Current aspects of multimodal ultrasound liver diagnostics using contrast-enhanced ultrasonography (CEUS), fat evaluation, fibrosis assessment, and perfusion analysis – An update

Stroszczynski

2023

Self Cite

Goal of the study was the assessment of AI-assisted diagnosis of solid thyroid foci with multimodal modern ultrasound imaging. 50 patients (26–81 years, 54.7±13.1 years) were included in the study. Multimodal ultrasound imaging by means of B-mode with linear probe (4–12 MHz) with option of automated documentation of findings by means of AI, with supplementary Ultra MicroAngiography (UMA) was used. Macrovascularisation was assessed by dynamic contrast ultrasonography (CEUS) with parametric evaluation and perfusion analysis, and microvascularization was assessed by combined strain and shear wave elastography on a novel high-performance ultrasound system (Resono R9/Mindray) by an experienced examiner with independent reading. The evaluation was performed according to TI-RADS III-V. The volume of the thyroid lobes on both sides averaged 39 ml±5 ml (27 to 69 ml). The 13 cases of histologically confirmed thyroid carcinomas (8 papillary, 2 medullary, 2 microfollicular, 1 anaplastic CA) with a mean size of 15 mm±6 mm (9–21 mm) were correctly evaluated by TI-RADS V on the basis of irregular shape, induration > 2.5 m or > 30kPA and striking wash-out kinetics. Tumor lymph nodes could only be correctly detected preoperatively in one case of medullary carcinoma according to the surgical findings, based on irregular vascularization with UMA in roundish shape with cortex > 4 mm, transverse diameter up to 11 mm. In 25 cases of inhomogeneous nodular goiter an evaluation with TI-RADS III was performed in 31 cases, in 4 cases with incomplete marginal contour, partial marginal vascularization with UMA and partial wash out with indurations up to 2.5 m/s 30 kPA an evaluation with TI-RADS IV and surgical excision for nodular goiter. In 12 cases regressive nodular changes without relevant malignancy criteria resulted in nodular goiter, with focal changes up to 1.5 cm in diameter, classified as requiring control with TI-RADS III. There were no relevant changes in findings in the controls after 6 months. From the AI tool, the 20/25 goiter nodes were assessed as TI-RADS III, 7/12 adenomas, 5 goiter nodes, and 5 adenomas as TI-RADS IV, 5/13 carcinomas as TI-RADS IV, and 8/13 carcinomas as TI-RADS V. Multimodal ultrasound diagnostics supported by AI has a high diagnostic potential for the evaluation of solid thyroid lesions and standardizes the reporting with digital representative image documentation. CEUS perfusion and modern elastography techniques allow targeted follow-up of TI-RADS III findings.

Section: Discussionmentioning

confidence: 99%

“…If hemodynamic parameters are adjusted to very low values, a large number of artifacts may occur, making valid assessment difficult. Here, new high-resolution techniques of low-angle-dependent ultrasound microangiography (UMA) seem promising [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Advanced multimodal imaging of solid thyroid lesions with artificial intelligence-optimized B-mode, elastography, and contrast-enhanced ultrasonography parametric and with perfusion imaging: Initial results

Stroszczynski

2023

Self Cite

“…Whether or not there are diagnostic advantages for CEUS with a novel mode of investigation, such as HIFI, must be decided after further studies regarding diagnostic safety, detection, and characterization of solid liver tumors; differentiation of complicated cystic lesions; and dynamic acquisition and digital storage of the dynamics of unclear lesions on CT or MRI from the early arterial phase after 10-15 s to a late phase of 5-6 min [29,30]. Furthermore, CEUS brings an advantage in certain cases of patient with liver cirrhosis, as it provides a non-invasive method for generic cirrhosis of the liver using parametric images (CEUS-PAT) [31].…”

Section: Discussionmentioning

confidence: 99%

Color Mapping using Ultrasound System-integrated Perfusion Software for Evaluation of Focal Liver Lesions: A Possible First Step for More Independent Reading

Dropco,

Kaiser,

Wagner

et al. 2023

JGLD

Aims: To assess the value of using integrated parametric ultrasound software for contrast-enhanced ultrasonography (CEUS) of liver tumors. Methods: 107 patients with liver tumors were studied. CEUS were performed to detect focal lesions. Parametric images were based on continuous CINE LOOPs, from the early-arterial phase (15 s) to the portal-venous phase (1 min) generated by perfusion software. The evaluations of the parametric images and their dignity for liver lesions were performed independently by an experienced and a less-experienced investigator. Computed tomography, magnetic resonance imaging scans or histological analysis were used as references. Results: High parametric image quality were obtained in all patients. Among the patients, 44% lesions were benign, 56% were malignant. The experienced investigator correctly classified 46 of 47 (98%) as benign, and 60 of 60 (100%) as malignant tumors based on the parametric images. The less-experienced investigator correctly classified 39 of 47 (83%) as benign, and 49 of 60 (82%) malignant tumors, acheaving a high statistical accuracy of 98% with this type of diagnostic. Conclusion: Parametric imaging for grading the malignant degree of tumor may be a good complement to existing ultrasound techniques and was particularly helpful for improving the assessments of the less-experienced examiner.

“…By taking part in initiatives based on this concept, physicians would have the chance to directly explore and evaluate the most up-to-date ultrasound technology for both diagnostic purposes and ultrasound-guided interventions during patient examinations at university ultrasound centres in China. The exchange of knowledge with fellow professionals and system developers would also be a significant component of this experience [1][2][3][4][5][6][7][8][9][10][11].This concept was deliberated in small group discussions and individual meetings, focusing on forthcoming advancements in technology. Subsequently, there was an in-depth exploration of standards for scientific publications and environmentally conscious aspects of science and technology.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

New aspects of high-resolution ultrasound for tumor detection and treatments: M-Elite Program

Michael,

Xiaoyan,

Xiaoer

2024

The concept of bringing together physicians with ultrasound expertise worldwide and ultrasound technology developers in terms of planning, design, and production would offer extensive opportunities for advancing ultrasound diagnostics. By taking part in initiatives based on this concept, physicians would have the chance to directly explore and evaluate the most up-to-date ultrasound technology for both diagnostic purposes and ultrasound-guided interventions during patient examinations at university ultrasound centres in China. The exchange of knowledge with fellow professionals and system developers would also be a significant component of this experience [1][2][3][4][5][6][7][8][9][10][11].This concept was deliberated in small group discussions and individual meetings, focusing on forthcoming advancements in technology. Subsequently, there was an in-depth exploration of standards for scientific publications and environmentally conscious aspects of science and technology. Finally, an individual-focused survey was conducted to assess the potential for fostering comprehensive exchanges and the possibility of engaging in important, future-proof ultrasound developments via social media platforms, specifically through case discussions.The prolonged duration of the pandemic has underscored the significance of direct interpersonal exchanges among ultrasound technology developers, investigators, users, learners, teachers, and researchers worldwide. Among this community, a notable segment actively participates in the M-Elite initiative, which facilitates on-site interactions at research and development centres across China. It is from these interactions that the current "M-Elite Program" format originated. Regarding the latest advancements in ultrasound technology, it is essential to conduct multi-centre evaluations on each imaging modality to assess their suitability for future clinical applications. This approach will allow for defining the threshold values for tissue properties (such as fibrosis and inflammation) in correlation with various diseases.