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Jesrani AK, Faiq SM, Rashid R, Kalwar TA, Mohsin R, Aziz T, Khan NA, Mubarak M. Comparison of resistive index and shear-wave elastography in the evaluation of chronic kidney allograft dysfunction. World J Transplant 2024; 14:89255. [PMID: 38576755 PMCID: PMC10989465 DOI: 10.5500/wjt.v14.i1.89255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/18/2024] [Accepted: 02/27/2024] [Indexed: 03/15/2024] Open
Abstract
BACKGROUND Detection of early chronic changes in the kidney allograft is important for timely intervention and long-term survival. Conventional and novel ultrasound-based investigations are being increasingly used for this purpose with variable results. AIM To compare the diagnostic performance of resistive index (RI) and shear wave elastography (SWE) in the diagnosis of chronic fibrosing changes of kidney allograft with histopathological results. METHODS This is a cross-sectional and comparative study. A total of 154 kidney transplant recipients were included in this study, which was conducted at the Departments of Transplantation and Radiology, Sindh Institute of Urology and Transplan tation, Karachi, Pakistan, from August 2022 to February 2023. All consecutive patients with increased serum creatinine levels and reduced glomerular filtration rate (GFR) after three months of transplantation were enrolled in this study. SWE and RI were performed and the findings of these were evaluated against the kidney allograft biopsy results to determine their diagnostic utility. RESULTS The mean age of all patients was 35.32 ± 11.08 years. Among these, 126 (81.8%) were males and 28 (18.2%) were females. The mean serum creatinine in all patients was 2.86 ± 1.68 mg/dL and the mean estimated GFR was 35.38 ± 17.27 mL/min/1.73 m2. Kidney allograft biopsy results showed chronic changes in 55 (37.66%) biopsies. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SWE for the detection of chronic allograft damage were 93.10%, 96.87%%, 94.73%, and 95.87%, respectively, and the diagnostic accuracy was 95.45%. For RI, the sensitivity, specificity, PPV, and NPV were 76.92%, 83.33%, 70.17%, and 87.62%, respectively, and the diagnostic accuracy was 81.16%. CONCLUSION The results from this study show that SWE is more sensitive and specific as compared to RI in the evaluation of chronic allograft damage. It can be of great help during the routine follow-up of kidney transplant recipients for screening and early detection of chronic changes and selecting patients for allograft biopsy.
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Affiliation(s)
- Ameet Kumar Jesrani
- Department of Radiology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
| | - Syed M Faiq
- Department of Radiology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
| | - Rahma Rashid
- Department of Pathology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
| | - Tariq Ali Kalwar
- Department of Transplantation, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
| | - Rehan Mohsin
- Department of Urology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
| | - Tahir Aziz
- Department of Transplantation, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
| | - Nida Amin Khan
- Department of Radiology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
| | - Muhammed Mubarak
- Department of Pathology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
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Wiskin J, Malik B, Klock J. Low frequency 3D transmission ultrasound tomography: technical details and clinical implications. Z Med Phys 2023; 33:427-443. [PMID: 37295982 PMCID: PMC10517404 DOI: 10.1016/j.zemedi.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 04/03/2023] [Accepted: 04/11/2023] [Indexed: 06/12/2023]
Abstract
A novel 3D ultrasound tomographic (3D UT) method (called volography) that creates a speed of sound (SOS) map and a reflection modality that is co-registered are reviewed and shown to be artifact free even in the presence of high contrast and thus shown to be applicable for breast, orthopedic and pediatric clinical use cases. The 3D UT images are almost isotropic with mm resolution and the reflection image is compounded over 360 degrees to create sub-mm resolution in plane. METHODS The physics of ultrasound scattering requires 3D modeling and the concomitant high computational cost is ameliorated with a bespoke algorithm (paraxial approximation - discussed here) and Nvidia GPUs. The resulting reconstruction times are tabulated for clinical relevance. The resulting SOS map is used to create a refraction corrected reflection image at ∼3.6 MHz center frequency. The transmission data are highly redundant, collected over 360 degrees and at 2 mm levels by true matrix receiver arrays yielding 3D data. The high resolution SOS and attenuation maps and reflection images are used in a segmentation algorithm that optimally utilizes this information to segment out glandular, ductal, connective tissue, fat and skin. These volumes are used to estimate breast density, an important correlate to cancer. RESULTS Multiple SOS images of breast, knee and segmentations of breast glandular and ductal tissue are shown. Spearman rho is calculated between our volumetric breast density estimates and Volpara™ from mammograms, as 0.9332. Multiple timing results are shown and indicate the variability of the reconstruction times with breast size and type but are ∼30 minutes for average size breast. The timing results with the 3D algorithm indicate ∼60 minute reconstruction times for pediatrics with two Nvidia GPUs. Characteristic variations of the glandular and ductal volumes over time are shown. The SOS from QT images are compared with literature values. The results of a multi-reader multi-case (MRMC) study are shown that compares the 3D UT with full field digital mammography and resulted in an average increase in ROC AUC of 10%. Orthopedic (knee) 3D UT images compared with MRI indicate regions of zero signal in the MRI are clearly displayed in the QT image. Explicit representation of the acoustic field is shown, indicating its 3D nature. An image of in vivo breast with the chest muscle is shown and speed of sound agreement with literature values are tabulated. Reference is made to a recently published paper validating pediatric imaging. CONCLUSIONS The high Spearman rho indicates a monotonic (not necessarily linear) relation between our method and industry gold standard Volpara™ density. The acoustic field verifies the need for 3D modeling. The MRMC study, the orthopedic images, breast density study, and references, all indicate the clinical utility of the SOS and reflection images. The QT image of the knee shows its ability to monitor tissue the MRI cannot. The included references and images herein indicate the proof of concept for 3D UT as a viable and valuable clinical adjunct in pediatric and orthopedic situations in addition to the breast imaging.
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Affiliation(s)
- James Wiskin
- QT Imaging, Inc, 3 Hamilton Landing, Suite 160, CA 94949, USA.
| | - Bilal Malik
- QT Imaging, Inc, 3 Hamilton Landing, Suite 160, CA 94949, USA
| | - John Klock
- QT Imaging, Inc, 3 Hamilton Landing, Suite 160, CA 94949, USA
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Li Y, Gao Q, Chen N, Zhang Y, Wang J, Li C, He X, Jiao Y, Zhang Z. Clinical studies of magnetic resonance elastography from 1995 to 2021: Scientometric and visualization analysis based on CiteSpace. Quant Imaging Med Surg 2022; 12:5080-5100. [PMID: 36330182 PMCID: PMC9622435 DOI: 10.21037/qims-22-207] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 08/11/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND To assess the knowledge framework around magnetic resonance elastography (MRE) and to explore MRE research hotspots and emerging trends. METHODS The Science Citation Index Expanded of the Web of Science Core Collection was searched on 22 October 2021 for MRE-related studies published between 1995 and 2021. Excel 2016 and CiteSpace V (version 5.8.R3) were used to analyze the downloaded data. RESULTS In all, 1,236 articles published by 726 authors from 540 institutions in 40 countries were included in this study. The top 10 authors published 57.6% of all included articles. The 3 most productive countries were the USA (n=631), Germany (n=202), and France (n=134), and the 3 most productive institutions were the Mayo Clinic (n=240), Charité (n=131), and the University of Illinois (n=56). The USA and the Mayo Clinic had the highest betweenness centrality among countries and institutions, respectively, and played an important role in the field of MRE. In this study, the 24,347 distinct references were clustered into 48 categories via reasonable clustering using specific keywords, forming the knowledge framework. Among the 294 co-occurring keywords, "hepatic fibrosis", "stiffness", "skeletal muscle", "acoustic strain wave", "in vivo", and "non-invasive assessment" were research hotspots. "Diagnostic performance", "diagnostic accuracy", "hepatic steatosis", "chronic hepatitis B", "radiation force impulse", "children", and "echo" were frontier topics. CONCLUSIONS Scientometric and visualized analysis of MRE can provide information regarding the knowledge framework, research hotspots, frontier areas, and emerging trends in this field.
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Affiliation(s)
- Youwei Li
- Department of Radiology, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Qiang Gao
- Department of Gastroenterology and Hepatology, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Na Chen
- Department of Otorhinolaryngology, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Yuanfang Zhang
- Department of Radiology, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Juan Wang
- Department of Radiology, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Chang Li
- Department of Radiology, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Xuan He
- Department of Radiology, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Yang Jiao
- Department of Rehabilitation Psychology, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Zongming Zhang
- Department of General Surgery, Beijing Electric Power Hospital, State Grid Corporation of China, Capital Medical University, Beijing, China
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Beyazal M, Beyazal MS, Çeliker FB, Devrimsel G, Yıldırım M. The Association of Achilles Sonoelastography Findings with Disease
Activity, Functional Status and Enthesitis Index in Patients with Axial
Spondyloarthritis. AKTUEL RHEUMATOL 2022. [DOI: 10.1055/a-1749-4695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Abstract
Background Sonoelastography (SE) is a new ultrasound (US)-based technique
able to assess tissue elasticity. Using conventional US, it is sometimes
difficult or even impossible to distinguish pathologic tissue because it often
presents with the same echogenicity as the surrounding healthy tissue. This
study aimed to evaluate SE findings in Achilles tendons of patients with axial
spondyloarthritis (axSpA) and to assess how these findings are associated with
disease-related parameters.
Material and Methods Sixty-four consecutive patients (37 men, 27 women;
mean age 39.7 years; range 20–65 years) with axSpA and 30 sex and
age-matched healthy controls were enrolled in the study. Disease activity was
evaluated using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI),
whereas functional capacity was evaluated using the Bath Ankylosing Spondylitis
Functional Index (BASFI). Erythrocyte sedimentation rate (ESR), C-reactive
protein (CRP) and the Spondyloarthritis Research Consortium of Canada (SPARCC)
enthesitis index were recorded. All participants underwent an SE examination of
the Achilles tendon and measurement of the strain index (SI).
Results The mean right and left SI were significantly higher in axSpA
patients than in controls (2.96±0.94 vs. 1.90±0.45;
p<0.001; 2.95±0.95 vs. 1.92±0.48, p<0.001,
respectively). In axSpA patients, both right and left SI were significantly
correlated with the BASDAI, BASFI and SPARCC enthesitis indices, but not with
ESR or CRP.
Conclusion AxSpA patients had an increased SI compared with healthy
subjects and these values were associated with disease activity, functional
capacity and the enthesitis index. SE may be a useful tool for the evaluation of
Achilles tendons in patients with axSpA.
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Affiliation(s)
- Mehmet Beyazal
- Department of Radiology, Recep Tayyip Erdogan University Training and
Research Hospital, Rize, Turkey
| | - Münevver Serdaroğlu Beyazal
- Department of Physical Medicine and Rehabilitation, Recep Tayyip
Erdogan University Training and Research Hospital, Rize, Turkey
| | - Fatma Beyazal Çeliker
- Department of Radiology, Recep Tayyip Erdogan University Training and
Research Hospital, Rize, Turkey
| | - Gul Devrimsel
- Department of Physical Medicine and Rehabilitation, Recep Tayyip
Erdogan University Training and Research Hospital, Rize, Turkey
| | - Murat Yıldırım
- Department of Physical Medicine and Rehabilitation, Recep Tayyip
Erdogan University Training and Research Hospital, Rize, Turkey
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Bontzos G, Douglas VP, Douglas KAA, Kapsala Z, Drakonaki EE, Detorakis ET. Ultrasound Elastography in Ocular and Periocular Tissues: A Review. Curr Med Imaging 2021; 17:1041-1053. [PMID: 33319691 DOI: 10.2174/1573405616666201214123117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/31/2020] [Accepted: 10/15/2020] [Indexed: 11/22/2022]
Abstract
Ultrasound elastography has become available in everyday practice, allowing direct measurement of tissue elasticity with important and expanding clinical applications. Several studies that have evaluated pathological and non-pathological tissues have demonstrated that ultrasound elastography can actually improve the diagnostic accuracy of the underlying disease process by detecting differences in their elasticity. Ocular and periocular tissues can also be characterized by their elastic properties. In this context, a comprehensive review of literature on ultrasound elastography as well as its current applications in Ophthalmology is presented.
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Affiliation(s)
- Georgios Bontzos
- Department of Ophthalmology, University Hospital of Heraklion, Crete, Greece
| | | | | | - Zoi Kapsala
- Department of Ophthalmology, University Hospital of Heraklion, Crete, Greece
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Is early diagnosis of myofascial pain syndrome possible with the detection of latent trigger points by shear wave elastography? Pol J Radiol 2021; 86:e425-e431. [PMID: 34429789 PMCID: PMC8369817 DOI: 10.5114/pjr.2021.108537] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/02/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose The aim of the study was to investigate the contribution of shear wave elastography to the diagnosis of myo-fascial pain syndrome (MPS) of the upper part of the trapezius. Material and methods Ethical committee approval was obtained for the study. Thirty volunteer women with trigger points in the upper part of the trapezius muscle and 30 healthy women with a similar age distribution were included in the study. The patient group performed a self-stretching exercise program for 4 weeks. No intervention was applied to the control group. Muscle stiffness values of both groups were evaluated with shear wave elastography (SWE), and pain levels of all volunteers were evaluated by the Visual Analogue Scale at the beginning and the end of the study. The statistical analyses were performed using SPSS version 18.0. Results There was a significant decrease after the treatment in terms of upper trapezius muscle stiffness and the pain levels in the patient group (p < 0.001 and p < 0.001). In the patient group, there was a moderate correlation between the decrease in the pain level and the reductions in muscle stiffness (r = 0.595). In control group, there was no significant difference in terms of both muscle stiffness and pain levels before and after treatment (p > 0.05). Conclusions SWE is a reliable method for detecting latent trigger points in MPS, and it can be used for evaluating the response to treatment.
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Evaluation of MR elastography for prediction of lymph node metastasis in prostate cancer. Abdom Radiol (NY) 2021; 46:3387-3400. [PMID: 33651125 DOI: 10.1007/s00261-021-02982-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/17/2021] [Accepted: 02/09/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE To assess the relationship between MRE stiffness of prostate cancer (PCa) and the extent of lymph node metastasis (LNM) in patients with PCa undergoing radical prostatectomy (RP) and extended pelvic lymph node dissection (ePLND). MATERIALS The local institutional review board approved this retrospective study. We retrospectively analyzed 49 patients, who had undergone MRE, mpMRI and pelvic MRI on a 3.0 T MRI scanner, with histopathological confirmed PCa after RP (from June 2015 to December 2019). For each patient, preoperative clinical data and characteristics of MRE, mpMRI and pelvic MRI were recorded. Independent-samples t test, univariate and multivariate logistic regression analyses were performed. And receiver operating characteristic (ROC) analysis were performed to compare the diagnostic performances of multivariate models with the Briganti 2019 nomogram. RESULTS PCa MRE stiffness and maximum diameter were independent predictors of LNM. When PCa MRE stiffness at 60 Hz (odds ratio [OR] = 20.223, P = 0.013) and maximum diameter (OR = 4.575, P = 0.046) were combined, the sensitivity and specificity were 100% and 91.9% to predict LNM. When PCa MRE stiffness at 90 Hz (OR = 7.920, P = 0.013) and maximum diameter (OR = 2.810, P = 0.045) were combined, the sensitivity and specificity were 100% and 86.5% to predict LNM. The areas under curves (AUCs) of the combinations were higher than the AUC of the Briganti 2019 nomogram (0.982 vs. 0.904, P = 0.040 [60 Hz]; 0.975 vs. 0.904, P = 0.060 [90 Hz], respectively). CONCLUSIONS MRE-based assessment of PCa stiffness may be useful for predicting LNM of PCa preoperatively and noninvasively.
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Orhan K, Rozylo-Kalinowska I. Ultrasonography-guided invasive procedures of the temporomandibular joint. ACTA ACUST UNITED AC 2021. [PMCID: PMC7857093 DOI: 10.1007/s41894-020-00091-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Temporomandibular joint (TMJ) complex is one of the most complex joints, which connects the mandible to the skull. This kind of joint system has the ability to perform complex and bilateral movements. Due to complex anatomy, there is a need for a thorough investigation to find the correct etiology of TMJ disorders. For a thorough investigation, starting from clinical examination to imaging strategies should be performed meticulously. Radiographic imaging is an important element in the correct diagnosis. Because of the anatomic complexity of the temporomandibular joint and its proximity to the temporal bone, mastoid air cells, and auditory structures, imaging of the joint structures should also be investigated. Therefore, careful clinical and radiological examinations are essential in the evaluation of TMJ. The manuscript examines the potential use and technique of ultrasonography (USG) in fine-needle aspiration biopsy and intra-articular sodium hyaluronate/steroid injection.
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Affiliation(s)
- Kaan Orhan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Medical Design Application and Research Center (MEDITAM), Ankara University, Ankara, Turkey
| | - Ingrid Rozylo-Kalinowska
- Department of Dentomaxillofacial Radiology, Medical University of Lublin, Poland ul. Karmelicka 7 20-081, Lublin, Poland
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Obuchowicz R, Ambrozinski L, Kohut P. Influence of Load and Transducer Bandwidth on the Repeatability of In Vivo Tendon Stiffness Evaluation Using Shear Wave Elastography. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2020. [DOI: 10.1177/8756479320928999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective: To determine how different examination protocols with the use of transducers, of different bandwidths, and applied with varied tension to tendons would influence the sonographic study results. Methods: Thirty-one participants were divided into two groups, with one subject used for theoretical investigation (A) and the remaining participants (B = 30) forming the study cohort. Both sets of participants were examined with three different transducers (SL10–3, SL15–4, and SL18–7) as well as with variable loading on the Achilles tendon (relaxed, tensed, and loaded). The resulting coverage of the color map provided qualitative tendon stiffness and quantitative tendon stiffness values. Results: The estimated mean coverage extent, using elastographic color maps, produced by the three transducers was 98%, 98%, and 99%, respectively, in the relaxed state. Likewise, in the tensed state, mean coverage was 85%, 82%, and 77% in group A and 91%, 78%, and 71% in group B, respectively. Examining tendons that were loaded, the mean coverage was 68%, 42%, and 41%, respectively. The quantitative relaxed mean tendon elasticity values were 323, 366, and 393 kPa, respectively, in group A. Likewise, the relaxed mean values were 329, 341, and 358 kPa, respectively, in group B. The quantitative tensed mean tendon elasticity values were 413, 460, and 426 kPa, respectively, in group A. Likewise the tensed mean values were 412, 440, and 436 kPa, respectively, in group B. Conclusions: Varying the tendon loading significantly influenced the color map coverage, which governs the most reliable quantitative measurements on relaxed tendons. The best color map coverage was achieved using the transducer with the lowest frequency, regardless of the tension applied.
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Affiliation(s)
- Rafał Obuchowicz
- Department of Radiology, Collegium Medicum, Jagiellonian University, Krakow, Poland
| | | | - Piotr Kohut
- AGH University of Science and Technology, Krakow, Poland
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Aslan H, Analan PD, Kaya E. : Is there a correlation between the biceps brachii muscle stiffness measured by elastography and severity of lymphedema in patients with breast cancer-related lymphedema? ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE 2018. [DOI: 10.25000/acem.432532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Virtual touch IQ elastography in evaluation of Achilles tendon in patients with chronic renal failure. J Med Ultrason (2001) 2018; 46:45-49. [PMID: 30291574 DOI: 10.1007/s10396-018-0907-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 09/12/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To evaluate the sonoelastographic changes in the Achilles tendon in patients with chronic renal failure (CRF) using virtual touch imaging quantification (VTIQ) elastography. METHODS Twenty-six patients undergoing three hemodialysis sessions per week and 26 subjects admitted to our institution between January 2016 and April 2016 were included in this prospective study. The characteristics and body mass index of the patients were noted. Ultrasonography was performed parallel to the long axis of the bilateral Achilles tendons during relaxation of the legs using the Siemens Acuson S3000™ ultrasound device (Siemens HealthCare, Erlangen, Germany). Tendon thickness was reviewed, and tissue stiffness was quantitatively assessed using VTIQ elastography. Independent samples t test and Mann-Whitney U test were used for statistical analyses. RESULTS The median values of shear wave velocities of the Achilles tendon in patients with CRF were 7.19 m/s (4.23-9.77 m/s) on the right and 6.98 m/s (4.00-9.82 m/s) on the left, while they were 5.11 m/s (4.09-8.82 m/s) on the right and 5.36 m/s (4.05-8.80 m/s) on the left in controls. The stiffness of the Achilles tendons in patients with CRF was found to be higher than that in controls (right: P < 0.001, left: P = 0.004). There was no statistically significant difference in tendon thickness between the CRF and control groups (P > 0.05). CONCLUSION The thickness and stiffness of tendon can be effectively evaluated with sonoelastography. The thickness of the Achilles tendon did not significantly differ between the patients with CRF and healthy subjects. However, the stiffness of the Achilles tendon measured with VTIQ elastography was demonstrated to be increased in the patients with CRF.
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Hageman DJ, Wu S, Kilbreath S, Rockson SG, Wang C, Knothe Tate ML. Biotechnologies toward Mitigating, Curing, and Ultimately Preventing Edema through Compression Therapy. Trends Biotechnol 2018; 36:537-548. [PMID: 29606499 DOI: 10.1016/j.tibtech.2018.02.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 02/26/2018] [Accepted: 02/27/2018] [Indexed: 11/15/2022]
Abstract
For a century-old problem, edema and its treatment have gone remarkably unnoticed by the biomedical community. Given the prevalence of lymphedema and its debilitating repercussions, there is an acute need for both efficacy-based measures and clinical standards to guide compression garment design and therapeutic application. This review outlines the current state of the art in compression treatment and suggests an integrated biomedical engineering approach going forward. Characterizing the pressure gradient profiles of commercial compression sleeves is necessary to better understand the role of compression treatment in the mitigation of swelling. Integration of pressure sensor technologies with advanced materials design and manufacture provides a critical path not only to elucidate the mechanisms of but also to improve on current compression-based therapies and associated therapeutic devices.
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Affiliation(s)
- Daniel J Hageman
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia
| | - Shuying Wu
- School of Mechanical Engineering, University of New South Wales, Sydney, Australia
| | - Sharon Kilbreath
- Breast Cancer Research Laboratory, Division of Health Sciences, Sydney University, Sydney, Australia
| | - Stanley G Rockson
- Center for Lymphatic and Venous Disorders, Stanford University Hospital, Palo Alto, CA, USA
| | - Chun Wang
- School of Mechanical Engineering, University of New South Wales, Sydney, Australia
| | - Melissa L Knothe Tate
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, Australia.
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