Deep learning based classification of focal liver lesions with contrast-enhanced ultrasound

Classification of liver masses is important to early diagnosis of patients. In this paper, a diagnostic system of liver disease classification based on contrast enhanced ultrasound (CEUS) imaging is proposed. In the proposed system, the dynamic CEUS videos of hepatic perfusion are firstly retrieved. Secondly, time intensity curves (TICs) are extracted from the dynamic CEUS videos using sparse non-negative matrix factorizations. Finally, deep learning is employed to classify benign and malignant focal liver lesions based on these TICs. Quantitative comparisons demonstrate that the proposed method outperforms the compared classification methods in accuracy, sensitivity and specificity.     

Feasibility study of high intensity focused ultrasound (HIFU) for the treatment of hydatid cysts of the liver

This study evaluates the feasibility of using high intensity focused ultrasound (HIFU) for the treatment of hydatid cysts of the liver. HIFU ablation was carried out in 62 patients with echinococcosis of the liver. The mean age of patients was 40.76 ± 14.84 (range: 17–72 years). The effectiveness of the treatment was monitored in real-time by changes in the gray-scale, and by morphological studies, computed tomography, magnetic resonance imaging, and ultrasound.Criteria for evaluating the effectiveness of treatment in real time were outlines. Cytomorphological picture of destructive changes of parasitic elements was presented as well. Loss of embryonic elements of the parasite was observed at the subcellular level after HIFU-ablation and underlines the effectiveness of HIFU.     

Nonlinear response of ultrasound contrast agent microbubbles:From fundamentals to applications

Modelling and biomedical applications of ultrasound contrast agent(UCA) microbubbles have attracted a great deal of attention. In this review, we summarize a series of researches done in our group, including(i) the development of an all-in-one solution of characterizing coated bubble parameters based on the light scattering technique and flow cytometry;(ii) a novel bubble dynamic model that takes into consideration both nonlinear shell elasticity and viscosity to eliminate the dependences of bubble shell parameters on bubble size;(iii) the evaluation of UCA inertial cavitation threshold and its relationship with shell parameters; and(iv) the investigations of transfection efficiency and the reduction of cytotoxicity in gene delivery facilitated by UCAs excited by ultrasound exposures.     

高强度聚焦超声治疗子宫肌瘤中水囊耦合的影响评估*

水囊作为一种特殊的辅助器件在高强度聚焦超声治疗子宫肌瘤的过程中发挥着重要作用,但它同时也会让声通道变得更加复杂,对超声治疗效率和超声引导影像均造成负面影响。基于实际临床场景,利用k-Wave声学仿真软件建立高强度聚焦超声辐照靶组织及其超声引导过程的仿真模型,在有无水囊两个场景下,对治疗效率和监控影像质量进行定量评估。结果表明,加入水囊后,声波的聚焦性变差,焦域处的最高温度降低;通过分析超声图像的分辨率、对比度、对比噪声以及背景信噪比,发现加入水囊后超声图像的质量降低。建立的数值仿真模型能够初步评估水囊对治疗效率和监控影像质量的影响,可作为一种评估体系用于优化水囊参数,如水囊材料、厚度、形状、内部溶液成分等,为下一步实验探索对治疗效率和影像质量影响最小的水囊耦合方式提供评估手段。     

超声断层扫描数据压缩的时间窗构造及数据提取方法

介绍了一种针对三维超声断层扫描系统的数据压缩方法,该方法通过检测最早的目标反射重构目标表面位置;依据表面位置,计算目标回波信号的起止时间;以此为依据构造时间窗,标明成像算法所需数据在采样序列中存在的时间范围;最终提取有用数据,完成数据压缩。临床数据被用于算法的效果评价。结果表明,该方法可达到平均2.27的压缩率和0.21的压缩率标准差,以及2.25的数据传输加速比。较传统数据压缩方法,该方法只利用回波时域信息,可作为预压缩方法和传统方法结合使用以获得更高的压缩率。     

New Visualization Technique with a Three-Dimensional Video-Assisted Stereoendoscopic System: Application of the BVHIS Display Method During Endolaryngeal Surgery

A three-dimensional video-assisted stereoendoscopic system (3D video system) developed by the Shinko Optical Company, Ltd. (Tokyo, Japan), and referred to as the binocular vision by horizontal image shifting display method (BVHIS display method), has been developed to digitally process ordinary video signals obtained with a video camera connected to a direct videolaryngoscope. The three-dimensional video system provides the surgeon with stereoendoscopic video images and enhances the ability of the surgeon to perform delicate endoscopic procedures. The three-dimensional video-assisted stereoendoscopic laryngosurgical procedure and its underlying principles are described in this paper. A total of 12 patients with laryngeal lesions causing dysphonia underwent three-dimensional video-assisted stereoendoscopic laryngosurgery. Although the video image obtained with the BVHIS display method is only pseudo-three-dimensional, this method enables the surgeon to perceive both depth perception and realism. We describe a surgical procedure using this new visualizing technique and the underlying principles of the technique. Preoperative and postoperative evaluations of the patients' vocal functions are also described. This system is a useful tool for the treatment of laryngeal lesions causing dysphonia.     

Effects of therapeutic ultrasound on the nucleus and genomic DNA

In recent years, data have been accumulating on the ability of ultrasound to affect at a distance inside the cell. Previous conceptions about therapeutic ultrasound were mainly based on compromising membrane permeability and triggering some biochemical reactions. However, it was shown that ultrasound can access deep to the nuclear territory resulting in enhanced macromolecular localization as well as alterations in gene and protein expression. Recently, we have reported on the occurrence of DNA double-strand breaks in different human cell lines exposed to ultrasound in vitro with some insight into the subsequent DNA damage response and repair pathways. The impact of these observed effects again sways between extremes. It could be advantageous if employed in gene therapy, wound and bone fracture-accelerated healing to promote cellular proliferation, or in cancer eradication if the DNA lesions would culminate in cell death. However, it could be a worrying sign if they were penultimate to further cellular adaptations to stresses and thus shaking the safety of ultrasound application in diagnosis and therapy. In this review, an overview of the rationale of therapeutic ultrasound and the salient knowledge on ultrasound-induced effects on the nucleus and genomic DNA will be presented. The implications of the findings will be discussed hopefully to provide guidance to future ultrasound research.     

Histopathologically confirmed focal nodular hyperplasia of the liver: Gadoxetic acid-enhanced MRI characteristics

Purpose

The purpose of this study was to evaluate enhancement characteristics of histopathologically confirmed focal nodular hyperplasia (FNHs) with gadoxetic acid-enhanced MRI.

Materials and Methods

Twenty-seven patients with all histopathologically proven FNHs were retrospectively identified. MRI consisted of T₁- and T₂-weighted (w) sequences with and without fat saturation (FS), multiphase dynamic T₁-w images, and FS T₁-w images during the hepatobiliary phase. Standard of reference was surgical resection (n = 24) or biopsy (n = 3). Images were analyzed for morphology and contrast behavior including signal intensity (SI) measurement on T₁-w images normalized to the pre-contrast base line.

Results

In total 36 FNHs were evaluated. All FNHs showed enhancement in the arterial phase, significant reduction contrast enhancement (“wash-out”) in the late dynamic phases was not present. In the hepatobiliary phase, all FNHs (100%) showed enhancement (overall SI increase, 118% (± 91%), P < 0.001) with at least partial hyperintensity to the liver. Upon visual comparison, 3 of 36 FNHs appeared with heterogeneous/partial enhancement (8%) and 7 (19%) showed rim-accentuated enhancement.

Conclusion

The typical enhancement pattern of FNH with gadoxetic acid consists of arterial hyperperfusion, no wash-out during the venous phase, and at least partial hyperintensity compared to the liver in the hepatobiliary phase. Partial hypointensity or rim-accentuated enhancement rarely occurs.     

Focal nodular hyperplasia of the liver: diffusion and perfusion MRI characteristics

Purpose

To present diffusion and perfusion magnetic resonance imaging (MRI) characteristics of focal nodular hyperplasia (FNH) of the liver.

Materials and Methods

Thirty-five patients with 52 FNHs (21 were pathologically-confirmed) underwent MRI at 1.5-T device. MR diffusion [diffusion-weighted imaging (DWI)] was performed using a free-breathing single-shot, spin-echo, echo-planar sequence with b gradient factor value of 500 s/mm². MR perfusion [perfusion-weighted imaging (PWI)] consisted of a 3D free-breathing LAVA sequence repeated up to 5 minutes after injection of 7 mL Gd-BOPTA (MultiHance, Bracco, Italy) and 20 mL saline flush at a flow rate of 4 mL/s. Apparent diffusion coefficient (ADC) and time-signal intensity curve (TSIC) were obtained for both normal liver and each FNH by two reviewers in conference; maximum enhancement (ME) percentage, time to peak enhancement (TTP), and maximal slope (MS) were also calculated.

Results

On DWI mean ADC value was 1.624×10^− 3 mm²/s for normal liver and 1.629×10^− 3 mm²/s for FNH. ADC value for each FNH and the normal liver was not statistically different (P= .936). On PWI, TSIC-Type 1 (quick and marked enhancement and quick decay followed by slowly decaying) was observed in all 52 FNHs, and TSIC-Type 2 (fast enhancement followed by slowly decaying plateau) in all normal livers. The mean ME, TTP and MS values were significantly different for FNH and normal liver (P= .005).

Conclusion

FNHs of the liver showed typical diffusion and perfusion MRI characteristics in all cases. On the ADC map, we could get similar value between the FNHs and the background parenchyma. On the perfusion imaging, FNHs showed a different pattern distinguished from the background liver.     

经颅超声刺激人脑海马的数值仿真研究

颞叶癫痫、阿尔兹海默症等神经系统疾病与大脑海马的异常放电相关。近年兴起的经颅超声刺激治疗脑疾病具有无创、能深入脑组织和可调控海马神经元放电的特点。该文基于128阵元相控阵换能器、人头颅CT数据、水体建立超声经颅刺激海马数值仿真模型,数值仿真优选适应于海马刺激的换能器结构参数,并结合电容模型,探究超声声学参数对海马神经元放电的影响。结果表明曲率半径90 mm、开口半径56 mm、阵元半径2.0 mm、频率0.9 MHz的128阵元相控超声换能器可形成适应于刺激人脑海马大小的焦域;且在超声频率为0.9 MHz时对海马神经元放电有较好的抑制作用;在较小的占空比和较低的空间峰值时间平均声强条件下对神经元放电有较好的抑制作用。     

Inactivation of microorganisms by low-frequency high-power ultrasound: 2. A simple model for the inactivation mechanism

A simple theoretical model based on shear forces generated by the collapse of the ultrasound cavities near the surface of a microorganism is proposed. This model requires two parameters which take into account the number of acoustic cavitation bubbles, and the resistance of the cell wall of the microorganism to the shear forces generated by bubble collapse. To validate the model, high-power low frequency (20 kHz) ultrasound was used to inactivate two microorganisms with very different sizes, viz., a bacterium, Enterobacter aerogenes and a yeast, Aureobasidium pullulans. The inactivation ratio was experimentally measured as a function of sonication time for different ultrasound power and for different initial cell numbers. For both E. aerogenes and A. pullulans the Log of the inactivation ratio decreased linearly with sonication time, and the rate of inactivation increased (D-value decreased) with the increase in sonication power. The rate of inactivation was also found, for both microorganisms, to increase with a decrease in the initial cell number. The fits, obtained using the proposed model, are in very good agreement with the experimental data.     

Inactivation of microorganisms by low-frequency high-power ultrasound: 1. Effect of growth phase and capsule properties of the bacteria

The aim of this study was to determine the effects of high-intensity low-frequency (20 kHz) ultrasound treatment on the viability of bacteria suspension. More specifically, we have investigated the relationship between the deactivation efficiency and the physical (size, hydrophobicity) and biological (gram-status, growth phase) properties of the microbes. Enterobacter aerogenes, Bacillus subtilis, Staphylococcus epidermidis, S. epidermidis SK and Staphylococcus pseudintermedius were chosen for this study owing to their varying physical and biological properties. The survival ratio of the bacteria suspension was measured as a function of the ultrasound power (up to 13 W) for a constant sonication time of 20 min. Transmission electron microscopy was used to evaluate the ultrasound-induced damages to the microbes. Ultrasound treatment resulted in lethal damage to E. aerogenes and B. subtilis (up to 4.5-log reduction), whereas Staphylococcus spp. were not affected noticeably. Further, E. aerogenes suspensions were more sensitive to ultrasonication in exponential growth phase than when they were in stationary phase. The results of this study demonstrate that the main reason for bacterial resistance to ultrasonic deactivation is due to the properties of the bacterial capsule. Microbes with a thicker and “soft” capsule are highly resistant to ultrasonic deactivation process.     

Use of ultrasound irradiation during acid etching of the 2024 aluminum alloy: Effect on corrosion resistance after anodization

While aluminum alloys are widely used in industrial applications, their protection by anodization as surface treatment always requires a preparation step by alkaline or acid etching. In this paper, use of ultrasound during the acid etching step on the 2024 aluminum alloy was investigated. Etching rate, calculated as of weight loss, was measured under ultrasound irradiation, and compared to silent conditions. The etched surface was characterized by Scanning Electron Microscopy/Energy Dispersive X-ray Spectroscopy (SEM/EDS) and X-Ray Diffraction (XRD). Surface treatment was performed up to the final anodization step samples, and their final properties were evaluated as a function of various pre-treatments, including acid etching under ultrasound. The main evaluation concerned anticorrosion properties through electrochemical tests: polarization measurements and electrochemical impedance spectroscopy (EIS) in NaCl solution. Finally, use of ultrasound irradiation during acid preparation induced a beneficial effect on the corrosion performance of the anodic layer.     

Post-mortem ultrasound and freezing of rabbit meat: Effects on the physicochemical quality and weight loss

High intensity ultrasound (HIU) is a technique with the potential to improve meat quality, however, more research is needed on its application within the chain of cold storage and freezing. This study evaluates the effect of HIU (40 kHz, 9.6 W/cm², 20 and 40 min) and post-mortem development on the yield and physicochemical quality of rabbit meat in samples treated with HIU pre- and post-storage in a freezer (120 h at −20 °C). Twenty rabbit carcasses were vacuum packed 12 h post-mortem, placed in a fridge at 4 °C for 24 h, and divided in two groups (HIU application before or after freezing), before assigning the treatments. The results show that HIU before freezing produced intense and bright orange-yellow colours, whereas its application after freezing resulted in pale red tones. HIU application accelerates rigor mortis resolution when it is applied before freezing and causes a significant decrease in pH immediately following the HIU treatment. Post-freezing application of HIU is not recommended because it considerably increased weight loss and toughening of the meat when long exposure times were used (40 min). In contrast, a short treatment duration with HIU mitigated the effects of freezing and produced significant increases in water-holding capacity (WHC) after cold storage. The yield (weight loss) of the rabbit meat was not affected when HIU was applied pre-freezing. The application of HIU pre-freezing constitutes a promising technology because it increased the tenderness and the WHC of rabbit meat. However, more research is needed to improve the appearance before scaling up to industrial levels.     

Low intensity pulsed ultrasound for fracture healing: a review of the clinical evidence and the associated biological mechanism of action

Low intensity pulsed ultrasound is used in the clinical treatment of fractures and other osseous defects. Level I clinical studies demonstrate the ability of a specific ultrasound signal (1.5 MHz ultrasound pulsed at 1 kHz, 20% duty cycle, 30 mW/cm² intensity (SATA)) to accelerate the healing time in fresh tibia, radius and scaphoid fractures by up to 40%. Additionally, the same ultrasound signal has been shown to be effective at resolving all types of nonunions of all ages, following a wide range of fracture types and primary fracture management techniques.Recently, significant efforts have resulted in a more comprehensive understanding of the biological mechanism of action that produces the documented clinical outcomes. Low intensity pulsed ultrasound has been demonstrated to accelerate in vivo all stages of the fracture repair process (inflammation, soft callus formation, hard callus formation). In particular, accelerated mineralisation has been demonstrated in vitro with increases in osteocalcin, alkaline phosphatase, VEGF and MMP-13 expression. Integrins, a family of mechanoreceptors present on a wide range of cells involved in the fracture healing process, have been shown to be activated by the ultrasound signal. Downstream of the integrin activation, focal adhesions occur on the surface of cells with the activation of multiple signalling pathways, including the ERK, NF-κβ, and PI3 kinase pathways. These pathways have been directly linked to the production of COX-2 and prostaglandin, which are key to the processes of mineralisation and endochondral ossification in fracture healing.     

Effects of different ultrasound frequencies on the structure,rheological and functional properties of myosin: Significance of quorum sensing

Structure and rheological properties of myosin in myofibrillar protein (MP) after single frequency pulsed ultrasound (SFPU, G1-G2) and dual frequency pulsed ultrasound (DFPU, G3) were compared for the first time. Results showed SFPU and DFPU induced “stress response” through the action of cavitation on multiple myosin. In addition, there may be a certain quorum sensing among myosin, inducing a more stable β-antiparallel structure to resist negative effects of cavitation force. Results of particle size and synchronous fluorescence indicated that structure of myosin in MPs changed through stress. The increase in pH also assisted in the ultrasound process (G5-G7). Notably, DFPU induced stronger quorum sensing and formed a more stable structure. More so, effects of (−)-epigallocatechin-3-gallate (EGCG) and baicalein (BN) on the emulsion and gel properties of DFPU treated and non-treated MPs were also investigated. Results showed that ultrasound increased the stability of emulsion. Additionally, the texture and expressible moisture content (EMOC) of the gel were also improved after treatment.     

Emulsions stabilised by casein and hyaluronic acid: Effects of high intensity ultrasound on the stability and vitamin E digestive characteristics

This study aimed to prepare an emulsion stabilised by an ultrasound-treated casein (CAS)-hyaluronic acid (HA) complex and to protect vitamin E during in vitro digestion. It was found that high-intensity ultrasound (HIU) treatment significantly changed the hydrogen bonding, electrostatic interaction and hydrophobic interaction between CAS and HA, reduced the particle size of the CAS-HA complex, increased the intermolecular electrostatic repulsion, and thus significantly improved the emulsifying properties of the CAS-HA complex. Meanwhile, the creaming index (CI) and confocal laser scanning microscopy images showed that the stability of the CAS-HA-stabilised emulsion was the best when treated at 150 W for 10 min, which could be attributed to the enhanced adsorption capacity of the CAS-HA complex at the oil–water interface and the viscosity of the formed emulsion. In vitro digestion experiments revealed that the emulsion stabilised by the ultrasound-treated CAS-HA complex had a good protective effect on vitamin E. This study is significant for the development of emulsions for the delivery of lipophilic nutrients.     

Multi-frequency ultrasound:A potential method to improve the effects of surface decontamination and structural characteristics on large yellow croaker (Pseudosciaena crocea) during refrigerated storage

The effects of multi-frequency ultrasound on surface decontamination and structural characteristics of large yellow croaker (Pseudosciaena crocea) during refrigerated storage were evaluated. The results of total viable counts (TVCs) and psychrophilic bacteria counts (PBCs) demonstrated that multi-frequency ultrasound retarded the growth of microorganisms. The bacteriostatic effect was positively correlated with the increase of ultrasound frequencies. However, compared with triple-frequency ultrasound (TUS, 20/28/40 kHz) treatment, dual-frequency ultrasound (DUS, 20/28 kHz) treatment had higher water-holding capacity (WHC) and immobilized water content, better texture characteristics, lower pH and total volatile basic nitrogen (TVB-N). Through the results of myofibrillar fragmentation index (MFI), intrinsic fluorescence intensity (IFI) and atomic force microscope (AFM), multi-frequency ultrasound could effectively stabilize the myofibrillar protein structure of refrigerated large yellow croaker, which could maintain better texture characteristics. The effects of DUS were the most significant. Therefore, multi-frequency ultrasound treatment could inhibit the growth of microorganisms and improve the structural characteristics of large yellow croaker during refrigerated storage.     

Control of the dynamics of a boiling vapour bubble using pressure-modulated high intensity focused ultrasound without the shock scattering effect: A first proof-of-concept study

Boiling histotripsy is a promising High-Intensity Focused Ultrasound (HIFU) technique that can be used to induce mechanical tissue fractionation at the HIFU focus via cavitation. Two different types of cavitation produced during boiling histotripsy exposure can contribute towards mechanical tissue destruction: (1) a boiling vapour bubble at the HIFU focus and (2) cavitation clouds in between the boiling bubble and the HIFU source. Control of the extent and degree of mechanical damage produced by boiling histotripsy is necessary when treating a solid tumour adjacent to normal tissue or major blood vessels. This is, however, difficult to achieve with boiling histotripsy due to the stochastic formation of the shock scattering-induced inertial cavitation clouds. In the present study, a new histotripsy method termed pressure-modulated shockwave histotripsy is proposed as an alternative to or in addition to boiling histotripsy without inducing the shock scattering effect. The proposed concept is (a) to generate a boiling vapour bubble via localised shockwave heating and (b) subsequently control its extent and lifetime through manipulating peak pressure magnitudes and a HIFU pulse length. To demonstrate the feasibility of the proposed method, bubble dynamics induced at the HIFU focus in an optically transparent liver tissue phantom were investigated using a high speed camera and a passive cavitation detection systems under a single 10, 50 or 100 ms-long 2, 3.5 or 5 MHz pressure-modulated HIFU pulse with varying peak positive and negative pressure amplitudes from 5 to 89 MPa and −3.7 to −14.6 MPa at the focus. Furthermore, a numerical simulation of 2D nonlinear wave propagation with the presence of a boiling bubble at the focus of a HIFU field was conducted by numerically solving the generalised Westervelt equation. The high speed camera experimental results showed that, with the proposed pressure-modulated shockwave histotripsy, boiling bubbles generated by shockwave heating merged together, forming a larger bubble (of the order of a few hundred micron) at the HIFU focus. This coalesced boiling bubble then persisted and maintained within the HIFU focal zone until the end of the exposure (10, 50, or 100 ms). Furthermore, and most importantly, no violent cavitation clouds which typically appear in boiling histotripsy occurred during the proposed histotripsy excitation (i.e. no shock scattering effect). This was likely because that the peak negative pressure magnitude of the backscattered acoustic field by the boiling bubble was below the cavitation cloud intrinsic threshold. The size of the coalesced boiling bubble gradually increased with the peak pressure magnitudes. In addition, with the proposed method, an oval shaped lesion with a length of 0.6 mm and a width of 0.1 mm appeared at the HIFU focus in the tissue phantom, whereas a larger lesion in the form of a tadpole (length: 2.7 mm, width: 0.3 mm) was produced by boiling histotripsy. Taken together, these results suggest that the proposed pressure-modulated shockwave histotripsy could potentially be used to induce a more spatially localised tissue destruction with a desired degree of mechanical damage through controlling the size and lifetime of a boiling bubble without the shock scattering effect.     

Effects of dual-frequency slit ultrasound on the enzymolysis of high-concentration hydrolyzed feather meal: Biological activities and structural characteristics of hydrolysates

Ultrasound-assisted enzymolysis has been applied to improve conventional enzymolysis, while there are rare reports on the application of ultrasound to high-concentration feather protein enzymolysis. Therefore, the feasibility of dual-frequency slit ultrasound (DFSU) for enzymolysis of high-concentration hydrolyzed feather meal (HFM), as well as the biological activities and structural characteristics of hydrolysates were investigated. The single-factor test was used to optimize the ultrasonic processing parameters: substrate concentration, frequency mode, intermittent ratio, power density, and time. The results showed that protein recovery rate and conversion rate increased by 6.08% and 18.63% under the optimal conditions (200 g/L, 28/80 kHz, 5:2 s/s, 600 W/L, and 3 h) compared with conventional enzymolysis, respectively. The macromolecular proteins in hydrolysates were converted into micromolecular peptides (< 500 Da) when treated by DFSU, and antioxidant activity and angiotensin-I-converting enzyme (ACE) inhibitory activity of hydrolysates were increased. Scanning electron microscopy (SEM) and atomic force microscopy (AFM) images illustrated the microstructure changes of feather protein particles in the ultrasound-assisted enzymatic hydrolysates of HFM (UEH), including more porous, smaller, and more uniform. Additionally, the conformation of protein molecules was significantly affected (P < 0.05), including the increase in free sulfhydryl (SH), the decrease in disulfide bond (SS) and surface hydrophobicity (H₀). Fourier transform infrared (FTIR) spectra analysis further showed that the secondary structure of feather proteins was modified with a reduction in α-helix, β-turn, and β-sheet, while an increase in random coil content was observed. These results indicated that DFSU could be a promising method to enhance high-concentration HFM for preparing peptide-rich hydrolysates with high antioxidant activity and ACE inhibitory activity.