Search Results (3,093)

Appendicitis is a condition wherein the appendix becomes inflamed, and it can be difficult to diagnose accurately. The type of appendicitis can also be hard to determine, leading to misdiagnosis and difficulty in managing the condition. To avoid complications and reduce mortality, early diagnosis and treatment are crucial. While Alvarado’s clinical scoring system is not sufficient, ultrasound and computed tomography (CT) imaging are effective but have downsides such as operator-dependency and radiation exposure. This study proposes the use of machine learning methods and a locally collected reliable dataset to enhance the identification of acute appendicitis while detecting the differences between complicated and non-complicated appendicitis. Machine learning can help reduce diagnostic errors and improve treatment decisions. This study conducted four different experiments using various ML algorithms, including K-nearest neighbors (KNN), DT, bagging, and stacking. The experimental results showed that the stacking model had the highest training accuracy, test set accuracy, precision, and F1 score, which were 97.51%, 92.63%, 95.29%, and 92.04%, respectively. Feature importance and explainable AI (XAI) identified neutrophils, WBC_Count, Total_LOS, P_O_LOS, and Symptoms_Days as the principal features that significantly affected the performance of the model. Based on the outcomes and feedback from medical health professionals, the scheme is promising in terms of its effectiveness in diagnosing of acute appendicitis. Full article

Consuming an unbalanced diet and being overweight represent a global health problem in young people and adults of both sexes, and may lead to metabolic syndrome. The diet-induced obesity (DIO) model in the C57BL/6J mouse substrain that mimics the gradual weight gain in humans consuming a “Western-type” (WD) diet is of great interest. This study aims to characterize this animal model, using high-frequency ultrasound imaging (HFUS) as a complementary tool to longitudinally monitor changes in the liver, heart and kidney. Long-term WD feeding increased mice body weight (BW), liver/BW ratio and body condition score (BCS), transaminases, glucose and insulin, and caused dyslipidemia and insulin resistance. Echocardiography revealed subtle cardiac remodeling in WD-fed mice, highlighting a significant age–diet interaction for some left ventricular morphofunctional parameters. Qualitative and parametric HFUS analyses of the liver in WD-fed mice showed a progressive increase in echogenicity and echotexture heterogeneity, and equal or higher brightness of the renal cortex. Furthermore, renal circulation was impaired in WD-fed female mice. The ultrasound and histopathological findings were concordant. Overall, HFUS can improve the translational value of preclinical DIO models through an integrated approach with conventional methods, enabling a comprehensive identification of early stages of diseases in vivo and non-invasively, according to the 3Rs. Full article

This review article aims to summarize current tools used in the diagnosis of adenomyosis with relative pharmacological and surgical treatment and to clarify the relative association between adenomyosis and infertility, considering the importance of an accurate diagnosis of this heterogeneous disease. Among different reported concepts, direction invagination of gland cells from the basalis endometrium deep into the myometrium is the most widely accepted opinion on the development of adenomyosis. Adenomyosis has been increasingly identified in young women with pain, AUB, infertility, or no symptoms by using imaging techniques such as transvaginal ultrasound and magnetic resonance. Furthermore, adenomyosis often coexists with other gynecological conditions, such as endometriosis and uterine fibroids, increasing the heterogeneity of available data. However, there is no agreement on the definition and classification of adenomyotic lesions from both the histopathology and the imaging points of view, and diagnosis remains difficult and unclear. A standard, universally accepted classification system needs to be implemented to improve our understanding and inform precise diagnosis of the type of adenomyosis. This could be the key to designing RCT studies and evaluating the impact of adenomyosis on quality of life in terms of menstrual symptoms, fertility, and pregnancy outcome, given the high risk of miscarriage and obstetric complications. Full article

Aging affects the cardiovascular system, and this process may be accelerated in individuals with cardiovascular risk factors. The main vascular changes include arterial wall thickening, calcification, and stiffening, together with aortic dilatation and elongation. With aging, we can observe left ventricular hypertrophy with myocardial fibrosis and left atrial dilatation. These changes may lead to heart failure and atrial fibrillation. Using multimodality imaging, including ultrasound, computed tomography (CT), and magnetic resonance imaging, it is possible to detect these changes. Additionally, multimodality imaging, mainly via CT measurements of coronary artery calcium or ultrasound carotid intima-media thickness, enables advanced cardiovascular risk stratification and helps in decision-making about preventive strategies. The focus of this manuscript is to briefly review cardiovascular changes that occur with aging, as well as to describe how multimodality imaging may be used for the assessment of these changes and risk stratification of asymptomatic individuals. Full article

Cardiovascular diseases (CVDs) continue to be a major global health concern, representing a leading cause of morbidity and mortality. This review provides a comprehensive examination of CVDs, encompassing their pathophysiology, diagnostic biomarkers, advanced imaging techniques, pharmacological treatments, surgical interventions, and the emerging role of herbal remedies. The review covers various cardiovascular conditions such as coronary artery disease, atherosclerosis, peripheral artery disease, deep vein thrombosis, pulmonary embolism, cardiomyopathy, rheumatic heart disease, hypertension, ischemic heart disease, heart failure, cerebrovascular diseases, and congenital heart defects. The review presents a wide range of cardiac biomarkers such as troponins, C-reactive protein, CKMB, BNP, NT-proBNP, galectin, adiponectin, IL-6, TNF-α, miRNAs, and oxylipins. Advanced molecular imaging techniques, including chest X-ray, ECG, ultrasound, CT, SPECT, PET, and MRI, have significantly enhanced our ability to visualize myocardial perfusion, plaque characterization, and cardiac function. Various synthetic drugs including statins, ACE inhibitors, ARBs, β-blockers, calcium channel blockers, antihypertensives, anticoagulants, and antiarrhythmics are fundamental in managing CVDs. Nonetheless, their side effects such as hepatic dysfunction, renal impairment, and bleeding risks necessitate careful monitoring and personalized treatment strategies. In addition to conventional therapies, herbal remedies have garnered attention for their potential cardiovascular benefits. Plant extracts and their bioactive compounds, such as flavonoids, phenolic acids, saponins, and alkaloids, offer promising cardioprotective effects and enhanced cardiovascular health. This review underscores the value of combining traditional and modern therapeutic approaches to improve cardiovascular outcomes. This review serves as a vital resource for researchers by integrating a broad spectrum of information on CVDs, diagnostic tools, imaging techniques, pharmacological treatments and their side effects, and the potential of herbal remedies. Full article

Background: Human myiasis, the infestation of tissues by dipterous larvae, commonly manifests as painful, raised skin lesions, particularly in tropical regions such as Latin America, where Dermatobia hominis (the human botfly) is a frequent cause. With increased international travel, cases of travel-related myiasis have become more prevalent, necessitating awareness among healthcare providers in non-endemic regions. Methods: We present a case of cutaneous myiasis in a 69-year-old male who returned to the United States from Belize. The patient exhibited a painful skin lesion on his right knee, initially suspected to be an insect bite. The diagnosis was confirmed through ultrasound imaging, which revealed the presence of a subcutaneous larva. Conservative larva removal efforts failed, leading to surgical extraction of the larva. Results: The surgical intervention successfully removed the larva in its entirety, with the wound healing well after the procedure. Pathological examination confirmed the larva as Dermatobia hominis. The patient experienced a satisfactory recovery, with no complications observed during follow-up. Conclusions: This case underscores the importance of considering myiasis in the differential diagnosis of patients presenting with painful skin lesions following travel to tropical regions. As globalization increases, healthcare providers should be vigilant in recognizing and appropriately treating travel-related diseases such as myiasis to ensure prompt and effective care. Full article

Thoracic outlet syndrome (TOS) is a group of symptoms caused by the compression of neurovascular structures of the superior thoracic outlet. The knowledge of its clinical presentation with specific symptoms, as well as proper imaging examinations, ranging from plain radiographs to ultrasound, computed tomography and magnetic resonance imaging, may help achieve a precise diagnosis. Once TOS is recognized, proper treatment may comprise a conservative or a surgical approach. Full article

Breast cancer is the most prevalent cancer among women worldwide. B-mode ultrasound (US) is essential for early detection, offering high sensitivity and specificity without radiation exposure. This study introduces a semi-automatic method to streamline breast US report generation, aiming to reduce the burden on radiologists. Our method synthesizes comprehensive breast US reports by combining the extracted information from radiologists’ annotations during routine screenings with the analysis results from deep learning algorithms on multimodal US images. Key modules in our method include image classification using visual features (ICVF), type classification via deep learning (TCDL), and automatic report structuring and compilation (ARSC). Experiments showed that the proposed method reduced the average report generation time to 3.8 min compared to manual processes, even when using relatively low-spec hardware. Generated reports perfectly matched ground truth reports for suspicious masses without a single failure on our evaluation datasets. Additionally, the deep-learning-based algorithm, utilizing DenseNet-121 as its core model, achieved an overall accuracy of 0.865, precision of 0.868, recall of 0.847, F1-score of 0.856, and area under the receiver operating characteristics of 0.92 in classifying tissue stiffness in breast US shear-wave elastography (SWE-mode) images. These improvements not only streamline the report generation process but also allow radiologists to dedicate more time and focus on patient care, ultimately enhancing clinical outcomes and patient satisfaction. Full article

Background: Neoadjuvant chemotherapy (NAC) is currently used for treating breast cancer in selected cases. Our study aims to evaluate the role of automated breast ultrasound (ABUS) in the assessment of response to NAC and compare the ABUS results with MRI. Methods: A total of 52 consecutive patients were included in this study. ABUS and MRI sensitivity (SE), specificity (SP), diagnostic accuracy (DA), positive predictive value (PPV), and negative predictive value (NPV) were calculated and represented using Area Under ROC Curve (ROC) analysis, searching for any significant difference (p < 0.05). The McNemar test was used searching for any significant difference in terms of sensitivity by comparing the ABUS and MRI results. The inter-observer agreement between the readers in evaluating the response to NAC for both MRI and ABUS was calculated using Cohen’s kappa k coefficient. Results: A total of 35 cases of complete response and 17 cases of persistent disease were found. MRI showed SE, SP, DA, PPV, and NPV values of 100%, 88%, 92%, 81%, and 100%, respectively, with an AUC value of 0.943 (p < 0.0001). ABUS showed SE, SP, DA, PPV, and NPV values of 88%, 94%, 92%, 89%, and 94%, respectively, with an AUC of 0.913 (p < 0.0001). The McNemar test revealed no significant difference (p = 0.1250). The inter-observer agreement between the two readers in evaluating the response to NAC for MRI and ABUS was, respectively, 0.88 and 0.89. Conclusions: Automatic breast ultrasound represents a new accurate, tri-dimensional and operator-independent tool for evaluating patients referred to NAC. Full article

Ultrasound B-scan images are traditionally formed from the envelope of the received radiofrequency echoes, but the image texture is dominated by granular speckle patterns. Longstanding efforts at speckle reduction and deconvolution have been developed to lessen the detrimental aspects of speckle. However, we now propose an alternative approach to estimation (and image rendering) of the underlying fine grain scattering density of tissues based on power law constraints. The key steps are a whitening of the spectrum of the received signal while conforming to the original envelope shape and statistics, followed by a power law filtering in accordance with the known scattering behavior of tissues. This multiple step approach results in a high-spatial-resolution map of scattering density that is constrained by the most important properties of scattering from tissues. Examples from in vivo liver scans are shown to illustrate the change in image properties from this framework. Full article

Background: Anatomical variations of the first extensor compartment can affect de Quervain tendinopathy outcomes. Our study aimed to identify the anatomical prognostic indicators of symptom recurrence following a corticosteroid (CS) injection and to assess the efficacy of CS injections. Methods: Fifty consecutive patients received a single CS injection for de Quervain tendinopathy. Ultrasound imaging was used to assess anatomical factors of the first extensor tendon compartment of the wrist. The primary outcome was recurrence after six weeks and six months and the identification of the anatomical prognostic indicators of the recurrence. The Disabilities of the Arm, Shoulder, and Hand (DASH) score and the Visual Analogue Scale (VAS) for pain were evaluated as secondary outcomes. Results: Fifteen patients (30%) experienced symptom recurrence within six weeks. The intracompartmental septum and the number of tendon slips were associated with higher recurrence rates (adjusted odds ratio for the septum: 18.39, p = 0.045; adjusted odds ratio for each additional tendon slip: 24.68, p < 0.01). The mean DASH score improved from 74.1 ± 5 to 19.3 ± 25.3, and the mean VAS for pain from 8.5 ± 0.8 to 2 ± 2.7 (p < 0.01 for both scores). Five patients experienced minor adverse events with spontaneous improvement. Conclusions: CS injections are a viable treatment for de Quervain tendinopathy. Anatomical variations can predict treatment success. Counseling patients based on these factors can help guide treatment decisions, including surgical options. Full article

Recent epidemiological studies have shown that patients with right-sided breast cancer (RBC) treated with X-ray irradiation (IR) are more susceptible to developing cardiovascular diseases, such as arrhythmias, atrial fibrillation, and conduction disturbances after radiotherapy (RT). Our aim was to investigate the mechanisms induced by low to moderate doses of IR and to evaluate changes in the cardiac sympathetic nervous system (CSNS), atrial remodeling, and calcium homeostasis involved in cardiac rhythm. To mimic the RT of the RBC, female C57Bl/6J mice were exposed to X-ray doses ranging from 0.25 to 2 Gy targeting 40% of the top of the heart. At 60 weeks after RI, Doppler ultrasound showed a significant reduction in myocardial strain, ejection fraction, and atrial function, with a significant accumulation of fibrosis in the epicardial layer and apoptosis at 0.5 mGy. Calcium transient protein expression levels, such as RYR2, NAK, Kir2.1, and SERCA2a, increased in the atrium only at 0.5 Gy and 2 Gy at 24 h, and persisted over time. Interestingly, 3D imaging of the cleaned hearts showed an early reduction of CSNS spines and dendrites in the ventricles and a late reorientation of nerve fibers, combined with a decrease in SEMA3a expression levels. Our results showed that local heart IR from 0.25 Gy induced late cardiac and atrial dysfunction and fibrosis development. After IR, ventricular CSNS and calcium transient protein expression levels were rearranged, which affected cardiac contractility. The results are very promising in terms of identifying pro-arrhythmic mechanisms and preventing arrhythmias during RT treatment in patients with RBC. Full article

This article introduces a case of pelvic actinomycosis, which is easily confused with an ovarian malignant tumor. These images are from a 52-year-old woman who was admitted to hospital with difficulty defecating. Colonoscopy and biopsy indicated inflammatory changes within the intestinal tract, but the anti-inflammatory treatment was not effective. Later, she was readmitted due to abdominal pain and emaciation, and laboratory findings revealed mild anemia and inflammation. Various tumor markers are normal. CT suggested inflammatory lesions in the sigmoid colon and upper rectum. PET-CT considered a high metabolic mass originating from the mesentery. Ultrasound scan revealed a mixed-echo mass adjacent to the right side of the uterus, poorly demarcated from the rectum and right ovary, suggesting a neoplastic lesion. A biopsy of the right ovarian mass indicated suppurative inflammation, with negative antacid staining and microscopic observation of yellowish sulfur granules, suggestive of Actinomyces infection. Following a 12-month treatment regimen involving the removal of an intrauterine device and administration of penicillin, the patient’s condition markedly improved. Pelvic actinomycosis is usually characterized by abdominal pain accompanied by an abdominal mass, which is often related to an intrauterine device (IUD), and is very difficult to distinguish from pelvic tumors and tuberculosis, so it is necessary for doctors to understand its clinical and imaging features. Full article

This article reports the fine-tuning of the optical resonance wavelength (ORW) of surface-micromachined optical ultrasound transducer (SMOUT) arrays to enable ultrasound data readout with non-tunable interrogation light sources for photoacoustic computed tomography (PACT). Permanent ORW tuning is achieved by material deposition onto or subtraction from the top diaphragm of each element with sub-nanometer resolution. For demonstration, a SMOUT array is first fabricated, and its ORW is tuned for readout with an 808 nm laser diode (LD). Experiments are conducted to characterize the optical and acoustic performances of the elements within the center region of the SMOUT array. Two-dimensional and three-dimensional PACT (photoacoustic computed tomography) is also performed to evaluate the imaging performance of the ORW-tuned SMOUT array. The results show that the ORW tuning does not degrade the optical, acoustic, and overall imaging performances of the SMOUT elements. As a result, the fine-tuning method enables new SMOUT-based PACT systems that are low cost, compact, powerful, and even higher speed, with parallel readout capability. Full article

Background: Machine learning models can provide quick and reliable assessments in place of medical practitioners. With over 50 million adults in the United States suffering from osteoarthritis, there is a need for models capable of interpreting musculoskeletal ultrasound images. However, machine learning requires lots of data, which poses significant challenges in medical imaging. Therefore, we explore two strategies for enriching a musculoskeletal ultrasound dataset independent of these limitations: traditional augmentation and diffusion-based image synthesis. Methods: First, we generate augmented and synthetic images to enrich our dataset. Then, we compare the images qualitatively and quantitatively, and evaluate their effectiveness in training a deep learning model for detecting thickened synovium and knee joint recess distension. Results: Our results suggest that synthetic images exhibit some anatomical fidelity, diversity, and help a model learn representations consistent with human opinion. In contrast, augmented images may impede model generalizability. Finally, a model trained on synthetically enriched data outperforms models trained on un-enriched and augmented datasets. Conclusions: We demonstrate that diffusion-based image synthesis is preferable to traditional augmentation. Our study underscores the importance of leveraging dataset enrichment strategies to address data scarcity in medical imaging and paves the way for the development of more advanced diagnostic tools. Full article