To analyze the viscosity characteristics of breast masses and investigate the clinical value of ultrasound viscoelasticity imaging in the differential diagnosis of benign and malignant breast masses.
Methods
A total of 151 patients with breast masses (≤3 cm ) were prospectively collected in the First Affiliated Hospital of Nanchang University from September 2023 to June 2024.Conventional ultrasound, ultrasound viscoelasticity imaging, and shear wave elastography were performed before puncture biopsy or surgery.The elastic parameters and viscoelastic parameter values of the mass area and the 2 mm glandular tissue around the mass were measured.Taking the pathological results as the gold standard, the elastic and viscoelastic parameters with the largest area under the receiver operating characteristic curve(AUC) were selected as the optimal parameters.The breast imaging reporting and data system (BI-RADS)classification was adjusted according to the optimal cutoff values, and the adjusted diagnostic efficacy and accuracy were compared.
Results
This study included 151 lesions, of which 87 were diagnosed as benign lesions and 64 as malignant lesions.The best elasticity-related parameter for distinguishing benign and malignant breast masses was the maximum elasticity value of 2 mm glandular tissue around the mass(S-Emax), the best viscosity coefficient-related parameter was the maximum viscosity coefficient value of 2 mm glandular tissue around the mass (S-Vmax), and the best dispersion coefficient-related parameter was the maximum dispersion coefficient value of 2 mm glandular tissue around the mass (S-Dmax).The best cutoffvalues of these parameters were 89.76 kPa, 6.31 Pa·s, and 15.37 m/s/kHz, respectively.After adjusting the BI-RADS classification by the optimal cutoff values of S-Emax, S-Vmax, and S-Dmax, the accuracy rates were 88.08%, 90.73%, and 84.77%, and the AUC were 0.902, 0.920, and 0.899, respectively, which were all higher than the accuracy (80.13%) and AUC (0.847) before adjustment (P＜0.05).Among them, the AUC of BIRADS classification adjusted by S-Vmax was the highest, but there was no significant difference compared with those of the other two (P＞0.05).
Conclusions
Ultrasound viscoelasticity imaging technology can reflect the viscosity information of breast masses and their surrounding tissues.It has diagnostic efficacy comparable to that of shear wave elastography in differentiating benign from malignant breast masses and has potential clinical application value.
To evaluate the predictive value of intratumoral and peritumoral ultrasound imaging features for human epidermal growth factor receptor 2 (HER2) expression status in breast cancer patients.
Methods
A retrospective analysis was conducted on data from 403 breast cancer patients diagnosed at the Third People's Hospital of Chengdu between April 2021 and March 2024.The patients were randomly divided into a training set of 282 patients and a validation set of 121 patients.For conventional ultrasound, the maximum longitudinal axis of the tumor was used to delineate the intratumoral region of interest (ROI).A 3 mm extension outward from the tumor boundary was used to define the peritumoral ROI.Radiomics features were extracted from these ROIs.In the training set, features were reduced using the Mann-Whitney U test, Pearson correlation analysis,and the Least Absolute Shrinkage and Selection Operator (LASSO).A support vector machine (SVM) classifier was used to construct a radiomics model and calculate the radiomics score.Univariate and multivariate analyses were used to compare clinical pathological indicators between HER2-positive and HER2-negative groups to identify independent clinical risk factors and construct a clinical model.Radiomics scores and independent clinical risk factors were combined into a multivariate logistic regression model to create a combined model.The performance and clinical utility of the models were evaluated using ROC curve, calibration curve, and decision curve analyses.
Results
The area under the curve (AUC) values for the intratumoral model, peritumoral model, combined intratumoral and peritumoral model, clinical model, and combined model in the training set were 0.791, 0.786, 0.848,0.749, and 0.861, respectively.In the validation set, the corresponding AUC values were 0.733, 0.739, 0.839, 0.704,and 0.845, respectively.Decision curve analysis showed that the combined model had the highest clinical utility,and the calibration curve indicated that the combined model was close to the ideal curve.The Hosmer-Lemeshow test showed good goodness of fit for the combined model (P=0.209).
Conclusion
The ultrasound radiomics models considering both intratumoral and peritumoral features can non-invasively predict HER2 expression status in breast cancer patients before surgery.The combined model, which incorporates independent clinical risk factors,demonstrates higher predictive efficacy and has clinical application value.
To improve contrast-enhanced voiding urosonography (CeVUS) in pediatrics with regard to contrast medium dosage and examination method, and to preliminarily explore its effectiveness and clinical application value in improving the quality of contrast images.
Methods
A retrospective study was performed on 137 children who underwent CeVUS in the Department of Ultrasound of Children's Hospital of Fudan University from January 2019 to August 2023.Traditional contrast method(single dose) was used from January 2019 to December 2021, and improved contrast method (dose adjustment based on age, bladder capacity, etc.) was used from January 2022 to August 2023 to evaluate vesicoureteral reflux.The images of the bladder after injection of contrast agents were divided into levels I ~ III (the image quality of level I is the best, the outline of the bladder is complete and clear, and the back of the bladder is not obviously obscured by shadow).The classification of the developed images was compared between the traditional contrast method and the improved contrast method.The consistency between CeVUS and voiding cystouretrography (VCUG) was analyzed.
Results
Among the 137 cases, 100 were examined by the traditional CeVUS method and 37 by the modified CeVUS method.The classification of bladder images obtained by the traditional method was: 1 case at level I (1.0%, 1/100), 39 cases at level II (39.0%, 39/100),and 60 cases at level III (60.0%, 60/100); for bladder images obtained by the improved method, there were 17 cases at level I (45.9%, 17/37), 16 cases of level II (43.2%, 16/37), and 4 cases of level III (10.8%, 4/37).The image level obtained by the improved method was better than that of the traditional method (P＜0.01).A total of 22 children underwent radiology VCUG examination at a similar time to CeVUS, and the Kappa value of the two examinations was 0.449 (P=0.002).
Conclusion
The improved CeVUS method can optimize the examination process, make the image clearer, use less contrast agent dose, and have better safety, which is worthy of clinical application.
To preliminarily explore the clinicial application value of lung ultrasonography(LUS) in the imaging evaluation of pulmonary lesions in children with mycoplasma pneumoniae pneumonia (MPP).
Methods
A total of 500 MPP children (270 males and 230 females) who were hospitalized in the Pediatrics Department of Tangdu Hospital between July 2023 and December 2023 and underwent LUS examination were retrospectively included.The relevant clinical data and ultrasound image data of the patients were analysed.
Results
The mean age of the 500 patients was (6.86±2.64 ) years, including 243 patients with mild MPP (48.6%,243/500), 221 with severe MPP (44.2%, 221/500), and 36 with critical MPP (7.2%, 36/500).Four hundred and ninety-four patients (98.8%) presented with positive signs of LUS, including alveolar-interstitial syndrome (25.6%,128/500), pulmonary consolidation (14.0%, 837/6000), pleural line changes (25.7%, 1540/6000), and pleural effusion (3.5%, 35/1000).Lung lesions of children with MPP were mainly concentrated in lung segments 5 and 6 (back).The LUS score of the patients was 6 (4, 9) and the score was significantly different among the patients with different severities of MPP ( P＜0.0001).Spearman correlation analysis shows that there was a significant moderate correlation between the severity of MPP and the LUS score (rs=0.5000, P＜0.0001) and the maximum length of consolidated lung tissue (rs=0.5880, P＜0.0001) in patients with MPP.
Conclusion
LUS may help to detect lesions such as alveolar-interstitial syndrome, pulmonary consolidation, and pleural effusion in patients with MPP, and the severity of the disease can be reflected by the LUS score and the maximum length of consolidated lung tissue.LUS is expected to provide a safe and simple imaging method for the clinical noninvasive assessment of lung injury in MPP.
To investigate the safety and efficacy of the new microsecond-nanosecond pulsed electric field (μs-nsPEF) ablation technology, focusing on ablation range, degree of muscle contraction,and protection of vital vascular structures.
Methods
A three-dimensional (3D) model was established using 3D electric field simulation software, followed by an ultrasound-guided open-abdomen ablation procedure.Four pigs were randomly assigned to μs-nsPEF (n=2) and nanosecond pulsed electric field (nsPEF) groups(n=2).Safety and efficacy of μs-nsPEFs in porcine liver tissue were evaluated by comparing preoperative simulated electric field distributions, intraoperative muscle contraction measurements, postoperative ablation area, and histopathological findings between the two groups.Student's t-test was used for comparisons between groups.
Results
3D electric field distribution maps created with COMSOL software showed a maximum ablation area of 6.06±0.02 cm2 for the μs-nsPEF group and 5.00±0.03 cm2 for the nsPEF group (P＜0.01).Contrast-enhanced ultrasound (CEUS) imaging 10 minutes post-ablation indicated an ablation area of 4.70±1.62 cm2 for the μs-nsPEF group and 4.33±1.55 cm2 for the nsPEF group (P＞0.05).Ultrasound examination on postoperative day 7 revealed a hypoechoic area in the μs-nsPEF group, whereas no such area was observed in the nsPEF group.H&E staining on postoperative day 7 showed a well-defined ablation boundary in the μs-nsPEF group with an area of 0.15±0.08 cm2, while no ablation lesion was observed in the nsPEF group.H&E staining of the gallbladder wall indicated that on postoperative day 7, blood flow around the μs-nsPEF ablation site remained unobstructed, the gallbladder structure was intact, and liver and kidney function indicators showed no abnormalities.
Conclusion
The novel μs-nsPEF technique demonstrates sustained and effective liver ablation while ensuring muscle contraction and vascular protection during surgery, indicating promising clinical applications.
To investigate the repairing effect of low-intensity ultrasound (LIPUS)on cisplatin-induced ovarian cell damage in mice.
Methods
Forty ICR mice were divided into a control group (n=12), a cisplatin group (n=14), and a cisplatin+LIPUS group (n=14).Control mice were injected intraperitoneally with saline, mice in the cisplatin group were injected intraperitoneally with cisplatin, and the cisplatin+LIPUS group underwent intraperitoneal cisplatin injection, followed by LIPUS irradiation on the next day.The treatment cycle was 2 weeks long.Mouse ovary tissues were taken for HE staining for follicle counting.RNA sequencing, immunohistochemistry, TUNEL staining, protein immunoblotting (Western blot), and real-time fluorescence quantitative polymerase chain reaction (qPCR) were performed to detect the expression of cytokines in different cellular physiological events in the ovaries such as apoptosis, iron death,and oxidative stress.
Results
Compared to the control group, ovarian size was reduced in the cisplatin group; compared to the cisplatin group, ovary size was increased in the cisplatin+LIPUS group.Comparison of ovarian weights in the control, cisplatin, and cisplatin+LIPUS groups (8.8±1.34 vs 2.8±0.45 vs 5.6±1.35)revealed statistically significant differences (P＜0.05).Compared to the control group, the number of primordial follicles, primary follicles, secondary follicles and antral follicles was reduced in the cisplatin group; compared with the cisplatin group, the number of follicles at the corresponding levels was increased in the cisplatin+LIPUS group (P＜0.05).Between mice with LIPUS treatment and controls, differential genes were mainly enriched in events at the cellular physiological level, such as apoptosis, iron death, and oxidative stress.Compared to the control group, Bax, p-H2AX, TUNEL signal, 3-Nit, 4-HNE, and 8-OHdG levels were increased, while the levels of factors such as Bcl2, SIRT1, SIRT2, Nrf2, FPN, GPX4, Fth, and Ftl were reduced in the cisplatin group (P＜0.05); compared with the cisplatin group, the levels of Bax,p-H2AX, TUNEL signal, 3-Nit, 4-HNE, and 8-OHdG were reduced, while the levels of Bcl2 and iron death factors except SIRT2 were increased (P＜0.05).
Conclusion
LIPUS can alleviate cisplatin-induced ovarian damage in mice, possibly by regulating apoptosis, iron death, and oxidative stress.
