Search

Background: Microcirculatory perfusion disorder and inflammatory response are critical links in acute kidney injury (AKI). We aim to construct anti‐vascular cell adhesion molecule‐1(VCAM‐1) targeted microbubbles (TM) to monitor renal microcirculatory perfusion and inflammatory response. Methods: TM carrying VCAM‐1 polypeptide was constructed by biological coupling. The binding ability of TM to human umbilical vein endothelial cells (HUVECs) was detected. Bilateral renal ischemia–reperfusion injury (IRI) models of mice were established to evaluate microcirculatory perfusion and inflammatory response using TM. Thirty‐six mice were randomly divided into six groups according to the different reperfusion time (0.5, 2, 6, 12, and 24 h) and sham‐operated group (Sham group). The correlation of TM imaging with serum and histopathological biomarkers was investigated. Results: TM has advantages such as uniform distribution, regular shape, high stability, and good biosafety. TM could bind specifically to VCAM‐1 molecule expressed by tumor necrosis factor‐alpha (TNF‐α)‐treated HUVECs. In the renal IRI‐AKI model, the area under the curve (AUC) of TM significantly decreased both in the renal cortical and medullary after 2 h of reperfusion compared with the Sham group (p < 0.05). Normalized intensity difference (NID) of TM at different reperfusion time was all higher than that of blank microbubbles (BM) and the Sham group (p < 0.05). Ultrasound molecular imaging of TM could detect AKI early before commonly used renal function markers, histopathological biomarkers, and BM imaging. AUC of TM was negatively correlated with serum creatinine (Scr), blood urea nitrogen (BUN), and Cystatin C (Cys‐C) levels, and NID of TM was linearly correlated with VCAM‐1, TNF‐α, and interleukin‐6 (IL‐6) expression (p < 0.05). Conclusions: Ultrasound molecular imaging based on TM carrying VCAM‐1 polypeptide can accurately evaluate the changes in renal microcirculatory perfusion and inflammatory response, which might be a promising modality for early diagnosis of AKI. [ABSTRACT FROM AUTHOR]

The present study investigated ultrasound (US) phenotypes reflecting prostate cancer (PCa)‐related genetic mutations. Herein, integration of radiotranscriptomic data, US and contrast‐enhanced ultrasound (CEUS) radiomic images, and RNA sequencing was performed with the aim of significantly improving the accuracy of PCa prognosis. We performed radiotranscriptomic analysis of clinical, imaging, and two genomic (mRNA and microRNA expression) datasets from 48 and 22 men with PCa and benign prostatic hyperplasia (BPH), respectively. Twenty‐three US texture features and four microvascular perfusion features were associated with various patterns of 52 differentially expressed genes related to PCa (p < 0.05); 17 overexpressed genes were associated with two key texture features. Twelve overexpressed genes were identified using microvascular perfusion features. Furthermore, mRNA and miRNA biomarkers could be used to distinguish between PCa and BPH. Compared with RNA sequencing, B‐mode and CEUS features reflected genomic alterations associated with hormone receptor status, angiogenesis, and prognosis in patients with PCa. These findings indicate the potential of US to assess biomarker levels in patients with PCa. 1. Our radiotranscriptomics investigations of PCa provided three ultrasound key features identified with radiomics: two texture features and one microvascular perfusion feature. 2. The following co‐regulated, differentially expressed mRNAs and microRNAs were found in three datasets related to prostate cancer: SNAI2, CAV1, RD5A2, RND3, and miR205‐5p, miR205‐3p, miR221‐3p. 3. The enriched functions in the three key features of the significant genes included negative regulation of epithelial cell proliferation, the androgen metabolic process, male gonad development, and the lipid biosynthetic process. [ABSTRACT FROM AUTHOR]

Background: Ultrasound‐guided radiofrequency ablation (RFA) has been used in patients with papillary thyroid carcinoma (PTC) who refuse surgery or active surveillance. However, the long‐term outcomes are still limited. This study aimed to evaluate the clinical outcomes of RFA for solitary T1N0M0 PTC in a large cohort over a more than 5‐year follow‐up period. Methods: This retrospective study included 358 patients with solitary T1N0M0 PTC who were treated with RFA and followed for at least 5 years. The bipolar RFA procedure was performed using hydrodissection technique, transisthmic approach, and moving‐shot technique. The primary outcomes were disease progression, including lymph node metastasis (LNM), recurrent tumor, persistent tumor, and distant metastasis. The secondary outcomes were volume reduction rate, complete disappearance rate, complications, and delayed surgery. Results: During a mean follow‐up period of 75.5 ± 9.7 months, the overall disease progression was 5.0%. The incidence of LNM, recurrent tumor, and persistent tumor was 1.4%, 3.1%, and 0.6%, respectively. There were no significant differences in the disease progression (5.0% vs. 5.5%, p = 1.000), LNM (1.3% vs. 1.8%, p =.568), recurrent tumor (3.3% vs. 1.8%, p =.872), persistent tumors (0.3% vs. 1.8%, p =.284), and 5‐year recurrence‐free survival rates (95.4% vs. 96.4%, p =.785) in the T1a and T1b groups. Volume reduction rate was 100.0 ± 0.3%, with 96.9% of tumors disappearing. No complications occurred. No patients underwent delayed surgery because of anxiety. Conclusions: RFA is an effective and safe alternative for patients with T1N0M0 PTC and can offer a minimally invasive curative option for patients who refuse surgery or active surveillance. Plain Language Summary: During a mean follow‐up period of 75.5 ± 9.7 months, the overall papillary thyroid carcinoma disease progression was 5.0%. The volume reduction rate was 100.0 ± 0.3%, with 96.9% of tumors disappearing.The T1a and T1b groups had similar incidence of disease progression and 5‐year recurrence‐free survival rates. No patients experienced complications or underwent delayed surgery because of anxiety. During a mean follow‐up period of 75.5 ± 9.7 months, the overall disease progression of T1N0M0 papillary thyroid carcinoma was 5.0%. No significant differences were observed in disease progression and recurrence‐free survival rates between the T1a and T1b groups. [ABSTRACT FROM AUTHOR]

Background: Contrast‐enhanced ultrasound (CEUS) is now a guideline‐recommended strategy for diagnosing renal lesions. Tumor size is related to the risk of the treatment and prognosis in renal tumors. Thus, we aim to analyze the CEUS features of solid renal tumors in relation to tumor size. Methods: The CEUS appearance of 156 pathologically diagnosed solid renal tumors were retrospectively analyzed. Three groups were stratified according to the tumor size (≤2 cm [group I], 2.1–4 cm [group II] and 4.1–7 cm [group III]). For each group, the features of wash‐in type, enhancement degree, enhancement homogeneity, and the presence of a pseudocapsule sign were compared between benign and malignant tumors. Results: All 156 included lesions were detected by CEUS. The proportion of benign tumors in three size groups was 37.1%, 19.4%, and 20.4%, respectively. The proportion of malignant tumors was highest (80.6%) in group II, followed by group III (79.6%) and group I (62.9%). In group I, malignant and benign tumors differed significantly in the presence of a pseudocapsule sign (p = 0.015) and homogeneity (p = 0.007). In group II, the degree of enhancement differed (p = 0.02) between tumor types. In group III, the two tumor types differed in both the wash‐in pattern (p = 0.015) and enhancement degree (p = 0.024). The weighted and Cohen's kappa values for the concordance between inter‐observer agreement ranged from 0.31 (95% CI: 0.36–0.57) to 0.90 (95% CI: 0.77–1.00). Conclusions: CEUS features of malignant and benign renal tumors change along with the tumor size. The use of CEUS features in the diagnosis of benign and malignant tumors requires consideration of tumor size. [ABSTRACT FROM AUTHOR]

Aims/Introduction: There are mixed opinions on the influence of diabetes on the prognosis of patients receiving percutaneous coronary intervention (PCI). Therefore, in this study, the quantitative flow ratio (QFR), an emerging technology of functional evaluation, was used to explore the impact of diabetes on coronary physiology in patients who underwent PCI. Materials and Methods: Patients who underwent successful PCI and a 1‐year angiographic follow up were retrospectively screened and analyzed by the QFR. Based on the presence or absence of diabetes, 677 enrolled patients (794 vessels) were classified into a diabetes group (211 patients, 261 vessels) and a non‐diabetes group (466 patients, 533 vessels). The results of QFR analysis and clinical outcomes were compared between the two groups. Results: The two groups reached a similar level of post‐PCI QFR (0.95 ± 0.09 vs 0.96 ± 0.06, P = 0.292). However, at the 1‐year follow up, the QFR was lower (0.93 ± 0.11 vs 0.96 ± 0.07, P < 0.001), and the degree of QFR decline was more obvious (−0.024 ± 0.090 vs −0.008 ± 0.070, P = 0.023) in the diabetes group. Additionally, diabetes was independently associated with functional restenosis (odds ratio 2.164, 95% confidence interval 1.210–3.870, P = 0.009) and target vessel failure (odds ratio 2.654, 95% confidence interval 1.405–5.012, P = 0.003). Conclusion: As evaluated by the QFR, patients with diabetes received less coronary physiological benefit from PCI, which was consistent with their clinical outcomes. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effectiveness of ultrasound (US) guided intra‐hip joint injection to estimate the outcome of hip arthroscopy in patients with femoroacetabular impingement (FAI) syndrome. Methods: Patients with FAI syndrome (n = 60) were prospectively enrolled in our study. Before hip arthroscopy, a mix of 4 mL 2% lidocaine and 4 mL 1% ropivacaine were injected into the hip joint under the guidance of US. The clinical efficacy of the intra‐articular injection was evaluated by comparing the visual analog scale (VAS) and international hip outcome tool 12 (iHOT‐12) results before and after the injection. The outcome of hip arthroscopy was evaluated by iHOT‐12, the modified Harris hip score (MHHS), and the patient's satisfaction 12 months after the operation. The outcome of intra‐articular injection and hip arthroscopy were compared. Factors related to the outcomes of hip arthroscopy were evaluated. The correlation between the efficacy of intra‐hip joint injection and arthroscopy was evaluated. Results: The VAS of patients decreased from 11.3 ± 7.7 to 3.3 ± 4.5, and the iHOT‐12 increased from 52.1 ± 23.2 to 84.1 ± 18.1 after intra‐articular injection (all P < 0.001). The iHOT‐12 score increased from 52.1 ± 23.2 to 78.9 ± 19.2, and the MHHS increased from 66.5 ± 6.8 to 81.6 ± 8.1 after hip arthroscopy (all P < 0.001). The satisfaction rate of arthroscopy, including very satisfied and effective patients, was 93.3%. Multi‐variable logistic regression showed that only iHOT‐12 improved value after injection was included in the regression formula of satisfaction, with the β of −0.154, standard error of 0.071, Wald value of 4.720, and OR of 0.857 (95%CI 0.746–0.985) (P = 0.03). Significant correlation was detected between iHOT‐12 scores after intra‐articular anesthesia and at 12 months after arthroscopy (r = 0.784, P < 0.001). So was the iHOT‐12 improved value (r = 0.781, P < 0.001) and the iHOT‐12 improved ratio (r = 0.848, P < 0.001). If we had performed arthroscopy only on patients with post‐injection iHOT‐12 score improvement ≥10, the satisfaction rate of arthroscopy would have increased to 96.6%. Conclusions: US‐guided intra‐hip joint injection may provide a feasible way to estimate the outcome of hip arthroscopy in patients with FAI syndrome, and could be used as a method for indication selection of hip arthroscopy. [ABSTRACT FROM AUTHOR]

Objectives: To conduct a quantitative analysis of renal microvascular perfusion in diabetic patients with kidney injury using contrast‐enhanced ultrasound (CEUS). Methods: A total of 172 patients with type 2 diabetes mellitus and kidney injury were recruited from May 2017 to November 2019. After collection of clinical characteristics, a CEUS examination was performed after injection of the contrast agent SonoVue (Bracco SpA, Milan, Italy). Time‐intensity curves and renal perfusion parameters were analyzed. Ultrasound‐guided renal biopsy was performed. The patients were divided into a diabetic nephropathy (DN) group and a nondiabetic renal disease (NDRD) group according to renal pathologic results. The discrimination of perfusion parameters between the groups was analyzed statistically with SPSS version 19.0 software (IBM Corporation, Armonk, NY). Receiver operating characteristic curves were used to illustrate the diagnostic performance of indicators. Results: Ninety‐eight patients, including 45 with DN (29 male; mean age ± SD, 57.76 ± 10.47 years) and 53 with NDRD (40 male; mean age, 48.7 ± 13.88 years) were included in this study. The peak enhancement (PE), wash‐in the area under the curve (AUC), wash‐in rate, wash‐in perfusion index, wash‐out AUC, wash‐in and wash‐out AUC, and wash‐out rate were significantly different between the groups (P <.05). There were no differences in time‐related parameters between the DN and NDRD groups (P >.05). The receiver operating characteristic curve analysis showed that the AUC for PE was 0.727, and PE lower than 7712.426 had diagnostic potential, with sensitivity of 81% and specificity of 40% in discriminating between NDRD and DN. Conclusions: The quantification of CEUS parameters can discriminate DN in diabetic patients with kidney injury. The PE and AUC may be feasible parameters. Access the CME test here and search by article title. [ABSTRACT FROM AUTHOR]

Objective: Ultrasonography‐guided radiofrequency ablation (RFA) has been used to treat low‐risk small papillary thyroid carcinoma (PTC) and yielded promising results. However, little research has been conducted on the application of RFA for the management of T1bN0M0 PTC. Therefore, this study was to compare the midterm outcome of RFA with that of surgery for the treatment of clinical solitary T1bN0M0 PTC. Design: This is a retrospective study. Patients: In total, 182 patients with solitary T1bN0M0 PTC between April 2014 and May 2019 were treated with RFA or surgery (n = 91/group). Measurements: The primary end points were local tumour progression and complication rates. Local tumour progression were defined as: (a) new or persistent PTC confirmed by core needle biopsy; (b) cervical lymph node metastasis (LNM) confirmed by core needle biopsy or surgery; (c) ablation zone increased in the RFA group. Results: In the RFA group, local tumour progression was seen in four patients (4.4%, three persistent PTC and one LNM). In the surgery group, two patients (2.2%) developed LNM; no new or persistent PTC was confirmed. There was no significant difference between the two groups in local tumour progression. Permanent hypoparathyroidism was observed in four patients (4.4%) in the surgery group, while no major or minor complications were observed in the RFA group. Conclusions: Ultrasonography‐guided RFA is feasible and safe for treating solitary T1bN0M0 PTC, so it may be considered an alternative to surgery in select patients, especially those who are ineligible for or refusal of surgery. [ABSTRACT FROM AUTHOR]

Objective: Papillary thyroid microcarcinoma (PTMC) has a good prognosis and a long survival time, surgery is the common treatment including total thyroidectomy (TT) and unilateral lobectomy (LT), but recent studies showed that TT does not show an advantage over LT for PTMC in preventing cancer recurrence and reducing mortality. Given this, the health‐related quality of life (HRQoL) has become one of the important factors that physicians must consider when making treatment decisions. The aim of this study was to compare the HRQoL of patients between undergoing TT and LT. Methods: From October 2019 to December 2019, 69 PTMC patients were enrolled in our study, including 34 in the LT group and 35 in the TT group, respectively. We used three questionnaires which included the 36‐item short‐form health survey (SF‐36), thyroid cancer‐specific quality of life (THYCA‐QOL), and Fear of Progression Questionnaire‐Short Form (FoP‐Q‐SF) for each patient to evaluate their scores of HRQoL. Results: According to the SF‐36, the scores of the domain for the role limitation due to physical problems, emotional problems, and social function (RP, RE, and SF) as well as Physical Component Summary (PCS) and Mental Component Summary (MCS) showed a significant negative linear association between the LT group and TT group: RP (coefficient [coef]: −33.953 [confidence interval (CI) −51.187 to −16.720], p < 0.001, RE (coef: −21.633 [CI −39.500 to −3.766], p = 0.018), SF (coef: −10.169 [CI −19.586 to −0.752], p = 0.035)and PCS (coef: −10.571 [CI −17.768 to −3.373], p = 0.005), MCS (coef: −10.694 [CI −19.465 to −1.923], p = 0.018). The THYCA‐QOL showed that the scores of the TT group were higher than that of the LT group in the problem of scar (coef: 16.245 [CI 1.697 to 30.794], p = 0.029 according to the multivariate analysis), suggesting a higher level of complaint in the TT group. There was no statistically significant difference in the scores of FoP‐Q‐SF between the two groups. Conclusions: In patients with PTMC, LT offers an advantage over TT in terms of HRQoL, which supports the role of LT as an alternative strategy to TT. [ABSTRACT FROM AUTHOR]

Silicon (Si) photonics have established as leading technologies in addressing the rapidly increasing demands of huge data transfer in optical communication systems with compact footprints, small power consumption, and ultradense bandwidth, which are driven by the next generation supercomputers and big data era. Particularly, Si photonics will penetrate into optical communication links at an ever‐small scale, namely chip‐to‐chip and on‐chip. However, the nanostructures made of Si with an indirect bandgap are not ideal candidates for on‐chip light sources, modulators, and photodetectors, which most‐frequently require optical materials with direct bandgap. Thanks to the advent of graphene, transition metal dichalcogenides and other two‐dimensional (2D) materials, which can facilitate extraordinary progresses in improving device performance at the ultrathin scale, their integration with Si photonics furnishes a heterogeneous platform to construct fully functional and highly integrated photonic communication systems. In this work, the current advancements in the on‐chip applications of Si photonics‐2D materials heterostructures, inclusive of all essential chip‐scale modules and integrated circuits, as well as the future prospective and challenges are reviewed and discussed. The present study sets out to objectively measure the feasibility of the hybrid integration between Si photonics and 2D materials in on‐chip optical communications and the advanced applications beyond. [ABSTRACT FROM AUTHOR]

Background: Li‐Fraumeni Syndrome (LFS) is a rare cancer‐predisposing condition caused by germline mutations in TP53. Conventional wisdom and prior work has implied an increased risk of secondary malignancy in LFS patients treated with radiation therapy (RT); however, this risk is not well‐characterized. Here we describe the risk of subsequent malignancy and cancer‐related death in LFS patients after undergoing RT for a first or second primary cancer. Methods: We reviewed a multi‐institutional hereditary cancer registry of patients with germline TP53 mutations who were treated from 2004 to 2017. We assessed the rate of subsequent malignancy and death in the patients who received RT (RT group) as part of their cancer treatment compared to those who did not (non‐RT group). Results: Forty patients with LFS were identified and 14 received RT with curative intent as part of their cancer treatment. The median time to follow‐up after RT was 4.5 years. Fifty percent (7/14) of patients in the curative‐intent group developed a subsequent malignancy (median time 3.5 years) compared to 46% of patients in the non‐RT group (median time 5.0 years). Four of seven subsequent malignancies occurred within a prior radiation field and all shared histology with the primary cancer suggesting recurrence rather than new malignancy. Conclusion: We found that four of14 patients treated with RT developed in‐field malignancies. All had the same histology as the primary suggesting local recurrences rather than RT‐induced malignancies. We recommend that RT should be considered as part of the treatment algorithm when clinically indicated and after multidisciplinary discussion. [ABSTRACT FROM AUTHOR]

Objectives: Super‐resolution ultrasound (SRUS) has become a tool for in vivo microvascular imaging. Most of the SRUS methods are based on microbubble localization: namely, ultrasound localization microscopy (ULM). The aim of this study was to develop a nonlocalization SRUS method and verify its feasibility in microvascular imaging. Methods: We introduce a new super‐resolution strategy based on the postprocessing of contrast‐enhanced ultrasound. The proposed method, which is termed ultrasound diffraction attenuation microscopy (UDAM), uses super‐resolution radial fluctuations instead of microbubble localization to overcome acoustic diffraction limits. Biceps of Japanese long‐ear white rabbits were adopted to validate its feasibility on muscle vascular imaging, using a clinical accessible ultrasound system at a frame rate of 30 Hz under a single bolus injection of SonoVue (Bracco SpA, Milan, Italy). The super‐resolution image was compared with the maximum‐intensity projection and ULM. Results: The animal study illustrates that the proposed UDAM can obtain super‐resolution microvascular images of rabbits' muscles under a single bolus injection of SonoVue with a 150‐second contrast‐enhanced ultrasound video. Both ULM and UDAM can achieve a very similar vascular structure with the maximum‐intensity projection but much higher spatial resolution. The measurement of 1‐dimensional signals shows that UDAM can distinguish the subwavelength structures and substantial reduce the full width at half‐maximum of microvessels. Conclusions: We conclude UDAM provides a noninvasive tool for in vivo super‐resolution microvascular imaging. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to compare the diagnostic performance of multiparametric transrectal ultrasound (TRUS), including grayscale imaging, color Doppler imaging, shear wave elastography, and contrast‐enhanced ultrasound, to that of multiparametric magnetic resonance imaging (MRI), including T2‐weighted, diffusion‐weighted, and dynamic contrast‐enhanced MRI, in the diagnosis of localized prostate cancer (PCa; lesions at stage T2 or lower). Methods: Seventy‐eight patients were prospectively enrolled, including 40 in a benign prostate group and 38 in a localized PCa group (≤T2). The diagnostic performance of multiparametric TRUS and multiparametric MRI in detecting localized PCa was analyzed with surgical and biopsy pathologic results as the references. Results: Multiparametric TRUS had higher sensitivity, negative predictive value, and accuracy than multiparametric MRI (97.4% versus 94.7%, 96.9% versus 92.3%, and 87.2% versus 76.9%, respectively) for detecting localized PCa. The mean area under the receiver operating characteristic curve ± SD for multiparametric TRUS was 0.874 ± 0.043 (95% confidence interval, 0.790–0.959), and it was 0.774 ± 0.055 (95% confidence interval, 0.666–0.881) for multiparametric MRI. Conclusions: Our results suggest that multiparametric TRUS has high diagnostic performance in the diagnosis of localized PCa. Multiparametric TRUS is compatible with multiparametric MRI in the detection of localized PCa (≤T2). [ABSTRACT FROM AUTHOR]

Purpose: To investigate the value of sonography in the diagnosis of fibromatosis. Method: We retrospectively reviewed the sonographic findings, pathologic results, and other medical records of 42 patients with pathologically proven fibromatosis. The tumor's size and location were recorded. Echogenicity, margins, vascularity, and relationship with the adjacent tissue were analyzed. Results: A total of 42 patients with 44 lesions were included in the study. In 21 patients, the tumor was a primary tumor. In 7 of these patients, a preoperative diagnosis of fibromatosis was obtained via sonographically guided biopsy or surgical biopsy. In another 21 patients, the tumor was a recurrence (including 1 case of malignant transformation). Well-defined and regular margins were demonstrated in 26 lesions (59%), whereas poorly defined and irregular borders were seen in the other 18 lesions. On Doppler imaging, vascularity was absent in 66% (29/44) lesions, moderate in 23% (10/44), and marked in 11% (5/44). Infiltration into the adjacent skeletal muscles, cortical bone, or encasement vessels, nerves, or tendons was found in 21 (48%) lesions. Conclusion: In patients with fibromatosis, sonography demonstrates a nonspecific hypoechoic solid mass and can guide the percutaneous needle biopsy. [ABSTRACT FROM AUTHOR]