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Zhang C, Zheng Y, McAviney J, Ling SH. SSAT-Swin: Deep Learning-Based Spinal Ultrasound Feature Segmentation for Scoliosis Using Self-Supervised Swin Transformer. ULTRASOUND IN MEDICINE & BIOLOGY 2025; 51:999-1007. [PMID: 40082183 DOI: 10.1016/j.ultrasmedbio.2025.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2024] [Revised: 02/05/2025] [Accepted: 02/18/2025] [Indexed: 03/16/2025]
Abstract
OBJECTIVE Scoliosis, a 3-D spinal deformity, requires early detection and intervention. Ultrasound curve angle (UCA) measurement using ultrasound images has emerged as a promising diagnostic tool. However, calculating the UCA directly from ultrasound images remains challenging due to low contrast, high noise, and irregular target shapes. Accurate segmentation results are therefore crucial to enhance image clarity and precision prior to UCA calculation. METHODS We propose the SSAT-Swin model, a transformer-based multi-class segmentation framework designed for ultrasound image analysis in scoliosis diagnosis. The model integrates a boundary-enhancement module in the decoder and a channel attention module in the skip connections. Additionally, self-supervised proxy tasks are used during pre-training on 1,170 images, followed by fine-tuning on 109 image-label pairs. RESULTS The SSAT-Swin achieved Dice scores of 85.6% and Jaccard scores of 74.5%, with a 92.8% scoliosis bone feature detection rate, outperforming state-of-the-art models. CONCLUSION Self-supervised learning enhances the model's ability to capture global context information, making it well-suited for addressing the unique challenges of ultrasound images, ultimately advancing scoliosis assessment through more accurate segmentation.
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Affiliation(s)
- Chen Zhang
- School of Electrical and Data Engineering, University of Technology Sydney, NSW, Australia
| | - Yongping Zheng
- Department of Electronic and Information Engineering, Hong Kong Polytechnic University, Hong Kong, China
| | - Jeb McAviney
- ScoliCare Clinic Sydney (South), Kogarah, NSW, Australia
| | - Sai Ho Ling
- School of Electrical and Data Engineering, University of Technology Sydney, NSW, Australia.
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2
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Kim JH, Yoon H, Viswanath S, Dagdeviren C. Conformable Piezoelectric Devices and Systems for Advanced Wearable and Implantable Biomedical Applications. Annu Rev Biomed Eng 2025; 27:255-282. [PMID: 40310886 DOI: 10.1146/annurev-bioeng-020524-121438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2025]
Abstract
With increasing demands for continuous health monitoring remotely, wearable and implantable devices have attracted considerable interest. To fulfill such demands, novel materials and device structures have been investigated, since commercial biomedical devices are not compatible with flexible and conformable form factors needed for soft tissue monitoring and intervention. Among various materials, piezoelectric materials have been widely adopted for multiple applications including sensing, energy harvesting, neurostimulation, drug delivery, and ultrasound imaging owing to their unique electromechanical conversion properties. In this review, we provide a comprehensive overview of piezoelectric-based wearable and implantable biomedical devices. We first provide the basic principles of piezoelectric devices and device design strategies for wearable and implantable form factors. Then, we discuss various state-of-the-art applications of wearable and implantable piezoelectric devices and their design strategies. Finally, we demonstrate several challenges and outlooks for designing piezoelectric-based conformable biomedical devices.
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Affiliation(s)
- Jin-Hoon Kim
- Media Lab, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA;
| | - Hyeokjun Yoon
- Media Lab, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA;
| | - Shrihari Viswanath
- Media Lab, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA;
| | - Canan Dagdeviren
- Media Lab, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA;
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3
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Verma N, Setia A, Mehata AK, Randhave N, Badgujar P, Malik AK, Muthu MS. Recent Advancement of Indocyanine Green Based Nanotheranostics for Imaging and Therapy of Coronary Atherosclerosis. Mol Pharm 2024; 21:4804-4826. [PMID: 39225111 DOI: 10.1021/acs.molpharmaceut.4c00495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Atherosclerosis is a vascular intima condition in which any part of the circulatory system is affected, including the aorta and coronary arteries. Indocyanine green (ICG), a theranostic compound approved by the FDA, has shown promise in the treatment of coronary atherosclerosis after incorporation into nanoplatforms. By integration of ICG with targeting agents such as peptides or antibodies, it is feasible to increase its concentration in damaged arteries, hence increasing atherosclerosis detection. Nanotheranostics offers cutting-edge techniques for the clinical diagnosis and therapy of atherosclerotic plaques. Combining the optical properties of ICG with those of nanocarriers enables the improved imaging of atherosclerotic plaques and targeted therapeutic interventions. Several ICG-based nanotheranostics platforms have been developed such as polymeric nanoparticles, iron oxide nanoparticles, biomimetic systems, liposomes, peptide-based systems, etc. Theranostics for atherosclerosis diagnosis use magnetic resonance imaging (MRI), computed tomography (CT), near-infrared fluorescence (NIRF) imaging, photoacoustic/ultrasound imaging, positron emission tomography (PET), and single photon emission computed tomography (SPECT) imaging techniques. In addition to imaging, there is growing interest in employing ICG to treat atherosclerosis. In this review, we provide a conceptual explanation of ICG-based nanotheranostics for the imaging and therapy of coronary atherosclerosis. Moreover, advancements in imaging modalities such as MRI, CT, PET, SPECT, and ultrasound/photoacoustic have been discussed. Furthermore, we highlight the applications of ICG for coronary atherosclerosis.
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Affiliation(s)
- Nidhi Verma
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, India
| | - Aseem Setia
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, India
| | - Abhishesh Kumar Mehata
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, India
| | - Nandini Randhave
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, India
| | - Paresh Badgujar
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, India
| | - Ankit Kumar Malik
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, India
| | - Madaswamy S Muthu
- Department of Pharmaceutical Engineering and Technology, Indian Institute of Technology (BHU), Varanasi 221005, India
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Maini L, Genovés V, Furrer R, Cesarovic N, Hierold C, Roman C. An in vitro demonstration of a passive, acoustic metamaterial as a temperature sensor with mK resolution for implantable applications. MICROSYSTEMS & NANOENGINEERING 2024; 10:8. [PMID: 38261856 PMCID: PMC10794229 DOI: 10.1038/s41378-023-00632-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/13/2023] [Accepted: 10/30/2023] [Indexed: 01/25/2024]
Abstract
Wireless medical sensors typically utilize electromagnetic coupling or ultrasound for energy transfer and sensor interrogation. Energy transfer and management is a complex aspect that often limits the applicability of implantable sensor systems. In this work, we report a new passive temperature sensing scheme based on an acoustic metamaterial made of silicon embedded in a polydimethylsiloxane matrix. Compared to other approaches, this concept is implemented without additional electrical components in situ or the need for a customized receiving unit. A standard ultrasonic transducer is used for this demonstration to directly excite and collect the reflected signal. The metamaterial resonates at a frequency close to a typical medical value (5 MHz) and exhibits a high-quality factor. Combining the design features of the metamaterial with the high-temperature sensitivity of the polydimethylsiloxane matrix, we achieve a temperature resolution of 30 mK. This value is below the current standard resolution required in infrared thermometry for monitoring postoperative complications (0.1 K). We fabricated, simulated, in vitro tested, and compared three acoustic sensor designs in the 29-43 °C (~302-316 K) temperature range. With this concept, we demonstrate how our passive metamaterial sensor can open the way toward new zero-power smart medical implant concepts based on acoustic interrogation.
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Affiliation(s)
- Lucrezia Maini
- Micro- and Nanosystems, Department of Mechanical and Process Engineering, ETH Zurich, Tannenstrasse 3, 8092 Zurich, Switzerland
| | - Vicente Genovés
- Translational Cardiovascular Technology, Department of Health Science and Technology, ETH Zurich, Leopold-Ruzicka-Weg 4, 8093 Zurich, Switzerland
| | - Roman Furrer
- Transport at Nanoscale Interfaces, Swiss Federal Laboratories for Materials Science and Technology, EMPA, Überlandstrasse 129, 8600 Dübendorf, Switzerland
| | - Nikola Cesarovic
- Translational Cardiovascular Technology, Department of Health Science and Technology, ETH Zurich, Leopold-Ruzicka-Weg 4, 8093 Zurich, Switzerland
- Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charite (DHZC), 13353 Berlin, Germany
| | - Christofer Hierold
- Micro- and Nanosystems, Department of Mechanical and Process Engineering, ETH Zurich, Tannenstrasse 3, 8092 Zurich, Switzerland
| | - Cosmin Roman
- Micro- and Nanosystems, Department of Mechanical and Process Engineering, ETH Zurich, Tannenstrasse 3, 8092 Zurich, Switzerland
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Hughes KA, Misra B, Maghareh M, Bobbala S. Use of stimulatory responsive soft nanoparticles for intracellular drug delivery. NANO RESEARCH 2023; 16:6974-6990. [PMID: 36685637 PMCID: PMC9840428 DOI: 10.1007/s12274-022-5267-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/30/2022] [Accepted: 10/31/2022] [Indexed: 05/24/2023]
Abstract
Drug delivery has made tremendous advances in the last decade. Targeted therapies are increasingly common, with intracellular delivery highly impactful and sought after. Intracellular drug delivery systems have limitations due to imprecise and non-targeted release profiles. One way this can be addressed is through using stimuli-responsive soft nanoparticles, which contain materials with an organic backbone such as lipids and polymers. The choice of biomaterial is essential for soft nanoparticles to be responsive to internal or external stimuli. The nanoparticle must retain its integrity and payload in non-targeted physiological conditions while responding to particular intracellular environments where payload release is desired. Multiple internal and external factors could stimulate the intracellular release of drugs from nanoparticles. Internal stimuli include pH, oxidation, and enzymes, while external stimuli include ultrasound, light, electricity, and magnetic fields. Stimulatory responsive soft nanoparticulate systems specifically utilized to modulate intracellular delivery of drugs are explored in this review.
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Affiliation(s)
- Krystal A. Hughes
- Department of Pharmaceutical Sciences, West Virginia University School of Pharmacy, Morgantown, WV 26505 USA
| | - Bishal Misra
- Department of Pharmaceutical Sciences, West Virginia University School of Pharmacy, Morgantown, WV 26505 USA
| | - Maryam Maghareh
- Department of Clinical Pharmacy, West Virginia University School of Pharmacy, Morgantown, WV 26505 USA
| | - Sharan Bobbala
- Department of Pharmaceutical Sciences, West Virginia University School of Pharmacy, Morgantown, WV 26505 USA
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6
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Probe Selection. Regen Med 2023. [DOI: 10.1007/978-3-030-75517-1_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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7
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Harmsen MJ, Trommelen LM, de Leeuw RA, Tellum T, Juffermans LJM, Griffioen AW, Thomassin-Naggara I, Van den Bosch T, Huirne JAF. Uterine junctional zone and adenomyosis: comparison of MRI, transvaginal ultrasound and histology. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2022. [PMID: 36370446 DOI: 10.1002/uog.26117] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/27/2022] [Accepted: 10/21/2022] [Indexed: 06/02/2023]
Abstract
The uterine junctional zone is the subendometrial area in the myometrium that contributes to peristalsis and aids in spermatozoa and blastocyst transport. Alterations in the appearance of the junctional zone on transvaginal sonography (TVS) or magnetic resonance imaging (MRI) are associated with adenomyosis. The lack of standardization of description of its appearance and ill-defined boundaries on both histology and imaging hamper understanding of the junctional zone and limit its role in the diagnosis of adenomyosis. The objectives of this review were to investigate the accordance in definition of the junctional zone across different diagnostic approaches and to examine how imaging findings can be linked to histological findings in the context of diagnosis of adenomyosis. A comprehensive literature review was conducted of articles describing the appearance on imaging and the histological structure of the uterine junctional zone. Our review suggests that the junctional zone is distinguished from the middle and outer myometrium by gradual changes in smooth-muscle cell density, extracellular space, connective tissue, water content and vascular properties. However, while the signal intensity from the junctional zone to the middle myometrium changes abruptly on MRI, the histopathological changes are gradual and its border may be difficult or impossible to distinguish on two-dimensional TVS. Moreover, the thickness of the junctional zone measured on MRI is larger than that measured on TVS. Thus, these two imaging modalities reflect this zone differently. Although a thickened junctional zone is often used to diagnose adenomyosis on MRI, the presence of adenomyosis can be described more accurately as interruptions of the junctional zone by endometrial tissue, which leads to direct signs on imaging such as subendometrial lines and buds on two- and three-dimensional TVS or bright foci on MRI. The histopathological criteria for diagnosis are based on enlargement of the uterus with severe adenomyosis, and might not reflect its early stages. Clinicians should be aware that findings on MRI cannot be extrapolated readily to ultrasound. An understanding of this is necessary when investigating the uterine junctional zone as a functional unit and the association between visualization of direct features of adenomyosis in the junctional zone and clinical symptoms. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- M J Harmsen
- Department of Obstetrics & Gynaecology, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - L M Trommelen
- Department of Obstetrics & Gynaecology, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - R A de Leeuw
- Department of Obstetrics & Gynaecology, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - T Tellum
- Department of Gynecology, Oslo University Hospital, Oslo, Norway
| | - L J M Juffermans
- Department of Obstetrics & Gynaecology, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - A W Griffioen
- Angiogenesis Laboratory, Department of Medical Oncology, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - I Thomassin-Naggara
- Department of Diagnostic and Interventional Imaging (IRIS), Sorbonne Université, Assistance Publique Hopitaux de Paris, Paris, France
| | - T Van den Bosch
- Department of Obstetrics and Gynecology, University Hospitals KU Leuven, Leuven, Belgium
| | - J A F Huirne
- Department of Obstetrics & Gynaecology, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
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Sampietro-Martínez R, Pérez-Monreal J, Sánchez-Torres A, Bara-Casaus J, Gay-Escoda C. Color doppler ultrasound for the assessment of palatal fibromucosa thickness and the trajectory of the greater palatine artery: A pilot study. J Clin Exp Dent 2022; 14:e528-e533. [PMID: 35912032 PMCID: PMC9328489 DOI: 10.4317/jced.59704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 05/23/2022] [Indexed: 11/22/2022] Open
Abstract
Background The primary objective of this study was to determine the position and course of the greater palatine artery using color doppler ultrasound. The secondary objective was to determine the thickness of the palatine fibromucosa.
Material and Methods A pilot case series study was performed in a private clinic during February 2020. The scans were performed with a Mindray® M9 ultrasound machine (Mindray North America, NJ, USA) coupled to an L16-4Hs® hockey-type angled probe. For each participant, the arterial path and thickness of the palatal fibromucosa were determined at 5 different points.
Results A total of 6 volunteers (3 males and 3 females) with a mean age of 39.2 (±16) years were included. While the thickness of the fibromucosa decreased along the anterior area, the distance from the cementoenamel junction to the position of the artery was generally maintained up to the canine position, where it was found to be closed to teeth.
Conclusions Color doppler ultrasound allows accurate localization of the artery as well as measurement of the thickness of the palatine fibromucosa. It would help to select the best area for graft harvesting in order to avoid bleeding complications due to vascular sectioning. Key words:Hard palate, doppler ultrasonography, diagnosis, connective tissue graft.
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Affiliation(s)
- Raúl Sampietro-Martínez
- DDS. MS. Master Degree Program in Oral Surgery and Orofacial Implantology (EFHRE International University/FUCSO)
| | - Javier Pérez-Monreal
- MD, MSc, PhD, EBPh. Director of the Department of Vascular Doppler Ultrasound, MAZ Hospital. Zaragoza, Spain. Associate Professor of the Master Degree Program in Phlebology and Lymphology, University of Alcala. Madrid, Spain
| | - Alba Sánchez-Torres
- DDS, MS. Master of Oral Surgery and Orofacial Implantology. Associate Professor of the Oral Surgery Department, School of Dentistry, University of Barcelona, Spain
| | - Javier Bara-Casaus
- MD, PhD, OMFS. Director of the Maxillofacial Institute of Sagrat Cor University Hospital, Barcelona, Spain. Co-Director of the Specialist Course in TMJ and Orofacial Pain, University of Barcelona. Director of the Postgraduate Course in Oral Medicine and Surgery of the Catalan Society of Odontology and Stomatology
| | - Cosme Gay-Escoda
- MD, DDS, MS, PhD, EBOS, OMFS. Chairman and Professor of the Oral and Maxillofacial Surgery Department, School of Dentistry, Uni¬versity of Barcelona. Director of the Master Degree Program in Oral Surgery and Implantology (EFHRE International University / FUCSO). Coordinator/Researcher of the IDIBELL Institute. Head of the Oral and Maxillofacial Surgery and Implantology Department, Teknon Medical Center, Barcelona, Spain
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9
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Khan MN, Altalbe A. Experimental evaluation of filters used for removing speckle noise and enhancing ultrasound image quality. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2021.103399] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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10
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Winiker K, Burnip E, Gozdzikowska K, Hernandez EG, Hammond R, Macrae P, Thomas P, Huckabee ML. Ultrasound: Reliability of a Pocket-Sized System in the Assessment of Swallowing. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:2928-2940. [PMID: 34260263 DOI: 10.1044/2021_jslhr-21-00026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose Ultrasound imaging offers a noninvasive adjunct to clinical swallowing assessment. Published reliability of sophisticated ultrasound systems is promising; however, no data exist for reliability using more affordable, pocket-sized devices. This study explored intrarater, interrater, and test-retest reliability of swallowing measures acquired with pocket-sized ultrasound technology. Method Five participants collected measures of swallowing from 20 healthy individuals using the Clarius ultrasound. Hyoid excursion and thyrohyoid approximation were derived during saliva, liquid, and puree swallowing. The cross-sectional area of the floor of mouth muscles and tongue thickness were obtained at rest. Measures were collected at two occasions minimum 11 days apart. Reliability was assessed for the entire process of data acquisition including scanning and online measurement, and for offline measurement of saved images. Results For most measures, reliability was poor (ICC [intraclass correlation coefficient] < .50) to moderate (ICC = .50-.75) for the entire process of data acquisition and poor to good (ICC > .75) when measuring saved images. Conclusion Further work is needed to elucidate whether our study findings apply to the Clarius system only or the data suggest a general limitation of pocket-sized ultrasound technology.
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Affiliation(s)
- Katharina Winiker
- Department of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
- University of Canterbury Rose Centre for Stroke Recovery and Research, Christchurch, New Zealand
- Swiss University of Speech and Language Sciences, Rorschach, Switzerland
| | - Emma Burnip
- Department of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
- University of Canterbury Rose Centre for Stroke Recovery and Research, Christchurch, New Zealand
| | - Kristin Gozdzikowska
- Department of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
- University of Canterbury Rose Centre for Stroke Recovery and Research, Christchurch, New Zealand
- Research and Innovation, University of Canterbury, Christchurch, New Zealand
| | - Esther Guiu Hernandez
- Department of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
- University of Canterbury Rose Centre for Stroke Recovery and Research, Christchurch, New Zealand
| | - Rebecca Hammond
- Department of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
- University of Canterbury Rose Centre for Stroke Recovery and Research, Christchurch, New Zealand
- Waitematā District Health Board, Auckland, New Zealand
| | - Phoebe Macrae
- Department of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
- University of Canterbury Rose Centre for Stroke Recovery and Research, Christchurch, New Zealand
| | - Paige Thomas
- Department of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
- University of Canterbury Rose Centre for Stroke Recovery and Research, Christchurch, New Zealand
| | - Maggie-Lee Huckabee
- Department of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
- University of Canterbury Rose Centre for Stroke Recovery and Research, Christchurch, New Zealand
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Drug Delivery by Ultrasound-Responsive Nanocarriers for Cancer Treatment. Pharmaceutics 2021; 13:pharmaceutics13081135. [PMID: 34452096 PMCID: PMC8397943 DOI: 10.3390/pharmaceutics13081135] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 12/13/2022] Open
Abstract
Conventional cancer chemotherapies often exhibit insufficient therapeutic outcomes and dose-limiting toxicity. Therefore, there is a need for novel therapeutics and formulations with higher efficacy, improved safety, and more favorable toxicological profiles. This has promoted the development of nanomedicines, including systems for drug delivery, but also for imaging and diagnostics. Nanoparticles loaded with drugs can be designed to overcome several biological barriers to improving efficiency and reducing toxicity. In addition, stimuli-responsive nanocarriers are able to release their payload on demand at the tumor tissue site, preventing premature drug loss. This review focuses on ultrasound-triggered drug delivery by nanocarriers as a versatile, cost-efficient, non-invasive technique for improving tissue specificity and tissue penetration, and for achieving high drug concentrations at their intended site of action. It highlights aspects relevant for ultrasound-mediated drug delivery, including ultrasound parameters and resulting biological effects. Then, concepts in ultrasound-mediated drug delivery are introduced and a comprehensive overview of several types of nanoparticles used for this purpose is given. This includes an in-depth compilation of the literature on the various in vivo ultrasound-responsive drug delivery systems. Finally, toxicological and safety considerations regarding ultrasound-mediated drug delivery with nanocarriers are discussed.
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Naeve I, Mommens M, Arukwe A, Virtanen J, Hoque ME, Kjørsvik E. Ultrasound as a noninvasive tool for monitoring reproductive physiology in male Atlantic salmon (Salmo salar). Physiol Rep 2020; 7:e14167. [PMID: 31286664 PMCID: PMC6640606 DOI: 10.14814/phy2.14167] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/18/2019] [Accepted: 06/19/2019] [Indexed: 01/24/2023] Open
Abstract
We examined the potential for ultrasound as a noninvasive tool for maturation monitoring in Atlantic salmon (Salmo salar) males. Ultrasound examination and measurements were compared to common practices for maturation monitoring such as gonadosomatic index (GSI), sex hormone analysis, and histological analysis of spermatogenesis. There were significant correlations (R2 = 0.68, P < 0.01) between ultrasound‐based measurements of the left testis and total testes weight and GSI, and ultrasound could be used for noninvasive GSI measurements. Echogenicity of ultrasound images corresponded to the histological stages observed, which added nuance to ultrasound‐based GSI measurements during final weeks preceding stripping. We propose that ultrasound can be used as an alternative to more invasive methods for sexual maturation monitoring in wild and farmed Atlantic salmon males. Using ultrasound technology, we have established a quick and noninvasive method that could reduce the number of stressful handlings and unwanted sacrifice of broodfish required for maturation monitoring in Atlantic salmon males.
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Affiliation(s)
| | | | | | - Jonni Virtanen
- Department of Biology, NTNU, Trondheim, Norway.,Clewer Aquaculture Oy, Turku, Finland
| | - Md Enamul Hoque
- Department of Biology, NTNU, Trondheim, Norway.,Department of Oceanography, University of Chittagong, Chattogram, Bangladesh
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Ultrasound in Chronic Pain Management. Pain 2019. [DOI: 10.1007/978-3-319-99124-5_50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
For inexperienced users, training with phantoms is an important part of training. Inexperienced users can teach themselves to gain significant procedural skills. Participating in training courses or practising with experts can enhance the outcomes. Inexperienced users need to understand the indications, clinical pearls, and pitfalls of each procedure to avoid potential complications. Inexperienced users can also train and teach themselves to become proficient in ultrasound techniques.
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Affiliation(s)
- Jeffrey Huang
- Anesthesiology, University of Central Florida, Orlando, USA
| | - Jinlei Li
- Anesthesiology, Yale University, New Haven , USA
| | - Hong Wang
- Anesthesiology, West Virginia University, Morgantown, USA
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15
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Abstract
Ultrasonography is an imaging modality that facilitates the diagnosis of pathology and injection therapy without exposing the patient to radiation. In addition, ultrasonography has become popular because of its portability, low cost, and production of real-time tomographic images that provide a cross-sectional view of anatomic structures. Despite its benefits and widespread adoption in general medicine and other specialties, however, ultrasonography is not as well adapted as a diagnostic and research tool in orthopaedic surgery. An understanding of the basic principles of ultrasonography and the evidence supporting its use can aid the orthopaedic surgeon in applying this modality appropriately in clinical practice.
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La Mura M, Lamberti NA, Mauti BL, Caliano G, Savoia AS. Acoustic reflectivity minimization in Capacitive Micromachined Ultrasonic Transducers (CMUTs). ULTRASONICS 2017; 73:130-139. [PMID: 27643654 DOI: 10.1016/j.ultras.2016.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 07/14/2016] [Accepted: 09/01/2016] [Indexed: 06/06/2023]
Abstract
When Capacitive Micromachined Ultrasonic Transducers (CMUTs) are coupled with water, they show high front-face acoustic reflectivity, due to the impedance mismatch between the transducer substrate material, typically based on silicon, and the propagation medium. During pulse-echo operation, surface reflectivity is responsible for multiple reflections of the received acoustic signals, which result in a set of unwanted echoes. In ultrasound imaging applications, this signal reverberation creates artifacts and reduces the image contrast. In this paper, a method to reduce front-face reflectivity is proposed, and a Reverberation Level (RL) index is introduced in order to quantify the unwanted reverberation of the signal returned to the transducer surface. The proposed method combines the increase of the bias voltage, the application of an optimized resistive load and the addition of a low-impedance acoustic backing to CMUTs realized by Reverse Fabrication Process (RFP). In this way, the mechanical energy conversion and transmission to the backing, as well as the electrical energy dissipation, are improved, thus reducing the energy reflection into the medium. The proposed method is analyzed by means of Finite Element simulations and is experimentally validated by characterizing single-element RFP-CMUTs, provided with different backing materials and electrical loads. In the analyzed prototypes, a RL reduction of 8.6dB is obtained.
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Affiliation(s)
- Monica La Mura
- Dipartimento di Ingegneria Industriale, Università degli Studi di Salerno, Italy.
| | - Nicola A Lamberti
- Dipartimento di Ingegneria Industriale, Università degli Studi di Salerno, Italy
| | - Barbara L Mauti
- Dipartimento di Ingegneria, Università degli Studi Roma Tre, Italy
| | - Giosuè Caliano
- Dipartimento di Ingegneria, Università degli Studi Roma Tre, Italy
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Ureta MM, Olivera DF, Salvadori VO. Influence of baking conditions on the quality attributes of sponge cake. FOOD SCI TECHNOL INT 2016; 23:156-165. [PMID: 27574030 DOI: 10.1177/1082013216666618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sponge cake is a sweet bakery product characterized by its aerated and soft crumb and by its thin-coloured crust. The aim of this work is to analyse the influence of baking conditions (natural or forced convection, steam injection, oven temperature from 140 ℃ to 180 ℃) on sponge cake quality. Both crust and crumb regions were characterized by means of colour development, water content, crust/crumb relation, crust thickness and crumb structure (in terms of porosity, crumb density and texture). Colour measurements allowed obtaining an accurate model for browning kinetics. Crumb water content remains almost constant, while considerable dehydration occurs in the crust. In general, no significant differences due to baking conditions were found in the instrumental quality analysis.
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Affiliation(s)
- M Micaela Ureta
- 1 Centro de Investigación y Desarrollo en Criotecnología de Alimentos (CIDCA), CCT-CONICET La Plata and Facultad de Ciencias Exactas, UNLP, La Plata, Argentina
| | - Daniela F Olivera
- 1 Centro de Investigación y Desarrollo en Criotecnología de Alimentos (CIDCA), CCT-CONICET La Plata and Facultad de Ciencias Exactas, UNLP, La Plata, Argentina
| | - Viviana O Salvadori
- 1 Centro de Investigación y Desarrollo en Criotecnología de Alimentos (CIDCA), CCT-CONICET La Plata and Facultad de Ciencias Exactas, UNLP, La Plata, Argentina.,2 DIQ, Facultad de Ingeniería, UNLP, La Plata, Argentina
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18
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Lang I, Sklair-Levy M, Spitzer H. Multi-scale texture-based level-set segmentation of breast B-mode images. Comput Biol Med 2016; 72:30-42. [PMID: 27010737 DOI: 10.1016/j.compbiomed.2016.02.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 02/25/2016] [Accepted: 02/25/2016] [Indexed: 12/11/2022]
Abstract
Automatic segmentation of ultrasonographic breast lesions is very challenging, due to the lesions' spiculated nature and the variance in shape and texture of the B-mode ultrasound images. Many studies have tried to answer this challenge by applying a variety of computational methods including: Markov random field, artificial neural networks, and active contours and level-set techniques. These studies focused on creating an automatic contour, with maximal resemblance to a manual contour, delineated by a trained radiologist. In this study, we have developed an algorithm, designed to capture the spiculated boundary of the lesion by using the properties from the corresponding ultrasonic image. This is primarily achieved through a unique multi-scale texture identifier (inspired by visual system models) integrated in a level-set framework. The algorithm׳s performance has been evaluated quantitatively via contour-based and region-based error metrics. We compared the algorithm-generated contour to a manual contour delineated by an expert radiologist. In addition, we suggest here a new method for performance evaluation where corrections made by the radiologist replace the algorithm-generated (original) result in the correction zones. The resulting corrected contour is then compared to the original version. The evaluation showed: (1) Mean absolute error of 0.5 pixels between the original and the corrected contour; (2) Overlapping area of 99.2% between the lesion regions, obtained by the algorithm and the corrected contour. These results are significantly better than those previously reported. In addition, we have examined the potential of our segmentation results to contribute to the discrimination between malignant and benign lesions.
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Affiliation(s)
- Itai Lang
- School of Electrical Engineering, Iby and Aladar Fleischman Faculty of Engineering, Tel-Aviv University, Tel-Aviv 69978, Israel.
| | - Miri Sklair-Levy
- Breast Imaging Unit, Diagnostic Imaging Department, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel.
| | - Hedva Spitzer
- School of Electrical Engineering, Iby and Aladar Fleischman Faculty of Engineering, Tel-Aviv University, Tel-Aviv 69978, Israel.
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19
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Wada H, Yasufuku K. Reply to Uramoto et al. Eur J Cardiothorac Surg 2015; 49:1539. [PMID: 26419773 DOI: 10.1093/ejcts/ezv343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 09/03/2015] [Indexed: 11/14/2022] Open
Affiliation(s)
- Hironobu Wada
- Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, Canada
| | - Kazuhiro Yasufuku
- Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, Canada
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20
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Alenezi H, Olvera-Posada D, Cadieux PA, Denstedt JD, Razvi H. The Effect of Renal Cysts on the Fragmentation of Renal Stones During Shockwave Lithotripsy: A Comparative In Vitro Study. J Endourol 2015; 30 Suppl 1:S12-7. [PMID: 26414112 DOI: 10.1089/end.2015.0253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To assess the potential effect of simple renal cysts (SRC) on stone fragmentation during shockwave lithotripsy (SWL) in an in vitro model. MATERIALS AND METHODS The in vitro model was constructed using 10% ordnance gelatin (OG). Models were created to mimic four scenarios: Model A-with an air-filled cavity (suboptimal for stone fragmentation); model B-without a cavity (normal anatomy); model C-with a 3-cm serum filled cavity (to represent a small SRC); model D-with a 4-cm serum filled cavity (to represent a larger SRC). SWL was applied to 24 standardized phantom stones (weight of 2±0.1 g) in each model using a standardized protocol. Stone fragments were retrieved, then dried overnight at room air temperature. Fragmentation coefficient (FC) was calculated for each stone, for fragments<4 mm and <2 mm. RESULTS The OG in vitro model was robust enough for the proposed research. There was no fragmentation evident in model A as expected. The mean FC was 29.7 (±20.5) and 39.7 (±23.7) for <4 mm fragments (P=0.069) and 7.6 (±4.1) and 10.6 (±6.7) for <2 mm fragments (P=0.047), for noncystic and cystic models, respectively. The mean FC was 29.7 (±20.5), 38.8 (±26.2) and 40.7 (±21.3) for <4 mm fragments (P=0.213) and 7.6 (±4.1), 11.1 (±8) and 10.2 (±5.3) for <2 mm fragments (P=0.138), for models B, C, and D, respectively. CONCLUSION Our in vitro experiment confirms better stone fragmentation associated with SWL in the presence of adjacent SRC.
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Affiliation(s)
- Husain Alenezi
- 1 Division of Urology, Department of Surgery, Schulich School of Medicine and Dentistry, The University of Western Ontario , London, Ontario, Canada
| | - Daniel Olvera-Posada
- 1 Division of Urology, Department of Surgery, Schulich School of Medicine and Dentistry, The University of Western Ontario , London, Ontario, Canada
| | - Peter A Cadieux
- 2 Department of Microbiology and Immunology, The University of Western Ontario , London, Ontario, Canada .,3 School of Health Sciences, Fanshawe College , London, Ontario, Canada
| | - John D Denstedt
- 1 Division of Urology, Department of Surgery, Schulich School of Medicine and Dentistry, The University of Western Ontario , London, Ontario, Canada
| | - Hassan Razvi
- 1 Division of Urology, Department of Surgery, Schulich School of Medicine and Dentistry, The University of Western Ontario , London, Ontario, Canada
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Alansari M, Alotair H, Al Aseri Z, Elhoseny MA. Use of ultrasound guidance to improve the safety of percutaneous dilatational tracheostomy: a literature review. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2015; 19:229. [PMID: 25981550 PMCID: PMC4436098 DOI: 10.1186/s13054-015-0942-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Patients in ICUs frequently require tracheostomy for long-term ventilator support, and the percutaneous dilatational tracheostomy (PDT) method is preferred over surgical tracheostomy. The use of ultrasound (US) imaging to guide ICU procedures and interventions has recently emerged as a simple and noninvasive tool. The current evidence regarding the applications of US in PDT is encouraging; however, the exact role of US-guided dilatational tracheostomy (US-PDT) remains poorly defined. In this review, we describe the best available evidence concerning the safety and efficacy of US-PDT and briefly delineate the general principles of US image generation for the airway and of US-PDT procedures.
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Affiliation(s)
- Mariam Alansari
- Department of Critical Care Medicine, King Khalid University Hospital, College of Medicine, King Saud University, PO Box: 2925 (95), Riyadh, 11461, Kingdom of Saudi Arabia.
| | - Hadil Alotair
- Department of Critical Care Medicine, King Khalid University Hospital, College of Medicine, King Saud University, PO Box: 2925 (95), Riyadh, 11461, Kingdom of Saudi Arabia.
| | - Zohair Al Aseri
- Department of Emergency Medicine, King Khalid University Hospital, College of Medicine, King Saud University, PO Box: 2925 (95), Riyadh, 11461, Kingdom of Saudi Arabia.
| | - Mohammed A Elhoseny
- Department of Critical Care Medicine, King Khalid University Hospital, College of Medicine, King Saud University, PO Box: 2925 (95), Riyadh, 11461, Kingdom of Saudi Arabia.
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Rajpoot N, Nayak A, Nayak R, Bankur PK. Evaluation of variation in the palatal gingival biotypes using an ultrasound device. J Clin Diagn Res 2015; 9:ZC56-60. [PMID: 25954707 DOI: 10.7860/jcdr/2015/12041.5724] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Accepted: 02/11/2015] [Indexed: 01/28/2023]
Abstract
BACKGROUND The dimensions of gingiva and different parts of the masticatory mucosa have become a subject of considerable interest in Periodontics. Studies assessing the thickness of the facial gingiva are often seen in the literature. The thickness of the palatal gingiva is a subject still less researched in periodontal therapy and implantology. OBJECTIVES To measure the thickness of the palatal gingiva using an ultrasound device 'Biometric A- Scan' and to evaluate the variation in the thickness of the palatal gingiva at the sites examined. MATERIALS AND METHODS In the 50 subjects examined, the thickness of the palatal gingiva was assessed at the maxillary anteriors, premolars and molars by an ultrasound device 'Biometric A-Scan'. The results were subjected to statistical analysis using one-way ANOVA test and Newman-Keuls multiple post hoc procedure. RESULTS Statistically significant variations existed in the palatal gingival thickness. The thickness was highest at the lateral incisor region, followed by canine, premolars, molars and central incisor. INTERPRETATION AND CONCLUSION In the subjects assessed, the thickness of the palatal gingiva at the lateral-canine area was the highest followed by the premolar area. In periodontal root coverage procedures and during implant therapy, we suggest the inclusion of the lateral incisor area, apart from the canine and premolar area, as a potential donor site for harvesting soft tissue grafts from the palatal area. However, the effect of several factors like age and sex of the patient, the anatomy of the palatal area, the influence of rugae patterns and racial and geographical differences should be taken into consideration prior to harvesting a graft from these sites. Apart from this, the study suggests that, the ultrasonographic measurements provide an elegant means of obtaining the measurements of gingival and mucosal tissues rapidly, accurately and non-invasively. Our endeavour in this research project attempts to open more avenues for studies in the field of advanced periodontal diagnosis, with the use of ultrasound, and expand the horizons of periodontal plastic surgery and implant therapy as well.
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Affiliation(s)
- Nami Rajpoot
- Senior Lecturer, Department of Periodontics , College of Dental sciences , Amargadh, Bhavnagar, Gujarat, India
| | - Aarati Nayak
- Professor and Head, Department of Periodontics, Maratha Mandal's N.G.H Institute of Dental sciences and Research Centre , Belgaum, Karnataka, India
| | - Ranganath Nayak
- Professor and Head, Department of Oral and Maxillofacial surgery, Maratha Mandal's N.G.H Institute of Dental sciences and Research Centre , Belgaum, Karnataka, India
| | - Praveen Kumar Bankur
- Senior Lecturer, Department of Periodontics, Guru Gobind Singh Dental College , Burhanpur, Madhya Pradesh, India
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23
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Shanthanna H. Review of essential understanding of ultrasound physics and equipment operation. World J Anesthesiol 2014; 3:12-17. [DOI: 10.5313/wja.v3.i1.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 12/09/2013] [Accepted: 02/18/2014] [Indexed: 02/06/2023] Open
Abstract
Ultrasound (US) is being extensively used an imaging tool in regional anesthesia (RA) and pain practice. Although it was first used in a regional block in 1978, it was only in 1994 that the first direct use of US in RA was reported. Like any other medical tool, its utility is only realized when the performing physician is able to understand the principles behind its application. Efficient use of US also requires an understanding of physical variables which can be suitable modified to produce a clear image of the structure of importance. This brief narrative review summarises the advantages of US in RA and pain practice over the conventionally used localising or imaging tools. The second section deals with the physics behind US. It highlights the necessary physical concepts such as wavelength, frequency and generation of US waves. It also informs the reader about the possible US and tissue interactions, use of US transducers and their differences. The third section deals with understanding the control variables in a typical US machine and how they could be modified to improve the image quality. The final section highlights the various artifacts that could be associated.
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Abstract
Through-transmission alveolar ultrasonography (TAU) is a novel imaging modality in dental medicine. A brief introduction to through-transmission ultrasonography (TTU) is followed by a description of the first commercially available TAU device, the Cavitat CAV 4000 (Cavitat Medical Technologies, Inc., Alba, TX). Recent associations between systemic osteoporosis, oral osteoporosis, periodontal diseases, and cardiovascular diseases underline the importance of early detection and treatment of oral cancellous bone pathologies associated with low bone density (LBD), such as regional ischemic osteoporosis, chronic nonsuppurative osteomyelitis, bone marrow edema, and cavitational ischemic osteonecrosis (osteocavitation). While the impact of osteoporosis on maxillofacial bones is acknowledged, there is a lack of reliable prevalence rate, and the National Institutes of Health (NIH) recommend that more attention should be paid to skeletal health, especially in persons with conditions known to be associated with secondary osteoporosis. TAU, a safe and effective imaging modality, can be a valuable tool in research as well as for the clinical assessment of alveolar cancellous bone pathologies associated with LBD and ischemia.
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Affiliation(s)
- Jacques Imbeau
- Dental Services, Bay of Plenty Environmental Health Clinic, New Zealand.
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26
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Ahn H, Hernández-Andrade E, Romero R, Ptwardhan M, Goncalves LF, Aurioles-Garibay A, Garcia M, Hassan SS, Yeo L. Mirror artifacts in obstetric ultrasound: case presentation of a ghost twin during the second-trimester ultrasound scan. Fetal Diagn Ther 2013; 34:248-52. [PMID: 24071724 DOI: 10.1159/000353702] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 06/11/2013] [Indexed: 11/19/2022]
Abstract
Mirror artifacts are produced by the reflection of ultrasound waves after they propagate through a structure and encounter a strong and smooth interface capable of acting as a mirror. Ultrasound waves bounce back and forth between the mirroring interface and the reflective object and then eventually return to the transducer. The typical display of the mirror artifact consists of two similar structures separated and at similar distances from the reflective interface. We report a mirror artifact in a patient with a singleton gestation at 18 weeks. The image was interpreted as consistent with a twin gestation using transabdominal and transvaginal ultrasound. The differential diagnosis consisted of an abdominal heterotopic pregnancy. The presence of synchronized but opposite movements of both fetuses, and the blurred image of the second fetus, suggested a mirror artifact. The reflective surface was created by the interface located between a distended rectosigmoid filled with gas and the posterior uterine wall. Mirror artifacts can lead to diagnostic errors. This case illustrates how a distended rectosigmoid colon can generate an image that simulates either a twin gestation or an abdominal heterotopic pregnancy.
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Affiliation(s)
- Hyunyoung Ahn
- Perinatology Research Branch, Program for Perinatal Research and Obstetrics, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, MD, USA
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Rau JM, Måsøy SE, Hansen R, Angelsen B, Tangen TA. Methods for reverberation suppression utilizing dual frequency band imaging. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2013; 134:2313-2325. [PMID: 23967962 DOI: 10.1121/1.4817900] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Reverberations impair the contrast resolution of diagnostic ultrasound images. Tissue harmonic imaging is a common method to reduce these artifacts, but does not remove all reverberations. Dual frequency band imaging (DBI), utilizing a low frequency pulse which manipulates propagation of the high frequency imaging pulse, has been proposed earlier for reverberation suppression. This article adds two different methods for reverberation suppression with DBI: the delay corrected subtraction (DCS) and the first order content weighting (FOCW) method. Both methods utilize the propagation delay of the imaging pulse of two transmissions with alternating manipulation pressure to extract information about its depth of first scattering. FOCW further utilizes this information to estimate the content of first order scattering in the received signal. Initial evaluation is presented where both methods are applied to simulated and in vivo data. Both methods yield visual and measurable substantial improvement in image contrast. Comparing DCS with FOCW, DCS produces sharper images and retains more details while FOCW achieves best suppression levels and, thus, highest image contrast. The measured improvement in contrast ranges from 8 to 27 dB for DCS and from 4 dB up to the dynamic range for FOCW.
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Affiliation(s)
- Jochen M Rau
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, 7491 Trondheim, Norway.
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In vivo quantitative ultrasound image analysis of femoral subchondral bone in knee osteoarthritis. ScientificWorldJournal 2013; 2013:182562. [PMID: 23781150 PMCID: PMC3678463 DOI: 10.1155/2013/182562] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 04/28/2013] [Indexed: 12/29/2022] Open
Abstract
A potential of quantitative noninvasive knee ultrasonography (US) for detecting changes in femoral subchondral bone related to knee osteoarthritis (OA) was investigated. Thirty-nine patients referred to a knee arthroscopy underwent dynamic noninvasive US examination of the knee joint. The subchondral bone was semiautomatically segmented from representative US images of femoral medial and lateral condyles and intercondylar notch area. Subsequently, the normalized mean gray-level intensity profile, starting from the cartilage-bone interface and extending to the subchondral bone depth of -1.7 mm, was calculated. The obtained profile was divided into 5 depth levels and the mean of each level, as well as the slope of the profile within the first two levels, was calculated. The US quantitative data were compared with the arthroscopic Noyes' grading and radiographic Kellgren-Lawrence (K-L) grading. Qualitatively, an increase in relative subchondral bone US gray-level values was observed as OA progressed. Statistically significant correlations were observed between normalized US mean intensity or intensity slope especially in subchondral bone depth level 2 and K-L grading (r = 0.600, P < 0.001; r = 0.486, P = 0.006, resp.) or femoral arthroscopic scoring (r = 0.332, P = 0.039; r = 0.335, P = 0.037, resp.). This novel quantitative noninvasive US analysis technique is promising for detection of femoral subchondral bone changes in knee OA.
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Sperandeo M, Varriale A, Sperandeo G, Polverino E, Feragalli B, Piattelli ML, Maggi MM, Palmieri VO, Terracciano F, De Sio I, Villella M, Copetti M, Pellegrini F, Vendemiale G, Cipriani C. Assessment of ultrasound acoustic artifacts in patients with acute dyspnea: a multicenter study. Acta Radiol 2012; 53:885-92. [PMID: 22919052 DOI: 10.1258/ar.2012.120340] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Recent reports indicate that numerical assessment of B-lines during transthoracic ultrasound may aid the differential diagnosis of acute diffuse pleuropulmonary disorders. PURPOSE To determine whether B-lines are different in normal and diseased lungs and whether they can be used to discriminate between different types of pulmonary disorders in acutely ill patients. MATERIAL AND METHODS In this multicenter study, transthoracic ultrasonography was performed on 193 patients with acute dyspnea, 193 healthy non-smokers, and 58 patients who had undergone pneumonectomy for lung cancer. Examinations were done with a low-medium frequency (3.5-5.0 MHz) convex probe and a high-frequency (8-12.5 MHz) linear probe. Video recordings were re-examined by a second set of examiners. In each participant, we measured the number of B-lines observed per scan. RESULTS B-lines counts were higher in dyspnoic patients (means: 3.11 per scan per linear probe scan vs. 1.93 in healthy controls and 1.86 in pneumonectomized patients; P < 0.001 for all); all counts were higher when convex probes were used (5.4 in dyspnoic patients and 2 in healthy controls; P < 0.001 vs. the linear probe). Subgroups of dyspnoic patients defined by cause of dyspnea displayed no significant differences in the number of B-lines. CONCLUSION Our results demonstrate that there are a significant higher number of B-lines in the lungs of patients with dyspnea compared to healthy subjects and to pneumonectomized patients. Nevertheless, the quantification of B-lines does not make any significant contribution to the differential diagnosis of dyspnea.
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Affiliation(s)
- Marco Sperandeo
- Unit of Internal Medicine, IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Foggia, Italy
| | - Antonio Varriale
- Unit of Internal Medicine, IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Foggia, Italy
| | - Giuseppe Sperandeo
- Department of Radiology, IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Foggia, Italy
| | - Eva Polverino
- Respiratory Department, Hospital Clinic-IDIBAPS, Biomedical Research Centre in Red-Lung Disease, Barcelona, Spain
| | - Beatrice Feragalli
- Department of Clinical Sciences and Bioimaging, Institute of Radiology, SS. Annunziata Hospital, Chieti, Italy
| | - Maria Luisa Piattelli
- Department of Emergency, “San Camillo De Lellis” Hospital, Manfredonia, Foggia, Italy
| | - Michele M Maggi
- Department of Emergency, IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Foggia, Italy
| | | | - Fulvia Terracciano
- Department of Gastroenterology, IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Foggia, Italy
| | - Ilario De Sio
- Department of Internal Medicine, Second University of Naples, Naples, Italy
| | - Massimo Villella
- Cardiologic ICU, IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Foggia, Italy
| | - Massimiliano Copetti
- Unit of Biostatistic IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Foggia, Italy
| | - Fabio Pellegrini
- Unit of Biostatistic IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Foggia, Italy
| | - Gianluigi Vendemiale
- Unit of Internal Medicine, IRCCS “Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo, Foggia, Italy
| | - Cristiana Cipriani
- Department of Internal Medicine and Medical Disciplines, “Sapienza” University of Rome, Rome, Italy
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Kurjak A, Predojević M, Stanojević M, Talić A, Honemeyer U, Kadić AS. The use of 4D imaging in the behavioral assessment of high-risk fetuses. ACTA ACUST UNITED AC 2011. [DOI: 10.2217/iim.11.39] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Intraoperative Monitoring with Transesophageal Echocardiography in Cardiac Surgery. Braz J Anesthesiol 2011; 61:495-512. [DOI: 10.1016/s0034-7094(11)70058-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2010] [Accepted: 12/13/2010] [Indexed: 11/23/2022] Open
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Tomar S, Rao JP, Malhotra N. Rational Use of TVS/Color and 3D in Evaluating Subfertile Women. ACTA ACUST UNITED AC 2011. [DOI: 10.5005/jp-journals-10009-1204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
ABSTRACT
Infertility is defined as the failure to conceive a desired pregnancy after 12 months of unprotected intercourse and affects approximately 10% of married couples. With recent technological development and proper use of medically assisted reproduction techniques, one half of these couples will become pregnant.
More than any other new method, ultrasound has made significant improvements in the modern management of female infertility. Transvaginal sonography provides the reproductive endocrinologists with a tool that cannot only evaluate normal and stimulated cycles but also assist in follicle aspiration and subsequent transfer of the embryo. The addition of color Doppler capabilities to transvaginal probes permits visualization of small intraovarian and endometrial vessels, allowing depiction of normal and abnormal physiologic changes in the ovary and uterus. This article reviews on the assessment of ovarian, uterine and tubal causes of infertility and on the current and future role of color Doppler and three-dimensional ultrasound in the field of reproductive endocrinology.
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Kurjak A, Carrera J, Medic M, Azumendi G, Andonotopo W, Stanojevic M. The antenatal development of fetal behavioral patterns assessed by four-dimensional sonography. J Matern Fetal Neonatal Med 2009; 17:401-16. [PMID: 16009643 DOI: 10.1080/14767050400029657] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The investigation of fetal intrauterine activities has been enabled by the development of two-dimensional ultrasound. It has been shown that the earliest signs of fetal motor activity can be in the late embryonic period, and that the characteristics of fetal motor patterns change constantly throughout gestation. During the first trimester of pregnancy, the repertoire and frequency fetal movement patterns constantly expand, whereas the second and third trimesters are characterized by the progressive organization of fetal activities into complex and clearly distinct behavioral patterns. The comparison of real time ultrasonic studies of fetal behavior with the morphological studies of fetal brains has revealed that the appearance of new behavioral patterns or the transition of existing patterns directly reflect the complex neurodevelopment processes. It has been suggested that the assessment of fetal behavioral patterns could give us insight into the integrity of fetal central nervous system and enable the early detection of cerebral dysfunctions. The development of a new ultrasonic technique, four dimensional sonography, could represent a significant improvement in the assessment of fetal behavior. According to the preliminary results, this new technique could open a new perspective for the investigations of fetal behavioral patterns and contribute significantly to our better understanding of complex neurodevelopmental events. The most important neurodevelopmental events, the basic technology of 4D ultrasound and its application in the assessment of functional development of fetal central nervous system will be the subject of this review.
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Affiliation(s)
- A Kurjak
- Department of Obstetrics and Gynecology, Medical School, University of Zagreb, Sveti Duh Hospital, Zagreb, Croatia.
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Erdogan O, Esen E. Biological aspects and clinical importance of ultrasound therapy in bone healing. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2009; 28:765-776. [PMID: 19470817 DOI: 10.7863/jum.2009.28.6.765] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVES The purpose of this study was to review past and recent literature findings regarding the effects of ultrasound therapy on bone healing and its clinical efficacy in medical and dental interventions. METHODS A literature review was conducted on the effects of ultrasound therapy on bone healing. The studies regarding clinical applications in long bones and maxillofacial bones were evaluated separately from each other. RESULTS The effects of therapeutic ultrasound on bone healing have been studied for half a century. Numerous clinical and experimental studies have addressed this relationship, and many of them have shown positive correlations. Although several theories have been proposed to explain the mechanism of action, the exact mechanism has not been fully understood. CONCLUSIONS Therapeutic ultrasound therapy in clinical settings is a noninvasive application and has no serious complications or side effects. It may be an acceptable treatment of choice in many types of clinical procedures involving maxillofacial bones.
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Affiliation(s)
- Ozgür Erdogan
- Department of Dental Services, Diyarbakir Military Hospital, Diyarbakir, Turkey.
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Abstract
INTRODUCTION Supraclavicular brachial plexus block provides consistently effective anesthesia to the upper extremity. However, traditional nerve localization techniques may be associated with a high risk of pneumothorax. In the present study, we report block success and clinical outcome data from 510 consecutive patients who received an ultrasound-guided supraclavicular block for upper extremity surgery. METHODS After institutional review board approval, the outcome of 510 consecutive patients who received an ultrasound-guided supraclavicular block for upper extremity surgery was reviewed. Real-time ultrasound guidance was used with a high-frequency linear probe. The neurovascular structures were imaged on short axis, and the needle was inserted using an in-plane technique with either a medial-to-lateral or lateral-to-medial orientation. RESULTS Five hundred ten ultrasound-guided supraclavicular blocks were performed (50 inpatients, 460 outpatients) by 47 different operators at different levels of training over a 24-month period. Successful surgical anesthesia was achieved in 94.6% of patients after a single attempt; 2.8% required local anesthetic supplementation of a single peripheral nerve territory; and 2.6% received an unplanned general anesthetic. No cases of clinically symptomatic pneumothorax developed. Complications included symptomatic hemidiaphragmatic paresis (1%), Horner syndrome (1%), unintended vascular punctures (0.4%), and transient sensory deficits (0.4%). CONCLUSIONS Ultrasound-guided supraclavicular block is associated with a high rate of successful surgical anesthesia and a low rate of complications and thus may be a safe alternative for both inpatients and outpatients. Severe underlying respiratory disease and coagulopathy should remain a contraindication for this brachial plexus approach.
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de Josemaría B, Gálvez I, Reinoso-Barbero F. [Ultrasound guidance in pediatric regional anesthesia]. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2009; 56:170-179. [PMID: 19408783 DOI: 10.1016/s0034-9356(09)70359-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Ultrasound imaging is being used to guide pediatric nerve block procedures. Difficulties that arise because of the smaller anatomical structures in children can be compensated for by the greater aqueous consistency and reduced calcification. Given the shorter distance between the surface of the skin and nerves, it is advisable to use a linear array transducer working at a high frequency (7-10 MHz). Like adults, children benefit when ultrasound guidance is used in the performance of neuraxial nerve trunk blocks, particularly of the umbilical and ilioinguinal nerves, and in greater measure in spinal blocks. Ultrasound guidance enhances efficacy and also affords the important advantage of greater safety. The main disadvantages are the cost of equipment and the necessary learning curve.
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Affiliation(s)
- B de Josemaría
- Servicio de Anestesiología y Reanimación, Hospital San Juan de Dios, Barcelona
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Huang J, Triedman JK, Vasilyev NV, Suematsu Y, Cleveland RO, Dupont PE. Imaging artifacts of medical instruments in ultrasound-guided interventions. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2007; 26:1303-22. [PMID: 17901134 DOI: 10.7863/jum.2007.26.10.1303] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE Real-time 3-dimensional (3D) ultrasound imaging has the potential to become a dominant imaging technique for minimally invasive surgery. One barrier to its widespread use is that surgical instruments generate imaging artifacts, which can obfuscate their location, orientation, and geometry and obscure nearby tissue. The purpose of this study was to identify and describe the types of artifacts which could be produced by metallic instruments during interventions guided by 3D ultrasound imaging. METHODS Three imaging studies were performed. First, imaging artifacts from stainless steel rods were identified in vitro and acoustically characterized. Second, 3 typical minimally invasive instruments were imaged (in vitro and in vivo), and their artifacts were analyzed. The third study compared the intensity of imaging artifacts (in vitro and in vivo) from stainless steel rods with rods composed of 3 different materials and stainless steel rods with roughened and coated surfaces. RESULTS For the stainless steel rods, all observed artifacts are described and illustrated, and their physical origins are explained. Artifacts from the 3 minimally invasive instruments are characterized with the use of the artifacts observed with the rods. Finally, it is shown that artifacts can be greatly reduced through the use of alternate materials or by surface modification. CONCLUSIONS Instrument artifacts in 3D ultrasound images can be more confusing than those from the same instruments imaged in 2 dimensions. Real-time 3D ultrasound imaging can, however, be used effectively for in vivo imaging of minimally invasive instruments by using artifact mitigation techniques, including careful selection of probe and incision locations, as well as by instrument modification.
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Affiliation(s)
- Jinlan Huang
- Department of Cardiology, Division of Basic Cardiovascular Research, Children's Hospital Boston, Boston, Massachusetts, USA
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McFarlin BL, O'Brien WD, Oelze ML, Zachary JF, White-Traut RC. Quantitative ultrasound assessment of the rat cervix. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2006; 25:1031-40. [PMID: 16870896 PMCID: PMC2654570 DOI: 10.7863/jum.2006.25.8.1031] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVE The purpose of this research was to detect cervical ripening with a new quantitative ultrasound technique. METHODS Cervices of 13 nonpregnant and 65 timed pregnant (days 15, 17, 19, 20, and 21 of pregnancy) Sprague Dawley rats were scanned ex vivo with a 70-MHz ultrasound transducer. Ultrasound scatterer property estimates (scatterer diameter [SD], acoustic concentration [AC], and scatterer strength factor [SSF]) from the cervices were quantified and then compared to hydroxyproline and water content. Insertion loss (attenuation) was measured in 3 rats in each of the 6 groups. Discriminant analysis was used to predict gestational age group (cervical ripening) from the ultrasound variables SD, SSF, and AC. RESULTS Differences were observed between the groups (SD, AC, and SSF; P < .0001). Quantitative ultrasound measures changed as the cervix ripened: (1) SD increased from days 15 to 21; (2) AC decreased from days 15 to 21; and (3) SSF was the greatest in the nonpregnant group and the least in the day 21 group. Cervix hydroxyproline content increased as pregnancy progressed (P < .003) and correlated with group, SD, AC, and SSF (P < .001). Discriminant analysis of ultrasound variables predicted 56.4% of gestational group assignment (P < .001) and increased to 77% within 2 days of the predicted analysis. Cervix insertion loss was greatest for the nonpregnant group and least for the day 21 group. CONCLUSIONS Quantitative ultrasound predicted cervical ripening in the rat cervix, but before use in humans, quantitative ultrasound will need to predict gestational age in the later days of gestation with more precision.
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Affiliation(s)
- Barbara L McFarlin
- Department of Maternal Child Nursing, University of Illinois at Chicago, IL 60612, USA.
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Kirchmair L, Moriggl B, Greher M. One view is no view. Anesth Analg 2004; 98:1812. [PMID: 15155358 DOI: 10.1213/01.ane.0000120089.29979.3e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Lukas Kirchmair
- Bezirkskrankenhaus Hall, Tyrol, Austria Institute of Anatomy, Histology and Embryology, Medical University of Innsbruck, Innsbruck, Austria Department of Anaesthesia and Intensive Care, University of Vienna, Vienna, Austria
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