1
|
Karageorgos GM, Qiu J, Peng X, Yang Z, Ghose S, Dentinger A, Xu Z, Jo J, Ragupathi S, Xu G, Abdulaziz N, Gandikota G, Wang X, Mills D. Automated Deep Learning-Based Finger Joint Segmentation in 3-D Ultrasound Images With Limited Dataset. ULTRASONIC IMAGING 2024:1617346241277178. [PMID: 39295443 DOI: 10.1177/01617346241277178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/21/2024]
Abstract
Ultrasound imaging has shown promise in assessing synovium inflammation associated early stages of rheumatoid arthritis (RA). The precise identification of the synovium and the quantification of inflammation-specific imaging biomarkers is a crucial aspect of accurately quantifying and grading RA. In this study, a deep learning-based approach is presented that automates the segmentation of the synovium in ultrasound images of finger joints affected by RA. Two convolutional neural network architectures for image segmentation were trained and validated in a limited number of 2-D images, extracted from N = 18 3-D ultrasound volumes acquired from N = 9 RA patients, with sparse ground truth annotations of the synovium. Various augmentation strategies were employed to enhance the diversity and size of the training dataset. The utilization of geometric and noise augmentation transforms resulted in the highest dice score (0.768 ± 0 . 031 , N = 6 ) , and intersection over union ( 0 . 624 ± 0.040, N = 6), as determined via six-fold cross-validation. In addition, the segmentation model is used to generate dense 3-D segmentation maps in the ultrasound volumes, based on the available sparse annotations. The developed technique shows promise in facilitating more efficient and standardized workflow for RA screening using ultrasound imaging.
Collapse
Affiliation(s)
| | - Jianwei Qiu
- GE Healthcare Technology and Innovation Center, Niskayuna, NY, USA
| | - Xiaorui Peng
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Zhaoyuan Yang
- GE Healthcare Technology and Innovation Center, Niskayuna, NY, USA
| | - Soumya Ghose
- GE Healthcare Technology and Innovation Center, Niskayuna, NY, USA
| | - Aaron Dentinger
- GE Healthcare Technology and Innovation Center, Niskayuna, NY, USA
| | - Zhanpeng Xu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Janggun Jo
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Siddarth Ragupathi
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Guan Xu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Nada Abdulaziz
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Girish Gandikota
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Xueding Wang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - David Mills
- GE Healthcare Technology and Innovation Center, Niskayuna, NY, USA
| |
Collapse
|
2
|
Chen J, Yin Y, Li G, Tian H, Ding Z, Mo S, Xu J, Huang Z, Dong F. Integrated nomogram to predict HER2 expression in breast tumor: Clinical, Ultrasound, and Photoacoustic imaging approaches. Eur J Cancer 2024; 209:114259. [PMID: 39111206 DOI: 10.1016/j.ejca.2024.114259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 07/11/2024] [Accepted: 07/22/2024] [Indexed: 08/25/2024]
Abstract
BACKGROUND HER2 is a key biomarker for breast cancer treatment and prognosis. Traditional assessment methods like immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) are effective but costly and time-consuming. Our model incorporates these methods alongside photoacoustic imaging to enhance diagnostic accuracy and provide more comprehensive clinical insights. MATERIALS AND METHODS A total of 301 breast tumors were included in this study, divided into HER2-positive (3+ or 2+ with gene amplification) and HER2-negative (below 3+ and 2+ without gene amplification) groups. Samples were split into training and validation sets in a 7:3 ratio. Statistical analyses involved t-tests, chi-square tests, and rank-sum tests. Predictive factors were identified using univariate and multivariate logistic regression, leading to the creation of three models: ModA (clinical factors only), ModB (clinical plus ultrasound factors), and ModC (clinical, ultrasound, and photoacoustic imaging-derived oxygen saturation (SO2)). RESULTS The area under the curve (AUC) for ModA was 0.756 (95 % CI: 0.69-0.82), ModB increased to 0.866 (95 % CI: 0.82-0.91), and ModC showed the highest performance with an AUC of 0.877 (95 % CI: 0.83-0.92). These results indicate that the comprehensive model combining clinical, ultrasound, and photoacoustic imaging data (ModC) performed best in predicting HER2 expression. CONCLUSION The findings suggest that integrating clinical, ultrasound, and photoacoustic imaging data significantly enhances the accuracy of predicting HER2 expression. For personalised breast cancer treatment, the integrated model could provide a comprehensive and reproducible decision support tool.
Collapse
Affiliation(s)
- Jing Chen
- Ultrasound Department, Shenzhen Peoples Hospital, Shenzhen 518020, China; Ultrasound Department, The Second Clinical Medical College, Jinan University, Shenzhen, 518020, China; Ultrasound Department, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, 518020, China
| | - Yunqing Yin
- The Second Clinical Medical College, Jinan University, Shenzhen 518020, China
| | - Guoqiu Li
- Ultrasound Department, The Second Clinical Medical College, Jinan University, Shenzhen, 518020, China
| | - Hongtian Tian
- Ultrasound Department, Shenzhen Peoples Hospital, Shenzhen 518020, China; Ultrasound Department, The Second Clinical Medical College, Jinan University, Shenzhen, 518020, China; Ultrasound Department, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, 518020, China
| | - Zhimin Ding
- Ultrasound Department, Shenzhen Peoples Hospital, Shenzhen 518020, China; Ultrasound Department, The Second Clinical Medical College, Jinan University, Shenzhen, 518020, China; Ultrasound Department, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, 518020, China
| | - Sijie Mo
- Ultrasound Department, The Second Clinical Medical College, Jinan University, Shenzhen, 518020, China
| | - Jinfeng Xu
- Ultrasound Department, Shenzhen Peoples Hospital, Shenzhen 518020, China; Ultrasound Department, The Second Clinical Medical College, Jinan University, Shenzhen, 518020, China; Ultrasound Department, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, 518020, China.
| | - Zhibin Huang
- Ultrasound Department, Shenzhen Peoples Hospital, Shenzhen 518020, China; Ultrasound Department, The Second Clinical Medical College, Jinan University, Shenzhen, 518020, China.
| | - Fajin Dong
- Ultrasound Department, Shenzhen Peoples Hospital, Shenzhen 518020, China; Ultrasound Department, The Second Clinical Medical College, Jinan University, Shenzhen, 518020, China; Ultrasound Department, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, 518020, China.
| |
Collapse
|
3
|
Li G, Huang Z, Tian H, Wu H, Zheng J, Wang M, Mo S, Chen Z, Xu J, Dong F. Deep learning combined with attention mechanisms to assist radiologists in enhancing breast cancer diagnosis: a study on photoacoustic imaging. BIOMEDICAL OPTICS EXPRESS 2024; 15:4689-4704. [PMID: 39346992 PMCID: PMC11427196 DOI: 10.1364/boe.530249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 07/10/2024] [Accepted: 07/10/2024] [Indexed: 10/01/2024]
Abstract
Accurate prediction of breast cancer (BC) is essential for effective treatment planning and improving patient outcomes. This study proposes a novel deep learning (DL) approach using photoacoustic (PA) imaging to enhance BC prediction accuracy. We enrolled 334 patients with breast lesions from Shenzhen People's Hospital between January 2022 and January 2024. Our method employs a ResNet50-based model combined with attention mechanisms to analyze photoacoustic ultrasound (PA-US) images. Experiments demonstrated that the PAUS-ResAM50 model achieved superior performance, with an AUC of 0.917 (95% CI: 0.884 -0.951), sensitivity of 0.750, accuracy of 0.854, and specificity of 0.920 in the training set. In the testing set, the model maintained high performance with an AUC of 0.870 (95% CI: 0.778-0.962), sensitivity of 0.786, specificity of 0.872, and accuracy of 0.836. Our model significantly outperformed other models, including PAUS-ResNet50, BMUS-ResAM50, and BMUS-ResNet50, as validated by the DeLong test (p < 0.05 for all comparisons). Additionally, the PAUS-ResAM50 model improved radiologists' diagnostic specificity without reducing sensitivity, highlighting its potential for clinical application. In conclusion, the PAUS-ResAM50 model demonstrates substantial promise for optimizing BC diagnosis and aiding radiologists in early detection of BC.
Collapse
Affiliation(s)
- Guoqiu Li
- Department of Ultrasound, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, Guangdong, China
| | - Zhibin Huang
- Department of Ultrasound, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, Guangdong, China
| | - Hongtian Tian
- Department of Ultrasound, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, Guangdong, China
| | - Huaiyu Wu
- Department of Ultrasound, Shenzhen People's Hospital, Shenzhen 518020, Guangdong, China
| | - Jing Zheng
- Department of Ultrasound, Shenzhen People's Hospital, Shenzhen 518020, Guangdong, China
| | - Mengyun Wang
- Department of Ultrasound, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, Guangdong, China
| | - Sijie Mo
- Department of Ultrasound, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, Guangdong, China
| | - Zhijie Chen
- Ultrasound imaging system development department, Shenzhen Mindray Bio-Medical Electronics Co., Ltd. Shenzhen, Guangdong, China
| | - Jinfeng Xu
- Department of Ultrasound, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, Guangdong, China
- Department of Ultrasound, Shenzhen People's Hospital, Shenzhen 518020, Guangdong, China
| | - Fajin Dong
- Department of Ultrasound, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, Guangdong, China
- Department of Ultrasound, Shenzhen People's Hospital, Shenzhen 518020, Guangdong, China
- Department of Ultrasound, Shenzhen People's Hospital, Longhua Branch, Shenzhen 518020, Guangdong, China
| |
Collapse
|
4
|
Huang Z, Liu D, Mo S, Hong X, Xie J, Chen Y, Liu L, Song D, Tang S, Wu H, Xu J, Dong F. Multimodal PA/US imaging in Rheumatoid Arthritis: Enhanced correlation with clinical scores. PHOTOACOUSTICS 2024; 38:100615. [PMID: 38817689 PMCID: PMC11137597 DOI: 10.1016/j.pacs.2024.100615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/25/2024] [Accepted: 05/05/2024] [Indexed: 06/01/2024]
Abstract
Background Accurate assessment of Rheumatoid Arthritis (RA) activity remains a challenge. Multimodal photoacoustic/ultrasound (PA/US) joint imaging emerges as a novel imaging modality capable of depicting microvascularization and oxygenation levels in inflamed joints associated with RA. However, the scarcity of large-scale studies limits the exploration of correlating joint oxygenation status with disease activity. Objective This study aimed to explore the correlation between multimodal PA/US imaging scores and RA disease activity, assessing its clinical applicability in managing RA. Methods In this study, we recruited 111 patients diagnosed with RA and conducted examinations of seven small joints on their clinically dominant side using a PA/US imaging system. The PA and power Doppler ultrasound (PDUS) signals were semi-quantitatively assessed using a 0-3 grading system. The cumulative scores for PA and PDUS across these seven joints (PA-sum and PDUS-sum) were calculated. Relative oxygen saturation (So2) values of inflamed joints on the clinically dominant side were measured, and categorized into four distinct PA+So2 patterns. The correlation between PA/US imaging scores and disease activity indices was systematically evaluated. Results Analysis of 777 small joints in 111 patients revealed that the PA-sum scores exhibited a strong positive correlation with standard clinical scores for RA, including DAS28 [ESR] (ρ = 0.682), DAS28 [CRP] (ρ = 0.683), CDAI (ρ = 0.738), and SDAI (ρ = 0.739), all with p < 0.001. These correlations were superior to those of the PDUS-sum scores (DAS28 [ESR] ρ = 0.559, DAS28 [CRP] ρ = 0.555, CDAI ρ = 0.575, SDAI ρ = 0.581, p < 0.001). Significantly, in patients with higher PA-sum scores, notable differences were observed in the erythrocyte sedimentation rate (ESR) (p < 0.01) and swollen joint count 28 (SJC28) (p < 0.01) between hypoxia and intermediate groups. Notably, RA patients in the hypoxia group exhibited higher clinical scores in certain clinical indices. Conclusion Multi-modal PA/US imaging introduces potential advancements in RA assessment, especially regarding So2 evaluations in synovial tissues and associated PA scores. However, further studies are warranted, particularly with more substantial sample sizes and in multi-center settings. Summary This study utilized multi-modal PA/US imaging to analyze Rheumatoid Arthritis (RA) patients' synovial tissues and affected joints. When juxtaposed with traditional PDUS imaging, the PA approach demonstrated enhanced sensitivity, especially concerning detecting small vessels in thickened synovium and inflamed tendon sheaths. Furthermore, correlations between the derived PA scores, PA+So2 patterns, and standard clinical RA scores were observed. These findings suggest that multi-modal PA/US imaging could be a valuable tool in the comprehensive assessment of RA, offering insights not only into disease activity but also into the oxygenation status of synovial tissues. However, as promising as these results are, further investigations, especially in larger and diverse patient populations, are imperative. Key points ⸸ Multi-modal PA/US Imaging in RA: This novel technique was used to assess the So2 values in synovial tissues and determine PA scores of affected RA joints.⸸ Correlation significantly with Clinical RA Scores: Correlations significantly were noted between PA scores, PA+So2 patterns, and standard clinical RA metrics, hinting at the potential clinical applicability of the technique.
Collapse
Affiliation(s)
- Zhibin Huang
- Department of Ultrasound, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, China
| | - Dongzhou Liu
- Department of Rheumatology and Immunology, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, China
| | - Sijie Mo
- Department of Ultrasound, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, China
| | - Xiaoping Hong
- Department of Rheumatology and Immunology, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, China
| | - Jingyi Xie
- Department of Rheumatology and Immunology, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, China
| | - Yulan Chen
- Department of Rheumatology and Immunology, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, China
| | - Lixiong Liu
- Department of Rheumatology and Immunology, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, China
| | - Di Song
- Department of Ultrasound, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, China
| | - Shuzhen Tang
- Department of Ultrasound, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, China
| | - Huaiyu Wu
- Department of Ultrasound, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, China
| | - Jinfeng Xu
- Department of Ultrasound, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, China
| | - Fajin Dong
- Department of Ultrasound, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen 518020, China
| |
Collapse
|
5
|
Huang Z, Tian H, Luo H, Yang K, Chen J, Li G, Ding Z, Luo Y, Tang S, Xu J, Wu H, Dong F. Assessment of Oxygen Saturation in Breast Lesions Using Photoacoustic Imaging: Correlation With Benign and Malignant Disease. Clin Breast Cancer 2024; 24:e210-e218.e1. [PMID: 38423948 DOI: 10.1016/j.clbc.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/04/2024] [Accepted: 01/10/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Hypoxia is a hallmark of breast cancer (BC). Photoacoustic (PA) imaging, based on the use of laser-generated ultrasound (US), can detect oxygen saturation (So2) in the tissues of breast lesion patients. PURPOSE To measure the oxygenation status of tissue in and on both sides of the lesion in breast lesion participants using a multimodal Photoacoustic/ultrasound (PA/US) imaging system and to determine the correlation between So2 measured by PA imaging and benign or malignant disease. MATERIALS AND METHODS Multimodal PA/US imaging and gray-scale US (GSUS) of breast lesion was performed in consecutive breast lesion participants imaged in the US Outpatient Clinic between 2022 and 2023. Dual-wavelength PA imaging was used to measure the So2 value inside the lesion and on both sides of the tissue, and to distinguish benign from malignant lesions based on the So2 value. The ability of So2 to distinguish benign from malignant breast lesions was evaluated by the receiver operating characteristic curve (ROC) and the De-Long test. RESULTS A total of 120 breast lesion participants (median age, 42.5 years) were included in the study. The malignant lesions exhibited lower So2 levels compared to benign lesions (malignant: 71.30%; benign: 83.81%; P < .01). Moreover, PA/US imaging demonstrates superior diagnostic results compared to GSUS, with an area under the curve (AUC) of 0.89 versus 0.70, sensitivity of 89.58% versus 85.42%, and specificity of 86.11% versus 55.56% at the So2 cut-off value of 78.85 (P < .001). The false positive rate in GSUS reduced by 30.75%, and the false negative rate diminished by 4.16% with PA /US diagnosis. Finally, the So2 on both sides tissues of malignant lesions are lower than that of benign lesions (P < .01). CONCLUSION PA imaging allows for the assessment of So2 within the lesions of breast lesion patients, thereby facilitating a superior distinction between benign and malignant lesions.
Collapse
Affiliation(s)
- Zhibin Huang
- Department of Ultrasound, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen, 518020, China
| | - Hongtian Tian
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong, China
| | - Hui Luo
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong, China
| | - Keen Yang
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong, China
| | - Jing Chen
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong, China
| | - Guoqiu Li
- Department of Ultrasound, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen, 518020, China; Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong, China
| | - Zhimin Ding
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong, China
| | - Yuwei Luo
- Department of Breast Surgery, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong, China; Department of General Surgery, Shenzhen People's Hospital, Shenzhen 518020, Guangdong, China
| | - Shuzhen Tang
- Department of Ultrasound, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen, 518020, China; Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong, China
| | - Jinfeng Xu
- Department of Ultrasound, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen, 518020, China; Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong, China
| | - Huaiyu Wu
- Department of Ultrasound, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen, 518020, China; Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong, China.
| | - Fajin Dong
- Department of Ultrasound, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen, 518020, China; Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong, China.
| |
Collapse
|
6
|
Peng X, Dentinger A, Kewalramani S, Xu Z, Gray S, Ghose S, Tan YT, Yang Z, Jo J, Chamberland D, Xu G, Abdulaziz N, Gandikota G, Mills D, Wang X. An Automatic 3-D Ultrasound and Photoacoustic Combined Imaging System for Human Inflammatory Arthritis. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2023; 70:1691-1702. [PMID: 37379174 PMCID: PMC10754277 DOI: 10.1109/tuffc.2023.3290824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Aiming at a point-of-care device for rheumatology clinics, we developed an automatic 3-D imaging system combining the emerging photoacoustic (PA) imaging with conventional Doppler ultrasound (US) for detecting human inflammatory arthritis. This system is based on a commercial-grade GE HealthCare (GEHC, Chicago, IL, USA) Vivid E95 US machine and a Universal Robot UR3 robotic arm. This system automatically locates the patient's finger joints from a photograph taken by an overhead camera powered by an automatic hand joint identification method, followed by the robotic arm moving the imaging probe to the targeted joint to scan and obtain 3-D PA and Doppler US images. The GEHC US machine was modified to enable high-speed, high-resolution PA imaging while maintaining the features available on the system. The commercial-grade image quality and the high sensitivity in detecting inflammation in peripheral joints via PA technology hold great potential to significantly benefit clinical care of inflammatory arthritis in a novel way.
Collapse
|
7
|
Zhang Z, Wang R, Xue H, Knoedler S, Geng Y, Liao Y, Alfertshofer M, Panayi AC, Ming J, Mi B, Liu G. Phototherapy techniques for the management of musculoskeletal disorders: strategies and recent advances. Biomater Res 2023; 27:123. [PMID: 38017585 PMCID: PMC10685661 DOI: 10.1186/s40824-023-00458-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 10/28/2023] [Indexed: 11/30/2023] Open
Abstract
Musculoskeletal disorders (MSDs), which include a range of pathologies affecting bones, cartilage, muscles, tendons, and ligaments, account for a significant portion of the global burden of disease. While pharmaceutical and surgical interventions represent conventional approaches for treating MSDs, their efficacy is constrained and frequently accompanied by adverse reactions. Considering the rising incidence of MSDs, there is an urgent demand for effective treatment modalities to alter the current landscape. Phototherapy, as a controllable and non-invasive technique, has been shown to directly regulate bone, cartilage, and muscle regeneration by modulating cellular behavior. Moreover, phototherapy presents controlled ablation of tumor cells, bacteria, and aberrantly activated inflammatory cells, demonstrating therapeutic potential in conditions such as bone tumors, bone infection, and arthritis. By constructing light-responsive nanosystems, controlled drug delivery can be achieved to enable precise treatment of MSDs. Notably, various phototherapy nanoplatforms with integrated imaging capabilities have been utilized for early diagnosis, guided therapy, and prognostic assessment of MSDs, further improving the management of these disorders. This review provides a comprehensive overview of the strategies and recent advances in the application of phototherapy for the treatment of MSDs, discusses the challenges and prospects of phototherapy, and aims to promote further research and application of phototherapy techniques.
Collapse
Affiliation(s)
- Zhenhe Zhang
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, China
| | - Rong Wang
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China
| | - Hang Xue
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, China
| | - Samuel Knoedler
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02152, USA
- Institute of Regenerative Biology and Medicine, Helmholtz Zentrum München, Max-Lebsche-Platz 31, 81377, Munich, Germany
| | - Yongtao Geng
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, China
| | - Yuheng Liao
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, China
| | - Michael Alfertshofer
- Division of Hand, Plastic and Aesthetic Surgery, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Adriana C Panayi
- Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02152, USA
- Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwig-Guttmann-Strasse 13, 67071, Ludwigshafen, Rhine, Germany
| | - Jie Ming
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China.
| | - Bobin Mi
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China.
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, China.
| | - Guohui Liu
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China.
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, China.
| |
Collapse
|
8
|
Carrino JA. Advances in Musculoskeletal Imaging: It is Tough to Make Predictions, Especially About the Future, But Here Goes. Radiology 2023; 308:e230642. [PMID: 37642567 DOI: 10.1148/radiol.230642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Affiliation(s)
- John A Carrino
- From the Department of Radiology and Imaging, Weill Medicine, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021
| |
Collapse
|
9
|
Peng X, Xu Z, Dentinger A, Kewalramani S, Jo J, Xu G, Chamberland D, Abdulaziz N, Gandikota G, Mills D, Wang X. Longitudinal volumetric assessment of inflammatory arthritis via photoacoustic imaging and Doppler ultrasound imaging. PHOTOACOUSTICS 2023; 31:100514. [PMID: 37255965 PMCID: PMC10225933 DOI: 10.1016/j.pacs.2023.100514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/26/2023] [Accepted: 05/20/2023] [Indexed: 06/01/2023]
Abstract
Aiming at clinical translation, we developed an automatic 3D imaging system combining the emerging photoacoustic imaging with conventional Doppler ultrasound for detecting inflammatory arthritis. This system was built with a GE HealthCare (GEHC) Vivid™ E95 ultrasound system and a Universal Robot UR3 robotic arm. In this work, the performance of this system was examined with a longitudinal study utilizing a clinically relevant adjuvant induced arthritis (AIA) murine model. After adjuvant injection, daily imaging of the rat ankle joints was conducted until joint inflammation was obvious based on visual inspection. Processed imaging results and statistical analyses indicated that both the hyperemia (enhanced blood volume) detected by photoacoustic imaging and the enhanced blood flow detected by Doppler ultrasound reflected the progress of joint inflammation. However, photoacoustic imaging, by leveraging the highly sensitive optical contrast, detected inflammation earlier than Doppler ultrasound, and also showed changes that are more statistically significant. This side-by-side comparison between photoacoustic imaging and Doppler ultrasound using the same commercial grade GEHC ultrasound machine demonstrates the advantage and potential value of the emerging photoacoustic imaging for rheumatology clinical care of arthritis.
Collapse
Affiliation(s)
- Xiaorui Peng
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Zhanpeng Xu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | | | - Shivangi Kewalramani
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Janggun Jo
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Guan Xu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - David Chamberland
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Nada Abdulaziz
- Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Girish Gandikota
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - David Mills
- General Electric Research, Niskayuna, NY, USA
| | - Xueding Wang
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
10
|
Wang Z, Tong Z, Chen H, Nie G, Hu J, Liu W, Wang E, Yuan B, Wang Z, Hu J. Photoacoustic/ultrasonic dual-mode imaging for monitoring angiogenesis and synovial erosion in rheumatoid arthritis. PHOTOACOUSTICS 2023; 29:100458. [PMID: 36816882 PMCID: PMC9929594 DOI: 10.1016/j.pacs.2023.100458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/03/2023] [Accepted: 02/05/2023] [Indexed: 02/08/2023]
Abstract
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by the formation of new vessels, synovial proliferation and destruction of articular cartilage. However, characteristic early diagnostic and therapeutic monitoring methods are still lacking. We report a study using a photoacoustic/ultrasound (PA/US) dual-mode imaging for RA disease. By establishing a collagen-induced (CIA) RA mouse model to classify disease states based on a subjective grading system, PA/US imaging allows real-time assessment of synovial erosion and vascular opacification within the knee joint in different disease states at high spatial resolution. The system also quantitatively monitors subcutaneous vascular physiology and morphology in the hind paw of mice, measuring the area and photoacoustic signal intensity of vascular proliferation and showing a positive correlation with disease grading. Compared to traditional subjective scoring of arthritis severity, the PA/US imaging is more sensitive i.e., vascular signals and synovial erosion can be observed early in the course of arthritis.
Collapse
Affiliation(s)
- Zhen Wang
- Department of Orthopaedics, The First Affiliated Hospital of Shantou University Medical College, Shantou, PR China
- Orthopaedic Medical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, PR China
| | - Zhuangzhuang Tong
- MOE Key Laboratory of Laser Life Science & Guangdong Provincial Key Laboratory of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, PR China
| | - Hongjiang Chen
- Department of Orthopaedics, The First Affiliated Hospital of Shantou University Medical College, Shantou, PR China
- Orthopaedic Medical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, PR China
| | - Guangshuai Nie
- Department of Orthopaedics, The First Affiliated Hospital of Shantou University Medical College, Shantou, PR China
- Orthopaedic Medical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, PR China
| | - Jia Hu
- Department of Orthopaedics, The First Affiliated Hospital of Shantou University Medical College, Shantou, PR China
- Orthopaedic Medical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, PR China
| | - Weiyang Liu
- Department of Orthopaedics, The First Affiliated Hospital of Shantou University Medical College, Shantou, PR China
- Orthopaedic Medical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, PR China
| | - Erqi Wang
- MOE Key Laboratory of Laser Life Science & Guangdong Provincial Key Laboratory of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, PR China
| | - Bo Yuan
- MOE Key Laboratory of Laser Life Science & Guangdong Provincial Key Laboratory of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, PR China
| | - Zhiyang Wang
- MOE Key Laboratory of Laser Life Science & Guangdong Provincial Key Laboratory of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou, PR China
- Corresponding author.
| | - Jun Hu
- Department of Orthopaedics, The First Affiliated Hospital of Shantou University Medical College, Shantou, PR China
- Orthopaedic Medical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, PR China
- Correspondence to: Department of Orthopaedics, First Affiliated Hospital of Shantou University Medical College, Shantou, PR China.
| |
Collapse
|