Objective Primary liver cancer,predominantly hepatocellular carcinoma(HCC),is a significant global health issue,ranking as the sixth most diagnosed cancer and the third leading cause of cancer-related mortality.Accura...Objective Primary liver cancer,predominantly hepatocellular carcinoma(HCC),is a significant global health issue,ranking as the sixth most diagnosed cancer and the third leading cause of cancer-related mortality.Accurate and early diagnosis of HCC is crucial for effective treatment,as HCC and non-HCC malignancies like intrahepatic cholangiocarcinoma(ICC)exhibit different prognoses and treatment responses.Traditional diagnostic methods,including liver biopsy and contrast-enhanced ultrasound(CEUS),face limitations in applicability and objectivity.The primary objective of this study was to develop an advanced,lightweighted classification network capable of distinguishing HCC from other non-HCC malignancies by leveraging the automatic analysis of brightness changes in CEUS images.The ultimate goal was to create a user-friendly and cost-efficient computer-aided diagnostic tool that could assist radiologists in making more accurate and efficient clinical decisions.Methods This retrospective study encompassed a total of 161 patients,comprising 131 diagnosed with HCC and 30 with non-HCC malignancies.To achieve accurate tumor detection,the YOLOX network was employed to identify the region of interest(ROI)on both B-mode ultrasound and CEUS images.A custom-developed algorithm was then utilized to extract brightness change curves from the tumor and adjacent liver parenchyma regions within the CEUS images.These curves provided critical data for the subsequent analysis and classification process.To analyze the extracted brightness change curves and classify the malignancies,we developed and compared several models.These included one-dimensional convolutional neural networks(1D-ResNet,1D-ConvNeXt,and 1D-CNN),as well as traditional machine-learning methods such as support vector machine(SVM),ensemble learning(EL),k-nearest neighbor(KNN),and decision tree(DT).The diagnostic performance of each method in distinguishing HCC from non-HCC malignancies was rigorously evaluated using four key metrics:area under the receiver operating characteristic(AUC),accuracy(ACC),sensitivity(SE),and specificity(SP).Results The evaluation of the machine-learning methods revealed AUC values of 0.70 for SVM,0.56 for ensemble learning,0.63 for KNN,and 0.72 for the decision tree.These results indicated moderate to fair performance in classifying the malignancies based on the brightness change curves.In contrast,the deep learning models demonstrated significantly higher AUCs,with 1D-ResNet achieving an AUC of 0.72,1D-ConvNeXt reaching 0.82,and 1D-CNN obtaining the highest AUC of 0.84.Moreover,under the five-fold cross-validation scheme,the 1D-CNN model outperformed other models in both accuracy and specificity.Specifically,it achieved accuracy improvements of 3.8%to 10.0%and specificity enhancements of 6.6%to 43.3%over competing approaches.The superior performance of the 1D-CNN model highlighted its potential as a powerful tool for accurate classification.Conclusion The 1D-CNN model proved to be the most effective in differentiating HCC from non-HCC malignancies,surpassing both traditional machine-learning methods and other deep learning models.This study successfully developed a user-friendly and cost-efficient computer-aided diagnostic solution that would significantly enhances radiologists’diagnostic capabilities.By improving the accuracy and efficiency of clinical decision-making,this tool has the potential to positively impact patient care and outcomes.Future work may focus on further refining the model and exploring its integration with multimodal ultrasound data to maximize its accuracy and applicability.展开更多
BACKGROUND Contrast-enhanced ultrasonography(CEUS)is utilized to assess the therapeutic efficacy of interventional therapy in liver cancer patients,offering insights into tumor blood flow changes,angiogenesis,and tumo...BACKGROUND Contrast-enhanced ultrasonography(CEUS)is utilized to assess the therapeutic efficacy of interventional therapy in liver cancer patients,offering insights into tumor blood flow changes,angiogenesis,and tumor markers.AIM To evaluate the use of CEUS in examining the effectiveness of interventional therapy for liver cancer,we aim to investigate its diagnostic utility for tumor perfusion patterns,microvessel density,perfusion recovery,blood flow enhancement response,and alterations in tumor markers among patients receiving interventional therapy for liver cancer.METHODS The study involved 124 patients who underwent interventional therapy for liver cancer at Guangzhou First People’s Hospital from January 2022 to February 2024.All patients were examined using CEUS before treatment and at 1 month,3 months,and 6 months,and the concentrations of tumor markers were collected and statistically analyzed using Statistical Package for the Social Sciences 25.0.Receiver operating characteristic(ROC)curves were used to evaluate the diagnostic efficacy of CEUS and analyze its sensitivity,specificity,and correlation with clinical indicators.RESULTS Before treatment,tumor blood flow was primarily enhanced.After treatment,enhanced perfusion declined,while uniform and non-uniform perfusion increased,indicating reduced tumor activity.Enhanced perfusion decreased from 68.25%before treatment to 53.75%at 6 months post-treatment(F=6.123,P=0.016),indicating reduced tumor activity.The microvessel density of the tumors decreased significantly after treatment(P<0.05),and the proportion of low microvessel density increased.After treatment,perfusion recovery in the tumor area improved,the proportion of complete and partial responses gradually increased,and the proportion of stable lesions decreased(P<0.05).The levels of alphafetoprotein,carcinoembryonic antigen,and carbohydrate antigen 19-9 decreased by 68.7%,30.4%,and 41.6%,respectively,at 6 months post-treatment(P<0.05).CEUS showed a sensitivity of 85.72%,specificity of 92.31%,and area under the curve of 0.911(95%CI:0.883–0.939)for evaluating treatment response.ROC curve analysis showed that CEUS had high sensitivity and specificity and could effectively evaluate the efficacy of interventional therapy for liver cancer.CONCLUSION CEUS has high diagnostic value in evaluating therapeutic effects in patients with liver cancer following interventional therapy.It can reflect changes in tumor blood flow,angiogenesis,and tumor marker levels,providing an effective basis for real-time monitoring of treatment outcomes.展开更多
Liver transplantation is the primary therapeutic choice for end-stage liver disease.Currently,biliary complications are among the main factors affecting the survival rate and quality of life of liver transplant recipi...Liver transplantation is the primary therapeutic choice for end-stage liver disease.Currently,biliary complications are among the main factors affecting the survival rate and quality of life of liver transplant recipients.Nevertheless,the clinical manifestations of biliary complications following liver transplantation are often non-specific,making early diagnosis and timely treatment crucial for improving patient outcomes.Ultrasound is the preferred imaging method following liver transplantation.Importantly,contrast-enhanced ultrasound,with the adminis-tration of contrast agents,can improve the resolution of biliary images and enable real-time,dynamic visualization of microcirculation perfusion in the biliary system and surrounding tissues.The present article describes the normal ultra-sonic features of the biliary system following liver transplantation and briefly reviews the progress in the ultrasonic diagnosis of common biliary complications,including anastomotic biliary strictures,non-anastomotic biliary strictures,biliary leakage,biloma,and bile sludge/bile stone.展开更多
Background:This study evaluates the efficacy of gabexate mesylate thermosensitive in-situ gel(GMTI) in the treatment of beagle grade Ⅲ pancreatic trauma(PT) with the assistance of contrast-enhanced ultrasound(CEUS) a...Background:This study evaluates the efficacy of gabexate mesylate thermosensitive in-situ gel(GMTI) in the treatment of beagle grade Ⅲ pancreatic trauma(PT) with the assistance of contrast-enhanced ultrasound(CEUS) and investigates its mechanism of action.Methods:A grade Ⅲ PT model consisting of 15 beagle dogs with severed main pancreatic ducts was created and treated with cephalic vein injection of gabexate mesylate(GM)(1.54mL/10kg,TID) and peripancreatic injection of GMTI(4.63 mL/10 kg,QD) guided by CEUS within 24h post-surgery.Ascites and serum levels of amylase(AMY),lipase(LPS),C-reactive protein(CRP),interleukin(IL)-6,tumor necrosis factor(TNF)-α,and urinary trypsinogen activating peptide(TAP) were detected by ELISA.Histopathological changes in the canine pancreas were observed by Hematoxylin and Eosin staining.Results:CEUS accurately displayed pancreatic lesions and guided catheterisation.Compared to the control group,the ascites was significantly reduced after treatment(p<0.01).AMY and LPS ascites significantly decreased on post-operative 1st and 2nd day(p<0.01).The levels of AMY,LPS,CRP,IL-6,and TNF-α in serum were decreased(p<0.05 or p <0.01).Urinary TAP was decreased 1 and 2 days after treatment(p<0.05or p<0.01,respectively).In the control group,pancreatic tissue necrosis was evident in the wound area.Normal glandular cell structures and fibrous tissue hyperplasia were observed in the wound area after GMTI treatment.The GMTI group performed better than the GM group in improving pancreatic histology and reducing AMY levels in the early post-operative period.Conclusion:Guided by CEUS,daily peripancreatic injections of GMTI in Beagles effectively inhibit pancreatic enzyme activity and aid in the adjuvant treatment of pancreatic trauma.展开更多
BACKGROUND The expression level of Ki-67 and the degree of differentiation in pancreatic cancer determine tumor aggressiveness and patient prognosis,which holds significant implications for clinical decision-making.A ...BACKGROUND The expression level of Ki-67 and the degree of differentiation in pancreatic cancer determine tumor aggressiveness and patient prognosis,which holds significant implications for clinical decision-making.A major challenge in preoperative pancreatic ductal adenocarcinoma management is predicting tumor malignancy.Contrast-enhanced ultrasound(CEUS),a dynamic imaging technique based on blood pool visualization,can reveal lesion vasculature and provide quantitative perfusion data reflecting angiogenesis.By tracking contrast agent kinetics,CEUS offers non-invasive insights into tumor vascularization,helping assess malig-nancy potential.AIM To investigate the correlation between Ki-67 and pancreatic cancer differentiation using CEUS quantitative parameters and evaluated their diagnostic accuracy.METHODS This retrospective study analyzed pancreatic cancer patients who underwent CEUS and pathological confirmation.Pathological differentiation,clinical data,and quantitative CEUS parameters[maximum intensity(IMAX),rise time(RT),rise slope 50%(Rs50),rise slope 10%-90%(Rs1090),etc.]were collected.Based on Ki-67 expression(<50%vs≥50%),patients were divided into low-and high-expression groups.The study evaluated correlations between Ki-67 expression,differentiation degree,and CEUS quantitative parameters to assess tumor aggressiveness.RESULTS Among 54 patients(25 high Ki-67,29 low Ki-67),significant differences(P<0.05)were observed in Rs50,IMAX,wash-out area under the curve(WoutAUC),wash-in and out area under curve,and Rs1090 between high and low Ki-67 groups.High-expression patients showed elevated Rs50,IMAX,WoutAUC,and area under the curve(AUC),while RT and falling slope 50%(Fs50)were lower.Rs1090 demonstrated the highest diagnostic accuracy(AUC=0.863,sensitivity=0.92,specificity=0.759).Fs50 was effective in low Ki-67 detection(AUC=0.838).No correlation was found between enhancement patterns and Ki-67 or differentiation.CONCLUSION CEUS parameters(Rs50,IMAX,WoutAUC,Rs1090)strongly correlate with Ki-67,aiding non-invasive pancreatic cancer assessment.Rs1090/IMAX predict high Ki-67;Fs50 identifies low Ki-67,supporting CEUS for tumor aggressiveness evaluation.展开更多
Objective:To systematically evaluate global research trends on contrast-enhanced ultrasound(CEUS)in tumor diagnosis using bibliometric methods.Methods:Publications from January 2000 to June 2025 were retrieved from th...Objective:To systematically evaluate global research trends on contrast-enhanced ultrasound(CEUS)in tumor diagnosis using bibliometric methods.Methods:Publications from January 2000 to June 2025 were retrieved from the Web of Science Core Collection(SCI-EXPANDED).Only English-language articles and reviews were included.A total of 3,493 records were analyzed.VOSviewer 1.6.20 were used for bibliometric and visualization analyses,covering annual output,countries and institutions,authors,journals,keyword co-occurrence,collaboration networks,and co-citation patterns.Results:The number of publications demonstrated steady growth with acceleration after 2018,peaking in 2021 and 2023(>350 papers/year).Dietrich Christoph F.was the most productive and influential author,while Chinese scholars(e.g.,Dong Yi,Wang Wen-Ping)and institutions such as Sun Yat-sen University and Fudan University emerged as leading contributors.European journals,particularly Ultrasound in Medicine and Biology and European Radiology,showed high academic influence.Keyword analysis revealed liver cancer,especially hepatocellular carcinoma,as the dominant research theme,with expanding applications in breast,renal,and prostate tumors.Collaboration networks highlighted strong partnerships between China and Europe,whereas North American participation remained limited.Co-citation analysis indicated that a small number of highly cited studies shaped the intellectual foundation of the field.Conclusion:CEUS research in tumor diagnosis has expanded rapidly,characterized by concentrated leadership,thematic diversification,and strengthening international collaboration.With advances in artificial intelligence,super-resolution imaging,and novel contrast agents,CEUS is expected to evolve from a diagnostic tool into an integrated platform for tumor detection,treatment monitoring,and personalized cancer care.展开更多
BACKGROUND Colorectal cancer stands among the most prevalent digestive system malignancies.The microsatellite instability(MSI)profile plays a crucial role in determining patient outcomes and therapy responsiveness.Tra...BACKGROUND Colorectal cancer stands among the most prevalent digestive system malignancies.The microsatellite instability(MSI)profile plays a crucial role in determining patient outcomes and therapy responsiveness.Traditional MSI evaluation methods require invasive tissue sampling,are lengthy,and can be compromised by intratumoral heterogeneity.AIM To establish a non-invasive technique utilizing dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)radiomics and machine learning algorithms to determine MSI status in patients with intermediate-stage rectal cancer.METHODS This retrospective analysis examined 120 individuals diagnosed with stage II/III rectal cancer[30 MSI-high(MSI-H)and 90 microsatellite stability(MSS)/MSI-low(MSI-L)cases].We extracted comprehensive radiomics signatures from DCE-MRI scans,encompassing textural parameters that reflect tumor heterogeneity,shapebased metrics,and histogram-derived statistical values.Least absolute shrinkage and selection operator regression facilitated feature selection,while predictive frameworks were developed using various classification algorithms(logistic regression,support vector machine,and random forest).Performance assessment utilized separate training and validation cohorts.RESULTS Our investigation uncovered distinctive imaging characteristics between MSI-H and MSS/MSI-L neoplasms.MSIH tumors exhibited significantly elevated entropy values(7.84±0.92 vs 6.39±0.83,P=0.004),enhanced surface-tovolume proportions(0.72±0.14 vs 0.58±0.11,P=0.008),and heightened signal intensity variation(3642±782 vs 2815±645,P=0.007).The random forest model demonstrated superior classification capability with area under the curves(AUCs)of 0.891 and 0.896 across training and validation datasets,respectively.An integrated approach combining radiomics with clinical parameters further enhanced performance metrics(AUC 0.923 and 0.914),achieving 88.5%sensitivity alongside 87.2%specificity.CONCLUSION DCE-MRI radiomics features interpreted through machine learning frameworks offer an effective strategy for MSI status assessment in intermediate-stage rectal cancer.展开更多
BACKGROUND Rectal cancer requires accurate preoperative assessment of T stage and differentiation grade for treatment planning.Traditional imaging and serum markers have limitations in diagnostic accuracy.AIM To evalu...BACKGROUND Rectal cancer requires accurate preoperative assessment of T stage and differentiation grade for treatment planning.Traditional imaging and serum markers have limitations in diagnostic accuracy.AIM To evaluate the predictive value of dynamic contrast-enhanced-magnetic resonance imaging(DCE-MRI)parameters and serum biomarkers[carbohydrate antigen(CA)19-9,CA125]for determining T stage and differentiation grade in rectal cancer.METHODS We conducted a retrospective review of clinical data from 126 patients who were pathologically diagnosed with rectal cancer between January 2021 to June 2024.Each patient underwent DCE-MRI scans and serum tests for CA19-9 and CA125.Receiver operating characteristic curves were utilized to assess the diagnostic value of DCE-MRI parameters,including volume transfer constant(Ktrans),rate constant(Kep),and volume fraction of extravascular extracellular space(Ve),as well as serum biomarkers for staging and grading rectal cancer.The DeLong test algorithm was employed to evaluate differences in diagnostic performance among the various indicators.RESULTS There were statistically higher levels of Ktrans,Ve,CA19-9,and CA125 serum concentrations of patients with advanced T stages and on poorly differentiated tumors than that in patients with low stages and moderate to high differentiation(P<0.05).Combined use of Ktrans and Ve for T stage diagnosis showed an area under the curve(AUC)of 0.892[95%confidence interval(CI):0.832-0.952],which increased to 0.923(95%CI:0.865-0.981)when combined with serum biomarkers.For grades differentiation,the combined DCE-MRI parameters had an AUC of 0.883(95%CI:0.821-0.945),which rose to 0.912(95%CI:0.855-0.969)when combined with serum markers.According to the Delong test,the combined diagnostic method performed better than a single diagnostic method(P<0.05).CONCLUSION The combined application of DCE-MRI functional parameters and serum tumor markers can significantly improve the diagnostic accuracy of T staging and differentiation degree of rectal cancer,providing a new approach to improve the preoperative assessment system of rectal cancer.This combined diagnostic model has important clinical application value,but further validation is needed through large-scale multicenter studies.展开更多
AIM To assess the utility of NLR,PLR,IMT and contrast-enhanced ultrasound(CEUS)aspredictive markers for monitoring inflammatory responses and the disease activity in cardiac involvementin Takayasu’s arteritis.METHODS...AIM To assess the utility of NLR,PLR,IMT and contrast-enhanced ultrasound(CEUS)aspredictive markers for monitoring inflammatory responses and the disease activity in cardiac involvementin Takayasu’s arteritis.METHODS A cohort retrospective study encompassing 86 patients(43 withcardiac compromise and 43 without)was conducted.A comparative analysis of NLR,PLR,IMT,andCEUS between TA patients with and without cardiac compromise was undertaken.RESULTS The NLR and PLR of the heart damage group were significantly higher than those of the non heart damagegroup(2.9±1.0 vs.2.1±0.8,P<0.01;166±79 vs.117±51,P<0.01).The IMT and CEUS of the heartdamage group were significantly higher than those of the TA non heart damage group(2.6±0.6 vs.1.5±0.4,P<0.01;2.6±0.5 vs.1.6±0.6,P<0.01).The NLR level of the heart damage group was positivelycorrelated with CRP(r=0.42,P<0.01),and PLR was positively correlated with CRP and CEUS(r=0.34,P<0.05;r=0.35,P<0.05).The results of multiple logistic regression analysis showed that NLR,IMT,andCEUS were independent risk factors for TA and cardiac damage.The area under the ROC curve for NLRto determine cardiac damage is 0.865,with a cut-off value of 2.265,a sensitivity of 69.8%,and aspecificity of 90.7%.The area under the ROC curve for determining cardiac damage using PLR is 0.812,with a cut-off value of 111.275,a sensitivity of 76.7%,and a specificity of 79.1%.CONCLUSION NLR and PLR,in conjunction with contrast-enhanced ultrasound,can be employed to assessinflammatory response and the disease activity in cardiac involvement in Takayasu’s arteritis.展开更多
BACKGROUND The role of cerebral microvascular dysfunction in early cognitive impairment and dementia has become increasingly recognized.Furthermore,pathological changes in both Alzheimer’s disease and vascular dement...BACKGROUND The role of cerebral microvascular dysfunction in early cognitive impairment and dementia has become increasingly recognized.Furthermore,pathological changes in both Alzheimer’s disease and vascular dementia are almost always associated with cerebral hemodynamic deficits.AIM To investigate the diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)assessment of the blood-brain barrier(BBB)in combination with relevant plasma biomarkers for mild cognitive impairment(MCI).METHODS This study selected 50 patients with non-amnestic MCI(na-MCI group),52 patients with amnestic MCI(a-MCI group),and 55 healthy elderly controls(control group).The Chinese version of the Montreal cognitive assessment(MoCA),auditory verbal learning test(AVLT),Hamilton anxiety/depression scale(HAMA/HAMD),and activity of daily living(ADL)scales were used to analyze the characteristics of mental and behavioral symptoms of patients with MCI.The DCE-MRI technique was used to assess the contrast enhancement kinetics.The Patlak model was utilized to analyze the BBB permeability(volume transfer constants).Further,fasting blood was was used to quantify plasma homocysteine(Hcy),β-amyloid protein(Aβ)40,Aβ42,human phosphorylated tau-181 protein(p-tau181),intercellular adhesion molecule-1(ICAM-1),vascular cell adhesion molecule-1(VCAM-1),and plasminogen activator inhibitor-1(PAI-1)levels,as well as serum neurofilament light chain(NFL)and glial fibrillary acidic protein(GFAP)concentrations.RESULTS The na-MCI and a-MCI groups demonstrated significantly lower MoCA and AVLT-Huashan version scores,and statistically higher HAMA,HAMD,and ADL scores compared to the control group.Moreover,the a-MCI group showed notably higher HAMA,HAMD,and ADL scores compared to the na-MCI group.Cranial MRI results revealed significant disparities in cerebral blood flow in the left and right frontal lobes,temporal lobes,hippocampi,cuneus,precuneus,parietal lobes,basal ganglia,and occipital lobes between the a-MCI and na-MCI groups.Compared to healthy controls,patients with MCI demonstrated a smaller amplitude of hippocampal contrast enhancement kinetics and a slower decay rate,indicating smaller vascular volume and increased BBB permeability.Further,Hcy,p-tau181,ICAM-1,VCAM-1,PAI-1,and NFL levels were substantially higher in the a-MCI group than in the na-MCI group,whereas the Aβ42 level was significantly lower.We did not observe any significant differences in Aβ40 and GFAP levels.CONCLUSION Patients with MCI may have experienced cerebrovascular system changes in the hippocampal region.Disorders associated with changes in cerebral blood supply may begin before pathophysiological changes are visible by imaging,which provides references for the assessment and treatment of patients with cognitive disorders.Further,DCE-MRI provides a noninvasive approach to diagnose subtle BBB leakage associated with cerebrovascular pathology.展开更多
BACKGROUND Microvascular invasion(MVI)is a significant indicator of the aggressive behavior of hepatocellular carcinoma(HCC).Expanding the surgical resection margin and performing anatomical liver resection may improv...BACKGROUND Microvascular invasion(MVI)is a significant indicator of the aggressive behavior of hepatocellular carcinoma(HCC).Expanding the surgical resection margin and performing anatomical liver resection may improve outcomes in patients with MVI.However,no reliable preoperative method currently exists to predict MVI status or to identify patients at high-risk group(M2).AIM To develop and validate models based on contrast-enhanced computed tomo-graphy(CECT)radiomics and clinicoradiological factors to predict MVI and identify M2 among patients with hepatitis B virus-related HCC(HBV-HCC).The ultimate goal of the study was to guide surgical decision-making.METHODS A total of 270 patients who underwent surgical resection were retrospectively analyzed.The cohort was divided into a training dataset(189 patients)and a validation dataset(81)with a 7:3 ratio.Radiomics features were selected using intra-class correlation coefficient analysis,Pearson or Spearman’s correlation analysis,and the least absolute shrinkage and selection operator algorithm,leading to the construction of radscores from CECT images.Univariate and multivariate analyses identified significant clinicoradiological factors and radscores associated with MVI and M2,which were subsequently incorporated into predictive models.The models’performance was evaluated using calibration,discrimination,and clinical utility analysis.RESULTS Independent risk factors for MVI included non-smooth tumor margins,absence of a peritumoral hypointensity ring,and a high radscore based on delayed-phase CECT images.The MVI prediction model incorporating these factors achieved an area under the curve(AUC)of 0.841 in the training dataset and 0.768 in the validation dataset.The M2 prediction model,which integrated the radscore from the 5 mm peritumoral area in the CECT arterial phase,α-fetoprotein level,enhancing capsule,and aspartate aminotransferase level achieved an AUC of 0.865 in the training dataset and 0.798 in the validation dataset.Calibration and decision curve analyses confirmed the models’good fit and clinical utility.CONCLUSION Multivariable models were constructed by combining clinicoradiological risk factors and radscores to preoper-atively predict MVI and identify M2 among patients with HBV-HCC.Further studies are needed to evaluate the practical application of these models in clinical settings.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(ICC)represent the predominant histological types of primary liver cancer,comprising over 99%of cases.Given their differing biological behavio...BACKGROUND Hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(ICC)represent the predominant histological types of primary liver cancer,comprising over 99%of cases.Given their differing biological behaviors,prognoses,and treatment strategies,accurately differentiating between HCC and ICC is crucial for effective clinical management.Radiomics,an emerging image processing technology,can automatically extract various quantitative image features that may elude the human eye.Reports on the application of ultrasound(US)-based radiomics methods in distinguishing HCC from ICC are limited.METHODS In our retrospective study,we included a total of 280 patients who were diagnosed with ICC(n=140)and HCC(n=140)between 1999 and 2019.These patients were divided into training(n=224)and testing(n=56)groups for analysis.US images and relevant clinical characteristics were collected.We utilized the XGBoost method to extract and select radiomics features and further employed a random forest algorithm to establish ultrasomics models.We compared the diagnostic performances of these ultrasomics models with that of radiologists.RESULTS Four distinct ultrasomics models were constructed,with the number of selected features varying between models:13 features for the US model;15 for the contrast-enhanced ultrasound(CEUS)model;13 for the combined US+CEUS model;and 21 for the US+CEUS+clinical data model.The US+CEUS+clinical data model yielded the highest area under the receiver operating characteristic curve(AUC)among all models,achieving an AUC of 0.973 in the validation cohort and 0.971 in the test cohort.This performance exceeded even the most experienced radiologist(AUC=0.964).The AUC for the US+CEUS model(training cohort AUC=0.964,test cohort AUC=0.955)was significantly higher than that of the US model alone(training cohort AUC=0.822,test cohort AUC=0.816).This finding underscored the significant benefit of incorporating CEUS information in accurately distin-guishing ICC from HCC.CONCLUSION We developed a radiomics diagnostic model based on CEUS images capable of quickly distinguishing HCC from ICC,which outperformed experienced radiologists.展开更多
Contrast-enhanced endoscopic ultrasound(CH-EUS)can overcome the limi-tations of endoscopic ultrasound-guided acquisition by identifying microvessels inside inhomogeneous tumours and improving the characterization of t...Contrast-enhanced endoscopic ultrasound(CH-EUS)can overcome the limi-tations of endoscopic ultrasound-guided acquisition by identifying microvessels inside inhomogeneous tumours and improving the characterization of these tumours.Despite the initial enthusiasm that oriented needle sampling under CH-EUS guidance could provide better diagnostic yield in pancreatic solid lesions,further studies did not confirm the supplementary values in cases of tissue acquisition guided by CH-EUS.This review details the knowledge based on the available data on contrast-guided procedures.The indications for CH-EUS tissue acquisition include isoechoic EUS lesions with poor visible delineation where CH-EUS can differentiate the lesion vascularisation from the surrounding parenchyma and also the mural nodules within biliopancreatic cystic lesions,which occur in select cases.Additionally,the roles of CH-EUS-guided therapy in patients whose pancreatic fluid collections or bile ducts that have an echogenic content have indications for drainage,and patients who have nonvisualized vessels that need to be highlighted via Doppler EUS are presented.Another indication is represented if there is a need for an immediate assessment of the post-radiofrequency ablation of pancreatic neuroendocrine tumours,in which case CH-EUS can be used to reveal the incomplete tumour destruction.展开更多
BACKGROUND The detection rate of peptic ulcer in children is improving,with development of diagnostic procedures.Gastroscopy is the gold standard for the diagnosis of peptic ulcer,but it is an invasive procedure.Gastr...BACKGROUND The detection rate of peptic ulcer in children is improving,with development of diagnostic procedures.Gastroscopy is the gold standard for the diagnosis of peptic ulcer,but it is an invasive procedure.Gastrointestinal contrast-enhanced ultrasonography(CEUS)has the advantages of being painless,noninvasive,nonradioactive,easy to use,and safe.AIM To investigate the clinical value of CEUS for diagnosis and treatment of peptic ulcer in children.METHODS We investigated 43 children with digestive tract symptoms in our hospital from January 2021 to June 2022.All children were examined by routine ultrasound,gastrointestinal CEUS,and gastroscopy.The pathological results of gastroscopy were taken as the gold standard.Routine ultrasonography was performed before gastrointestinal CEUS.Conventional ultrasound showed the thickness of the gastroduodenal wall,gastric peristalsis,and the adjacent organs and tissues around the abdominal cavity.Gastrointestinal CEUS recorded the thickness of the gastroduodenal wall;the size,location and shape of the ulcer;gastric peristalsis;and adjacent organs and tissues around the abdominal cavity.The results of routine ultrasound and gastrointestinal ultrasound were compared with those of gastroscopy to evaluate the diagnostic results and coincidence rate of routine ultrasound and gastrointestinal CEUS.All children received informed consent from their guardians for CEUS.This study was reviewed and approved by the hospital medical ethics committee.RESULTS Among the 43 children,17(15 male,2 female)were diagnosed with peptic ulcer by gastroscopy.There were 26 children with nonpeptic ulcer.There were eight cases of peptic ulcer and 35 of nonpeptic ulcer diagnosed by conventional ultrasound.The diagnostic coincidence rate of peptic ulcer in children diagnosed by conventional ultrasound was 79.1%(34/43),which was significantly different from that of gastroscopy(P=0.033).It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is low.Fifteen cases of peptic ulcer and 28 of nonpeptic ulcer were diagnosed by CEUS.The diagnostic coincidence rate of peptic ulcer in children was 95.3%(41/43).There was no significant difference between CEUS and gastroscopy(P=0.655).It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is high.CONCLUSION Gastrointestinal CEUS has a high coincidence rate in the diagnosis of peptic ulcer in children,and can be used as a preliminary examination method.展开更多
BACKGROUND Gastric cancer(GC)is the most common malignant tumor and ranks third for cancer-related deaths among the worldwide.The disease poses a serious public health problem in China,ranking fifth for incidence and ...BACKGROUND Gastric cancer(GC)is the most common malignant tumor and ranks third for cancer-related deaths among the worldwide.The disease poses a serious public health problem in China,ranking fifth for incidence and third for mortality.Knowledge of the invasive depth of the tumor is vital to treatment decisions.AIM To evaluate the diagnostic performance of double contrast-enhanced ultrasonography(DCEUS)for preoperative T staging in patients with GC by comparing with multi-detector computed tomography(MDCT).METHODS This single prospective study enrolled patients with GC confirmed by preoperative gastroscopy from July 2021 to March 2023.Patients underwent DCEUS,including ultrasonography(US)and intravenous contrast-enhanced ultrasonography(CEUS),and MDCT examinations for the assessment of preoperative T staging.Features of GC were identified on DCEUS and criteria developed to evaluate T staging according to the 8th edition of AJCC cancer staging manual.The diagnostic performance of DCEUS was evaluated by comparing it with that of MDCT and surgical-pathological findings were considered as the gold standard.RESULTS A total of 229 patients with GC(80 T1,33 T2,59 T3 and 57 T4)were included.Overall accuracies were 86.9%for DCEUS and 61.1%for MDCT(P<0.001).DCEUS was superior to MDCT for T1(92.5%vs 70.0%,P<0.001),T2(72.7%vs 51.5%,P=0.041),T3(86.4%vs 45.8%,P<0.001)and T4(87.7%vs 70.2%,P=0.022)staging of GC.CONCLUSION DCEUS improved the diagnostic accuracy of preoperative T staging in patients with GC compared with MDCT,and constitutes a promising imaging modality for preoperative evaluation of GC to aid individualized treatment decision-making.展开更多
BACKGROUND The incidence and mortality of lung cancer have increased annually.Accurate diagnosis can help improve therapeutic efficacy of interventions and prognosis.Percutaneous lung biopsy is a reliable method for t...BACKGROUND The incidence and mortality of lung cancer have increased annually.Accurate diagnosis can help improve therapeutic efficacy of interventions and prognosis.Percutaneous lung biopsy is a reliable method for the clinical diagnosis of lung cancer.Ultrasound-guided percutaneous lung biopsy technology has been widely promoted and applied in recent years.AIM To investigate the diagnostic value of contrast-enhanced ultrasound(CEUS)-guided percutaneous biopsy in peripheral pulmonary lesions.METHODS We retrospectively collected data on 237 patients with peripheral thoracic focal lesions who underwent puncture biopsy at Wuxi People’s Hospital.The patients were randomly divided into two groups:The CEUS-guided before lesion puncture group(contrast group)and conventional ultrasound-guided group(control group).Analyze the diagnostic efficacy of the puncture biopsy,impact of tumor size,and number of puncture needles and complications were analyzed and compared between the two groups.RESULTS Accurate pathological results were obtained for 92.83%(220/237)of peripheral lung lesions during the first biopsy,with an accuracy rate of 95.8%(113/118)in the contrast group and 89.9%(107/119)in the control group.The difference in the area under the curve(AUC)between the contrast and the control groups was not statistically significant(0.952 vs 0.902,respectively;P>0.05).However,when the lesion diameter≥5 cm,the diagnostic AUC of the contrast group was higher than that of the control group(0.952 vs 0.902,respectively;P<0.05).In addition,the average number of puncture needles in the contrast group was lower than that in the control group(2.58±0.53 vs 2.90±0.56,respectively;P<0.05).CONCLUSION CEUS guidance can enhance the efficiency of puncture biopsy of peripheral pulmonary lesions,especially for lesions with a diameter≥5 cm.Therefore,CEUS guidance has high clinical diagnostic value in puncture biopsy of peripheral focal lung lesions.展开更多
Objective:Complete resection of malignant gliomas is often challenging.Our previous study indicated that intraoperative contrast-enhanced ultrasound(ICEUS)could aid in the detection of residual tumor remnants and the ...Objective:Complete resection of malignant gliomas is often challenging.Our previous study indicated that intraoperative contrast-enhanced ultrasound(ICEUS)could aid in the detection of residual tumor remnants and the total removal of brain lesions.This study aimed to investigate the survival rates of patients undergoing resection with or without the use of ICEUS and to assess the impact of ICEUS on the prognosis of patients with malignant glioma.Methods:A total of 64 patients diagnosed with malignant glioma(WHO grade HI and IV)who underwent surgery between 2012 and 2018 were included.Among them,29 patients received ICEUS.The effects of ICEUS on overall survival(OS)and progression-free survival(PFS)of patients were evaluated.A quantitative analysis was performed to compare ICEUS parameters between gliomas and the surrounding tissues.Results:The ICEUS group showed better survival rates both in OS and PFS than the control group.The univariate analysis revealed that age,pathology and ICEUS were significant prognostic factors for PFS,with only age being a significant prognostic factor for OS.In multivariate analysis,age and ICEUS were significant prognostic factors for both OS and PFS.The quantitative analysis showed that the intensity and transit time of microbubbles reaching the tumors were significantly different from those of microbubbles reaching the surrounding tissue.Conclusion:ICEUS facilitates the identification of residual tumors.Age and ICEUS are prognostic factors for malignant glioma surgery,and use of ICEUS offers a better prognosis for patients with malignant glioma.展开更多
BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a highly malignant and aggressive tumor,and high Ki-67 expression indicates poor histological differentiation and prognosis.Therefore,one of the challenges in diagno...BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a highly malignant and aggressive tumor,and high Ki-67 expression indicates poor histological differentiation and prognosis.Therefore,one of the challenges in diagnosing preoperatively patients with PDAC is predicting the degree of malignancy.Dynamic contrast-enhanced ultrasonography(DCE-US)plays a crucial role in abdominal tumor diagnosis,and can adequately show the microvascular composition within the tumors.However,the relationship between DCE-US and the Ki-67 labelling index remains unclear at the present time.AIM To predict the correlation between Ki-67 expression and the parameters of DCEUS.METHODS Patients with PDAC who underwent DCE-US were retrospectively analyzed.Patients who had received any treatment(radiotherapy or chemotherapy)prior to DCE-US;had incomplete clinical,imaging,or pathologic information;and had poor-quality image analysis were excluded.Correlations between Ki-67 expression and the parameters of DCE-US in patients with PDAC were assessed using Spearman’s rank correlation analysis.The diagnostic performances of these parameters in high Ki-67 expression group were evaluated according to receiver operating characteristic curve.RESULTS Based on the Ki-67 labelling index,30 patients were divided into two groups,i.e.,the high expression group and the low expression group.Among the relative quantitative parameters between the two groups,relative half-decrease time(rHDT),relative peak enhancement,relative wash-in perfusion index and relative wash-in rate were significantly different between two groups(P=0.018,P=0.025,P=0.028,P=0.035,respectively).The DCE-US parameter rHDT was moderately correlated with Ki-67 expression,and rHDT≥1.07 was more helpful in accurately diagnosing high Ki-67 expression,exhibiting a sensitivity and specificity of 53.8%and 94.1%,respectively.CONCLUSION One parameter of DCE-US,rHDT,correlates with high Ki-67 expression.It demonstrates that parameters obtained noninvasively by DCE-US could better predict Ki-67 expression in PDAC preoperatively.展开更多
BACKGROUND Oral contrast-enhanced ultrasound(OCEUS)is widely used in the noninvasive diagnosis and screening of gastric cancer(GC)in China.AIM To investigate the clinical application of OCEUS in evaluating the preoper...BACKGROUND Oral contrast-enhanced ultrasound(OCEUS)is widely used in the noninvasive diagnosis and screening of gastric cancer(GC)in China.AIM To investigate the clinical application of OCEUS in evaluating the preoperative T staging of gastric cancer.METHODS OCEUS was performed before the operation,and standard ultrasound images were retained.The depth of infiltration of GC(T-stage)was evaluated according to the American Joint Committee on Cancer 8th edition of the tumor-nodemetastasis staging criteria.Finally,with postoperative pathological staging as the gold standard reference,the sensitivity,specificity,negative predictive value,positive predictive value,and diagnostic value of OCEUS T staging were evaluated.RESULTS OCEUS achieved diagnostic accuracy rates of 76.6%(T1a),69.6%(T1b),62.7%(T2),60.8%(T3),88.0%(T4a),and 88.7%(T4b),with an average of 75.5%.Ultrasonic T staging sensitivity exceeded 62%,aside from T1b at 40.3%,while specificity was over 91%,except for T3 with 83.5%.The Youden index was above 60%,with T1b and T2 being exceptions.OCEUS T staging corresponded closely with pathology in T4b(kappa>0.75)and moderately in T1a,T1b,T2,T3,and T4a(kappa 0.40-0.75),registering a concordance rate exceeding 84%.CONCLUSION OCEUS was effective,reliable,and accurate in diagnosing the preoperative T staging of GC.As a noninvasive diagnostic technique,OCEUS merits clinical popularization.展开更多
BACKGROUND The incidence of gastric cancer remains high,and it is the sixth most common cancer and the fourth leading cause of cancer deaths worldwide.Oral contrastenhanced ultrasonography is a simple,non-invasive,and...BACKGROUND The incidence of gastric cancer remains high,and it is the sixth most common cancer and the fourth leading cause of cancer deaths worldwide.Oral contrastenhanced ultrasonography is a simple,non-invasive,and painless method for the diagnosis of gastric tumors.AIM To explore the diagnostic value of oral contrast-enhanced ultrasonography for the detection of gastric tumors.METHODS The screening results based on oral contrast-enhanced ultrasonography and electronic gastroscopy were compared with those of the postoperative pathological examination.RESULTS Among 42 patients with gastric tumors enrolled in the study,the diagnostic accordance rate was 95.2%for oral contrast-enhanced ultrasonography(n=40)and 90.5%for electronic gastroscopy(n=38)compared with postoperative pathological examination.The Kappa value of consistency test with pathological findings was 0.812 for oral contrast-enhanced ultrasonography and 0.718 for electronic gastroscopy,and there was no significant difference between them(P=0.397).For the TNM staging of gastric tumors,the accuracy rate of oral contrast enhanced ultrasonography was 81.9%for the overall T staging and 50%,77.8%,100%,and 100%for T1,T2,T3,and T4 staging,respectively.The sensitivity and specificity were both 100%for stages T3 and T4.The diagnostic accuracy rate of oral contrast-enhanced ultrasonography was 93.8%,80%,100%,and 100%for stages N0,N1-N3,M0,and M1,respectively.CONCLUSION The accordance rate of qualitative diagnosis by oral contrast-enhanced ultrasonography is comparable to that of gastroscopy,and it could be used as the preferred method for the early screening of gastric tumors.展开更多
文摘Objective Primary liver cancer,predominantly hepatocellular carcinoma(HCC),is a significant global health issue,ranking as the sixth most diagnosed cancer and the third leading cause of cancer-related mortality.Accurate and early diagnosis of HCC is crucial for effective treatment,as HCC and non-HCC malignancies like intrahepatic cholangiocarcinoma(ICC)exhibit different prognoses and treatment responses.Traditional diagnostic methods,including liver biopsy and contrast-enhanced ultrasound(CEUS),face limitations in applicability and objectivity.The primary objective of this study was to develop an advanced,lightweighted classification network capable of distinguishing HCC from other non-HCC malignancies by leveraging the automatic analysis of brightness changes in CEUS images.The ultimate goal was to create a user-friendly and cost-efficient computer-aided diagnostic tool that could assist radiologists in making more accurate and efficient clinical decisions.Methods This retrospective study encompassed a total of 161 patients,comprising 131 diagnosed with HCC and 30 with non-HCC malignancies.To achieve accurate tumor detection,the YOLOX network was employed to identify the region of interest(ROI)on both B-mode ultrasound and CEUS images.A custom-developed algorithm was then utilized to extract brightness change curves from the tumor and adjacent liver parenchyma regions within the CEUS images.These curves provided critical data for the subsequent analysis and classification process.To analyze the extracted brightness change curves and classify the malignancies,we developed and compared several models.These included one-dimensional convolutional neural networks(1D-ResNet,1D-ConvNeXt,and 1D-CNN),as well as traditional machine-learning methods such as support vector machine(SVM),ensemble learning(EL),k-nearest neighbor(KNN),and decision tree(DT).The diagnostic performance of each method in distinguishing HCC from non-HCC malignancies was rigorously evaluated using four key metrics:area under the receiver operating characteristic(AUC),accuracy(ACC),sensitivity(SE),and specificity(SP).Results The evaluation of the machine-learning methods revealed AUC values of 0.70 for SVM,0.56 for ensemble learning,0.63 for KNN,and 0.72 for the decision tree.These results indicated moderate to fair performance in classifying the malignancies based on the brightness change curves.In contrast,the deep learning models demonstrated significantly higher AUCs,with 1D-ResNet achieving an AUC of 0.72,1D-ConvNeXt reaching 0.82,and 1D-CNN obtaining the highest AUC of 0.84.Moreover,under the five-fold cross-validation scheme,the 1D-CNN model outperformed other models in both accuracy and specificity.Specifically,it achieved accuracy improvements of 3.8%to 10.0%and specificity enhancements of 6.6%to 43.3%over competing approaches.The superior performance of the 1D-CNN model highlighted its potential as a powerful tool for accurate classification.Conclusion The 1D-CNN model proved to be the most effective in differentiating HCC from non-HCC malignancies,surpassing both traditional machine-learning methods and other deep learning models.This study successfully developed a user-friendly and cost-efficient computer-aided diagnostic solution that would significantly enhances radiologists’diagnostic capabilities.By improving the accuracy and efficiency of clinical decision-making,this tool has the potential to positively impact patient care and outcomes.Future work may focus on further refining the model and exploring its integration with multimodal ultrasound data to maximize its accuracy and applicability.
基金Supported by Science and Technology Program of Guangzhou,No.2024A03J1029Science and Technology Program of Chinese Medicine and Integrated Chinese and Western Medicine in Guangzhou,No.20252A010001.
文摘BACKGROUND Contrast-enhanced ultrasonography(CEUS)is utilized to assess the therapeutic efficacy of interventional therapy in liver cancer patients,offering insights into tumor blood flow changes,angiogenesis,and tumor markers.AIM To evaluate the use of CEUS in examining the effectiveness of interventional therapy for liver cancer,we aim to investigate its diagnostic utility for tumor perfusion patterns,microvessel density,perfusion recovery,blood flow enhancement response,and alterations in tumor markers among patients receiving interventional therapy for liver cancer.METHODS The study involved 124 patients who underwent interventional therapy for liver cancer at Guangzhou First People’s Hospital from January 2022 to February 2024.All patients were examined using CEUS before treatment and at 1 month,3 months,and 6 months,and the concentrations of tumor markers were collected and statistically analyzed using Statistical Package for the Social Sciences 25.0.Receiver operating characteristic(ROC)curves were used to evaluate the diagnostic efficacy of CEUS and analyze its sensitivity,specificity,and correlation with clinical indicators.RESULTS Before treatment,tumor blood flow was primarily enhanced.After treatment,enhanced perfusion declined,while uniform and non-uniform perfusion increased,indicating reduced tumor activity.Enhanced perfusion decreased from 68.25%before treatment to 53.75%at 6 months post-treatment(F=6.123,P=0.016),indicating reduced tumor activity.The microvessel density of the tumors decreased significantly after treatment(P<0.05),and the proportion of low microvessel density increased.After treatment,perfusion recovery in the tumor area improved,the proportion of complete and partial responses gradually increased,and the proportion of stable lesions decreased(P<0.05).The levels of alphafetoprotein,carcinoembryonic antigen,and carbohydrate antigen 19-9 decreased by 68.7%,30.4%,and 41.6%,respectively,at 6 months post-treatment(P<0.05).CEUS showed a sensitivity of 85.72%,specificity of 92.31%,and area under the curve of 0.911(95%CI:0.883–0.939)for evaluating treatment response.ROC curve analysis showed that CEUS had high sensitivity and specificity and could effectively evaluate the efficacy of interventional therapy for liver cancer.CONCLUSION CEUS has high diagnostic value in evaluating therapeutic effects in patients with liver cancer following interventional therapy.It can reflect changes in tumor blood flow,angiogenesis,and tumor marker levels,providing an effective basis for real-time monitoring of treatment outcomes.
基金Supported by the Shenzhen Third People’s Hospital Research Fund,No.25270G1043The Basic and Applied Basic Research Foundation of Guangdong Province,No.2025A1515011934.
文摘Liver transplantation is the primary therapeutic choice for end-stage liver disease.Currently,biliary complications are among the main factors affecting the survival rate and quality of life of liver transplant recipients.Nevertheless,the clinical manifestations of biliary complications following liver transplantation are often non-specific,making early diagnosis and timely treatment crucial for improving patient outcomes.Ultrasound is the preferred imaging method following liver transplantation.Importantly,contrast-enhanced ultrasound,with the adminis-tration of contrast agents,can improve the resolution of biliary images and enable real-time,dynamic visualization of microcirculation perfusion in the biliary system and surrounding tissues.The present article describes the normal ultra-sonic features of the biliary system following liver transplantation and briefly reviews the progress in the ultrasonic diagnosis of common biliary complications,including anastomotic biliary strictures,non-anastomotic biliary strictures,biliary leakage,biloma,and bile sludge/bile stone.
文摘Background:This study evaluates the efficacy of gabexate mesylate thermosensitive in-situ gel(GMTI) in the treatment of beagle grade Ⅲ pancreatic trauma(PT) with the assistance of contrast-enhanced ultrasound(CEUS) and investigates its mechanism of action.Methods:A grade Ⅲ PT model consisting of 15 beagle dogs with severed main pancreatic ducts was created and treated with cephalic vein injection of gabexate mesylate(GM)(1.54mL/10kg,TID) and peripancreatic injection of GMTI(4.63 mL/10 kg,QD) guided by CEUS within 24h post-surgery.Ascites and serum levels of amylase(AMY),lipase(LPS),C-reactive protein(CRP),interleukin(IL)-6,tumor necrosis factor(TNF)-α,and urinary trypsinogen activating peptide(TAP) were detected by ELISA.Histopathological changes in the canine pancreas were observed by Hematoxylin and Eosin staining.Results:CEUS accurately displayed pancreatic lesions and guided catheterisation.Compared to the control group,the ascites was significantly reduced after treatment(p<0.01).AMY and LPS ascites significantly decreased on post-operative 1st and 2nd day(p<0.01).The levels of AMY,LPS,CRP,IL-6,and TNF-α in serum were decreased(p<0.05 or p <0.01).Urinary TAP was decreased 1 and 2 days after treatment(p<0.05or p<0.01,respectively).In the control group,pancreatic tissue necrosis was evident in the wound area.Normal glandular cell structures and fibrous tissue hyperplasia were observed in the wound area after GMTI treatment.The GMTI group performed better than the GM group in improving pancreatic histology and reducing AMY levels in the early post-operative period.Conclusion:Guided by CEUS,daily peripancreatic injections of GMTI in Beagles effectively inhibit pancreatic enzyme activity and aid in the adjuvant treatment of pancreatic trauma.
基金Supported by the Liaoning Province Science and Technology Plan Joint Program,No.2024JH2/102600310.
文摘BACKGROUND The expression level of Ki-67 and the degree of differentiation in pancreatic cancer determine tumor aggressiveness and patient prognosis,which holds significant implications for clinical decision-making.A major challenge in preoperative pancreatic ductal adenocarcinoma management is predicting tumor malignancy.Contrast-enhanced ultrasound(CEUS),a dynamic imaging technique based on blood pool visualization,can reveal lesion vasculature and provide quantitative perfusion data reflecting angiogenesis.By tracking contrast agent kinetics,CEUS offers non-invasive insights into tumor vascularization,helping assess malig-nancy potential.AIM To investigate the correlation between Ki-67 and pancreatic cancer differentiation using CEUS quantitative parameters and evaluated their diagnostic accuracy.METHODS This retrospective study analyzed pancreatic cancer patients who underwent CEUS and pathological confirmation.Pathological differentiation,clinical data,and quantitative CEUS parameters[maximum intensity(IMAX),rise time(RT),rise slope 50%(Rs50),rise slope 10%-90%(Rs1090),etc.]were collected.Based on Ki-67 expression(<50%vs≥50%),patients were divided into low-and high-expression groups.The study evaluated correlations between Ki-67 expression,differentiation degree,and CEUS quantitative parameters to assess tumor aggressiveness.RESULTS Among 54 patients(25 high Ki-67,29 low Ki-67),significant differences(P<0.05)were observed in Rs50,IMAX,wash-out area under the curve(WoutAUC),wash-in and out area under curve,and Rs1090 between high and low Ki-67 groups.High-expression patients showed elevated Rs50,IMAX,WoutAUC,and area under the curve(AUC),while RT and falling slope 50%(Fs50)were lower.Rs1090 demonstrated the highest diagnostic accuracy(AUC=0.863,sensitivity=0.92,specificity=0.759).Fs50 was effective in low Ki-67 detection(AUC=0.838).No correlation was found between enhancement patterns and Ki-67 or differentiation.CONCLUSION CEUS parameters(Rs50,IMAX,WoutAUC,Rs1090)strongly correlate with Ki-67,aiding non-invasive pancreatic cancer assessment.Rs1090/IMAX predict high Ki-67;Fs50 identifies low Ki-67,supporting CEUS for tumor aggressiveness evaluation.
文摘Objective:To systematically evaluate global research trends on contrast-enhanced ultrasound(CEUS)in tumor diagnosis using bibliometric methods.Methods:Publications from January 2000 to June 2025 were retrieved from the Web of Science Core Collection(SCI-EXPANDED).Only English-language articles and reviews were included.A total of 3,493 records were analyzed.VOSviewer 1.6.20 were used for bibliometric and visualization analyses,covering annual output,countries and institutions,authors,journals,keyword co-occurrence,collaboration networks,and co-citation patterns.Results:The number of publications demonstrated steady growth with acceleration after 2018,peaking in 2021 and 2023(>350 papers/year).Dietrich Christoph F.was the most productive and influential author,while Chinese scholars(e.g.,Dong Yi,Wang Wen-Ping)and institutions such as Sun Yat-sen University and Fudan University emerged as leading contributors.European journals,particularly Ultrasound in Medicine and Biology and European Radiology,showed high academic influence.Keyword analysis revealed liver cancer,especially hepatocellular carcinoma,as the dominant research theme,with expanding applications in breast,renal,and prostate tumors.Collaboration networks highlighted strong partnerships between China and Europe,whereas North American participation remained limited.Co-citation analysis indicated that a small number of highly cited studies shaped the intellectual foundation of the field.Conclusion:CEUS research in tumor diagnosis has expanded rapidly,characterized by concentrated leadership,thematic diversification,and strengthening international collaboration.With advances in artificial intelligence,super-resolution imaging,and novel contrast agents,CEUS is expected to evolve from a diagnostic tool into an integrated platform for tumor detection,treatment monitoring,and personalized cancer care.
基金Supported by the Natural Science Foundation of Fujian Province,China,No.2022J011460。
文摘BACKGROUND Colorectal cancer stands among the most prevalent digestive system malignancies.The microsatellite instability(MSI)profile plays a crucial role in determining patient outcomes and therapy responsiveness.Traditional MSI evaluation methods require invasive tissue sampling,are lengthy,and can be compromised by intratumoral heterogeneity.AIM To establish a non-invasive technique utilizing dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)radiomics and machine learning algorithms to determine MSI status in patients with intermediate-stage rectal cancer.METHODS This retrospective analysis examined 120 individuals diagnosed with stage II/III rectal cancer[30 MSI-high(MSI-H)and 90 microsatellite stability(MSS)/MSI-low(MSI-L)cases].We extracted comprehensive radiomics signatures from DCE-MRI scans,encompassing textural parameters that reflect tumor heterogeneity,shapebased metrics,and histogram-derived statistical values.Least absolute shrinkage and selection operator regression facilitated feature selection,while predictive frameworks were developed using various classification algorithms(logistic regression,support vector machine,and random forest).Performance assessment utilized separate training and validation cohorts.RESULTS Our investigation uncovered distinctive imaging characteristics between MSI-H and MSS/MSI-L neoplasms.MSIH tumors exhibited significantly elevated entropy values(7.84±0.92 vs 6.39±0.83,P=0.004),enhanced surface-tovolume proportions(0.72±0.14 vs 0.58±0.11,P=0.008),and heightened signal intensity variation(3642±782 vs 2815±645,P=0.007).The random forest model demonstrated superior classification capability with area under the curves(AUCs)of 0.891 and 0.896 across training and validation datasets,respectively.An integrated approach combining radiomics with clinical parameters further enhanced performance metrics(AUC 0.923 and 0.914),achieving 88.5%sensitivity alongside 87.2%specificity.CONCLUSION DCE-MRI radiomics features interpreted through machine learning frameworks offer an effective strategy for MSI status assessment in intermediate-stage rectal cancer.
文摘BACKGROUND Rectal cancer requires accurate preoperative assessment of T stage and differentiation grade for treatment planning.Traditional imaging and serum markers have limitations in diagnostic accuracy.AIM To evaluate the predictive value of dynamic contrast-enhanced-magnetic resonance imaging(DCE-MRI)parameters and serum biomarkers[carbohydrate antigen(CA)19-9,CA125]for determining T stage and differentiation grade in rectal cancer.METHODS We conducted a retrospective review of clinical data from 126 patients who were pathologically diagnosed with rectal cancer between January 2021 to June 2024.Each patient underwent DCE-MRI scans and serum tests for CA19-9 and CA125.Receiver operating characteristic curves were utilized to assess the diagnostic value of DCE-MRI parameters,including volume transfer constant(Ktrans),rate constant(Kep),and volume fraction of extravascular extracellular space(Ve),as well as serum biomarkers for staging and grading rectal cancer.The DeLong test algorithm was employed to evaluate differences in diagnostic performance among the various indicators.RESULTS There were statistically higher levels of Ktrans,Ve,CA19-9,and CA125 serum concentrations of patients with advanced T stages and on poorly differentiated tumors than that in patients with low stages and moderate to high differentiation(P<0.05).Combined use of Ktrans and Ve for T stage diagnosis showed an area under the curve(AUC)of 0.892[95%confidence interval(CI):0.832-0.952],which increased to 0.923(95%CI:0.865-0.981)when combined with serum biomarkers.For grades differentiation,the combined DCE-MRI parameters had an AUC of 0.883(95%CI:0.821-0.945),which rose to 0.912(95%CI:0.855-0.969)when combined with serum markers.According to the Delong test,the combined diagnostic method performed better than a single diagnostic method(P<0.05).CONCLUSION The combined application of DCE-MRI functional parameters and serum tumor markers can significantly improve the diagnostic accuracy of T staging and differentiation degree of rectal cancer,providing a new approach to improve the preoperative assessment system of rectal cancer.This combined diagnostic model has important clinical application value,but further validation is needed through large-scale multicenter studies.
文摘AIM To assess the utility of NLR,PLR,IMT and contrast-enhanced ultrasound(CEUS)aspredictive markers for monitoring inflammatory responses and the disease activity in cardiac involvementin Takayasu’s arteritis.METHODS A cohort retrospective study encompassing 86 patients(43 withcardiac compromise and 43 without)was conducted.A comparative analysis of NLR,PLR,IMT,andCEUS between TA patients with and without cardiac compromise was undertaken.RESULTS The NLR and PLR of the heart damage group were significantly higher than those of the non heart damagegroup(2.9±1.0 vs.2.1±0.8,P<0.01;166±79 vs.117±51,P<0.01).The IMT and CEUS of the heartdamage group were significantly higher than those of the TA non heart damage group(2.6±0.6 vs.1.5±0.4,P<0.01;2.6±0.5 vs.1.6±0.6,P<0.01).The NLR level of the heart damage group was positivelycorrelated with CRP(r=0.42,P<0.01),and PLR was positively correlated with CRP and CEUS(r=0.34,P<0.05;r=0.35,P<0.05).The results of multiple logistic regression analysis showed that NLR,IMT,andCEUS were independent risk factors for TA and cardiac damage.The area under the ROC curve for NLRto determine cardiac damage is 0.865,with a cut-off value of 2.265,a sensitivity of 69.8%,and aspecificity of 90.7%.The area under the ROC curve for determining cardiac damage using PLR is 0.812,with a cut-off value of 111.275,a sensitivity of 76.7%,and a specificity of 79.1%.CONCLUSION NLR and PLR,in conjunction with contrast-enhanced ultrasound,can be employed to assessinflammatory response and the disease activity in cardiac involvement in Takayasu’s arteritis.
文摘BACKGROUND The role of cerebral microvascular dysfunction in early cognitive impairment and dementia has become increasingly recognized.Furthermore,pathological changes in both Alzheimer’s disease and vascular dementia are almost always associated with cerebral hemodynamic deficits.AIM To investigate the diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)assessment of the blood-brain barrier(BBB)in combination with relevant plasma biomarkers for mild cognitive impairment(MCI).METHODS This study selected 50 patients with non-amnestic MCI(na-MCI group),52 patients with amnestic MCI(a-MCI group),and 55 healthy elderly controls(control group).The Chinese version of the Montreal cognitive assessment(MoCA),auditory verbal learning test(AVLT),Hamilton anxiety/depression scale(HAMA/HAMD),and activity of daily living(ADL)scales were used to analyze the characteristics of mental and behavioral symptoms of patients with MCI.The DCE-MRI technique was used to assess the contrast enhancement kinetics.The Patlak model was utilized to analyze the BBB permeability(volume transfer constants).Further,fasting blood was was used to quantify plasma homocysteine(Hcy),β-amyloid protein(Aβ)40,Aβ42,human phosphorylated tau-181 protein(p-tau181),intercellular adhesion molecule-1(ICAM-1),vascular cell adhesion molecule-1(VCAM-1),and plasminogen activator inhibitor-1(PAI-1)levels,as well as serum neurofilament light chain(NFL)and glial fibrillary acidic protein(GFAP)concentrations.RESULTS The na-MCI and a-MCI groups demonstrated significantly lower MoCA and AVLT-Huashan version scores,and statistically higher HAMA,HAMD,and ADL scores compared to the control group.Moreover,the a-MCI group showed notably higher HAMA,HAMD,and ADL scores compared to the na-MCI group.Cranial MRI results revealed significant disparities in cerebral blood flow in the left and right frontal lobes,temporal lobes,hippocampi,cuneus,precuneus,parietal lobes,basal ganglia,and occipital lobes between the a-MCI and na-MCI groups.Compared to healthy controls,patients with MCI demonstrated a smaller amplitude of hippocampal contrast enhancement kinetics and a slower decay rate,indicating smaller vascular volume and increased BBB permeability.Further,Hcy,p-tau181,ICAM-1,VCAM-1,PAI-1,and NFL levels were substantially higher in the a-MCI group than in the na-MCI group,whereas the Aβ42 level was significantly lower.We did not observe any significant differences in Aβ40 and GFAP levels.CONCLUSION Patients with MCI may have experienced cerebrovascular system changes in the hippocampal region.Disorders associated with changes in cerebral blood supply may begin before pathophysiological changes are visible by imaging,which provides references for the assessment and treatment of patients with cognitive disorders.Further,DCE-MRI provides a noninvasive approach to diagnose subtle BBB leakage associated with cerebrovascular pathology.
基金Supported by Anhui Provincial Key Research and Development Plan,No.202104j07020048.
文摘BACKGROUND Microvascular invasion(MVI)is a significant indicator of the aggressive behavior of hepatocellular carcinoma(HCC).Expanding the surgical resection margin and performing anatomical liver resection may improve outcomes in patients with MVI.However,no reliable preoperative method currently exists to predict MVI status or to identify patients at high-risk group(M2).AIM To develop and validate models based on contrast-enhanced computed tomo-graphy(CECT)radiomics and clinicoradiological factors to predict MVI and identify M2 among patients with hepatitis B virus-related HCC(HBV-HCC).The ultimate goal of the study was to guide surgical decision-making.METHODS A total of 270 patients who underwent surgical resection were retrospectively analyzed.The cohort was divided into a training dataset(189 patients)and a validation dataset(81)with a 7:3 ratio.Radiomics features were selected using intra-class correlation coefficient analysis,Pearson or Spearman’s correlation analysis,and the least absolute shrinkage and selection operator algorithm,leading to the construction of radscores from CECT images.Univariate and multivariate analyses identified significant clinicoradiological factors and radscores associated with MVI and M2,which were subsequently incorporated into predictive models.The models’performance was evaluated using calibration,discrimination,and clinical utility analysis.RESULTS Independent risk factors for MVI included non-smooth tumor margins,absence of a peritumoral hypointensity ring,and a high radscore based on delayed-phase CECT images.The MVI prediction model incorporating these factors achieved an area under the curve(AUC)of 0.841 in the training dataset and 0.768 in the validation dataset.The M2 prediction model,which integrated the radscore from the 5 mm peritumoral area in the CECT arterial phase,α-fetoprotein level,enhancing capsule,and aspartate aminotransferase level achieved an AUC of 0.865 in the training dataset and 0.798 in the validation dataset.Calibration and decision curve analyses confirmed the models’good fit and clinical utility.CONCLUSION Multivariable models were constructed by combining clinicoradiological risk factors and radscores to preoper-atively predict MVI and identify M2 among patients with HBV-HCC.Further studies are needed to evaluate the practical application of these models in clinical settings.
基金Supported by National Natural Science Foundation of China,No.92059201.
文摘BACKGROUND Hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(ICC)represent the predominant histological types of primary liver cancer,comprising over 99%of cases.Given their differing biological behaviors,prognoses,and treatment strategies,accurately differentiating between HCC and ICC is crucial for effective clinical management.Radiomics,an emerging image processing technology,can automatically extract various quantitative image features that may elude the human eye.Reports on the application of ultrasound(US)-based radiomics methods in distinguishing HCC from ICC are limited.METHODS In our retrospective study,we included a total of 280 patients who were diagnosed with ICC(n=140)and HCC(n=140)between 1999 and 2019.These patients were divided into training(n=224)and testing(n=56)groups for analysis.US images and relevant clinical characteristics were collected.We utilized the XGBoost method to extract and select radiomics features and further employed a random forest algorithm to establish ultrasomics models.We compared the diagnostic performances of these ultrasomics models with that of radiologists.RESULTS Four distinct ultrasomics models were constructed,with the number of selected features varying between models:13 features for the US model;15 for the contrast-enhanced ultrasound(CEUS)model;13 for the combined US+CEUS model;and 21 for the US+CEUS+clinical data model.The US+CEUS+clinical data model yielded the highest area under the receiver operating characteristic curve(AUC)among all models,achieving an AUC of 0.973 in the validation cohort and 0.971 in the test cohort.This performance exceeded even the most experienced radiologist(AUC=0.964).The AUC for the US+CEUS model(training cohort AUC=0.964,test cohort AUC=0.955)was significantly higher than that of the US model alone(training cohort AUC=0.822,test cohort AUC=0.816).This finding underscored the significant benefit of incorporating CEUS information in accurately distin-guishing ICC from HCC.CONCLUSION We developed a radiomics diagnostic model based on CEUS images capable of quickly distinguishing HCC from ICC,which outperformed experienced radiologists.
文摘Contrast-enhanced endoscopic ultrasound(CH-EUS)can overcome the limi-tations of endoscopic ultrasound-guided acquisition by identifying microvessels inside inhomogeneous tumours and improving the characterization of these tumours.Despite the initial enthusiasm that oriented needle sampling under CH-EUS guidance could provide better diagnostic yield in pancreatic solid lesions,further studies did not confirm the supplementary values in cases of tissue acquisition guided by CH-EUS.This review details the knowledge based on the available data on contrast-guided procedures.The indications for CH-EUS tissue acquisition include isoechoic EUS lesions with poor visible delineation where CH-EUS can differentiate the lesion vascularisation from the surrounding parenchyma and also the mural nodules within biliopancreatic cystic lesions,which occur in select cases.Additionally,the roles of CH-EUS-guided therapy in patients whose pancreatic fluid collections or bile ducts that have an echogenic content have indications for drainage,and patients who have nonvisualized vessels that need to be highlighted via Doppler EUS are presented.Another indication is represented if there is a need for an immediate assessment of the post-radiofrequency ablation of pancreatic neuroendocrine tumours,in which case CH-EUS can be used to reveal the incomplete tumour destruction.
基金Supported by Scientific Research Fund of the Wenzhou Science and Technology Division,No.Y2020798 and No.Y2020805.
文摘BACKGROUND The detection rate of peptic ulcer in children is improving,with development of diagnostic procedures.Gastroscopy is the gold standard for the diagnosis of peptic ulcer,but it is an invasive procedure.Gastrointestinal contrast-enhanced ultrasonography(CEUS)has the advantages of being painless,noninvasive,nonradioactive,easy to use,and safe.AIM To investigate the clinical value of CEUS for diagnosis and treatment of peptic ulcer in children.METHODS We investigated 43 children with digestive tract symptoms in our hospital from January 2021 to June 2022.All children were examined by routine ultrasound,gastrointestinal CEUS,and gastroscopy.The pathological results of gastroscopy were taken as the gold standard.Routine ultrasonography was performed before gastrointestinal CEUS.Conventional ultrasound showed the thickness of the gastroduodenal wall,gastric peristalsis,and the adjacent organs and tissues around the abdominal cavity.Gastrointestinal CEUS recorded the thickness of the gastroduodenal wall;the size,location and shape of the ulcer;gastric peristalsis;and adjacent organs and tissues around the abdominal cavity.The results of routine ultrasound and gastrointestinal ultrasound were compared with those of gastroscopy to evaluate the diagnostic results and coincidence rate of routine ultrasound and gastrointestinal CEUS.All children received informed consent from their guardians for CEUS.This study was reviewed and approved by the hospital medical ethics committee.RESULTS Among the 43 children,17(15 male,2 female)were diagnosed with peptic ulcer by gastroscopy.There were 26 children with nonpeptic ulcer.There were eight cases of peptic ulcer and 35 of nonpeptic ulcer diagnosed by conventional ultrasound.The diagnostic coincidence rate of peptic ulcer in children diagnosed by conventional ultrasound was 79.1%(34/43),which was significantly different from that of gastroscopy(P=0.033).It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is low.Fifteen cases of peptic ulcer and 28 of nonpeptic ulcer were diagnosed by CEUS.The diagnostic coincidence rate of peptic ulcer in children was 95.3%(41/43).There was no significant difference between CEUS and gastroscopy(P=0.655).It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is high.CONCLUSION Gastrointestinal CEUS has a high coincidence rate in the diagnosis of peptic ulcer in children,and can be used as a preliminary examination method.
基金This study was reviewed and approved by the Ethics Committee of Sun Yat-sen University Cancer Center(Approval No.B2023-219-03).
文摘BACKGROUND Gastric cancer(GC)is the most common malignant tumor and ranks third for cancer-related deaths among the worldwide.The disease poses a serious public health problem in China,ranking fifth for incidence and third for mortality.Knowledge of the invasive depth of the tumor is vital to treatment decisions.AIM To evaluate the diagnostic performance of double contrast-enhanced ultrasonography(DCEUS)for preoperative T staging in patients with GC by comparing with multi-detector computed tomography(MDCT).METHODS This single prospective study enrolled patients with GC confirmed by preoperative gastroscopy from July 2021 to March 2023.Patients underwent DCEUS,including ultrasonography(US)and intravenous contrast-enhanced ultrasonography(CEUS),and MDCT examinations for the assessment of preoperative T staging.Features of GC were identified on DCEUS and criteria developed to evaluate T staging according to the 8th edition of AJCC cancer staging manual.The diagnostic performance of DCEUS was evaluated by comparing it with that of MDCT and surgical-pathological findings were considered as the gold standard.RESULTS A total of 229 patients with GC(80 T1,33 T2,59 T3 and 57 T4)were included.Overall accuracies were 86.9%for DCEUS and 61.1%for MDCT(P<0.001).DCEUS was superior to MDCT for T1(92.5%vs 70.0%,P<0.001),T2(72.7%vs 51.5%,P=0.041),T3(86.4%vs 45.8%,P<0.001)and T4(87.7%vs 70.2%,P=0.022)staging of GC.CONCLUSION DCEUS improved the diagnostic accuracy of preoperative T staging in patients with GC compared with MDCT,and constitutes a promising imaging modality for preoperative evaluation of GC to aid individualized treatment decision-making.
基金the Ethic Committee of Wuxi People's Hospital(No.KY17071).
文摘BACKGROUND The incidence and mortality of lung cancer have increased annually.Accurate diagnosis can help improve therapeutic efficacy of interventions and prognosis.Percutaneous lung biopsy is a reliable method for the clinical diagnosis of lung cancer.Ultrasound-guided percutaneous lung biopsy technology has been widely promoted and applied in recent years.AIM To investigate the diagnostic value of contrast-enhanced ultrasound(CEUS)-guided percutaneous biopsy in peripheral pulmonary lesions.METHODS We retrospectively collected data on 237 patients with peripheral thoracic focal lesions who underwent puncture biopsy at Wuxi People’s Hospital.The patients were randomly divided into two groups:The CEUS-guided before lesion puncture group(contrast group)and conventional ultrasound-guided group(control group).Analyze the diagnostic efficacy of the puncture biopsy,impact of tumor size,and number of puncture needles and complications were analyzed and compared between the two groups.RESULTS Accurate pathological results were obtained for 92.83%(220/237)of peripheral lung lesions during the first biopsy,with an accuracy rate of 95.8%(113/118)in the contrast group and 89.9%(107/119)in the control group.The difference in the area under the curve(AUC)between the contrast and the control groups was not statistically significant(0.952 vs 0.902,respectively;P>0.05).However,when the lesion diameter≥5 cm,the diagnostic AUC of the contrast group was higher than that of the control group(0.952 vs 0.902,respectively;P<0.05).In addition,the average number of puncture needles in the contrast group was lower than that in the control group(2.58±0.53 vs 2.90±0.56,respectively;P<0.05).CONCLUSION CEUS guidance can enhance the efficiency of puncture biopsy of peripheral pulmonary lesions,especially for lesions with a diameter≥5 cm.Therefore,CEUS guidance has high clinical diagnostic value in puncture biopsy of peripheral focal lung lesions.
基金funded by grants from the Natural Science Foundation of Hubei Province,China(No.2022CFB307)and the Foundation of Tongji Hospital(No.2020JZKT292).
文摘Objective:Complete resection of malignant gliomas is often challenging.Our previous study indicated that intraoperative contrast-enhanced ultrasound(ICEUS)could aid in the detection of residual tumor remnants and the total removal of brain lesions.This study aimed to investigate the survival rates of patients undergoing resection with or without the use of ICEUS and to assess the impact of ICEUS on the prognosis of patients with malignant glioma.Methods:A total of 64 patients diagnosed with malignant glioma(WHO grade HI and IV)who underwent surgery between 2012 and 2018 were included.Among them,29 patients received ICEUS.The effects of ICEUS on overall survival(OS)and progression-free survival(PFS)of patients were evaluated.A quantitative analysis was performed to compare ICEUS parameters between gliomas and the surrounding tissues.Results:The ICEUS group showed better survival rates both in OS and PFS than the control group.The univariate analysis revealed that age,pathology and ICEUS were significant prognostic factors for PFS,with only age being a significant prognostic factor for OS.In multivariate analysis,age and ICEUS were significant prognostic factors for both OS and PFS.The quantitative analysis showed that the intensity and transit time of microbubbles reaching the tumors were significantly different from those of microbubbles reaching the surrounding tissue.Conclusion:ICEUS facilitates the identification of residual tumors.Age and ICEUS are prognostic factors for malignant glioma surgery,and use of ICEUS offers a better prognosis for patients with malignant glioma.
文摘BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a highly malignant and aggressive tumor,and high Ki-67 expression indicates poor histological differentiation and prognosis.Therefore,one of the challenges in diagnosing preoperatively patients with PDAC is predicting the degree of malignancy.Dynamic contrast-enhanced ultrasonography(DCE-US)plays a crucial role in abdominal tumor diagnosis,and can adequately show the microvascular composition within the tumors.However,the relationship between DCE-US and the Ki-67 labelling index remains unclear at the present time.AIM To predict the correlation between Ki-67 expression and the parameters of DCEUS.METHODS Patients with PDAC who underwent DCE-US were retrospectively analyzed.Patients who had received any treatment(radiotherapy or chemotherapy)prior to DCE-US;had incomplete clinical,imaging,or pathologic information;and had poor-quality image analysis were excluded.Correlations between Ki-67 expression and the parameters of DCE-US in patients with PDAC were assessed using Spearman’s rank correlation analysis.The diagnostic performances of these parameters in high Ki-67 expression group were evaluated according to receiver operating characteristic curve.RESULTS Based on the Ki-67 labelling index,30 patients were divided into two groups,i.e.,the high expression group and the low expression group.Among the relative quantitative parameters between the two groups,relative half-decrease time(rHDT),relative peak enhancement,relative wash-in perfusion index and relative wash-in rate were significantly different between two groups(P=0.018,P=0.025,P=0.028,P=0.035,respectively).The DCE-US parameter rHDT was moderately correlated with Ki-67 expression,and rHDT≥1.07 was more helpful in accurately diagnosing high Ki-67 expression,exhibiting a sensitivity and specificity of 53.8%and 94.1%,respectively.CONCLUSION One parameter of DCE-US,rHDT,correlates with high Ki-67 expression.It demonstrates that parameters obtained noninvasively by DCE-US could better predict Ki-67 expression in PDAC preoperatively.
文摘BACKGROUND Oral contrast-enhanced ultrasound(OCEUS)is widely used in the noninvasive diagnosis and screening of gastric cancer(GC)in China.AIM To investigate the clinical application of OCEUS in evaluating the preoperative T staging of gastric cancer.METHODS OCEUS was performed before the operation,and standard ultrasound images were retained.The depth of infiltration of GC(T-stage)was evaluated according to the American Joint Committee on Cancer 8th edition of the tumor-nodemetastasis staging criteria.Finally,with postoperative pathological staging as the gold standard reference,the sensitivity,specificity,negative predictive value,positive predictive value,and diagnostic value of OCEUS T staging were evaluated.RESULTS OCEUS achieved diagnostic accuracy rates of 76.6%(T1a),69.6%(T1b),62.7%(T2),60.8%(T3),88.0%(T4a),and 88.7%(T4b),with an average of 75.5%.Ultrasonic T staging sensitivity exceeded 62%,aside from T1b at 40.3%,while specificity was over 91%,except for T3 with 83.5%.The Youden index was above 60%,with T1b and T2 being exceptions.OCEUS T staging corresponded closely with pathology in T4b(kappa>0.75)and moderately in T1a,T1b,T2,T3,and T4a(kappa 0.40-0.75),registering a concordance rate exceeding 84%.CONCLUSION OCEUS was effective,reliable,and accurate in diagnosing the preoperative T staging of GC.As a noninvasive diagnostic technique,OCEUS merits clinical popularization.
文摘BACKGROUND The incidence of gastric cancer remains high,and it is the sixth most common cancer and the fourth leading cause of cancer deaths worldwide.Oral contrastenhanced ultrasonography is a simple,non-invasive,and painless method for the diagnosis of gastric tumors.AIM To explore the diagnostic value of oral contrast-enhanced ultrasonography for the detection of gastric tumors.METHODS The screening results based on oral contrast-enhanced ultrasonography and electronic gastroscopy were compared with those of the postoperative pathological examination.RESULTS Among 42 patients with gastric tumors enrolled in the study,the diagnostic accordance rate was 95.2%for oral contrast-enhanced ultrasonography(n=40)and 90.5%for electronic gastroscopy(n=38)compared with postoperative pathological examination.The Kappa value of consistency test with pathological findings was 0.812 for oral contrast-enhanced ultrasonography and 0.718 for electronic gastroscopy,and there was no significant difference between them(P=0.397).For the TNM staging of gastric tumors,the accuracy rate of oral contrast enhanced ultrasonography was 81.9%for the overall T staging and 50%,77.8%,100%,and 100%for T1,T2,T3,and T4 staging,respectively.The sensitivity and specificity were both 100%for stages T3 and T4.The diagnostic accuracy rate of oral contrast-enhanced ultrasonography was 93.8%,80%,100%,and 100%for stages N0,N1-N3,M0,and M1,respectively.CONCLUSION The accordance rate of qualitative diagnosis by oral contrast-enhanced ultrasonography is comparable to that of gastroscopy,and it could be used as the preferred method for the early screening of gastric tumors.
