Journal Detail Information

1

Cite

Share

Benefits of contrast-enhanced ultrasonography for interventional procedures

Constantin Arndt MARSCHNER ; Johannes RÜBENTHALER ; Matthias Frank FROELICH ; Vincent SCHWARZE ; Dirk-André CLEVERT

Ultrasonography.2021;40(2):207-216. doi:10.14366/usg.20083

For evaluating unclear tumorous lesions, contrast-enhanced ultrasonography (CEUS) is an important imaging modality in addition to contrast-enhanced computed tomography and magnetic resonance imaging, and may provide valuable insights into the microvascularization of tumors in dynamic examinations. In interventional procedures, CEUS can make a valuable contribution in pre-, peri-, and post-interventional settings, reduce radiation exposure and, under certain circumstances, decrease the number of interventions needed for patients.

2

Cite

Share

Artificial intelligence in breast ultrasonography

Jaeil KIM ; Hye Jung KIM ; Chanho KIM ; Won Hwa KIM

Ultrasonography.2021;40(2):183-190. doi:10.14366/usg.20117

Although breast ultrasonography is the mainstay modality for differentiating between benign and malignant breast masses, it has intrinsic problems with false positives and substantial interobserver variability. Artificial intelligence (AI), particularly with deep learning models, is expected to improve workflow efficiency and serve as a second opinion. AI is highly useful for performing three main clinical tasks in breast ultrasonography: detection (localization/ segmentation), differential diagnosis (classification), and prognostication (prediction). This article provides a current overview of AI applications in breast ultrasonography, with a discussion of methodological considerations in the development of AI models and an up-to-date literature review of potential clinical applications.

3

Cite

Share

Ultrasonography and dual-energy computed tomography: impact for the detection of gouty deposits

Christoph SCHWABL ; Mihra TALJANOVIC ; Gerlig WIDMANN ; James TEH ; Andrea S. KLAUSER

Ultrasonography.2021;40(2):197-206. doi:10.14366/usg.20063

Ultrasonography (US) and dual-energy computed tomography (DECT) are useful and sensitive diagnostic tools to identify monosodium urate deposits in joints and soft tissues. The purpose of this review is to overview the imaging findings obtained by US and DECT in patients with gout, to understand the strengths and weaknesses of each imaging modality, and to evaluate the added value of using both modalities in combination.

4

Cite

Share

Current status of deep learning applications in abdominal ultrasonography

Kyoung Doo SONG

Ultrasonography.2021;40(2):177-182. doi:10.14366/usg.20085

Deep learning is one of the most popular artificial intelligence techniques used in the medical field. Although it is at an early stage compared to deep learning analyses of computed tomography or magnetic resonance imaging, studies applying deep learning to ultrasound imaging have been actively conducted. This review analyzes recent studies that applied deep learning to ultrasound imaging of various abdominal organs and explains the challenges encountered in these applications.

5

Cite

Share

Focused ultrasound and prostate cancer

Sung Kyu HONG ; Hakmin LEE

Ultrasonography.2021;40(2):191-196. doi:10.14366/usg.20100

Focused ultrasound (FUS) has been utilized for the treatment of localized prostate cancer. Initially, FUS was performed as a whole-gland treatment comparable to radical prostatectomy or radiation therapy. However, after overall downward stage migration due to health screening programs involving prostate-specific antigen testing, as well as advances in conservative or observative strategies such as active surveillance, FUS has evolved from a whole-gland treatment to a focal treatment. This new treatment technique aims to ablate tumors while preserving the normal prostate tissue, thereby ensuring better preservation of urinary and erectile function. In this article, we review the mechanism and clinical outcomes of the FUS procedure.

6

Cite

Share

Key imaging features for differentiating cystic biliary atresia from choledochal cyst: prenatal ultrasonography and postnatal ultrasonography and MRI

Hyun Joo SHIN ; Haesung YOON ; Seok Joo HAN ; Kyong IHN ; Hong KOH ; Ja-Young KWON ; Mi-Jung LEE

Ultrasonography.2021;40(2):301-311. doi:10.14366/usg.20061

Purpose: This study compared clinical and radiologic differences between cystic biliary atresia (cBA) and choledochal cyst (CC) type Ia/b. Methods: Infants (≤12 months old) who were diagnosed with cBA or CC type Ia/b from 2005 to 2019 were retrospectively reviewed. Imaging features on preoperative ultrasonography (US) and magnetic resonance imaging (MRI) were compared between the cBA and CC groups. Logistic regression and area under the receiver operating characteristic curve (AUC) analyses were performed for the diagnosis of cBA. Changes in cyst size were also evaluated when prenatal US exams were available. Results: Ten patients (5.5% of biliary atresia cases) with cBA (median age, 48 days) and 11 infants with CC type Ia/b (Ia:Ib=10:1; median age, 20 days) were included. Triangular cord thickness on US (cutoff, 4 mm) showed 100% sensitivity and 90.9% specificity (AUC, 0.964; 95% confidence interval [CI], 0.779 to 1.000) and cyst size on MRI (cutoff, 2.2 cm) had 70% sensitivity and 100% specificity (AUC, 0.900; 95% CI, 0.690 to 0.987) for diagnosing cBA. Gallbladder mucosal irregularity on US and an invisible distal common bile duct on MRI were only seen in the cBA group (10 of 10). Only the CC group showed prenatal cysts exceeding 1 cm with postnatal enlargement. Conclusion Small cyst size (<1 cm) on prenatal US, triangular cord thickening (≥4 mm) and gallbladder mucosal irregularity on postnatal US, and small cyst size (≤2.2 cm) and an invisible distal common bile duct on MRI can discriminate cBA from CC type Ia/b in infancy.

7

Cite

Share

A new method for assessing the performance of signal processing filters in suppressing the side lobe level

Mok Kun JEONG ; Sung Jae KWON

Ultrasonography.2021;40(2):289-300. doi:10.14366/usg.20032

Purpose: This study aimed to propose a new ground truth ultrasound imaging method and to confirm its efficacy when applied to side lobe suppression filtering. Methods: Using a computer simulation, we synthesized a side lobe-free image (i.e., with no side lobe whatsoever) by separating the main and side lobe signals in the construction of point target, speckled cyst, and pseudo-kidney images. During signal processing, we assessed the quality of the filtered image by comparing it with a ground truth image (i.e., the main lobe image). Results: We examined the effect of reducing the side lobe by applying aperture apodization, side lobe estimation and reduction filtering, and minimum variance beamforming, which are widely used as side lobe suppression techniques. Despite the drawback of decreased resolution, the commonly used apodization method increases the contrast, which improves ultrasound image quality and enables a better diagnosis. Although side lobe estimation and reduction filtering and minimum variance beamforming are demanding in terms of computational resources, they can considerably improve ultrasound images. Compounding of ultrasound images processed by various signal processing methods increases the resolution and contrast, while reducing the speckle noise. Conclusion Although it appears that the proposed method can only be used for computer-generated radiofrequency data, this method can improve ultrasound image quality by identifying the characteristics of signal processing filters for side lobe suppression and applying appropriately adjusted filters to in vivo human imaging data.

8

Cite

Share

Hepatic and splenic sonographic and sonoelastographic findings in pulmonary arterial hypertension

İlhan HEKIMSOY ; Burçin KIBAR ÖZTÜRK ; Hatice SONER KEMAL ; Meral KAYIKÇIOĞLU ; Ömer Faruk DADAŞ ; Gülgün KAVUKÇU ; Mehmet Nurullah ORMAN ; Sanem NALBANTGIL ; Sadık TAMSEL ; Hakan KÜLTÜRSAY ; Süha Süreyya ÖZBEK

Ultrasonography.2021;40(2):281-288. doi:10.14366/usg.20076

Purpose: The aim of this study was to evaluate the associations of sonographic and sonoelastographic parameters with clinical cardiac parameters, as well as to assess their value in predicting survival in patients with pulmonary arterial hypertension (PAH). Methods: Thirty-six patients with PAH and normal liver function were prospectively enrolled in this prospective study along with 26 healthy controls, all of whom underwent ultrasound and point shear wave elastography examinations. Additionally, the portal vein pulsatility index (PVPI), inferior vena cava collapsibility index, and clinical cardiac variables were obtained in PAH patients. The values of hepatic (LVs) and splenic shear wave velocity (SVs) were compared between PAH patients and controls. The relationships between all sonographic and clinical parameters in the PAH patients were analyzed. Furthermore, their prognostic value in predicting survival was investigated. Results: LVs values in PAH patients (median, 1.62 m/s) were significantly higher than in controls (median, 0.99 m/s), while no significant difference was observed in SVs values. Patients with higher grades of tricuspid regurgitation (TR) had significantly different values of PVPI (P=0.010) and sonoelastographic parameters (P<0.001 for LVs and P=0.004 for SVs) compared to those with less severe TR. Tricuspid annular plane systolic excursion values were the only investigated parameter found to be associated with survival (hazard ratio, 0.814; 95% confidence interval, 0.694 to 0.954; P=0.011). Conclusion Our results demonstrated a direct association between cardiac congestion (i.e., the severity of TR) and liver stiffness, which should be kept in mind during the assessment of fibrosis in patients with PAH.

9

Cite

Share

The semi-erect position for better visualization of subphrenic hepatocellular carcinoma during ultrasonography examinations

Seong Eun KO ; Min Woo LEE ; Hyo Keun LIM ; Ji Hye MIN ; Dong Ik CHA ; Tae Wook KANG ; Kyoung Doo SONG ; Min Ju KIM ; Hyunchul RHIM

Ultrasonography.2021;40(2):274-280. doi:10.14366/usg.20059

Purpose: This study investigated which body position is more useful for visualizing subphrenic hepatocellular carcinomas (HCCs) during ultrasonography (US) examinations. Methods: This prospective study was approved by the institutional review board and written informed consent was obtained from all patients. Twenty consecutive patients with a single subphrenic HCC (treatment-naïve, 1 to 3 cm) underwent a US examination for planning radiofrequency ablation. The examinations were done by one of three radiologists and the patients were examined in four different body positions-supine, right posterior oblique (RPO), left lateral decubitus (LLD), and semi-erect-by being positioned on a tilted table. The visibility of the index tumor was prospectively assessed using a 4-point scale. Needle insertion was considered to be technically feasible if the visibility score was lower than 2. The visibility score and technical feasibility were compared using the Wilcoxon signed rank test and the McNemar test, respectively, for pairwise comparisons between different body positions. Results: The visibility score was significantly lower in the semi-erect position (median, 2; interquartile range, 1 to 2.75) than in the supine (3, 2 to 4), RPO (3, 2 to 4), and LLD (4, 3.25 to 4) positions (P=0.007, P=0.005, and P=0.001, respectively). The technical feasibility of needle insertion was also significantly higher in the semi-erect position (75%, 15/20) than in the supine (45%, 9/45), RPO (35%, 7/20), and LLD (20%, 4/20) positions (P=0.031, P=0.021, and P=0.001, respectively). Conclusion The semi-erect position is more useful for the visualization of subphrenic HCCs than the supine, RPO, or LLD positions.

10

Cite

Share

What shear wave elastography parameter best differentiates breast cancer and predicts its histologic aggressiveness?

Hyunjin KIM ; Jeongmin LEE ; Bong Joo KANG ; Sung Hun KIM

Ultrasonography.2021;40(2):265-273. doi:10.14366/usg.20007

Purpose: This study aimed to identify useful shear wave elastography (SWE) parameters for differentiating breast cancer and predicting associated immunohistochemical factors and subtypes. Methods: From November 2018 to February 2019, a total of 211 breast lesions from 190 patients who underwent conventional breast ultrasonography and SWE were included. The Breast Imaging Reporting and Data System categories and qualitative and quantitative SWE parameters for each lesion were obtained. Pathologic results including immunohistochemical factors were evaluated. The diagnostic performance of each parameter and its correlation with histological characteristics, immunohistochemical factors, and subtypes of breast cancer were analyzed using analysis of variance, the independent t test, the Fisher exact test, logistic regression analysis, and the DeLong method. Results: Among 211 breast lesions, 82 were malignant, and 129 were benign. Of the SWE parameters, Emax showed the highest area under the curve (AUC) for differentiating malignant from benign lesions (AUC, 0.891; cut-off>50.85). Poor tumor differentiation and progesterone receptor-negativity were correlated with higher SDmean and Emax (P<0.05). Ki-67-positive breast cancer showed higher SDmean and a heterogeneous color distribution (P<0.05). Ki-67 and cytokeratin 5/6-positive breast cancers showed higher Emax/Efat ratios (P<0.05). Luminal B, human epidermal growth factor receptor 2-enriched, and triple-negative (non-basal) subtypes showed somewhat higher SDmean values than the luminal A and triple-negative (basal) subtypes (P=0.028). Conclusion Emax is a reliable parameter for differentiating malignancies from benign breast lesions. In addition, high stiffness and SDmean values in tumors measured on SWE could be used to predict poorly differentiated, progesterone receptor-negative, or Ki-67-positive breast cancer.

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share