Ultrasound Measurements Research Articles

Medial meniscus extrusion is associated with meniscus tears in US and MRI: A case control study.

To study the medial meniscus extrusion (MME) in subjects with and without medial meniscal tears on magnetic resonance imaging (MRI), supine ultrasound (US), and weight-bearing US. Forty-seven cases (mean age 43.7 years) with medial meniscus tears and 53 healthy controls (mean age 36.6 years) were assessed. Two experienced sonographers performed the US evaluations, and a fellowship-trained musculoskeletal radiologist assessed the menisci on MRI. Independent and paired T-tests and ICC were used for statistical analyses. On supine US, the mean MME was 3.9 mm for the cases and 2.3 mm for the controls (p < 0.001). On weight-bearing US, the values were 4.2 and 2.8 mm (p < 0.001), and on MRI 3.0 and 2.0 mm (p < 0.001), respectively. The mean difference between supine and weight-bearing US extrusion was 0.38 mm for the cases and 0.49 mm for the controls (p = 0.291). Correlation between supine US and MRI MME measurements was good (ICC = 0.660, CIs [0.533-0.758]). MME can be assessed using US with good correlation to MRI. US-observed extrusion was significantly increased in supine and standing positions for medial meniscus tears. The mean difference between examination positions was reduced with medial meniscus tears although this result was statistically insignificant.

Quantum critical fluctuations in a transverse-field Ising magnet

CoNb2O6 is a model system for a spin-1/2 one-dimensional (1D) transverse-field Ising magnet (TFIM) with a rather low three-dimensional (3D) Néel ordering temperature at TN=2.95 K. We studied CoNb2O6 using ultrasound measurements down to 0.3 K in transverse magnetic fields applied along the b direction. Upon entering the 3D ordered state, we observe pronounced anomalies in the transverse acoustic mode c 66. In particular, from 1.3 to 1.5 K and around 4.7 T, this mode reveals an almost diverging softening, which is considerably reduced at lower and higher magnetic fields. We interpret this as an influence of quantum critical fluctuations emerging from the quantum critical point (QCP) of the 1D Ising spin chains at about 4.75 T, which lies below the QCP of the 3D ordering at about 5.4 T. This is clear experimental evidence of the predicted generic phase diagram for a TFIM with superimposed 3D ordering.

Impact of body mass index on sonographic measurement of head perineum distance before operative vaginal delivery.

To evaluate the impact of body mass index (BMI) on sonographic measurement of head perineum distance (HPD) before operative vaginal delivery (OVD). This was a single-center retrospective cohort study (Lille, France) conducted from March 1, 2019 to October 31, 2020 including all singleton and OVD. HPD measurement was systematically performed without and with compression on the perineum soft tissues. The level of station was defined by vaginal examination and three maternal BMI groups were defined (normal BMI [<24.9 kg/m2] vs overweight [25-29.9 kg/m2] vs obese [≥30 kg/m2]). HPD measures were compared between BMI groups and compression, in distinct level of station, using a two-factor analysis of variance including BMI groups, the compression, and the interaction term BMI group compression. A total of 775 women were included: 488 with normal BMI, 181 overweight patients and 106 obese patients. The measurement of HPD before OVD without and with compression on the soft tissues was significantly different between the BMI groups only in the lower part, particularly between normal BMI and obese patients (mean difference (95% CI): 6.6 mm (4.0 to 9.2) without compression; 3.8 (1.1 to 6.4) with compression). The values of HPD without and with compression on the soft tissues on the maternal perineum were different according to the maternal BMI concerning lower part station. Thus, it seems important to define thresholds of HPD measures corresponding to each head station levels according to maternal BMI.

Comparing Fetal Ultrasound Biometric Measurements to Neonatal Anthropometry at the Extremes of Birthweight.

Error in birthweight prediction by sonographic estimated fetal weight (EFW) has clinical implications, such as avoidable cesarean or misclassification of fetal risk in labor. We aimed to evaluate optimal timing of ultrasound and which fetal measurements contribute to error in fetal ultrasound estimations of birth size at the extremes of birthweight. We compared differences in head circumference (HC), abdominal circumference (AC), femur length, and EFW between ultrasound and corresponding birth measurements within 14 (n = 1,290) and 7 (n = 617) days of birth for small- (SGA, <10th percentile), appropriate- (AGA, 10th-90th), and large-for-gestational age (LGA, >90th) newborns. Average differences between EFW and birthweight for SGA neonates were: -40.2 g (confidence interval [CI]: -82.1, 1.6) at 14 days versus 13.6 g (CI: -52.4, 79.7) at 7 days; for AGA, -122.4 g (-139.6, -105.1) at 14 days versus -27.2 g (-50.4, -4.0) at 7 days; and for LGA, -242.8 g (-306.5, -179.1) at 14 days versus -72.1 g (-152.0, 7.9) at 7 days. Differences between fetal and neonatal HC were larger at 14 versus 7 days, and similar to patterns for EFW and birthweight, differences were the largest for LGA at both intervals. In contrast, differences between fetal and neonatal AC were larger at 7 versus 14 days, suggesting larger error in AC estimation closer to birth. Using a standardized ultrasound protocol, SGA neonates had ultrasound measurements closer to actual birth measurements compared with AGA or LGA neonates. LGA neonates had the largest differences between fetal and neonatal size, with measurements 14 days from delivery showing 3- to 4-fold greater differences from birthweight. Differences in EFW and birthweight may not be explained by a single fetal measurement; whether estimation may be improved by incorporation of other knowable factors should be evaluated in future research. · Ultrasound measurements may be inadequate to predict neonatal size at birth.. · Birthweight estimation error is higher for neonates >90th percentile.. · There is higher error in AC closer to birth..

A Pilot Comparative Study between Creatinine- and Cystatin-C-Based Equations to Estimate GFR and Kidney Ultrasound Percentiles in Children with Congenital Anomalies of the Kidney and Urinary Tract

Congenital anomalies affecting the kidneys present significant challenges in pediatric nephrology, needing precise methods for assessing renal function and guiding therapeutic intervention. Bedside Schwartz formula with the cystatin-C-based Full Age Spectrum formula and Chronic Kidney Disease in Children (CKiD) U 25 formula used in estimating glomerular filtration rate (eGFR) and also to assess if the eGFR in association with kidney length percentiles can be a monitoring parameter for the progression of chronic kidney disease in children with congenital anomalies of the kidney and urinary tract (CAKUT). A total of 64 pediatric patients (median age at diagnostic was 12 months with an interquartile range of 2 to 60) were diagnosed with congenital anomalies in the kidney and urinary tract between June 2018 and May 2023 at “Louis Turcanu” Emergency Hospital for Children in Timisoara, Romania. Baseline characteristics, CAKUT types, associated pathologies, CKD staging, and eGFR using creatinine and cystatin C were analyzed. The mean age at the moment of examination was 116.50 months; (65, 180). Chronic kidney disease staging revealed a predominance of patients in CKD stages G1 and A1. Analysis of eGFR methods revealed a small mean difference between eGFR estimated by creatinine and cystatin C, with a moderate-strong positive correlation observed between the eGFR and ultrasound parameters. Using cystatin-C-based formulas for eGFR, in conjunction with ultrasound measurements, may offer reliable insights into renal function in pediatric patients with congenital anomalies affecting the kidney and urinary tract. However, the economic aspect must be taken into consideration because cystatin C determination is approximately eight times more expensive than that of creatinine. An interdisciplinary approach is crucial for managing patients with CAKUT.

Effect of extended days on feed on carcass gain, efficiency, and quality of individually fed beef steers

Abstract Crossbred steers (n = 114, initial BW = 334 kg; SEM = 5 kg) were serially harvested to evaluate the change in carcass composition by feeding cattle 21 or 42 d longer than the 2014 industry average subjective measure of finish, 1.27 cm of 12th rib fat thickness. Carcass ultrasound measurements were collected on 76 steers at 1, 78, and 134 days on feed (DOF) to project appropriate harvest date. Steers were sorted into three harvest groups, and serially harvested at 142, 163, or 185 DOF, with the first harvest date selected based on an estimated 12th rib fat thickness of 1.27 cm via ultrasound measurement. Steers were fed using an individual animal feeding system, to determine individual performance metrics. Steer DMI did not differ (P ≥ 0.31) between harvest groups, while carcass-adjusted ADG and G:F decreased linearly (P ≤ 0.04) as DOF increased. Carcass weight increased linearly (P &amp;lt; 0.01) as DOF increased from 142 to 185 DOF, with steers gaining an additional 36 kg of HCW when fed an additional 42 DOF. Carcass LM area quadratically increased (P = 0.04) to 163 DOF and remained constant to 185 DOF. Marbling score was not different (P = 0.14) between harvest groups, however, the opportunity to grade USDA Premium Choice was improved for steers fed to 185 DOF. Calculated YG and 12th rib fat thickness increased linearly (P &amp;lt; 0.01) as DOF increased, with distributions across YG 1 through 5 differing between harvest groups (P &amp;lt; 0.01), and 185-d carcasses having the greatest frequency of YG 4 carcasses. As cattle are fed for additional DOF, live ADG and G:F decline, while HCW and LM area increase.

Dynamic changes of hepatic vein Doppler velocities predict preload responsiveness in mechanically ventilated critically ill patients

BackgroundAssessment of dynamic parameters to guide fluid administration is one of the mainstays of current resuscitation strategies. Each test has its own limitations, but passive leg raising (PLR) has emerged as one of the most versatile preload responsiveness tests. However, it requires real-time cardiac output (CO) measurement either through advanced monitoring devices, which are not routinely available, or echocardiography, which is not always feasible. Analysis of the hepatic vein Doppler waveform change, a simpler ultrasound-based assessment, during a dynamic test such as PLR could be useful in predicting preload responsiveness. The objective of this study was to assess the diagnostic accuracy of hepatic vein Doppler S and D-wave velocities during PLR as a predictor of preload responsiveness.MethodsProspective observational study conducted in two medical–surgical ICUs in Chile. Patients in circulatory failure and connected to controlled mechanical ventilation were included from August to December 2023. A baseline ultrasound assessment of cardiac function was performed. Then, simultaneously, ultrasound measurements of hepatic vein Doppler S and D waves and cardiac output by continuous pulse contour analysis device were performed during a PLR maneuver.ResultsThirty-seven patients were analyzed. 63% of the patients were preload responsive defined by a 10% increase in CO after passive leg raising. A 20% increase in the maximum S wave velocity after PLR showed the best diagnostic accuracy with a sensitivity of 69.6% (49.1–84.4) and specificity of 92.8 (68.5–99.6) to detect preload responsiveness, with an area under curve of receiving operator characteristic (AUC–ROC) of 0.82 ± 0.07 (p = 0.001 vs. AUC–ROC of 0.5). D-wave velocities showed worse diagnostic accuracy.ConclusionsHepatic vein Doppler assessment emerges as a novel complementary technique with adequate predictive capacity to identify preload responsiveness in patients in mechanical ventilation and circulatory failure. This technique could become valuable in scenarios of basic hemodynamic monitoring and when echocardiography is not feasible. Future studies should confirm these results.

Optimising flow without congestion using the venous‐arterial Doppler enhanced resuscitation framework

AbstractIntroductionUltrasonography as a guide for intravenous (IV) fluid therapy is increasingly accepted within the spheres of acute care. Initial investigations and protocols often focused on measures of arterial flow as an objective approach for personalising organ ‘perfusion.’ More recently, and with literature associating excessive IV fluid with adverse outcomes, venous ultrasound as a measure of organ ‘congestion’ is taking hold. Yet, arterial (i.e., ‘perfusion’) and venous (i.e., ‘congestion’) Doppler ultrasound measures are often performed separately and can be time‐consuming, especially for novices.MethodsWe report a case, wherein venous and arterial Doppler were simultaneously measured using a wireless, wearable ultrasound as a means to optimise flow without congestion.ResultsBefore IV volume expansion, the patient had Doppler measures consistent with low central venous pressure (CVP) and stroke volume (SV). Following IV volume expansion, venous Doppler remained the same; however, carotid corrected flow time (ccFT) increased significantly.ConclusionA framework for venous‐arterial Doppler enhanced resuscitation (VADER) can be used to guide IV volume in patients at risk for venous congestion.

PROSPECTIVE STUDY ON THE EFFECTIVENESS OF PLATELET-RICH PLASMA IN MANAGING CHRONIC PLANTAR FASCIITIS

Objectives: The objectives of this study were as follows: (1) Assess the impact of a single dose of platelet-rich plasma (PRP) injection on visual analog scale (VAS) scores for heel pain. (2) Evaluate the functional outcome scores following PRP treatment for chronic plantar fasciitis. (3) Measure and confirm the restoration of plantar fascia thickness through ultrasound (USG) assessments. (4) Determine the safety and viability of local PRP injection as a treatment option for individuals with chronic plantar fasciitis. Methods: This hospital-based prospective case series, spanning January 2019 to January 2020, enrolled 40 participants aged 25–65 with unilateral, persistent plantar fasciitis resistant to conservative treatment. Exclusion criteria included BMI ≥30, various pathologies, and recent injections. Ethical clearance was obtained, and participants received autologous PRP injections, with ultrasound measuring plantar fascia thickness. Post-injection, patients were monitored for adverse reactions, initiated stretching exercises, and progressed to weight-bearing activities after 6 weeks. Results: The study cohort, averaging 45 years (standard deviation [SD] 7.7), primarily comprised females with the right-foot prevalence. Symptom duration averaged 20 weeks (SD 4.5). Pre-injection VAS scores (6.7±1.2) significantly improved at 6 weeks (2.9±0.6) and 12 weeks (2.0±0.9) post-PRP injection (p&lt;0.001). Plantar fascia thickness reduced from 5.1 mm (SD 0.6) to 4.1 mm (SD 0.5) at 12 weeks (p&lt;0.001) and regular foot thickness: 3.7 mm (SD 0.5). Conclusion: The study reveals that a singular PRP injection brings about substantial and clinically meaningful enhancements in heel pain, functional outcomes, and the restoration of plantar fascia thickness, supported by ultrasound measurements. This underscores local PRP injection as a viable and safe therapeutic choice for those grappling with chronic plantar fasciitis.

Measurement of Nasal Skin Thickness and Body Mass Index in Preoperative Rhinoplasty Patients Utilizing Computed Tomography Scanning and Ultrasound Techniques: A Prospective Comparative Study.

One of the most important indicators of rhinoplasty success is nasal skin thickness. Nasal thickness can lead to irregularities over the osseocartilaginous framework among patients with thin nasal skin and difficulty making tip work changes in patients with thick nasal skin. This study aimed to compare different objective methods. These include computed tomography (CT) and ultrasound (US) techniques, and report the relationship between nasal skin thickness and body mass index (BMI). A prospective cross-sectional study that included all patients at the rhinoplasty clinic (King Abdul-Aziz University Hospital), Riyadh, Saudi Arabia, between December 2022 and March 2023. Age, sex, and Fitzpatrick skin type were collected from the patients' histories and physical examinations. Body mass index was calculated for the subjects. The study sample included 29 patients. The median age of the patients was 25 years (interquartile range: 20-32 y). Most of the included patients were Saudi (89.7%, n = 26). Females represented 62.1% of the study sample. The average BMI was 25.6 ± 4.95 kg/m2. The highest correlation was observed between the US and CT tip (r = 0.544, P < 0.01) and rhinion (r = 0.525, P < 0.01) measurements. Body mass index was not associated with any US or CT measurements when BMI was used as a continuous or ordinal variable. The correlation between the US and CT measurements was highest for rhinoin and tip measurements, whereas supratip measurements were not correlated (r = -0.029, P = 0.88). The correlation between mid-dorsum and nasion measurements was low (~0.3). The correlation between nasal skin thickness using CT and US varies depending on the nasal point and location. Body mass index was not associated with nasal skin thickness.

PSII-8 Analysis of maternal influence on phenotypic ultrasound measurements of weaned Angus calves

Abstract Ultrasound carcass data can be used to accurately estimate the body composition of beef cattle in comparison with a body composition score. Literature regarding the analysis of phenotypic carcass data has focused predominately on yearling or mature cattle with limited measurements on weaned calves. Therefore, the influence of the milking ability of the dam on body composition traits measured via carcass ultrasound is unknown. The objective of this study was to estimate correlations between the maternal influence of the dam on the phenotypic ultrasound measurements of the calf. To quantify maternal influence, the expected progeny difference (EPD) for milk (MILK) of the dam was correlated to three ultrasound measurements of the calf: backfat thickness (BFAT), ribeye area (REA), and intramuscular fat (IMF). Ultrasound measurements were collected 1 wk after weaning on 104 purebred Angus heifer calves from the Iowa State University McNay Memorial Research and Demonstration Farm located outside Chariton, Iowa. The average age and body weight for heifers were 187 d and 195 kg, respectively. The milk EPD of the dam was correlated to the ultrasound measurements taken on the calves. For each trait, Pearson’s correlations were calculated between the ultrasound traits of the calf to the dam’s milk EPD using R Statistical Software version 4.3.1. A small positive correlation was identified between MILK and REA (r = 0.28, P = 0.004). This suggests a weak phenotypic relationship between MILK and REA for weaned heifers. The correlation between MILK to BFAT and IMF was 0.10 (P = 0.318) and -0.05 (P = 0.619), respectively. These correlations were not significantly different from zero. This suggests the potential for milk production of the dam has little association with BFAT and IMF for weaned heifers. Although further research is needed, the results from this study indicate little to no relationship between milk EPD of the dam on ultrasound measures of the calf for BFAT, REA, and IMF.

288 Effects of increasing water concentrations of oregano essential oil supplementation for lactating sows

Abstract The use of essential oils as a supplement for sows has gained attention in recent years to potentially improve sow and litter performance. Sows (n = 182; avg. lactation length = 19.8 d) were blocked by parity, genetics, estimated farrowing date, and randomly allotted to one of four treatments when entering the farrowing barn. Treatments included: control, 0 mL, (CON, n = 46), 31 mL (L-OEO, n = 45), 47 mL (M-OEO, n = 46), or 63 mL (H-OEO, n = 45) of oregano oil (OEO; Ecodiar Liquid, Nutrinae, Palo Alto, CA) per liter of dosing water with medicators set at 1:128 dilution. Sows were fed a corn-soybean meal-DDGS based lactation diet that met or exceeded NRC (2012) requirements. Sow body weight (BW) was recorded upon entry, 2 d post-farrowing, and weaning. Sow backfat depth (BF) and loin muscle depth (LD) ultrasound measurements, body condition score (BCS), and Knauer sow caliper measurements were collected upon entry and weaning. Sow average daily feed intake (ADFI) was recorded daily 1-wk post-farrowing, then weekly until weaning. Sow water intake was recorded daily (DWI). Individual piglet BW were recorded d 1, d 7, and weaning. Data were analyzed using Proc Mixed procedure in SAS 9.4 with treatment and rep as fixed effects, parity class (P1, P2/P3, P4+) as a covariate, and individual sow as a random effect. Lactation length and number of piglets weaned were used as covariates for weaning data. Linear, quadratic, and cubic contrasts were analyzed among treatments. Litter scouring and medication rates were analyzed using chi-square analysis in the Proc Freq procedure in SAS 9.4. Differences were considered significant at P ≤ 0.05 and trend at 0.05 &amp;lt; P ≤ 0.10. Week 3 lactation sow ADFI increased for L-OEO and H-OEO treatments but decreased for M-OEO compared with CON sows (CON: 7.29 kg/d, L-OEO: 7.60 kg/d, M-OEO: 7.03 kg/d, H-OEO: 7.55 kg/d; cubic; P = 0.0427). No differences were observed among treatments in overall lactation ADFI, DWI, changes in BF, LD, BCS, and piglet and litter growth performance. Sow BW change tended to decline and then increased as OEO increased in the water (CON: -8.79 kg, L-OEO: -6.36 kg, M-OEO: -8.03 kg, H-OEO: -10.52 kg; quadratic, P = 0.0640). There was a cubic tendency for OEO supplementation to reduce loss of caliper measurement (CON: -1.91, L-OEO: -0.98, M-OEO: -1.68, H-OEO: -1.00; P = 0.0598). Percentage of piglets treated with medications for various health issues decreased in the H-OEO supplemented group compared with the L-OEO and M-OEO supplemented groups, with CON group being intermediate and not different (CON: 7.01%, L-OEO: 9.35%, M-OEO: 9.91%, H-OEO: 4.15%; P = 0.0322). Overall, there were no significant impacts of OEO supplementation on sow and litter performance in this study. Future research is needed to determine the effectiveness of OEO in health-challenged sows and litters and the long-term effects of OEO on piglets post-weaning.

Role of muscle ultrasound in frailty assessment in older adults with type 2 diabetes mellitus

BackgroundFrailty is a geriatric syndrome that is characterized by increased vulnerability to intrinsic and extrinsic stressors due to decreased biologic reserves. Muscle ultrasound (US) is a valid and reliable method for assessing muscle quantity in older adults. The study aims to examine the relationship between frailty definitions and US-derived muscle parameters.MethodsWe conducted a cross-sectional study with type 2 diabetes mellitus outpatients in a tertiary hospital, and all participants underwent a comprehensive geriatric assessment. For frailty assessment, the Fried Frailty Phenotype (FFP), the Clinical Frailty Scale (CFS), and the Edmonton Frailty Scale (EFS) were performed. Muscle US measurements included Gastrocnemius Medialis (GM) muscle thickness, GM fascicle length, GM pennation angle, Rectus Femoris (RF) muscle thickness, Rectus Femoris cross-sectional area (RFCSA), Rectus Abdominis (RA) muscle thickness, External Oblique (EO) muscle thickness, Internal Oblique (IO) muscle thickness, and Transverse Abdominis (TA) muscle thickness.ResultsIn all, 373 participants were included in the study. The median age of participants was 72.7 ± 5.9 years, and 64.6% of them were female. According to the FFP, 18.2% of the participants were living with frailty, 56% of them were pre-frail; 57.4% of them were living with frailty according to the CFS; 25.2% of them were living with frailty, and 20.6% of them were pre-frail according to the EFS. The FFP, CFS, and EFS scores were related to muscle thickness of GM, RF, and RA, fascicle length of GM, and pennation angle of GM and RFCSA. Particularly, GM pennation angle, RF muscle thickness, and RFCSA were associated with an increased risk of frailty. Besides muscle thickness of GM, RF, and RA, fascicle length of GM, pennation angle of GM, and RFCSA were significant for predicting the presence of frailty.ConclusionsUS-derived regional muscle measurements are associated with frailty definitions (in both physical, cumulative deficit, and multidimensional models) in a diabetic geriatric population.

From ultrasound to microscopy: Actualities in thyroid investigation in cattle.

Thyroid ultrasonography examination is widely used in human and small animal medicine. However, it has rarely been applied in cattle. The aim of this study was to determine whether the measurements of the thyroid gland by ultrasound examination correlate to those taken during post-mortem examination. A sample of 22 cows and 23 calves was selected for thyroid gland evaluation. An ultrasound scan was performed ante-mortem, followed by euthanasia (for medical reasons) or slaughtered in the food chain and the dissection of the thyroid gland was therefore performed. Post-mortem, the gland was weighed and its dimensions and volume measured. The volume and weight measurements were compared with the predicted ones on US using the formulas available in the literature. Finally, histological examination was performed on thyroid glands. The dimensions of the thyroid gland measured by ultrasonography were significantly different (p<0.05) from those observed post-mortem, except for lobe lengths in calves (p>0.1). However, in calves, there was no systematic bias between the ultrasound and post-mortem examination of the thyroid gland, which were concordant (with an average error of 18%). Cystic lesions were observed on ultrasound in 9/22 cows and could be found on histological examination in 7 of these. Other lesions, such as follicular hypoplasia and hyperplasia, were seen on histological examination but not on ultrasound. Although the ultrasound measurements did not significantly correlate with those taken post-mortem, this examination may allow to differentiate non-standard thyroids in the case of hyperplastic goiter, as demonstrated in other species. This study also describes and illustrates interesting lesions of the thyroid gland in cattle. These findings are innovative in the description of the use of thyroid ultrasound in cattle, although further studies are needed to allow deeper conclusions.

Reproducibility of freehand vs. foam cast as well as the intrarater reliability of foam cast ultrasound scans assessing the muscle architecture and tissue organization of the gastrocnemius medialis and vastus lateralis muscles

BackgroundThis study compares the reproducibility of freehand (FH) vs. foam cast (FC) scans and investigates the intrarater reliability of the ultrasound FC muscle architecture and tissue organization measurements of the gastrocnemius medialis (GM) and vastus lateralis (VL) muscles with fixed and repositioning FC scans.MethodsThirteen young adults (22 ± 3 years) underwent repeated sagittal B-mode ultrasound measurements of GM and VL. FH, FC, and repositioned FC scans were conducted. Muscle architecture measurements included muscle thickness (MT), pennation angle (PA), and fascicle length (FL). Spatial frequency analysis assessed muscle tissue organization.ResultsMT decreased from 2.1 to 1.8 cm in GM and from 2.4 to 2.2 cm in VL with the FC compared with the FH. Reproducibility between the FH and the FC showed poor to good intraclass correlation coefficients (ICCs) for MT (0.46–0.77) and PA (0.09–0.86) as well as poor to moderate ICCs for FL (0.41), with very low to moderate test–retest variability (TRV) (4%–18%). Tissue organization indicated low to good ICCs (0.21–0.80) with low to moderate TRV (4%–19.5%). The re-scanning results of fixed FC indicated excellent ICCs for MT (0.95–0.996), good for PA (0.77–0.90), and moderate for FL (0.73–0.76), with low TRV (5%–10%) for both muscles. Tissue organization displayed moderate to good ICCs (0.61–0.87) with very low to low TRV (4%–9%). For repositioned FC scans in GM and VL, MT showed good to excellent ICCs (0.86–0.98) with very low to low TRV (2%–8%). PA and FL demonstrated moderate to good ICCs (0.57–0.75), with very low to moderate TRV (2%–13%). Tissue organization revealed ICCs ranging from poor to good (0.13–0.87) for both muscles, with low to moderate TRV (5%–18%).ConclusionThe FC systematically reduced MT by 2–3 mm. Furthermore, reproducibility revealed low ICCs and high data variability for several muscle architecture and tissue organization parameters. Thus, switching methods within a single study is not recommended. Nevertheless, FC ultrasound scans demonstrated excellent intrarater reliability for assessing MT. In the case of fixed FC scans particularly, moderate to excellent ICCs were observed for all muscle architecture and tissue organization parameters, accompanied by very low to low variability. Therefore, FC scans are recommended for investigating acute effects on muscle architecture and tissue organization when the FC remains on the leg throughout the period of measurements.

Abstract PO4-17-06: Real World Data: A single institute experience with neoadjuvant endocrine therapy for ER+ breast cancer — clinical response rates, clinical predictors of response and long-term outcomes following breast conserving surgery

Abstract Background: Neoadjuvant endocrine therapy (NET) in postmenopausal women (PMW) with large or locally advanced oestrogen receptor (ER)-rich breast cancer allows more women to be treated by breast-conserving surgery (BCS). A comprehensive analysis of the factors affecting clinical response to NET and the long-term safety of this strategy has been studied. Patients: A retrospective cohort was studied of 435 PMW (median age: 77 years; range: 50-98) with ER-positive breast cancer treated with NET (aromatase inhibition) (median duration: 6.8 months; range 3-43 months), between 2001-15. Clinical response was monitored throughout NET treatment with periodic 3D ultrasound measurements of the primary tumour. All patients went on to have surgery, 55% had adjuvant radiotherapy and all had adjuvant ET for at least 5 years. All patients had routine follow-up (median follow-up 12.3 years). To-date, this represents the largest cohort of patients treated with &amp;gt;3 months NET. Results: Clinical response to NET was excellent, with only 3.2% of tumours progressing on-treatment based on RECIST 1.1 criteria. Mean percentage reduction in tumour on NET was 71%. Response rate (partial/complete response) was 59% and response continued until 12 months and then levelled off. Following NET, over 92% of patients were suitable for BCS and 61% achieved clinical TNM down-staging. Multivariate analysis revealed that only ER level (response highest in patients with Allred scores 7 and 8), and percentage change in tumour volume by 6 weeks were significant predictors of overall clinical response to NET. Clinical response to NET was not associated with node status or tumour grade. BCS following NET had a local disease control rate of 89% (95%CI±0.06) at 10 years, but actuarial local recurrence at 10 years was only 7% in those having radiotherapy compared with 30% in the group who did not receive radiotherapy (P&amp;lt; 0.0001). In addition, the overall recurrence rate (P=0.028) was improved by radiotherapy irrespective of nodal status. Radiotherapy did not improve overall breast cancer-specific survival (BCSS). Systemic recurrence and BCSS was higher with greater nodal involvement. Most patients in this study died of other causes (14-year crude all-cause mortality was 71%). Conclusion: NET followed by BCS is an effective strategy in PMW with ER-rich breast cancer. Excellent clinical response rates are seen even in women with node-positive or high-grade disease. Less than 5% showed evidence of progression. Early response to NET predicts for long-term tumour volume reduction and NET can achieve continued tumour shrinkage for up to 1 year. NET followed by BCS appears a safe treatment approach and offers good long-term outcomes when BCS is followed by adjuvant radiotherapy. Citation Format: Arran K Turnbull, Carlos Martinez-Perez, Charlene Kay, Rebecca Swan, Lorna Renshaw, J Michael Dixon. Real World Data: A single institute experience with neoadjuvant endocrine therapy for ER+ breast cancer — clinical response rates, clinical predictors of response and long-term outcomes following breast conserving surgery [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-17-06.

Sonographic vascularity indices' study in ectopic pregnancies, after Methotrexate treatment

ObjectivesEctopic pregnancy is a crucial problem in Gynaecology. Previous studies concerning the medical treatment of ectopic pregnancies, have used only β-hCG (beta- human chorionic gonadotropin) values, to monitor the successful response to treatment. The current study was a PhD (Doctorate of Philosophy) thesis research, which has evaluated the vascularity indices’ changes. The values of vascularity indices could be used, in combination with β-hCG values and the gestational sac dimensions, in every medically treated ectopic pregnancy. The results could be used, for monitoring the course of all medically treated ectopic pregnancies. Study design72 women of reproductive age have taken part in the study. They have been admitted due to secondary amenorrhea, positive β-hCG test, with or without vaginal bleeding. The participants took part voluntarily and were allocated in two groups. The first group consisted of 37 women, who were possible normal or threatened intrauterine pregnancies (control group). The second group consisted of 35 women, whose sonographic findings suggested ectopic pregnancy, and qualified for methotrexate treatment (study group). Sonographic control and measurement of the vascularity indices (PI – RI) (Pulsatility index – Resistance index) of the ectopic pregnancy was conducted, in combination with β-hCG values for every admitted or outpatient woman.The dimensions of the gestational sac of both groups were measured during four consecutive periods of time. The control group has shown progressively increasing sac dimensions, whereas, in the study group sac dimensions were more stable or growing gradually smaller. The exception where those ectopic pregnancies that ruptured, which have also shown a gradual enlargement of the sac. ResultsThe endometrial thickness of the study group was gradually decreasing up to 76% per day, and the more eminent, but not statistically significant decrease, was observed in the single dose regiment of methotrexate. Moreover, the quantitative PI and RI were evaluated, and the main finding was that there were no statistically significant decreases in any of the two groups. Concerning the study group, methotrexate treatment was successful, since there was a decrease of up to 80%, whereas a clearly significant correlation was found between the β-hCG levels and the RI. ConclusionThe vascularity indices could be used safely, in combination with β-hCG levels and the decrease of the gestational sac dimensions, as criteria for the evaluation of response to medical treatment of ectopic pregnancies.

Neglected cardiometabolic risk factors and subclinical target organ damage in post-menopausal women with normal glucose tolerance.

Menopausal transition is a crucial step in the women's cardiovascular health, and the risk stratification in apparently health post-menopausal females has been rarely assessed. Heart ultrasonography, unusually performed in such subjects, would be able to detect initial signs of organ damage. We described the cardiovascular risk profile of non-diabetic post-menopausal women, evaluating how easily computed, biochemistry-derived scores were related to ultrasonographic measures of target organ damage. We analyzed the characteristics of a cohort of two-hundred and seventy-three women consecutively referring to a prevention program of Azienda Ospedaliero-Universitaria Pisana (years 2017-2022) who underwent clinical evaluation, complete routine biochemical analyses with proxies of insulin resistance, heart and carotid ultrasonography. The cohort was further divided into four groups according to presence of isolated hypercholesterolemia (HC, 37%), isolated hypertension (HT, 5%), both HC/HT (38%), or none of them. In HC and HC/HT, LDL cholesterol was sharply above the recommended values (149 [134-171] mg/dL and 141 [123-159] mg/dL, respectively). E/e' ratio and left atrium size were augmented in HT women and further worsened in HT/HC, with an independent effect of hypertension (E/e' ß=0.055, P=0.013, left atrium volume ß=0.059, P=0.003). Presence of carotid plaques was independently linked to hypertension (ß=0.474, P=0.003). In HC and HC/HT, the Triglycerides-Glucose Index, a surrogate of insulin resistance, was higher than in the other classes (P=0.0013), and it was associated with E/A in HC and HT/HC, with a significative interaction (P=0.0004) with hypertension. Past hormone replacement therapy did not influence clinical, biochemical or echocardiographic parameters. Postmenopausal women display a high cardiovascular risk burden; a simple clinical and biochemistry screening would be advisable to identify and treat those more at risk. Cardiac ultrasonographic parameters were worse in hypertensive, hypercholesterolemic and insulin-resistant subjects, who may also deserve a deep and early instrumental characterization, especially when these conditions are associated.

Impact of Breathing Control Training Program on sonographic quantification of abdominal vasculature.

To compare vascular scanning parameters (vessel diameter, peak systolic velocity, end-diastolic velocity, and resistive index) and scanning time before and after breathing control training program for selected abdominal vessels. This study was pre and post quasi-experimental. The researchers designed a breathing training program that gives participants instructions through a video describing breathing maneuvers. Data were collected at the ultrasound laboratory/College of Health and Rehabilitation Sciences in Princess Nourah bint Abdul Rahman University, Riyadh, Saudi Arabia from January 2023 to November 2023. About 49 volunteers at the university participated in the study. Scanning was performed two times for the right renal artery, upper abdominal aorta, inferior vena cava, and superior mesenteric artery. Scanning time was measured before and after the program as well. A paired sample t-test was used to compare the parameters means and time before and after the program. The program had a significant effect on the following parameters: right renal artery peak systolic velocity (p=0.042), upper abdominal aortic peak systolic velocity, and resistive index (p=0.014, p=0.014 respectively), superior mesenteric artery and inferior vena cava diameters (p=0.010 and p=0.020). The scanning time was reduced significantly (p<0.001). The breathing training program saves time and improves ultrasound measurement quality. Hospitals and health centers should consider the importance of breathing control training programs before abdominal scanning.

Using DFT on Ultrasound Measurements to Determine Patient-Specific Blood Flow Boundary Conditions for Computational Hemodynamics of Intracranial Aneurysms

Boundary conditions (BCs) is one pivotal factor influencing the accuracy of hemodynamic predictions on intracranial aneurysms (IAs) using computational fluid dynamics (CFD) modeling. Unfortunately, a standard procedure to secure accurate BCs for hemodynamic modeling does not exist. To bridge such knowledge gap, two representative patient-specific IA models (Case-I and Case-II) were reconstructed and their blood flow velocity waveforms in the ICA were measured by ultrasonic techniques and modeled by discrete Fourier transform (DFT). Then, numerical investigations were conducted to explore the appropriate number of samples (N) for DFT modeling to secure the accurate BC by comparing a series of hemodynamic parameters using in-vitro validated CFD modeling. Subsequently, a comprehensive comparison in hemodynamic characteristics under patient-specific BCs and a generalized BC based on a one-dimensional (1D) model was conducted to reinforce the understanding that a patient-specific BC is pivotal for accurate hemodynamic risk evaluations on IA pathophysiology. In addition, the influence of the variance of heart rate/cardiac pulsatile period on hemodynamic characteristics in IA models was studied preliminarily. The results showed that N 16 for DFT model is a decent choice to secure the proper BC profile to calculate time-averaged hemodynamic parameters, while more data points such as N 36 can ensure the accuracy of instantaneous hemodynamic predictions. In addition, results revealed the generalized BC could overestimate or underestimate the hemodynamic risks on IAs significantly; thus, patient-specific BCs are highly recommended for hemodynamic modeling for IA risk evaluation. Furthermore, this study discovered the variance of heart rate has rare influences on hemodynamic characteristics in both instantaneous and time-averaged parameters under the assumption of an identical blood flow rate.