Radiomics in Carotid Plaque: A Systematic Review and Radiomics Quality Score Assessment.

Imaging modalities provide information on plaque morphology and vulnerability; however, they are operator dependent and miss a great deal of microscopic information. Recently, many radiomics models for carotid plaque that identify unstable plaques and predict cardiovascular outcomes have been proposed. This systematic review was aimed at assessing whether radiomics is a reliable and reproducible method for the clinical prediction of carotid plaque. A systematic search was conducted to identify studies published in PubMed and Cochrane library from January 1, 2001, to September 30, 2022. Both retrospective and prospective studies that developed and/or validated machine learning models based on radiomics data to classify or predict carotid plaques were included. The general characteristics of each included study were selected, and the methodological quality of radiomics reports and risk of bias were evaluated using the radiomics quality score (RQS) tool and Quality Assessment of Diagnostic Accuracy Studies-2, respectively. Two investigators independently reviewed each study, and the consensus data were used for analysis. A total of 2429 patients from 16 studies were included. The mean area under the curve of radiomics models for diagnostic or predictive performance of the included studies was 0.88 ± 0.02, with a range of 0.741-0.989. The mean RQS was 9.25 (standard deviation: 6.04), representing 25.7% of the possible maximum value of 36, whereas the lowest point was -2, and the highest score was 22. Radiomics models have revealed additional information on patients with carotid plaque, but with respect to methodological quality, radiomics reports are still in their infancy, and many hurdles need to be overcome.

Corrigendum to "Intraoperative Contrast Enhanced Ultrasound Evaluates the Grade of Glioma".

[This corrects the article DOI: 10.1155/2016/2643862.].

Ultrasound shear wave elastography in assessment of muscle stiffness in patients with Parkinson's disease: a primary observation.

OBJECTIVE: The aim of this study was to assess the capability of ultrasound shear wave elastography (SWE) in evaluating the muscle stiffness in patients with Parkinson's diseases (PD). METHODS: Ultrasound SWE of the longitudinal biceps brachii was performed on 46 patients with PD and 31 healthy controls from May 2013 to October 2013. The stiffness of the biceps brachii muscles measured with quantitative Young's modulus (kPa) was compared between the remarkably symptomatic arms and mildly symptomatic arms in the PD and between PD and controls with unpaired t test. The correlation between the Young's modulus of the biceps brachii measured by SWE and motion scores assessed by unified Parkinson's disease rating scale (UPDRS) part III was analyzed by Pearson's correlation coefficient. The reliability of SWE in assessment of biceps brachii stiffness was tested using intraclass correlation coefficient (ICC). RESULTS: The mean Young's modulus of biceps brachii in remarkably symptomatic arms, mildly symptomatic arms, and healthy controls was 59.94±20.91 kPa, 47.77±24.00 kPa, and 24.28±5.09 kPa, respectively. A significant difference in Young's modulus of biceps brachii was found between healthy controls and all PD patients (all P<.05); however, it was not between remarkably symptomatic and mildly symptomatic arms. A positive linear correlation was found between the Young's modulus of the biceps brachii and the motion score by UPDRS in patients with PD (r=0.646, P=.000). The ICC for interobserver and intraobserver variation in measuring Young's modulus of the biceps brachii with SWE was 0.74 (95% confidence interval 0.68-0.78) and 0.78 (95% confidence interval 0.75-0.82), respectively. CONCLUSIONS: SWE of the biceps brachii can be used as a quantitative assessment of muscle stiffness in the patients with PD.

Ultrasound strain elastography in assessment of resting biceps brachii muscle stiffness in patients with Parkinson's disease: a primary observation.

The aim of this study was to evaluate the feasibility of ultrasound strain elastography (SE) for the assessment of resting biceps brachii muscle (BBM) stiffness in patients with Parkinson's diseases (PD). From May 2014 to December 2014, we prospectively performed SE of BBM in 14 patients with PD and 10 healthy controls. Based on the Unified Parkinson's Disease Rating Scale for scoring muscle rigidity (UPDRS, part III), muscle rigidity scores in 14 patients with PD included 3 patients with high rigidity (UPDRS III-IV) and 11 patients with low rigidity (UPDRS I-II). Ultrasound strain was represented by the deformation of the BBM and subcutaneous soft tissues that was produced by external compression with a sand bag (1.5 kg) tied onto an ultrasound transducer. Deformation was estimated with two-dimensional speckle tracking. The difference in strain ratio (SR, defined as mean BBM strain divided by mean subcutaneous soft tissue strain) between PD and healthy controls was tested by unpaired t test. The correlation between SR and muscle rigidity score was analyzed by Pearson correlation coefficient. The reliability of SR in assessment of BBM stiffness was tested using intraclass correlation coefficient. In our result, the SR in PD and healthy controls measured 2.65±0.36 and 3.30±0.27, respectively. A significant difference in SR was noted between the healthy controls and PD (P=.00011). A negative correlation was found between SR and UPDRS rigidity score (r=-0.78). Our study suggests that the SR of BBM to reference tissue can be used as a quantitative biomarker in assessing resting muscle stiffness associated with muscle rigidity in PD.

Intraoperative Contrast Enhanced Ultrasound Evaluates the Grade of Glioma.

OBJECTIVE: The aim of our study was to investigate the value of intraoperative contrast enhanced ultrasound (CEUS) for evaluating the grade of glioma and the correlation between microvessel density (MVD) and vascular endothelial growth factor (VEGF). METHODS: We performed intraoperative conventional ultrasound (CUS) and CEUS on 88 patients with gliomas. All of the patients have undergone surgery and obtained the results of pathology. All patients have undergone intraoperative CUS and CEUS to compare the characteristics of different grade gliomas and the results of CUS and CEUS were compared with pathological results. RESULTS: The time to start (TTS) and time to peak (TTP) of low grade glioma (LGG) were similar to those of edema and normal brain surrounding glioma. The enhanced extent of LGG was higher than that of the normal brain and edema. The TTS and TTP of high grade glioma were earlier than those of the edema and normal brain surrounding glioma. The enhancement of HGG was higher than that of LGG. The absolute peak intensity (API) was correlated with MVD and VEGF. CONCLUSION: Intraoperative CEUS could help in determining boundary of peritumoral brain edema of glioma. Intraoperative CEUS parameters in cerebral gliomas could indirectly reflect the information of MVD and VEGF.

Ultrasound Strain Elastography in Assessment of Muscle Stiffness in Acute Levodopa Challenge Test: A Feasibility Study.

To evaluate the feasibility of ultrasound strain elastography in assessing the response of muscle stiffness to the acute levodopa test, we prospectively performed strain elastography on the biceps brachii muscle (BBM) of 18 patients to diagnose Parkinson's disease. BBM and subcutaneous tissue strains (deformations) were produced by external compression with an ultrasound transducer and estimated using 2-D speckle tracking. We used the strain ratio (SR = BBM strain/reference strain) to assess BBM stiffness. The rate of increase in SR [rate = (SR after levodopa-SR before levodopa)/SR before levodopa] was used to assess the muscle stiffness response to levodopa. SR significantly increased after levodopa administration in 11 patients with Parkinson's disease (p = 0.02), whereas it did not in 7 patients with parkinsonian syndrome (from non-Parkinson's causes) (p = 0.14). The area under the receiver operating characteristic curve for the rate of increase in SR in determining Parkinson's disease was 0.96. The rate of increase in SR seems to be feasible in evaluating the effect of levodopa on muscle stiffness in the diagnosis of Parkinson's disease.

Ultrasound strain elastography in assessment of cortical mechanical behavior in acute renal vein occlusion: in vivo animal model.

To assess the correlation of quantitative ultrasound strain parameters with the severity of cortical edema in renal vein occlusion, we prospectively performed ultrasound strain elastography on a canine acute renal vein occlusion model prior to and following 10, 20, and 40min of renal vein ligation. Strain and strain relaxation time representing the deformation and relaxation of the renal cortices and reference soft tissue were produced by the external compression with the ultrasound transducer and estimated using commercially available 2-D speckle tracking software. Cortical thickness was additionally measured. Repeated-measures analysis of variance was used to examine the difference in cortical thickness, strain ratio (mean cortical strain divided by mean reference tissue strain), and strain relaxation time ratio (cortical relaxation time divided by reference tissue relaxation time) prior to and after renal vein ligation. Pearson's correlation coefficient was applied to test the relationship between strain parameters and the time of the renal vein ligation. There was a strong positive correlation between the duration of renal vein ligation and strain (R(2)=0.97) and strain relaxation time (R(2)=0.98) ratios. Significant differences in strain and strain relaxation time ratios were found at all measured timepoints (all P≪.001). Cortical thickness, however, showed no significant difference between timepoints (P=.065). Our result suggest that strain and strain relaxation time ratios may be used as quantitative markers for the assessment of the renal cortical mechanical behavior in subclinical acute renal vein occlusion.

Intraoperative contrast-enhanced ultrasound in traumatic brain surgery.

OBJECTIVE: The objective was to assess intraoperative contrast-enhanced ultrasound (CEUS) in traumatic brain surgery. METHODS: We prospectively performed intraoperative conventional ultrasound (IOUS) and CEUS in 32 patients who underwent emergency surgery for the treatment of traumatic brain injury (TBI). Sonographic appearance including echogenicity, border, and size of the traumatic lesion and adjacent brain tissue on CEUS were compared with those on IOUS using surgical results as the gold standard. The differences in the size and contrast enhancement parameters of the lesions between IOUS and CEUS were analyzed with a paired t test. RESULTS: The accuracy of CEUS in assessing TBI was 100%, whereas IOUS was 51%. The absolute peak intensity (API) varied depending on the severity of brain injury. Lower API was observed in severely damaged brain tissue, whereas high API was seen in normal brain tissue or the brain tissue with mild injury. The border of the trauma lesion was more clearly defined on CEUS when compared to IOUS. The size of the lesions measured on CEUS was significantly larger than that on IOUS (P<.01). Importantly, small vessels supplying blood to the tissue in traumatic lesions, as an indication of possible brain vitality, were optimized on CEUS during the surgery. Based on the parameter of time intensity curve and appearances of the lesions on CEUS, the severity of lesions was reclassified and surgical intervention was redesigned in 21 (21/32, 66%) cases. CONCLUSION: Intraoperative CEUS improves accuracy in classification of traumatic brain injury, which helps neurosurgeons to effectively remove hematoma, preserve normal brain tissue, and prevent damaging the vessels during surgical intervention.