffness value, yielding the maximal sum of sensitivity and specificity, was 70.7kPa showing sensitivity of 72% and specificity of 65.7% for detecting invasiveness. Qualitative elasticity colour scores were significantly correlated with the histological upgrade, mammographic density, and B-mode category (P < .04). Mean stiffness values evaluated through SWE can be utilized as a preoperative predictor of histological upgrade to invasive cancer in DCIS confirmed at US-guided needle biopsy. • Higher stiffness values were noted in invasive cancer than DCIS. • Qualitative SWE colour scores significantly correlated with the histological upgrade. • Qualitative SWE colour scores had excellent interobserver agreement.

PD06-06 THE EFFECT OF NEUROVASCULAR BUNDLE PRESERVATION ON CHANGES IN PENIS LENGTHS AND ELASTICITY SCORES FOLLOWING RADICAL PROSTATECTOMY

You have accessJournal of UrologyImaging/Radiology: Uroradiology II1 Apr 2016PD06-06 THE EFFECT OF NEUROVASCULAR BUNDLE PRESERVATION ON CHANGES IN PENIS LENGTHS AND ELASTICITY SCORES FOLLOWING RADICAL PROSTATECTOMY Nurullah Hamidi, Evren Suer, Ilker Gokce, Namik Altinbas, Cemil Yagci, Sumer Baltaci, and Kadir Turkolmez Nurullah HamidiNurullah Hamidi More articles by this author , Evren SuerEvren Suer More articles by this author , Ilker GokceIlker Gokce More articles by this author , Namik AltinbasNamik Altinbas More articles by this author , Cemil YagciCemil Yagci More articles by this author , Sumer BaltaciSumer Baltaci More articles by this author , and Kadir TurkolmezKadir Turkolmez More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2626AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To date, many articles have been published about penile atrophy following radical prostatectomy (RP). In this study, we aimed to evaluate the changes in penis lengths and cavernous body elasticity scores in patients who underwent RP with neurovascular bundle (NVB) preserving or not. METHODS We prospectively recorded data of 65 pre-op potent patients who underwent RP for organ-confined prostate cancer, at our institution, between April 2014-March 2015. Patients who have penile deformity were excluded. Patients were divided into three groups(G): non-nerve spared (G1=22 patients), unilateral (left or right) nerve spared (G2=22 patients) and bilateral nerve spared (G3=21 patients). Data include pre and post-op (3rd and 6thmonths) penis lengths and elasticity scores. Elasticity of cavernous tissue (at level of peno-scrotal junction) was assessed with real-time elastography. All elastography measures performed by a single radiologist between 0-6 scores (0: elastic, 6: fibrotic). Penis lengths were measured from pubo-penile junction to tip of glans with maximum contraction of flaccid penis. RESULTS Age, mean pre-op penis lengths and elasticity scores were similar for three groups (p=0.22, p=0.82, p=0.36, respectively). Pre-op, post-op 3rd and 6th months penis lengths and elasticity scores were showed in fig 1. The differences of post-op penis lengths and elasticity scores between G1-G2 and G1-G3 were statistically significant. However, difference between G2 and G3 was not statistically significant (table 1). Also negative correlation was detected between penis lengths and elasticity scores in Spearman’s correlation test at post-op 3rd(r=-0.243) and 6th (r=-0.263) months. CONCLUSIONS Shorter penis lengths and higher elasticity (in favor of fibrosis) scores were observed in bilateral non-nerve sparing group after RP. Although further prospective and large sample trials are needed for confirmation our results, preserve of NVB in at least one side mediates less penile atrophy and lower elasticity scores. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e176 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Nurullah Hamidi More articles by this author Evren Suer More articles by this author Ilker Gokce More articles by this author Namik Altinbas More articles by this author Cemil Yagci More articles by this author Sumer Baltaci More articles by this author Kadir Turkolmez More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Shear wave elastography of the placenta in patients with gestational diabetes mellitus

To evaluate placental elasticty in women with gestational diabetes mellitus (GDM) and non-diabetic controls. Thirty-three pregnant women with GDM according to the current criteria of the American Diabetes Association and 43 healthy pregnant women who were admitted to the antenatal clinic were recruited for this case–control study. Elasticity values of both the peripheral and the central parts of the placentas of the patients in both groups were determined by shear wave elastography (SWE) imaging. Mean elasticity values of both the central and the peripheral part of the placentas were significantly higher in GDM pregnancies (p < 0.001). No difference was observed in the mean elasticity values of the central and the peripheral part of the placentas in two groups (p > 0.05). SWE imaging technology might provide a quantitative assessment of the morphological pathologies of placentas in pregnant women with GDM.

Diagnostic Value of Elastography in the Diagnosis of Intermetatarsal Neuroma

The objective of the present study was to characterize the ultrasound and elastographic properties of intermetatarsal neuroma (interdigital neuroma) and their contribution to diagnosis. Eighteen patients with metatarsalgia, who had presented to an orthopedic clinic from April 2013 to February 2015, were diagnosed with 25 intermetatarsal neuromas (11 unilateral [61.11%], 7 bilateral [38.89%]). These patients underwent evaluation with ultrasonography and simultaneous ultrasound strain elastography to assess the elastographic properties of the tissues in the intermetatarsal space. The intermetatarsal neuroma diagnosis was confirmed by histopathologic inspection. The lesion contours, localization, dimensions, and vascularization were evaluated before surgical excision. The elasticity and strain ratio values were compared between the neuroma and adjacent healthy intermetatarsal space. Of the 25 intermetatarsal neuromas, 1 (4%) was not detected by ultrasonography (incidence of detection of 96%). The mean neuroma width was 6.35 (range 3.7 to 13) mm in the coronal plane, and the mean elasticity and strain ratio values were 3.44 (range 1.1 to 5.1) and 9.47 (range 2.3 to 19.3), respectively. The elasticity and strain ratio values were significantly greater in the presence of an interdigital neuroma than in the adjacent healthy intermetatarsal spaces (Z = −3.964, p = .0001 and Z = −3.927, p = .0001, respectively). The diagnostic cutoff values were calculated as 2.52 for elasticity and 6.1 for the strain ratio. Four neuromas (16%) were not demarcated, and the elasticity and strain ratio values for these were lower than those for neuromas with demarcated contours but were greater than those for healthy intermetatarsal spaces (p < .006 and p < .005, respectively). Patients with clinically suspected intermetatarsal neuromas that do not show demarcation and with smaller lesions might benefit from the use of ultrasound elastography for diagnosis.

Relationship between ultrasound elastography and myofibroblast distribution in breast cancer and its clinical significance.

The study investigated the relationship between ultrasound elastography (USE) scoring and myofibroblast distribution with expression features of α-SMA + /CD34− in patients of Uyghur and Han ethnicities with breast masses in Xinjiang, China. The data was used to evaluate its clinical significance in the early diagnosis of breast cancer. A total of 300 patients with breast masses were included in the study, which involved conventional sonography and USE, with histopathologic diagnosis as the reference standard. Myofibroblast distribution was investigated by detecting the expression levels of α-SMA and CD34 in lesions using immunohistochemistry and real-time PCR. Out of 300 lesions, 185 were histologically malignant and 115 benign. The mean elasticity score for malignant lesions was significantly higher than for benign lesions. The expression level of α-SMA was elevated while the expression level of CD34 was lower in malignancies, compared with benign lesions. The expression of α-SMA was positively associated with the USE scores, while a negative relationship was observed between CD34 expression and USE scoring. The combination of USE and molecular diagnosis provides a promising modality for the early diagnosis and evaluation of the risks in particular types of breast cancer.