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A cost-effective, widely available, and practical diagnostic imaging tool for prostate cancer (PCa) localization is still lacking. Recently, the contrast-ultrasound dispersion imaging (CUDI) technique has been developed for PCa localization by quantifying dynamic contrast-enhanced ultrasound (DCE-US) acquisitions. Tissue stiffness is an additional PCa biomarker that can be quantified by ultrasound shear-wave elastography (SWE). In this work, a dedicated preprocessing of 3D DCE-US acquisitions was investigated by using multilinear singular value decomposition (MLSVD), aiming at improving the CUDI performance. Moreover, the diagnostic potential of a multiparametric ultrasound imaging approach combining 3D CUDI features with SWE tissue elasticity for clinically significant (cs)PCa localization was evaluated by comparison with the histopathological outcome of systematic biopsies. In this multiparametric approach, the performance of five classifiers was evaluated and compared for biopsy-region csPCa classification. The classification performance was assessed by the area under the Receiver Operating Characteristics curve (AUC) in a k-fold cross validation fashion comprising sequential floating forward selection of the features. The combination of CUDI features with MLSVD preprocessing and SWE elasticity yielded the best AUC=0.87 for csPCa localization. Our results suggest 3D multiparametric ultrasound imaging approach combing a dedicated preprocessing step to be a useful tool for PCa diagnostics.

Additional file 1: Supporting information including additional methods and figures.

Additional file 1: Figure S1. a Cellular uptake of Zr-TCPP(TPP)/R837@M. b In vitro cell viability of 4T1 cells. Figure S2. 4T1, MDA-MB-468, Hepa1-6, and Bxpc-3 after 8 h incubation with Zr-TCPP(TPP)/R837. Figure S3. CRT exposure. Figure S4. a The ex vivo fluorescence image of major organs and tumour and b quantification analysis of the tissue content of Zr-TCPP(TPP)/R837 and Zr-TCPP(TPP)/R837@M; data are expressed as means ± SD (n = 3). Statistical significance was calculated by one-way ANOVA Tukey's multiple comparisons test. P-value: *P

Additional file 1: Fig. S1. Structural formula and synthesis method of ultra-small Ti-TCPP MOF. Fig. S2. TEM images and DLS measurement of Ti-TCPP MOF in PBS for 21 days (a) and FBS for 7 days (b) at 4 ℃. Scale bar: 50 nm. Fig. S3. XRD pattern of Ti-TCPP MOF in PBS for 21 days at 4 ℃. Fig. S4. TEM images and DLS measurement of Ti-TCPP MOF in PBS (a) and FBS for 3 days (b) at 37 ℃. Scale bar: 50 nm. Fig. S5. TEM images and DLS measurement of Ti-TCPP MOF in PBS after US irradiation (0.5 W cm−2, 1 MHz, 50% duty cycle, 1 min). Scale bar: 50 nm. Fig. S6. N2 adsorption/desorption result of Ti-TCPP MOF. Fig. S7. (a) Power-dependent 1O2 generation after US irradiation under normoxia conditions. (b) A standard curve of H2O2 generation measured by multiscan spectrum. Fig. S8. The PA signal of Ti-TCPP MOF under 680–900 nm pulse laser irradiation in vitro. Fig. S9. Cell viability of Panc02 (a) and hTERT-HPNE (b) cells after incubated with Ti-TCPP MOF for 24 h. Fig. S10. Cell viability of BxPC-3 cells after US irradiation (1 MHz, 50% duty cycle, 1 min) for 24 h. Fig. S11. Detection of ROS generation by DCFH-DA kit in tumor cells. Fig. S12. The quantified levels of Bax/Bcl-2 was analyzed by Image J software. The data were expressed as mean ± S.D. (n = 3). ***P

Introduction: Congenital cystic adenomatoid malformation (CCAM) is a rare developmental lung abnormality, that typically manifests in neonates and infants but rarely in adults. Ultrasound is an important method of diagnosing CCAM in neonates and infants; however, few articles have reported the value of transthoracic lung ultrasound in the diagnosis of CCAM in adults. Patient concerns: We present a case of a 34-year-old woman with a cavitary lesion in her left lower lobe, that suggested chronic inflammation. Diagnosis: The patient underwent ultrasound examination and contrast-enhanced ultrasound-guided transthoracic core biopsy; histology suggested the diagnosis of lung hamartoma. Surgical resection of the lesion followed by histopathological analysis confirmed the diagnosis of CCAM. Interventions: The patient underwent transthoracic core biopsy under contrast-enhanced ultrasound guidance. A left lower lobectomy was then performed subsequently. Outcomes: The patient had a smooth recovery and remained asymptomatic during the 12-months of postoperative follow-up. Conclusion: We report a rare case of CCAM to suggest that transthoracic ultrasound combined with contrast-enhanced ultrasound is a safe and effective method of diagnosing the subpleural lung malformations in adults, thereby avoiding multiple radiation exposures and associated complications.

This study aimed to improve the diagnostic accuracy of abdominal unicentric Castleman's disease (UCD) by retrospectively summarizes the relatively specific imaging features of UCD. This study retrospectively collected fifteen patients with abdominal UCD confirmed by pathology. All patients were underwent ultrasound (US), computed tomography (CT), or magnetic resonance imaging (MRI) examination. The imaging findings of UCDs were analyzed by senior radiologists. Fifteen patients included 7 males and 8 females, aged 30 to 68 years old, with an average age of 51.73 ± 13.57. In the 15 cases, 7 were located around the mesentery, 4 were located in the retroperitoneal space, and 4 in the liver. Fifteen cases contained solid masses, of which 13 had clear margins and 2 had blurred margins. The size of the mass ranged from 1.5 to 14.2 cm, with an average of 6.49 ± 4.16 cm. US showed that 9 lesions were presented with hypo-echogenicity while 5 lesions presented with hyper-echogenicity spots. Unenhanced CT showed that the lesions were comprised of soft tissue while calcified lesions were found in 10 of the cases (66.67%, 10/15). T1-weighted imaging (T1WI) suggested the lesions as iso/hypo-signal, and mildly hyper-signal on T2-weighted imaging (T2WI). Diffusion-weighted imaging (DWI) showed different degrees of hyper-signal. Contrast-enhanced US and CT/MRI showed obvious enhancement at the arterial phase in 12 cases (85.71%, 12/14), most of which (50%, 7/14) showed continuous enhancement at the delayed phase. Feeding vessel could be seen within, or around the lesion in 5 cases (35.71%, 5/14). The study suggests that abdominal UCD commonly manifests as well-defined, homogeneous, solid, and hypervascular masses. Calcification and the presence of feeding vessel in the tumors are relatively specific features of abdominal UCD.

Chun Liufu,1 Yue Li,1 Jiawei Tu,1 Hui Zhang,1 Jinsui Yu,1 Yi Wang,1 Pintong Huang,2 Zhiyi Chen1 1Department of Ultrasound Medicine, Laboratory of Ultrasound Molecular Imaging, The Third Affiliated Hospital of Guangzhou Medical University, Experimental Center, The Liwan Hospital of The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510000, People’s Republic of China; 2Department of Ultrasound, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People’s Republic of ChinaCorrespondence: Zhiyi ChenDepartment of Ultrasound Medicine, Laboratory of Ultrasound Molecular Imaging, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, People’s Republic of ChinaTel +86-020-81292115Email winchen@vip.126.comBackground: Cancer stem cells (CSCs) are responsible for cancer therapeutic resistance and metastasis. To date, in addition to surgery, chemotherapy, and radiotherapy, gene delivery has emerged as a potential therapeutic modality for ovarian cancer. Efficient and safe targeted gene delivery is complicated due to the tumor heterogeneity barrier. Ultrasound (US)-stimulated microbubbles (MBs) have demonstrated a method of enabling non-invasive targeted gene delivery.Purpose: The purpose of our study was to show the utility of poly(ethylene glycol)-SS-polyethylenimine-loaded microbubbles (PSP@MB) as an ultrasound theranostic and redox-responsive agent in a gene delivery system.Patients and methods: PSP nanoparticles were conjugated to the MB surface through biotin–avidin linkage, increasing the gene-loading efficiency of MB. The significant increase in the release of genes from the PSP@MB complexes was achieved upon ultrasound exposure. The positive surface charge in PSP@MB can condense the plasmid through electrostatic interactions; agarose-gel electrophoresis further confirmed the ability of PSP@MB to condense plasmids. The morphology, particle sizes and zeta potential of PSP@MB were characterized by transmission electron microscopy and dynamic light scattering.Results: Laser confocal microscopy showed that the combination of ultrasound with PSP@MB could promote the cellular uptake of plasmids. Plasmids which encode enhanced green fluorescence protein (EGFP) reporter genes or luciferase reporter genes were delivered to CSCs in vitro and to subcutaneous xenografts in vivo via the combination of ultrasound with PSP@MB. Gene transfection efficiency was evaluated by fluorescence microscopy and In Vivo Imaging Systems. This study demonstrated that the combination of ultrasound with PSP@MB can remarkably promote gene delivery to solid tumors as well as diminishing the toxicity towards normal tissues in vivo. The combination of PSP@MB and the use of ultrasound can efficiently enhance accumulation, extravasation and penetration into solid tumors.Conclusion: Taken together, our study showed that this novel PSP@MB and ultrasound-mediated gene delivery system could efficiently target CSCs.Keywords: ultrasound, PEGylated PEI-loaded microbubble, cancer stem cell, gene delivery

Mei Mei,1 Ligang Ye,2 Juan Quan,1 Pintong Huang1 1Department of Ultrasound, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, China; 2Department of Emergency, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310000, China Purpose: Contrast-enhanced ultrasound (CEUS) is a new technique used to distinguish benign from metastatic superficial lymph nodes (LNs) with variable accuracy. The objective of this meta-analysis was to evaluate the accuracy of CEUS for the diagnosis of superficial metastatic LNs.Methods: A comprehensive literature search of PubMed, Web of Science, Medline, Embase, and the Cochrane Library was performed until April 2018. Nine articles reporting the diagnosis of 436 LNs by CEUS were investigated. The Mantel–Haenszel and DerSimonian–Laird methods were used to analyze pooled sensitivity, specificity, diagnostic OR, positive likelihood ratio (LR), and negative LR, and a summary receiver operating characteristic (SROC) curve was also evaluated.Results: The pooled sensitivity and specificity of CEUS for the differential diagnosis of benign and metastatic superficial LNs were 0.88 (95% CI, 0.83–0.92) and 0.80 (95% CI, 0.74–0.85), respectively. The pooled positive LR, negative LR, and diagnostic OR were 4.36 (95% CI, 2.38–7.99), 0.17 (95% CI, 0.10–0.31), and 32.75 (95% CI, 11.08–96.84), respectively. SROC area under the curve (AUC) was 0.9288. The subgroup analysis excluding outliers implied that the heterogeneity was almost eliminated, and the pooled sensitivity and specificity were 0.87 (95% CI, 0.81–0.92) and 0.79 (95% CI, 0.71–0.85), respectively. The SROC AUC was 0.8950.Conclusion: CEUS, a novel imaging modality for the characterization of superficial LNs, shows a high sensitivity and specificity in the diagnosis of superficial metastatic LNs. The different diagnostic standards, contrast agents, and contrast modes contribute to a considerable level of heterogeneity among studies. A uniform standard for distinguishing between benign and metastatic LNs is needed for further clinical application. Keywords: contrast-enhanced ultrasound, benign, metastatic, lymph nodes, meta-analysis