Ultrasound Readings Research Articles

Decision Support System Software for Normal Pregnancy, in Maritime Medicine, Setting for Costal Situation, Recommended for Making A Decision Support System for Diving Fishermen

Background: The coastal situation in Indonesia with thousands of islands and its area, the use of Ultra Sono Graph (USG) as a tool for general practitioners will be useful to facilitate examinations, consult with experts, and make referrals easily and quickly. Objective: For ultrasound readings that require decisions, using the Decision Support System makes it easier and there are friends to discuss, indirectly with experts, even machines. Theoretical Basis: DSS is very important to clarify and speed up decision-making with the help of software and computers. Use Process: The ultrasound software will guide and direct the appropriate diagnosis so that decisions can be made or referred and handled quickly and precisely. DSS will be very useful in preventing accidents among diving fishermen, by using the P02 benchmark which is easy to use. Conclusion: The use of the Decision Support System for normal and abnormal pregnancy ultrasound is beneficial for coastal area support for early diagnosis and implementation of a referral system. By looking at examples of use like this, it is recommended to create a Decision Support System for Diving Fishermen.

Abstract PO2-28-10: Analysis of whole breast ultrasound image sequence reading time with a new FDA approved automated whole breast ultrasound tomography system for supplemental screening in women with dense breasts

Abstract Purpose: Ultrasound technology as a supplement to mammography for screening women with dense breasts increases cancer detection. However, automated whole breast ultrasound technologies have been shown to substantially increase radiologist reading time. We conducted a reading validation program to assess how quickly and accurately radiologists could interpret images from a new automated whole breast ultrasound prior to launching a prospective case collection registry. Methods: The study analyzed 500 reading times of bilateral screening breast ultrasounds obtained from SoftVue Automated Whole Breast Ultrasound (SV) (Delphinus Medical) in women with dense breasts. For this proctored reading validation program, 20 bilateral screening ultrasound cases were selected. Thecases included a mix of normal, cysts, benign masses, cancers, and implants. 25 MSQA-trained radiologists with varying experience from 9 institutions across the United States each read the 20 cases. The same hanging protocol was used, beginning with sequences of Wafer and Sound Speed to identify an area of interest, Reflection to determine if the area persists, and then Stiffness Fusion for further confirmation and characterization. The primary outcome was reading time per bilateral ultrasound. Reading times were compared using linear mixed effects models for findings in neither, one, or both breasts and for subgroups of cancer and benign findings. Mean reading time was 3.3± 1.76 minutes (n=498, median 2.9min) per case. Cases that were negative in both breasts tended to have faster read times (2.7min, sd=1.32) compared to those with findings in one breast (3.2min, sd=1.57) or findings in both breasts (3.8min, sd=2.14). Mean read times for cases with clinical findings were within a minute of the mean time for normal cases across all case types. Conclusion Breast image sequences of Wafer, Sound Speed, Reflection, and Stiffness Fusion from SV ultrasound tomography facilitate bilateral ultrasound mean reading times of less than 4 minutes per case. Clinical Significance: SV, used as an adjunct to mammography in screening women with dense breasts, offers the benefits of increased cancer detection with supplemental ultrasound with little increase in radiologist reading time. Table 1: Analysis of Bilateral SV Read Time Across Types of Case Clinical Findings Citation Format: Mary Yamashita, Taylor Mahoney, Patrick Walker, Linda Hovanessian Larsen. Analysis of whole breast ultrasound image sequence reading time with a new FDA approved automated whole breast ultrasound tomography system for supplemental screening in women with dense breasts [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 PO2-28-10.

IJCM_77A: Predictors of fetal growth restriction in preterm birth

Background: Fetal growth restriction (FGR) is defined as fetuses whose estimated fetal weight or abdominal circumference is below the 10th percentile for gestational age. As Africa and South Asia account for 60-85% of these births, it becomes important to study the predictive factors of fetal growth restriction in preterm birth. Objective: To study the socio-demographic and obstetrics factors as predictive factors of fetal growth restriction in preterm birth. Methodology: This was a case-control study. The sample size was 10 (four mothers with a preterm baby with fetal growth restriction and six mothers with a preterm baby without fetal growth restriction). Through a proforma the socio-demographic, obstetric, neonatal details, and ultrasound readings were collected. The results were summarized using mean and standard deviations. Results: The average gestational age was 32.5 weeks in cases and 32.7 weeks in controls. In this study, oligohydramnios (0.011) and history of abortion (0.011) were seen more in mothers with fgr in preterm birth compared to those in mothers with non-fgr in preterm birth babies. Conclusion: Oligohydramnios and history of abortion were the predictors of fetal growth restriction in preterm birth.

Practice Patterns Affecting Delays in Care of Testicular Torsion

To compare impact of day or on-call team, pediatric or adult attending, and patient age on testicular torsion management and outcomes. A retrospective study of patients with testicular torsion between 2012 and 2022 at a single institution was conducted. Variables impacting management time were assessed using univariate analyses. 134 patients were included: 49 underwent orchiectomies and 84 underwent orchiopexies. There was no significant difference between efficiency of on-call versus day team regarding time to ultrasound or time to operating room (OR). There were no significant differences between pediatric versus adult attending surgeons for time to surgery, intraoperative length of surgery, or testicular salvage rates. However, when patients were stratified by age greater or younger than 18 years, older patients had significantly longer symptom duration (91.9 vs 20.0 min, p = 0.005), time to receive an ultrasound from emergency room (ER) registration (152 vs 87 min, p < 0.001), time to OR from ER registration (268 vs 185 min, p < 0.001), and time to OR from ultrasound read (187 vs 123 min, p = 0.03). Older patients also had lower rates of testicular salvage approaching significance (orchiectomy rate 48.8% vs 31.5%, p = 0.057). While no significant delays in testicular torsion management were detected between management by on-call versus day team nor pediatric versus adult attending, increased age of patient was associated with delays in definitive surgical management. Greater index of suspicion for testicular torsion diagnosis in adult patients may improve the rate of testicular salvage.

MP54-16 PRACTICE PATTERNS AFFECTING DELAYS IN CARE OF TESTICULAR TORSION

You have accessJournal of UrologyCME1 Apr 2023MP54-16 PRACTICE PATTERNS AFFECTING DELAYS IN CARE OF TESTICULAR TORSION Kelley Zhao, Brian Shkolnik, Jennifer Lu, Rachel Davis, and Pankti Kothari Kelley ZhaoKelley Zhao More articles by this author , Brian ShkolnikBrian Shkolnik More articles by this author , Jennifer LuJennifer Lu More articles by this author , Rachel DavisRachel Davis More articles by this author , and Pankti KothariPankti Kothari More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003307.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Testicular salvage after testicular torsion is largely dependent on time to definitive management. Therefore, delay in presentation, diagnosis, or management can increase the risk of testicular loss. While several studies have examined the time burden of multiple components of the management course for testicular torsion, our study aims to evaluate other factors, including management by the day or on-call team, management by a pediatric or adult attending, and impact of patient age. METHODS: A retrospective case-controlled study of patients with a history of testicular torsion between 2012 and 2022 at a single institution was conducted. Variables impacting testicular torsion management time was assessed using univariate analyses. RESULTS: 134 patients were included, of whom 49 underwent an orchiectomy and 84 underwent an orchiopexy. There was no significant difference between efficiency of the on-call team versus day team regarding time from registration to ultrasound (113 vs 97 min, p=0.37), ultrasound to urology consult (66 vs 86 min, p=0.46), ED registration to OR (219 vs 196 min, p=0.39), ultrasound to OR (155 vs 126 min, p=0.30), and testicular salvage rate (35.7% vs 38.8%, p=0.80). A difference was seen, however, when patients were stratified by age (>18 vs≤18 years old). Patients greater than 18 years of age had significantly longer symptom duration (91.9 vs 20.0 min, p=0.005), longer time to receive an ultrasound from ER registration (152 vs 87 min, p<0.001), longer time to OR from ER registration (268 vs 185 min, p<0.001) and longer time to OR from ultrasound read (187 vs 123 min, p=0.03). In comparing pediatric attendings to adult attendings, there was no difference in time to surgery, intraoperative length of surgery, or testicular salvage rates. Intra-operatively, adult attending urologists had shorter length of surgery approaching significance (58 minutes vs 65 min, p=0.07) and older patients had lower rates of testicular salvage approaching significance (orchiectomy rate 48.8% vs 31.5%, p=0.057). CONCLUSIONS: While no significant delays in testicular torsion management was detected between management by on-call versus day team nor pediatric versus adult attending, age of patient was associated with greater delays in receiving definitive surgical management of testicular torsion. Greater suspicion for testicular torsion diagnosis in older patients with acute scrotum may improve the rate of testicular salvage. Source of Funding: None. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e760 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kelley Zhao More articles by this author Brian Shkolnik More articles by this author Jennifer Lu More articles by this author Rachel Davis More articles by this author Pankti Kothari More articles by this author Expand All Advertisement PDF downloadLoading ...

Association of Carotid Atherosclerosis With Hearing Loss

To describe the association between midlife carotid atherosclerosis and late-life hearing loss among participants in the Atherosclerosis Risk in Communities (ARIC) study. For this cross-sectional study and temporal analysis of a cohort within the ongoing ARIC prospective cohort study, participants were recruited from 4 communities in the US. The analysis evaluated information on mean carotid intima-media thickness (cIMT), from visit 1 (1987-1989) to visit 4 (1994-1996), carotid plaque presence at visit 4, and audiometric data from visit 6 (2016-2017). The cIMT measures were calculated from ultrasonography recordings by trained readers at the ARIC Ultrasound Reading Center. At each visit, cIMT was computed as the average of 3 segments: the distal common carotid, the carotid artery bifurcation, and the proximal internal carotid arteries. Presence of carotid plaque was determined based on an abnormal wall thickness, shape, or wall texture. Audiometric 4-frequency pure tone average (PTA) was measured and calculated for the better-hearing ear and modeled as a continuous variable. Linear regression estimated the association between cIMT and carotid plaque with hearing, adjusting for age, sex, race and study center, education level, body mass index (calculated as weight in kilograms divided by height in meters squared), smoking status, hypertension, cholesterol levels, diabetes, and exposure to occupational noise. Missing data (exposure and covariates) were imputed with multiple imputation by chained equations. Data analyses were performed from April 6 to July 13, 2022. Hearing loss assessed using 4-frequency (0.5, 1.0, 2.0, and 4.0 kilohertz) PTA for both ears and carotid plaque at visit 4 and mean cIMT from visit 1 to visit 4. Among a total of 3594 participants (mean [SD] age at visit 4, 59.4 [4.6] years; 2146 [59.7%] female; 819 [22.8%] Black and 2775 [77.2%] White individuals), fully adjusted models indicated that an additional 0.1 mm higher mean cIMT was associated with 0.59 dB (95% CI, 0.17 to 1.02 dB) higher PTA. Compared with participants without carotid plaque, plaque presence was associated with 0.63 dB (95% CI, -0.57 to 1.84 dB) higher PTA. The findings of this cross-sectional study with temporal analyses of a cohort with the ongoing ARIC study found that subclinical atherosclerosis in midlife was associated with worse hearing in older adulthood. Prevention and control of carotid atherosclerosis during middle age may positively affect the hearing health of older adults.

Automated 3D ultrasound enables novice users to measure arteriovenous fistula maturation parameters with comparable accuracy to conventional duplex by trained sonographers: Results of a benchtop study.

Arteriovenous fistulae (AVF) are considered the preferred hemodialysis access but up to 50% of all AVF created in the United States never mature. Doppler ultrasound (DUS) is useful for predicting fistula maturity and impending fistula failure. DUS is resource-intensive and is associated with poor compliance rates in dialysis patients, ranging from 12% to 33%. EchoSure is an FDA-cleared 3D Doppler ultrasound device that automatically delivers quantitative blood flow and anatomic vascular information. The technology can be used at the bedside by personnel without formal sonographic training, nullifying limitations of traditional Duplex ultrasound imaging. This study compared the EchoSure system in the hands of inexpert personnel to a traditional expert-operated DUS for rapid assessment of a benchtop model vascular system with flow, diameter, and depth expected in a human AVF. Both Duplex and EchoSure performed within the expected tolerance of ultrasound readings (35%) for volume flow, with the average error (AE) between the observed measurement and the ground truth being 8% for Duplex and 8% for EchoSure. However, the average coefficient of variation (CV) for Duplex pooled over all flow rate measurements was 17% versus 4% for EchoSure. Regarding diameter, Duplex measurements had AE of 15% with an average CV of 6% across all measurements versus EchoSure AE of 4% and average CV of 2%. Duplex and EchoSure measurements over all depths had the same AE of 2%. The two modalities were not statistically different for depth measurement (p = 0.05) but EchoSure measured closer to the ground truth for flow rate and vessel diameter (flow: p = 0.028, ρ = -0.07; diameter: p < 0.001, ρ = 0.69). The inexpert personnel using EchoSure acquired data 62% faster than the expert sonographers using the Duplex ultrasound (141 min for Duplex vs 87 min for EchoSure). EchoSure may offer an accurate and convenient alternative for imaging fistulas in the clinic.

Effective Ultrasound Acoustic Measurement to Monitor the Lithium-Ion Battery Electrode Drying Process with Various Coating Thicknesses.

The electrode drying process (DP) is a crucial step in the lithium-ion battery manufacturing chain and plays a fundamental role in governing the performance of the cells. The DP is extremely complex, with the dynamics and their implication in the production of electrodes generally being poorly understood. To date, there is limited discussion of these processes in the literature due to the limitation of the existing in situ metrology. Here, ultrasound acoustic measurements are demonstrated as a promising tool to monitor the physical evolution of the electrode coating in situ. These observations are validated by gravimetric analysis to show the feasibility of the technique to monitor the DP and identify the three different drying stages. A possible application of this technique is to adjust the drying rates based upon the ultrasound readings at different drying stages and to speed up the drying time. These findings prove that this measurement can be used as a cost-effective and simple tool to provide characteristic diagnostics of the electrode, which can be applied in large-scale coating manufacturing.

Correlation between Age, Nodule Diameter, and TI-RADS Score in Thyroid Nodule Classification on Follicular Thyroid Carcinoma

Background: Thyroid cancer is a malignancy of the endocrine gland with the highest incidence. There are many radiological examination modalities that are used to help diagnose thyroid carcinoma, one of which is Ultrasonography. Ultrasonography (USG) can be useful to support the diagnosis of thyroid malignancy. A classification method that categorizes thyroid nodules based on risk for cancer, one of which is by using the Thyroid Imaging Reporting and Data System (TI-RADS). TI-RADS (Thyroid Imaging, Reporting and Data System) is a classification of thyroid ultrasound readings to differentiate between benign and malignant thyroid nodules. Several research efforts that have been done at Dr. Soetomo Hospital previously related to diagnostic of thyroid carcinoma but the results are meaningless and require large funds for the laboratory examination. The aim of this study is to make a relatively easy and inexpensive method using the TI-RADS classification, which is expected to assist in the preoperative diagnostics of a follicular thyroid carcinoma. It is hoped that there will be a method or modality that is easier, cheaper, accurate, and minimally invasive in predicting a follicular thyroid carcinoma. Methods: In this cross-sectional study, we included patients with thyroid mass who underwent treatment in Surgery Department, Dr. Soetomo Teaching Hospital between January 2012 and December 2020. In this study, we utilized the patients’ medical record to collect the necessary clinical data. The inclusion criteria in this study were patients with singular thyroid nodule, underwent thyroid ultrasound, and diagnosed as follicular nodular carcinoma by histopathology examination. Finally, a total of 53 patients were included for further analysis. Ethical approval was obtained from the Ethics Committee of Dr. Soetomo Teaching Hospital (Surabaya, Indonesia). Results: From a total of 53 research subjects, the subjects with the most age were more than 50 years old with a percentage of 52.8% or 28 patients and the rest, 47.2% or 25 patients. The results of this study indicates that nodule diameters less than 5 cm and more than 5 cm have almost the same number based on the number of data samples in this study, namely 53 patients. This can be seen from the number of respectively 27 (50.9%) and 26 (49%). In the TIRADS nodule score, the largest percentage obtained from medical data records in the form of a TIRADS score, namely a TIRADS score greater than TR 4 with a percentage of 60.4% or as many as 32 patients and the rest, namely a TIRADS score less than TR 4 of 39.6% or as much as 21 patients. In the third dependent variable, the authors looked for the odd ratio value for each variable on follicular carcinoma. The authors calculated the OR values ​​for each variable, obtaining results of 1.012 for age, 1.111 for nodule size, and 3.520 for TIRADS scores. Conclusion: There is a correlation between the TIRADS scores with the incidence of follicular thyroid carcinoma. Keywords: Thyroid cancer, TIRADS, Follicular Thyroid Carcinoma.

Evaluation of stiffness loss of reinforced concrete beams using the diffuse ultrasound method

Flexural cracks are common in reinforced concrete (RC) beams. At service loads, the tensile stresses induced by the bending moments cause beam sections to crack, leading to loss of stiffness and a consequent increase in beam deflections. Serviceability limit states in RC beam design include maximum deflection and maximum crack widths. Cracks affect the propagation of ultrasound by disrupting its travel path, which leads to a strongly scattering of the ultrasonic waves. As a result, there is a delay in the arrival of the ultrasonic energy flux, which can be observed by the increasing formation of coda waves. This resultant incoherent wavefield can be approximated by the diffuse ultrasound method. The diffuse ultrasound method can better describe the cracking effects over a larger region of the RC element compared to the ultrasonic pulse velocity, the most used ultrasound parameter in concrete applications. Changes in the diffuse ultrasound parameters (diffusivity, dissipation and ATME) can be related to the extent of cracking in a RC element. The objective of this research was to apply the diffuse ultrasound method to evaluate the stiffness loss due to flexural cracking of RC beams. Beams with different longitudinal flexural reinforcement ratios were cast and submitted to a bending test. The deflection at mid-span, and thus beam stiffness, was monitored during the test. Ultrasound transducers were installed in the central region of the beams with ultrasound readings performed during the tests in order to acquire the waveforms at various loading stages. For each waveform, the diffuse ultrasound parameters were recovered using a time–frequency analysis. The behavior of the diffuse parameters with increasing progressive damage caused by flexural cracking was analyzed and correlated to the stiffness loss of the beams. As a result, it was observed that diffusivity and ATME were the most sensitive parameters to identify the onset of cracking and also were seen to be related to beam stiffness variation at early cracking stage. When correlated with stiffness loss values up to 70%, diffusivity and ATME presented high mean correlation coefficients, allowing to conclude that it is possible to estimate the stiffness loss through the diffuse ultrasound parameters in the interval following the beginning of the cracking process.

39. Evaluation for Gynecologic Anomalies in Girls with Imperforate Anus

<h3>Background</h3> The most common anorectal malformation in girls is imperforate anus (IA). There is a known association between gynecologic anomalies and IA, but data are limited. The approach to gynecologic evaluation in girls with IA is not well described and may contribute to neglect of gynecologic evaluation in these patients. <h3>Methods</h3> One hundred forty-four patients with imperforate anus were retrospectively reviewed with a focus on gynecologic evaluation. Cloacal malformations were excluded. Statistical analysis included descriptive statistics, Chi squared, and Fisher's exact tests. IRB approval obtained. <h3>Results</h3> Seventy-eight (54%) patients had any type of gynecologic evaluation. Thirty-six (25%) had both vaginal evaluation and pelvic imaging, 68 (47%) had pelvic imaging, and 45 (31%) had vaginal evaluation. Of those with gynecologic evaluation, 28 (36%) were found to have an anomaly, all with an upper genital tract anomaly and 19 (24%) also with a lower genital tract anomaly (Table 1). Of 28 patients with a normal vagina and single cervix noted on vaginoscopy, 6 (21%) were found to have a uterine anomaly on imaging. Seven patients had uterine anomalies diagnosed on pelvic ultrasound prior to age 2; however, three patients eventually diagnosed with a uterine anomaly had an initial pelvic ultrasound read as normal. Comparing girls with a gynecologic anomaly to those without, there was a significant difference in age (13.0 years vs 6.6 years, p<0.01) and having at least one additional anatomic anomaly (93% vs 68%, p=0.01) but no difference in other baseline characteristics (Table 2). Girls with IA were also noted to have non-anatomic gynecologic complaints such as labial adhesions (3, 2%), urethral prolapse (2, 1%), and precocious puberty (3, 2%). <h3>Conclusions</h3> Our study reiterates the high incidence of gynecologic anomalies in girls with IA without cloaca, consistent with findings in prior case series. We found the incidence of uterine anomaly is high even with normal vaginoscopy. Universal vaginoscopy in this population, ideally by a gynecologist, has been previously recommended. Based on our findings, we also recommend universal pelvic imaging in addition to vaginoscopy. Given parents express a desire for earlier knowledge of gynecologic anatomy, we recommend pelvic ultrasound at the time of initial diagnosis/evaluation and again at puberty. Despite previous reports of this association, gynecologic evaluation of girls with IA without cloaca remains inconsistent. Ultimately, increased awareness of the need for gynecologic assessment in girls with IA is needed along with further studies to increase understanding of the association.

Evaluation of bedside sonography performed by emergency physicians to detect intussusception in children in the emergency department.

The aim of our study was to evaluate the test characteristics of point-of-care ultrasound (POCUS) performed by emergency physicians with varying levels of experience among children having undergone diagnostic radiology ultrasound for intussusception in a pediatric emergency department (PED). This was a subanalysis of a prospective cohort study conducted at a tertiary care PED. The study population was a sample of children younger than 5years old who required an abdominal ultrasound for suspected intussusception. Participating physicians had varying levels of POCUS experience. They received a 1-hour didactic and practical training session on intussusception ultrasound. All POCUS was performed following the initial physical examination and prior to further radiologic evaluation. The final outcome was determined by radiologic evaluation performed by a pediatric radiologist. Test characteristics were calculated for POCUS compared with the criterion standard of ultrasound read by a pediatric radiologist. A secondary analysis compared test characteristics of POCUS performed by physicians with different level of POCUS training. A total of 131 children were evaluated by POCUS, of whom 45 (34%) had an intussusception. Twenty-four physicians performed between one and 25 POCUS procedures. POCUS identified 39 of 45 intussusception cases, with a sensitivity of 0.87 (95% confidence interval [CI]= 0.74 to 0.94). A normal or inconclusive POCUS was reported for 83 of the 86 negative studies, with a specificity of 0.97 (95% CI= 0.90 to 0.99). When excluding the 28 patients for whom the physician reported an inconclusive examination, the sensitivity improved to 0.98 (95% CI= 0.97 to 1.00) and the specificity to 0.94 (95% CI= 0.85 to 0.99). The accuracy of diagnosis using POCUS was 42 of 43 (98%) for experienced sonographers in comparison to 81 of 88 (92%) for novices. This study demonstrated a very good sensitivity and specificity of POCUS for intussusception in children when performed by multiple emergency physicians with varying POCUS experience.

Effectiveness of using ultrasound readings to predict carcass traits and sensory quality in young bulls

The objectives of this study were to develop ultrasound-derived prediction equations in young bulls before slaughter to estimate carcass traits and beef sensory parameters and to determine the optimum moment pre-slaughter to estimate the sensory quality of beef from young bulls. Ultrasound images were measured in twenty live young bulls at 50, 25 and 1 days prior to slaughter. Intramuscular fat content, longissimus lumborum muscle area, carcass fatness, texture and sensory analysis were measured by a trained panel after slaughter. Partial least square methodology was used to find the relationship between the ultrasound measurements and the dependent variables, such as carcass traits, Warner-Bratzler shear force and the sensory profile. Additionally, a stepwise procedure was used to select the most informative ultrasound variables in the prediction equations for carcass and beef sensory traits. The results indicate that ultrasound testing in the feedlot offers promising potential. Early ultrasound scan measurements were useful during fattening to predict intramuscular fat content (R2 = 0.619, RMSE = 0.44%, 50 days prior to slaughter), while ultrasound scans taken close to slaughter were useful to predict kidney fat content (R2 = 0.717, RMSE = 0.96%, 1 day prior to slaughter). However, the prediction of sensory beef attributes was only useful for fatty flavor (R2 = 0.556, RMSE = 0.47%) at 1 day pre-slaughter. Thus, the prediction of fat parameters using ultrasound measurements could constitute a valuable tool in the process of selecting beef quality traits in young bulls before slaughter.

Systematic approach towards reliable estimation of abdominal aortic aneurysm size by ultrasound imaging and CT.

BackgroundThe management of abdominal aortic aneurysm (AAA) is fully dictated by AAA size, but there are no uniform measurement guidelines, and systematic differences exist between ultrasound- and CT-based size estimation. The aim of this study was to devise a uniform ultrasound acquisition and measurement protocol, and to test whether harmonization of ultrasound and CT readings is feasible.MethodsA literature review was undertaken to evaluate evidence for ultrasound-based measurement of AAA. A protocol for measuring AAA was then developed, and intraobserver and interobserver reproducibility was tested. Finally, agreement between ultrasound readings and CT-based AAA diameters was evaluated. This was an observational study of patients with a small AAA who participated in two pharmaceutical intervention trials.ResultsBased on a literature review, an ultrasound acquisition and reading protocol was devised. Evaluation of the protocol showed an intraobserver repeatability of 1.6 mm (2s.d.) and an interobserver intraclass correlation coefficient (ICC) of 0.97. Comparison of protocolled ultrasound readings and local CT readings indicated a good correlation (r = 0.81), but a systematic +4.1-mm difference for CT. Harmonized size readings for ultrasound imaging and CT increased the correlation (r = 0.91) and reduced the systematic difference to +1.8 mm by CT. Interobserver reproducibility of protocolized CT measurements showed an ICC of 0.94 for the inner-to-inner method and 0.96 for the outer-to-outer method.ConclusionThe absence of harmonized size acquisition and reading guidelines results in overtreatment and undertreatment of patients with AAA. This can be avoided by the implementation of standardized ultrasound acquisition and a harmonized reading protocol for ultrasound- and CT-based readings.

Solitary Thyroid Nodule: Clinical, Sonography and Pathological Evaluation Risk of Malignancy

Aim: To determined risk of increases Incidence of Thyroid cancer in solitary thyroid nodules so Preoperative distinction between benign and malignant in solitary thyroid nodules is important and helps to avoid unnecessary surgery and its adverse effects, such as hypothyroidism, hypocalcemia, and recurrent nerve injury. Methods: Descriptive perspective analyzed data over a period of 6 years April 2015-April 2021 in Saudi Hospital at Hajjah, Yemen. 226 thyroid operations for 207 patients, 135 patient’s diagnosis as Solitary thyroid nodule and 72 patients as Multi nodular goiter. Patients with a clinically solitary thyroid nodule were included in the study group. Results: 135 cases of clinically detected solitary thyroid nodules, 126 female and 9 male patients, between 14 - 65 years age, median 41 years and mean 39.76 years, (94, 41) patients respectively Right side thyroid effect more than Left side, Fine needle aspiration cytology (FNAC) sensitivity, specificity and accuracy was (61%, 72%, 64%) respectively. Postoperative histopathology reported 100 (74%) patients as having benign thyroid nodules and 35 patients (26%) as having malignant thyroid nodules. Postoperative transient hypocalcemia was observed in 9 patients (7%), and temporary hoarseness was observed in 3 patients (2%). Conclusion: The incidence of malignancy in solitary thyroid nodules is high. Rapid growth by history and hard fixed nodule by examination and hypoechoic, micro calcification and cervical lymphadenopathy on Thyroid Ultrasound frequently in malignant nodules. Male risk factors for thyroid cancer but age, number and size of nodules not included as risk factor. Fine needle aspiration cytology (FNAC) is more helpful for diagnosing if aspiration under Ultrasound guidance and reading by experience histopathologists. The type of surgery depends on preoperative evaluation, including history, examination, ultrasound, fine needle aspiration cytology (FNAC) result, and intraoperative assessment of the nodule. There are fewer complications of thyroid surgery by experienced surgeons.

Comparison of Quadriceps Muscle Girth Using Ultrasound Imaging In Supervised vs Unsupervised Post Operative ACL Reconstruction

Injury to the anterior cruciate ligament (ACL) is one of the most common knee ligament injuries. The ACLinjury is a sprain or tear of the anterior ligament (ACL). Effective exercises will reduce the risk of ACLinjury. An ACL injury in athletes is a higher incidence than other general public, such as soccer, basketball,hockey, etc. The aim of this studywas to compare the effectiveness, recovery rate and variance in bothknee-affected and non-affected muscle girth readings in supervised v/s unsupervised patient groups after thepatient underwent ACL reconstruction surgery. The participants were divided into two groups(A-Supervisedand B-Unsupervised) through a random sampling. The supervised exercise in group A performed accordingto the WILK protocol at RML hospital and un-superviseed group B performed the same WILK protocol athome. The ultrasound scans were performed after 2-4 weeks and 12-14 weeks post operation to measurethe muscle girth in both the groups. The study findings indicated the significant difference in recovery rateas well as the difference in between supervisedv/s unsupervised groups i.e. the difference of affected andunaffected knees based on ultrasound imaging was higher in un-supervised group compared to supervisedgroup (a difference of 2.3 mm in post-operation muscle girth after 12-14 weeks). The ultrasound readingof the muscle girth after 2-4 weeks post-operation showed a decline in the recovery of the muscle girth inboth the groups (9% and 8% for supervised and un-supervised groups respectively). This reduction in themuscle girth value as compared to the pre-operative values was due to arthroscopic effect, which showedthere was a transient deactivation of the muscle take place due to surgery. The ultrasound reading of themuscle girth after 12-14 weeks post-operation showed a different progressive recovery of the muscle girth inboth the groups as 31% and 10% for supervised and un-supervised groups respectively .We concluded thatsupervised exercises was better than unsupervised exercises for the early recovery after ACL recontraction.

A submicrometre silicon-on-insulator resonator for ultrasound detection.

Ultrasound detectors use high-frequency sound waves to image objects and measure distances, but the resolution of these readings is limited by the physical dimensions of the detecting element. Point-like broadband ultrasound detection can greatly increase the resolution of ultrasonography and optoacoustic (photoacoustic) imaging1,2, but current ultrasound detectors, such as those used for medical imaging, cannot be miniaturized sufficiently. Piezoelectric transducers lose sensitivity quadratically with size reduction3, and optical microring resonators4 and Fabry-Pérot etalons5 cannot adequately confine light to dimensions smaller than about 50 micrometres. Micromachining methods have been used to generate arrays of capacitive6 and piezoelectric7 transducers, but with bandwidths of only a few megahertz and dimensions exceeding 70 micrometres. Here we use the widely available silicon-on-insulator technology to develop a miniaturized ultrasound detector, with a sensing area of only 220 nanometres by 500 nanometres. The silicon-on-insulator-based optical resonator design provides per-area sensitivity that is 1,000 times higher than that of microring resonators and 100,000,000 times better than that of piezoelectric detectors. Our design also enables an ultrawide detection bandwidth, reaching 230 megahertz at -6 decibels. In addition to making the detectors suitable for manufacture in very dense arrays, we show that the submicrometre sensing area enables super-resolution detection and imaging performance. We demonstrate imaging of features 50 times smaller than the wavelength of ultrasound detected. Our detector enables ultra-miniaturization of ultrasound readings, enabling ultrasound imaging at a resolution comparable to that achieved with optical microscopy, and potentially enabling the development of very dense ultrasound arrays on a silicon chip.

Clinical Quantitative Evaluation of Tooth Wear: A 4-year Longitudinal Study.

This study investigated the progression of incisal tooth wear clinically for 4-years, using various diagnostic methods. Effectiveness of occlusal splints (night guards) for patients with nocturnal bruxism was also evaluated. Forty maxillary incisors from 10 patients with nocturnal bruxism were selected. Group 1 (n=5) wore occlusal splints for 6 months, whereas group 2 (n=5) didn't. Ultrasound, cast-model analysis (control), digital radiography, FluoreCam and colorimeter were used for measurements. Clinical progression of incisal wear monitored at baseline, 3, 6, 12, 24 and 48 months, respectively. Ultrasound, cast-model analysis and FluoreCam readings gradually and statistically significantly decreased during the overall evaluation period for both groups (p<0.001). Regarding colorimeter, statistically significant differences in periodical measurements were observed from 24 months and 12 months, for group 1 and group 2, respectively (p<0.001). There were no statistically significant differences in readings at evaluation periods, between the groups, for ultrasound, digital radiography and cast-model analysis (p≥0.05); however, statistically significant differences were observed for colorimeter at 24 months (p=0.010) and 48 months (p<0.001), and for FluoreCam at 12, 24, 48 months (p<0.001). Annual decrease in mean crown length was determined as 20-30 µm for group 1 and 40-50 µm for group 2. The decreases in mean crown length were statistically significantly lower for group 1 compared to group 2, regarding the assessments for 1 year, 2 years and 4 years (p<0.001). Positive and good correlations were observed between ultrasound, cast-model analysis and FluoreCam measurements (p<0.001). Ultrasound, FluoreCam and colorimeter showed promising results for monitoring any change and progression of incisal tooth wear clinically. Ultrasound might be considered as a quantitative, reliable and repeatable method. Precision of the measurements varied among the diagnostic methods used. Occlusal splints may have a potential preventive effect for progressive tooth wear.

A case series of recurrent myotendinous rotator cuff tears repaired and augmented with dermal allograft: clinical outcomes at two years

We conducted a retrospective chart review of 9 patients with a type II rotator cuff tear medially at the myotendinous junction, arthroscopically repaired and augmented with acellular dermal allograft by a single surgeon. Two-year follow-up was obtained to evaluate pain, function, range of motion, and structural integrity of the repair via ultrasound. Of all 9 patients, the mean visual analog scale preoperatively was 5.1 (standard error, ±2.1). With 9 patients having 2-year follow-up, the mean visual analog scale score continued to improve to 1.9 (standard error, ±2.4). At 2 years, the mean American Shoulder and Elbow Surgeons based on 8 patients was 76.1, and the mean Short Form 36 for all 9 patients was 78.7. All 9 patients with 2-year follow-up had an intact repair on ultrasound read by a musculoskeletal fellowship-trained radiologist. Based on the early outcome data, patient satisfaction scores, and intact repairs visualized on ultrasound at 2 years postoperatively, the use of acellular human dermal matrix augmentation appears to be an efficacious and worthwhile treatment option for patients with recurrent rotator cuff tears at the medial myotendinous junction.

Future use of musculoskeletal ultrasonography and magnetic resonance imaging in rheumatoid arthritis.

Musculoskeletal ultrasonography (MSUS) and magnetic resonance imaging (MRI) play important roles in diagnosis, monitoring, and prognostication of rheumatoid arthritis. This review highlights recent literature in this field and aims to provide insight into the future use in clinical practice. Recent studies concerning the use of MSUS and MRI in clinical practice show how MSUS and MRI can improve diagnosis and monitoring of rheumatoid arthritis and how they can predict both radiographic progression and clinical outcome (e.g., successful tapering of medical treatment). Moreover, novel technical developments of the two imaging modalities, such as 3D ultrasonography, ultrasound image reading with convolutional neural network, image fusion (MSUS and MRI) and whole-body MRI show promising results. Further validation of these novel techniques is required prior to implementation. MSUS and MRI will be important parts of the future management of rheumatoid arthritis patients, mostly because of their ability to detect rheumatoid arthritis changes at a very early stage and to predict the course of disease. However, the exact role in routine clinical practice is still to be defined.