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Huang H, Zheng Y, Chang M, Song J, Xia L, Wu C, Jia W, Ren H, Feng W, Chen Y. Ultrasound-Based Micro-/Nanosystems for Biomedical Applications. Chem Rev 2024. [PMID: 38924776 DOI: 10.1021/acs.chemrev.4c00009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
Due to the intrinsic non-invasive nature, cost-effectiveness, high safety, and real-time capabilities, besides diagnostic imaging, ultrasound as a typical mechanical wave has been extensively developed as a physical tool for versatile biomedical applications. Especially, the prosperity of nanotechnology and nanomedicine invigorates the landscape of ultrasound-based medicine. The unprecedented surge in research enthusiasm and dedicated efforts have led to a mass of multifunctional micro-/nanosystems being applied in ultrasound biomedicine, facilitating precise diagnosis, effective treatment, and personalized theranostics. The effective deployment of versatile ultrasound-based micro-/nanosystems in biomedical applications is rooted in a profound understanding of the relationship among composition, structure, property, bioactivity, application, and performance. In this comprehensive review, we elaborate on the general principles regarding the design, synthesis, functionalization, and optimization of ultrasound-based micro-/nanosystems for abundant biomedical applications. In particular, recent advancements in ultrasound-based micro-/nanosystems for diagnostic imaging are meticulously summarized. Furthermore, we systematically elucidate state-of-the-art studies concerning recent progress in ultrasound-based micro-/nanosystems for therapeutic applications targeting various pathological abnormalities including cancer, bacterial infection, brain diseases, cardiovascular diseases, and metabolic diseases. Finally, we conclude and provide an outlook on this research field with an in-depth discussion of the challenges faced and future developments for further extensive clinical translation and application.
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Affiliation(s)
- Hui Huang
- School of Environmental and Chemical Engineering, Shanghai University, Shanghai 200444, P. R. China
- Materdicine Lab, School of Life Sciences, Shanghai University, Shanghai 200444, P. R. China
| | - Yi Zheng
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, P. R. China
| | - Meiqi Chang
- Laboratory Center, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, P. R. China
| | - Jun Song
- Materdicine Lab, School of Life Sciences, Shanghai University, Shanghai 200444, P. R. China
| | - Lili Xia
- Materdicine Lab, School of Life Sciences, Shanghai University, Shanghai 200444, P. R. China
| | - Chenyao Wu
- Materdicine Lab, School of Life Sciences, Shanghai University, Shanghai 200444, P. R. China
| | - Wencong Jia
- Materdicine Lab, School of Life Sciences, Shanghai University, Shanghai 200444, P. R. China
| | - Hongze Ren
- Materdicine Lab, School of Life Sciences, Shanghai University, Shanghai 200444, P. R. China
| | - Wei Feng
- School of Environmental and Chemical Engineering, Shanghai University, Shanghai 200444, P. R. China
- Materdicine Lab, School of Life Sciences, Shanghai University, Shanghai 200444, P. R. China
| | - Yu Chen
- School of Environmental and Chemical Engineering, Shanghai University, Shanghai 200444, P. R. China
- Materdicine Lab, School of Life Sciences, Shanghai University, Shanghai 200444, P. R. China
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Barkovich KJ, Gibson AC, Brahmbhatt S, Tadisetty S, Wilds EC, Nelson LW, Gupta M, Gedaly R, Khurana A. Contrast-enhanced ultrasound of renal masses in the pre-transplant setting: literature review with case highlights. Abdom Radiol (NY) 2024:10.1007/s00261-024-04366-w. [PMID: 38900316 DOI: 10.1007/s00261-024-04366-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 04/29/2024] [Accepted: 04/29/2024] [Indexed: 06/21/2024]
Abstract
With the rising incidence of chronic kidney disease worldwide, an increasing number of patients are expected to require renal transplantation, which remains the definitive treatment of end stage renal disease. Medical imaging, primarily ultrasonography and contrast-enhanced CT and/or MRI, plays a large role in pre-transplantation assessment, especially in the characterization of lesions within the native kidneys. However, patients with CKD/ESRD often have relative contraindications to CT- and MR-contrast agents, limiting their utilization within this patient population. Contrast-enhanced ultrasound (CEUS), which combines the high temporal and spatial resolution of ultrasonography with intravascular microbubble contrast agents, provides a promising alternative. This review aims to familiarize the reader with the literature regarding the use of CEUS in the evaluation of cystic and solid renal lesions and provide case examples of its use at our institution in the pre-transplant setting.
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Affiliation(s)
- Krister J Barkovich
- Department of Radiology, University of California, San Diego, La Jolla, CA, 92093, USA
| | - Amanda C Gibson
- Department of Radiology, University of Kentucky, Lexington, KY, 40508, USA
| | - Sneh Brahmbhatt
- Department of Radiology, Mayo Clinic Florida, Jacksonville, FL, 32224, USA
| | - Sindhura Tadisetty
- Department of Radiology, University of Kentucky, Lexington, KY, 40508, USA
| | - Emory C Wilds
- College of Medicine, University of Kentucky, Lexington, KY, 40506, USA
| | - Leslie W Nelson
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792, USA
| | - Meera Gupta
- Department of Surgery, University of Kentucky, Lexington, KY, 40508, USA
| | - Roberto Gedaly
- Department of Surgery, University of Kentucky, Lexington, KY, 40508, USA
| | - Aman Khurana
- Department of Radiology, University of California, San Diego, La Jolla, CA, 92093, USA.
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Zhu YF, Liu ML, Zheng WT, Fu F, Xue ES, Fan XQ, Zhang HP, Lian GT, Ye Q. Predictive Model of CK7 Expression in Patients With Clear Cell Renal Cell Carcinoma by Combined Multimodal Ultrasound Diagnostic Techniques: A Retrospective Study. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:520-527. [PMID: 38281886 DOI: 10.1016/j.ultrasmedbio.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/18/2023] [Accepted: 12/07/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVE The aim of the work described here was to develop and validate a predictive model for cytokeratin 7 (CK7) expression in clear cell renal cell carcinoma (ccRCC) patients by combining multimodal ultrasound diagnostic techniques. METHODS This retrospective study enrolled 157 surgically confirmed ccRCC patients. All patients underwent pre-operative multimodal ultrasound diagnostic examinations, including B-mode ultrasound (US), color Doppler flow imaging (CDFI) and contrast-enhanced ultrasound (CEUS). The patients were randomly divided into a training group (103 cases) and a testing group (54 cases). Univariate and multivariate logistic regression analyses were performed in the training group to identify independent indicators associated with CK7 positivity. These indicators were included in the predictive model. Receiver operating characteristic (ROC) curves and calibration curves were used to evaluate the model's discriminative ability and accuracy. Decision curve analysis (DCA) and nomogram visualization were used to assess the clinical utility of the predictive model. RESULTS Univariate logistic regression analysis revealed that US and CDFI observations were not correlated with CK7 expression and could not predict it. Multivariate logistic regression analysis identified age (odds ratio [OR] = 0.953, 95% confidence interval [CI]: 0.909-0.999), wash-in pattern (OR = 0.180, 95% CI: 0.063-0.513) and enhancement homogeneity (OR = 11.610, 95% CI: 1.394-96.675) as independent factors related to CK7 positivity in ccRCC. Incorporating these variables into the predictive model resulted in areas under the receiver operating characteristic curve of 0.812 (95% CI: 0.711-0.913) for the training group and 0.792 (95% CI: 0.667-0.924) for the testing group. The calibration curve and DCA revealed that the model had good accuracy and clinical utility of the model. CONCLUSION The combination of multimodal ultrasound diagnostic techniques in constructing a predictive model for CK7 expression in ccRCC patients has significant predictive value.
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Affiliation(s)
- Yi-Fan Zhu
- Department of Ultrasound/Fujian Provincial Institute of Ultrasonic Medicine, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
| | - Mao-Lin Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian Province, China
| | - Wen-Ting Zheng
- Department of Ultrasound/Fujian Provincial Institute of Ultrasonic Medicine, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
| | - Fen Fu
- Department of Ultrasound/Fujian Provincial Institute of Ultrasonic Medicine, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
| | - En-Sheng Xue
- Department of Ultrasound/Fujian Provincial Institute of Ultrasonic Medicine, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
| | - Xiao-Qing Fan
- Department of Ultrasound/Fujian Provincial Institute of Ultrasonic Medicine, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
| | - Hui-Ping Zhang
- Department of Ultrasound/Fujian Provincial Institute of Ultrasonic Medicine, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
| | - Guang-Tian Lian
- Department of Ultrasound/Fujian Provincial Institute of Ultrasonic Medicine, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China
| | - Qin Ye
- Department of Ultrasound/Fujian Provincial Institute of Ultrasonic Medicine, Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.
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Li D, Zhang R, Lan H, Chen M, Huang Z, Zhao H, Guo S, Xu M, Lei Y. A retrospective study on adverse events of intravenous administration of sulfur hexafluoride microbubbles in abdominal and superficial applications in 83,778 patients. Insights Imaging 2024; 15:65. [PMID: 38411872 PMCID: PMC10899544 DOI: 10.1186/s13244-024-01632-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 01/27/2024] [Indexed: 02/28/2024] Open
Abstract
OBJECTIVES To investigate the rate of adverse events (AEs) caused by intravenous administration of sulfur hexafluoride microbubbles in abdominal and superficial applications retrospectively and to explore practical measures for prevention and treatment of them. MATERIALS AND METHODS This study enrolled 83,778 contrast-enhanced ultrasound (CEUS) examinations using sulfur hexafluoride microbubbles intravenously performed during 11 years. Age, gender, and target organs of all CEUS patients were recorded. For cases of AEs, their medical history and laboratory results were also collected. The process of AEs was assessed and categorized. Besides, the management of AEs were recorded. RESULTS Twenty patients had sulfur hexafluoride microbubbles-related AEs. The AE rate was 0.024%. No significant difference was observed between patients with AEs and the whole group for age and sex distribution. All AEs happened in liver examinations. Among them, 7 (35%) were mild, 8 (40%) were moderate, and 5 (25%) were severe. They were categorized into 15 allergic-like reactions and 5 physiologic reactions. The manifestations of mild and moderate AEs mainly include urticaria, chills, and mild hypoxia, which could be eased by simple management. Severe cases had anaphylactic shock, generalized convulsions, and diffuse erythema with hypotension respectively. They need close monitoring and oxygen inhalation with anti-shock and anti-anaphylactic treatment. Most cases started within 30 min and recovered within 1 day. CONCLUSIONS Intravenous administration of sulfur hexafluoride microbubbles in abdominal and superficial applications was safe with rare AEs. AEs were more likely to happen in abdominal applications than superficial ones. A well-designed emergency plan should be available for clinical use of sulfur hexafluoride microbubbles to reduce AEs and to deal with AEs properly. CRITICAL RELEVANCE STATEMENT Intravenous administration of sulfur hexafluoride microbubbles in abdominal and superficial applications reported few AEs and could be considered safe but severe AEs are life-threatening. We analyzed the influence factors of AEs and propose some methods for prevention and treatment of them, which can further improve the safety of sulfur hexafluoride microbubbles in clinical practice. KEY POINTS • The AE rate of sulfur hexafluoride microbubbles in abdominal and superficial applications was 0.024%. • Patients were more likely to have AEs in abdominal applications than superficial ones. • Severe AEs are life-threatening and need prompt identification and treatment. • We summarized some detailed suggestions for clinical prevention and treatment of AEs.
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Affiliation(s)
- Di Li
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Rui Zhang
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Huixia Lan
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Mianni Chen
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhenli Huang
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Huijuan Zhao
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Shan Guo
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ming Xu
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
| | - Yangyang Lei
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
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Wang Y, Weng W, Liang R, Zhou Q, Hu H, Li M, Chen L, Chen S, Peng S, Kuang M, Xiao H, Wang W. Predicting T Cell-Inflamed Gene Expression Profile in Hepatocellular Carcinoma Based on Dynamic Contrast-Enhanced Ultrasound Radiomics. J Hepatocell Carcinoma 2023; 10:2291-2303. [PMID: 38143911 PMCID: PMC10742767 DOI: 10.2147/jhc.s437415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/10/2023] [Indexed: 12/26/2023] Open
Abstract
Purpose The T cell-inflamed gene expression profile (GEP) quantifies 18 genes' expression indicative of a T-cell immune tumor microenvironment, playing a crucial role in the immunotherapy of hepatocellular carcinoma (HCC). Our study aims to develop a radiomics-based machine learning model using contrast-enhanced ultrasound (CEUS) for predicting T cell-inflamed GEP in HCC. Methods The primary cohort of HCC patients with preoperative CEUS and RNA sequencing data of tumor tissues at the single center was used to construct the model. A total of 5936 radiomics features were extracted from the regions of interest in representative images of each phase, and the least absolute shrinkage and selection operator and logistic regression were used to construct four models including three phase-specific models and an integrated model. The area under the curve (AUC) was calculated to evaluate the performance of the model. The independent cohort of HCC patients with preoperative CEUS and Immunoscore based on immunohistochemistry and digital pathology was used to validate the correlation between model prediction value and T-cell infiltration. Results There were 268 patients enrolled in the primary cohort and 46 patients enrolled in the independent cohort. Compared with the other three models, the AP model constructed by 36 arterial phase (AP) features showed good performance with a mean AUC of 0.905 in the 5-fold cross-validation and was easier to apply in the clinical setting. The decision curve and calibration curve confirmed the clinical utility of the model. In the independent cohort, patients with high Immunoscores showed significantly higher GEP prediction values than those with low Immunoscores (t=-2.359, p=0.029). Conclusion The CEUS-based model is a reliable predictive tool for T cell-inflamed GEP in HCC, and might facilitate individualized immunotherapy decision-making.
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Affiliation(s)
- Yijie Wang
- Department of Gastroenterology and Hepatology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Weixiang Weng
- Center of Hepato-Pancreato-Biliary Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Ruiming Liang
- Clinical Trials Unit, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Qian Zhou
- Clinical Trials Unit, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Hangtong Hu
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Mingde Li
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Lida Chen
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Shuling Chen
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Sui Peng
- Department of Gastroenterology and Hepatology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, People’s Republic of China
- Clinical Trials Unit, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Ming Kuang
- Center of Hepato-Pancreato-Biliary Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, People’s Republic of China
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, People’s Republic of China
- Cancer Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Han Xiao
- Department of Medical Ultrasonics, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Wei Wang
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, People’s Republic of China
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Cheng MQ, Huang H, Ruan SM, Xu P, Tong WJ, He DN, Huang Y, Lin MX, Lu MD, Kuang M, Wang W, Wu SH, Chen LD. Complementary Role of CEUS and CT/MR LI-RADS for Diagnosis of Recurrent HCC. Cancers (Basel) 2023; 15:5743. [PMID: 38136289 PMCID: PMC10741803 DOI: 10.3390/cancers15245743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/25/2023] [Accepted: 12/02/2023] [Indexed: 12/24/2023] Open
Abstract
PURPOSE We retrospectively compared the diagnostic performance of contrast-enhanced ultrasonography (CEUS) and contrast-enhanced computer tomography-magnetic resonance imaging (CT/MRI) for recurrent hepatocellular carcinoma (HCC) after curative treatment. MATERIALS AND METHODS After curative treatment with 421 ultrasound (US) detected lesions, 303 HCC patients underwent both CEUS and CT/MRI. Each lesion was assigned a Liver Imaging Reporting and Data System (LI-RADS) category according to CEUS and CT/MRI LI-RADS. Receiver-operating characteristic (ROC) curves were computed to determine the optimal diagnosis algorithms for CEUS, CT and MRI. The diagnostic accuracy, sensitivity, specificity, and area under the curve (AUC) were compared between CEUS and CT/MRI. RESULTS Among the 421 lesions, 218 were diagnosed as recurrent HCC, whereas 203 lesions were diagnosed as benign. In recurrent HCC, CEUS detected more arterial hyperenhancement (APHE) and washout than CT and more APHE than MRI. CEUS yielded better diagnostic performance than CT (AUC: 0.981 vs. 0.958) (p = 0.024) comparable diagnostic performance to MRI (AUC: 0.952 vs. 0.933) (p > 0.05) when using their optimal diagnostic criteria. CEUS missed 12 recurrent HCCs, CT missed one, and MRI missed none. The detection rate of recurrent HCC on CEUS (94.8%, 218/230) was lower than that on CT/MRI (99.6%, 259/260) (p = 0.001). Lesions located on the US blind spots and visualization score C would hinder the ability of CEUS to detect recurrent HCC. CONCLUSION CEUS demonstrated excellent diagnostic performance but an inferior detection rate for recurrent HCC. CEUS and CT/MRI played a complementary role in the detection and characterization of recurrent HCC.
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Affiliation(s)
- Mei-Qing Cheng
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; (M.-Q.C.); (H.H.); (S.-M.R.); (W.-J.T.); (Y.H.); (M.-X.L.); (M.-D.L.); (M.K.); (W.W.)
| | - Hui Huang
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; (M.-Q.C.); (H.H.); (S.-M.R.); (W.-J.T.); (Y.H.); (M.-X.L.); (M.-D.L.); (M.K.); (W.W.)
| | - Si-Min Ruan
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; (M.-Q.C.); (H.H.); (S.-M.R.); (W.-J.T.); (Y.H.); (M.-X.L.); (M.-D.L.); (M.K.); (W.W.)
| | - Ping Xu
- Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China;
| | - Wen-Juan Tong
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; (M.-Q.C.); (H.H.); (S.-M.R.); (W.-J.T.); (Y.H.); (M.-X.L.); (M.-D.L.); (M.K.); (W.W.)
| | - Dan-Ni He
- Department of Medical Ultrasonics, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518107, China;
| | - Yang Huang
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; (M.-Q.C.); (H.H.); (S.-M.R.); (W.-J.T.); (Y.H.); (M.-X.L.); (M.-D.L.); (M.K.); (W.W.)
| | - Man-Xia Lin
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; (M.-Q.C.); (H.H.); (S.-M.R.); (W.-J.T.); (Y.H.); (M.-X.L.); (M.-D.L.); (M.K.); (W.W.)
| | - Ming-De Lu
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; (M.-Q.C.); (H.H.); (S.-M.R.); (W.-J.T.); (Y.H.); (M.-X.L.); (M.-D.L.); (M.K.); (W.W.)
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Ming Kuang
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; (M.-Q.C.); (H.H.); (S.-M.R.); (W.-J.T.); (Y.H.); (M.-X.L.); (M.-D.L.); (M.K.); (W.W.)
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Wei Wang
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; (M.-Q.C.); (H.H.); (S.-M.R.); (W.-J.T.); (Y.H.); (M.-X.L.); (M.-D.L.); (M.K.); (W.W.)
| | - Shao-Hong Wu
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; (M.-Q.C.); (H.H.); (S.-M.R.); (W.-J.T.); (Y.H.); (M.-X.L.); (M.-D.L.); (M.K.); (W.W.)
| | - Li-Da Chen
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China; (M.-Q.C.); (H.H.); (S.-M.R.); (W.-J.T.); (Y.H.); (M.-X.L.); (M.-D.L.); (M.K.); (W.W.)
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Santolamazza G, Virdis F, Abu-Zidan F, Cioffi SPB, Reitano E, Altomare M, Bini R, Spota A, Podda M, Kumar J, Chiara O, Cimbanassi S. Contrast-enhanced ultrasound (CEUS) in the follow-up of abdominal solid organ trauma: an international survey prior to the PseAn study. Eur J Trauma Emerg Surg 2023:10.1007/s00068-023-02364-z. [PMID: 37828351 DOI: 10.1007/s00068-023-02364-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/08/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND The blunt and penetrating abdominal trauma follow-up relies on contrast CT scan to detect solid organ injuries. CEUS is not widely used worldwide, despite its accuracy and feasibility in identifying parenchymal and vascular lesions. This survey aims to define the current use of CEUS in Trauma Centers and the expectations of Emergency Surgeons regarding its role. METHODS We sent an online questionnaire composed of 10 questions to trauma physicians worldwide during the period of September 2022 to March 2023. RESULTS 59 participants from 53 different centers answered the questionnaire. 76.2% of the enrolled participants have CEUS available at their Institution, and 49.2% think that it can replace CT scan. Contrast-CT scan remains the preferred option in the follow-up of blunt liver (69.5%), spleen (72.9%) and kidney (76.3%) injuries, followed by CEUS which is used in 18.6% for liver, 20.3% for spleen and 15.3% for kidney injuries. The results are similar for penetrating abdominal trauma, with contrast CT scan being the first-line imaging technique (91.5% for liver, 91.5% for spleen and 88.1% for kidney injuries), followed by CEUS (5.1% for liver, 5.1% for spleen and 6.8% for kidney injuries). CONCLUSIONS Our survey shows that CEUS is still underutilized in the follow-up of abdominal trauma, even though many emergency surgeons consider it as a valid alternative to contrast CT scan.
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Affiliation(s)
- Giuliano Santolamazza
- Department of Emergency and Trauma Surgery, Trauma and Acute Care Surgery Unit, ASST Grande Ospedale Metropolitano Niguarda, Piazza Dell'Ospedale Maggiore, 3, 20162, Milan, MI, Italy
| | - Francesco Virdis
- Department of Emergency and Trauma Surgery, Trauma and Acute Care Surgery Unit, ASST Grande Ospedale Metropolitano Niguarda, Piazza Dell'Ospedale Maggiore, 3, 20162, Milan, MI, Italy.
| | - Fikri Abu-Zidan
- The Research Office, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Stefano Piero Bernardo Cioffi
- Department of Emergency and Trauma Surgery, Trauma and Acute Care Surgery Unit, ASST Grande Ospedale Metropolitano Niguarda, Piazza Dell'Ospedale Maggiore, 3, 20162, Milan, MI, Italy
| | - Elisa Reitano
- IRCAD Research Institute Against Digestive Cancer, Strasbourg, France
| | - Michele Altomare
- Department of Emergency and Trauma Surgery, Trauma and Acute Care Surgery Unit, ASST Grande Ospedale Metropolitano Niguarda, Piazza Dell'Ospedale Maggiore, 3, 20162, Milan, MI, Italy
| | - Roberto Bini
- Department of Emergency and Trauma Surgery, Trauma and Acute Care Surgery Unit, ASST Grande Ospedale Metropolitano Niguarda, Piazza Dell'Ospedale Maggiore, 3, 20162, Milan, MI, Italy
| | - Andrea Spota
- Department of Emergency and Trauma Surgery, Trauma and Acute Care Surgery Unit, ASST Grande Ospedale Metropolitano Niguarda, Piazza Dell'Ospedale Maggiore, 3, 20162, Milan, MI, Italy
- Tissue Bank and Therapy, ASST GOM Niguarda, Milan, Italy
| | - Mauro Podda
- Department of General and Emergency Surgery, Cagliari University Hospital, Cagliari, Italy
| | - Jayant Kumar
- Department of Medicine, Faculty of Surgery and Cancer, Imperial College London, London, England
| | - Osvaldo Chiara
- Department of Emergency and Trauma Surgery, Trauma and Acute Care Surgery Unit, ASST Grande Ospedale Metropolitano Niguarda, Piazza Dell'Ospedale Maggiore, 3, 20162, Milan, MI, Italy
| | - Stefania Cimbanassi
- Department of Emergency and Trauma Surgery, Trauma and Acute Care Surgery Unit, ASST Grande Ospedale Metropolitano Niguarda, Piazza Dell'Ospedale Maggiore, 3, 20162, Milan, MI, Italy
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8
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Russell G, Strnad BS, Ludwig DR, Middleton WD, Itani M, Khot R, Mellnick V, Malone C. Contrast-Enhanced Ultrasound for Image-Guided Procedures. Tech Vasc Interv Radiol 2023; 26:100913. [PMID: 38071027 DOI: 10.1016/j.tvir.2023.100913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Contrast-enhanced ultrasound (CEUS) uses intravenously injected gas microbubbles as a pure blood pool contrast agent to demonstrate blood flow and tissue perfusion at a much higher sensitivity than color Doppler and power Doppler ultrasound. CEUS has gained traction in abdominal diagnostic imaging for improved lesion detection and characterization and a complementary problem-solving tool to CT and MRI. In addition to its diagnostic applications, CEUS has also proven useful for pre-procedure planning, procedure guidance, and post-procedure evaluation. This review provides a practical overview and guides to the application of CEUS in percutaneous, ultrasound-guided, needle-driven procedures, focusing on 2 common procedures, which illustrate the many benefits of CEUS- core needle biopsy (CNB) and percutaneous hepatic lesion ablation.
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Affiliation(s)
- Gentry Russell
- Mallinckrodt Institute of Radiology, Barnes-Jewish Hospital/Washington University School of Medicine, St Louis, MO
| | - Benjamin S Strnad
- Mallinckrodt Institute of Radiology, Barnes-Jewish Hospital/Washington University School of Medicine, St Louis, MO
| | - Daniel R Ludwig
- Mallinckrodt Institute of Radiology, Barnes-Jewish Hospital/Washington University School of Medicine, St Louis, MO
| | - William D Middleton
- Mallinckrodt Institute of Radiology, Barnes-Jewish Hospital/Washington University School of Medicine, St Louis, MO
| | - Malak Itani
- Mallinckrodt Institute of Radiology, Barnes-Jewish Hospital/Washington University School of Medicine, St Louis, MO
| | - Rachita Khot
- Department of Radiology, University of Virginia Medical Center/University of Virginia School of Medicine, Charlottesville, VA
| | - Vincent Mellnick
- Mallinckrodt Institute of Radiology, Barnes-Jewish Hospital/Washington University School of Medicine, St Louis, MO
| | - Christopher Malone
- Mallinckrodt Institute of Radiology, Barnes-Jewish Hospital/Washington University School of Medicine, St Louis, MO.
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Lang M, Liang P, Shen H, Li H, Yang N, Chen B, Chen Y, Ding H, Yang W, Ji X, Zhou P, Cui L, Wang J, Xu W, Ye X, Liu Z, Yang Y, Wei T, Wang H, Yan Y, Wu C, Wu Y, Shi J, Wang Y, Fang X, Li R, Yu J. Head-to-head comparison of perfluorobutane contrast-enhanced US and multiparametric MRI for breast cancer: a prospective, multicenter study. Breast Cancer Res 2023; 25:61. [PMID: 37254149 DOI: 10.1186/s13058-023-01650-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/22/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Multiparametric magnetic resonance imaging (MP-MRI) has high sensitivity for diagnosing breast cancers but cannot always be used as a routine diagnostic tool. The present study aimed to evaluate whether the diagnostic performance of perfluorobutane (PFB) contrast-enhanced ultrasound (CEUS) is similar to that of MP-MRI in breast cancer and whether combining the two methods would enhance diagnostic efficiency. PATIENTS AND METHODS This was a head-to-head, prospective, multicenter study. Patients with breast lesions diagnosed by US as Breast Imaging Reporting and Data System (BI-RADS) categories 3, 4, and 5 underwent both PFB-CEUS and MP-MRI scans. On-site operators and three reviewers categorized the BI-RADS of all lesions on two images. Logistic-bootstrap 1000-sample analysis and cross-validation were used to construct PFB-CEUS, MP-MRI, and hybrid (PFB-CEUS + MP-MRI) models to distinguish breast lesions. RESULTS In total, 179 women with 186 breast lesions were evaluated from 17 centers in China. The area under the receiver operating characteristic curve (AUC) for the PFB-CEUS model to diagnose breast cancer (0.89; 95% confidence interval [CI] 0.74, 0.97) was similar to that of the MP-MRI model (0.89; 95% CI 0.73, 0.97) (P = 0.85). The AUC of the hybrid model (0.92, 95% CI 0.77, 0.98) did not show a statistical advantage over the PFB-CEUS and MP-MRI models (P = 0.29 and 0.40, respectively). However, 90.3% false-positive and 66.7% false-negative results of PFB-CEUS radiologists and 90.5% false-positive and 42.8% false-negative results of MP-MRI radiologists could be corrected by the hybrid model. Three dynamic nomograms of PFB-CEUS, MP-MRI and hybrid models to diagnose breast cancer are freely available online. CONCLUSIONS PFB-CEUS can be used in the differential diagnosis of breast cancer with comparable performance to MP-MRI and with less time consumption. Using PFB-CEUS and MP-MRI as joint diagnostics could further strengthen the diagnostic ability. Trial registration Clinicaltrials.gov; NCT04657328. Registered 26 September 2020. IRB number 2020-300 was approved in Chinese PLA General Hospital. Every patient signed a written informed consent form in each center.
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Affiliation(s)
- Manlin Lang
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical School, Beijing, 100039, China
| | - Ping Liang
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China
| | - Huiming Shen
- Department of Ultrasound, Zhongda Hospital Southeast University, Nanjing, 210009, China
| | - Hang Li
- Department of Breast Surgery, Affiliated Hospital of Putian University, Putian, 351100, China
| | - Ning Yang
- Department of Ultrasound, Xingcheng People's Hospital, Xingcheng, 125100, China
| | - Bo Chen
- Department of Ultrasound Medicine, Lu'an People's Hospital of Anhui Province, Liuan, 237000, China
| | - Yixu Chen
- Department of Ultrasound, The Fifth People's Hospital of Chengdu, Chengdu, 611130, China
| | - Hong Ding
- Department of Ultrasound, Huashan Hospital, Shanghai, 200040, China
| | - Weiping Yang
- Department of Ultrasound, Guangxi Medical University Cancer Hospital, Nanning, 530021, China
| | - Xiaohui Ji
- Department of Ultrasound, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, China
| | - Ping Zhou
- Department of Ultrasound, The Third Xiangya Hospital, Changsha, 410000, China
| | - Ligang Cui
- Department of Ultrasound, Peking University Third Hospital, Beijing, 100191, China
| | - Jiandong Wang
- General Surgery, Chinese PLA General Hospital, Beijing, 100853, China
| | - Wentong Xu
- General Surgery, Chinese PLA General Hospital, Beijing, 100853, China
| | - Xiuqin Ye
- Department of Ultrasound, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical College of Jinan University, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital, Shenzhen, 518020, China
| | - Zhixing Liu
- Department of Ultrasound Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Yu Yang
- Department of Ultrasound, Beijing Friendship Hospital, Beijing, 100050, China
| | - Tianci Wei
- Department of Ultrasound, The 2nd Affiliated Hospital of Harbin, Harbin, 150001, China
| | - Hui Wang
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, 130033, China
| | - Yuanyuan Yan
- Department of Ultrasound, Zhengzhou Central Hospital, Zhengzhou, 450000, China
| | - Changjun Wu
- Department of Ultrasonography, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Yiyun Wu
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China
| | - Jingwen Shi
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Yaxi Wang
- Department of Ultrasound, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, China
| | - Xiuxia Fang
- Department of Ultrasound, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, China
| | - Ran Li
- Department of Ultrasound, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453100, China
| | - Jie Yu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China.
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Zeng H, Zhang M, Xie Y, Wang M, Dai J, Zhu X, Zeng Y, Xu N, Huang P, Zhao J, Sun G, Zeng H, Shen P. Primary renal mucinous adenocarcinoma masquerading as a giant renal cyst: a case report. Front Oncol 2023; 13:1129680. [PMID: 37223683 PMCID: PMC10200912 DOI: 10.3389/fonc.2023.1129680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/26/2023] [Indexed: 05/25/2023] Open
Abstract
Mucinous adenocarcinoma of the kidney is rarely reported in the literature. We present a previously unreported mucinous adenocarcinoma arising from the renal parenchyma. A 55-year-old male patient with no complaints showed a large cystic hypodense lesion in the upper left kidney on contrast-enhanced computed tomography (CT) scan. A left renal cyst was initially considered, and a partial nephrectomy (PN) was performed. During the operation, a large amount of jelly-like mucus and bean-curd-like necrotic tissue was found in the focus. The pathological diagnosis was mucinous adenocarcinoma, and further systemic examination revealed no clinical evidence of primary disease elsewhere. Then the patient underwent left radical nephrectomy (RN), and the cystic lesion was found in the renal parenchyma, while neither the collecting system nor the ureters were involved. Postoperative sequential chemotherapy and radiotherapy were administered, and no signs of disease recurrence were observed over 30 months of follow-up. Based on a literature review, we summarize the lesion with rarity and the associated dilemma in preoperative diagnosis and treatment. Given the high degree of malignancy, a careful history analysis accompanied by dynamic observation of imaging and tumor markers is recommended for the diagnosis of the disease. Comprehensive treatment based on surgery may improve its clinical outcomes.
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Affiliation(s)
- Hong Zeng
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Mengni Zhang
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yandong Xie
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Minghao Wang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jindong Dai
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xudong Zhu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuhao Zeng
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Nanwei Xu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Peng Huang
- Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jinge Zhao
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Guangxi Sun
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hao Zeng
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Pengfei Shen
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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11
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Odedra D, Sabongui S, Khalili K, Schieda N, Pei Y, Krishna S. Autosomal Dominant Polycystic Kidney Disease: Role of Imaging in Diagnosis and Management. Radiographics 2023; 43:e220126. [DOI: 10.1148/rg.220126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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12
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Huang J, Yang J, Ding J, Zhou J, Yang R, Li J, Luo Y, Lu Q. Development and validation of an ultrasound-based prediction model for differentiating between malignant and benign solid pancreatic lesions. Eur Radiol 2022; 32:8296-8305. [PMID: 35751698 DOI: 10.1007/s00330-022-08930-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 04/20/2022] [Accepted: 05/30/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To identify the diagnostic ability of precontrast and contrast-enhanced ultrasound (CEUS) in differentiating between malignant and benign solid pancreatic lesions (MSPLs and BSPLs) and to develop an easy-to-use diagnostic nomogram. MATERIALS AND METHODS This study was approved by the institutional review board. Patients with pathologically confirmed solid pancreatic lesions were enrolled from one tertiary medical centre from March 2011 to June 2021 and in two tertiary institutions between January 2015 and June 2021. A prediction nomogram model was established in the training set by using precontrast US and CEUS imaging features that were independently associated with MSPLs. The performance of the prediction model was further externally validated. RESULTS A total of 155 patients (mean age, 55 ± 14.6 years, M/F = 84/71) and 78 patients (mean age, 59 ± 13.4 years, M/F = 36/42) were included in the training and validation cohorts, respectively. In the training set, an ill-defined border and dilated main pancreatic duct on precontrast ultrasound, CEUS patterns of hypoenhancement in both the arterial and venous phases of CEUS, and hyperenhancement/isoenhancement followed by washout were independently associated with MSPLs. The prediction nomogram model developed with the aforementioned variables showed good performance in differentiating MSPLs from BSPLs with an area under the curve (AUC) of 0.938 in the training set and 0.906 in the validation set. CONCLUSION Hypoenhancement in all phases, hyperenhancement/isoenhancement followed by washout on CEUS, an ill-defined border, and a dilated main pancreatic duct were independent risk factors for MSPLs. The nomogram constructed based on these predictors can be used to diagnose MSPLs. KEY POINTS • An ill-defined border and dilated main pancreatic duct on precontrast ultrasound, hypoenhancement in all phases of CEUS, and hyperenhancement/isoenhancement followed by washout were independently associated with MSPLs. • The ultrasound-based prediction model showed good performance in differentiating MSPLs from BSPLs with an AUC of 0.938 in the training set and 0.906 in the external validation set. • An ultrasound-based nomogram is an easy-to-use tool to differentiate between MSPLs and BSPLs with high efficacy.
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Affiliation(s)
- Jiayan Huang
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Jie Yang
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Jianming Ding
- Department of Ultrasound, Tianjin Third Central Hospital, Tianjin, 300170, China
| | - Jing Zhou
- Department of Ultrasound, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Rui Yang
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Jiawu Li
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Yan Luo
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, 610041, China.
| | - Qiang Lu
- Department of Ultrasound, Laboratory of Ultrasound Medicine, West China Hospital of Sichuan University, Chengdu, 610041, China.
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