Objective To explore the diagnostic value of quantitative radiomics features from dual-modal ultrasound composed of elastography and B-mode for axillary lymph node metastasis in breast cancer patients. Methods We retrospectively analyzed 161 axillary lymph nodes (69 benign and 92 metastatic) undergoing real-time elastography and B-mode ultrasound from 158 patients with breast cancer. We extracted a total of 428 features, consisting of morphologic features from B-mode, and intensity features and gray-level co-occurrence matrix features from the dual modalities,and the optimal subsut of features was selected through least absolute shrinkage and selection operator (Lasso) under the condition of leave-one-out cross validation. We used SVM for the classification of benign and metastatic nodes. Results The sensitivity, specificity, accuracy and Youden's index of the 35 radiomics features selected with Lasso were 86.96%, 85.51%, 86.34% and 72.46%, respectively. Conclusion The radiomics features from dual-modal ultrasound (elastography and B-mode) have demonstrated good performance for classification and have potential to be applied to clinical diagnosis of axillary lymph node metastasis.

The placement of the flexible ureteroscopic sheath during lithotripsy may injure the ureter. We have developed a double-tube flexible ureteral access sheath. Thirteen patients with renal calculi were treated with double-tube and flexible sheath in one stage. CT examination of 13 cases showed that the ureter was normal. The double-tube flexible ureteral access sheath makes the operation of sheathing easy, safe and effective.