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1.
Ultrason Imaging ; : 1617346241256120, 2024 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-38873927

RESUMO

The Quantitative Ultrasound backscatter coefficient provides the capability to evaluate tissue microstructure parameters. Tissue-based scatterer parameters are extracted using ultrasound scattering models. It is challenging to correlate ultrasound scatterer parameters of tissue structures from optical-measured histology, possibly because of inappropriate scattering models or the presence of multiple scatterers. The objective of this study is to pursue the quantification of pertinent scatterer parameters with scattering models that consider ultrasound scattering from nuclei and cells. The concentric sphere model (CSM) and the structure factor model adapted for two types of scatterers (SFM2) are evaluated for cell-pellet biophantoms and ex vivo tumors of four cell lines: 4T1, JC, LMTK, and MAT. The structure factor model (SFM) was used for comparison. CSM and SFM2 provided scatterer parameters closer to histology (lower relative errors) for nucleus and cell radii and volume fractions than SFM but were not always accompanied by lower dispersion of the scatterer distribution (lower coefficient of variation). CSM and SFM2 quantified cell and nucleus radius and volume fraction parameters with lower relative error compared to SFM. For tumors, CSM provided better results than SFM2.

2.
Artigo em Inglês | MEDLINE | ID: mdl-38781055

RESUMO

The use of the structure function (SF) to model inter-scatterer contribution to ultrasonic scattering is a major step to improve the capability and accuracy of quantitative ultrasound (QUS) and tissue characterization. However, existing QUS-based SF models rely on the hard-sphere (HS) model, which is limited in its applicability for complex scatterer distributions in real tissue. This paper introduces the sticky hard-sphere (SHS) model for QUS and tissue characterization, which considers a very short-range attractive potential that accounts for the adhesive nature of biological cells and yields a new parameter called stickiness. Herein, the analytical SF expression is presented for monodisperse scatterer size and validated using simulations of scatterer distributions with varying degrees of grouping and volume fractions (0.16, 0.32, and 0.40) over the frequency range from 15 to 110 MHz. The SHS model is applied to three mammary tumor types with differing spatial distributions of tumor cells. The histology-derived SF is computed by considering the nuclei as the main sources of scattering. The results show that the SHS model provides more accurate scatterer radius and volume fraction estimates than the HS model when fitted to histology-derived SF versus frequency curves. Furthermore, the new stickiness parameter provided by SHS is sensitive to the grouping structure in tumor cell distribution. This stickiness parameter, combined with the radius and volume fraction estimated from the SHS model, enables better differentiation between different tumor types than using the radius and volume fraction obtained from the HS model. This study demonstrates the potential of the SHS model to improve QUS tissue characterization.

3.
Am J Obstet Gynecol MFM ; 6(5S): 101250, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38070676

RESUMO

BACKGROUND: Historically, clinicians have relied on medical risk factors and clinical symptoms for preterm birth risk assessment. In nulliparous women, clinicians may rely solely on reported symptoms to assess for the risk of preterm birth. The routine use of ultrasound during pregnancy offers the opportunity to incorporate quantitative ultrasound scanning of the cervix to potentially improve assessment of preterm birth risk. OBJECTIVE: This study aimed to investigate the efficiency of quantitative ultrasound measurements at relatively early stages of pregnancy to enhance identification of women who might be at risk for spontaneous preterm birth. STUDY DESIGN: A prospective cohort study of pregnant women was conducted with volunteer participants receiving care from the University of Illinois Hospital in Chicago, Illinois. Participants received a standard clinical screening followed by 2 research screenings conducted at 20±2 and 24±2 weeks. Quantitative ultrasound scans were performed during research screenings by registered diagnostic medical sonographers using a standard cervical length approach. Quantitative ultrasound features were computed from calibrated raw radiofrequency backscattered signals. Full-term birth outcomes and spontaneous preterm birth outcomes were included in the analysis. Medically indicated preterm births were excluded from the analysis. Using data from each visit, logistic regression with Akaike information criterion feature selection was conducted to derive predictive models for each time frame based on historical clinical and quantitative ultrasound features. Model evaluations included a likelihood ratio test of quantitative ultrasound features, cross-validated receiver operating characteristic curve analysis, sensitivity, and specificity. RESULTS: On the basis of historical clinical features alone, the best predictive model had an estimated receiver operating characteristic area under the curve of 0.56±0.03. By the time frame of Visit 1, a predictive model using both historical clinical and quantitative ultrasound features provided a modest improvement in the area under the curve (0.63±0.03) relative to that of the predictive model using only historical clinical features. By the time frame of Visit 2, the predictive model using historical clinical and quantitative ultrasound features provided significant improvement (likelihood ratio test, P<.01), with an area under the curve of 0.69±0.03. CONCLUSION: Accurate identification of women at risk for spontaneous preterm birth solely through historical clinical features has been proven to be difficult. In this study, a history of preterm birth was the most significant historical clinical predictor of preterm birth risk, but the historical clinical predictive model performance was not statistically significantly better than the no-skill level. According to our study results, including quantitative ultrasound yields a statistically significant improvement in risk prediction as the pregnancy progresses.

4.
Ultrasound Med Biol ; 49(5): 1145-1152, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36740462

RESUMO

OBJECTIVE: Predicting women at risk for spontaneous pre-term birth (sPTB) has been medically challenging because of the lack of signs and symptoms of pre-term birth until interventions are too late. We hypothesized that prediction of the sPTB risk level is enhanced when using both historical clinical (HC) data and quantitative ultrasound (QUS) data compared with using only HC data. HC data defined herein included birth history prior to that of the current pregnancy as well as, from the current pregnancy, a clinical cervical length assessment and physical examination data. METHODS: The study population included 248 full-term births (FTBs) and 26 sPTBs. QUS scans (Siemens S2000 and MC9-4) were performed by registered diagnostic medical sonographers using a standard cervical length approach. Two cervical QUS scans were conducted at 20 ± 2 and 24 ± 2 wk of gestation. Multiple QUS features were evaluated from calibrated raw radiofrequency backscattered ultrasonic signals. Two statistical models designed to determine sPTB risk were compared: (i) HC data alone and (ii) combined HC and QUS data. Model comparisons included a likelihood ratio test, cross-validated receiver operating characteristic area under the curve, sensitivity and specificity. The study's birth outcomes were only FTBs and sPTBs; medically induced pre-term births were not included. DISCUSSION: Combined HC and QUS data identified women at risk of sPTB with better AUC (0.68, 95% confidence interval [CI]: 0.57-0.78) compared with HC data alone (0.53, 95% CI: 0.40-0.66) and HC data + cervical length at 18-20 wk of gestation (average AUC = 0.51, 95% CI: 0.38-0.64). A likelihood ratio test for significance of QUS features in the classification model was highly statistically significant (p < 0.01). CONCLUSION: Even with only 26 sPTBs among 274 births, value was added in predicting sPTB when QUS data were included with HC data.


Assuntos
Nascimento Prematuro , Nascimento a Termo , Gravidez , Humanos , Feminino , Nascimento Prematuro/diagnóstico por imagem , Nascimento Prematuro/epidemiologia , Medida do Comprimento Cervical/efeitos adversos , Colo do Útero/diagnóstico por imagem , Sensibilidade e Especificidade
5.
Radiology ; 304(1): 75-82, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35348378

RESUMO

Background MRI-derived proton density fat fraction (PDFF) is an accurate, reliable, and safe biologic marker for use in the noninvasive diagnosis of hepatic steatosis in patients with nonalcoholic fatty liver disease (NAFLD). Because of the cost and limited availability of MRI, it is necessary to develop an accurate method to diagnose NAFLD with potential point-of-care access. Purpose To compare the diagnostic accuracy of the quantitative US (QUS) fat fraction (FF) estimator with that of the controlled attenuation parameter (CAP) in the diagnosis of NAFLD using contemporaneous MRI-derived PDFF as the reference standard. Materials and Methods Participants with or suspected of having NAFLD were prospectively recruited at the NAFLD Research Center between July 2015 and July 2019. All participants underwent MRI-derived PDFF measurement, transient elastography with CAP measurement, and QUS. QUS FF was derived using computed QUS parameters from the acquired radiofrequency US data using a calibrated reference phantom. The area under the receiver operating characteristic curve (AUC) was calculated to assess the accuracy of QUS FF and CAP in the diagnosis of hepatic steatosis (defined as MRI-derived PDFF ≥ 5%). AUCs were compared using the DeLong test. Results A total of 123 participants were included (mean age, 52 years ± 13 [SD]; 67 [54%] women). Of these participants, 100 (81%) had MRI-derived PDFF of 5% or more. QUS FF had a significantly higher AUC for diagnosis of NAFLD than did CAP (0.92 [95% CI: 0.87, 0.98] vs 0.79 [95% CI: 0.67, 0.90], P = .03). QUS FF had a sensitivity of 98% (98 of 100) and a specificity of 48% (11 of 23). CAP had a sensitivity of 87% (87 of 100) and a specificity of 57% (13 of 23). Conclusion The quantitative US fat fraction estimator is more accurate than the controlled attenuation parameter in the diagnosis of hepatic steatosis in patients with or suspected of having nonalcoholic fatty liver disease. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Ito in this issue.


Assuntos
Técnicas de Imagem por Elasticidade , Hepatopatia Gordurosa não Alcoólica , Técnicas de Imagem por Elasticidade/métodos , Feminino , Humanos , Fígado/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Estudos Prospectivos , Prótons , Padrões de Referência
6.
J Ultrasound Med ; 41(1): 175-184, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33749862

RESUMO

OBJECTIVES: To develop and evaluate deep learning models devised for liver fat assessment based on ultrasound (US) images acquired from four different liver views: transverse plane (hepatic veins at the confluence with the inferior vena cava, right portal vein, right posterior portal vein) and sagittal plane (liver/kidney). METHODS: US images (four separate views) were acquired from 135 participants with known or suspected nonalcoholic fatty liver disease. Proton density fat fraction (PDFF) values derived from chemical shift-encoded magnetic resonance imaging served as ground truth. Transfer learning with a deep convolutional neural network (CNN) was applied to develop models for diagnosis of fatty liver (PDFF ≥ 5%), diagnosis of advanced steatosis (PDFF ≥ 10%), and PDFF quantification for each liver view separately. In addition, an ensemble model based on all four liver view models was investigated. Diagnostic performance was assessed using the area under the receiver operating characteristics curve (AUC), and quantification was assessed using the Spearman correlation coefficient (SCC). RESULTS: The most accurate single view was the right posterior portal vein, with an SCC of 0.78 for quantifying PDFF and AUC values of 0.90 (PDFF ≥ 5%) and 0.79 (PDFF ≥ 10%). The ensemble of models achieved an SCC of 0.81 and AUCs of 0.91 (PDFF ≥ 5%) and 0.86 (PDFF ≥ 10%). CONCLUSION: Deep learning-based analysis of US images from different liver views can help assess liver fat.


Assuntos
Fígado , Redes Neurais de Computação , Humanos , Fígado/diagnóstico por imagem , Aprendizado de Máquina
7.
Artigo em Inglês | MEDLINE | ID: mdl-34543195

RESUMO

This study investigates the role of age and sex on the cardiovascular effects of 3.5-MHz pulsed ultrasound (US) in a rat model. Ultrasonic bursts of 2.0-MPa peak rarefactional pressure amplitude (equivalent to an in vitro spatial-peak temporal-peak intensity of ~270 W/cm2 and a mechanical index of 1.1) were delivered in five consecutive 10-s intervals, one interval for each pulse repetition frequency (PRF) (6, 5, 4, 5, and 6 Hz; always the same order) for a total exposure duration of 50 consecutive seconds. Sixty F344 rats were split into 12 groups in a 3×2×2 factorial design (three ages, male versus female, and US application versus control). This study is the first study on US-induced cardiac effects that contains data across three age groups of rats (premenopause, fertile, and postmenopause) to mimic the fertile and nonfertile human window. US was applied transthoracically, while heart rate, stroke volume, ejection fraction, temperature, and other physiologic parameters were recorded at baseline and after exposure. Significant decreases in cardiac output compared to respective control groups were observed in multiple experimental groups, spanning both females and males. A negative chronotropic effect was observed in young male (~7%) and female (~16%) rats, in five-month-old male (~9%) and female (~15%) rats, and in old rats where the effect was not statistically significant. Younger groups and, to a lesser extent, lower weight groups generally had more significant effects. The pathophysiology of US-induced cardiovascular effects appears to be multifactorial and not strictly related to hormones, menopause, weight, sex, or age, individually.


Assuntos
Coração , Terapia por Ultrassom , Animais , Feminino , Coração/diagnóstico por imagem , Masculino , Ratos , Ratos Endogâmicos F344 , Ratos Sprague-Dawley , Ultrassonografia
8.
Artigo em Inglês | MEDLINE | ID: mdl-34822328

RESUMO

The histologically identifiable cellular structure(s) involved in ultrasonic scattering is(are) yet to be uniquely identified. The study quantifies six possible cellular scattering parameters, namely, cell and nucleus radii and their respective cell and nucleus volume fractions as well as a combination of cell and nucleus radii and their volume fraction. The six cellular parameters are each derived from four cell lines (4T1, JC, LMTK, and MAT) and two tissue types (cell-pellet biophantom and ex vivo tumor). Optical histology and quantitative ultrasound (QUS), both independent approaches, are used to yield these cellular parameters. QUS scatterer parameters are experimentally determined using two ultrasonic scattering models: the spherical Gaussian model (GM) and the structure factor model (SFM) to yield insight about scattering from nuclei only and cells only. GM is a classical ultrasonic scattering model to evaluate QUS parameters and is well adapted for diluted media. SFM is adapted for dense media to estimate reasonably well scatterer parameters of cellular structures from ex vivo tissue. Nucleus and cell radii and volume fractions are measured optically from histology. They were used as inputs to calculate BSC for scattering from cells, nuclei, and both cells and nuclei. The QUS-derived scatterers (radii and volume fractions) distributions were then compared to the optical histology scatterer parameters derived from these calculated BSCs. The results suggest scattering from cells only (LMTK and MAT) or both cells and nuclei (4T1 and JC) for cell-pellet biophantoms and scattering from nuclei only for tumors.


Assuntos
Neoplasias , Estruturas Celulares , Técnicas Histológicas , Humanos , Distribuição Normal , Ultrassonografia/métodos
9.
J Nutr ; 151(11): 3421-3430, 2021 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-34386819

RESUMO

BACKGROUND: Tomatoes contain carotenoids that have the potential to alter the effects of external beam radiation therapy (EBRT). OBJECTIVES: We hypothesized that dietary lyophilized tomato paste (TP) would reduce apoptosis within carotenoid-containing nonneoplastic tissues in EBRT-treated TRansgenic Adenocarcinoma of the Mouse Prostate (TRAMP) mice. METHODS: Male TRAMP mice (n = 73) were provided an AIN-93G diet or a modified AIN-93G diet containing 10% TP (wt:wt) at 4 wk of age. Prostate tumor growth was monitored by ultrasound. The caudal half of the mouse was irradiated with 7.5 Gy (Rad) or 0 Gy (sham) at 24 wk of age or after the tumor volume exceeded 1000 mm3 with a Cobalt-60 source. Mice were euthanized 24 h postradiation. Carotenoids and α-tocopherol were measured by HPLC and compared by a t test. Tissues were assessed for radiation-induced changes (hematoxylin and eosin) and apoptosis [cleaved caspase-3 (CC3)] and compared by Kruskal-Wallis test or Freedman-Lane's permutation test. RESULTS: Serum concentrations of lycopene (52% lower), phytoene (26% lower), and α-tocopherol (22% lower) were decreased in TP-fed irradiated mice (TP-Rad) compared with TP-fed sham mice (P < 0.05). CC3 scores increased within the prostate tumor with radiation treatments (P < 0.05), but were not affected by tomato consumption. In nonneoplastic tissues, TP-Rad had a lower percentage of CC3-positive cells within the cranial (67% lower) and caudal (75% lower) duodenum than irradiated mice on the control diet (Rad) (P < 0.005). Likewise, CC3 scores within the dorsolateral prostate of TP-Rad trended toward lower scores than for Rad (P = 0.07). CONCLUSIONS: TP selectively reduces radiation-induced apoptosis in extratumoral tissues without decreasing radiation-induced apoptosis within the prostate tumor in TRAMP mice. Additional studies are needed to confirm and expand upon these findings.


Assuntos
Neoplasias da Próstata , Solanum lycopersicum , Animais , Dieta , Humanos , Licopeno , Masculino , Camundongos , Camundongos Transgênicos , Próstata , Neoplasias da Próstata/radioterapia
10.
JASA Express Lett ; 1(8): 082001, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34396365

RESUMO

Pulsed ultrasound can produce chronotropic and inotropic effects on the heart with potential therapeutic applications. Fourteen 3-month-old female rats were exposed transthoracically to 3.5-MHz 2.0-MPa peak rarefactional pressure amplitude ultrasonic pulses of increasing 5-s duration pulse repetition frequency (PRF) sequences. An increase in the heart rate was observed following each PRF sequence: an ∼50% increase after the 4-5-6 Hz sequence, an ∼57% increase after the 5-6-7 Hz sequence, and an ∼48% increase after the 6-7-8 Hz sequence. Other cardiac parameters showed a normal or indicated a compensatory decrease at 3 and 15 min post-ultrasound compared to control.

11.
J Ultrasound Med ; 2020 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-32964505

RESUMO

An advantage of therapeutic ultrasound (US) is the ability to cause controlled biological effects noninvasively. Depending on the magnitude and frequency of exposure parameters, US can interact in different ways with a variety of biological tissues. The development and clinical utility of therapeutic US techniques are now rapidly growing, especially with regard to the application of US pulses for cardiac pacing and the potential treatment of cardiovascular diseases. This review outlines the basic principles of US-based therapy in cardiology, including the acoustic properties of the cardiovascular tissue, and the use of US in therapeutic cardiovascular medicine.

12.
J Nutr ; 150(7): 1808-1817, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32369574

RESUMO

BACKGROUND: Dietary tomato products or lycopene protect against prostate carcinogenesis, but their impact on the emergence of castration-resistant prostate cancer (CRPC) is unknown. OBJECTIVE: We hypothesized that tomato or lycopene products would reduce the emergence of CRPC. METHODS: Transgenic adenocarcinoma of the mouse prostate (TRAMP) mice were castrated at 12-13 wk and the emergence of CRPC was monitored by ultrasound in each study. In Study 1, TRAMP mice (n = 80) were weaned onto an AIN-93G-based control diet (Con-L, n = 28), a 10% tomato powder diet (TP-L, 10% lyophilized w/w, n = 26), or a control diet followed by a tomato powder diet after castration (TP-Int1, n = 26). In Study 2, TRAMP mice (n = 85) were randomized onto a control diet with placebo beadlets (Con-Int, n = 29), a tomato diet with placebo beadlets (TP-Int2, n = 29), or a control diet with lycopene beadlets (Lyc-Int, n = 27) following castration (aged 12 wk). Tumor incidence and growth were monitored by ultrasound beginning at an age of 10 wk. Mice were euthanized 4 wk after tumor detection or aged 30 wk if no tumor was detected. Tissue weights were compared by ANOVA followed by Dunnett's test. Tumor volumes were compared using generalized linear mixed model regression. RESULTS: Ultrasound estimates for the in vivo tumor volume were strongly correlated with tumor weight at necropsy (R2 = 0.75 and 0.94, P <0.001 for both Studies 1 and 2, respectively). Dietary treatments after castration did not significantly impact cancer incidence, time to tumor detection, or final tumor weight. CONCLUSIONS: In contrast to studies of de novo carcinogenesis in multiple preclinical models, tomato components had no significant impact on the emergence of CRPC in the TRAMP model. It is possible that specific mutant subclones of prostate cancer may continue to show some antiproliferative response to tomato components, but further studies are needed to confirm this.


Assuntos
Dieta , Licopeno/uso terapêutico , Neoplasias de Próstata Resistentes à Castração/patologia , Solanum lycopersicum , Animais , Masculino , Camundongos , Orquiectomia , Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico
13.
Radiology ; 295(2): 342-350, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32096706

RESUMO

Background Radiofrequency ultrasound data from the liver contain rich information about liver microstructure and composition. Deep learning might exploit such information to assess nonalcoholic fatty liver disease (NAFLD). Purpose To develop and evaluate deep learning algorithms that use radiofrequency data for NAFLD assessment, with MRI-derived proton density fat fraction (PDFF) as the reference. Materials and Methods A HIPAA-compliant secondary analysis of a single-center prospective study was performed for adult participants with NAFLD and control participants without liver disease. Participants in the parent study were recruited between February 2012 and March 2014 and underwent same-day US and MRI of the liver. Participants were randomly divided into an equal number of training and test groups. The training group was used to develop two algorithms via cross-validation: a classifier to diagnose NAFLD (MRI PDFF ≥ 5%) and a fat fraction estimator to predict MRI PDFF. Both algorithms used one-dimensional convolutional neural networks. The test group was used to evaluate the classifier for sensitivity, specificity, positive predictive value, negative predictive value, and accuracy and to evaluate the estimator for correlation, bias, limits of agreements, and linearity between predicted fat fraction and MRI PDFF. Results A total of 204 participants were analyzed, 140 had NAFLD (mean age, 52 years ± 14 [standard deviation]; 82 women) and 64 were control participants (mean age, 46 years ± 21; 42 women). In the test group, the classifier provided 96% (95% confidence interval [CI]: 90%, 99%) (98 of 102) accuracy for NAFLD diagnosis (sensitivity, 97% [95% CI: 90%, 100%], 68 of 70; specificity, 94% [95% CI: 79%, 99%], 30 of 32; positive predictive value, 97% [95% CI: 90%, 99%], 68 of 70; negative predictive value, 94% [95% CI: 79%, 98%], 30 of 32). The estimator-predicted fat fraction correlated with MRI PDFF (Pearson r = 0.85). The mean bias was 0.8% (P = .08), and 95% limits of agreement were -7.6% to 9.1%. The predicted fat fraction was linear with an MRI PDFF of 18% or less (r = 0.89, slope = 1.1, intercept = 1.3) and nonlinear with an MRI PDFF greater than 18%. Conclusion Deep learning algorithms using radiofrequency ultrasound data are accurate for diagnosis of nonalcoholic fatty liver disease and hepatic fat fraction quantification when other causes of steatosis are excluded. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Lockhart and Smith in this issue.


Assuntos
Redes Neurais de Computação , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Ultrassonografia/métodos , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Ondas de Rádio , Distribuição Aleatória , Sensibilidade e Especificidade
14.
J Ultrasound Med ; 39(8): 1581-1587, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32073680

RESUMO

OBJECTIVES: The aim of this study was to explore the motivations of pregnant women in participating in an ultrasound study and the acceptability of vaginal ultrasound examinations. METHODS: A prospective sample of 270 women were asked one question: "Can you tell me what motivated you to participate in the study?" The data were then analyzed through a qualitative thematic analysis with an inductive approach. In addition to the thematic analysis, quantification of the data was performed to enhance the qualitative result. RESULTS: Through the thematic analysis, 5 themes emerged from the responses of the participants: altruism, research, personal experience, personal benefit, and finding out. All responses were relatively short, and some responses included more than one theme. CONCLUSIONS: Vaginal ultrasound examinations were acceptable to the participants, and pregnant women had many motivations to participate. Regardless of race, ethnicity, or insurance status, the women in our study were altruistic and curious about our research.


Assuntos
Gestantes , Sujeitos da Pesquisa , Feminino , Humanos , Motivação , Gravidez , Estudos Prospectivos , Ultrassonografia
15.
Radiology ; 295(1): 106-113, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32013792

RESUMO

Background Advanced confounder-corrected chemical shift-encoded MRI-derived proton density fat fraction (PDFF) is a leading parameter for fat fraction quantification in nonalcoholic fatty liver disease (NAFLD). Because of the limited availability of this MRI technique, there is a need to develop and validate alternative parameters to assess liver fat. Purpose To assess relationship of quantitative US parameters to MRI PDFF and to develop multivariable quantitative US models to detect hepatic steatosis and quantify hepatic fat. Materials and Methods Adults with known NAFLD or who were suspected of having NAFLD were prospectively recruited between August 2015 and February 2019. Participants underwent quantitative US and chemical shift-encoded MRI liver examinations. Liver biopsies were performed if clinically indicated. The correlation between seven quantitative US parameters and MRI PDFF was evaluated. By using leave-one-out cross validation, two quantitative US multivariable models were evaluated: a classifier to differentiate participants with NAFLD versus participants without NAFLD and a fat fraction estimator. Classifier performance was summarized by area under the receiver operating characteristic curve and area under the precision-recall curve. Fat fraction estimator performance was evaluated by correlation, linearity, and bias. Results Included were 102 participants (mean age, 52 years ± 13 [standard deviation]; 53 women), 78 with NAFLD (MRI PDFF ≥ 5%). A two-variable classifier yielded a cross-validated area under the receiver operating characteristic curve of 0.89 (95% confidence interval: 0.82, 0.96) and an area under the precision-recall curve of 0.96 (95% confidence interval: 0.93, 0.99). The cross-validated fat fraction predicted by a two-variable fat fraction estimator was correlated with MRI PDFF (Spearman ρ = 0.82 [P < .001]; Pearson r = 0.76 [P < .001]). The mean bias was 0.02% (P = .97), and 95% limits of agreement were ±12.0%. The predicted fat fraction was linear with MRI PDFF (R 2 = 0.63; slope, 0.69; intercept, 4.3%) for MRI PDFF of 34% or less. Conclusion A multivariable quantitative US approach yielded excellent correlation with MRI proton density fat fraction for hepatic steatosis assessment in nonalcoholic fatty liver disease. © RSNA, 2020 Online supplemental material is available for this article.


Assuntos
Fígado Gorduroso/diagnóstico por imagem , Adulto , Idoso , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Estudos Prospectivos , Ultrassonografia/métodos
16.
Artigo em Inglês | MEDLINE | ID: mdl-31217100

RESUMO

This article evaluated the repeatability and reproducibility (R&R) of quantitative ultrasound (QUS) biomarkers attenuation coefficient (AC) and backscatter coefficient (BSC) in transvaginal QUS reference phantoms for obstetric applications. Five phantoms were scanned by three sonographers according to the scanning protocol. Each sonographer scanned each phantom with four transvaginal transducers of the same model (MC9-4) and three probe cover types (latex cover, nonlatex cover, and no cover). The AC and BSC were estimated by using a reference phantom method. The R&R analysis was performed for the frequency-averaged AC and logBSC (= 10log10BSC) (5.4-5.8 MHz) by using three-factor random effects Analysis of Variance with interaction. The total R&R variabilities for AC and logBSC are small (AC: 0.042-0.065 dB/cm-MHz; logBSC: 0.50-0.68 dB), indicating high measurement precision. These values are small compared to the ranges of AC (0.28-0.99 dB/cm-MHz) and logBSC (-33.16 to -20.35 dB) of the five phantoms. The AC and logBSC biomarkers measured on transvaginal QUS phantoms using the reference phantom method are repeatable, and reproducible between sonographers, transducers, and probe covers.


Assuntos
Ultrassonografia/métodos , Vagina , Feminino , Humanos , Imagens de Fantasmas , Reprodutibilidade dos Testes , Transdutores
17.
Nutr Res ; 63: 95-105, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30824402

RESUMO

Untreated nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) lead to irreversible liver damage. We hypothesized that a low-fat diet (LFD) or a high-fat diet (HFD) with soy protein isolate (SPI) would be an effective intervention to halt or reverse NAFLD progression. To test these hypotheses, we conducted 2 studies. In the first study, we fed an HFD to 7-week-old C57BL/6J mice to induce NAFLD compared to an LFD (control). Hepatic steatosis was monitored by quantitative ultrasound (QUS) scans (in vivo and ex vivo). Animals were euthanized after 0, 2, 4, and 6 weeks of feeding. In the second study, 7-week-old mice were randomized onto an LFD or HFD with SPI intervention after 4 weeks of feeding HFD. Animals from each group were scanned with QUS and euthanized after 4, 9, and 12 weeks of feeding. Animals fed the HFD developed NAFLD (100%) and NASH (80%) characterized by increased liver weight, lipid accumulation, and histological scores for inflammation by 4 weeks in the first study. In the second study, the LFD ameliorated this NAFLD phenotype after 5 weeks of feeding; however, the SPI intervention failed to significantly attenuate NAFLD. QUS parameters were significantly increased with the HFDs (P < .05) and steatosis grade (P < .05) and were positively correlated with hepatic lipid concentrations. In conclusion, dietary modification may be effective at reversing NAFLD and NASH at early stages. Furthermore, QUS may become a valuable tool to track hepatic steatosis. Additional studies are needed to further evaluate the effectiveness of these interventions.


Assuntos
Dieta com Restrição de Gorduras , Dieta Hiperlipídica , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Hepatopatia Gordurosa não Alcoólica/prevenção & controle , Proteínas de Soja/uso terapêutico , Animais , Caseínas/administração & dosagem , Progressão da Doença , Fígado/diagnóstico por imagem , Fígado/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Ultrassonografia/métodos
18.
Eur Radiol ; 29(9): 4699-4708, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30783789

RESUMO

OBJECTIVES: To assess inter-platform reproducibility of ultrasonic attenuation coefficient (AC) and backscatter coefficient (BSC) estimates in adults with known/suspected nonalcoholic fatty liver disease (NAFLD). METHODS: This HIPAA-compliant prospective study was approved by an institutional review board; informed consent was obtained. Participants with known/suspected NAFLD were recruited and underwent same-day liver examinations with clinical ultrasound scanner platforms from two manufacturers. Each participant was scanned by the same trained sonographer who performed multiple data acquisitions in the right liver lobe using a lateral intercostal approach. Each data acquisition recorded a B-mode image and the underlying radio frequency (RF) data. AC and BSC were calculated using the reference phantom method. Inter-platform reproducibility was evaluated for AC and log-transformed BSC (logBSC = 10log10BSC) by intraclass correlation coefficient (ICC), Pearson's correlation, Bland-Altman analysis with computation of limits of agreement (LOAs), and within-subject coefficient of variation (wCV; applicable to AC). RESULTS: Sixty-four participants were enrolled. Mean AC values measured using the two platforms were 0.90 ± 0.13 and 0.94 ± 0.15 dB/cm/MHz while mean logBSC values were - 30.6 ± 5.0 and - 27.9 ± 5.6 dB, respectively. Inter-platform ICC was 0.77 for AC and 0.70 for log-transformed BSC in terms of absolute agreement. Pearson's correlation coefficient was 0.81 for AC and 0.80 for logBSC. Ninety-five percent LOAs were - 0.21 to 0.13 dB/cm/MHz for AC, and - 9.48 to 3.98 dB for logBSC. The wCV was 7% for AC. CONCLUSIONS: Hepatic AC and BSC are reproducible across two different ultrasound platforms in adults with known or suspected NAFLD. KEY POINTS: • Ultrasonic attenuation coefficient and backscatter coefficient are reproducible between two different ultrasound platforms in adults with NAFLD. • This inter-platform reproducibility may qualify quantitative ultrasound biomarkers for generalized clinical application in patients with suspected/known NAFLD.


Assuntos
Interpretação de Imagem Assistida por Computador/métodos , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Ultrassonografia/métodos , Adulto , Idoso , Feminino , Humanos , Fígado/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Reprodutibilidade dos Testes
19.
J Ultrasound Med ; 38(8): 2093-2102, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30575064

RESUMO

OBJECTIVES: To show that quantitative ultrasound biomarkers attenuation (AC) and backscatter (BSC) coefficients are effective tools to detect early changes in acute pancreatitis, using a cerulein-induced pancreatitis rat model. METHODS: Sprague-Dawley rats (n = 68) were divided into 8 groups: uninjected cage controls, saline-injected controls, and cerulein-injected rats euthanized at 2, 4, 15, 24, 48, and 60 hours after injection. Pancreatic AC and BSC (25-55 MHz) were estimated in vivo (Vevo 2100, VisualSonics, Toronto, CA) and ex vivo (40-MHz transducer). The pancreas of each rat was evaluated histopathologically. RESULTS: Changes in both in vivo and ex vivo AC and BSC relative to controls reflected temporal histomorphologic changes. Overall, there were decreased AC and BSC at early time points and then rebound toward control values over time. Maximal in vivo AC and BSC decreases occurred at 2 hours after cerulein injection. Attenuation coefficient changes corresponded well with early pancreatic edema and acinar cell vacuolation, with rebound as edema decreased, autophagy/cellular death occurred, and histiocytic infiltrates and fibrosis manifested. Backscatter coefficient decreased early but rebounded as autophagy and apoptosis increased, only to fall as acinar atrophy peaked, and fibrosis and histiocytic infiltration increased. CONCLUSIONS: Cerulein-induced pancreatitis is an excellent model for studying ultrasonic AC and BSC biomarkers during the early stages of acute pancreatitits, reflecting microscopic structural changes. Edema followed by cell shrinkage and apoptosis, then histiocytic infiltration and fibrosis, has certain similarities with the morphologies of some forms of pancreatic carcinoma. This suggests that quantitative ultrasound may be very useful for early detection of disease onset or response to therapy for not only acute pancreatitis but also pancreatic cancer.


Assuntos
Pancreatite/diagnóstico por imagem , Ultrassonografia/métodos , Doença Aguda , Animais , Modelos Animais de Doenças , Diagnóstico Precoce , Estudos de Avaliação como Assunto , Feminino , Pâncreas/diagnóstico por imagem , Ratos , Ratos Sprague-Dawley
20.
Eur Radiol ; 28(12): 4992-5000, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29869170

RESUMO

OBJECTIVES: To assess inter-sonographer reproducibility of ultrasound attenuation coefficient (AC), backscatter coefficient (BSC) and shear wave speed (SWS) in adults with known/suspected non-alcoholic fatty liver disease (NAFLD). METHODS: The institutional review board approved this HIPAA-compliant prospective study; informed consent was obtained. Participants with known/suspected NAFLD were recruited and underwent same-day liver examinations with a clinical scanner. Each participant was scanned by two of the six trained sonographers. Each sonographer performed multiple data acquisitions in the right liver lobe using a lateral intercostal approach. A data acquisition was a single operator button press that recorded a B-mode image, radio-frequency data, and the SWS value. AC and BSC were calculated from the radio-frequency data using the reference phantom method. SWS was calculated automatically using product software. Intraclass correlation coefficient (ICC) and within-subject coefficient of variation (wCV) were calculated for applicable metrics. RESULTS: Sixty-one participants were recruited. Inter-sonographer ICC was 0.86 (95% confidence interval: 0.77-0.92) for AC and 0.87 (0.78-0.92) for log-transformed BSC (logBSC = 10log10BSC) using one acquisition per sonographer. ICC was 0.88 (0.80-0.93) for both AC and logBSC averaging 5 acquisitions. ICC for SWS was 0.57 (0.29-0.74) using one acquisition per sonographer, and 0.84 (0.66-0.93) using 10 acquisitions. The wCV was ~7% for AC, and 19-43% for SWS, depending on number of acquisitions. CONCLUSIONS: Hepatic AC, BSC and SWS measures on a clinical scanner have good inter-sonographer reproducibility in adults with known or suspected NAFLD. Multiple acquisitions are required for SWS but not AC or BSC to achieve good inter-sonographer reproducibility. KEY POINTS: • AC, BSC and SWS measurements are reproducible in adults with NAFLD. • Inter-sonographer reproducibility of SWS measurement improves with more acquisitions being averaged. • Multiple acquisitions are required for SWS but not AC or BSC.


Assuntos
Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Ultrassonografia/normas , Adulto , Análise de Variância , Técnicas de Imagem por Elasticidade/métodos , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Fígado/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Imagens de Fantasmas , Estudos Prospectivos , Reprodutibilidade dos Testes , Software
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