Automatic detection of breast lesions in automated 3D breast ultrasound with cross-organ transfer learning

Background Deep convolutional neural networks have garnered considerable attention in numerous machine learning applications,particularly in visual recognition tasks such as image and video analyses.There is a growing interest in applying this technology to diverse applications in medical image analysis.Automated three dimensional Breast Ultrasound is a vital tool for detecting breast cancer,and computer-assisted diagnosis software,developed based on deep learning,can effectively assist radiologists in diagnosis.However,the network model is prone to overfitting during training,owing to challenges such as insufficient training data.This study attempts to solve the problem caused by small datasets and improve model detection performance.Methods We propose a breast cancer detection framework based on deep learning(a transfer learning method based on cross-organ cancer detection)and a contrastive learning method based on breast imaging reporting and data systems(BI-RADS).Results When using cross organ transfer learning and BIRADS based contrastive learning,the average sensitivity of the model increased by a maximum of 16.05%.Conclusion Our experiments have demonstrated that the parameters and experiences of cross-organ cancer detection can be mutually referenced,and contrastive learning method based on BI-RADS can improve the detection performance of the model.

Sequential transcatheter arterial chemoembolization,three-dimensional conformal radiotherapy,and high-intensity focused ultrasound treatment for unresectable hepatocellular carcinoma patients

The purpose of this study was to evaluate the outcome of patients with unresectable hepatocellular carcinoma（HCC） treated by sequential therapy of transcatheter arterial chemoembolization（TACE）,three-dimensional conformal radiotherapy（3-DCRT） and high-intensity focused ultrasound（HIFU）.From October,2005 to September,2010,120 patients with unresectable HCC received the sequential treatments of several courses of TACE followed in 2-4 weeks by 3-DCRT and then a single session of HIFU with a curative intent.The median tumor irradiation dose was 40 Gy.Tumor response,toxicity and overall survival rate were analyzed.Clinicopathologic factors affecting the primary technique effectiveness and overall survival rates were investigated by univariate analysis or multivariate analysis.All 120 HCC patients were followed up by the last follow-up time.Among these patients,hepatic toxicities due to treatment were notable in 9 cases.Gastrointestinal bleeding after the overall treatment occurred in 2 cases,leukopenia of grade III was detected in 1 case,radiation-induced liver disease（RILD） was observed in 2 patients,and first-and second-degree skin burn around the HIFU treatment zone were observed in 2 patients and 1 patient,respectively.Among 120 patients,23,83 and 14 cases achieved partial response,stable disease and progressive disease,respectively.The overall survival rates at 1 year,3 years and 5 years were 70%,35% and 15%,respectively,with a median survival time of 26 months.Both Child-Pugh liver function grading and radiation dose were determined to be independent predictors for overall survival revealed by the multivariate analysis.It is concluded that the sequential therapy of TACE,3-DCRT and HIFU is a promising therapeutic regimen for unresectable HCC.

The Clinical Value of Ultrasound Image Texture Analysis in the Diagnosis of Uterine Adhesions

Purpose: This review examines the diagnostic value of transvaginal 3D ultrasound image texture analysis for the diagnosis of uterine adhesions. Materials and Methods: The total clinical data of 53 patients with uterine adhesions diagnosed by hysteroscopy and the imaging data of transvaginal three-dimensional ultrasound from the Second Affiliated Hospital of Chongqing Medical University from June 2022 to August 2023 were retrospectively analysed. Based on hysteroscopic surgical records, patients were divided into two independent groups: normal endometrium and uterine adhesion sites. The samples were divided into a training set and a test set, and the transvaginal 3D ultrasound was used to outline the region of interest (ROI) and extract texture features for normal endometrium and uterine adhesions based on hysteroscopic surgical recordings, the training set data were feature screened and modelled using lasso regression and cross-validation, and the diagnostic efficacy of the model was assessed by applying the subjects’ operating characteristic (ROC) curves. Results: For each group, 290 texture feature parameters were extracted and three higher values were screened out, and the area under the curve of the constructed ultrasonographic scoring model was 0.658 and 0.720 in the training and test sets, respectively. Conclusion Relative clinical value of transvaginal three-dimensional ultrasound image texture analysis for the diagnosis of uterine adhesions.

Contrast-enhanced 3D ultrasound in the radiofrequency ablation of liver tumors

Liver metastases and hepatocellular carcinomas are two of the most common causes of cancer deaths in the world.Radiofrequency ablation(RFA) is a well recognized,effective and minimally invasive means of treating malignant hepatic tumors.This article describes the use of contrast-enhanced 3D ultrasound(CE-3DUS) in the staging,targeting and follow-up of patients with liver tumors undergoing RFA.In particular,its value in the management of large hepatic lesions will be illustrated.Current limitations of CE-3DUS and future developments in the technique will also be discussed.In summary,CE-3DUS is useful in the RFA of liver tumors with improved detection and display of occult lesions and recurrence,in the assessment of lesional geometry and orientation for a more accurate planning and guidance of multiple RFA needle electrodes in large tumors and in the evaluation of residual or recurrent disease within the immediate and/or subsequent follow-up periods.

Transvaginal 3D Ultrasound Evaluation of Post-Cesarean Section Uterine Diverticulum

Objectives: This study focused on evaluating the value of transvaginal 3D ultrasound for the diagnosis and prognostic assessment of post-cesarean section uterine diverticulum. Materials and Methods: We retrospectively analyzed the data from 32 patients with post-cesarean section uterine diverticulum over three recent years. In all patients, transvaginal 3D ultrasound was used to measure the size of the uterine diverticulum and the thickness of the lower uterine segment (LUS) and myometrium. Patients with a LUS with a myometrial thickness under 4 mm underwent resection and repair surgery;those with a LUS with a myometrial thickness over 4 mm underwent hysteroscopic resection. The postoperative sonograms were compared with preoperative images to evaluate the efficacy of various treatments. Results: The mean length, width and depth of the uterine diverticula were 18.30 ± 2.80 mm, 9.14 ± 3.20 mm and 11.49 ± 2.71 mm, respectively. The average LUS myometrial thickness was 3.40 ± 0.80 mm (with a range of 1.6 mm - 6.3 mm). After surgery, two patients’ sonograms still showed diverticula at the post-cesarean section scar, measuring 6 mm × 7 mm × 6 mm and 6 mm × 8 mm × 4 mm. There were significant differences in the size of uterine diverticula between preoperative and postoperative sonograms (P < 0.05) and the effective rate of surgery was 93.75% (30/32). Conclusions: Transvaginal 3D ultrasound is an accurate method for detecting post-cesarean section uterine diverticulum and is helpful for assessing surgical options and prognosis. The LUS myometrial thickness, which is considered as an optional index of post-cesarean section uterine diverticulum, should be measured routinely.

State-of-the-art imaging techniques in endoscopic ultrasound

Endoscopic ultrasound (EUS) has recently evolved through technological improvement of equipment,with a major clinical impact in digestive and mediastinal diseases.State-of-the-art EUS equipment now includes real-time sono-elastography,which might be useful for a better characterization of lesions and increased accuracy of differential diagnosis (for e.g.lymph nodes or focal pancreatic lesions).Contrast-enhanced EUS imaging is also available,and is already being used for the differential diagnosis of focal pancreatic masses.The recent development of low mechanical index contrast harmonic EUS imaging offers hope for improved diagnosis,staging and monitoring of anti-angiogenic treatment.Tridimensional EUS (3D-EUS) techniques can be applied to enhance the spatial understanding of EUS anatomy,especially for improved staging of tumors,obtained through a better assessment of the relationship with major surrounding vessels.Despite the progress gained through all these imaging techniques,they cannot replace cytological or histological diagnosis.However,real-time optical histological diagnosis can be achieved through the use of single-fiber confocal laser endomicroscopy techniques placed under real-time EUS-guidance through a 22G needle.Last,but not least,EUS-assisted natural orifice transluminal endoscopic surgery (NOTES) procedures offer a whole new area of imaging applications,used either for combination of NOTES peritoneoscopy and intraperitoneal EUS,but also for access of retroperitoneal organs through posterior EUS guidance.

Resection of Vaginal Septum in Obstructed Hemivagina and Ipsilateral Renal Anomaly: Utility of Three Dimensional Intraoperative Ultrasound

Background: Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome is a rare congenital condition of the female urogenital tract, presenting intraoperative challenges. We demonstrate the utility of three dimensional intraoperative ultrasound to better delineate anatomy and aid in optimal resection of the vaginal septum. Case: A 12-year-old female was referred to pediatric and adolescent gynecology for irregular periods and evaluation of her gynecologic organs. Imaging studies confirmed OHVIRA syndrome. She underwent uncomplicated vaginal septum resection, guided by three dimensional intraoperative ultrasound. Summary and Conclusion: Intraoperative ultrasound can better delineate challenging anatomy. We show that three dimensional intraoperative ultrasound offers significant advantages over traditional two dimensional ultrasound and is a supplement to MRI, which may be helpful in complex anatomical cases like OHVIRA syndrome.

Detecting Accuracy of Three Dimensional Power Doppler (3DPD) Vascular Indices for Prenatal Diagnosis of Morbidly Adherent Placenta in Patients with Placenta Previa

Objective:?The study’s objective was to assess the accuracy of using prenatal 3-dimensional power Doppler analysis of vascular placental indices to accurately diagnose morbidly adherent placenta objectively. Background:?Traditionally, 2D ultrasound was used for the diagnosis of a suspected morbidly adherent placenta (MAP) previa. More objective techniques like 3D power Doppler haven’t been well studied. Study Design:?A prospective cohort study?is?designed for women with gestational age between 28 and?32 weeks with suspected placenta previa. Patients were examined by 2D ultrasound which was used in management decisions.?3D Power Doppler’s VI, FI and VFI were measured during the same examination after manual tracing of placenta;data were blinded to obstetricians. Histopathology was performed to confirm MAP. Results: Our results showed that the 3D power Doppler VI ≥ 16 predicted the diagnosis of MAP with 100% sensitivity, 100% specificity which is better than those of 2D ultrasound. While VI > 33.1 measured by 3D Doppler predicted severe MAP with a sensitivity of 73.9% and specificity of 86.4%, which was superior to 2D ultrasound. Conclusion:?In patients with placenta previa, the 3D Doppler’s vascular index accurately predicts MAP. Furthermore, vascular and vascular flow indices of 3D Doppler were more predictive of severe cases of MAP compared to 2D ultrasound.

TV-CDFI指标联合FAR、D-D预测卵巢癌手术预后价值

目的:探究经阴道彩色多普勒血流成像(TV-CDFI)指标联合血纤维蛋白原/白蛋白比值(FAR)、D-二聚体(D-D)对卵巢癌手术预后的预测价值。方法:选取2015年1月-2021年1月本院接受手术治疗的227例卵巢癌患者,术后进行3年随访,统计患者预后情况,分析卵巢癌患者预后影响因素,评价TV-CDFI测定血流指标、FAR、D-D对卵巢癌预后的预测价值。结果:随访3年,227例卵巢癌患者中,失访15例,共212例(93.4%)完成随访,复发82例,复发率38.7%(82/212),中位复发时间11(8,15)个月。COX回归分析显示,肿瘤分期Ⅲ~Ⅳ期、淋巴结转移、TV-CDFI指标异常、FAR升高、D-D升高均为卵巢癌预后影响因素(P<0.05);绘制受试者工作特征曲线显示,TV-CDFI指标、FAR、D-D预测卵巢癌手术预后的曲线下面积(AUC)均≥0.7,各指标联合预测时AUC为0.983,预测效能更高。结论:卵巢癌术前患者TV-CDFI血流指标异常、血FAR升高、血D-D升高均与不良预后有关,临床检测其水平有助于预测卵巢癌手术预后,为临床治疗提供参考。

珠线式模板在Freehand超声图像快速标定中的应用

为了精确标定freehand超声图像坐标系与固定于超声探头上的跟踪设备坐标系间坐标转换关系,提出一种"Z"形珠线模板,由双层"Z"形棉线与精确定位的圆珠构成。定位珠能够引导用户将探头准确定位,即将定位珠全部收入图像视野中。计算定位珠在超声图像中成像点间距的比例关系,根据其相应的模板空间间距比例制定优化算法,校准用户拾取的图像坐标。应用同源点匹配算法得到超声图像平面坐标系与磁跟踪设备坐标系间的空间转换关系,从而实现2-D超声图像向3-D空间坐标系的定位转换。标定结果显示此方法与以往的标定方法相比:加快了标定速度,且标定精度与重建精度有所提高。试验采用磁定位方式进行探头的跟踪定位,此方法同样适用于其他定位方式。

7-氨基-6-氰基-5-(3-硝基苯基)吡喃并嘧啶-2,4-二酮的合成

报道了常温、超声辐射、水中、无催化剂条件下,以3-硝基苯甲醛、丙二腈和巴比妥酸为原料合成标题化合物的方法。考察了超声技术、反应时间及反应温度对反应的影响。最佳反应条件为:室温、超声辐射2h,收率为86.2%。

TPUS检查对子宫全切术后患者PFD发生情况的评估价值

本文旨在分析经会阴超声(TPUS)检查对子宫全切术后患者盆底功能障碍(PFD)发生情况的评估价值。选取行子宫全切术的患者157例,根据术后是否出现PFD,分为未发生PFD组103例和发生PFD组54例,均行TPUS检查。结果显示,与未发生PFD组相比,发生PFD组膀胱下移距离、直肠下移距离、阴道穹窿下移距离、膀胱尿道后角、肛提肌裂孔左右径、前后径、面积、周长升高,尿道倾斜角降低(P<0.05)两组肛提肌厚度比较,差异无统计学意义(P>0.05)。与经会阴二维、三维、四维超声检查单独检查相比,三项联合诊断价值较高(P<0.05)。研究结果表明,子宫全切术患者术后存在PFD,TPUS检查对PFD的诊断价值较为理想,可用于子宫全切术后患者PFD发生的临床诊断评估。

Gastric accommodation assessed by ultrasonography

Gastric accommodation is important for the understanding of the pathophysiology in functional dyspepsia and is also relevant for symptom generation in other disorders. The term gastric accommodation has at least three different meanings： The accommodation process, the accommodation reflex, and the accommodation response. The gastric accommodation process is a complex phenomenon that describes how the size of the gastric compartment changes in response to a meal. The electronic barostat is considered the gold standard in assessing gastric accommodation. Imaging methods, including MRI, SPECT, and ultrasonography may also be used, particularly in patients who are stress-responsive, e.g. functional dyspepsia patients, as a non-invasive and less stress-inducing method is favourable. Ultrasonography satisfies these criteria as it does not by itself distort the physiological response in stress-responsive individuals.

Research progress of localization technique assisted neuroendoscopy for cerebral hemorrhage

Neurosurgeons who perform intracere-bral hemorrhage(ICH)evacuation procedures have lim-ited options for monitoring hematoma evacuation and intraoperatively assessing residual-hematoma burden.In recent years,neuroendoscope-assisted,minimally inva-sive surgery for spontaneous ICH is simple and effective and becoming increasingly common.Many methods are applied in neuronavigation-assisted surgery for ICH evac-uation,such as neuroendoscopy,three-dimensional(3D)reconstruction,intraoperative ultrasound,and stereotac-tic craniotomy.Compared with a traditional craniotomy operation,hematoma removal(using methods of accurate localization)can reduce iatrogenic damage,protect white matter,and shorten patients’recovery time.This paper mainly outlines the treatment of basal ganglia-cerebral hemorrhage with neuroendoscopy assistance using local-ization techniques.

三维能量多普勒超声在孕11～13^(+6)周预测胎儿生长受限的应用

目的研究三维能量多普勒超声在孕11~13^(+6)周预测胎儿生长受限的应用价值。方法对2013年9月~2015年6月在珠海市第二人民医院就诊的孕11~13^(+6)周孕妇留取胎盘三维彩色多普勒容积数据存至硬盘,并随访至足月胎儿出生,记录新生儿体重等指标及妊娠结局,共有32例诊断为FGR。将32例FGR胎儿及60例正常胎儿作为研究对象,采用Q-LAB软件取得胎盘三维能量多普勒指数,包括血管化指数(VI),血流指数(FI),血管化-血流指数(VFI),对比分析二者之间的差异,研究其在孕孕11~13^(+6)周预测胎儿生长受限的应用价值。结果 92例研究对象其胎盘三维能量图及多普勒指数均获得,正常组与FGR组在胎盘FI、VI、VFI差异有统计学意义。结论早孕期胎盘的三维能量多普勒指数与胎儿生长受限呈密切相关,在尽早预测FGR的发生方面有一定的应用价值。

Can We Predict Menorrhagia with Intrauterine Contraceptive Device (IUCD) Insertion?

Objective: Studying sub endometrial vascularity and blood flow in cases using intrauterine contraceptive devices for contraception with and without menorrhagia compared to cases not using intrauterine contraceptive devices. Methods: Three hundred and fifteen women attending gynecology and family planning outpatient clinics in the maternity hospital, Ain Shams University were included in the study. They were classified into three groups, 105 women using IUCD with menorrhagia (group I), 105 women using IUCD without menorrhagia (group II), and 105 normal controls not using IUCD (group III). After excluding local causes for bleeding, blood disease or any medical disorders, transvaginal ultrasound including three dimensional power Doppler (3DPD) ultrasound was done for all women. Right and left uterine artery pulsatility index (PI) and resistance index (RI) were calculated, subednometrial blood flow RI and PI were obtained then 3DPD Vascular indices (VI, FI and VFI) of subendometrial blood flow were obtained for all cases. Statistical analysis was done to compare between the three groups. Results: A significant statistical difference was found as regards subendometrial vascularity indices, while there was no difference as regards bilateral uterine arteries Doppler indices in the three groups. Conclusion: Subendometrial vascularity in cases of menorrhagia with IUCD was markedly higher than in cases without menorrhagia and cases with no IUCD. 3DPD may be used for selection of cases prior to insertion of IUCD.

A novel classification method for mild adolescent idiopathic scoliosis using 3D ultrasound imaging

Mild adolescent idiopathic scoliosis(AIS),with Cobb<20°,was hypothesized as the right stage to intervene to prevent progression.AIS curve can be categorized into either structural or non-structural depending on the spine morphology(flexibility).Using X-ray to characterize AIS curves remains the clinical gold standard whilecompromising the risks of radiation exposure.In previous works,3D ultrasound imaging had proved the reli-ability of the coronal spinal curvature measurement This research aimed at developing a mild AIs clasificationscheme through examining spine flexibility using 3D ultrasound imaging.For the preliminary study,90 mild AIS subjects(21 M and 69 F;Age:14.5±1.7 years old;Cobb:18.2±6.4°)underwent both 3D ultrasound and X-ray scanning on the same day.For each case,a clinician measured Cobbs and denoted major curve as ground truth.Bending Asymmetry Index(BAl)was developed to indicate the presence of a possible structural curve.The curve classification was coded to a modfied Lenke classification for mild cases(m-Lenke).The results of 3D ultrasound classification were evaluated with the X-ray.It was shown that 70.1%of the subjects had identical curve clssification results and 72.0%had the correct major curve detection.Lumbar-dominated curves had distinctive performance(p=0.91,r=0.91)against others.The study demonstrated the possibility of a 3D ultrasound-based method for mild AIS curve classification.Thediscrepancies could be partially explained by the limitations of the ultrasound scanning in proximal thoracicreg ion.Subsequent studies will validate the proposed method with a larger cohort.

Spinal deformity measurement using a low-density flexible array ultrasound transducer:A feasibility study with phantoms

Spinal deformities assessment using 3D ultrasound scanning has limitations in fitting onto different back surface contour as well as fitting within the gaps between subject and their spinal brace during bracing assessments.The study proposed a flexible array ultrasound transducer to overcome these limitations.The results demonstrated the feasibility of spinal deformity assessments with a flexible ultrasound array when arranged in four shapes,namely Linear,Concave,Convex,and S-shaped.For comparisons of imaging performance on spinous process using the four shapes,Convex and S-shaped transducer showed a depth dependence and lateral location dependence of the lateral intensity distribution of spinous process,respectively.S-shaped transducer had the least accurate prediction of the location of spinous process,with measurement error of 4.8
3.2 mm,it also showed poorer prediction on spinal curvature measurements.This is suggested to be due to the asymmetrical distortion to the spinous process due to the lateral location dependence of the image.However,the coronal curve prediction of spine phantom performed well with R-squared values of>0.97 in all transducer shapes.The results of this study paved the way for further investigation on the improvement of image quality and measurement accuracy under different shapes for the flexible array,mechanism of dynamic shape change during the scanning to fit different body contour,as well as extension from 1D to 2D flexible array.

三维超声用于青少年特发性脊柱侧凸评估的信度与效度研究

目的:探索三维超声成像技术在临床上评估和测量青少年特发性脊柱侧凸(AIS)患者椎体侧凸角度的可行性;通过与磁共振成像(MRI)的测量方法比较,评价三维超声测量结果的信度与效度。方法:16例AIS女性患者在同一上午进行三维超声和MRI的全脊柱扫描。将三维超声和MRI的图像进行随机分配,两位评测者随机抽取图像进行测量;所有图像均需进行3次测量,每次测量间隔1周,且测量过程中对两位评测者采取盲法。在冠状面上,三维超声成像采用椎板中心法(COL)测量AIS的椎体侧凸角度;而MRI成像采用Cobb方法。通过计算组内相关系数(ICC[2,k])评价三维超声测量方法的信度;通过与MRI测量结果比较,采用配对t检验及Pearson相关系数,评价三维超声测量方法的效度。结果:在冠状面上,三维超声成像COL测量方法评估AIS患者椎体侧凸角度具有较高的评测者内和评测者间信度(ICC[2,K]>0.9,P<0.05)。三维超声成像COL测量方法和MRI成像Cobb测量方法评估AIS椎体侧凸角度的结果之间没有显著性差异(P<0.05);两种测量方法具有较高的相关性(r>0.9)。结论:三维超声成像技术可用于评估AIS患者椎体在冠状面上的侧凸角度,具有较高的信度和效度。

超声引导下经皮经肝穿刺微波凝固治疗肝癌的临床研究

目的 在实时超声引导下将微波天线直接插入人体肝脏肿瘤 ,产生凝固坏死 (PMCT)。评价该方法在治疗肝脏肿瘤中的价值。方法 应用HSE 8M微波治疗仪 (频率 2 45 0MHz)对 3 2例患者的 5 1个肝癌结节进行微波凝固治疗 ,并用Levovist(利声显 )超声造影、3 DUS和实验室检查等观察疗效。结果 微波凝固治疗后 ,Levovist造影显示肿瘤内血流消失或明显减少 ,3 2例中有 2 0例原发性肝癌 ,其中 16例AFP明显下降 ,一例下降近 3万单位 ,无严重并发症 ,临床疗效较满意。结论 PMCT可使肿瘤留置固化、原位灭活 ,是一种安全、有效、副作用小、可供选择的肝癌非手术治疗方法 ;将肿瘤内血管树主干作为凝固治疗的主要目标 ,可提高疗效 ;Levovist造影观察PMCT前后肝脏肿瘤内血流的变化应当作为判断PMCT疗效的金标准 ;3 DUS成像可以非常直观地观察凝固区形态 ,准确测量凝固区体积 ,客观评价疗效。