Clinical Application of Preliminary Breast Cancer Screening for Dense Breasts Using Real-Time AI-Powered Ultrasound with Deep-Learning Computer Vision

Objective:We propose a solution that is backed by cloud computing,combines a series of AI neural networks of computer vision;is capable of detecting,highlighting,and locating breast lesions from a live ultrasound video feed,provides BI-RADS categorizations;and has reliable sensitivity and specificity.Multiple deep-learning models were trained on more than 300,000 breast ultrasound images to achieve object detection and regions of interest classification.The main objective of this study was to determine whether the performance of our Al-powered solution was comparable to that of ultrasound radiologists.Methods:The noninferiority evaluation was conducted by comparing the examination results of the same screening women between our AI-powered solution and ultrasound radiologists with over 10 years of experience.The study lasted for one and a half years and was carried out in the Duanzhou District Women and Children's Hospital,Zhaoqing,China.1,133 females between 20 and 70 years old were selected through convenience sampling.Results:The accuracy,sensitivity,specificity,positive predictive value,and negative predictive value were 93.03%,94.90%,90.71%,92.68%,and 93.48%,respectively.The area under the curve(AUC)for all positives was 0.91569 and the AUC for all negatives was 0.90461.The comparison indicated that the overall performance of the AI system was comparable to that of ultrasound radiologists.Conclusion:This innovative AI-powered ultrasound solution is cost-effective and user-friendly,and could be applied to massive breast cancer screening.

Evaluation of The Effectiveness of Abdominal and Vaginal B-Ultrasound in The Diagnosis of Acute Abdomen in Obstetrics and Gynecology

Objective: To explore the clinical effect of the combined application of abdominal and vaginal B-ultrasound in the diagnosis of acute abdomen in obstetrics and gynecology. Methods: Eighty patients admitted to our hospital from March 2023 to March 2024 were selected, all of whom were acute abdomen patients admitted to the Department of Obstetrics and Gynecology. In this study, the patients were divided into two groups. One group of 40 patients was given a simple abdominal B-ultrasound diagnosis (control group). The other group of 40 patients was given both abdominal and vaginal B-ultrasound examinations (experimental group). The diagnostic accuracy between the two groups was compared. Results: Patients in the experimental group had higher consistency rates with pathological diagnosis results in ectopic pregnancy rupture, embryonic arrest, acute pelvic inflammation, corpus luteum rupture, and intrauterine adhesions as compared to the control group. At the same time, the inspection accuracy rate of the experimental group (92.50%) was higher than that of the control group (70.00%) (P < 0.05). Conclusion: The combined application of abdominal and vaginal B-ultrasound in the diagnosis of acute abdomen was of great significance in improving the accuracy of clinical diagnosis and guiding doctors to provide effective treatment.

Analysis of the Efficacy of Prenatal B-Ultrasound in Diagnosing Fetal Abnormalities

Objective:To explore the positive significance of using prenatal B-ultrasound in diagnosing fetal abnormalities.Methods:A total of 200 pregnant women who visited Shaanxi Provincial People’s Hospital between January 2023 and January 2024 were recruited as the research subjects.All pregnant women received prenatal examinations.A retrospective analysis was carried out to analyze the positive significance of prenatal B-ultrasound examination in the diagnosis of fetal abnormalities.Results:Prenatal B-ultrasound examination detected 10 cases of fetal abnormalities,with a detection rate of 5.00%.When compared with the postnatal examination results of 5.50%,the difference was insignificant(P>0.05).Moreover,comparing the fetal limb abnormalities and cardiovascular abnormalities in prenatal B-ultrasound examination and postnatal examination,one case of congenital heart disease was missed in the prenatal B-ultrasound examination,and the others were consistent with the postnatal examination results,with a coincidence rate of 90.91%,indicating a high compliance rate.Conclusion:Fetal abnormalities have a great impact on mothers,babies,and families,and it is particularly important to strengthen diagnosis during this process.Prenatal B-ultrasound examination can improve the accuracy of diagnosis of fetal abnormalities and can be promoted in clinical practice as a basis for screening fetal abnormalities.

Relationship between neonatal respiratory distress syndrome pulmonary ultrasonography and respiratory distress score,oxygenation index,and chest radiography grading

BACKGROUND Accurate condition assessment is critical for improving the prognosis of neonatal respiratory distress syndrome(RDS),but current assessment methods for RDS pose a cumulative risk of harm to neonates.Thus,a less harmful method for assessing the health of neonates with RDS is needed.AIM To analyze the relationships between pulmonary ultrasonography and respiratory distress scores,oxygenation index,and chest X-ray grade of neonatal RDS to identify predictors of neonatal RDS severity.METHODS This retrospective study analyzed the medical information of 73 neonates with RDS admitted to the neonatal intensive care unit of Liupanshui Maternal and Child Care Service Center between April and December 2022.The pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest Xray grade of each newborn before and after treatment were collected.Spearman correlation analysis was performed to determine the relationships among these values and neonatal RDS severity.RESULTS The pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest X-ray RDS grade of the neonates were significantly lower after treatment than before treatment(P<0.05).Spearman correlation analysis showed that before and after treatment,the pulmonary ultrasonography score of neonates with RDS was positively correlated with the respiratory distress score,oxygenation index,and chest X-ray grade(ρ=0.429–0.859,P<0.05).Receiver operating characteristic curve analysis indicated that pulmonary ultrasonography screening effectively predicted the severity of neonatal RDS(area under the curve=0.805–1.000,P<0.05).CONCLUSION The pulmonary ultrasonography score was significantly associated with the neonatal RDS score,oxygenation index,and chest X-ray grade.The pulmonary ultrasonography score was an effective predictor of neonatal RDS severity.

Correlation Study of Aortic Velocity Propagation, Abdominal Aortic Intima-Media Thickness, and Epicardial Adipose Tissue Thickness in Subclinical Hypothyroidism Patients

Objective:To explore the correlation between epicardial fat thickness(EFT),aortic velocity propagation(AVP),and abdominal aortic intima-media thickness(AA-IMT)in patients with subclinical hypothyroidism(SH).Additionally,to compare these indicators between SH patients and healthy individuals,providing a new theoretical basis for the clinical prevention and treatment of cardiovascular diseases.Method:Clinical data from 50 SH patients(23 males and 27 females)and 50 healthy outpatient examinees(22 males and 28 females)were analyzed.The participants were selected from January 2022 to December 2023 at Loudi Central Hospital.EFT,AVP,and AA-IMT were measured,and their correlations were analyzed.Results:SH patients had significantly higher EFT and AA-IMT levels than the control group,while their AVP was significantly lower,with these differences being statistically significant(P<0.05).Correlation analysis revealed a significant negative correlation between EFT and AVP(P<0.001),a significant positive correlation between EFT and AAO-IMT(P<0.001),and a significant negative correlation between AVP and AAO-IMT(P<0.001).Multivariate binary logistic regression analysis identified increased EFT,decreased AVP,and increased AAO-IMT as independent risk factors for SH patients.Conclusion:In SH patients,EFT and AAO-IMT are elevated,whereas AVP is reduced.EFT and AVP are significantly correlated with AAO-IMT.EFT and AAO-IMT can serve as reliable indicators for evaluating subclinical atherosclerosis in SH patients,providing a diagnostic basis for clinical practice.

Early warning study of color doppler ultrasound in children with thyroid nodules and thyroid cancer

Objective: To study the diagnostic value of color doppler ultrasound in children with thyroid nodules and thyroid cancer. Methods: A total of sixty children with thyroid nodules treated in our hospital from March 2017 to March 2018 were selected for study. All patients underwent color Doppler ultrasound diagnosis. According to the diagnostic data, benign thyroid nodules and thyroid cancer were analyzed. The nodule nature was grouped into benign nodules group and malignant nodules group. The aspect ratio and boundary of the two groups were compared in blurring, calcification, blood flow signal classification, etc. Results: A total of 95 nodules were diagnosed by color doppler ultrasonography in 60 cases of thyroid nodules. 49 cases were benign nodules. There were 80 nodules, accounting for 82.11%, 11 cases of thyroid cancer, and 15 nodules. Accounted for 15.79%. Biopsy puncture pathology confirmed 77 benign nodules and 18 malignant nodules. The pathological results were gold standard. The specificity of color Doppler ultrasound was 90%, the sensitivity was 66.67%, and the accuracy of ultrasound diagnosis was 86.32%.The two nodules were statistically significant in terms of boundary, aspect ratio, calcification, echo, and resistance index (P<0.05), but the end-diastolic blood flow velocity (EDV) and peak systolic blood flow velocity ( There was no statistical difference between the PSV levels (P>0.05).Conclusion: Color Doppler ultrasound has the advantages of simple operation, high accuracy, non-invasive and painless, and reproducible detection. The high-frequency probe can clearly display changes such as minute lesions, blood flow signals, echoes, calcifications, etc., and can diagnose thyroid cancer in time. It provides a favorable basis for clinical treatment and has important clinical warning value, especially for children with thyroid examination.

Contrast-enhanced ultrasound in portal venous system aneurysms: A multi-center study

AIM: To investigate contrast-enhanced ultrasound (CEUS) findings in portal venous system aneurysms (PVSAs).

Observation on the therapeutic effect of aspirin in Correlation of Doppler ultrasound parameters with angiogenesis and cancer cell growth in endometrial cancer

Objective:To study the correlation of Doppler ultrasound parameters with angiogenesis and cancer cell growth in endometrial cancer.Methods: Patients with endometrial cancer and fibroids who accepted surgical resection in the Central Hospital of Enshi Autonomous Prefecture between March 2015 and June 2017 were selected as the research subjects and enrolled in the observation group and control group of the study respectively. The preoperative pelvic Doppler ultrasonography was done to determine the blood flow parameters resistance index (RI) and pulsatility index (PI) of the endometrial lesions;after surgical resection, the endometrial cancer lesion tissue was collected from the observation group and normal endometrial tissue was collected from the control group to determine the contents of pro-proliferation molecules, pro-invasion molecules and angiogenesis molecules.Results: PI and RI levels in endometrial cancer lesion of observation group were significantly lower than those of control group, and cIAP1, cIAP2, RLIP76, p-Pak4ser474, EFEMP2, CXCR4, CXCR7, Snail, Septin-9,β-arrestin2 and SOX2 protein levels in endometrial cancer lesion were significantly higher than those of control group;PI and RI levels in endometrial cancer lesion were negatively correlated with cIAP1, cIAP2, RLIP76, p-Pak4ser474, EFEMP2, CXCR4, CXCR7, Snail, Septin-9,β-arrestin2 and SOX2 protein levels.Conclusion: The Doppler ultrasound parameters of endometrial carcinoma lesion are closely related to the angiogenesis and cancer cell growth in the lesion.

Ultrasound evaluation of fetal left ventricular Tei index in gestational hypertension and its correlation with the degree of placental hypoxia

Objective:To determine the fetal left ventricular Tei index level in gestational hypertension, and evaluate its correlation with the degree of placental hypoxia.Methods: A total of 98 pregnant women with gestational hypertension who gave birth in our hospital between May 2013 and May 2016 were selected as the gestational hypertension group and 50 normal pregnant women were selected as the normal pregnancy group. Before delivery, the color Doppler diasonograph was used to detect fetal left ventricular Tei index and umbilical blood flow parameters, enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of hypoxia-related indexes and nerve injury indexes in umbilical venous blood after delivery of baby, and Pearson test was used to further evaluate the internal relations between fetal left ventricular Tei index and placental hypoxia degree.Results: Fetal left ventricular Tei index level of gestational hypertension group was higher than that of normal pregnancy group. Fetal ultrasonic umbilical blood flow parameters RI, PI and S/D levels of gestational hypertension group were higher than those of normal pregnancy group, ischemia hypoxia indexes HIF-1α and HSP70 contents in umbilical venous blood were higher than those of normal pregnancy group while NO content was lower than that of normal pregnancy group, and nerve injury indexes NSE, S100B and MBP contents in umbilical venous blood were higher than those of normal pregnancy group. After Pearson test, fetal left ventricular Tei index in gestational hypertension was directly correlated with umbilical blood flow parameter levels as well as ischemia hypoxia index and nerve injury index contents in umbilical venous blood. Conclusion:Fetal left ventricular Tei index level in gestational hypertension is higher than that in normal fetus, and Tei index level is directly correlated with placental ischemia hypoxia degree.

Reference values of carotid intima-media thickness and arterial stiffness in Chinese adults based on ultrasound radio frequency signal:A nationwide,multicenter study

Background:Carotid intima-media thickness(IMT)and diameter,stiffness,and wave reflections,are independent and important clinical biomarkers and risk predictors for cardiovascular diseases.The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical determinants.Methods:A total of 3053 healthy Han Chinese adults(1922 women)aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022.The real-time tracking of common carotid artery walls was achieved by the radio frequency(RF)ultrasound system.The IMT,diameter,compliance coefficient,βstiffness,local pulse wave velocity(PWV),local systolic blood pressure,augmented pressure(AP),and augmentation index(AIx)were then automatically measured and reported.Data were stratified by age groups and sex.The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions.The major clinical determinants of carotid properties were identified by Pearson’s correlation,multiple linear regression,and analyses of covariance.Results:All the parameters of carotid properties demonstrated significantly age-related trajectories.Women showed thinner IMT,smaller carotid diameter,larger AP,and AIx than men.Theβstiffness and PWV were significantly higher in men than women before forties,but the differences reversed after that.The increase rate of carotid IMT(5.5µm/year in women and 5.8µm/year in men)and diameter(0.03 mm/year in both men and women)were similar between men and women.For the stiffness and wave reflections,women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes(all P for age by sex interaction<0.05).The blood pressures,body mass index(BMI),and triglyceride levels were identified as major clinical determinants of carotid properties with adjustment of age and sex.Conclusions:The age-and sex-specific reference values of carotid properties measured by RF ultrasound for healthy Chinese adults were established.The blood pressures,BMI,and triglyceride levels should be considered for clinical application of corresponding reference values.

The Impacts of Maternal Gestational Diabetes Mellitus (GDM) on Fetal Hearts

Objective To evaluate the fetal cardiac function in gestational diabetes mellitus （GDM） pregnancies under different maternal glycemic controls. Methods Forty four GDM mothers received 78 fetal echocardiographic evaluations at three gestational periods （〈28, 28-34 and ≥34 weeks） and were divided into poorly-（DM1） and well-（DM2） controlled groups according to their glycemic control at examination. Seventy uncomplicated mothers were selected as controls. Parameters of fetal cardiac anatomy and function were measured and analyzed. Results GDM fetuses＇ cardiac ventricular walls were thicker than controls＇, and the differences between DM1 and DM2 were not significant except for end-diastolic left ventricular walls. In both GDM groups, the aortic flow velocities increased earlier than pulmonary artery and DM1 fetuses changed earlier than DM2 ones. GDM fetuses＇ left atrial shortening fraction was smaller than the controls＇ in the period of ≥34 weeks and negatively correlated with thicknesses of left ventricular walls and interventricular septum in DM1 fetuses （r=-0.438 and -0.506）. The right ventricular diastolic function in DM1 and DM2 fetuses decreased after the period of 28-34 weeks and in the period of ≥34 weeks respectively. Tel index of both left and right ventricles increased in DM1 group after the period of 〈28 weeks and in DM2 group only in the period of ≥ 34 weeks, with no significant differences between DM1 and DM2 groups in this period. Conclusion Fetuses of GDM mothers showed cardiac function impairments. Good maternal glycemic control may delay the impairments, but cannot reduce the degree. Some cardiac changes in GDM fetuses were similar to those in pregestational diabetic pregnancies except for several parameters and their changing time.

Adjuvant percutaneous radiofrequency ablation of feeding artery of hepatocellular carcinoma before treatment

AIM:To evaluate the feasibility and efficacy of percutaneous radiofrequency ablation(RFA) of the feeding artery of hepatocellular carcinoma(HCC) in reducing the blood-flow-induced heat-sink effect of RFA.METHODS:A total of 154 HCC patients with 177 pathologically confirmed hypervascular lesions participated in the study and were randomly assigned into two groups.Seventy-one patients with 75 HCCs(average tumor size,4.3 ± 1.1 cm) were included in group A,in which the feeding artery of HCC was identified by color Doppler flow imaging,and were ablated with multiple small overlapping RFA foci [percutaneous ablation of feeding artery(PAA)] before routine RFA treatment of the tumor.Eighty-three patients with 102 HCC(average tumor size,4.1 ± 1.0 cm) were included in group B,in which the tumors were treated routinely with RFA.Contrast-enhanced computed tomography was used as post-RFA imaging,when patients were followed-up for 1,3 and 6 mo.RESULTS:In group A,feeding arteries were blocked in 66(88%) HCC lesions,and the size of arteries decreased in nine(12%).The average number of punctures per HCC was 2.76 ± 1.12 in group A,and 3.36 ± 1.60 in group B(P = 0.01).The tumor necrosis rate at 1 mo post-RFA was 90.67%(68/75 lesions) in group A and 90.20%(92/102 lesions) in group B.HCC recur-rence rate at 6 mo post-RFA was 17.33%(13/75) in group A and 31.37%(32/102) in group B(P = 0.04).CONCLUSION:PAA blocked effectively the feeding artery of HCC.Combination of PAA and RFA significantly decreased post-RFA recurrence and provided an alternative treatment for hypervascular HCC.

Resection vs thermal ablation of small hepatocellular carcinoma:What's the first choice?

Nowadays,hepatocellular carcinoma(HCC) is frequently diagnosed at an early stage,opening good perspectives to radical treatment by means of liver transplantation,surgical resection,or percutaneous ablation.Liver transplantation is considered the best option,but the lack of liver donors represents a major limitation.Therefore,surgical resection,offering a 5-year-survival rate of over 50%,is considered the first-choice treatment for patients with early stage HCC,whereas percutaneous ablation is usually reserved to patients who are not candidate to surgery.However,in the recent years some trials showed that percutaneous radiofrequency ablation(RFA) can be as effective as surgical resection in terms of overall survival and recurrencefree survival rates in patients with small HCC,and a retrospective comparative study reported 1-,3-,and 5-year overall survival rates and recurrence-free survival rates significantly better in patients with central HCC measuring 2 cm or smaller treated with RFA than in those treated with surgical resection.RFA is less expensive,less invasive,with lower complication rate and shorter hospital stay than surgical resection,and on the basis of the results of these studies it should be considered the first option in the treatment of very early HCC.However,RFA is size-dependent,so at present the need to achieve an adequate safety margin around the tumor limits to about 2 cm the diameter of the nodules that can be ablated with long-term outcomes comparable to or better than surgical resection.The main goal of the next technical developments of the thermal ablation systems should be the achievement of larger ablation areas with a single needle insertion.In this regard,the recent improvements in microwave energy delivery systems seem to open interesting perspectives to percutaneous microwave ablation,which could become the ablation technique of choice in the next future.

Emerging roles for transthoracic ultrasonography in pulmonary diseases

As a result of many advantages such as the absence of radiation exposure,non-invasiveness,low cost,safety,and ready availability,transthoracic ultrasonography(TUS) represents an emerging and useful technique in the management of pleural and pulmonary diseases.In this second part of a comprehensive review that deals with the role of TUS in pleuropulmonary pathology,the normal findings,sonographic artifacts and morphology of the most important and frequent pulmonary diseases are described.In particular,the usefulness of TUS in diagnosing or raising suspicion of pneumonia,pulmonary embolism,atelectasis,diffuse parenchymal diseases,adult and newborn respiratory distress syndrome,lung cancer and lung metastases are discussed,as well as its role in guidance for diagnostic and therapeutic interventional procedures.Moreover,the preliminary data about the role of contrast enhanced ultrasonography in the study of pulmonary pleural-based lesions are also reported.Finally,the limits of TUS when compared with chest computed tomography are described,highlighting the inability of TUS to depict lesions that are not in contact with the pleura or are located under bony structures,poor visualization of the mediastinum,and the need for very experienced examiners to obtain reliable results.

Shear wave elastography results correlate with liver fibrosis histology and liver function reserve

AIM: To evaluate the correlation of shear wave elastography (SWE) results with liver fibrosis histology and quantitative function reserve. METHODS: Weekly subcutaneous injection of 60% carbon tetrachloride (1.5 mL/kg) was given to 12 canines for 24 wk to induce experimental liver fibrosis, with olive oil given to 2 control canines. At 24 wk, liver condition was evaluated using clinical biochemistry assays, SWE imaging, lidocaine metabolite monoethylglycine-xylidide (MEGX) test, and histologic fibrosis grading. Clinical biochemistry assays were performed at the institutional central laboratory for routine liver function evaluation. Liver stiffness was measured in triplicate from three different intercostal spaces and expressed as mean liver stiffness modulus (LSM). Plasma concentrations of lidocaine and its metabolite MEGX were determined using high-performance liquid chromatography repeated in duplicate. Liver biopsy samples were fixed in 10% formaldehyde, and liver fibrosis was graded using the modified histological activity index Knodell score (F0-F4). Correlations among histologic grading, LSM, and MEGX measures were analyzed with the Pearson linear correlation coefficient. RESULTS: At 24 wk liver fibrosis histologic grading was as follows: F0, n = 2 (control); F1, n = 0; F2, n = 3; F3, n = 7; and F4, n = 2. SWE LSM was positively correlated with histologic grading (r = 0.835, P < 0.001). Specifically, the F4 group had a significantly higher elastic modulus than the F3, F2, and F0 groups (P = 0.002, P = 0.003, and P = 0.006, respectively), and the F3 group also had a significantly higher modulus than the control F0 group (P = 0.039). LSM was negatively associated with plasma MEGX concentrations at 30 min (r = -0.642; P = 0.013) and 60 min (r = -0.651; P = 0.012), time to 1/2 of the maximum concentration (r = -0.538; P = 0.047), and the area under the curve (r = -0.636; P = 0.014). Multiple comparisons showed identical differences in these three measures: significantly lower with F4 (P = 0.037) and F3 (P = 0.032) as compared to F0 and significantly lower with F4 as compared to F2 (P = 0.032). CONCLUSION: SWE LSM shows a good correlation with histologic fibrosis grading and pharmacologic quantitative liver function reserve in experimental severe fibrosis and cirrhosis.

经皮肝穿刺射频消融治疗包膜下肝肿瘤与非包膜下肝肿瘤效用与安全性的前瞻性对照研究

目的评价经皮肝穿刺射频（RF）消融治疗包膜下肝肿瘤的效用与安全性。方法本研究经伦理委员会批准，所有受试者都签署了知情同意书。18t例病人（男79例，女102例，年龄36～85岁）的361个原发或继发（转移的）肝肿瘤进行了超声引导下的经皮RF消融治疗。44例病人有1个或1个以上包膜下肿瘤（组1），137病人仅有非包膜下肿瘤（组2）。总共80个包膜下结节和281个非包膜下结节。RF消融后1个月进行增强CT扫描评价消融的完整性。如果CT显示肿瘤残留，则再次进行RF消融。所有1次或2次RF消融治疗后的病人，每3个月进行CT或增强US进行监控。

Serous pancreatic neoplasia, data and review

AIM To describe the imaging features of serous neoplasms of the pancreas using ultrasound, endoscopic ultrasound, computed tomography and magnetic resonance imaging.METHODS This multicenter international collaboration enhances a literature review to date, reporting features of 287 histologically confirmed cases of serous pancreatic cystic neoplasms(SPN). RESULTS Female predominance is seen with most SPN presenting asymptomatically in the 5th through 7th decade. Mean lesion size was 38.7 mm, 98% were single, 44.2% cystic, 46% mixed cystic and solid, and 94% hypoechoic on B-mode ultrasound. Vascular patterns and contrast-enhancement profiles are described as hypervascular and hyperenhancing.CONCLUSION The described ultrasound features can aid differentiation of SPN from other neoplastic lesions under most circumstances.

Diagnostic accuracy of real-time tissue elastography for breast cancer:a meta-analysis

Objective The present study aimed to determine the accuracy of real-time tissue elastography （RTE） for the diagnosis of breast cancer. Methods The search was conducted in the PubMed, Web of Science, Cochrane Library, and China Biology Medicine databases from inception through December 31, 2014, without language restrictions. The meta-analysis was conducted using STATA version 12.0 and Meta-Disc version 1.4. We calculated the summary statistics for sensitivity （Sen）, specificity （Spe）, positive and negative likelihood ratio （LR＋/LR–）, diagnostic odds ratio （DOR）, and summary receiver operating characteristic （SROC） curve. Results Ten studies that met al inclusion criteria were included in the meta-analysis. A total of 608 ma-lignant breast lesions and 1292 benign breast tumors were assessed. Al breast lesions were histological y confirmed after RTE. The pooled Sen was 0.83 （95% CI = 0.79–0.86）; the pooled Spe was 0.86 （95% CI = 0.84–0.88）. The pooled LR＋ was 9.87 （95% CI = 2.66–36.71）; the pooled LR– was 0.20 （95% CI = 0.17–0.23）. The pooled DOR of RTE for the diagnosis of breast cancer was 62.21 （95% CI = 33.88–114.24）. The area under the SROC curve was 0.9334 （standard error = 0.00125）. We found no evidence of publica-tion bias （t = –0.57, P = 0.582）. Conclusion RTE may have high diagnostic accuracy for the dif erential diagnosis of benign and malig-nant breast tumors. RTE may be a good tool for breast cancer diagnosis.

Microwave ablation is as effective as radiofrequency ablation for very-early-stage hepatocellular carcinoma

Background: Percutaneous radiofrequency ablation(RFA) is a first?line treatment for very?early?stage hepatocellular carcinoma(HCC), whereas the efficacy of percutaneous microwave ablation(MWA) for very?early?stage HCC remains unclear. The purpose of this study was to clarify this issue by comparing the safety and efficacy of percutaneous MWA with percutaneous RFA in treating very?early?stage HCC.Methods: Clinical data of 460 patients who were diagnosed with very?early?stage HCC and treated with percutane?ous MWA or RFA between January 2007 and July 2012 at the Eastern Hepatobiliary Surgery Hospital, The Second Mili?tary Medical University, in Shanghai, China were retrospectively analyzed. Of these 460 patients, 159 received RFA, 301 received MWA. Overall survival(OS), recurrence?free survival(RFS), local tumor progression(LTP), complete ablation, and complication occurrence rates were compared between the two groups, and the prognostic factors associated with survival were analyzed.Results: No significant differences were observed between the two groups in terms of the 1?, 3?, or 5?year OS rates(99.3%, 90.4%, and 78.3% for MWA vs. 98.7%, 86.8%, and 73.3% for RFA, respectively; P = 0.331). Furthermore, no signif?icant differences were observed between the two groups in terms of the corresponding RFS rates(94.4%, 71.8%, and 46.9% for MWA vs. 89.9%, 67.3%, and 54.9% for RFA, respectively; P ete ablation rates(98.3% vs. 98.1%, P = 0.309), the LTP rates(9.6% vs. 10.1%, P = 0.883), the compl multivariate analysis, LTP, an= 0.860), or the occurrence rates of major complications(0.7% vs. 0.6%, P = 0.691). Bytiviral therapy, and treatment of recurrence were independent risk fac?tors for OS(P < 0.001), and the alpha?fetoprotein level was an independent prognostic factor for RFS(P = 0.002).Conclusions: MWA is as safe and effective as RFA in treating very?early?stage HCC, supporting MWA as a first?line treatment option for this disease.

Evaluation of right ventricular volume and systolic function in normal fetuses using intelligent spatiotemporal image correlation

BACKGROUND Heart defects are the most common congenital malformations in fetuses.Fetal cardiac structure and function abnormalities lead to changes in ventricular volume.As ventricular volume is an important index for evaluating fetal cardiovascular development,an effective and reliable method for measuring fetal ventricular volume and cardiac function is necessary for accurate ultrasonic diagnosis and effective clinical treatment.The new intelligent spatiotemporal image correlation(iSTIC)technology acquires high-resolution volumetric images.In this study,the iSTIC technique was used to measure right ventricular volume and to evaluate right ventricular systolic function to provide a more accurate and convenient evaluation of fetal heart function.AIM To investigate the value of iSTIC in evaluating right ventricular volume and systolic function in normal fetuses.METHODS Between October 2014 and September 2015,a total of 123 pregnant women received prenatal ultrasound examinations in our hospital.iSTIC technology was used to acquire the entire fetal cardiac volume with off-line analysis using QLAB software.Cardiac systolic and diastolic phases were defined by opening of the atrioventricular valve and the subsequent closure of the atrioventricular valve.The volumetric data of the two phases were measured by manual tracking and summation of multiple slices and recording of the right ventricular end-systolic volume and the right ventricular end-diastolic volume.The data were used to calculate the right stroke volume,the right cardiac output,and the right ejection fraction.The correlations of changes between the above-mentioned indices and gestational age were analyzed.The right ventricular volumes of 30 randomly selected cases were measured twice by the same sonographer,and the intraobserver agreement measurements were calculated.RESULTS Among the 123 normal fetuses,the mean right ventricular end-diastolic volume increased from 0.99±0.34 mL at 22 wk gestation to 3.69±0.36 mL at 35+6 wk gestation.The mean right ventricular end-systolic volume increased from 0.43±0.18 mL at 22 wk gestation to 1.36±0.22 mL at 35+6 wk gestation.The mean right stroke volume increased from 0.62±0.29 mL at 22 wk gestation to 2.33±0.18 mL at 35+6 wk gestation.The mean right cardiac output increased from 92.23±40.67 mL/min at 22 wk gestation to 335.83±32.75 mL/min at 35+6 wk gestation.Right ventricular end-diastolic volume,right ventricular end-systolic volume,right stroke volume,and right cardiac output all increased with gestational age and the correlations were linear(P<0.01).Right ejection fraction had no apparent correlation with gestational age(P>0.05).CONCLUSION Fetal right ventricular volume can be quantitatively measured using iSTIC technology with relative ease and high repeatability.iSTIC technology is expected to provide a new method for clinical evaluation of fetal cardiac function.