Science.gov

Sample records for medical diagnostic ultrasound

  1. Synergistic advances in diagnostic and therapeutic medical ultrasound

    NASA Astrophysics Data System (ADS)

    Lizzi, Frederic L.

    2003-04-01

    Significant advances are more fully exploiting ultrasound's potential for noninvasive diagnosis and treatment. Therapeutic systems employ intense focused beams to thermally kill cancer cells in, e.g., prostate; to stop bleeding; and to treat specific diseases (e.g., glaucoma). Diagnostic ultrasound techniques can quantitatively image an increasingly broad spectrum of physical tissue attributes. An exciting aspect of this progress is the emerging synergy between these modalities. Advanced diagnostic techniques may contribute at several stages in therapy. For example, treatment planning for small ocular tumors uses 50-MHz, 3-D ultrasonic images with 0.05-mm resolution. Thermal simulations employ these images to evaluate desired and undesired effects using exposure stategies with specially designed treatment beams. Therapy beam positioning can use diagnostic elastography to sense tissue motion induced by radiation pressure from high-intensity treatment beams. Therapy monitoring can sense lesion formation using elastography motion sensing (to detect the increased stiffness in lesions); harmonic imaging (to sense altered nonlinear properties); and spectrum analysis images (depicting changes in the sizes, concentration, and configuration of sub-resolution structures.) Experience from these applications will greatly expand the knowledge of acoustic phenomena in living tissues and should lead to further advances in medical ultrasound.

  2. Ultrasound Metrology in Mexico: a round robin test for medical diagnostics

    NASA Astrophysics Data System (ADS)

    Amezola Luna, R.; López Sánchez, A. L.; Elías Juárez, A. A.

    2011-02-01

    This paper presents preliminary statistical results from an on-going imaging medical ultrasound study, of particular relevance for gynecology and obstetrics areas. Its scope is twofold, firstly to compile the medical ultrasound infrastructure available in cities of Queretaro-Mexico, and second to promote the use of traceable measurement standards as a key aspect to assure quality of ultrasound examinations performed by medical specialists. The experimental methodology is based on a round robin test using an ultrasound phantom for medical imaging. The physician, using its own ultrasound machine, couplant and facilities, measures the size and depth of a set of pre-defined reflecting and absorbing targets of the reference phantom, which simulate human illnesses. Measurements performed give the medical specialist an objective feedback regarding some performance characteristics of their ultrasound examination systems, such as measurement system accuracy, dead zone, axial resolution, depth of penetration and anechoic targets detection. By the end of March 2010, 66 entities with medical ultrasound facilities, from both public and private institutions, have performed measurements. A network of medical ultrasound calibration laboratories in Mexico, with traceability to The International System of Units via national measurement standards, may indeed contribute to reduce measurement deviations and thus attain better diagnostics.

  3. Source Book of Educational Materials for Diagnostic Medical Ultrasound. Radiological Health Series.

    ERIC Educational Resources Information Center

    Pijar, Mary Lou, Comp; And Others

    This report is a compilation of educational materials that are available in the field of diagnostic medical ultrasound. Materials, which include publications, audiovisual aids, and teaching aids, are listed under the following categories: abdominal imaging; anatomy and physiology; anatomy and embryology; bioeffects; cardiology and vasculature;…

  4. Visualizing and measuring the temperature field produced by medical diagnostic ultrasound using thermography

    NASA Astrophysics Data System (ADS)

    Vachutka, J.; Grec, P.; Mornstein, V.; Caruana, C. J.

    2008-11-01

    The heating of tissues by diagnostic ultrasound can pose a significant hazard particularly in the imaging of the unborn child. The demonstration of the temperature field in tissue is therefore an important objective in the teaching of biomedical physics to healthcare professionals. The temperature field in a soft tissue model was made visible and measured using thermography. Temperature data from the images were used to investigate the dependence of temperature increase within the model on ultrasound exposure time and distance from the transducer. The experiment will be used within a multi-professional biomedical physics teaching laboratory for enhancing learning regarding the principles of thermography and the thermal effects of ultrasound to medical and healthcare students and also for demonstrating the quantitative use of thermographic imaging to students of biophysics, medical physics and medical technology.

  5. Visualizing and Measuring the Temperature Field Produced by Medical Diagnostic Ultrasound Using Thermography

    ERIC Educational Resources Information Center

    Vachutka, J.; Grec, P.; Mornstein, V.; Caruana, C. J.

    2008-01-01

    The heating of tissues by diagnostic ultrasound can pose a significant hazard particularly in the imaging of the unborn child. The demonstration of the temperature field in tissue is therefore an important objective in the teaching of biomedical physics to healthcare professionals. The temperature field in a soft tissue model was made visible and…

  6. Visualizing and Measuring the Temperature Field Produced by Medical Diagnostic Ultrasound Using Thermography

    ERIC Educational Resources Information Center

    Vachutka, J.; Grec, P.; Mornstein, V.; Caruana, C. J.

    2008-01-01

    The heating of tissues by diagnostic ultrasound can pose a significant hazard particularly in the imaging of the unborn child. The demonstration of the temperature field in tissue is therefore an important objective in the teaching of biomedical physics to healthcare professionals. The temperature field in a soft tissue model was made visible and…

  7. The effects of transducer geometry on artifacts common to diagnostic bone imaging with conventional medical ultrasound.

    PubMed

    Mauldin, F William; Owen, Kevin; Tiouririne, Mohamed; Hossack, John A

    2012-06-01

    The portability, low cost, and non-ionizing radiation associated with medical ultrasound suggest that it has potential as a superior alternative to X-ray for bone imaging. However, when conventional ultrasound imaging systems are used for bone imaging, clinical acceptance is frequently limited by artifacts derived from reflections occurring away from the main axis of the acoustic beam. In this paper, the physical source of off-axis artifacts and the effect of transducer geometry on these artifacts are investigated in simulation and experimental studies. In agreement with diffraction theory, the sampled linear-array geometry possessed increased off-axis energy compared with single-element piston geometry, and therefore, exhibited greater levels of artifact signal. Simulation and experimental results demonstrated that the linear-array geometry exhibited increased artifact signal when the center frequency increased, when energy off-axis to the main acoustic beam (i.e., grating lobes) was perpendicularly incident upon off-axis surfaces, and when off-axis surfaces were specular rather than diffusive. The simulation model used to simulate specular reflections was validated experimentally and a correlation coefficient of 0.97 between experimental and simulated peak reflection contrast was observed. In ex vivo experiments, the piston geometry yielded 4 and 6.2 dB average contrast improvement compared with the linear array when imaging the spinous process and interlaminar space of an animal spine, respectively. This work indicates that off-axis reflections are a major source of ultrasound image artifacts, particularly in environments comprising specular reflecting (i.e., bone or bone-like) objects. Transducer geometries with reduced sensitivity to off-axis surface reflections, such as a piston transducer geometry, yield significant reductions in image artifact.

  8. Ultrasound introscopic image quantitative characteristics for medical diagnostics and refinements of physical noise rise reasons

    NASA Astrophysics Data System (ADS)

    Novoselets, Mikhail K.; Radchenko, Sergiy P.; Tsubin, Vitaliy A.; Gridko, Alexander N.

    1994-05-01

    Ultrasound images obtained with a simple sector scan show a granular appearance, called `speckle'. The speckle is the useless property of the ultrasound introskopic images as it mask all small differences of the images. The possibility of the speckle noise reduction by special created filter is analyzed. The computer processing results of ultrasound introskopic thyroid gland images by such filter are presented.

  9. Abdominal ultrasound and medical education.

    PubMed

    García de Casasola Sánchez, G; Torres Macho, J; Casas Rojo, J M; Cubo Romano, P; Antón Santos, J M; Villena Garrido, V; Diez Lobato, R

    2014-04-01

    Ultrasound is a very versatile diagnostic modality that permits real-time visualization of multiple internal organs. It is of invaluable help for the physical examination of the patients. To assess if ultrasound can be incorporated into medical education and if the students can perform a basic abdominal ultrasound examination without the necessity of a long period of training. Twelve medical students were trained in basic abdominal ultrasound during a 15-h training program including a 5-h theoretical and practical course and supervised practice in 20 selected patients. Subsequently, we conducted an evaluation test that assessed the ability of students to obtain the ultrasound views and to detect various pathologies in five different patients. The students were able to correctly identify the abdominal views more than 90% of the times. This percentage was only lower (80%) in the right subcostal view to locate the gallbladder. The accuracy or global efficiency of the ultrasound for the diagnosis of relevant pathological findings of the patients was greater than 90% (91.1% gallstones, abdominal aortic aneurysm 100%; splenomegaly 98.3%, ascites 100%; dilated inferior vena cava 100%; acute urinary retention 100%). The ultrasound may be a feasible learning tool in medical education. Ultrasound can help students to improve the physical examination. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  10. Quo vadis medical ultrasound?

    PubMed

    Lewin, Peter A

    2004-04-01

    The last three decades of development in diagnostic ultrasound imaging and technology are briefly reviewed and the impact of the crucial link between the two apparently independent research efforts, which eventually facilitated implementation of harmonic imaging modality is explored. These two efforts included the experiments with piezoelectric PVDF polymer material and studies of the interaction between ultrasound energy and biological tissue. Harmonic imaging and its subsequent improvements revolutionized the diagnostic power of clinical ultrasound and brought along images of unparalleled resolution, close to that of magnetic resonance imaging (MRI) quality. The nonlinear propagation effects and their implications for both diagnostic and therapeutic applications of ultrasound are also briefly addressed. In diagnostic applications, the impact of these effects on image resolution and tissue characterization is reviewed; in therapeutic applications, the influence of nonlinear propagation effects on highly localized tissue ablation and cauterization is examined. Next, the most likely developments and future trends in clinical ultrasound technology, including 3D and 4D imaging, distant palpation, image enhancement using contrast agents, monitoring, and merger of diagnostic and therapeutic applications by e.g. introducing ultrasonically controlled targeted drug delivery are reviewed. Finally, a possible competition from other imaging modalities is discussed.

  11. Medical ultrasound systems.

    PubMed

    Powers, Jeff; Kremkau, Frederick

    2011-08-06

    Medical ultrasound imaging has advanced dramatically since its introduction only a few decades ago. This paper provides a short historical background, and then briefly describes many of the system features and concepts required in a modern commercial ultrasound system. The topics addressed include array beam formation, steering and focusing; array and matrix transducers; echo image formation; tissue harmonic imaging; speckle reduction through frequency and spatial compounding, and image processing; tissue aberration; Doppler flow detection; and system architectures. It then describes some of the more practical aspects of ultrasound system design necessary to be taken into account for today's marketplace. It finally discusses the recent explosion of portable and handheld devices and their potential to expand the clinical footprint of ultrasound into regions of the world where medical care is practically non-existent. Throughout the article reference is made to ways in which ultrasound imaging has benefited from advances in the commercial electronics industry. It is meant to be an overview of the field as an introduction to other more detailed papers in this special issue.

  12. Nonlinear acoustics in diagnostic ultrasound.

    PubMed

    Duck, Francis A

    2002-01-01

    The propagation of ultrasonic waves is nonlinear. Phenomena associated with the propagation of diagnostic ultrasound pulses cannot be predicted using linear assumptions alone. These include a progressive distortion in waveform, the generation of frequency harmonics and acoustic shocks, excess deposition of energy and acoustic saturation. These effects occur most strongly when ultrasound propagates within liquids with comparatively low acoustic attenuation, such as water, amniotic fluid or urine. Within soft tissues, similar effects occur, although they are limited by absorption and scattering. Nonlinear effects are of considerable importance during acoustic measurements, especially when these are used to predict in situ exposure. Harmonic generation may be used to create images. These offer improvements over conventional B-mode images in spatial resolution and, more significantly, in the suppression of acoustic clutter and side-lobe artifacts. B/A has promise as a parameter for tissue characterisation, but methods for imaging B/A have shown limited success.

  13. Ultrasound microscope: the new field in ultrasound diagnostics

    NASA Astrophysics Data System (ADS)

    Novyc'kyy, Victor V.; Lushchyk, Ulyana B.

    2001-06-01

    A device which is a new stage in the development of medical equipment has been developed. The device works as an ultrasound microscope in vivo and provides 4 up to 32 colored histological image. It gives possibility to estimate tissue acoustic density with the help of 4 up to 32 gradation coloring different tissues and enables tissue microcirculation visualization. With the help of the device a doctor can objectify fatty hepatitis and cirrhosis, edema of different organs and tissues as well as microcirculation in organs and tissues (e.g. muscles, myocard and bone system). New promising applications of ultrasound systems in diagnostics and for choosing individual treatment tactics, with pathogenesis being taken into account, may be developed with the help of the device.

  14. Integrated photoacoustic, ultrasound and fluorescence platform for diagnostic medical imaging-proof of concept study with a tissue mimicking phantom

    PubMed Central

    James, Joseph; Murukeshan, Vadakke Matham; Woh, Lye Sun

    2014-01-01

    The structural and molecular heterogeneities of biological tissues demand the interrogation of the samples with multiple energy sources and provide visualization capabilities at varying spatial resolution and depth scales for obtaining complementary diagnostic information. A novel multi-modal imaging approach that uses optical and acoustic energies to perform photoacoustic, ultrasound and fluorescence imaging at multiple resolution scales from the tissue surface and depth is proposed in this paper. The system comprises of two distinct forms of hardware level integration so as to have an integrated imaging system under a single instrumentation set-up. The experimental studies show that the system is capable of mapping high resolution fluorescence signatures from the surface, optical absorption and acoustic heterogeneities along the depth (>2cm) of the tissue at multi-scale resolution (<1µm to <0.5mm). PMID:25071954

  15. WE-AB-206-01: Diagnostic Ultrasound Imaging Quality Assurance.

    PubMed

    Zagzebski, J

    2016-06-01

    The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. The goal of this ultrasound hands-on workshop is to demonstrate quality control (QC) testing in diagnostic ultrasound and to provide updates in ACR ultrasound accreditation requirements. The first half of this workshop will include two presentations reviewing diagnostic ultrasound QA/QC and ACR ultrasound accreditation requirements. The second half of the workshop will include live demonstrations of basic QC tests. An array of ultrasound testing phantoms and ultrasound scanners will be available for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations and on-site instructors. The targeted attendees are medical physicists in diagnostic imaging.

  16. Medical Ultrasound Imaging.

    ERIC Educational Resources Information Center

    Hughes, Stephen

    2001-01-01

    Explains the basic principles of ultrasound using everyday physics. Topics include the generation of ultrasound, basic interactions with material, and the measurement of blood flow using the Doppler effect. (Author/MM)

  17. Medical Ultrasound Imaging.

    ERIC Educational Resources Information Center

    Hughes, Stephen

    2001-01-01

    Explains the basic principles of ultrasound using everyday physics. Topics include the generation of ultrasound, basic interactions with material, and the measurement of blood flow using the Doppler effect. (Author/MM)

  18. Medical diagnostic applications and sources.

    PubMed

    Whittingham, T A

    2007-01-01

    The ways in which ultrasound is used in medical diagnosis are reviewed, with particular emphasis on the ultrasound source (probe) and implications for acoustic exposure. A brief discussion of the choice of optimum frequency for various target depths is followed by a description of the general features of diagnostic ultrasound probes, including endo-probes. The different modes of diagnostic scanning are then discussed in turn: A-mode, M-mode, B-mode, three-dimensional (3D) and 4D scanning, continuous wave (CW) Doppler, pulse-wave spectral Doppler and Doppler imaging. Under the general heading of B-mode imaging, there are individual descriptions of the principles of chirps and binary codes, B-flow, tissue harmonic imaging and ultrasound contrast agent-specific techniques. Techniques for improving image quality within the constraints of real-time operation are discussed, including write zoom, parallel beam forming, spatial compounding and multiple zone transmission focusing, along with methods for reducing slice thickness. At the end of each section there is a summarising comment on the basic features of the acoustic output and its consequences for patient safety.

  19. Brief group training of medical students in focused cardiac ultrasound may improve diagnostic accuracy of physical examination.

    PubMed

    Stokke, Thomas M; Ruddox, Vidar; Sarvari, Sebastian I; Otterstad, Jan E; Aune, Erlend; Edvardsen, Thor

    2014-11-01

    Physical examination and auscultation can be challenging for medical students. The aim of this study was to investigate whether a brief session of group training in focused cardiac ultrasound (FCU) with a pocket-sized device would allow medical students to improve their ability to detect clinically relevant cardiac lesions at the bedside. Twenty-one medical students in their clinical curriculum completed 4 hours of FCU training in groups. The students examined patients referred for echocardiography with emphasis on auscultation, followed by FCU. Findings from physical examination and FCU were compared with those from standard echocardiography performed and analyzed by cardiologists. In total, 72 patients were included in the study, and 110 examinations were performed. With a stethoscope, sensitivity to detect clinically relevant (moderate or greater) valvular disease was 29% for mitral regurgitation, 33% for aortic regurgitation, and 67% for aortic stenosis. FCU improved sensitivity to detect mitral regurgitation (69%, P < .001). However, sensitivity to detect aortic regurgitation (43%) and aortic stenosis (70%) did not improve significantly. Specificity was ≥89% for all valvular diagnoses by both methods. For nonvalvular diagnoses, FCU's sensitivity to detect moderate or greater left ventricular dysfunction (90%) was excellent, detection of right ventricular dysfunction (79%) was good, while detection of dilated left atrium (53%), dilated right atrium (49%), pericardial effusion (40%), and dilated aortic root (25%) was less accurate. Specificity varied from 57% to 94%. After brief group training in FCU, medical students could detect mitral regurgitation significantly better compared with physical examination, whereas detection of aortic regurgitation and aortic stenosis did not improve. Left ventricular dysfunction was detected with high sensitivity. More extensive training is advised. Copyright © 2014 American Society of Echocardiography. Published by

  20. WE-A-210-00: Educational: Diagnostic Ultrasound QA

    SciTech Connect

    2015-06-15

    This presentation will focus on the present role of ultrasound medical physics in clinical practices. The first part of the presentation will provide an overview of ultrasound QC methodologies and testing procedures. A brief review of ultrasound phantoms utilized in these testing procedures will be presented. The second part of the presentation will summarize ultrasound imaging technical standards and professional guidelines by American College of Radiology (ACR), American Institute of Ultrasound in Medicine (AIUM), American Association of Physicists in Medicine (AAPM) and International Electrotechnical Commission (IEC). The current accreditation requirements by ACR and AIUM for ultrasound practices will be described and the practical aspects of implementing QC programs to be compliant with these requirements will be discussed. Learning Objectives: Achieve familiarity with common ultrasound QC test methods and ultrasound phantoms. Understand the coverage of the existing testing standards and professional guidelines on diagnostic ultrasound imaging. Learn what a medical physicist needs to know about ultrasound program accreditation and be able to implement ultrasound QC programs accordingly.

  1. Systematic evaluation of a secondary method for measuring diagnostic-level medical ultrasound transducer output power based on a large-area pyroelectric sensor

    NASA Astrophysics Data System (ADS)

    Zeqiri, B.; Žauhar, G.; Rajagopal, S.; Pounder, A.

    2012-06-01

    A systematic study of the application of a novel pyroelectric technique to the measurement of diagnostic-level medical ultrasound output power is described. The method exploits the pyroelectric properties of a 0.028 mm thick membrane of polyvinylidene fluoride (PVDF), backed by an acoustic absorber whose ultrasonic absorption coefficient approaches 1000 dB cm-1 at 3 MHz. When exposed to an ultrasonic field, absorption of ultrasound adjacent to the PVDF-absorber interface results in heating and the generation of a pyroelectric output voltage across gold electrodes deposited on the membrane. For a sensor large enough to intercept the whole of the acoustic beam, the output voltage can be calibrated for the measurement of acoustic output power. A number of key performance properties of the method have been investigated. The technique is very sensitive, with a power to voltage conversion factor of typically 0.23 V W-1. The frequency response of a particular embodiment of the sensor in which acoustic power reflected at the absorber-PVDF interface is subsequently returned to the pyroelectric membrane to be absorbed, has been evaluated over the frequency range 1.5 MHz to 10 MHz. This has shown the frequency response to be flat to within ±4%, above 2.5 MHz. Below this frequency, the sensitivity falls by 20% at 1.5 MHz. Linearity of the technique has been demonstrated to within ±1.6% for applied acoustic power levels from 1 mW up to 120 mW. A number of other studies targeted at assessing the achievable measurement uncertainties are presented. These involve: the effects of soaking, the influence of the angle of incidence of the acoustic beam, measurement repeatability and sensitivity to transducer positioning. Additionally, over the range 20 °C to 30 °C, the rate of change in sensitivity with ambient temperature has been shown to be +0.5% °C-1. Implications of the work for the development of a sensitive, traceable, portable, secondary method of ultrasound output power

  2. [Ultrasound diagnostics of diffuse liver diseases].

    PubMed

    Jung, E M; Wiggermann, P; Stroszczynski, C; Reiser, M F; Clevert, D-A

    2012-08-01

    The current improvements in modern high resolution ultrasound technology, like Tissue Harmonic Imaging (THI), Speckle Reduction Imaging (SRI), partial color coding of B-mode (Color Coded Imaging), and also the advent of ultrasound based elastography as well as contrast-enhanced ultrasound (CEUS) offer fundamentally new ways to characterize diffuse alterations of the liver parenchyma. Besides metabolic disease, disorders of liver fat distribution, infectious and malignant diseases can cause diffuse alterations of the liver parenchyma. In case of liver fibrosis, only a combination of different ultrasound techniques including CEUS, allows the differentiation between benign dysplastic and malignant lesions. Ultrasound elastography allows assessing the extent of the fibrosis. This article focuses on the different ultrasound based diagnostic possibilities in case of diffuse liver disease.

  3. Ultrasound Detection of Soft Tissue Abscesses Performed by Non-Physician U.S. Army Medical Providers Naïve to Diagnostic Sonography.

    PubMed

    LaDuke, Mike; Monti, Jon; Cronin, Aaron; Gillum, Bart

    2017-03-01

    Patients commonly present to emergency rooms and primary care clinics with cellulitic skin infections with or without abscess formation. In military operational units, non-physician medical personnel provide most primary and initial emergency medical care. The objective of this study was to determine if, after minimal training, Army physician assistants and medics could use portable ultrasound (US) machines to detect superficial soft tissue abscesses. This was a single-blinded, randomized, prospective observational study conducted over the course of 2 days at a military installation. Active duty military physician assistants and medics with little or no US experience were recruited as participants. They received a short block of training on abscess detection using both clinical examination skills (inspection/palpation) and US examination. The participants were then asked to provide a yes/no answer regarding abscess presence in a chicken tissue model. Results were analyzed to assess the participants' abilities to detect abscesses, compare the diagnostic accuracy of their clinical examinations with their US examinations, and assess how often US results changed treatment plans initially on the basis of clinical examination findings alone. 22 participants performed a total of 220 clinical examinations and 220 US scans on 10 chicken tissue abscess models. Clinical examination for abscess detection yielded a sensitivity of 73.5% (95% confidence interval [CI], 65.3-80.3%) and a specificity of 77.2% (95% CI, 67.4-84.9%), although US examination for abscess detection yielded a sensitivity of 99.2% (95% CI, 95.4-99.9%) and a specificity of 95.5% (95% CI, 88.5-98.6%). Clinical examination yielded a diagnostic accuracy of 75.0% (95% CI, 68.9-80.3) although US examination yielded a diagnostic accuracy of 97.7% (95% CI, 94.6-99.2%), a difference in accuracy of 22.7% favoring US (p < 0.01). US changed the diagnosis in 56 of 220 cases (25.4% of all cases, p = 0.02). Of these 56

  4. National ultrasound curriculum for medical students.

    PubMed

    Baltarowich, Oksana H; Di Salvo, Donald N; Scoutt, Leslie M; Brown, Douglas L; Cox, Christian W; DiPietro, Michael A; Glazer, Daniel I; Hamper, Ulrike M; Manning, Maria A; Nazarian, Levon N; Neutze, Janet A; Romero, Miriam; Stephenson, Jason W; Dubinsky, Theodore J

    2014-03-01

    Ultrasound (US) is an extremely useful diagnostic imaging modality because of its real-time capability, noninvasiveness, portability, and relatively low cost. It carries none of the potential risks of ionizing radiation exposure or intravenous contrast administration. For these reasons, numerous medical specialties now rely on US not only for diagnosis and guidance for procedures, but also as an extension of the physical examination. In addition, many medical school educators recognize the usefulness of this technique as an aid to teaching anatomy, physiology, pathology, and physical diagnosis. Radiologists are especially interested in teaching medical students the appropriate use of US in clinical practice. Educators who recognize the power of this tool have sought to incorporate it into the medical school curriculum. The basic question that educators should ask themselves is: "What should a student graduating from medical school know about US?" To aid them in answering this question, US specialists from the Society of Radiologists in Ultrasound and the Alliance of Medical School Educators in Radiology have collaborated in the design of a US curriculum for medical students. The implementation of such a curriculum will vary from institution to institution, depending on the resources of the medical school and space in the overall curriculum. Two different examples of how US can be incorporated vertically or horizontally into a curriculum are described, along with an explanation as to how this curriculum satisfies the Accreditation Council for Graduate Medical Education competencies, modified for the education of our future physicians.

  5. External Diagnostic Ultrasound Capabilities, Limitations, And Future Trends

    NASA Astrophysics Data System (ADS)

    Von Behren, Patrick L.; Lee, Richard M.; Milburn, Donald T.

    1989-08-01

    External ultrasound has achieved an important niche in the spectrum of diagnostic imaging modalities. Its real-time capability, ease of use, and relative low cost have brought it to prominence as an important diagnostic tool. Medical ultrasound imaging, driven by advances in technology and by clinical needs, continues to improve its diagnostic capabilities. Key technologies for ultrasound development are new transducers, advances in signal processing algorithms, and increased computer power. Although external ultrasound image quality continues to steadily improve, certain clinical limitations such as organ access and tissue attenuation have spurred the development of more invasive scanning techniques. Endorectal, endovaginal, and transesophageal probes provide better access to--and provide superior images for--the prostate, uterus and heart. Intraluminal ultrasound is an emerging field of imaging, employing miniature, high-frequency probes which can be inserted into arteries to monitor interventional procedures. To put these developments into perspective, this manuscript reviews the capabilities and limitations of existing ultrasound technology and discusses the impetus for future developments.

  6. Virtual Guidance Ultrasound: A Tool to Obtain Diagnostic Ultrasound for Remote Environments

    NASA Technical Reports Server (NTRS)

    Caine,Timothy L.; Martin David S.; Matz, Timothy; Lee, Stuart M. C.; Stenger, Michael B.; Platts, Steven H.

    2012-01-01

    Astronauts currently acquire ultrasound images on the International Space Station with the assistance of real-time remote guidance from an ultrasound expert in Mission Control. Remote guidance will not be feasible when significant communication delays exist during exploration missions beyond low-Earth orbit. For example, there may be as much as a 20- minute delay in communications between the Earth and Mars. Virtual-guidance, a pre-recorded audio-visual tutorial viewed in real-time, is a viable modality for minimally trained scanners to obtain diagnostically-adequate images of clinically relevant anatomical structures in an autonomous manner. METHODS: Inexperienced ultrasound operators were recruited to perform carotid artery (n = 10) and ophthalmic (n = 9) ultrasound examinations using virtual guidance as their only instructional tool. In the carotid group, each each untrained operator acquired two-dimensional, pulsed, and color Doppler of the carotid artery. In the ophthalmic group, operators acquired representative images of the anterior chamber of the eye, retina, optic nerve, and nerve sheath. Ultrasound image quality was evaluated by independent imaging experts. RESULTS: Eight of the 10 carotid studies were judged to be diagnostically adequate. With one exception the quality of all the ophthalmic images were adequate to excellent. CONCLUSION: Diagnostically-adequate carotid and ophthalmic ultrasound examinations can be obtained by untrained operators with instruction only from an audio/video tutorial viewed in real time while scanning. This form of quick-response-guidance, can be developed for other ultrasound examinations, represents an opportunity to acquire important medical and scientific information for NASA flight surgeons and researchers when trained medical personnel are not present. Further, virtual guidance will allow untrained personnel to autonomously obtain important medical information in remote locations on Earth where communication is

  7. MO-AB-210-00: Diagnostic Ultrasound Imaging Quality Control and High Intensity Focused Ultrasound Therapy Hands-On Workshop

    SciTech Connect

    2015-06-15

    The goal of this ultrasound hands-on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound. HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well-defined regions of necrosis. This completely non-invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands-on demonstrations with on-site instructors at separate stations. The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations of the techniques. Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high-intensity focused ultrasound and in diagnostic ultrasound QC. Learning Objectives: Learn ultrasound physics and safety for HIFU applications through live demonstrations Get an overview of the state-of-the art in HIFU technologies and equipment Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools List of supporting vendors for HIFU and diagnostic ultrasound QC hands-on workshop: Philips Healthcare Alpinion Medical Systems Verasonics, Inc Zonare Medical Systems, Inc Computerized Imaging Reference Systems (CIRS), Inc. GAMMEX, Inc., Cablon Medical BV Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant 5R25NS

  8. Diagnostic ultrasound: Text and cases. Second edition

    SciTech Connect

    Sarti, D.A.

    1986-01-01

    This is a textbook and reference. New added improvements and features include: approximately 1,000 new scans have been added, increasing the number to almost 1,900; new chapters have been added on the breast, neonatal head, the scrotum, pediatrics, and intraoperative ultrasound, real-time scanning; information updated to keep pace with the technological and diagnostic advances in the field; and an expanded and revised text.

  9. Medical Imaging with Ultrasound: Some Basic Physics.

    ERIC Educational Resources Information Center

    Gosling, R.

    1989-01-01

    Discussed are medical applications of ultrasound. The physics of the wave nature of ultrasound including its propagation and production, return by the body, spatial and contrast resolution, attenuation, image formation using pulsed echo ultrasound techniques, measurement of velocity and duplex scanning are described. (YP)

  10. Medical Imaging with Ultrasound: Some Basic Physics.

    ERIC Educational Resources Information Center

    Gosling, R.

    1989-01-01

    Discussed are medical applications of ultrasound. The physics of the wave nature of ultrasound including its propagation and production, return by the body, spatial and contrast resolution, attenuation, image formation using pulsed echo ultrasound techniques, measurement of velocity and duplex scanning are described. (YP)

  11. Integrated medical school ultrasound: development of an ultrasound vertical curriculum

    PubMed Central

    2013-01-01

    Background Physician-performed focused ultrasonography is a rapidly growing field with numerous clinical applications. Focused ultrasound is a clinically useful tool with relevant applications across most specialties. Ultrasound technology has outpaced the education, necessitating an early introduction to the technology within the medical education system. There are many challenges to integrating ultrasound into medical education including identifying appropriately trained faculty, access to adequate resources, and appropriate integration into existing medical education curricula. As focused ultrasonography increasingly penetrates academic and community practices, access to ultrasound equipment and trained faculty is improving. However, there has remained the major challenge of determining at which level is integrating ultrasound training within the medical training paradigm most appropriate. Methods The Ohio State University College of Medicine has developed a novel vertical curriculum for focused ultrasonography which is concordant with the 4-year medical school curriculum. Given current evidenced-based practices, a curriculum was developed which provides medical students an exposure in focused ultrasonography. The curriculum utilizes focused ultrasonography as a teaching aid for students to gain a more thorough understanding of basic and clinical science within the medical school curriculum. The objectives of the course are to develop student understanding in indications for use, acquisition of images, interpretation of an ultrasound examination, and appropriate decision-making of ultrasound findings. Results Preliminary data indicate that a vertical ultrasound curriculum is a feasible and effective means of teaching focused ultrasonography. The foreseeable limitations include faculty skill level and training, initial cost of equipment, and incorporating additional information into an already saturated medical school curriculum. Conclusions Focused

  12. Integrated medical school ultrasound: development of an ultrasound vertical curriculum.

    PubMed

    Bahner, David P; Adkins, Eric J; Hughes, Daralee; Barrie, Michael; Boulger, Creagh T; Royall, Nelson A

    2013-07-02

    Physician-performed focused ultrasonography is a rapidly growing field with numerous clinical applications. Focused ultrasound is a clinically useful tool with relevant applications across most specialties. Ultrasound technology has outpaced the education, necessitating an early introduction to the technology within the medical education system. There are many challenges to integrating ultrasound into medical education including identifying appropriately trained faculty, access to adequate resources, and appropriate integration into existing medical education curricula. As focused ultrasonography increasingly penetrates academic and community practices, access to ultrasound equipment and trained faculty is improving. However, there has remained the major challenge of determining at which level is integrating ultrasound training within the medical training paradigm most appropriate. The Ohio State University College of Medicine has developed a novel vertical curriculum for focused ultrasonography which is concordant with the 4-year medical school curriculum. Given current evidenced-based practices, a curriculum was developed which provides medical students an exposure in focused ultrasonography. The curriculum utilizes focused ultrasonography as a teaching aid for students to gain a more thorough understanding of basic and clinical science within the medical school curriculum. The objectives of the course are to develop student understanding in indications for use, acquisition of images, interpretation of an ultrasound examination, and appropriate decision-making of ultrasound findings. Preliminary data indicate that a vertical ultrasound curriculum is a feasible and effective means of teaching focused ultrasonography. The foreseeable limitations include faculty skill level and training, initial cost of equipment, and incorporating additional information into an already saturated medical school curriculum. Focused ultrasonography is an evolving concept in medicine

  13. Fetal thermal effects of diagnostic ultrasound.

    PubMed

    Abramowicz, Jacques S; Barnett, Stanley B; Duck, Francis A; Edmonds, Peter D; Hynynen, Kullervo H; Ziskin, Marvin C

    2008-04-01

    Processes that can produce a biological effect with some degree of heating (ie, about 1 degrees C above the physiologic temperature) act via a thermal mechanism. Investigations with laboratory animals have documented that pulsed ultrasound can produce elevations of temperature and damage in biological tissues in vivo, particularly in the presence of bone (intracranial temperature elevation). Acoustic outputs used to induce these adverse bioeffects are within the diagnostic range, although exposure times are usually considerably longer than in clinical practice. Conditions present in early pregnancy, such as lack of perfusion, may favor bioeffects. Thermally induced teratogenesis has been shown in many animal studies, as well as several controlled human studies; however, human studies have not shown a causal relationship between diagnostic ultrasound exposure during pregnancy and adverse biological effects to the fetus. All human epidemiologic studies, however, were conducted with commercially available devices predating 1992, that is, with acoustic outputs not exceeding a spatial-peak temporal-average intensity of 94 mW/cm2. Current limits in the United States allow a spatial-peak temporal-average intensity of 720 mW/cm2 for fetal applications. The synergistic effect of a raised body temperature (febrile status) and ultrasound insonation has not been examined in depth. Available evidence, experimental or epidemiologic, is insufficient to conclude that there is a causal relationship between obstetric diagnostic ultrasound exposure and obvious adverse thermal effects to the fetus. However, very subtle effects cannot be ruled out and indicate a need for further research, although research in humans may be extremely difficult to realize.

  14. Errors and mistakes in breast ultrasound diagnostics

    PubMed Central

    Jakubowski, Wiesław; Migda, Bartosz

    2012-01-01

    Sonomammography is often the first additional examination performed in the diagnostics of breast diseases. The development of ultrasound imaging techniques, particularly the introduction of high frequency transducers, matrix transducers, harmonic imaging and finally, elastography, influenced the improvement of breast disease diagnostics. Nevertheless, as in each imaging method, there are errors and mistakes resulting from the technical limitations of the method, breast anatomy (fibrous remodeling), insufficient sensitivity and, in particular, specificity. Errors in breast ultrasound diagnostics can be divided into impossible to be avoided and potentially possible to be reduced. In this article the most frequently made errors in ultrasound have been presented, including the ones caused by the presence of artifacts resulting from volumetric averaging in the near and far field, artifacts in cysts or in dilated lactiferous ducts (reverberations, comet tail artifacts, lateral beam artifacts), improper setting of general enhancement or time gain curve or range. Errors dependent on the examiner, resulting in the wrong BIRADS-usg classification, are divided into negative and positive errors. The sources of these errors have been listed. The methods of minimization of the number of errors made have been discussed, including the ones related to the appropriate examination technique, taking into account data from case history and the use of the greatest possible number of additional options such as: harmonic imaging, color and power Doppler and elastography. In the article examples of errors resulting from the technical conditions of the method have been presented, and those dependent on the examiner which are related to the great diversity and variation of ultrasound images of pathological breast lesions. PMID:26675358

  15. Errors and mistakes in breast ultrasound diagnostics.

    PubMed

    Jakubowski, Wiesław; Dobruch-Sobczak, Katarzyna; Migda, Bartosz

    2012-09-01

    Sonomammography is often the first additional examination performed in the diagnostics of breast diseases. The development of ultrasound imaging techniques, particularly the introduction of high frequency transducers, matrix transducers, harmonic imaging and finally, elastography, influenced the improvement of breast disease diagnostics. Nevertheless, as in each imaging method, there are errors and mistakes resulting from the technical limitations of the method, breast anatomy (fibrous remodeling), insufficient sensitivity and, in particular, specificity. Errors in breast ultrasound diagnostics can be divided into impossible to be avoided and potentially possible to be reduced. In this article the most frequently made errors in ultrasound have been presented, including the ones caused by the presence of artifacts resulting from volumetric averaging in the near and far field, artifacts in cysts or in dilated lactiferous ducts (reverberations, comet tail artifacts, lateral beam artifacts), improper setting of general enhancement or time gain curve or range. Errors dependent on the examiner, resulting in the wrong BIRADS-usg classification, are divided into negative and positive errors. The sources of these errors have been listed. The methods of minimization of the number of errors made have been discussed, including the ones related to the appropriate examination technique, taking into account data from case history and the use of the greatest possible number of additional options such as: harmonic imaging, color and power Doppler and elastography. In the article examples of errors resulting from the technical conditions of the method have been presented, and those dependent on the examiner which are related to the great diversity and variation of ultrasound images of pathological breast lesions.

  16. Review of Quantitative Ultrasound: Envelope Statistics and Backscatter Coefficient Imaging and Contributions to Diagnostic Ultrasound.

    PubMed

    Oelze, Michael L; Mamou, Jonathan

    2016-02-01

    Conventional medical imaging technologies, including ultrasound, have continued to improve over the years. For example, in oncology, medical imaging is characterized by high sensitivity, i.e., the ability to detect anomalous tissue features, but the ability to classify these tissue features from images often lacks specificity. As a result, a large number of biopsies of tissues with suspicious image findings are performed each year with a vast majority of these biopsies resulting in a negative finding. To improve specificity of cancer imaging, quantitative imaging techniques can play an important role. Conventional ultrasound B-mode imaging is mainly qualitative in nature. However, quantitative ultrasound (QUS) imaging can provide specific numbers related to tissue features that can increase the specificity of image findings leading to improvements in diagnostic ultrasound. QUS imaging can encompass a wide variety of techniques including spectral-based parameterization, elastography, shear wave imaging, flow estimation, and envelope statistics. Currently, spectral-based parameterization and envelope statistics are not available on most conventional clinical ultrasound machines. However, in recent years, QUS techniques involving spectral-based parameterization and envelope statistics have demonstrated success in many applications, providing additional diagnostic capabilities. Spectral-based techniques include the estimation of the backscatter coefficient (BSC), estimation of attenuation, and estimation of scatterer properties such as the correlation length associated with an effective scatterer diameter (ESD) and the effective acoustic concentration (EAC) of scatterers. Envelope statistics include the estimation of the number density of scatterers and quantification of coherent to incoherent signals produced from the tissue. Challenges for clinical application include correctly accounting for attenuation effects and transmission losses and implementation of QUS on

  17. The Evolution of Diagnostic and Interventional Ultrasound in Sports Medicine.

    PubMed

    Finnoff, Jonathan T

    2016-03-01

    Diagnostic and interventional ultrasound is a rapidly evolving field in sports medicine. The use of ultrasound has increased exponentially during the past decades. This imaging modality is appealing to sports medicine physicians because of its broad diagnostic and interventional capabilities. In sports medicine, the indications for diagnostic ultrasound extend well beyond the musculoskeletal realm to include other conditions such as ocular trauma, thoracoabdominal trauma, and cardiac morphology. Thus, the term "sports ultrasound" has been adopted as a more accurate representation of the broad and unique applications of ultrasound in this specialty. Ultrasound-guided procedures also have evolved from the commonly performed joint and tendon sheath injections to include ultrasound-guided surgical procedures. This article will discuss the evolution of diagnostic and interventional ultrasound in sports medicine using a case-based approach to highlight its many new applications.

  18. Signal processing in ultrasound. [for diagnostic medicine

    NASA Technical Reports Server (NTRS)

    Le Croissette, D. H.; Gammell, P. M.

    1978-01-01

    Signal is the term used to denote the characteristic in the time or frequency domain of the probing energy of the system. Processing of this signal in diagnostic ultrasound occurs as the signal travels through the ultrasonic and electrical sections of the apparatus. The paper discusses current signal processing methods, postreception processing, display devices, real-time imaging, and quantitative measurements in noninvasive cardiology. The possibility of using deconvolution in a single transducer system is examined, and some future developments using digital techniques are outlined.

  19. Recent advances in medical ultrasound

    NASA Astrophysics Data System (ADS)

    Crum, Lawrence

    2014-03-01

    Ultrasound has become one of the most widely used imaging modalities in medicine; yet, before ultrasound-imaging systems became available, high intensity ultrasound was used as early as the 1950s to ablate regions in the brains of human patients. Recently, a variety of novel applications of ultrasound have been developed that include site-specific and ultrasound-mediated drug delivery, acoustocautery, lipoplasty, histotripsy, tissue regeneration, and bloodless surgery, among many others. This lecture will review several new applications of therapeutic ultrasound and address some of the basic scientific questions and future challenges in developing these methods and technologies for general use in our society. We shall particularly emphasize the use of High Intensity Focused Ultrasound (HIFU) in the treatment of benign and malignant tumors.

  20. Diagnostic Flow Metering using Ultrasound Tomography

    NASA Astrophysics Data System (ADS)

    Chun, Sejong; Yoon, Byung-Ro; Lee, Kwang-Bock; Paik, Jong-Seung

    2010-06-01

    Flow meters, which are used for transferring water or crude oil through pipelines, require well-defined flow conditions for accurate flow rate monitoring. Even though all the installation conditions for the flow meters are satisfied, there could be unexpected flow disturbances, such as abrupt increase of upstream pressure, affecting on the performance of flow meters. To investigate any differences between measured and actual flow rates, flow velocity profiles inside the pipeline must be known. Ultrasound tomography is a means of reconstructing flow profiles from line-averaged velocities by Radon transformation. Diagnostic parameters are then extracted from the reconstructed flow profiles to give information whether the flow conditions are appropriate for accurate flow metering. In the present study, flow profiles downstream of a mass flow meter and a butterfly valve are reconstructed. Flow diagnostic parameters are defined using statistical moments such as mean value, standard deviation, skewness and kurtosis. The measured diagnostic parameters in the above-mentioned flow conditions are compared with those of fully-developed laminar and turbulent flow profiles to validate their usefulness.

  1. Ultrasound in undergraduate medical education: a systematic and critical review.

    PubMed

    Feilchenfeld, Zac; Dornan, Tim; Whitehead, Cynthia; Kuper, Ayelet

    2017-04-01

    The use of point-of-care ultrasound (POCUS) in clinical care is growing rapidly and advocates have recently proposed the integration of ultrasound into undergraduate medical education (UME). The evidentiary basis for this integration has not been evaluated critically or systematically. We conducted a critical and systematic review framed by the rationales enumerated in academic publications by advocates of ultrasound in UME. This research was conducted in two phases. First, the dominant discursive rationales for the integration of ultrasound in UME were identified from an archive of 403 academic publications using techniques from Foucauldian critical discourse analysis (CDA). We then sought empirical evidence in support of these rationales, using a critical synthesis methodology also adapted from CDA. We identified four dominant discursive rationales with different levels of evidentiary support. The use of ultrasound was not demonstrated to improve students' understanding of anatomy. The benefit of ultrasound in teaching physical examination was inconsistent and rests on minimal evidence. With POCUS, students' diagnostic accuracy was improved for certain pathologies, but findings were inconsistent for others. Finally, the rationale that ultrasound training in UME will improve the quality of patient care was difficult to evaluate. Our analysis has shown that the frequently repeated rationales for the integration of ultrasound in UME are not supported by a sufficient base of empirical research. The repetition of these dominant discursive rationales in academic publications legitimises them and may preclude further primary research. As the value of clinical ultrasound use by medical students remains unproven, educators must consider whether the associated financial and temporal costs are justified or whether more research is required. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  2. Early medical abortion without prior ultrasound.

    PubMed

    Raymond, Elizabeth G; Bracken, Hillary

    2015-09-01

    To explore the potential for using last menstrual period (LMP) rather than ultrasound to establish gestational age (GA) eligibility for medical abortion. We used the results of a recently published systematic review to identify studies with data on the number of abortion patients with GA more than 63 or 70 days by ultrasound but less than those or other specific limits by LMP. We analyzed data from these studies to estimate the proportion of women with GAs greater than 63 or 70 days by ultrasound in various subgroups of women defined by LMP. We found three studies with relevant data. One enrolled 4257 medical abortion patients of whom 4% had GAs of >70 days by ultrasound. Of the 2681 who were certain that their LMPs began no more than 56 days prior, only 16 (0.6%) were >70 days by ultrasound. In a second much smaller study of surgical abortion patients, of whom 19% were >70 days by ultrasound, 90 women were certain that their LMPs started more than 56 days prior, and of those, 7 (7.8%) had GAs of >70 days by ultrasound. In the third study, which included surgical abortion patients with a mean GA of 61 days, at least 12% of the 138 patients with LMPs <63 days prior were >70 days by ultrasound. The possibility that access to medical abortion can be enhanced for selected women by omitting the requirement for a screening ultrasound is promising and should be further investigated. Gestational dating using LMP rather than ultrasound may be reasonable for selected patients before medical abortion. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Enhanced ultrasound for advanced diagnostics, ultrasound tomography for volume limb imaging and prosthetic fitting

    NASA Astrophysics Data System (ADS)

    Anthony, Brian W.

    2016-04-01

    Ultrasound imaging methods hold the potential to deliver low-cost, high-resolution, operator-independent and nonionizing imaging systems - such systems couple appropriate algorithms with imaging devices and techniques. The increasing demands on general practitioners motivate us to develop more usable and productive diagnostic imaging equipment. Ultrasound, specifically freehand ultrasound, is a low cost and safe medical imaging technique. It doesn't expose a patient to ionizing radiation. Its safety and versatility make it very well suited for the increasing demands on general practitioners, or for providing improved medical care in rural regions or the developing world. However it typically suffers from sonographer variability; we will discuss techniques to address user variability. We also discuss our work to combine cylindrical scanning systems with state of the art inversion algorithms to deliver ultrasound systems for imaging and quantifying limbs in 3-D in vivo. Such systems have the potential to track the progression of limb health at a low cost and without radiation exposure, as well as, improve prosthetic socket fitting. Current methods of prosthetic socket fabrication remain subjective and ineffective at creating an interface to the human body that is both comfortable and functional. Though there has been recent success using methods like magnetic resonance imaging and biomechanical modeling, a low-cost, streamlined, and quantitative process for prosthetic cup design and fabrication has not been fully demonstrated. Medical ultrasonography may inform the design process of prosthetic sockets in a more objective manner. This keynote talk presents the results of progress in this area.

  4. Diagnostic Emergency Ultrasound: Assessment Techniques In The Pediatric Patient.

    PubMed

    Guttman, Joshua; Nelson, Bret P

    2016-01-01

    Emergency ultrasound is performed at the point of care to answer focused clinical questions in a rapid manner. Over the last 20 years, the use of this technique has grown rapidly, and it has become a core requirement in many emergency medicine residencies and in some pediatric emergency medicine fellowships. The use of emergency ultrasound in the pediatric setting is increasing due to the lack of ionizing radiation with these studies, as compared to computed tomography. Utilizing diagnostic ultrasound in the emergency department can allow clinicians to arrive at a diagnosis at the bedside rather than sending the patient out of the department for another study. This issue focuses on common indications for diagnostic ultrasound, as found in the pediatric literature or extrapolated from adult literature where pediatric evidence is scarce. Limitations, current trends, controversies, and future directions of diagnostic ultrasound in the emergency department are also discussed.

  5. Medical ultrasound education for bioengineers

    NASA Astrophysics Data System (ADS)

    Vaezy, Shahram

    2005-04-01

    The widespread adoption of ultrasound technologies in medicine has necessitated the development of educational programs to address the growing demand for trained expertise in both academia and industry. The demand has been especially great in the field of therapeutic ultrasound that has experienced a significant level of research and development activities in the past decade. The applications cover a wide range including cancer treatment, hemorrhage control, cardiac ablation, gene therapy, and cosmetic surgery. A comprehensive educational program in ultrasound is well suited for bioengineering departments at colleges and universities. Our educational program for students in Bioengineering at the University of Washington includes a year-long coursework covering theory and practice of ultrasound, conducting research projects, attending and presenting at weekly seminars on literature survey, presentations at scientific meetings, and attending specialized workshops offered by various institutions for specific topics. An important aspect of this training is its multi-disciplinary approach, encompassing science, engineering, and medicine. The students are required to build teams with expertise in these disciplines. Our experience shows that these students are well prepared for careers in academia, conducting cutting edge research, as well as industry, being involved in the transformation of research end-products to commercially viable technology.

  6. Integrating ultrasound into modern medical curricula.

    PubMed

    Patel, Shilpan G; Benninger, Brion; Mirjalili, S Ali

    2017-05-01

    Ultrasonography is widely practiced in many disciplines. It is becoming increasingly important to design well-structured curricula to introduce imaging to students during medical school. This review aims to analyze the literature for evidence of how ultrasonography has been incorporated into anatomy education in medical school curricula worldwide. A literature search was conducted using multiple databases with the keywords: "Ultrasound OR Ultrasonographic examination*" and "Medical student* OR Undergraduate teaching* OR Medical education*" and "Anatomy* OR Living anatomy* OR Real-time anatomy.*" This review found that ultrasound curricula vary in stage of implementation, course length, number of sessions offered to students as well as staffing and additional course components. Most courses consisted of didactic lectures supplemented with demonstration sessions and/or hands-on ultrasound scanning sessions. The stage of course implementation tended to depend on the aim of the course; introductory courses were offered earlier in a student's career. Most courses improved student confidence and exam performance, and more junior students tended to benefit more from learning anatomy with ultrasound guidance rather than learning clinical examination skills. Students tended to prefer smaller groups when learning ultrasound to get more access to using the machines themselves. Ultrasonography is an important skill, which should be taught to medical students early in their careers as it facilitates anatomical education and is clinically relevant, though further objective research required to support the use of ultrasound education as a tool to improve clinical examination skills in medical students. Clin. Anat. 30:452-460, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  7. Diagnostic ultrasound and telemedicine utilization in the international space station

    NASA Astrophysics Data System (ADS)

    Carter, Stephen J.; Stewart, Brent K.; Kushmerick, Martin J.; Langer, Steve G.; Schmiedl, Udo P.; Winter, Thomas C.; Conley, Kevin E.; Jubrias, Sharon A.

    1999-01-01

    Clinical diagnostic ultrasound (US) is experiencing an expanding role that is well suited to application on the International Space Station (ISS). Diagnostic US can be used to reduce the risks associated with long duration human space flight by providing a non-invasive tool with head-to-toe diagnostic capability in both biomedical research and crew health care. General health care of the astronauts will be diagnosed with US, e.g., kidney stones, gall bladder disease, appendicitis, etc. Initial studies will focus on detection of ``ureteral jets'' in the bladder. This is a non-invasive test to rule out obstructive uropathy from kidney stones with minimal requirements for crew training. Biomedical research experiments, focusing on the effects of the microgravity environment, will be performed using both the HHU and the HDI 5000. US will be used to evaluate bone density and muscle mass in this environment. Prolonged or emergency EVAs may occur with the ISS. The hand-held ultrasound unit (HHU) and its telemedicine capability will be used in EVA settings to monitor events such as decompression sickness (DCS) microbubble formation in the cardiovascular system. There will be telemetry links between the HHU and the ATL/Lockheed Martin rack mounted HDI 5000 in the ISS Human Research Facility (HRF), as well as between the HRF and medical expertise on the ground. These links will provide the ISS with both real-time and store-and-forward telemedicine capabilities. The HHU can also be used with the existing telemedicine instrument pack (TIP).

  8. Diagnostic ultrasound in sports medicine: current concepts and advances.

    PubMed

    Nofsinger, Charles; Konin, Jeff G

    2009-03-01

    Diagnostic ultrasound is a valuable imaging tool that is slowly gaining in popularity among sports medicine clinicians. Commonly referred to as "musculoskeletal ultrasound," its valuable role in assisting with sports medicine diagnoses has been to date underused for a variety of reasons. Effective clinical usage for sports medicine diagnoses includes commonly seen conditions such as rotator cuff disease, ulnar collateral ligament of the elbow injury, and internal derangement of the knee, among many others. Limitation of clinical usage has been deterred by the cost of the unit, perception of time associated with assessment procedures, and the lack of formal training associated with diagnostic implementation. However, when properly used, musculoskeletal ultrasound can increase the accuracy of diagnosis and treatment, improve time to treatment intervention, and improve patient satisfaction. The purpose of this paper is to review the fundamentals of musculoskeletal ultrasound and present its specific diagnostic uses.

  9. A Guide to Ultrasound of the Shoulder, Part 2: The Diagnostic Evaluation.

    PubMed

    Panero, Alberto J; Hirahara, Alan M

    2016-01-01

    Ultrasound is becoming an increasingly accessible modality for its easy and accurate evaluation of shoulder pathology. In Part 1 of our series (Am J Orthop. 2016;45(3):176-182), we showed how musculoskeletal ultrasound can be properly coded and reimbursed and can be as effective in evaluating the shoulder as magnetic resonance imaging, yet more economical. With more physicians beginning to incorporate this technology into their practice, we describe the physics of ultrasound and our methods for evaluating the shoulder with ultrasound. In the coming year, new certifications are emerging that may be required to perform and bill for these services. Staying abreast with the current guidelines and protocols being introduced by the American Institute of Ultrasound in Medicine and the American Registry for Diagnostic Medical Sonography will be essential.

  10. Cost minimization analysis of ultrasound-guided diagnostic evaluation of probably benign breast lesions.

    PubMed

    Lee, Christoph I; Wells, Colin J; Bassett, Lawrence W

    2013-01-01

    The objective of this study was to compare direct health care costs for two competing diagnostic strategies for probably benign breast lesions detected by ultrasound in young women. We developed a decision analytic model and performed a cost minimization analysis comparing ultrasound-guided vacuum-assisted core biopsy and conservative short-term diagnostic ultrasound follow-up. Relative probabilities for diagnostic outcomes were derived from pooled analysis of the medical literature. Direct health care costs were estimated using United States national average figures from calendar year 2010. Deterministic sensitivity analyses were conducted, as well as a first-order Monte Carlo simulation to confirm cost differences between the two strategies. The conservative short-term imaging follow-up strategy ($639.55 average cost per patient) was the most economical strategy compared to immediate vacuum-assisted core biopsy ($879.55 average cost per patient). Sensitivity analyses demonstrated that the preferred strategy is most dependent on the probabilities of detecting change in appearance on follow-up ultrasound, having a benign finding on immediate core biopsy, and finding cancer on a biopsy triggered by an interval change in ultrasound appearance. The model was also sensitive to the costs of vacuum-assisted core biopsy and diagnostic ultrasound. Conservative imaging follow-up of BIRADS 3 breast masses by ultrasound is cost saving compared to immediate vacuum-assisted core biopsy, with a potential of saving more than one-third of overall costs associated with the diagnostic work-up of such lesions. Watchful waiting with short-term interval follow-up ultrasounds will spare women from unnecessary procedures and spare the United States health care system from unnecessary direct health care costs. © 2012 Wiley Periodicals, Inc.

  11. Phased-array ultrasound technology enhances accuracy of dual frequency ultrasound measurements - towards improved ultrasound bone diagnostics.

    PubMed

    Linder, Hans; Malo, Markus K H; Liukkonen, Jukka; Jurvelin, Jukka S; Töyräs, Juha

    2016-08-01

    Overlying soft tissues attenuate ultrasound backscattered from bone, complicating diagnostics of osteoporosis at the most important fracture sites. Dual-frequency ultrasound technique (DFUS) has been proposed to solve this problem through determination of thickness and composition of overlying soft tissue. This study applies DFUS technique for the first time with a phased-array transducer to investigate if the thickness of two interfering layers (oil and water) can be accurately determined in a variety of configurations. Results indicate that DFUS may be used with phased-array ultrasound systems, making them a suitable combination to consider in future development of clinical in vivo ultrasound methodologies.

  12. Assessing the Risks for Modern Diagnostic Ultrasound Imaging

    NASA Astrophysics Data System (ADS)

    William, Jr.

    1998-05-01

    Some 35 years after Paul-Jacques and Pierre Curie discovered piezoelectricity, ultrasonic imaging was developed by Paul Langevin. During this work, ultrasonic energy was observed to have a detrimental biological effect. These observations were confirmed a decade later by R. W. Wood and A. L. Loomis. It was not until the early 1950s that ultrasonic exposure conditions were controlled and specified so that studies could focus on the mechanisms by which ultrasound influenced biological materials. In the late 1940s, pioneering work was initiated to image the human body by ultrasonic techniques. These engineers and physicians were aware of the deleterious ultrasound effects at sufficiently high levels; this endeavored them to keep the exposure levels reasonably low. Over the past three decades, diagnostic ultrasound has become a sophisticated technology. Yet, our understanding of the potential risks has not changed appreciably. It is very encouraging that human injury has never been attributed to clinical practice of diagnostic ultrasound.

  13. Role of diagnostic ultrasound in the assessment of musculoskeletal diseases

    PubMed Central

    Patil, Pravin

    2012-01-01

    The wide availability and recent improvement in technology coupled with portability, low cost and safety makes ultrasound the first choice imaging investigation for the evaluation of musculoskeletal diseases. Diagnostic use of ultrasound findings is greatly enhanced by knowledge of the clinical presentation. Conversely, ultrasound skills with its prerequisite anatomical knowledge make the clinical diagnosis more precise and reduce uncertainty in the choice of therapy. Therefore, it is essential for rheumatologists to acquire ultrasonography skills in order to improve patient care. Ultrasound examination provides an excellent opportunity for patient education and to explain the rationale for therapy. This review summarizes the indications for musculoskeletal ultrasound and describes its role in diagnosis, monitoring and prognosis. PMID:23024711

  14. Dependence of thresholds for pulmonary capillary hemorrhage on diagnostic ultrasound frequency.

    PubMed

    Miller, Douglas L; Dou, Chunyan; Raghavendran, Krishnan

    2015-06-01

    Pulmonary ultrasound examination has become routine for diagnosis in many clinical and point-of-care medical settings. However, the phenomenon of pulmonary capillary hemorrhage (PCH) induction during diagnostic ultrasound imaging presents a poorly understood risk factor. PCH was observed in anesthetized rats exposed to 1.5-, 4.5- and 12.0-MHz diagnostic ultrasound to investigate the frequency dependence of PCH thresholds. PCH was detected in the ultrasound images as growing comet tail artifacts and was assessed using photographs of the surface of excised lungs. Previous photographs acquired after exposure to 7.6-MHz diagnostic ultrasound were included for analysis. In addition, at each frequency we measured dosimetric parameters, including peak rarefactional pressure amplitude and spatial peak, pulse average intensity attenuated by rat chest wall samples. Peak rarefactional pressure amplitude thresholds determined at each frequency, based on the proportion of PCH in groups of five rats, were 1.03 ± 0.02, 1.28 ± 0.14, 1.18 ± 0.12 and 1.36 ± 0.15 MPa at 1.5, 4.5, 7.6 and 12.0 MHz, respectively. Although the PCH lesions decreased in size with increasing ultrasonic frequency, owing to the smaller beam widths and scan lengths, the peak rarefactional pressure amplitude thresholds remained approximately constant. This dependence was different from that of the mechanical index, which indicates a need for a specific dosimetric parameter for safety guidance in pulmonary ultrasound.

  15. Diagnostic ultrasound at MACH 20: retroperitoneal and pelvic imaging in space.

    PubMed

    Jones, J A; Sargsyan, A E; Barr, Y R; Melton, S; Hamilton, D R; Dulchavsky, S A; Whitson, P A

    2009-07-01

    An operationally available diagnostic imaging capability augments spaceflight medical support by facilitating the diagnosis, monitoring and treatment of medical or surgical conditions, by improving medical outcomes and, thereby, by lowering medical mission impacts and the probability of crew evacuation due to medical causes. Microgravity-related physiological changes occurring during spaceflight can affect the genitourinary system and potentially cause conditions such as urinary retention or nephrolithiasis for which ultrasonography (U/S) would be a useful diagnostic tool. This study describes the first genitourinary ultrasound examination conducted in space, and evaluates image quality, frame rate, resolution requirements, real-time remote guidance of nonphysician crew medical officers and evaluation of on-orbit tools that can augment image acquisition. A nonphysician crew medical officer (CMO) astronaut, with minimal training in U/S, performed a self-examination of the genitourinary system onboard the International Space Station, using a Philips/ATL Model HDI-5000 ultrasound imaging unit located in the International Space Station Human Research Facility. The CMO was remotely guided by voice commands from experienced, earth-based sonographers stationed in Mission Control Center in Houston. The crewmember, with guidance, was able to acquire all of the target images. Real-time and still U/S images received at Mission Control Center in Houston were of sufficient quality for the images to be diagnostic for multiple potential genitourinary applications. Microgravity-based ultrasound imaging can provide diagnostic quality images of the retroperitoneum and pelvis, offering improved diagnosis and treatment for onboard medical contingencies. Successful completion of complex sonographic examinations can be obtained even with minimally trained nonphysician ultrasound operators, with the assistance of ground-based real-time guidance.

  16. Optoelectronic tweezers for medical diagnostics

    NASA Astrophysics Data System (ADS)

    Kremer, Clemens; Neale, Steven; Menachery, Anoop; Barrett, Mike; Cooper, Jonathan M.

    2012-01-01

    Optoelectronic tweezers (OET) allows the spatial patterning of electric fields through selected illumination of a photoconductive surface. This enables the manipulation of micro particles and cells by creating non-uniform electrical fields that then produce dielectrophoretic (DEP) forces. The DEP responses of cells differ and can produce negative or positive (repelled or attracted to areas of high electric field) forces. Therefore OET can be used to manipulate individual cells and separate different cell types from each other. Thus OET has many applications for medical diagnostics, demonstrated here with work towards diagnosing Human African Trypanosomiasis, also known as sleeping sickness.

  17. Uncertainty evaluation of dead zone of diagnostic ultrasound equipment

    NASA Astrophysics Data System (ADS)

    Souza, R. M.; Alvarenga, A. V.; Braz, D. S.; Petrella, L. I.; Costa-Felix, R. P. B.

    2016-07-01

    This paper presents a model for evaluating measurement uncertainty of a feature used in the assessment of ultrasound images: dead zone. The dead zone was measured by two technicians of the INMETRO's Laboratory of Ultrasound using a phantom and following the standard IEC/TS 61390. The uncertainty model was proposed based on the Guide to the Expression of Uncertainty in Measurement. For the tested equipment, results indicate a dead zone of 1.01 mm, and based on the proposed model, the expanded uncertainty was 0.17 mm. The proposed uncertainty model contributes as a novel way for metrological evaluation of diagnostic imaging by ultrasound.

  18. Using Ultrasound to Teach Medical Students Cardiac Physiology

    ERIC Educational Resources Information Center

    Bell, Floyd E., III; Wilson, L. Britt; Hoppmann, Richard A.

    2015-01-01

    Ultrasound is being incorporated more into undergraduate medical education. Studies have shown that medical students have positive perceptions about the value of ultrasound in teaching courses like anatomy and physiology. The purpose of the present study was to provide objective evidence of whether ultrasound helps students learn cardiac…

  19. Using Ultrasound to Teach Medical Students Cardiac Physiology

    ERIC Educational Resources Information Center

    Bell, Floyd E., III; Wilson, L. Britt; Hoppmann, Richard A.

    2015-01-01

    Ultrasound is being incorporated more into undergraduate medical education. Studies have shown that medical students have positive perceptions about the value of ultrasound in teaching courses like anatomy and physiology. The purpose of the present study was to provide objective evidence of whether ultrasound helps students learn cardiac…

  20. Wireless medical ultrasound video transmission through noisy channels.

    PubMed

    Panayides, A; Pattichis, M S; Pattichis, C S

    2008-01-01

    Recent advances in video compression such as the current state-of-the-art H.264/AVC standard in conjunction with increasingly available bitrate through new technologies like 3G, and WiMax have brought mobile health (m-Health) healthcare systems and services closer to reality. Despite this momentum towards m-Health systems and especially e-Emergency systems, wireless channels remain error prone, while the absence of objective quality metrics limits the ability of providing medical video of adequate diagnostic quality at a required bitrate. In this paper we investigate different encoding schemes and loss rates in medical ultrasound video transmission and come to conclusions involving efficiency, the trade-off between bitrate and quality, while we highlight the relationship linking video quality and the error ratio of corrupted P and B frames. More specifically, we investigate IPPP, IBPBP and IBBPBBP coding structures under packet loss rates of 2%, 5%, 8% and 10% and derive that the latter attains higher SNR ratings in all tested cases. A preliminary clinical evaluation shows that for SNR ratings higher than 30 db, video diagnostic quality may be adequate, while above 30.5 db the diagnostic information available in the reconstructed ultrasound video is close to that of the original.

  1. Ultrasound in medical education: listening to the echoes of the past to shape a vision for the future.

    PubMed

    Lane, N; Lahham, S; Joseph, L; Bahner, D P; Fox, J C

    2015-10-01

    Ultrasound in medical education has seen a tremendous growth over the last 10-20 years but ultrasound technology has been around for hundreds of years and sound has an even longer scientific history. The development of using sound and ultrasound to understand our body and our surroundings has been a rich part of human history. From the development of materials to produce piezoelectric conductors, ultrasound has been used and improved in many industries and medical specialties. As diagnostic medical ultrasound has improved its resolution and become more portable, various specialties from radiology, cardiology, obstetrics and more recently emergency, critical care and proceduralists have found the added benefits of using ultrasound to safely help patients. The past advancements in technology have established the scaffold for the possibilities of diagnostic ultrasound's use in the present and future. A few medical educators have integrated ultrasound into medical school while a wealth of content exists online for learning ultrasound. Twenty-first century learners prefer blended learning where material can be reviewed online and personalize the education on their own time frame. This material combined with hands-on experience and mentorship can be used to develop learners' aptitude in ultrasound. As educators embrace this ultrasound technology and integrate it throughout the medical education journey, collaboration across specialties will synthesize a clear path forward when needs and resources are paired with vision and a strategic plan.

  2. Resolution enhancement in medical ultrasound imaging

    PubMed Central

    Ploquin, Marie; Basarab, Adrian; Kouamé, Denis

    2015-01-01

    Abstract. Image resolution enhancement is a problem of considerable interest in all medical imaging modalities. Unlike general purpose imaging or video processing, for a very long time, medical image resolution enhancement has been based on optimization of the imaging devices. Although some recent works purport to deal with image postprocessing, much remains to be done regarding medical image enhancement via postprocessing, especially in ultrasound imaging. We face a resolution improvement issue in the case of medical ultrasound imaging. We propose to investigate this problem using multidimensional autoregressive (AR) models. Noting that the estimation of the envelope of an ultrasound radio frequency (RF) signal is very similar to the estimation of classical Fourier-based power spectrum estimation, we theoretically show that a domain change and a multidimensional AR model can be used to achieve super-resolution in ultrasound imaging provided the order is estimated correctly. Here, this is done by means of a technique that simultaneously estimates the order and the parameters of a multidimensional model using relevant regression matrix factorization. Doing so, the proposed method specifically fits ultrasound imaging and provides an estimated envelope. Moreover, an expression that links the theoretical image resolution to both the image acquisition features (such as the point spread function) and a postprocessing feature (the AR model) order is derived. The overall contribution of this work is threefold. First, it allows for automatic resolution improvement. Through a simple model and without any specific manual algorithmic parameter tuning, as is used in common methods, the proposed technique simply and exclusively uses the ultrasound RF signal as input and provides the improved B-mode as output. Second, it allows for the a priori prediction of the improvement in resolution via the knowledge of the parametric model order before actual processing. Finally, to achieve

  3. Resolution enhancement in medical ultrasound imaging.

    PubMed

    Ploquin, Marie; Basarab, Adrian; Kouamé, Denis

    2015-01-01

    Image resolution enhancement is a problem of considerable interest in all medical imaging modalities. Unlike general purpose imaging or video processing, for a very long time, medical image resolution enhancement has been based on optimization of the imaging devices. Although some recent works purport to deal with image postprocessing, much remains to be done regarding medical image enhancement via postprocessing, especially in ultrasound imaging. We face a resolution improvement issue in the case of medical ultrasound imaging. We propose to investigate this problem using multidimensional autoregressive (AR) models. Noting that the estimation of the envelope of an ultrasound radio frequency (RF) signal is very similar to the estimation of classical Fourier-based power spectrum estimation, we theoretically show that a domain change and a multidimensional AR model can be used to achieve super-resolution in ultrasound imaging provided the order is estimated correctly. Here, this is done by means of a technique that simultaneously estimates the order and the parameters of a multidimensional model using relevant regression matrix factorization. Doing so, the proposed method specifically fits ultrasound imaging and provides an estimated envelope. Moreover, an expression that links the theoretical image resolution to both the image acquisition features (such as the point spread function) and a postprocessing feature (the AR model) order is derived. The overall contribution of this work is threefold. First, it allows for automatic resolution improvement. Through a simple model and without any specific manual algorithmic parameter tuning, as is used in common methods, the proposed technique simply and exclusively uses the ultrasound RF signal as input and provides the improved B-mode as output. Second, it allows for the a priori prediction of the improvement in resolution via the knowledge of the parametric model order before actual processing. Finally, to achieve the

  4. Statistical Characterization of the Medical Ultrasound Echo Signals

    PubMed Central

    Cai, Runqiu

    2016-01-01

    Medical ultrasound echo signals provide the basic information for obtaining the ultrasonic image in medical ultrasound technology. The statistics of the ultrasound echo signals reveals the systematic structure of the medical ultrasonic image via analyzing the corresponding statistical distributions. A novel statistical distribution, the ascending order K distribution, was proposed here to model the medical ultrasound echo signals. The ascending order K distribution was developed in light of the statistical analysis of the sequential waveforms in the echo signals. Comparison with the previous statistical distributions was made to verify the superiority of the ascending order K distribution. Further discussion showed the determination of the statistical principles for the ultrasound signals can enhance our understanding of the statistical principles of the ultrasound imaging, and thus, facilitate the optimization of the ultrasound image and the tissue identification in the ultrasound diagnosis. PMID:27991564

  5. Statistical Characterization of the Medical Ultrasound Echo Signals

    NASA Astrophysics Data System (ADS)

    Cai, Runqiu

    2016-12-01

    Medical ultrasound echo signals provide the basic information for obtaining the ultrasonic image in medical ultrasound technology. The statistics of the ultrasound echo signals reveals the systematic structure of the medical ultrasonic image via analyzing the corresponding statistical distributions. A novel statistical distribution, the ascending order K distribution, was proposed here to model the medical ultrasound echo signals. The ascending order K distribution was developed in light of the statistical analysis of the sequential waveforms in the echo signals. Comparison with the previous statistical distributions was made to verify the superiority of the ascending order K distribution. Further discussion showed the determination of the statistical principles for the ultrasound signals can enhance our understanding of the statistical principles of the ultrasound imaging, and thus, facilitate the optimization of the ultrasound image and the tissue identification in the ultrasound diagnosis.

  6. Requirements for dry hard copy in medical diagnostic applications

    NASA Astrophysics Data System (ADS)

    De Langhe, Dirk; De Clerck, Marc; Tytgat, Bart; McLain, Jim; Defieuw, Geert; Verdonck, Emiel

    1996-03-01

    Today, dry process and color printers are more and more common in medical applications. The main applications for these printers are in ultrasound, nuclear medicine, medical imaging workstations and endoscopy. Each of these disciplines has its specific application requirements. Image quality and other considerations with regard to medical applications are discussed. Although the emphasis in medical imaging lies within grayscale imaging, the increased use of techniques such as doppler imaging, power doppler in ultrasound and image processing with workstations, intensify the need for high quality color output on hardcopy. For the radiology department, hardcopy must be of diagnostic quality and suitable for light box viewing. The different criteria to meet these requirements such as resolution, noise, density and physical properties are discussed. Also a short description of the implementation in the Agfa DRYSTAR 2000TM printer and its consumables will be explained. The achieved quality level will be supported by measurements. Starting from specific image processing for grayscale imaging (such as Look Up Tables) and specific imaging processing for color imaging, a new dedicated image processing method for medical dry hard copy will be presented. Both optimal grayscale imaging and color imaging combined are needed in ultrasound. In relation to this item, some non resolved issues will be explained. As a conclusion, a brief presentation of a hospital application test, validating the system for diagnostic purposes is given.

  7. [Economic aspects of ultrasound diagnostics in gastroenterological outpatient care].

    PubMed

    Weidenhiller, S

    2003-04-01

    Due to new examination techniques, the quality of gastroenterological ultrasound diagnostics has improved considerably in the last few years. In the long term these techniques are an indispensable requirement for competent examinations. However, the price of such high-quality apparatus has increased considerably. To ascertain the financial prerequisites for highly specialised ultrasound services in a gastroenterological out-patient department. Systematic determination of costs and income from ultrasound diagnostics within the public health system for the second quarter of 2001 (KV Bayern) and precise definition of the cost of individual services. We apply the results obtained to other settings e.g. in-patient departments. The use of a grade 3 ultrasound appliance (DEGUM criteria) is cost-effective on the basis of 1940 examinations per year within taking a fictitious physician's fee into account. Based on a fee of 50.00 Euros per hour, an examination frequency of 5,834 per year would be required, whereas a fee of 100.00 Euros per hour could not be recovered even by an extremely large number of examinations. The present fee paid by the public health sector does not cover the expenses of a grade 3 ultrasound appliance. We discuss feasible solutions for offering a highly specialized, customer-friendly and cost-effective method for ultrasound examinations within the gastroenterological practice.

  8. Heating of fetal bone by diagnostic ultrasound

    NASA Astrophysics Data System (ADS)

    Doody, Claire

    Most pregnant women in the Western world undergo an ultrasound examination and so it is important to ensure that exposure of the embryo or fetus does not produce unwanted effects. It is known that ultrasound can heat tissue, especially bone, and so this thesis explores the degree to which fetal bone might be heated during a pulsed Doppler examination. This is done both by carrying out measurements and by developing computer models. Thermal measurements on human fetal thoracic vertebrae of gestational age ranging from 14 to 39 weeks are reported. The bone samples were insonated in vitro with an ultrasound beam which had power and intensity values typical of those from a clinical scanner operating in pulsed Doppler mode. Temperature rises ranging from 0.6°C to 1.8°C were observed after five minutes, with approximately 75% of the temperature rise occurring in the first minute. Two approaches to computer modelling are described. These are the heated disc technique, which is commonly used to model the temperature rise generated by an ultrasound beam, and finite element modelling, a more general approach used to obtain solutions to differential equations. The degree to which our limited knowledge of the properties of fetal tissue affect our ability to make accurate predictions of in vivo heating is explored. It is shown that the present uncertainty in the value of the thermal conductivity and attenuation coefficient of fetal bone can lead to significant uncertainty in predictions of heating. The degree to which the simplifications inherent in the heated disc model affect the results will also be discussed. The results from the models are compared with the experimental measurements in order to estimate the attenuation coefficient of the bone.

  9. High-Accuracy Ultrasound Contrast Agent Detection Method for Diagnostic Ultrasound Imaging Systems.

    PubMed

    Ito, Koichi; Noro, Kazumasa; Yanagisawa, Yukari; Sakamoto, Maya; Mori, Shiro; Shiga, Kiyoto; Kodama, Tetsuya; Aoki, Takafumi

    2015-12-01

    An accurate method for detecting contrast agents using diagnostic ultrasound imaging systems is proposed. Contrast agents, such as microbubbles, passing through a blood vessel during ultrasound imaging are detected as blinking signals in the temporal axis, because their intensity value is constantly in motion. Ultrasound contrast agents are detected by evaluating the intensity variation of a pixel in the temporal axis. Conventional methods are based on simple subtraction of ultrasound images to detect ultrasound contrast agents. Even if the subject moves only slightly, a conventional detection method will introduce significant error. In contrast, the proposed technique employs spatiotemporal analysis of the pixel intensity variation over several frames. Experiments visualizing blood vessels in the mouse tail illustrated that the proposed method performs efficiently compared with conventional approaches. We also report that the new technique is useful for observing temporal changes in microvessel density in subiliac lymph nodes containing tumors. The results are compared with those of contrast-enhanced computed tomography.

  10. The prudent use of diagnostic ultrasound. British Institute of Radiology presidential address 1986.

    PubMed

    Wells, P N

    1986-12-01

    Progress in diagnostic ultrasound is driven by the development of new technology. The place of new techniques in diagnostic algorithms has to be determined jointly by radiologists and clinicians and appropriate arrangements have to be made for training. About 30 million pounds per year is currently spent on diagnostic ultrasound in the UK. Diagnostic ultrasound depends on the information obtained as a result of ultrasonic irradiation of the patient. Biological effects, some of which are undesirable, can be produced by ultrasound but there is no evidence that the exposures used in diagnosis carry any risk. In judging whether ultrasonic scanning is appropriate in any particular situation, it is necessary to consider benefits, costs and available resources. The costs include not only the costs of the test but also the cost of any hypothetical ultrasonic hazard and the cost of misdiagnosis. The most prudent use of ultrasound is that which maximises the benefit-total-cost ratio and although this cannot presently be quantified, some of the concepts involved can be understood in terms of the health increment and the health decrement, the latter apparently being equal to zero when the diagnosis is correctly made using contemporary equipment. This approach can be extended to introduce the idea of profit arising from the test. As an example, obstetric ultrasound is considered to be appropriate when there is a medical indication for it. Although routine scanning at 16 weeks of pregnancy has been shown to result in a very large profit, there is still conflicting guidance about its advisability on the grounds of safety and existing accounting systems may restrict access to the profit. In discussing the desirability of ultrasonic scanning, patients can be informed that there is no reason to believe that there are any risks related to ultrasonic exposure. The imminent availability of inexpensive ultrasonic scanners for the layman is a worrying prospect to which the medical

  11. Errors and mistakes in ultrasound diagnostics of the thyroid gland.

    PubMed

    Dobruch-Sobczak, Katarzyna; Jędrzejowski, Maciej; Jakubowski, Wiesław; Trzebińska, Anna

    2014-03-01

    Ultrasound examination of the thyroid gland permits to evaluate its size, echogenicity, margins, and stroma. An abnormal ultrasound image of the thyroid, accompanied by other diagnostic investigations, facilitates therapeutic decision-making. The ultrasound image of a normal thyroid gland does not change substantially with patient's age. Nevertheless, erroneous impressions in thyroid imaging reports are sometimes encountered. These are due to diagnostic pitfalls which cannot be prevented by either the continuing development of the imaging equipment, or the growing experience and skill of the practitioners. Our article discusses the most common mistakes encountered in US diagnostics of the thyroid, the elimination of which should improve the quality of both the ultrasound examination itself and its interpretation. We have outlined errors resulting from a faulty examination technique, the similarity of the neighboring anatomical structures, and anomalies present in the proximity of the thyroid gland. We have also pointed out the reasons for inaccurate assessment of a thyroid lesion image, such as having no access to clinical data or not taking them into account, as well as faulty qualification for a fine needle aspiration biopsy. We have presented guidelines aimed at limiting the number of misdiagnoses in thyroid diseases, and provided sonograms exemplifying diagnostic mistakes.

  12. Unilateral Opening of Rat Blood-Brain Barrier Assisted by Diagnostic Ultrasound Targeted Microbubbles Destruction

    PubMed Central

    Cui, Hai; Zhu, Qiong; Hua, Xing; Xia, Hongmei; Tan, Kaibin; Gao, Yunhua; Zhao, Jing

    2016-01-01

    Objective. Blood-brain barrier (BBB) is a key obstacle that prevents the medication from blood to the brain. Microbubble-enhanced cavitation by focused ultrasound can open the BBB and proves to be valuable in the brain drug delivery. The study aimed to explore the feasibility, efficacy, and safety of unilateral opening of BBB using diagnostic ultrasound targeted microbubbles destruction in rats. Methods. A transtemporal bone irradiation of diagnostic ultrasound and intravenous injection of lipid-coated microbubbles were performed at unilateral hemisphere. Pathological changes were monitored. Evans Blue extravasation grades, extraction from brain tissue, and fluorescence optical density were quantified. Lanthanum nitrate was traced by transmission electron microscopy. Results. After diagnostic ultrasound mediated microbubbles destruction, Evans Blue extravasation and fluorescence integrated optical density were significantly higher in the irradiated hemisphere than the contralateral side (all p < 0.01). Erythrocytes extravasations were demonstrated in the ultrasound-exposed hemisphere (4 ± 1, grade 2) while being invisible in the control side. Lanthanum nitrate tracers leaked through interendothelial cleft and spread to the nerve fiber existed in the irradiation side. Conclusions. Transtemporal bone irradiation under DUS mediated microbubble destruction provides us with a more accessible, safer, and higher selective BBB opening approach in rats, which is advantageous in brain targeted drugs delivery. PMID:27579317

  13. Unilateral Opening of Rat Blood-Brain Barrier Assisted by Diagnostic Ultrasound Targeted Microbubbles Destruction.

    PubMed

    Xu, Yali; Cui, Hai; Zhu, Qiong; Hua, Xing; Xia, Hongmei; Tan, Kaibin; Gao, Yunhua; Zhao, Jing; Liu, Zheng

    2016-01-01

    Objective. Blood-brain barrier (BBB) is a key obstacle that prevents the medication from blood to the brain. Microbubble-enhanced cavitation by focused ultrasound can open the BBB and proves to be valuable in the brain drug delivery. The study aimed to explore the feasibility, efficacy, and safety of unilateral opening of BBB using diagnostic ultrasound targeted microbubbles destruction in rats. Methods. A transtemporal bone irradiation of diagnostic ultrasound and intravenous injection of lipid-coated microbubbles were performed at unilateral hemisphere. Pathological changes were monitored. Evans Blue extravasation grades, extraction from brain tissue, and fluorescence optical density were quantified. Lanthanum nitrate was traced by transmission electron microscopy. Results. After diagnostic ultrasound mediated microbubbles destruction, Evans Blue extravasation and fluorescence integrated optical density were significantly higher in the irradiated hemisphere than the contralateral side (all p < 0.01). Erythrocytes extravasations were demonstrated in the ultrasound-exposed hemisphere (4 ± 1, grade 2) while being invisible in the control side. Lanthanum nitrate tracers leaked through interendothelial cleft and spread to the nerve fiber existed in the irradiation side. Conclusions. Transtemporal bone irradiation under DUS mediated microbubble destruction provides us with a more accessible, safer, and higher selective BBB opening approach in rats, which is advantageous in brain targeted drugs delivery.

  14. American Medical Society for Sports Medicine recommended sports ultrasound curriculum for sports medicine fellowships.

    PubMed

    Finnoff, Jonathan T; Berkoff, David; Brennan, Fred; DiFiori, John; Hall, Mederic M; Harmon, Kimberly; Lavallee, Mark; Martin, Sean; Smith, Jay; Stovak, Mark

    2015-02-01

    The American Medical Society for Sports Medicine (AMSSM) developed a musculoskeletal ultrasound curriculum for sports medicine fellowships in 2010. As the use of diagnostic and interventional ultrasound in sports medicine has evolved, it became clear that the curriculum needed to be updated. Furthermore, the name 'musculoskeletal ultrasound' was changed to 'sports ultrasound' (SPORTS US) to reflect the broad range of diagnostic and interventional applications of ultrasound in sports medicine. This document was created to outline the core competencies of SPORTS US and to provide sports medicine fellowship directors and others interested in SPORTS US education with a guide to create a SPORTS US curriculum. By completing this SPORTS US curriculum, sports medicine fellows and physicians can attain proficiency in the core competencies of SPORTS US required for the practice of sports medicine.

  15. International recommendations and guidelines for the safe use of diagnostic ultrasound in medicine.

    PubMed

    Barnett, S B; Ter Haar, G R; Ziskin, M C; Rott, H D; Duck, F A; Maeda, K

    2000-03-01

    Modern sophisticated ultrasonographic equipment is capable of delivering substantial levels of acoustic energy into the body when used at maximum outputs. The risk of producing bioeffects has been studied by international expert groups during symposia supported by the World Federation for Ultrasound in Medicine and Biology (WFUMB). These have resulted in the publication of internationally accepted conclusions and recommendations. National ultrasound safety committees have published guidelines as well. These recommendations and safety guidelines offer valuable information to help users apply diagnostic ultrasound in a safe and effective manner. Acoustic output from ultrasound medical devices is directly regulated only in the USA and this is done by the Food and Drug Administration (FDA). However, there is also a modern trend towards self-regulation which has implications for the worldwide use of diagnostic ultrasound. It has resulted in a move away from the relatively simple scheme of FDA-enforced, application-specific limits on acoustic output to a scheme whereby risk of adverse effects of ultrasound exposure is assessed from information provided by the equipment in the form of a real-time display of safety indices. Under this option, the FDA allows a relaxation of some intensity limits, specifically approving the use of medical ultrasound devices that can expose the fetus or embryo to nearly eight times the intensity that was previously allowed. The shift of responsibility for risk assessment from a regulatory authority to the user creates an urgent need for awareness of risk and the development of knowledgeable and responsible attitudes to safety issues. To encourage this approach, it is incumbent on authorities, ultrasound societies and expert groups to provide relevant information on biological effects that might result from ultrasonographic procedures. It is obvious from the continued stream of enquiries received by ultrasound societies that effective

  16. The value of diagnostic medical imaging.

    PubMed

    Bradley, Don; Bradley, Kendall E

    2014-01-01

    Diagnostic medical imaging has clear clinical utility, but it also imposes significant costs on the health care system. This commentary reviews the factors that drive the cost of medical imaging, discusses current interventions, and suggests possible future courses of action.

  17. Sialoendoscopy, sialography, and ultrasound: a comparison of diagnostic methods

    PubMed Central

    Pniak, Tomáš; Štrympl, Pavel; Staníková, Lucia; Zeleník, Karol; Matoušek, Petr

    2016-01-01

    Abstract Objective To compare the accuracy of ultrasound, sialography, and sialendoscopy for examining benign salivary gland obstructions. Methods In this prospective study, patients with symptoms of obstruction of the major salivary gland duct system presenting at the ENT Clinic University Hospital, Ostrava, from June 2010 to December 2013 were included. All patients (n=76) underwent ultrasound, sialography, and sialoendoscopy. The signs of sialolithiasis, ductal stenosis, or normal findings were recorded after the examinations. Statistical analysis of the sensitivity and specificity of all the methods was performed, as well as a comparison of the accuracy of each method for different kinds of pathology (sialolithiasis or stenosis). Results The sensitivity of ultrasound, sialography, and sialoendoscopy for sialolithiasis findings were 71.9%, 86.7 %, and 100%, respectively. The sensitivity of sialography and sialoendoscopy for stenosis of the duct was 69.0%, and 100%, respectively. The study showed impossibility of ultrasonic diagnostics of ductal stenosis. The sensitivity of sialoendoscopy for both pathologies was significantly higher than that from ultrasound or sialography (p<0.05). The specificity of sialoendoscopy was significantly higher than that from by ultrasound or sialography (p<0.05). Conclusion Sialoendoscopy was the most accurate method for examination ductal pathology, with significantly higher sensitivity and specificity than by ultrasound or sialography. PMID:28352836

  18. Advanced ultrasound probes for medical imaging

    NASA Astrophysics Data System (ADS)

    Wildes, Douglas G.; Smith, L. Scott

    2012-05-01

    New medical ultrasound probe architectures and materials build upon established 1D phased array technology and provide improved imaging performance and clinical value. Technologies reviewed include 1.25D and 1.5D arrays for elevation slice thickness control; electro-mechanical and 2D array probes for real-time 3D imaging; catheter probes for imaging during minimally-invasive procedures; single-crystal piezoelectric materials for greater frequency bandwidth; and cMUT arrays using silicon MEMS in place of piezo materials.

  19. Virtual guidance as a tool to obtain diagnostic ultrasound for spaceflight and remote environments.

    PubMed

    Martin, David S; Caine, Timothy L; Matz, Timothy; Lee, Stuart M C; Stenger, Michael B; Sargsyan, Ashot E; Platts, Steven H

    2012-10-01

    With missions planned to travel greater distances from Earth at ranges that make real-time two-way communication impractical, astronauts will be required to perform autonomous medical diagnostic procedures during future exploration missions. Virtual guidance is a form of just-in-time training developed to allow novice ultrasound operators to acquire diagnostically-adequate images of clinically relevant anatomical structures using a prerecorded audio/visual tutorial viewed in real-time. Individuals without previous experience in ultrasound were recruited to perform carotid artery (N = 10) and ophthalmic (N = 9) ultrasound examinations using virtual guidance as their only training tool. In the carotid group, each untrained operator acquired two-dimensional, pulsed and color Doppler of the carotid artery. In the ophthalmic group, operators acquired representative images of the anterior chamber of the eye, retina, optic nerve, and nerve sheath. Ultrasound image quality was evaluated by independent imaging experts. Of the studies, 8 of the 10 carotid and 17 of 18 of the ophthalmic images (2 images collected per study) were judged to be diagnostically adequate. The quality of all but one of the ophthalmic images ranged from adequate to excellent. Diagnostically-adequate carotid and ophthalmic ultrasound examinations can be obtained by previously untrained operators with assistance from only an audio/video tutorial viewed in real time while scanning. This form of just-in-time training, which can be applied to other examinations, represents an opportunity to acquire important information for NASA flight surgeons and researchers when trained medical personnel are not available or when remote guidance is impractical.

  20. High definition ultrasound imaging for battlefield medical applications

    SciTech Connect

    Kwok, K.S.; Morimoto, A.K.; Kozlowski, D.M.; Krumm, J.C.; Dickey, F.M.; Rogers, B; Walsh, N.

    1996-06-23

    A team has developed an improved resolution ultrasound system for low cost diagnostics. This paper describes the development of an ultrasound based imaging system capable of generating 3D images showing surface and subsurface tissue and bone structures. We include results of a comparative study between images obtained from X-Ray Computed Tomography (CT) and ultrasound. We found that the quality of ultrasound images compares favorably with those from CT. Volumetric and surface data extracted from these images were within 7% of the range between ultrasound and CT scans. We also include images of porcine abdominal scans from two different sets of animal trials.

  1. Characterization of various tissue mimicking materials for medical ultrasound imaging

    NASA Astrophysics Data System (ADS)

    Thouvenot, Audrey; Poepping, Tamie; Peters, Terry M.; Chen, Elvis C. S.

    2016-04-01

    Tissue mimicking materials are physical constructs exhibiting certain desired properties, which are used in machine calibration, medical imaging research, surgical planning, training, and simulation. For medical ultrasound, those specific properties include acoustic propagation speed and attenuation coefficient over the diagnostic frequency range. We investigated the acoustic characteristics of polyvinyl chloride (PVC) plastisol, polydimethylsiloxane (PDMS), and isopropanol using a time-of-light technique, where a pulse was passed through a sample of known thickness contained in a water bath. The propagation speed in PVC is approximately 1400ms-1 depending on the exact chemical composition, with the attenuation coefficient ranging from 0:35 dB cm-1 at 1MHz to 10:57 dB cm-1 at 9 MHz. The propagation speed in PDMS is in the range of 1100ms-1, with an attenuation coefficient of 1:28 dB cm-1 at 1MHz to 21:22 dB cm-1 at 9 MHz. At room temperature (22 °C), a mixture of water-isopropanol (7:25% isopropanol by volume) exhibits a propagation speed of 1540ms-1, making it an excellent and inexpensive tissue-mimicking liquid for medical ultrasound imaging.

  2. Bone Composition Diagnostics: Photoacoustics Versus Ultrasound

    NASA Astrophysics Data System (ADS)

    Yang, Lifeng; Lashkari, Bahman; Mandelis, Andreas; Tan, Joel W. Y.

    2015-06-01

    Ultrasound (US) backscatter from bones depends on the mechanical properties and the microstructure of the interrogated bone. On the other hand, photoacoustics (PA) is sensitive to optical properties of tissue and can detect composition variation. Therefore, PA can provide complementary information about bone health and integrity. In this work, a comparative study of US backscattering and PA back-propagating signals from animal trabecular bones was performed. Both methods were applied using a linear frequency modulation chirp and matched filtering. A 2.2 MHz ultrasonic transducer was employed to detect both signals. The use of the frequency domain facilitates spectral analysis. The variation of signals shows that in addition to sensitivity to mineral changes, PA exhibits sensitivity to changes in the organic part of the bone. It is, therefore, concluded that the combination of both modalities can provide complementary detailed information on bone health than either method separately. In addition, comparison of PA and US depthwise images shows the higher penetration of US. Surface scan images exhibit very weak correlation between US and PA which could be caused by the different signal generation origins in mechanical versus optical properties, respectively.

  3. Diagnostic considerations for the medically complex patient.

    PubMed

    D'Ambrosio, J A; Raborn, G W

    1992-10-01

    As advances in medical diagnostic and treatment modalities continue to increase the life expectancy of the population, the likelihood of encountering patients in dental practice with concomitant medical problems will also rise. Thus it will become increasingly important for practicing dentists to take thorough medical histories, recognize signs of systemic disorders, and work closely with their medical colleagues to ensure that safe dental care is rendered to these medically complex patients. Although acutely ill or severely compromised individuals may be best treated in a hospital setting by those with special training, all dental practitioners should possess the diagnostic and communicative skills needed to manage those who are receiving out-patient medical care.

  4. Diagnostic Imaging in the Medical Support of the Future Missions to the Moon

    NASA Technical Reports Server (NTRS)

    Sargsyan, Ashot E.; Jones, Jeffrey A.; Hamilton, Douglas R.; Dulchavsky, Scott A.; Duncan, J. Michael

    2007-01-01

    This viewgraph presentation is a course that reviews the diagnostic imaging techniques available for medical support on the future moon missions. The educational objectives of the course are to: 1) Update the audience on the curreultrasound imaging in space flight; 2) Discuss the unique aspects of conducting ultrasound imaging on ISS, interplanetary transit, ultrasound imaging on ISS, interplanetary transit, and lunar surface operations; and 3) Review preliminary data obtained in simulations of medical imaging in lunar surface operations.

  5. Transient Cavitation Induced by High Amplitude Diagnostic Ultrasound.

    NASA Astrophysics Data System (ADS)

    Ayme, Eveline J.

    1988-07-01

    Study of the response of gaseous microbubbles to medical ultrasound is essential to apprehend the potentially dangerous effects of transient cavitation on living tissues. However, the prediction of such response is complicated by the finite -amplitude distortion associated with high amplitude acoustic fields. Through a combination of theoretical developments, computer simulations, and experiments, this dissertation investigates the consequences of the interaction between finite-amplitude distortion and transient cavitation, in the context of a diagnostic ultrasonic field. The theoretical approach is to synthesize the asymmetry between compression and rarefaction half-cycles which characterizes a typical nonlinearly distorted pulse obtained at the focus of a diagnostic transducer immersed in water. The synthetic pulse is used to drive a theoretical model for nonlinear bubble dynamics. Comparison with sinusoidal pulses "equivalent" to the distorted pulse as measured by a selection of descriptive parameters shows that: (i) the peak-positive pressure (P_{+} ) in the distorted pulse is a very poor predictor of transient cavitation, (ii) the peak-negative pressure (P_{-}) is a better indicator but underestimates the actual bubble response, (iii) the best predictor is the pressure amplitude of the fundamental (P_{F}) in a Fourier series representation of the distorted pulse. These predictions are tested experimentally on Drosophila larvae. The larvae are exposed to pulsed, symmetric, sinusoidal fields and to pulsed, asymmetric, distorted fields. The killing ratio of the larvae is plotted as a function of the same selection of descriptive parameters, namely P_{+}, P_{ -}, and P_{F}. The resulting curves are compared with the killing ratio plotted against the peak pressure in the sinusoidal, undistorted pulse (P_{A}). If the distorted pulse is described in terms of P_ {-} or P_{+} , the killing ratios are significantly different; if the distorted pulse is described in terms

  6. Direct effect of diagnostic ultrasound on genetically interesting molecules

    SciTech Connect

    Ciatti, S.; Domokos, G.; Koevesi-Domokos, S.; Milano, F.

    1981-01-01

    Ultrasound is a non-ionizing radiation and at typical intensities used in diagnostic sonography, macroscopic damage to tissues is negligible. Some recent experiments, however, provided evidence for possible genetic damage caused by relatively low-intensity ultrasound irradiation. Although the implications of such experiments concerning possible genetic damage caused by low intensity ultrasound irradiation are not yet completely understood, the very existence of such results raises an important theoretical question. Is it possible that a non-ionizing radiation can cause significant changes in the structure of a typical DNA molecule. Several mechanisms exist which are responsible for such changes including: (1) structural changes in the molecule due to sound absorption from a high harmonic of the repetition frequency of a pulsed ultrasound radiation; (2) structural changes due to multi-phonon absorption from low harmonics of the repetition frequency; and (3) break-up of the molecule as a consequence of the excitation of collective vibrations. The calculations presented suggest that, should damage to DNA in vitro caused by low-intensity ultrasound be confirmed beyond reasonable doubt, such catastrophic changes in the structure of DNA molecules are more likely to arise as a result of their collective modes rather than from a localizable breakup of some hydrogen bonds. (ERB)

  7. Ethical analysis of non-medical fetal ultrasound.

    PubMed

    Leung, John Lai Yin; Pang, Samantha Mei Che

    2009-09-01

    Obstetric ultrasound is the well-recognized prenatal test used to visualize and determine the condition of a pregnant woman and her fetus. Apart from the clinical application, some businesses have started promoting the use of fetal ultrasound machines for nonmedical reasons. Non-medical fetal ultrasound (also known as 'keepsake' ultrasound) is defined as using ultrasound to view, take a picture, or determine the sex of a fetus without a medical indication. Notwithstanding the guidelines and warnings regarding ultrasound safety issued by governments and professional bodies, the absence of scientifically proven physical harm to fetuses from this procedure seems to provide these businesses with grounds for rapid expansion. However, this argument is too simplistic because current epidemiological evidence is not synchronous with advancing ultrasound technology. As non-medical fetal ultrasound has aroused very significant public attention, a thorough ethical analysis of this topic is essential. Using a multifaceted approach, we analyse the ethical perspective of non-medical fetal ultrasound in terms of the expectant mother, the fetus and health professionals. After applying four major theories of ethics and principles (the precautionary principle; theories of consequentialism and impartiality; duty-based theory; and rights-based theories), we conclude that obstetric ultrasound practice is ethically justifiable only if the indication for its use is based on medical evidence. Non-medical fetal ultrasound can be considered ethically unjustifiable. Nevertheless, the ethical analysis of this issue is time dependent owing to rapid advancements in ultrasound technology and the safety issue. The role of health professionals in ensuring that obstetric ultrasound is an ethically justifiable practice is also discussed.

  8. Medical ultrasound - From inner space to outer space

    NASA Technical Reports Server (NTRS)

    Rooney, J. A.

    1984-01-01

    During the last decade, medical ultrasound has rapidly become a widely accepted imaging modality used in many medical specialties. It has the advantages that it is noninvasive, does not use ionizing radiation, is relatively inexpensive and is easy to use. Future trends in ultrasound include expanded areas of use, advanced signal processing and digital image analysis including tissue characterization and three-dimensional reconstructions.

  9. The Dependence of Thresholds for Pulmonary Capillary Hemorrhage on Diagnostic Ultrasound Frequency

    PubMed Central

    Miller, Douglas L.; Dou, Chunyan; Raghavendran, Krishnan

    2015-01-01

    Pulmonary ultrasound examination has become routine for diagnosis in many clinical and point-of-care medical settings. However, the phenomenon of pulmonary capillary hemorrhage (PCH) induction during diagnostic ultrasound imaging presents a poorly understood risk factor. PCH was observed for 1.5 MHz, 4.5 MHz and 12.0 MHz diagnostic ultrasound of anesthetized rats to investigate the frequency dependence of PCH thresholds. PCH was detected in the ultrasound images as growing comet tail artifacts, and assessed using photographs of the surface of excised lungs. Previous photographs acquired with 7.6 MHz diagnostic ultrasound were also included for analysis. In addition, dosimetric parameters were measured at each frequency, including peak rarefactional pressure amplitudes (PRPA) and spatial peak pulse-average (SPPA) intensities attenuated by rat chest-wall samples. PRPA thresholds were determined at each frequency, based on the proportion of PCH occurrence in groups of 5 rats, and were 1.03 ± 0.02 MPa, 1.28 ± 0.14 MPa, 1.18 ± 0.12 MPa and 1.36 ± 0.15 MPa at 1.5, 4.5, 7.6 and 12.0 MHz, respectively. Although the PCH lesions decreased in size with increasing ultrasonic frequency, owing to the smaller beam widths and scan lengths, the PRPA thresholds remained approximately constant. This dependence was different from that of the Mechanical Index, which indicates a need for a specific dosimetric parameter for safety guidance in pulmonary ultrasound. PMID:25746909

  10. American Medical Society for Sports Medicine (AMSSM) position statement: interventional musculoskeletal ultrasound in sports medicine.

    PubMed

    Finnoff, Jonathan T; Hall, Mederic M; Adams, Erik; Berkoff, David; Concoff, Andrew L; Dexter, William; Smith, Jay

    2015-02-01

    The use of diagnostic and interventional ultrasound has significantly increased over the past decade. A majority of the increased utilization is by nonradiologists. In sports medicine, ultrasound is often used to guide interventions such as aspirations, diagnostic or therapeutic injections, tenotomies, releases, and hydrodissections. This American Medical Society for Sports Medicine (AMSSM) position statement critically reviews the literature and evaluates the accuracy, efficacy, and cost-effectiveness of ultrasound-guided injections in major, intermediate, and small joints, and soft tissues, all of which are commonly performed in sports medicine. New ultrasound-guided procedures and future trends are also briefly discussed. Based upon the evidence, the official AMSSM position relevant to each subject is made.

  11. American Medical Society for Sports Medicine position statement: interventional musculoskeletal ultrasound in sports medicine.

    PubMed

    Finnoff, Jonathan T; Hall, Mederic M; Adams, Erik; Berkoff, David; Concoff, Andrew L; Dexter, William; Smith, Jay

    2015-01-01

    The use of diagnostic and interventional ultrasound has significantly increased over the past decade. A majority of the increased utilization is by nonradiologists. In sports medicine, ultrasound is often used to guide interventions such as aspirations, diagnostic or therapeutic injections, tenotomies, releases, and hydrodissections. This American Medical Society for Sports Medicine (AMSSM) position statement critically reviews the literature and evaluates the accuracy, efficacy, and cost-effectiveness of ultrasound-guided injections in major, intermediate, and small joints, and soft tissues, all of which are commonly performed in sports medicine. New ultrasound-guided procedures and future trends are also briefly discussed. Based on the evidence, the official AMSSM position relevant to each subject is made.

  12. Chest Ultrasound Integrated Teaching of Respiratory System Physiology to Medical Students: A First Experience

    ERIC Educational Resources Information Center

    Paganini, M.; Rubini, A.

    2015-01-01

    Ultrasound imaging is a useful diagnostic technique that has spread among several different medical specialties within the last few years. Initially restricted to radiology, cardiology, obstetrics, and gynecology, today it is widely used by many specialists, especially in critical care. New graduate physicians will need to be comfortable with…

  13. Chest Ultrasound Integrated Teaching of Respiratory System Physiology to Medical Students: A First Experience

    ERIC Educational Resources Information Center

    Paganini, M.; Rubini, A.

    2015-01-01

    Ultrasound imaging is a useful diagnostic technique that has spread among several different medical specialties within the last few years. Initially restricted to radiology, cardiology, obstetrics, and gynecology, today it is widely used by many specialists, especially in critical care. New graduate physicians will need to be comfortable with…

  14. Prehospital stroke diagnostics based on neurological examination and transcranial ultrasound.

    PubMed

    Herzberg, Moriz; Boy, Sandra; Hölscher, Thilo; Ertl, Michael; Zimmermann, Markus; Ittner, Karl-Peter; Pemmerl, Josef; Pels, Hendrik; Bogdahn, Ulrich; Schlachetzki, Felix

    2014-02-27

    Transcranial color-coded sonography (TCCS) has proved to be a fast and reliable tool for the detection of middle cerebral artery (MCA) occlusions in a hospital setting. In this feasibility study on prehospital sonography, our aim was to investigate the accuracy of TCCS for neurovascular emergency diagnostics when performed in a prehospital setting using mobile ultrasound equipment as part of a neurological examination. Following a '911 stroke code' call, stroke neurologists experienced in TCCS rendezvoused with the paramedic team. In patients with suspected stroke, TCCS examination including ultrasound contrast agents was performed. Results were compared with neurovascular imaging (CTA, MRA) and the final discharge diagnosis from standard patient-centered stroke care. We enrolled '232 stroke code' patients with follow-up data available in 102 patients with complete TCCS examination. A diagnosis of ischemic stroke was made in 73 cases; 29 patients were identified as 'stroke mimics'. MCA occlusion was diagnosed in ten patients, while internal carotid artery (ICA) occlusion/high-grade stenosis leading to reversal of anterior cerebral artery flow was diagnosed in four patients. The initial working diagnosis 'any stroke' showed a sensitivity of 94% and a specificity of 48%. 'Major MCA or ICA stroke' diagnosed by mobile ultrasound showed an overall sensitivity of 78% and specificity of 98%. The study demonstrates the feasibility and high diagnostic accuracy of emergency transcranial ultrasound assessment combined with neurological examinations for major ischemic stroke. Future combination with telemedical support, point-of-care analysis of blood serum markers, and probability algorithms of prehospital stroke diagnosis including ultrasound may help to speed up stroke treatment.

  15. Prehospital stroke diagnostics based on neurological examination and transcranial ultrasound

    PubMed Central

    2014-01-01

    Background Transcranial color-coded sonography (TCCS) has proved to be a fast and reliable tool for the detection of middle cerebral artery (MCA) occlusions in a hospital setting. In this feasibility study on prehospital sonography, our aim was to investigate the accuracy of TCCS for neurovascular emergency diagnostics when performed in a prehospital setting using mobile ultrasound equipment as part of a neurological examination. Methods Following a ‘911 stroke code’ call, stroke neurologists experienced in TCCS rendezvoused with the paramedic team. In patients with suspected stroke, TCCS examination including ultrasound contrast agents was performed. Results were compared with neurovascular imaging (CTA, MRA) and the final discharge diagnosis from standard patient-centered stroke care. Results We enrolled ‘232 stroke code’ patients with follow-up data available in 102 patients with complete TCCS examination. A diagnosis of ischemic stroke was made in 73 cases; 29 patients were identified as ‘stroke mimics’. MCA occlusion was diagnosed in ten patients, while internal carotid artery (ICA) occlusion/high-grade stenosis leading to reversal of anterior cerebral artery flow was diagnosed in four patients. The initial working diagnosis ‘any stroke’ showed a sensitivity of 94% and a specificity of 48%. ‘Major MCA or ICA stroke’ diagnosed by mobile ultrasound showed an overall sensitivity of 78% and specificity of 98%. Conclusions The study demonstrates the feasibility and high diagnostic accuracy of emergency transcranial ultrasound assessment combined with neurological examinations for major ischemic stroke. Future combination with telemedical support, point-of-care analysis of blood serum markers, and probability algorithms of prehospital stroke diagnosis including ultrasound may help to speed up stroke treatment. PMID:24572006

  16. Introduction of Basic Dermatologic Ultrasound in Undergraduate Medical Education.

    PubMed

    Alfageme, F; Cerezo, E; Fernandez, I S; Aguilo, R; Vilas-Sueiro, A; Roustan, G

    2016-11-01

    Purpose: Teaching ultrasound procedures to undergraduates has recently been proposed to improve the quality of medical education. We address the impact of applying standardized dermatologic ultrasound teaching to our undergraduates. Materials and Methods: Medical students were offered an additional theoretical and practical seminar involving hands-on ultrasound dermatologic ultrasound during their mandatory dermatology practical training. The students' theoretical knowledge and dermatologic ultrasoud skills were tested with a multiple choice questionnaire extracted from Level 1 Spanish Society of Ultrasound Dermatologic Ultrasound accreditation exam before and after the course. After the course, the students were asked to answer a course evaluation questionnaire Results: The multiple-choice question scores after the course showed statistically significant improvement (5.82 vs. 8.71%; P<0.001). The questionnaire revealed that students were satisfied with the course, felt that it increased both their dermatologic and ultrasound knowledge, and indicated that they wanted more sonographic hands-on training in both dermatologic ultrasound and other medical fields. Conclusion: Using both objective and subjective methods, we showed that the introduction of standardized ultrasound training programs in undergraduate medical education can improve both students' understanding of the technique and the quality of medical education in dermatology.

  17. Introduction of Basic Dermatologic Ultrasound in Undergraduate Medical Education

    PubMed Central

    Alfageme, F.; Cerezo, E.; Fernandez, I. S.; Aguilo, R.; Vilas-Sueiro, A.; Roustan, G.

    2016-01-01

    Purpose: Teaching ultrasound procedures to undergraduates has recently been proposed to improve the quality of medical education. We address the impact of applying standardized dermatologic ultrasound teaching to our undergraduates. Materials and Methods: Medical students were offered an additional theoretical and practical seminar involving hands-on ultrasound dermatologic ultrasound during their mandatory dermatology practical training. The students’ theoretical knowledge and dermatologic ultrasoud skills were tested with a multiple choice questionnaire extracted from Level 1 Spanish Society of Ultrasound Dermatologic Ultrasound accreditation exam before and after the course. After the course, the students were asked to answer a course evaluation questionnaire Results: The multiple-choice question scores after the course showed statistically significant improvement (5.82 vs. 8.71%; P<0.001). The questionnaire revealed that students were satisfied with the course, felt that it increased both their dermatologic and ultrasound knowledge, and indicated that they wanted more sonographic hands-on training in both dermatologic ultrasound and other medical fields. Conclusion: Using both objective and subjective methods, we showed that the introduction of standardized ultrasound training programs in undergraduate medical education can improve both students’ understanding of the technique and the quality of medical education in dermatology. PMID:27933321

  18. Diagnostic Medical Sonographers: Seeing with Sound.

    ERIC Educational Resources Information Center

    Lacey, Alan

    2001-01-01

    Explains how diagnostic medical sonographers use special equipment to direct high frequency sound waves into areas of a patient's body. Describes specialties within the occupation, working conditions, employment and outlook, earnings, and necessary training and qualifications. (JOW)

  19. Noninvasive Medical Diagnostics & Treatment Using Ultrasonics

    NASA Technical Reports Server (NTRS)

    Bar-Cohen, Y.; Siegel, R.; Grandia, W.

    1998-01-01

    In parallel to the industrial application of NDE to flaw detection and material property determination, the medical community has succesfully adapted such methods to the noninvasaive diagnostics and treatment of many conditions and disorders of the human body.

  20. Diagnostic Medical Sonographers: Seeing with Sound.

    ERIC Educational Resources Information Center

    Lacey, Alan

    2001-01-01

    Explains how diagnostic medical sonographers use special equipment to direct high frequency sound waves into areas of a patient's body. Describes specialties within the occupation, working conditions, employment and outlook, earnings, and necessary training and qualifications. (JOW)

  1. Noninvasive Medical Diagnostics & Treatment Using Ultrasonics

    NASA Technical Reports Server (NTRS)

    Bar-Cohen, Y.; Siegel, R.; Grandia, W.

    1998-01-01

    In parallel to the industrial application of NDE to flaw detection and material property determination, the medical community has succesfully adapted such methods to the noninvasaive diagnostics and treatment of many conditions and disorders of the human body.

  2. 78 FR 32612 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-31

    ... TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR Part 1195 RIN 3014-AA40 Medical Diagnostic Equipment.... ACTION: Notice of advisory committee meeting. SUMMARY: The Medical Diagnostic Equipment Accessibility... previously published Notice of Proposed Rulemaking (NPRM) on Medical Diagnostic Equipment...

  3. 78 FR 16448 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-15

    ... TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR Part 1195 RIN 3014-AA40 Medical Diagnostic Equipment.... ACTION: Notice of advisory committee meeting. SUMMARY: The Medical Diagnostic Equipment Accessibility... previously published Notice of Proposed Rulemaking (NPRM) on Medical Diagnostic Equipment...

  4. 77 FR 67595 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-13

    ... TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR Part 1195 RIN 3014-AA40 Medical Diagnostic Equipment.... ACTION: Notice of advisory committee meeting. SUMMARY: The Medical Diagnostic Equipment Accessibility... Rulemaking (NPRM) on Medical Diagnostic Equipment Accessibility Standards. DATES: The Committee will meet...

  5. 78 FR 23872 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-23

    ... TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR Part 1195 RIN 3014-AA40 Medical Diagnostic Equipment.... ACTION: Notice of advisory committee meeting. SUMMARY: The Medical Diagnostic Equipment Accessibility... previously published Notice of Proposed Rulemaking (NPRM) on Medical Diagnostic Equipment...

  6. 78 FR 1166 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-08

    ... TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR Part 1195 RIN 3014-AA40 Medical Diagnostic Equipment.... ACTION: Notice of advisory committee meeting. SUMMARY: The Medical Diagnostic Equipment Accessibility... previously published Notice of Proposed Rulemaking (NPRM) on Medical Diagnostic Equipment...

  7. Munchausen Syndrome by Proxy: Medical Diagnostic Criteria.

    ERIC Educational Resources Information Center

    Rosenberg, Donna Andrea

    2003-01-01

    Medical diagnostic criteria for Munchausen Syndrome by Proxy (a persistent fabrication by one individual of illness in another) are presented. Since the strength of the known facts may vary from case to case, diagnostic criteria are given for a definitive diagnosis, a possible diagnosis, an inconclusive determination, and the definitely excluded…

  8. Biological Signals In Medical Diagnostics

    NASA Astrophysics Data System (ADS)

    Kozlíková, Katarína

    2010-01-01

    Biological signals—biosignals are material carriers of the information about the state of the biological system of interest. They are the basis of all diagnostic methods. This paper gives an overview of biosignals used in medicine, their classification and processing.

  9. Evaluation of chest ultrasound integrated teaching of respiratory system physiology to medical students.

    PubMed

    Paganini, Matteo; Bondì, Michela; Rubini, Alessandro

    2017-12-01

    Ultrasound imaging is a widely used diagnostic technique, whose integration in medical education is constantly growing. The aim of this study was to evaluate chest ultrasound usefulness in teaching respiratory system physiology, students' perception of chest ultrasound integration into a traditional lecture in human physiology, and short-term concept retention. A lecture about respiratory physiology was integrated with ultrasound and delivered to third-year medical students. It included basic concepts of ultrasound imaging and the physiology of four anatomic sectors of the body of a male volunteer, shown with a portable ultrasound device (pleural sliding, diaphragmatic movement, inferior vena cava diameter variations, cardiac movements). Students' perceptions of the integrated lecture were assessed, and attendance recorded. After 4 mo, four multiple-choice questions about respiratory physiology were administered during the normal human physiology examinations, and the results of students who attended the lesson and those of who did not were compared. One hundred thirty-four students attended the lecture. Most of them showed encouragement for the study of the subject and considered the ultrasound integrated lecture more interesting than a traditional one and pertinent to the syllabus. Exposed students achieved a better score at the examination and committed less errors than did nonexposed students. The chest ultrasound integrated lecture was appreciated by students. A possible association between the exposure to the lecture and short-term concept retention is shown by better performances of the exposed cohort at the examination. A systematic introduction of ultrasound into physiology traditional teaching will be promoted by the Ultrasound-Based Medical Education movement. Copyright © 2017 the American Physiological Society.

  10. EFSUMB Statement on Medical Student Education in Ultrasound [long version

    PubMed Central

    Cantisani, V.; Dietrich, C. F.; Badea, R.; Dudea, S.; Prosch, H.; Cerezo, E.; Nuernberg, D.; Serra, A. L.; Sidhu, P. S.; Radzina, M.; Piscaglia, F.; Bachmann Nielsen, M.; Ewertsen, C.; Săftoiu, A.; Calliada, F.; Gilja, O. H.

    2016-01-01

    The European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) recommends that ultrasound should be used systematically as an easy accessible and instructive educational tool in the curriculum of modern medical schools. Medical students should acquire theoretical knowledge of the modality and hands-on training should be implemented and adhere to evidence-based principles. In this paper we report EFSUMB policy statements on medical student education in ultrasound that in a short version is already published in Ultraschall in der Medizin 1. PMID:27689163

  11. Focused Acute Medicine Ultrasound (FAMUS) - point of care ultrasound for the Acute Medical Unit.

    PubMed

    Smallwood, Nicholas; Dachsel, Martin; Matsa, Ramprasad; Tabiowo, Eugene; Walden, Andrew

    2016-01-01

    Point of care ultrasound (POCU) is becoming increasingly popular as an extension to clinical examination techniques. Specific POCU training pathways have been developed in specialties such as Emergency and Intensive Care Medicine (CORE Emergency Ultrasound and Core UltraSound Intensive Care, for example), but until this time there has not been a curriculum for the acutely unwell medical patient outside of Critical Care. We describe the development of Focused Acute Medicine Ultrasound (FAMUS), a curriculum designed specifically for the Acute Physician to learn ultrasound techniques to aid in the management of the unwell adult patient. We detail both the outline of the curriculum and the process involved for a candidate to achieve FAMUS accreditation. It is anticipated this will appeal to both Acute Medical Unit (AMU) clinicians and general physicians who deal with the unwell or deteriorating medical or surgical patient. In time, the aspiration is for FAMUS to become a core part of the AIM curriculum.

  12. [Viability of human cancer cells in culture after exposure to diagnostic ultrasound].

    PubMed

    Farges, M F; Gioanni, J; Bruneton, J N; Costa, A; Lalanne, C M

    1985-01-01

    Reports have appeared in the literature regarding biological damage to human cells following exposure to diagnostic ultrasound. We have examined the effects of diagnostic ultrasound (Sonel 400, C.G.R.) on human cell lines established in our laboratory. We report here that exposure to diagnostic ultrasound, at maximum exposure intensity and at exposure time as long as 60 minutes, produces no cell lysis as determined by vital dye exclusion ability, and as confirmed by electron microscopy. However, the exposure to ultrasound produced by an apparatus delivering an acoustic power higher than the diagnostic levels (Sonoscope-Alcatel) can cause the complete lysis of the same cells.

  13. [Introduction of Prehospital Emergency Ultrasound into an Emergency Medical Service Area].

    PubMed

    Weilbach, C; Kobiella, A; Rahe-Meyer, N; Johanning, K

    2017-01-01

    Emergency ultrasound as part of the provision of emergency medical services using mobile devices offers great benefits regarding to some important questions related to the management of critically ill and injured patients in the prehospital situation where diagnostic resources are limited. The aim of this study is to determine whether the comprehensive introduction of prehospital emergency ultrasound examinations into a German Emergency Medical Services ("rescue services") area is both feasible and beneficial for patients. All emergency physicians at a rural emergency physician base were trained in emergency ultrasound scanning techniques (FAST, FEEL, 14 h of instruction), followed by regular weekly training sessions of approximately 30 min. Over a period of 12 months, prehospital ultrasound examinations performed during emergency physician callouts at this base were documented and analysed. A total of 87 emergency ultrasound examinations were performed during 1343 callouts. Among these, focussed assessment with sonography for trauma (FAST) was performed in 35 patients (40.2%) and focused echocardiography in emergency life support (FEEL) in 41 patients (47.1%). In 11 patients (12.6%), ultrasound scans were performed for other indications (e. g. to rule out urinary tract obstruction in a case of flank pain). One trauma patient's life was saved by the decision to transport him to the nearest hospital and once there directly to the operating room, based on the ultrasound finding of significant free intra-abdominal fluid (ruptured spleen and liver). Prehospital emergency ultrasound can be introduced into an emergency medical service area as a diagnostic modality that provides benefits to patients. Emergency physicians have to be specifically trained and to participate in continuous education activities. Especially in rural areas with longer transport routes and journey times, the early diagnosis of for example massive intra-abdominal bleeding is

  14. Watermarking of ultrasound medical images in teleradiology using compressed watermark.

    PubMed

    Badshah, Gran; Liew, Siau-Chuin; Zain, Jasni Mohamad; Ali, Mushtaq

    2016-01-01

    The open accessibility of Internet-based medical images in teleradialogy face security threats due to the nonsecured communication media. This paper discusses the spatial domain watermarking of ultrasound medical images for content authentication, tamper detection, and lossless recovery. For this purpose, the image is divided into two main parts, the region of interest (ROI) and region of noninterest (RONI). The defined ROI and its hash value are combined as watermark, lossless compressed, and embedded into the RONI part of images at pixel's least significant bits (LSBs). The watermark lossless compression and embedding at pixel's LSBs preserve image diagnostic and perceptual qualities. Different lossless compression techniques including Lempel-Ziv-Welch (LZW) were tested for watermark compression. The performances of these techniques were compared based on more bit reduction and compression ratio. LZW was found better than others and used in tamper detection and recovery watermarking of medical images (TDARWMI) scheme development to be used for ROI authentication, tamper detection, localization, and lossless recovery. TDARWMI performance was compared and found to be better than other watermarking schemes.

  15. Watermarking of ultrasound medical images in teleradiology using compressed watermark

    PubMed Central

    Badshah, Gran; Liew, Siau-Chuin; Zain, Jasni Mohamad; Ali, Mushtaq

    2016-01-01

    Abstract. The open accessibility of Internet-based medical images in teleradialogy face security threats due to the nonsecured communication media. This paper discusses the spatial domain watermarking of ultrasound medical images for content authentication, tamper detection, and lossless recovery. For this purpose, the image is divided into two main parts, the region of interest (ROI) and region of noninterest (RONI). The defined ROI and its hash value are combined as watermark, lossless compressed, and embedded into the RONI part of images at pixel’s least significant bits (LSBs). The watermark lossless compression and embedding at pixel’s LSBs preserve image diagnostic and perceptual qualities. Different lossless compression techniques including Lempel-Ziv-Welch (LZW) were tested for watermark compression. The performances of these techniques were compared based on more bit reduction and compression ratio. LZW was found better than others and used in tamper detection and recovery watermarking of medical images (TDARWMI) scheme development to be used for ROI authentication, tamper detection, localization, and lossless recovery. TDARWMI performance was compared and found to be better than other watermarking schemes. PMID:26839914

  16. How 3D immersive visualization is changing medical diagnostics

    NASA Astrophysics Data System (ADS)

    Koning, Anton H. J.

    2011-03-01

    Originally the only way to look inside the human body without opening it up was by means of two dimensional (2D) images obtained using X-ray equipment. The fact that human anatomy is inherently three dimensional leads to ambiguities in interpretation and problems of occlusion. Three dimensional (3D) imaging modalities such as CT, MRI and 3D ultrasound remove these drawbacks and are now part of routine medical care. While most hospitals 'have gone digital', meaning that the images are no longer printed on film, they are still being viewed on 2D screens. However, this way valuable depth information is lost, and some interactions become unnecessarily complex or even unfeasible. Using a virtual reality (VR) system to present volumetric data means that depth information is presented to the viewer and 3D interaction is made possible. At the Erasmus MC we have developed V-Scope, an immersive volume visualization system for visualizing a variety of (bio-)medical volumetric datasets, ranging from 3D ultrasound, via CT and MRI, to confocal microscopy, OPT and 3D electron-microscopy data. In this talk we will address the advantages of such a system for both medical diagnostics as well as for (bio)medical research.

  17. Optical tweezers for medical diagnostics.

    PubMed

    LaFratta, Christopher N

    2013-07-01

    Laser trapping by optical tweezers makes possible the spectroscopic analysis of single cells. Use of optical tweezers in conjunction with Raman spectroscopy has allowed cells to be identified as either healthy or cancerous. This combined technique is known as laser tweezers Raman spectroscopy (LTRS), or Raman tweezers. The Raman spectra of cells are complex, since the technique probes nucleic acids, proteins, and lipids; but statistical analysis of these spectra makes possible differentiation of different classes of cells. In this article the recent development of LTRS is described along with two illustrative examples for potential application in cancer diagnostics. Techniques to expand the uses of LTRS and to improve the speed of LTRS are also suggested.

  18. [Quality improvement of medical diagnostic laboratories].

    PubMed

    Horváth, Andrea Rita; Endröczi, Elemér; Mikó, Tivadar

    2003-07-13

    Service quality in medical laboratories is influenced by a number of variables. Medical laboratories have long recognized the need for total quality management that incorporates the continuous improvement of all stages, such as the pre-analytical, analytical and post-analytical phases, of the diagnostic process, in addition to the traditional internal and external quality control of analytical procedures. Based on national and international experience, continuous improvement of quality and its external assessment are of high priority in order to guarantee a reliable, effective and cost-effective diagnostic service. Certification of health care services, according to ISO 9001 standards in Hungarian hospitals, is not sufficient to prove professional competence of medical laboratories, which called for a system of laboratory accreditation. Accreditation is an external professional audit by which an independent accreditation body gives formal recognition that the medical laboratory is competent to provide high quality services that are compliant with rigorous professional standards of best practice. The primary aim of accreditation is the improvement of the quality of diagnostic services by voluntary participation, professional peer review, continuous training and education and compliance with professional standards. In vitro medical laboratories have pioneered quality control and quality assurance in health care. Based on these strengths and traditions, the introduction of the accreditation program of medical laboratories in Hungary is one of the key professional and ethical responsibilities of diagnostic professions, in order to improve the quality, efficiency and effectiveness of laboratory services during the course of Hungary's accession to the European Union.

  19. Using ultrasound to teach medical students cardiac physiology.

    PubMed

    Bell, Floyd E; Wilson, L Britt; Hoppmann, Richard A

    2015-12-01

    Ultrasound is being incorporated more into undergraduate medical education. Studies have shown that medical students have positive perceptions about the value of ultrasound in teaching courses like anatomy and physiology. The purpose of the present study was to provide objective evidence of whether ultrasound helps students learn cardiac physiology. In this study, 20 medical students took a pretest to assess their background knowledge of cardiac physiology. Next, they acquired ultrasound video loops of the heart. Faculty members taught them nonelectrical aspects of cardiac physiology using those loops. Finally, students took a posttest to evaluate for improvements in their knowledge. Students also completed an anonymous questionnaire about their experience. The mean pretest score was 4.8 of 9 (53.3%). The mean posttest score was 7.35 of 9 (81.7%). The mean difference was significant at P < 0.0001. Student feedback was very positive about the ultrasound laboratory. Ninety-five percent of the students agreed or strongly agreed that the ultrasound laboratory was a valuable teaching tool and that it improved their understanding of cardiac physiology. All students agreed or strongly agreed the laboratory was helpful from a visual learning standpoint. A hands-on ultrasound laboratory can indeed help medical students learn the nonelectrical components of cardiac physiology.

  20. Photoacoustic sensor for medical diagnostics

    NASA Astrophysics Data System (ADS)

    Wolff, Marcus; Groninga, Hinrich G.; Harde, Hermann

    2004-03-01

    The development of new optical sensor technologies has a major impact on the progress of diagnostic methods. Of the permanently increasing number of non-invasive breath tests, the 13C-Urea Breath Test (UBT) for the detection of Helicobacter pylori is the most prominent. However, many recent developments, like the detection of cancer by breath test, go beyond gastroenterological applications. We present a new detection scheme for breath analysis that employs an especially compact and simple set-up. Photoacoustic Spectroscopy (PAS) represents an offset-free technique that allows for short absorption paths and small sample cells. Using a single-frequency diode laser and taking advantage of acoustical resonances of the sample cell, we performed extremely sensitive and selective measurements. The smart data processing method contributes to the extraordinary sensitivity and selectivity as well. Also, the reasonable acquisition cost and low operational cost make this detection scheme attractive for many biomedical applications. The experimental set-up and data processing method, together with exemplary isotope-selective measurements on carbon dioxide, are presented.

  1. Acoustic waves in medical imaging and diagnostics.

    PubMed

    Sarvazyan, Armen P; Urban, Matthew W; Greenleaf, James F

    2013-07-01

    Up until about two decades ago acoustic imaging and ultrasound imaging were synonymous. The term ultrasonography, or its abbreviated version sonography, meant an imaging modality based on the use of ultrasonic compressional bulk waves. Beginning in the 1990s, there started to emerge numerous acoustic imaging modalities based on the use of a different mode of acoustic wave: shear waves. Imaging with these waves was shown to provide very useful and very different information about the biological tissue being examined. We discuss the physical basis for the differences between these two basic modes of acoustic waves used in medical imaging and analyze the advantages associated with shear acoustic imaging. A comprehensive analysis of the range of acoustic wavelengths, velocities and frequencies that have been used in different imaging applications is presented. We discuss the potential for future shear wave imaging applications. Copyright © 2013 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  2. Successful strategies for integrating bedside ultrasound into undergraduate medical education.

    PubMed

    Palma, James K

    2015-04-01

    Nearly all physician specialties currently utilize bedside ultrasound, and its applications continue to expand. Bedside ultrasound is becoming a core skill for physicians; as such, it should be taught during undergraduate medical education. When ultrasound is integrated in a longitudinal manner beginning in the preclerkship phase of medical school, it not only enhances teaching the basic science topics of anatomy, physiology, and pathology but also ties those skills and knowledge to the clerkship phase and medical decision-making. Bedside ultrasound is a natural bridge from basic science to clinical science. The Uniformed Services University of the Health Sciences, F. Edward Hébert School of Medicine is currently in its fourth year of implementing an integrated ultrasound curriculum in the school of medicine. In our experience, successful integration of a bedside ultrasound curriculum should: align with unique focuses of a medical schools' mission, simplify complex anatomy through multimodal teaching, correlate to teaching of the physical examination, solidify understanding of physiology and pathology, directly link to other concurrent content, narrow differential diagnoses, enhance medical decision-making, improve procedural skills, match to year-group skillsets, develop teaching and leadership abilities, and have elective experiences for advanced topics. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  3. Congenital anomalies of the uterus, and ultrasound diagnostics.

    PubMed

    Miseljic, Nenad; Izetbegovic, Sebija; Mehmedbasic, Senad; Miseljic, Sanja

    2010-01-01

    Sonographic detection and evaluation of congenital anomalies of the uterus represent an important segment in the additional therapeutic procedure, that is, treatment of patients with congenital anomalies of the uterus. Besides the primary reason that is manifested in the total cure of the patients, the secondary reason represents the decrease of costs of treatment of congenital anomalies of the uterus. Both descriptive and analytical methods were used in this paper. In 1997 Kurjak and Kupesic compared the sensitivity and specificity of transvaginal ultra sound, color Doppler, hysterosonography and three-dimensional ultrasound during diagnosis of the uterus septum. Representation of pathological findings in our paper in comparison to the examined group is: uterus subseptus = 15.38%, double horned uterus = 10.25%. The examined group includes intrauterine abnormalities of the uterus, analyzing, in that process, individual, pathological entities of intrauterine abnormalities. The research is a prospective, target, clinical study. In the examined group, due to the clinical suspicion of intrauterine abnormalities, 78 patients were examined in the following manner: two-dimensional transabdominal and transvaginal black-and-white and color Doppler ultrasound examinations were made and then three-dimensional transabdominal black-and-white and color Doppler ultrasound examinations. This means that in the detection of congenital anomalies of the uterus, the same sonographic techniques were first applied on the conventional and then also on the multidimensional base. Our research showed that three-dimensional technique is a more reliable diagnostic tool than two-dimensional technique. Sensitivity and specificity rate as well as positive predictive value show that this technique is an extraordinary one for assessing the volume, and position of congenital abnormalities.

  4. Robert Apfel's contribution to clinical diagnostic ultrasound: The mechanical index

    NASA Astrophysics Data System (ADS)

    Holland, Christy K.

    2004-05-01

    The mechanical index, MI, resulted from theoretical considerations of the short-pulse acoustic threshold for inertial cavitation in water populated with microbubbles of all sizes [R. E. Apfel and C. K. Holland, Ultrasound Med Biol. 17, 179-185 (1991)]. In this review, the onset of cavitation will be discussed with reference to Robert Apfel's legacy of theoretical and experimental data. The questions arise: Can the utility of the MI be extended to situations in which the threshold MI is exceeded, thereby allowing for some estimate of the quantification of a potential bioeffect due to microcavitation? Also, can the MI be extended to situations in which pulses are, unlike the original formulation, not short? Is there a theoretical or semi-empirical basis for the MI threshold below which cavitation is unlikely? Can the MI be used to predict gas contrast agent destruction? The possible consequences of gas body activation associated with aerated lung tissue, intestinal gas pockets or encapsulated gas contrast agents represent specific instances of cavitation considerations relevant to clinical practice. Monitoring the real-time display of the MI (mandated by the FDA) helps clinicians evaluate and minimize the potential risks in the use of diagnostic ultrasound instrumentation. [Research supported by National Institutes of Health Grant R29 HL58761.

  5. The diagnostic validity of musculoskeletal ultrasound in lateral epicondylalgia: a systematic review

    PubMed Central

    2014-01-01

    Background Ultrasound is considered a reliable, widely available, non-invasive and inexpensive imaging technique for assessing soft tissue involvement in Lateral epicondylalgia. Despite the number of diagnostic studies for Lateral Epicondylalgia, there is no consensus in the current literature on the best abnormal ultrasound findings that confirm lateral epicondylalgia. Methods Eligible studies identified by searching electronic databases, scanning reference lists of articles and chapters on ultrasound in reference books, and consultation of experts in sonography. Three reviewers (VCDIII, KP, KW) independently searched the databases using the agreed search strategy, and independently conducted all stages of article selection. Two reviewers (VCDIII, KP) then screened titles and abstracts to remove obvious irrelevance. Potentially relevant full text publications which met the inclusion criteria were reviewed by the primary investigator (VCDIII) and another reviewer (CGS). Results Among the 15 included diagnostic studies in this review, seven were Level II diagnostic accuracy studies for chronic lateral epicondylalgia based on the National Health and Medical Research Council Hierarchy of Evidence. Based from the pooled sensitivity of abnormal ultrasound findings with homogenous results (p > 0.05), the hypoechogenicity of the common extensor origin has the best combination of diagnostic sensitivity and specificity. It is moderately sensitive [Sensitivity: 0.64 (0.56-0.72)] and highly specific [Specificity: 0.82 (0.72-0.90)] in determining elbows with lateral epicondylalgia. Additionally, bone changes on the lateral epicondyle [Sensitivity: 0.56 (0.50-0.62)] were moderately sensitive to chronic LE. Conversely, neovascularity [Specificity: 1.00 (0.97-1.00)], calcifications [Specificity: 0.97 (0.94-0.99)] and cortical irregularities [Specificity: 0.96 (0.88-0.99)] have strong specificity for chronic lateral epicondylalgia. There is insufficient evidence supporting the

  6. The diagnostic validity of musculoskeletal ultrasound in lateral epicondylalgia: a systematic review.

    PubMed

    Dones, Valentin C; Grimmer, Karen; Thoirs, Kerry; Suarez, Consuelo G; Luker, Julie

    2014-03-03

    Ultrasound is considered a reliable, widely available, non-invasive and inexpensive imaging technique for assessing soft tissue involvement in Lateral epicondylalgia. Despite the number of diagnostic studies for Lateral Epicondylalgia, there is no consensus in the current literature on the best abnormal ultrasound findings that confirm lateral epicondylalgia. Eligible studies identified by searching electronic databases, scanning reference lists of articles and chapters on ultrasound in reference books, and consultation of experts in sonography. Three reviewers (VCDIII, KP, KW) independently searched the databases using the agreed search strategy, and independently conducted all stages of article selection. Two reviewers (VCDIII, KP) then screened titles and abstracts to remove obvious irrelevance. Potentially relevant full text publications which met the inclusion criteria were reviewed by the primary investigator (VCDIII) and another reviewer (CGS). Among the 15 included diagnostic studies in this review, seven were Level II diagnostic accuracy studies for chronic lateral epicondylalgia based on the National Health and Medical Research Council Hierarchy of Evidence. Based from the pooled sensitivity of abnormal ultrasound findings with homogenous results (p > 0.05), the hypoechogenicity of the common extensor origin has the best combination of diagnostic sensitivity and specificity. It is moderately sensitive [Sensitivity: 0.64 (0.56-0.72)] and highly specific [Specificity: 0.82 (0.72-0.90)] in determining elbows with lateral epicondylalgia. Additionally, bone changes on the lateral epicondyle [Sensitivity: 0.56 (0.50-0.62)] were moderately sensitive to chronic LE. Conversely, neovascularity [Specificity: 1.00 (0.97-1.00)], calcifications [Specificity: 0.97 (0.94-0.99)] and cortical irregularities [Specificity: 0.96 (0.88-0.99)] have strong specificity for chronic lateral epicondylalgia. There is insufficient evidence supporting the use of Power Doppler

  7. Thermal effects of diagnostic ultrasound in an anthropomorphic skull model.

    PubMed

    Vyskocil, E; Pfaffenberger, S; Kollmann, C; Gleiss, A; Nawratil, G; Kastl, S; Unger, E; Aumayr, K; Schuhfried, O; Huber, K; Wojta, J; Gottsauner-Wolf, M

    2012-12-01

    Exposure to diagnostic ultrasound (US) can significantly heat biological tissue although conventional routine examinations are regarded as safe. The risk of unwanted thermal effects increases with a high absorption coefficient and extended insonation time. Certain applications of transcranial diagnostic US (TC-US) require prolonged exposure. An anthropomorphic skull model (ASM) was developed to evaluate thermal effects induced by TC-US of different modalities. The objective was to determine whether prolonged continuous TC-US application results in potentially harmful temperature increases. The ASM consists of a human skull with tissue mimicking material and exhibits acoustic and anatomical characteristics of the human skull and brain. Experiments are performed with a diagnostic US device testing four different US modalities: Duplex PW (pulsed wave) Doppler, PW Doppler, color flow Doppler and B-mode. Temperature changes are recorded during 180 minutes of insonation. All measurements revealed significant temperature increases during insonation independent of the US modality. The maximum temperature elevation of + 5.25° C (p < 0.001) was observed on the surface of the skull exposed to duplex PW Doppler. At the bone-brain border a maximum temperature increae of + 2.01 °C (p < 0.001) was noted. Temperature increases within the brain were < 1.23 °C (p = 0.001). The highest values were registered using the duplex PW Doppler modality. TC-US induces significant local heating effects in an ASM. An application duration that extends routine clinical periods causes potentially harmful heating especially in tissue close to bone. TC-US elevates the temperature in the brain mimicking tissue but is not capable of producing harmful temperature increases during routine examinations. However, the risk of thermal injury in brain tissue increases significantly after an exposure time of > 2 hours. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Boosting medical diagnostics by pooling independent judgments

    PubMed Central

    Kurvers, Ralf H. J. M.; Herzog, Stefan M.; Hertwig, Ralph; Krause, Jens; Carney, Patricia A.; Bogart, Andy; Argenziano, Giuseppe; Zalaudek, Iris; Wolf, Max

    2016-01-01

    Collective intelligence refers to the ability of groups to outperform individual decision makers when solving complex cognitive problems. Despite its potential to revolutionize decision making in a wide range of domains, including medical, economic, and political decision making, at present, little is known about the conditions underlying collective intelligence in real-world contexts. We here focus on two key areas of medical diagnostics, breast and skin cancer detection. Using a simulation study that draws on large real-world datasets, involving more than 140 doctors making more than 20,000 diagnoses, we investigate when combining the independent judgments of multiple doctors outperforms the best doctor in a group. We find that similarity in diagnostic accuracy is a key condition for collective intelligence: Aggregating the independent judgments of doctors outperforms the best doctor in a group whenever the diagnostic accuracy of doctors is relatively similar, but not when doctors’ diagnostic accuracy differs too much. This intriguingly simple result is highly robust and holds across different group sizes, performance levels of the best doctor, and collective intelligence rules. The enabling role of similarity, in turn, is explained by its systematic effects on the number of correct and incorrect decisions of the best doctor that are overruled by the collective. By identifying a key factor underlying collective intelligence in two important real-world contexts, our findings pave the way for innovative and more effective approaches to complex real-world decision making, and to the scientific analyses of those approaches. PMID:27432950

  9. Application of superconductivity to medical diagnostics

    SciTech Connect

    Farrell, D.E.; Tripp, J.H.; Zanzucchi, P.E.

    1981-01-01

    This communication discusses a development in medical diagnostics, made possible by the application of a SQUID magnetic susceptometer to in vivo measurement of the iron stored in human tissue. Some new results are reported which indicate that a carefully designed susceptometer can provide the clinician with a useful non-invasive measure of excess iron in the human liver. Extension of this technique to other important iron storage problems is discussed.

  10. American Medical Society for Sports Medicine recommended sports ultrasound curriculum for sports medicine fellowships.

    PubMed

    Finnoff, Jonathan T; Berkoff, David; Brennan, Fred; DiFiori, John; Hall, Mederic M; Harmon, Kimberly; Lavallee, Mark; Martin, Sean; Smith, Jay; Stovak, Mark

    2015-01-01

    The following sports ultrasound (SPORTS US) curriculum is a revision of the curriculum developed by the American Medical Society for Sports Medicine (AMSSM) in 2010. Several changes have been made to the curriculum with the primary aim of providing a pathway by which a sports medicine fellow can obtain sufficient SPORTS US training to become proficient in the core competencies of SPORTS US. The core competencies of SPORTS US are outlined in the learning objectives section of this document. The term "SPORTS US" was purposefully chosen rather than "musculoskeletal ultrasound" (MSK US) because it was recognized by the panel that the evolving field of SPORTS US encompasses non-MSK applications of ultrasound such as the FAST examination (focused assessment with sonography for trauma). Although the SPORTS US core competencies in this curriculum are all MSK in nature, they represent the minimum SPORTS US knowledge a sports medicine fellow should acquire during fellowship. However, additional training in more advanced MSK and non-MSK applications of ultrasound can be provided at the fellowship director's discretion. Completion of this SPORTS US curriculum fulfills the American Institute of Ultrasound in Medicine's (AIUM) requirements to perform an MSK US examination and the prerequisites for the American Registry for Diagnostic Medical Sonography's (ARDMS) MSK sonography certification examination.

  11. Ultrasound imaging in medical student education: Impact on learning anatomy and physical diagnosis.

    PubMed

    So, Sokpoleak; Patel, Rita M; Orebaugh, Steven L

    2017-03-01

    Ultrasound use has expanded dramatically among the medical specialties for diagnostic and interventional purposes, due to its affordability, portability, and practicality. This imaging modality, which permits real-time visualization of anatomic structures and relationships in vivo, holds potential for pre-clinical instruction of students in anatomy and physical diagnosis, as well as providing a bridge to the eventual use of bedside ultrasound by clinicians to assess patients and guide invasive procedures. In many studies, but not all, improved understanding of anatomy has been demonstrated, and in others, improved accuracy in selected aspects of physical diagnosis is evident. Most students have expressed a highly favorable impression of this technology for anatomy education when surveyed. Logistic issues or obstacles to the integration of ultrasound imaging into anatomy teaching appear to be readily overcome. The enthusiasm of students and anatomists for teaching with ultrasound has led to widespread implementation of ultrasound-based teaching initiatives in medical schools the world over, including some with integration throughout the entire curriculum; a trend that likely will continue to grow. Anat Sci Educ 10: 176-189. © 2016 American Association of Anatomists.

  12. 75 FR 35439 - Medical Diagnostic Equipment Accessibility Standards

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-22

    ... TRANSPORTATION BARRIERS COMPLIANCE BOARD Medical Diagnostic Equipment Accessibility Standards AGENCY... equipment to ensure that such equipment is accessible to, and usable by, individuals with disabilities to... accessibility needs of individuals with disabilities with respect to medical diagnostic equipment and...

  13. Compressive Deconvolution in Medical Ultrasound Imaging.

    PubMed

    Chen, Zhouye; Basarab, Adrian; Kouamé, Denis

    2016-03-01

    The interest of compressive sampling in ultrasound imaging has been recently extensively evaluated by several research teams. Following the different application setups, it has been shown that the RF data may be reconstructed from a small number of measurements and/or using a reduced number of ultrasound pulse emissions. Nevertheless, RF image spatial resolution, contrast and signal to noise ratio are affected by the limited bandwidth of the imaging transducer and the physical phenomenon related to US wave propagation. To overcome these limitations, several deconvolution-based image processing techniques have been proposed to enhance the ultrasound images. In this paper, we propose a novel framework, named compressive deconvolution, that reconstructs enhanced RF images from compressed measurements. Exploiting an unified formulation of the direct acquisition model, combining random projections and 2D convolution with a spatially invariant point spread function, the benefit of our approach is the joint data volume reduction and image quality improvement. The proposed optimization method, based on the Alternating Direction Method of Multipliers, is evaluated on both simulated and in vivo data.

  14. Ultrasound in Space Medicine

    NASA Technical Reports Server (NTRS)

    Dulchavsky, Scott A.; Sargsyan, A.E.

    2009-01-01

    This slide presentation reviews the use of ultrasound as a diagnostic tool in microgravity environments. The goals of research in ultrasound usage in space environments are: (1) Determine accuracy of ultrasound in novel clinical conditions. (2) Determine optimal training methodologies, (3) Determine microgravity associated changes and (4) Develop intuitive ultrasound catalog to enhance autonomous medical care. Also uses of Ultrasound technology in terrestrial applications are reviewed.

  15. Acoustic Waves in Medical Imaging and Diagnostics

    PubMed Central

    Sarvazyan, Armen P.; Urban, Matthew W.; Greenleaf, James F.

    2013-01-01

    Up until about two decades ago acoustic imaging and ultrasound imaging were synonymous. The term “ultrasonography,” or its abbreviated version “sonography” meant an imaging modality based on the use of ultrasonic compressional bulk waves. Since the 1990s numerous acoustic imaging modalities started to emerge based on the use of a different mode of acoustic wave: shear waves. It was demonstrated that imaging with these waves can provide very useful and very different information about the biological tissue being examined. We will discuss physical basis for the differences between these two basic modes of acoustic waves used in medical imaging and analyze the advantages associated with shear acoustic imaging. A comprehensive analysis of the range of acoustic wavelengths, velocities, and frequencies that have been used in different imaging applications will be presented. We will discuss the potential for future shear wave imaging applications. PMID:23643056

  16. 77 FR 53163 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-31

    ... TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR Part 1195 RIN 3014-AA40 Medical Diagnostic Equipment.... ACTION: Notice of advisory committee meeting. SUMMARY: The Medical Diagnostic Equipment Accessibility...) on Medical Diagnostic Equipment Accessibility Standards. See 77 FR 6916 (February 9, 2012). The...

  17. 77 FR 39656 - Medical Diagnostic Equipment Accessibility Standards Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-05

    ... CFR Part 1195 [Docket No. ATBCB-2012-0003] RIN 3014-AA40 Medical Diagnostic Equipment Accessibility... Proposed Rulemaking on Medical Diagnostic Equipment Accessibility Standards. DATES: The first meeting of... Proposed Rulemaking (NPRM) on Medical Diagnostic Equipment Accessibility Standards. See 77 FR 14706...

  18. The diagnostic performance of ultrasound for acute appendicitis in pregnant and young nonpregnant women: A case-control study.

    PubMed

    Segev, Lior; Segev, Yakir; Rayman, Shlomi; Nissan, Aviram; Sadot, Eran

    2016-10-01

    Ultrasonography is frequently used to diagnose acute appendicitis in women of reproductive age, but its diagnostic value in pregnant patients remains unclear. This study sought to compare the diagnostic performance of ultrasound in pregnant and young nonpregnant women with suspected acute appendicitis. The database of a single tertiary medical center was reviewed for all women of reproductive age who underwent appendectomy either during pregnancy (2000-2014) or in the nonpregnant state (2004-2007) following ultrasound evaluation. The performance of ultrasound in terms of predicting the final pathologic diagnosis was compared between the pregnant and non pregnant groups using receiver operating characteristic curve analysis. Of 586 young women treated for appendicitis during the study periods (92 pregnant, 494 non-pregnant), 200 underwent preoperative ultrasound [67 pregnant, and 133 nonpregnant young women]. The pregnant and nonpregnant groups were comparable in age and presenting symptoms. There was no significant difference in the predictive performance of ultrasound between the two groups (AUC 0.76 and 0.73 respectively, p = 0.78) or within the pregnant group, by trimester [first (n = 23), AUC 0.73; second (n = 32), AUC 0.67; third (n = 12), AUC 0.86; p = 0.4]. Ultrasound had a positive predictive value of 0.94 in the pregnant group and 0.91 in the nonpregnant group; corresponding negative predictive values were 0.40 and 0.43. There appears to be no difference in the ability of ultrasound to predict the diagnosis of acute appendicitis between pregnant women and nonpregnant women of reproductive age. Therefore, similar preoperative imaging algorithms may be used in both patient populations. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  19. Diagnostic value of contrast-enhanced ultrasound in thyroid nodules with calcification.

    PubMed

    Jiang, Jue; Shang, Xu; Wang, Hua; Xu, Yong-Bo; Gao, Ya; Zhou, Qi

    2015-03-01

    The aim of this study was to investigate the diagnostic values of conventional ultrasound and contrast-enhanced ultrasound (CEUS) in benign and malignant thyroid nodules with calcification. Conventional ultrasound and CEUS were performed in 122 patients with thyroid nodules with calcification. The thyroid nodules were characterized as benign or malignant by pathological diagnosis. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accordance rate of the two imaging methods were determined. The area under the receiver operating characteristics curve (AUC) was used to assess the diagnostic values of the two imaging methods. In 122 cases of thyroid nodules with calcification, 73 benign nodules and 49 malignant nodules were verified by pathological diagnosis. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accordance rate of conventional ultrasound were 50%, 77%, 59%, 69%, and 66%, respectively, and those of CEUS were 90%, 92%, 88%, 93%, and 91%, respectively. There were significant differences between the two imaging methods. AUCs of conventional ultrasound and CEUS were 0.628 ± 0.052 and 0.908 ± 0.031, suggesting low and high diagnostic values, respectively. CEUS has high diagnostic values, being significantly greater than those of conventional ultrasound, in differential diagnosis of benign and malignant thyroid nodules with calcification.

  20. Effect of a Medical Student Emergency Ultrasound Clerkship on Number of Emergency Department Ultrasounds

    PubMed Central

    Fox, J Christian; Anderson, Craig L.; Ahmed, Suleman S.; McDonough, Joanne; Wiechmann, Warren; Waters, Michael; Barajas, Graciela; Lotfipour, Shahram

    2010-01-01

    Objective: To determine whether a medical student emergency ultrasound clerkship has an effect on the number of patients undergoing ultrasonography and the number of total scans in the emergency department. Methods: We conducted a prospective, single-blinded study of scanning by emergency medicine residents and attendings with and without medical students. Rotating ultrasound medical students were assigned to work equally on all days of the week. We collected the number of patients scanned and the number of scans, as well as participation of resident and faculty. Results: In seven months 2,186 scans were done on the 109 days with students and 707 scans on the 72 days without them. Data on 22 days was not recorded. A median of 13 patients per day were scanned with medical students (CI 12–15) versus seven (CI 6–9) when not. In addition, the median number of scans was 18 per day with medical students (CI 16–20) versus eight (CI 6–10) without them. Conclusion: There were significantly more patients scanned and scans done when ultrasound medical students were present. PMID:20411072

  1. Diagnostic Accuracy of Secondary Ultrasound Exam in Blunt Abdominal Trauma

    PubMed Central

    Rajabzadeh Kanafi, Alireza; Giti, Masoumeh; Gharavi, Mohammad Hossein; Alizadeh, Ahmad; Pourghorban, Ramin; Shekarchi, Babak

    2014-01-01

    Background: In stable patients with blunt abdominal trauma, accurate diagnosis of visceral injuries is crucial. Objectives: To determine whether repeating ultrasound exam will increase the sensitivity of focused abdominal sonography for trauma (FAST) through revealing additional free intraperitoneal fluid in patients with blunt abdominal trauma. Patients and Methods: We performed a prospective observational study by performing primary and secondary ultrasound exams in blunt abdominal trauma patients. All ultrasound exams were performed by four radiology residents who had the experience of more than 400 FAST exams. Five routine intraperitoneal spaces as well as the interloop space were examined by ultrasound in order to find free fluid. All patients who expired or were transferred to the operating room before the second exam were excluded from the study. All positive ultrasound results were compared with intra-operative and computed tomography (CT) findings and/or the clinical status of the patients. Results: Primary ultrasound was performed in 372 patients; 61 of them did not undergo secondary ultrasound exam; thus, were excluded from the study.Three hundred eleven patients underwent both primary and secondary ultrasound exams. One hundred and two of all patients were evaluated by contrast enhanced CT scan and 31 underwent laparotomy. The sensitivity of ultrasound exam in detecting intraperitoneal fluid significantly increased from 70.7% for the primary exam to 92.7% for the secondary exam. Examining the interloop space significantly improved the sensitivity of ultrasonography in both primary (from 36.6% to 70.7%) and secondary (from 65.9% to 92.7%) exams. Conclusions: Performing a secondary ultrasound exam in stable blunt abdominal trauma patients and adding interloop space scan to the routine FAST exam significantly increases the sensitivity of ultrasound in detecting intraperitoneal free fluid. PMID:25763079

  2. Combined Application of Ultrasound and CT Increased Diagnostic Value in Female Patients with Pelvic Masses.

    PubMed

    Liu, Yan; Zhang, Hui; Li, Xiaoqian; Qi, Guiqin

    2016-01-01

    Purpose. The current study aimed to evaluate whether combined application of ultrasound and CT had increased Diagnostic Value in Female Patients with Pelvic Masses over either method alone. Patients and Methods. 240 female patients with pelvic masses were detected preoperatively with ultrasound and CT prior to surgery. The sensitivity, specificity, and accuracy of ultrasound, CT, and combined ultrasound/CT application were evaluated, respectively. Results. The sensitivity, specificity, and accuracy of ultrasound were 52.8%, 86.7%, and 68.75%, respectively. The sensitivity, specificity, and accuracy of CT were 80.3%, 90.3%, and 85%, respectively. The sensitivity, specificity, and accuracy of combined application of ultrasound and CT were 89%, 94.7%, and 91.7%. The sensitivity, specificity, and accuracy of combined application of ultrasound and CT were higher than those of either ultrasound or CT. Conclusions. The combined application of ultrasound and CT had higher Diagnostic Value in Female Patients with Pelvic Masses than either method alone.

  3. Combined Application of Ultrasound and CT Increased Diagnostic Value in Female Patients with Pelvic Masses

    PubMed Central

    Liu, Yan; Zhang, Hui; Li, Xiaoqian

    2016-01-01

    Purpose. The current study aimed to evaluate whether combined application of ultrasound and CT had increased Diagnostic Value in Female Patients with Pelvic Masses over either method alone. Patients and Methods. 240 female patients with pelvic masses were detected preoperatively with ultrasound and CT prior to surgery. The sensitivity, specificity, and accuracy of ultrasound, CT, and combined ultrasound/CT application were evaluated, respectively. Results. The sensitivity, specificity, and accuracy of ultrasound were 52.8%, 86.7%, and 68.75%, respectively. The sensitivity, specificity, and accuracy of CT were 80.3%, 90.3%, and 85%, respectively. The sensitivity, specificity, and accuracy of combined application of ultrasound and CT were 89%, 94.7%, and 91.7%. The sensitivity, specificity, and accuracy of combined application of ultrasound and CT were higher than those of either ultrasound or CT. Conclusions. The combined application of ultrasound and CT had higher Diagnostic Value in Female Patients with Pelvic Masses than either method alone. PMID:27867419

  4. A fully programmable computing architecture for medical ultrasound machines.

    PubMed

    Schneider, Fabio Kurt; Agarwal, Anup; Yoo, Yang Mo; Fukuoka, Tetsuya; Kim, Yongmin

    2010-03-01

    Application-specific ICs have been traditionally used to support the high computational and data rate requirements in medical ultrasound systems, particularly in receive beamforming. Utilizing the previously developed efficient front-end algorithms, in this paper, we present a simple programmable computing architecture, consisting of a field-programmable gate array (FPGA) and a digital signal processor (DSP), to support core ultrasound signal processing. It was found that 97.3% and 51.8% of the FPGA and DSP resources are, respectively, needed to support all the front-end and back-end processing for B-mode imaging with 64 channels and 120 scanlines per frame at 30 frames/s. These results indicate that this programmable architecture can meet the requirements of low- and medium-level ultrasound machines while providing a flexible platform for supporting the development and deployment of new algorithms and emerging clinical applications.

  5. Medical diagnostics for indoor mold exposure.

    PubMed

    Hurraß, Julia; Heinzow, Birger; Aurbach, Ute; Bergmann, Karl-Christian; Bufe, Albrecht; Buzina, Walter; Cornely, Oliver A; Engelhart, Steffen; Fischer, Guido; Gabrio, Thomas; Heinz, Werner; Herr, Caroline E W; Kleine-Tebbe, Jörg; Klimek, Ludger; Köberle, Martin; Lichtnecker, Herbert; Lob-Corzilius, Thomas; Merget, Rolf; Mülleneisen, Norbert; Nowak, Dennis; Rabe, Uta; Raulf, Monika; Seidl, Hans Peter; Steiß, Jens-Oliver; Szewszyk, Regine; Thomas, Peter; Valtanen, Kerttu; Wiesmüller, Gerhard A

    2017-04-01

    In April 2016, the German Society of Hygiene, Environmental Medicine and Preventative Medicine (Gesellschaft für Hygiene, Umweltmedizin und Präventivmedizin (GHUP)) together with other scientific medical societies, German and Austrian medical societies, physician unions and experts has provided an AWMF (Association of the Scientific Medical Societies) guideline 'Medical diagnostics for indoor mold exposure'. This guideline shall help physicians to advise and treat patients exposed indoors to mold. Indoor mold growth is a potential health risk, even without a quantitative and/or causal association between the occurrence of individual mold species and health effects. Apart from the allergic bronchopulmonary aspergillosis (ABPA) and the mycoses caused by mold, there is only sufficient evidence for the following associations between moisture/mold damages and different health effects: Allergic respiratory diseases, asthma (manifestation, progression, exacerbation), allergic rhinitis, exogenous allergic alveolitis and respiratory tract infections/bronchitis. In comparison to other environmental allergens, the sensitizing potential of molds is estimated to be low. Recent studies show a prevalence of sensitization of 3-10% in the total population of Europe. The evidence for associations to mucous membrane irritation and atopic eczema (manifestation, progression, exacerbation) is classified as limited or suspected. Inadequate or insufficient evidence for an association is given for COPD, acute idiopathic pulmonary hemorrhage in children, rheumatism/arthritis, sarcoidosis, and cancer. The risk of infections from indoor molds is low for healthy individuals. Only molds that are capable to form toxins can cause intoxications. The environmental and growth conditions and especially the substrate determine whether toxin formation occurs, but indoor air concentrations are always very low. In the case of indoor moisture/mold damages, everyone can be affected by odor effects and

  6. Ultrasound-based lectures on cardiovascular physiology and reflexes for medical students.

    PubMed

    Paganini, M; Rubini, A

    2016-06-01

    Ultrasound has become a widely used diagnostic technique. While its role in patient evaluation is well known, its utility during preclinical courses such as anatomy and physiology is becoming increasingly recognized. The aim of the present study was to assess the feasibility/utility of integrating ultrasound-based sessions into conventional undergraduate medical school programs of physiology of the cardiovascular system and cardiovascular reflexes and to evaluate student perceptions of an ultrasound-based didactic session. Second-year medical students enrolled in the University of Padova attended a didactic session during which basic concepts regarding ultrasound instrumentation, image production, and spatial orientation were presented. Five anatomic sectors (the heart, aorta, neck vessels, inferior vena cava, and femoral veins) were then examined on a volunteer. Student perceptions of the images that were projected, the usefulness of the presentation, and the reproducibility of the experience were assessed at the end of the lecture with an anonymous questionnaire consisting of positive and negative items that were rated using a 5-point Likert scale and with two questions. One hundred eleven students attended the lecture; 99% of them found it very interesting, and none considered it boring or a waste of time. More than 96% thought it helped them to gain a better comprehension of the subject and would recommend it to a colleague. In conclusion, as ultrasound has been found to be a valuable resource for the teaching of physiology of the cardiovascular system and cardiovascular reflexes, efforts should be made to integrate ultrasound sessions into the traditional human physiology curriculum. Copyright © 2016 The American Physiological Society.

  7. An integrated ultrasound curriculum (iUSC) for medical students: 4-year experience.

    PubMed

    Hoppmann, Richard A; Rao, Victor V; Poston, Mary Beth; Howe, Duncan B; Hunt, Patrick S; Fowler, Stanley D; Paulman, Lance E; Wells, James R; Richeson, Nancy A; Catalana, Paul V; Thomas, Lynn K; Britt Wilson, L; Cook, Thomas; Riffle, Shaun; Neuffer, Francis H; McCallum, James B; Keisler, Brian D; Brown, Rachel S; Gregg, Anthony R; Sims, Kerry M; Powell, Caroline K; Garber, Matthew D; Morrison, James E; Owens, William B; Carnevale, Kevin A; Jennings, William R; Fletcher, Sarah

    2011-04-01

    A review of the development and implementation of a 4-year medical student integrated ultrasound curriculum is presented. Multiple teaching and assessment modalities are discussed as well as results from testing and student surveys. Lessons learned while establishing the curriculum are summarized. It is concluded that ultrasound is a well received, valuable teaching tool across all 4 years of medical school, and students learn ultrasound well, and they feel their ultrasound experience enhances their medical education.

  8. Enabling the mission through trans-atlantic remote mentored musculoskeletal ultrasound: case report of a portable hand-carried tele-ultrasound system for medical relief missions.

    PubMed

    Kirkpatrick, Andrew W; Blaivas, Michael; Sargsyan, Ashot E; McBeth, Paul B; Patel, Chirag; Xiao, Zhengwen; Pian, Linping; Panebianco, Nova; Hamilton, Douglas R; Ball, Chad G; Dulchavsky, Scott A

    2013-07-01

    Modern medical practice has become extremely dependent upon diagnostic imaging technologies to confirm the results of clinical examination and to guide the response to therapies. Of the various diagnostic imaging techniques, ultrasound is the most portable modality and one that is repeatable, dynamic, relatively cheap, and safe as long as the imaging provided is accurately interpreted. It is, however, the most user-dependent, a characteristic that has prompted the development of remote guidance techniques, wherein remote experts guide distant users through the use of information technologies. Medical mission work often brings specialist physicians to less developed locations, where they wish to provide the highest levels of care but are often bereft of diagnostic imaging resources on which they depend. Furthermore, if these personnel become ill or injured, their own care received may not be to the standard they have left at home. We herein report the utilization of a compact hand-carried remote tele-ultrasound system that allowed real-time diagnosis and follow-up of an acutely torn adductor muscle by a team of ultrasonographers, surgeons, and physicians. The patient was one of the mission surgeons who was guided to self-image. The virtual network of supporting experts was located across North America, whereas the patient was in Lome, Togo, West Africa. The system consisted of a hand-carried ultrasound, the output of which was digitized and streamed to the experts within standard voice-over-Internet-protocol software with an embedded simultaneous videocamera image of the ultrasonographer's hands using a customized graphical user interface. The practical concept of a virtual tele-ultrasound support network was illustrated through the clinical guidance of multiple physicians, including National Aeronautics and Space Administration Medical Operations remote guiders, Olympic team-associated surgeons, and ultrasound-focused emergentologists.

  9. Educational Assessment of Medical Student Rotation in Emergency Ultrasound

    PubMed Central

    Fox, J. Christian; Cusick, Seric; Scruggs, William; Henson, Travis W.; Anderson, Craig L; Barajas, Graciela; Zlidenny, Alexander; McDonough, JoAnne; Langdorf, Mark I.

    2007-01-01

    Background Medical student ultrasound education is sparse. In 2002, we began the first medical student rotation in emergency ultrasound. Objective To evaluate if medical students can learn and retain sonographic skills during a two- or four-week elective. Methods We gave students an exam on the first and last days of the rotation. Six months later, students took the exam a third time. A control group was used for comparison. Results Over a 19-month period, we enrolled 45 students (25 on the two-week and 20 on the four-week elective). The four-week student post-test score was significantly better than the two- week post-test score (81% vs 72%, p=0.003). On the six-month exam, the four-week student post-test score was significantly better than the two-week post-test score (77% vs 69%, p=0.008). The control group did not statistically improve. Conclusion Medical students can learn bedside ultrasound interpretation with clinical integration and retain the knowledge six months later. PMID:19561689

  10. Educational assessment of medical student rotation in emergency ultrasound.

    PubMed

    Fox, J Christian; Cusick, Seric; Scruggs, William; Henson, Travis W; Anderson, Craig L; Barajas, Graciela; Zlidenny, Alexander; McDonough, Joanne; Langdorf, Mark I

    2007-08-01

    Medical student ultrasound education is sparse. In 2002, we began the first medical student rotation in emergency ultrasound. To evaluate if medical students can learn and retain sonographic skills during a two- or four-week elective. We gave students an exam on the first and last days of the rotation. Six months later, students took the exam a third time. A control group was used for comparison. Over a 19-month period, we enrolled 45 students (25 on the two-week and 20 on the four-week elective). The four-week student post-test score was significantly better than the two- week post-test score (81% vs 72%, p=0.003). On the six-month exam, the four-week student post-test score was significantly better than the two-week post-test score (77% vs 69%, p=0.008). The control group did not statistically improve. Medical students can learn bedside ultrasound interpretation with clinical integration and retain the knowledge six months later.

  11. Diagnostic Reasoning across the Medical Education Continuum

    PubMed Central

    Smith, C. Scott; Hill, William; Francovich, Chris; Morris, Magdalena; Robbins, Bruce; Robins, Lynne; Turner, Andrew

    2014-01-01

    We aimed to study linguistic and non-linguistic elements of diagnostic reasoning across the continuum of medical education. We performed semi-structured interviews of premedical students, first year medical students, third year medical students, second year internal medicine residents, and experienced faculty (ten each) as they diagnosed three common causes of dyspnea. A second observer recorded emotional tone. All interviews were digitally recorded and blinded transcripts were created. Propositional analysis and concept mapping were performed. Grounded theory was used to identify salient categories and transcripts were scored with these categories. Transcripts were then unblinded. Systematic differences in propositional structure, number of concept connections, distribution of grounded theory categories, episodic and semantic memories, and emotional tone were identified. Summary concept maps were created and grounded theory concepts were explored for each learning level. We identified three major findings: (1) The “apprentice effect” in novices (high stress and low narrative competence); (2) logistic concept growth in intermediates; and (3) a cognitive state transition (between analytical and intuitive approaches) in experts. These findings warrant further study and comparison. PMID:27429275

  12. Lung ultrasound in critically ill patients: a new diagnostic tool.

    PubMed

    Dexheimer Neto, Felippe Leopoldo; Dalcin, Paulo de Tarso Roth; Teixeira, Cassiano; Beltrami, Flávia Gabe

    2012-01-01

    The evaluation of critically ill patients using lung ultrasound, even if performed by nonspecialists, has recently garnered greater interest. Because lung ultrasound is based on the fact that every acute illness reduces lung aeration, it can provide information that complements the physical examination and clinical impression, the main advantage being that it is a bedside tool. The objective of this review was to evaluate the clinical applications of lung ultrasound by searching the PubMed and the Brazilian Virtual Library of Health databases. We used the following search terms (in Portuguese and English): ultrasound; lung; and critical care. In addition to the most relevant articles, we also reviewed specialized textbooks. The data show that lung ultrasound is useful in the differential diagnosis of pulmonary infiltrates, having good accuracy in identifying consolidations and interstitial syndrome. In addition, lung ultrasound has been widely used in the evaluation and treatment of pleural effusions, as well as in the identification of pneumothorax. This technique can also be useful in the immediate evaluation of patients with dyspnea or acute respiratory failure. Other described applications include monitoring treatment response and increasing the safety of invasive procedures. Although specific criteria regarding training and certification are still lacking, lung ultrasound is a fast, inexpensive, and widely available tool. This technique should progressively come to be more widely incorporated into the care of critically ill patients.

  13. Enhanced cytotoxic effect of cisplatin using diagnostic ultrasound and microbubbles in vitro

    NASA Astrophysics Data System (ADS)

    Sasaki, Noboru; Nakamura, Kensuke; Murakami, Masahiro; Lim, Sue Yee; Ohta, Hiroshi; Yamasaki, Masahiro; Takiguchi, Mitsuyoshi

    2012-10-01

    Diagnostic ultrasound has accomplished drug and gene delivery by ultrasound targeted microbubble destruction (UTMD). However, the efficacy of delivery is still relatively low. Therefore, we optimized conditions of UTMD using diagnostic ultrasound and ultrasound contrast agent microbubbles. Canine thyroid adenocarcinoma cells were cultured in a 96-well plate. After addition of cisplatin and Sonazoid®, the plate was inverted to raise microbubbles near cells and incubated. Cells were exposed to diagnostic ultrasound using a linear probe operated in the contrast harmonic imaging mode. The center frequency was 2.5 MHz with a mechanical index of 1.33 and a frame rate of 48 frames/sec. Cytotoxic effect of cisplatin was evaluated 24h after exposure using trypan blue dye exclusion test. We optimized incubation duration, cisplatin concentration, and the relationship between microbubble concentration and exposure duration. The optimum enhancement was observed at incubation duration of 5min, cisplatin concentration of 1 μg/ml, and microbubble concentration of 2.4 × 105 microbubbles/ml. Exposure duration did not influence the enhancement at the microbubble concentration of 2.4 × 105 microbubbles/ml. Our results suggest that relative low concentrations of drug and microbubbles with short exposure duration might be sufficient for drug delivery by UTMD using diagnostic ultrasound.

  14. Creating thoracic phantoms for diagnostic and procedural ultrasound training

    PubMed Central

    Gawthrope, Ian

    2015-01-01

    The use of pleural and lung ultrasound is being performed increasingly by respiratory and critical care clinicians around the world. This article describes how to create cheap and reliable lung and pleural phantoms for teaching. The phantoms described replicate the appearance of normal ventilating lung, pneumothorax (including the contact or lung point), pulmonary oedema, pleural effusion and empyema. The pleural effusion phantom can be used to teach procedural ultrasound (pleurocentesis). PMID:28191142

  15. Teaching ultrasound in a curricular course according to certified EFSUMB standards during undergraduate medical education: a prospective study.

    PubMed

    Heinzow, Hauke S; Friederichs, Hendrik; Lenz, Philipp; Schmedt, Andre; Becker, Jan C; Hengst, Karin; Marschall, Bernhard; Domagk, Dirk

    2013-06-11

    As a non-invasive and readily available diagnostic tool, ultrasound is one of the most important imaging techniques in medicine. Ultrasound is usually trained during residency preferable according to German Society of Ultrasound in Medicine (DEGUM) standards. Our curriculum calls for undergraduate training in ultrasound of medical students in their 4th year of undergraduate education. An explorative pilot study evaluated the acceptance of this teaching method, and compared it to other practical activities in medical education at Muenster University. 240 medical students in their 4th year of undergraduate medical education participated in the training and completed a pre- and post-questionnaire for self-assessment of technical knowledge, self-assurance of the procedure, and motivation in performing ultrasound using a Likert scale. Moreover, students were asked about their interest in pursuing a career in internal medicine. To compare this training to other educational activities a standardized online evaluation tool was used. A direct observation of procedural skills assessment (DOPS) for the first time applied on ultrasound aimed to independently assess the success of our teaching method. There was a significant increase in technical knowledge and self-assurance (p < 0.001) of the students' self-assessments. The clinical relevance and self-motivation of the teaching were evaluated positively. The students' DOPS results demonstrated proficiency in the understanding of anatomic structures shown in ultrasonographic images, including terminology, machine settings, and transducer frequencies. Training ultrasound according to certified DEGUM standards was successful and should be offered in undergraduate medical education. The evaluation of the course affirmed the necessity, quality and clinical relevance of the course with a top ranking score of hands-on training courses within the educational activities of the Medical Faculty of Muenster.

  16. Treatment of deeply located acute intravascular thrombi with therapeutic ultrasound guided by diagnostic ultrasound and intravenous microbubbles.

    PubMed

    Tsutsui, Jeane M; Xie, Feng; Johanning, Jason; Lof, John; Cory, Brian; He, Amming; Thomas, Lewis; Matsunaga, Terry; Unger, Evan; Porter, Thomas R

    2006-09-01

    We sought to determine the added value of simultaneous imaging of intravenously infused microbubbles that are being used to dissolve an intravascular thrombus with therapeutic ultrasound (TUS). In a chronic canine arteriovenous graft occluded by a thrombus, TUS (1 MHz) was applied through a 6-cm-thick tissue-mimicking phantom (measured mean +/- SD peak negative pressure through the phantom, 958 +/- 104 kPa) during an intravenous infusion of either saline (n = 6 occlusions) or lipid-encapsulated microbubbles (ImaRx Therapeutics, Inc, Tucson, AZ). Therapeutic ultrasound was intermittently applied during the microbubble infusion either at set time intervals (n = 6 occlusions) or when simultaneous diagnostic ultrasound (DUS) indicated a sustained presence of microbubbles (n = 12 occlusions). Success was defined as return of rapid flow within the graft (grade 3 flow). Diagnostic ultrasound showed microbubbles moving through small channels within the thrombus before angiographic evidence of flow in the graft. This guided the timing of TUS application better than using set time intervals. Angiographic clearance of the thrombus and restoration of grade 3 flow at 45 minutes of treatment were seen in 33% of deeply located thrombosed grafts treated with TUS at set time intervals and 92% of grafts treated with TUS guided by DUS (P < .001 compared with set time intervals). The use of TUS with intravenous microbubbles has a high success rate in recanalizing deeply located thrombosed arteriovenous grafts when performed with DUS guidance.

  17. Acoustic radiation force elasticity imaging in diagnostic ultrasound.

    PubMed

    Doherty, Joshua R; Trahey, Gregg E; Nightingale, Kathryn R; Palmeri, Mark L

    2013-04-01

    The development of ultrasound-based elasticity imaging methods has been the focus of intense research activity since the mid-1990s. In characterizing the mechanical properties of soft tissues, these techniques image an entirely new subset of tissue properties that cannot be derived with conventional ultrasound techniques. Clinically, tissue elasticity is known to be associated with pathological condition and with the ability to image these features in vivo; elasticity imaging methods may prove to be invaluable tools for the diagnosis and/or monitoring of disease. This review focuses on ultrasound-based elasticity imaging methods that generate an acoustic radiation force to induce tissue displacements. These methods can be performed noninvasively during routine exams to provide either qualitative or quantitative metrics of tissue elasticity. A brief overview of soft tissue mechanics relevant to elasticity imaging is provided, including a derivation of acoustic radiation force, and an overview of the various acoustic radiation force elasticity imaging methods.

  18. Acoustic Radiation Force Elasticity Imaging in Diagnostic Ultrasound

    PubMed Central

    Doherty, Joshua R.; Trahey, Gregg E.; Nightingale, Kathryn R.; Palmeri, Mark L.

    2013-01-01

    The development of ultrasound-based elasticity imaging methods has been the focus of intense research activity since the mid-1990s. In characterizing the mechanical properties of soft tissues, these techniques image an entirely new subset of tissue properties that cannot be derived with conventional ultrasound techniques. Clinically, tissue elasticity is known to be associated with pathological condition and with the ability to image these features in vivo, elasticity imaging methods may prove to be invaluable tools for the diagnosis and/or monitoring of disease. This review focuses on ultrasound-based elasticity imaging methods that generate an acoustic radiation force to induce tissue displacements. These methods can be performed non-invasively during routine exams to provide either qualitative or quantitative metrics of tissue elasticity. A brief overview of soft tissue mechanics relevant to elasticity imaging is provided, including a derivation of acoustic radiation force, and an overview of the various acoustic radiation force elasticity imaging methods. PMID:23549529

  19. Wideband optical detector of ultrasound for medical imaging applications.

    PubMed

    Rosenthal, Amir; Kellnberger, Stephan; Omar, Murad; Razansky, Daniel; Ntziachristos, Vasilis

    2014-05-11

    Optical sensors of ultrasound are a promising alternative to piezoelectric techniques, as has been recently demonstrated in the field of optoacoustic imaging. In medical applications, one of the major limitations of optical sensing technology is its susceptibility to environmental conditions, e.g. changes in pressure and temperature, which may saturate the detection. Additionally, the clinical environment often imposes stringent limits on the size and robustness of the sensor. In this work, the combination of pulse interferometry and fiber-based optical sensing is demonstrated for ultrasound detection. Pulse interferometry enables robust performance of the readout system in the presence of rapid variations in the environmental conditions, whereas the use of all-fiber technology leads to a mechanically flexible sensing element compatible with highly demanding medical applications such as intravascular imaging. In order to achieve a short sensor length, a pi-phase-shifted fiber Bragg grating is used, which acts as a resonator trapping light over an effective length of 350 µm. To enable high bandwidth, the sensor is used for sideway detection of ultrasound, which is highly beneficial in circumferential imaging geometries such as intravascular imaging. An optoacoustic imaging setup is used to determine the response of the sensor for acoustic point sources at different positions.

  20. Wideband Optical Detector of Ultrasound for Medical Imaging Applications

    PubMed Central

    Rosenthal, Amir; Kellnberger, Stephan; Omar, Murad; Razansky, Daniel; Ntziachristos, Vasilis

    2014-01-01

    Optical sensors of ultrasound are a promising alternative to piezoelectric techniques, as has been recently demonstrated in the field of optoacoustic imaging. In medical applications, one of the major limitations of optical sensing technology is its susceptibility to environmental conditions, e.g. changes in pressure and temperature, which may saturate the detection. Additionally, the clinical environment often imposes stringent limits on the size and robustness of the sensor. In this work, the combination of pulse interferometry and fiber-based optical sensing is demonstrated for ultrasound detection. Pulse interferometry enables robust performance of the readout system in the presence of rapid variations in the environmental conditions, whereas the use of all-fiber technology leads to a mechanically flexible sensing element compatible with highly demanding medical applications such as intravascular imaging. In order to achieve a short sensor length, a pi-phase-shifted fiber Bragg grating is used, which acts as a resonator trapping light over an effective length of 350 µm. To enable high bandwidth, the sensor is used for sideway detection of ultrasound, which is highly beneficial in circumferential imaging geometries such as intravascular imaging. An optoacoustic imaging setup is used to determine the response of the sensor for acoustic point sources at different positions. PMID:24895083

  1. Diagnostic Criteria and Accuracy of Categorizing Malignant Thyroid Nodules by Ultrasonography and Ultrasound Elastography with Pathologic Correlation.

    PubMed

    Elsayed, Naglaa Mostafa; Elkhatib, Yasser Atta

    2016-03-01

    Thyroid nodules are a common medical and surgical concern. Thyroid ultrasound (US) is the primary imaging modality used for initial evaluation and assortment of nodules for fine needle aspiration (FNA) cytology/biopsy. Ultrasound elastography (USE) is believed to improve the diagnostic accuracy of US in distinguishing benign from malignant nodules. The aim of the work described here is to evaluate the diagnostic criteria and accuracy of US and USE in the diagnosis of malignant thyroid nodules. A prospective study of 88 patients who have thyroid nodules was performed. US, color Doppler, and USE were evaluated using a Philips iU22 equipped with a 5 to 12 MHz, linear transducer, followed by FNA of the each scanned nodule. The most sensitive US criteria for malignant nodules were a height-to-width ratio greater than one and the absence of a halo sign (sensitivity 0.875% and 1.000%, respectively). The most specific criteria for malignancy were a spiculated/blurred margin and the presence of microcalcifications (specificity 0.968% and 0.888%, respectively). The receiver operating characteristic curve showed that the cutoff diagnostic criteria of malignancy are two US characteristics and an elastography score of 4. The diagnostic accuracy of US for malignant thyroid nodules increases by combining US and USE.

  2. Effects of diagnostic levels of color Doppler ultrasound energy on the cell cycle of newborn rats.

    PubMed

    Zhu, J; Lin, J; Zhu, Z; Shou, W; Bi, D; Shi, L

    1999-04-01

    Our objective was to evaluate the safety of diagnostic levels of color Doppler ultrasound energy in the field of obstetrics and to provide the experimental data for its clinical application. After insonating pregnant rats with diagnostic levels of color Doppler ultrasound energy, we studied the cell cycles of the newborn rats by flow cytometry and factorial analysis. We found that the deoxyribonucleic acid content was not affected in any phase of the cell cycle in newborn rats by any of the different insonation times and frequencies.

  3. 3D ultrasound imaging for prosthesis fabrication and diagnostic imaging

    SciTech Connect

    Morimoto, A.K.; Bow, W.J.; Strong, D.S.

    1995-06-01

    The fabrication of a prosthetic socket for a below-the-knee amputee requires knowledge of the underlying bone structure in order to provide pressure relief for sensitive areas and support for load bearing areas. The goal is to enable the residual limb to bear pressure with greater ease and utility. Conventional methods of prosthesis fabrication are based on limited knowledge about the patient`s underlying bone structure. A 3D ultrasound imaging system was developed at Sandia National Laboratories. The imaging system provides information about the location of the bones in the residual limb along with the shape of the skin surface. Computer assisted design (CAD) software can use this data to design prosthetic sockets for amputees. Ultrasound was selected as the imaging modality. A computer model was developed to analyze the effect of the various scanning parameters and to assist in the design of the overall system. The 3D ultrasound imaging system combines off-the-shelf technology for image capturing, custom hardware, and control and image processing software to generate two types of image data -- volumetric and planar. Both volumetric and planar images reveal definition of skin and bone geometry with planar images providing details on muscle fascial planes, muscle/fat interfaces, and blood vessel definition. The 3D ultrasound imaging system was tested on 9 unilateral below-the- knee amputees. Image data was acquired from both the sound limb and the residual limb. The imaging system was operated in both volumetric and planar formats. An x-ray CT (Computed Tomography) scan was performed on each amputee for comparison. Results of the test indicate beneficial use of ultrasound to generate databases for fabrication of prostheses at a lower cost and with better initial fit as compared to manually fabricated prostheses.

  4. 77 FR 14706 - Medical Diagnostic Equipment Accessibility Standards

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-13

    ... TRANSPORTATION BARRIERS COMPLIANCE BOARD 36 CFR Part 1195 RIN 3014-AA40 Medical Diagnostic Equipment... the Federal Register, 77 FR 6916, on accessibility standards for medical diagnostic equipment and... equipment, in consultation with the Commissioner of the Food and Drug Administration. The Access...

  5. Bedside Ultrasound Reduces Diagnostic Uncertainty and Guides Resuscitation in Patients With Undifferentiated Hypotension.

    PubMed

    Shokoohi, Hamid; Boniface, Keith S; Pourmand, Ali; Liu, Yiju T; Davison, Danielle L; Hawkins, Katrina D; Buhumaid, Rasha E; Salimian, Mohammad; Yadav, Kabir

    2015-12-01

    Utilization of ultrasound in the evaluation of patients with undifferentiated hypotension has been proposed in several protocols. We sought to assess the impact of an ultrasound hypotension protocol on physicians' diagnostic certainty, diagnostic ability, and treatment and resource utilization. Prospective observational study. Emergency department in a single, academic tertiary care hospital. A convenience sample of patients with a systolic blood pressure less than 90 mm Hg after an initial fluid resuscitation, who lacked an obvious source of hypotension. An ultrasound-trained physician performed an ultrasound on each patient using a standardized hypotension protocol. Differential diagnosis and management plan was solicited from the treating physician immediately before and after the ultrasound. Blinded chart review was conducted for management and diagnosis during the emergency department and inpatient hospital stay. The primary endpoints were the identification of an accurate cause for hypotension and change in physicians' diagnostic uncertainty. The secondary endpoints were changes in treatment plan, use of resources, and changes in disposition after performing the ultrasound. One hundred eighteen patients with a mean age of 62 years were enrolled. There was a significant 27.7% decrease in the mean aggregate complexity of diagnostic uncertainty before and after the ultrasound hypotension protocol (1.85-1.34; -0.51 [95% CI, -0.41 to -0.62]) as well as a significant increase in the absolute proportion of patients with a definitive diagnosis from 0.8% to 12.7%. Overall, the leading diagnosis after the ultrasound hypotension protocol demonstrated excellent concordance with the blinded consensus final diagnosis (Cohen k = 0.80). Twenty-nine patients (24.6%) had a significant change in the use of IV fluids, vasoactive agents, or blood products. There were also significant changes in major diagnostic imaging (30.5%), consultation (13.6%), and emergency department

  6. [Different educational programs on medical ultrasound examination for radiological technologists and medical technologists].

    PubMed

    Ganjitsuda, Kazunori; Tagawa, Masami; Ikeda, Kenichi; Fukushi, Masahiro; Kameoka, Junichi

    2012-01-01

    Radiological technologists (RTs) and medical technologists (MTs) are legally allowed to work as sonographers performing medical ultrasound examination. Despite the total number, much fewer RTs work as sonographers than MTs. To explore the reason, we investigated educational programs, universities, and colleges for both specialties. First, we established five categories of sonographers' competency: 1) Anatomy for imaging diagnosis, 2) Diseases and diagnosis, 3) Imaging, 4) Structure and principle of the equipment, and 5) Evaluation of image quality, using competence reported by the International Society of Radiographers and Radiological Technologists (ISRRT) and diagnostic competency required of sonographers in Japan. Using these categories, we analyzed the content and total instruction time by lectures and seminars based on information written in the syllabi, and explored the differences in education related to sonographers' competency in both programs. "Anatomy for imaging diagnosis" was taught in 15 RT programs (93.8%), and 6 MT programs (31.6%). "Diseases and diagnosis" was taught in 13 RT programs (86.7%), and 8 MT programs (53.3%). "Imaging" was taught in 14 RT programs (100%), and 13 MT programs (76.5%). "Structure and principle of the equipment" was taught in 12 RT programs (85.7%), and 6 MT programs (31.6%). "Evaluation of image quality" was taught in 11 RT programs (84.6%), and 3 MT programs (15.0%). The average instruction time for RT was longer than for MT programs in all categories. RTs are educated and have a foundation to be sonographers at graduation, and may have the possibility to expand their career in this field.

  7. Training in Diagnostic Ultrasound: Essentials, Principles, and Standards. Report of a WHO Study Group. Technical Report Series 875.

    ERIC Educational Resources Information Center

    World Health Organization, Geneva (Switzerland).

    This report defines the essential training and skills necessary for the effective employment of diagnostic ultrasound in different health care settings. It reviews the present situation in ultrasonography and the trends in the utilization of diagnostic ultrasound in clinical practice. The report also examines worldwide practice with respect to…

  8. Diagnostic utility of musculoskeletal ultrasound in patients with suspected arthritis--a probabilistic approach.

    PubMed

    Rezaei, Hamed; Torp-Pedersen, Søren; af Klint, Erik; Backheden, Magnus; Kisten, Yogan; Györi, Noémi; van Vollenhoven, Ronald F

    2014-10-01

    This study aimed to assess the utility of musculoskeletal ultrasound (MSUS) in patients with joint symptoms using a probabilistic approach. One hundred and three patients without prior rheumatologic diagnosis and referred to our clinic for evaluation of inflammatory arthritis were included. Patients were assessed clinically including joint examination, laboratory testing including acute-phase reactants, rheumatoid factor (RF) and anti citrulinated protein antibody (ACPA), and radiographs of hands and feet if clinically indicated. A diagnostic assessment was then performed by the responsible rheumatologist where the probability of a) any inflammatory arthritis and b) rheumatoid arthritis was given on a 5-point scale ranging from 0 to 20% up to 80 to 100% probability. Subsequently, an ultrasound examination of the wrist, metacarpophalangeal (MCP), proximal interphalangeal (PIP) joints 2 to 5 in both hands, metatarsophalangeal (MTP) joints 2 to 5 in both feet and any symptomatic joints was performed and the results presented to the same rheumatologist. The latter then assessed the diagnostic probabilities again, using the same scale. The rheumatologists' certainty for presence/absence of inflammatory arthritis and rheumatoid arthritis was increased significantly following ultrasound performance. The proportion of patient for whom diagnostic certainty for inflammatory arthritis was maximal was 33.0% before and 71.8% after musculoskeletal ultrasound (P <0.001). With regard to a diagnosis of RA, the proportions were 31.1% pre-test and 61.2% post-test (P <0.001). MSUS findings agreed with the final diagnosis in 95% of patients. Musculoskeletal ultrasound, when added to routine rheumatologic investigation, greatly increases the diagnostic certainty in patients referred for the evaluation of inflammatory arthritis. The changes from pre-test to post-test probability quantify the diagnostic utility of musculoskeletal ultrasound in probabilistic terms.

  9. Medical Acoustics

    NASA Astrophysics Data System (ADS)

    Beach, Kirk W.; Dunmire, Barbrina

    Medical acoustics can be subdivided into diagnostics and therapy. Diagnostics are further separated into auditory and ultrasonic methods, and both employ low amplitudes. Therapy (excluding medical advice) uses ultrasound for heating, cooking, permeablizing, activating and fracturing tissues and structures within the body, usually at much higher amplitudes than in diagnostics. Because ultrasound is a wave, linear wave physics are generally applicable, but recently nonlinear effects have become more important, even in low-intensity diagnostic applications.

  10. Diagnostic image quality in gynaecological ultrasound: Who should measure it, what should we measure and how?

    PubMed

    Cantin, Peter; Knapp, Karen

    2014-02-01

    Assessment of diagnostic image quality in gynaecological ultrasound is an important aspect of imaging department quality assurance. This may be addressed through audit, but who should undertake the audit, what should be measured and how, remains contentious. The aim of this study was to identify whether peer audit is a suitable method of assessing the diagnostic quality of gynaecological ultrasound images. Nineteen gynaecological ultrasound studies were independently assessed by six sonographers utilising a pilot version of an audit tool. Outcome measures were levels of inter-rater agreement using different data collection methods (binary scores, Likert scale, continuous scale), effect of ultrasound study difficulty on study score and whether systematic differences were present between reviewers of different clinical grades and length of experience. Inter-rater agreement ranged from moderate to good depending on the data collection method. A continuous scale gave the highest level of inter-rater agreement with an intra-class correlation coefficient of 0.73. A strong correlation (r = 0.89) between study difficulty and study score was yielded. Length of clinical experience between reviewers had no effect on the audit scores, but individuals of a higher clinical grade gave significantly lower scores than those of a lower grade (p = 0.04). Peer audit is a promising tool in the assessment of ultrasound image quality. Continuous scales seem to be the best method of data collection implying a strong element of heuristically driven decision making by reviewing ultrasound practitioners.

  11. Diagnostic image quality in gynaecological ultrasound: Who should measure it, what should we measure and how?

    PubMed Central

    Knapp, Karen

    2013-01-01

    Assessment of diagnostic image quality in gynaecological ultrasound is an important aspect of imaging department quality assurance. This may be addressed through audit, but who should undertake the audit, what should be measured and how, remains contentious. The aim of this study was to identify whether peer audit is a suitable method of assessing the diagnostic quality of gynaecological ultrasound images. Nineteen gynaecological ultrasound studies were independently assessed by six sonographers utilising a pilot version of an audit tool. Outcome measures were levels of inter-rater agreement using different data collection methods (binary scores, Likert scale, continuous scale), effect of ultrasound study difficulty on study score and whether systematic differences were present between reviewers of different clinical grades and length of experience. Inter-rater agreement ranged from moderate to good depending on the data collection method. A continuous scale gave the highest level of inter-rater agreement with an intra-class correlation coefficient of 0.73. A strong correlation (r = 0.89) between study difficulty and study score was yielded. Length of clinical experience between reviewers had no effect on the audit scores, but individuals of a higher clinical grade gave significantly lower scores than those of a lower grade (p = 0.04). Peer audit is a promising tool in the assessment of ultrasound image quality. Continuous scales seem to be the best method of data collection implying a strong element of heuristically driven decision making by reviewing ultrasound practitioners. PMID:27433192

  12. Cystic Pancreatic Lymphangioma - Diagnostic Role of Endoscopic Ultrasound.

    PubMed

    Carvalho, Diana; Costa, Mariana; Russo, Pedro; Simas, Luís; Baptista, Teresa; Ramos, Gonçalo

    2016-01-01

    Pancreatic cystic lymphangiomas are rare benign lesions that arise from lymphatic vessels, accounting for less than 0.2% of all pancreatic cysts. Typically it is asymptomatic and discovery occurs during imaging exams for non-pancreatic disease. In the past, a definite diagnosis was made through surgery, with complete resection of all tumoral tissue to prevent recurrence. Nowadays, the development of endoscopic ultrasound (EUS) made it possible to identify these cysts combining morphologic ultrasound features, macroscopic aspirated fluid appearance, biochemical and cytological evaluation of the sample. We report two cases of cystic pancreatic lymphangioma diagnosed through EUS, allowing conservative management without surgery. These cases show that cystic pancreatic lymphangioma should be considered in the differential diagnosis of cystic pancreatic lesions and that EUS is an important tool for their recognition.

  13. Ultrasound introscopic image quantitative characteristics for medical diagnosis

    NASA Astrophysics Data System (ADS)

    Novoselets, Mikhail K.; Sarkisov, Sergey S.; Gridko, Alexander N.; Tcheban, Anatoliy K.

    1993-09-01

    The results on computer aided extraction of quantitative characteristics (QC) of ultrasound introscopic images for medical diagnosis are presented. Thyroid gland (TG) images of Chernobil Accident sufferers are considered. It is shown that TG diseases can be associated with some values of selected QCs of random echo distribution in the image. The possibility of these QCs usage for TG diseases recognition in accordance with calculated values is analyzed. The role of speckle noise elimination in the solution of the problem on TG diagnosis is considered too.

  14. [Digital scanning converter for medical endoscopic ultrasound imaging].

    PubMed

    Chen, Xiaodong; Zhang, Hongxu; Zhou, Peifan; Wen, Shijie; Yu, Daoyin

    2009-02-01

    This paper mainly introduces the design of digital scanning converter (DSC) for medical endoscopic ultrasound imaging. Fast modified vector totational CORDIC (FMVR-CORDIC) arithmetic complete coordinate conversion is used to increase the speed of ultrasonic scanning imaging. FPGA is used as the kernel module to control data transferring, related circuits and relevant chips' working, and to accomplish data preprocessing. With the advantages of simple structure, nice flexibility and convenience, it satisfies the demand for real-time displaying in this system. Finally, the original polar coordinate image is transformed to rectangular coordinate grey image through coordinate transformation. The system performances have been validated by the experimental result.

  15. Geometric distortion of area in medical ultrasound images

    NASA Astrophysics Data System (ADS)

    Bland, T.; Tong, J.; Ward, B.; Parker, N. G.

    2017-01-01

    Medical ultrasound scanners are typically calibrated to a speed of sound corresponding to the soft tissue average of 1540 m s-1. In regions of different sound speed, for example, organs and tumours, the B-mode image becomes geometrically distorted from the true tissue cross-section, due to refraction and the misrepresentation of length. A ray model is developed to predict this distortion for a generalized two-dimensional object with atypical speed of sound, and verified against ultrasound images of a test object. We quantify the areal image distortion as a function of the key dependencies, including the speed of sound mismatch, the scanning format, the object size and its elongation. Our findings show that the distortion of area can be significant, even for relatively small speed of sound mismatches. For example, a 5% speed mismatch typically leads to a 10 - 20% distortion in area. These findings have implications for the accuracy of ultrasound-based evaluation of area and volume.

  16. [How should anesthesiologists perform ultrasound examinations? Diagnostic use of ultrasound in emergency and intensive care and medicine].

    PubMed

    Maecken, T; Zinke, H; Zenz, M; Grau, T

    2011-03-01

    Ultrasound imaging has attained great significance as a tool for diagnostics in emergency and intensive care medicine. The major advantages of this technique are its instantaneous bedside availability and the possibility to perform repeatable examinations. These advantages are based on recent developments, such as portable ultrasound devices offering excellent imaging quality as well as a quick-start-function. Ultrasound imaging in critically ill patients is frequently performed under pressure of time depending on the current acute physical state. All standard examinations in echocardiography, vascular, abdominal and thoracic ultrasound scanning can be applied in these patients. Based on the clinical scenario the duration of examinations may vary from seconds during cardiopulmonary resuscitations to time-consuming repeated scanning. The transition from basic to subject-specific detailed examinations is flowing and has to be adjusted to local conditions. In the field of emergency and intensive care medicine the technique used is whole-body sonography. The goal is to classify the patient's present physical state and to define a targeted therapeutic approach. The characteristics of whole-body sonography are similar to the field of anesthesiology which is an interdisciplinary one. Currently, these characteristics deserve more attention in training in sonography.

  17. What they mean by "good science': the medical community's response to boutique fetal ultrasounds.

    PubMed

    Raucher, Michal S

    2009-10-01

    Since 1994, when the first fetal imaging boutique appeared in Texas, many sites have been established around the country for parents to receive nonmedical fetal imaging using three- and four-dimensional ultrasound machines. These businesses boast the benefits they offer to parental-fetal bonding, but the medical community objects to the use of ultrasound machines for nonmedical purposes. In this article, I present the statements released by the medical community, highlighting the alarmist strategies used to paint boutique ultrasounds as bad science and elevate the medical use of ultrasounds. Through a close reading of the statements, it is shown that the medical community's primary concern is not the health of the fetus or the woman but rather their place as the sole users of fetal ultrasounds. This detailed analysis reveals a medical community fearful that its authority is being usurped and is therefore responding with statements meant to denigrate boutique fetal ultrasounds.

  18. Prenatal Sex Selection and Missing Girls in China: Evidence from the Diffusion of Diagnostic Ultrasound

    ERIC Educational Resources Information Center

    Chen, Yuyu; Li, Hongbin; Meng, Lingsheng

    2013-01-01

    How much of the increase in sex ratio (male to female) at birth since the early 1980s in China is attributed to increased prenatal sex selection? This question is addressed by exploiting the differential introduction of diagnostic ultrasound in the country during the 1980s, which significantly reduced the cost of prenatal sex selection. We…

  19. Prenatal Sex Selection and Missing Girls in China: Evidence from the Diffusion of Diagnostic Ultrasound

    ERIC Educational Resources Information Center

    Chen, Yuyu; Li, Hongbin; Meng, Lingsheng

    2013-01-01

    How much of the increase in sex ratio (male to female) at birth since the early 1980s in China is attributed to increased prenatal sex selection? This question is addressed by exploiting the differential introduction of diagnostic ultrasound in the country during the 1980s, which significantly reduced the cost of prenatal sex selection. We…

  20. Mistakes in the ultrasound diagnostics of the abdominal cavity in pediatrics.

    PubMed

    Brodzisz, Agnieszka

    2017-03-01

    The diagnostics of the abdominal cavity in children, especially in the neonatal-infantile period, requires knowledge in the field of anatomical and physiopathological differences as well as clinical symptomatology and pathology at every stage of the child's development. Errors and mistakes in ultrasound diagnostics of the abdominal cavity in children result from many factors, including lack of experience in examining children and the knowledge concerning most frequent ailments and pathologies as well as the incidence or no changes in the ultrasound image of the abdominal cavity organs. The assessment of the ultrasound image should be always based on clinical data of the patient, information on the past diseases, surgeries and the results of additional examinations and laboratory tests. Particular attention should be paid to the occurrence of congenital diseases and inflammations, which may have varied clinical manifestation - especially in the case of pediatric diagnostics. The variety and non-specific nature of clinical symptoms may also mask the developing neoplastic process. Mistakes in ultrasound diagnostics, especially among the youngest children, may also be caused by technical difficulties related to carrying out the examination. The above situation results from lack of cooperation with the child, who is uneasy, wailing, fails to perform orders, which may lead to overlooking the existing lesion or overinterpreting, e.g. a full stomach or residual stool in the intestines to be a pathology. It is also of high importance to have a good class of the ultrasound equipment and technical knowledge concerning its operation. When performing an ultrasound examination in children, it is necessary to apply a wide range of phased-array, convex and linear heads and appropriate applications, the so-called pediatric software (stomach, kidneys, true pelvis, organs at the surface).

  1. Mistakes in the ultrasound diagnostics of the abdominal cavity in pediatrics

    PubMed Central

    2017-01-01

    The diagnostics of the abdominal cavity in children, especially in the neonatal-infantile period, requires knowledge in the field of anatomical and physiopathological differences as well as clinical symptomatology and pathology at every stage of the child’s development. Errors and mistakes in ultrasound diagnostics of the abdominal cavity in children result from many factors, including lack of experience in examining children and the knowledge concerning most frequent ailments and pathologies as well as the incidence or no changes in the ultrasound image of the abdominal cavity organs. The assessment of the ultrasound image should be always based on clinical data of the patient, information on the past diseases, surgeries and the results of additional examinations and laboratory tests. Particular attention should be paid to the occurrence of congenital diseases and inflammations, which may have varied clinical manifestation – especially in the case of pediatric diagnostics. The variety and non-specific nature of clinical symptoms may also mask the developing neoplastic process. Mistakes in ultrasound diagnostics, especially among the youngest children, may also be caused by technical difficulties related to carrying out the examination. The above situation results from lack of cooperation with the child, who is uneasy, wailing, fails to perform orders, which may lead to overlooking the existing lesion or overinterpreting, e.g. a full stomach or residual stool in the intestines to be a pathology. It is also of high importance to have a good class of the ultrasound equipment and technical knowledge concerning its operation. When performing an ultrasound examination in children, it is necessary to apply a wide range of phased-array, convex and linear heads and appropriate applications, the so-called pediatric software (stomach, kidneys, true pelvis, organs at the surface). PMID:28439431

  2. A Pilot Study of Diagnostic Neuromuscular Ultrasound in Bell's Palsy.

    PubMed

    Tawfik, Eman A; Walker, Francis O; Cartwright, Michael S

    2015-01-01

    Neuromuscular ultrasound of the cranial nerves is an emerging field which may help in the assessment of cranial neuropathies. The aim of this study was to evaluate the role of neuromuscular ultrasound in Bell's palsy. A second objective was to assess the possibility of any associated vagus nerve abnormality. Twenty healthy controls and 12 Bell's palsy patients were recruited. The bilateral facial nerves, vagus nerves, and frontalis muscles were scanned using an 18 MHz linear array transducer. Facial nerve diameter, vagus nerve cross-sectional area, and frontalis thickness were measured. Mean facial nerve diameter was .8 ± .2 mm in controls and 1.1 ± .3 mm in patients group. The facial nerve diameter was significantly larger in patients than controls (P = .006, 95% CI for the difference between groups of .12-.48), with a significant side-to-side difference in patients as well (P = .004, 95% CI for side-to-side difference of .08-.52). ROC curve analysis of the absolute facial nerve diameter revealed a sensitivity of 75% and a specificity of 70%. No significant differences in vagus nerve cross-sectional area or frontalis thickness were detected between patients and controls. Ultrasound can detect facial nerve enlargement in Bell's palsy and may have a role in assessment, or follow-up, of Bell's palsy and other facial nerve disorders. The low sensitivity of the current technique precludes its routine use for diagnosis, however, this study demonstrates its validity and potential for future research. Copyright © 2015 by the American Society of Neuroimaging.

  3. Errors made in the ultrasound diagnostics of the spleen

    PubMed Central

    Walas, Maria Krystyna

    2013-01-01

    Ultrasonography, like any imaging method, entails the risk of errors. From among all means of imaging, it is the most subjective and dependent on the examiner's knowledge and experience. This paper presents the causes of examiner-dependent errors as well as those which result from technical settings and preparation of the patient for the examination. Moreover, the authors discuss the most frequent errors in the diagnosis of splenic conditions, which result from insufficient knowledge concerning anatomical variants of this organ, wrong measurements and incorrect examination technique. The mistakes made in the differentiation of focal lesions of the spleen and its hilum are also discussed. Additionally, the differentiation of collateral circulation, lymph nodes and accessory spleens is mentioned. The authors also draw attention to erroneous interpretation of the left liver lobe as a fragment of the spleen as well as the prominent tail of the pancreas filled with gastric contents and intestinal loops as abnormal masses or fluid cisterns in the area of the splenic hilum. Furthermore, the pathologies of the hilum are discussed such as tumors of the splenic flexure of the colon, lesions arising from the left kidney or the left adrenal gland. The authors list characteristic imaging features of the most common focal lesions visualized in a standard ultrasound scan as well as enhancement patterns appearing in contrast-enhanced examinations. The article discusses the features and differentiation of, among others, infarction, splenic cysts including hydatid ones, abscesses and angiomas. The ultrasound appearance of lymphoma and secondary involvement of the spleen by other malignant neoplasms is also mentioned. Moreover, the authors provide useful tips connected with imaging techniques and interpretation of the findings. The ultrasound examination carried out in compliance with current standards allows for an optimal assessment of the organ and reduction of the error

  4. Errors made in the ultrasound diagnostics of the spleen.

    PubMed

    Walczyk, Joanna; Walas, Maria Krystyna

    2013-03-01

    Ultrasonography, like any imaging method, entails the risk of errors. From among all means of imaging, it is the most subjective and dependent on the examiner's knowledge and experience. This paper presents the causes of examiner-dependent errors as well as those which result from technical settings and preparation of the patient for the examination. Moreover, the authors discuss the most frequent errors in the diagnosis of splenic conditions, which result from insufficient knowledge concerning anatomical variants of this organ, wrong measurements and incorrect examination technique. The mistakes made in the differentiation of focal lesions of the spleen and its hilum are also discussed. Additionally, the differentiation of collateral circulation, lymph nodes and accessory spleens is mentioned. The authors also draw attention to erroneous interpretation of the left liver lobe as a fragment of the spleen as well as the prominent tail of the pancreas filled with gastric contents and intestinal loops as abnormal masses or fluid cisterns in the area of the splenic hilum. Furthermore, the pathologies of the hilum are discussed such as tumors of the splenic flexure of the colon, lesions arising from the left kidney or the left adrenal gland. The authors list characteristic imaging features of the most common focal lesions visualized in a standard ultrasound scan as well as enhancement patterns appearing in contrast-enhanced examinations. The article discusses the features and differentiation of, among others, infarction, splenic cysts including hydatid ones, abscesses and angiomas. The ultrasound appearance of lymphoma and secondary involvement of the spleen by other malignant neoplasms is also mentioned. Moreover, the authors provide useful tips connected with imaging techniques and interpretation of the findings. The ultrasound examination carried out in compliance with current standards allows for an optimal assessment of the organ and reduction of the error

  5. Non-stationary blind deconvolution of medical ultrasound scans

    NASA Astrophysics Data System (ADS)

    Michailovich, Oleg V.

    2017-03-01

    In linear approximation, the formation of a radio-frequency (RF) ultrasound image can be described based on a standard convolution model in which the image is obtained as a result of convolution of the point spread function (PSF) of the ultrasound scanner in use with a tissue reflectivity function (TRF). Due to the band-limited nature of the PSF, the RF images can only be acquired at a finite spatial resolution, which is often insufficient for proper representation of the diagnostic information contained in the TRF. One particular way to alleviate this problem is by means of image deconvolution, which is usually performed in a "blind" mode, when both PSF and TRF are estimated at the same time. Despite its proven effectiveness, blind deconvolution (BD) still suffers from a number of drawbacks, chief among which stems from its dependence on a stationary convolution model, which is incapable of accounting for the spatial variability of the PSF. As a result, virtually all existing BD algorithms are applied to localized segments of RF images. In this work, we introduce a novel method for non-stationary BD, which is capable of recovering the TRF concurrently with the spatially variable PSF. Particularly, our approach is based on semigroup theory which allows one to describe the effect of such a PSF in terms of the action of a properly defined linear semigroup. The approach leads to a tractable optimization problem, which can be solved using standard numerical methods. The effectiveness of the proposed solution is supported by experiments with in vivo ultrasound data.

  6. High-resolution, low-delay, and error-resilient medical ultrasound video communication using H.264/AVC over mobile WiMAX networks.

    PubMed

    Panayides, Andreas; Antoniou, Zinonas C; Mylonas, Yiannos; Pattichis, Marios S; Pitsillides, Andreas; Pattichis, Constantinos S

    2013-05-01

    In this study, we describe an effective video communication framework for the wireless transmission of H.264/AVC medical ultrasound video over mobile WiMAX networks. Medical ultrasound video is encoded using diagnostically-driven, error resilient encoding, where quantization levels are varied as a function of the diagnostic significance of each image region. We demonstrate how our proposed system allows for the transmission of high-resolution clinical video that is encoded at the clinical acquisition resolution and can then be decoded with low-delay. To validate performance, we perform OPNET simulations of mobile WiMAX Medium Access Control (MAC) and Physical (PHY) layers characteristics that include service prioritization classes, different modulation and coding schemes, fading channels conditions, and mobility. We encode the medical ultrasound videos at the 4CIF (704 × 576) resolution that can accommodate clinical acquisition that is typically performed at lower resolutions. Video quality assessment is based on both clinical (subjective) and objective evaluations.

  7. Computer-aided diagnostic system for detection of Hashimoto thyroiditis on ultrasound images from a Polish population.

    PubMed

    Acharya, U Rajendra; Sree, S Vinitha; Krishnan, M Muthu Rama; Molinari, Filippo; Zieleźnik, Witold; Bardales, Ricardo H; Witkowska, Agnieszka; Suri, Jasjit S

    2014-02-01

    Computer-aided diagnostic (CAD) techniques aid physicians in better diagnosis of diseases by extracting objective and accurate diagnostic information from medical data. Hashimoto thyroiditis is the most common type of inflammation of the thyroid gland. The inflammation changes the structure of the thyroid tissue, and these changes are reflected as echogenic changes on ultrasound images. In this work, we propose a novel CAD system (a class of systems called ThyroScan) that extracts textural features from a thyroid sonogram and uses them to aid in the detection of Hashimoto thyroiditis. In this paradigm, we extracted grayscale features based on stationary wavelet transform from 232 normal and 294 Hashimoto thyroiditis-affected thyroid ultrasound images obtained from a Polish population. Significant features were selected using a Student t test. The resulting feature vectors were used to build and evaluate the following 4 classifiers using a 10-fold stratified cross-validation technique: support vector machine, decision tree, fuzzy classifier, and K-nearest neighbor. Using 7 significant features that characterized the textural changes in the images, the fuzzy classifier had the highest classification accuracy of 84.6%, sensitivity of 82.8%, specificity of 87.0%, and a positive predictive value of 88.9%. The proposed ThyroScan CAD system uses novel features to noninvasively detect the presence of Hashimoto thyroiditis on ultrasound images. Compared to manual interpretations of ultrasound images, the CAD system offers a more objective interpretation of the nature of the thyroid. The preliminary results presented in this work indicate the possibility of using such a CAD system in a clinical setting after evaluating it with larger databases in multicenter clinical trials.

  8. The evolution of an integrated ultrasound curriculum (iUSC) for medical students: 9-year experience.

    PubMed

    Hoppmann, Richard A; Rao, Victor V; Bell, Floyd; Poston, Mary Beth; Howe, Duncan B; Riffle, Shaun; Harris, Stephen; Riley, Ruth; McMahon, Carol; Wilson, L Britt; Blanck, Erika; Richeson, Nancy A; Thomas, Lynn K; Hartman, Celia; Neuffer, Francis H; Keisler, Brian D; Sims, Kerry M; Garber, Matthew D; Shuler, C Osborne; Blaivas, Michael; Chillag, Shawn A; Wagner, Michael; Barron, Keith; Davis, Danielle; Wells, James R; Kenney, Donald J; Hall, Jeffrey W; Bornemann, Paul H; Schrift, David; Hunt, Patrick S; Owens, William B; Smith, R Stephen; Jackson, Allison G; Hagon, Kelsey; Wilson, Steven P; Fowler, Stanley D; Catroppo, James F; Rizvi, Ali A; Powell, Caroline K; Cook, Thomas; Brown, Eric; Navarro, Fernando A; Thornhill, Joshua; Burgis, Judith; Jennings, William R; McCallum, James B; Nottingham, James M; Kreiner, James; Haddad, Robert; Augustine, James R; Pedigo, Norman W; Catalana, Paul V

    2015-12-01

    Interest in ultrasound education in medical schools has increased dramatically in recent years as reflected in a marked increase in publications on the topic and growing attendance at international meetings on ultrasound education. In 2006, the University of South Carolina School of Medicine introduced an integrated ultrasound curriculum (iUSC) across all years of medical school. That curriculum has evolved significantly over the 9 years. A review of the curriculum is presented, including curricular content, methods of delivery of the content, student assessment, and program assessment. Lessons learned in implementing and expanding an integrated ultrasound curriculum are also presented as are thoughts on future directions of undergraduate ultrasound education. Ultrasound has proven to be a valuable active learning tool that can serve as a platform for integrating the medical student curriculum across many disciplines and clinical settings. It is also well-suited for a competency-based model of medical education. Students learn ultrasound well and have embraced it as an important component of their education and future practice of medicine. An international consensus conference on ultrasound education is recommended to help define the essential elements of ultrasound education globally to ensure ultrasound is taught and ultimately practiced to its full potential. Ultrasound has the potential to fundamentally change how we teach and practice medicine to the benefit of learners and patients across the globe.

  9. Expanding medical abortion: can medical abortion be effectively provided without the routine use of ultrasound?

    PubMed

    Kaneshiro, Bliss; Edelman, Alison; Sneeringer, Robyn K; Ponce de Leon, Rodolfo Gomez

    2011-03-01

    Medical abortion studies have traditionally relied on ultrasound to confirm gestational age, intrauterine location and abortion completion. However, the routine dependence on ultrasound can limit access to safe services for women living in low resource settings that are often most in need of safe abortion care. This review discusses the literature surrounding the safe provision of medical abortion without the routine use of ultrasonography and concludes that clinicians can use the reported last menstrual period (LMP) and physical examination to reasonably estimate gestational age. Completed pregnancy expulsion can be confirmed primarily through history and physical examination with some studies indicating that urine pregnancy tests may also play a limited role. Central to the discussion of whether medical abortion can be provided in most low resource settings without the routine use of ultrasonography is the fact that the mifepristone-misoprostol regimen is a highly effective procedure for pregnancy termination through 63 days' gestation. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. Ergonomic design and evaluation of a diagnostic ultrasound transducer holder.

    PubMed

    Ghasemi, Mohamad Sadegh; Hosseinzadeh, Payam; Zamani, Farhad; Ahmadpoor, Hossein; Dehghan, Naser

    2016-09-07

    Work-related musculoskeletal disorders (WMSDs) are injuries and disorders that affect the body's movement and musculoskeletal system. Awkward postures represent one of the major ergonomic risk factors that cause WMSDs among sonographers while working with an ultrasound transducer. This study aimed to design and evaluate a new holder for the ultrasound transducer. In the first phase a new holder was designed for the transducer, considering design principles. Evaluation of the new holder was then carried out by electrogoniometry and a locally perceived discomfort (LPD) scale. The application of design principles to the new holder resulted in an improvement of wrist posture and comfort. Wrist angles in extension, flexion, radial deviation and ulnar deviation were lower with utilization of the new holder. The severity of discomfort based on the LPD method in the two modes of work with and without the new holder was reported with values of 1.3 and 1.8, respectively (p < 0.05). Overall, this study indicated that applying ergonomics design principles was effective in minimizing wrist deviation and increasing comfort while working with the new holder.

  11. Direct thermal hard copy system for medical diagnostic applications

    NASA Astrophysics Data System (ADS)

    De Langhe, Dirk; De Clerck, Marc; Kaerts, Erik; Horsten, Bart; Defieuw, Geert; Borremans, Karel

    1997-05-01

    A new dry system based on a direct thermal technology with diagnostic properties has been developed. This paper discusses the major improvements in printer and film required to achieve the image quality needed to meet the diagnostic requirements. The concept of the printer and the film rate both explained. The image quality achieved in terms of contrast, resolution, noise and other parameters is discussed. The results of archivability and shelf life testing and the physical properties of the material are also presented. To validate the technology for diagnostic purposes, a hospital test has been performed for ultrasound, CT, MRI, R and F and vascular studies. The method and results of this testing are presented in the paper. The hospital tests showed that the images obtained with the dry system materials can be used for diagnostic purposes.

  12. [Subclinical findings in the knees of taekwondo athletes: diagnostic ultrasound study].

    PubMed

    Martínez Hernández, Luis Enrique; Hernández Díaz, Cristina; Pegueros Pérez, Andrea; Franco Sánchez, José Gilberto; Pineda Villaseñor, Carlos

    2014-12-01

    Taekwondo is associated with an increased incidence of musculoskeletal injuries such as tendinopathy, synovitis, chondropathy, and ligament and meniscus injuries that may have an asymptomatic course in their initial stages, especially those located in the knee. To describe the presence of morphostructural abnormalities in asymptomatic taekwondo athletes' (TKD) knees through the use of diagnostic ultrasound (US). A cross-sectional, descriptive and comparative study. We evaluated 32 knees of 16 subjects (8 TKD and 8 recreational athletes). All subjects underwent sport-medical history and knee US. A variety of intra- and extra-articular morphostructural abnormalities were observed; the most frequent were synovitis, meniscal extrusion, and enthesopathy. The practice of Taekwondo abnormalities associated with an increased risk of knee injuries that may go unnoticed in the early stages. The use of US as an auxiliary tool in the diagnosis of these injuries and/or advisable since it can define in detail the anatomical structures subject to overuse, biomechanical stress, or repetitive trauma, and contribute to early detection of asymptomatic morphostructural alterations that may ensure timely preventive and therapeutic interventions.

  13. The diagnostic value of ultrasound in cystic kidney diseases.

    PubMed

    Vester, Udo; Kranz, Birgitta; Hoyer, Peter F

    2010-02-01

    Renal cysts in childhood can be found in a variety of diseases, which can be congenital or acquired, or renal cysts may be part of a multiorgan disease or restricted to the kidneys only. Ultrasonography is the first-line diagnostic tool and is informative in many cases. However, there is a broad spectrum in the sonographic appearance of renal cysts, and family or genetic studies, a search for extrarenal organ involvement, or additional imaging modalities may be required to make a definitive diagnosis. The aim of this article is to summarize the diagnostic potential and limitations of ultrasonography and depict typical examples of the most important cystic entities.

  14. Contrast-Enhanced Ultrasound as a New Investigative Tool in Diagnostic Imaging of Muscle Injuries-A Pilot Study Evaluating Conventional Ultrasound, CEUS, and Findings in MRI.

    PubMed

    Hotfiel, Thilo; Heiss, Rafael; Swoboda, Bernd; Kellermann, Marion; Gelse, Kolja; Grim, Casper; Strobel, Deike; Wildner, Dane

    2017-07-11

    To emphasize the diagnostic value of contrast-enhanced ultrasound (CEUS) in the imaging of muscle injuries with different degrees of severity by comparing findings to established imaging modalities such as conventional ultrasound and magnetic resonance imaging (MRI). Case series. Institutional study. Conventional ultrasound and CEUS were performed in the Department of Internal Medicine. Magnetic resonance imaging was carried out in the Department of Radiology within the Magnetom Avanto 1.5T and Magnetom Skyra fit 3T (Siemens Healthineers, Erlangen, Germany) and in the Institution of Imaging Diagnostics and Therapy (Magnetom Avanto 1.5T; Siemens, Erlangen, Germany). Fifteen patients who underwent an acute muscle injury were recruited. The appearance and detectable size of muscle injuries were compared between each imaging modality. The injuries were assessed by 3 independent observers and blinded between imaging modalities. All 15 injuries were identified on MRI and CEUS, whereas 10 injuries showed abnormalities in conventional ultrasound. The determination and measurement revealed significant differences between conventional ultrasound and CEUS depending on injury severity. Contrast-enhanced ultrasound revealed an impairment of microcirculation in grade I lesions (corresponding to intramuscular edema observed in MRI), which was not detectable using conventional ultrasound. Our results indicate that performing CEUS seems to be a sensitive additional diagnostic modality in the early assessment of muscle injuries. Our results highlight the advantages of CEUS in the imaging of low-grade lesions when compared with conventional ultrasound, as this was the more accurate modality for identifying intramuscular edema.

  15. A Methodology for Anatomic Ultrasound Image Diagnostic Quality Assessment.

    PubMed

    Hemmsen, Martin Christian; Lange, Theis; Brandt, Andreas Hjelm; Nielsen, Michael Bachmann; Jensen, Jorgen Arendt

    2017-01-01

    This paper discusses the methods for the assessment of ultrasound image quality based on our experiences with evaluating new methods for anatomic imaging. It presents a methodology to ensure a fair assessment between competing imaging methods using clinically relevant evaluations. The methodology is valuable in the continuing process of method optimization and guided development of new imaging methods. It includes a three phased study plan covering from initial prototype development to clinical assessment. Recommendations to the clinical assessment protocol, software, and statistical analysis are presented. Earlier uses of the methodology has shown that it ensures validity of the assessment, as it separates the influences between developer, investigator, and assessor once a research protocol has been established. This separation reduces confounding influences on the result from the developer to properly reveal the clinical value. This paper exemplifies the methodology using recent studies of synthetic aperture sequential beamforming tissue harmonic imaging.

  16. New real-time strain imaging concepts using diagnostic ultrasound.

    PubMed

    Pesavento, A; Lorenz, A; Siebers, S; Ermert, H

    2000-06-01

    Two real-time strain imaging concepts and systems are presented. Both systems are based on a conventional ultrasound scanner that is connected to a PC with an A/D converter card for real-time data acquisition of rf data. Differential strain between successively acquired rf frames are estimated using phase root seeking. The first concept uses a special real-time implementation of manual elastography. In the second concept, denoted 'vibrography', the static compression is replaced by low-frequency axial vibration of the probe, still operating in quasistatic acquisition mode. The properties of both concepts are discussed with regard to noise and motion artefacts, and it is shown, using simulations and phantom experiments, that both imaging concepts yield the same kind of strain images. Vibrography has the advantage that no manual compression has to be applied, total compression can be very low and some motion artefacts are better suppressed.

  17. New real-time strain imaging concepts using diagnostic ultrasound

    NASA Astrophysics Data System (ADS)

    Pesavento, A.; Lorenz, A.; Siebers, S.; Ermert, H.

    2000-06-01

    Two real-time strain imaging concepts and systems are presented. Both systems are based on a conventional ultrasound scanner that is connected to a PC with an A/D converter card for real-time data acquisition of rf data. Differential strain between successively acquired rf frames are estimated using phase root seeking. The first concept uses a special real-time implementation of manual elastography. In the second concept, denoted `vibrography', the static compression is replaced by low-frequency axial vibration of the probe, still operating in quasistatic acquisition mode. The properties of both concepts are discussed with regard to noise and motion artefacts, and it is shown, using simulations and phantom experiments, that both imaging concepts yield the same kind of strain images. Vibrography has the advantage that no manual compression has to be applied, total compression can be very low and some motion artefacts are better suppressed.

  18. Treatment of acute intravascular thrombi with diagnostic ultrasound and intravenous microbubbles.

    PubMed

    Xie, Feng; Lof, John; Everbach, Carr; He, Anming; Bennett, Richard M; Matsunaga, Terry; Johanning, Jason; Porter, Thomas R

    2009-04-01

    The purpose of this study was to determine whether high mechanical index (MI) impulses from diagnostic ultrasound (DUS) could dissolve intravascular thrombi using intravenous microbubbles. Using a canine model, DUS was applied during a continuous intravenous infusion of microbubbles. Completely thrombosed grafts were assigned to 2 treatment regimens: low-MI (<0.5-MI) ultrasound alone; or intermittent high-MI impulses (1.9-MI) guided by low-MI ultrasound (contrast pulse sequencing). A 20-MHz cavitation detector was placed confocal to the ultrasound transducer to make intravascular cavitation measurements in 1 dog. Intravascular cavitational activity was detected when an MI of >0.5 was applied. In grafts treated with intermittent high-MI ultrasound, angiographic success was 71% at 30 min and 79% at 45 min, compared with 20% and 30% at these times in the low-MI ultrasound alone group (p < 0.05). We conclude that a commercially available DUS transducer can successfully recanalize acute intravascular thrombi during a continuous microbubble infusion.

  19. Can ultrasound predict IUD expulsion after medical abortion?

    PubMed

    Shimoni, Noa'a; Davis, Anne; Westhoff, Carolyn

    2014-05-01

    Our randomized trial compared early and delayed intrauterine device (IUD) insertion following medical abortion. In this planned substudy, we explore if endometrial thickness and initial IUD position were associated with IUD expulsion. We also describe IUD movement within the uterus during the 6 months after insertion. We recruited women undergoing medical abortion and choosing the copper IUD for contraception (n=156). Participants were randomly assigned to early insertion 1 week after mifepristone or delayed insertion 4-6 weeks later. We measured endometrial thickness by transvaginal sonogram 1 week after abortion and IUD distance from the fundal aspect of the endometrial cavity three times: at insertion, 6-8 weeks later and at 6 months. We analyzed endometrial thickness in 113 women, baseline IUD position in 114 women and IUD movement in 65 women. Women who expelled IUDs (n=15) had slightly thicker endometria (p=.007) and slightly lower baseline IUD positions (p=.03) than those who retained IUDs, but no clear cutoffs emerged in the receiver operating characteristic curve analysis. Retained IUDs commonly moved up and down throughout the 6 months (from 14 mm towards the fundus to 32 mm towards the cervix). Overall, retained IUDs moved a median of 2mm towards the cervix between insertion and exit (p<.0001). After medical abortion, the risk of IUD expulsion increases with thicker endometria and lower baseline position. Since no clear cutoffs emerged in the analysis and expulsion remained uncommon even with thicker endometria, we do not recommend restricting IUD insertion based on ultrasound data. Copper T IUDs often move within the uterus without expelling. Expulsion is uncommon, and we do not recommend restricting IUD insertion based on ultrasound data. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. [EXPERIENCE OF DIAGNOSTICS AND MEDICAL TREATMENT OF THE DIEULAFOYS DISEASE].

    PubMed

    P'iatykop, H I; Kravets', O V; Moskalenko, R A; Bratushka, V O

    2014-01-01

    The article is dedicated to the features of diagnostics and medical treatment of the Dieulafoys disease. Clinical description of six cases of foregoing pathology is resulted. The morphological features ulcers Dieulafoy are described. One fatal outcome of disease is analysed.

  1. Objective performance testing and quality assurance of medical ultrasound equipment.

    PubMed

    Thijssen, Johan M; Weijers, Gert; de Korte, Chris L

    2007-03-01

    There is an urgent need for a measurement protocol and software analysis for objective testing of the imaging performance of medical ultrasound equipment from a user's point of view. Methods for testing of imaging performance were developed. Simple test objects were used, which have a long life expectancy. First, the elevational focus (slice thickness) of the transducer was estimated and the in-plane transmit focus was positioned at the same depth. Next, the postprocessing look-up-table (LUT) was measured and linearized. The tests performed were echo level dynamic range (dB), contrast resolution (i.e., gamma of display, number of gray levels/dB) and sensitivity, overall system sensitivity, lateral sensitivity profile, dead zone, spatial resolution and geometric conformity of display. The concept of a computational observer was used to define the lesion signal-to-noise ratio, SNR(L) (or Mahalanobis distance), as a measure for contrast sensitivity. All the measurements were made using digitized images and quantified by objective means, i.e., by image analysis. The whole performance measurement protocol, as well as the quantitative measurements, have been implemented in software. An extensive data-base browser was implemented from which analysis of the images can be started and reports generated. These reports contain all the information about the measurements, such as graphs, images and numbers. The approach of calibrating the gamma by using a linearized LUT was validated by processing simultaneously acquired rf data. The contrast resolution and echo level of the rf data had to be compressed by a factor of two and amplified by a gain factor corresponding to 12 dB. This resulted in contrast curves that were practically identical to those obtained from DICOM image data. The effects of changing the transducer center frequency on the spatial resolution and contrast sensitivity were estimated to illustrate the practical usefulness of the developed approach of quality

  2. Simulation of diagnostic ultrasound image pulse sequences in cavitation bioeffects research.

    PubMed

    Miller, Douglas L; Dou, Chunyan; Wiggins, Roger C

    2007-10-01

    Research on cavitational bioeffects of diagnostic ultrasound (DUS) typically involves a diagnostic scanner as the exposure source. However, this can limit the ranges of exposure parameters for experimentation. Anesthetized hairless rats were mounted in a water bath and their right kidneys were exposed to ultrasound. Amplitude modulation with Gaussian envelopes simulated the image pulse sequences (IPSs) produced by diagnostic scanning. A 10 mulkgmin IV dose of Definity((R)) contrast agent was given during 1-5 min exposures. Glomerular capillary hemorrhage was assessed by histology. A stationary exposure approximated the bioeffects induced by DUS within the beam area. However, the use of five closely spaced exposures more faithfully reproduced the total effect produced within a DUS scan plane. Single pulses delivered at 1 s intervals induced the same effect as the simulated DUS. Use of 100 ms triangle-wave modulations for ramp-up or ramp-down of the IPS gave no effect or a large effect, respectively. Finally, an air-backed transducer simulating DUS without contrast agent showed a zero effect even operating at twice the present DUS guideline upper limit. Relatively simple single-element laboratory exposure systems can simulate diagnostic ultrasound exposure and allow exploration of parameter ranges beyond those available on present clinical systems.

  3. Handheld Diagnostic Device Delivers Quick Medical Readings

    NASA Technical Reports Server (NTRS)

    2014-01-01

    To monitor astronauts' health remotely, Glenn Research Center awarded SBIR funding to Cambridge, Massachusetts-based DNA Medical Institute, which developed a device capable of analyzing blood cell counts and a variety of medical biomarkers. The technology will prove especially useful in rural areas without easy access to labs.

  4. Investigating a unilateral pleural effusion: A tale of a medical error and diagnostic delays

    PubMed Central

    Welagedara, Suminda; Swe, Tokyo Moe; Sriram, Krishna Bajee

    2017-01-01

    We report the case of an elderly Asian man where a medical error and diagnostic delays obscured the diagnosis of pleural tuberculosis (TB). The patient was hospitalized for evaluation of a unilateral pleural effusion. Initially, the patient was subjected to a pleural aspiration on the wrong side due to a lack of bedside ultrasound guidance. Subsequently, the patient underwent several investigations but not a blind closed pleural biopsy (BCPB) due to a lack of equipment. Furthermore, the patient was deemed to be too sick to undergo a thoracoscopic pleural procedure. Eventually, a bronchoscopy was performed, and washings from the right upper lobe were cultured, which established the diagnosis of TB. This case highlights the need to use bedside ultrasound in the investigation of pleural effusions, the role of BCPB especially in frail patients and finally the utility of bronchoscopy in establishing a diagnosis of pleural TB. PMID:28144068

  5. Transport and use of point-of-care ultrasound by a disaster medical assistance team.

    PubMed

    Mazur, Stefan M; Rippey, James

    2009-01-01

    The role of ultrasound in disaster medicine has not been not well established. This report describes the transport and use of point-of-care ultrasound by a Disaster Medical Assistance Team (DMAT) responding to a mass-casualty incident due to a cyclone. Ultrasound-competent physicians on the team were able to use portable ultrasound on cyclone casualties to exclude intra-abdominal hemorrhage, pericardial fluid, pneumothoraces, and hemothoraces. Information obtained using ultrasound made initial patient management, and subsequent decisions regarding triage for transport safer and based on more detailed clinical information.

  6. Veterinary nurse to medical diagnostic radiographer.

    PubMed

    Taylor, Nicholas

    2017-08-19

    Nicholas Taylor is senior diagnostic radiographer at the Great Western Hospital, Swindon, having initially qualified as a veterinary nurse. It was a college lecture that initially sparked his interest in radiography - little did he know where it would lead. British Veterinary Association.

  7. Thoracic ultrasound: A complementary diagnostic tool in cardiology

    PubMed Central

    Trovato, Guglielmo M

    2016-01-01

    Clinical assessment and workup of patients referred to cardiologists may need an extension to chest disease. This requires more in-depth examination of respiratory co-morbidities due to uncertainty or severity of the clinical presentation. The filter and integration of ecg and echocardiographic information, addressing to the clues of right ventricular impairment, pulmonary embolism and pulmonary hypertension, and other less frequent conditions, such as congenital, inherited and systemic disease, usually allow more timely diagnosis and therapeutic choice. The concurrent use of thoracic ultrasound (TUS) is important, because, despite the evidence of the strict links between cardiac and respiratory medicine, heart and chest US imaging approaches are still separated. Actually, available expertise, knowledge, skills and training and equipment’s suitability are not equally fitting for heart or lung examination and not always already accessible in the same room or facility. Echocardiography is useful for study and monitoring of several respiratory conditions and even detection, so that this is nowadays an established functional complementary tool in pulmonary fibrosis and diffuse interstitial disease diagnosis and monitoring. Extending the approach of the cardiologist to lung and pleura will allow the achievement of information on pleural effusion, even minimal, lung consolidation and pneumothorax. Electrocardiography, pulse oximetry and US equipment are the friendly extension of the physical examination, if their use relies on adequate knowledge and training and on appropriate setting of efficient and working machines. Lacking these premises, overshadowing or misleading artefacts may impair the usefulness of TUS as an imaging procedure. PMID:27847557

  8. Correlation of diagnostic ultrasound and radionuclide imaging in scrotal disease

    SciTech Connect

    Chen, D.C.P.; Holder, L.E.; Kaplan, G.N.

    1984-01-01

    A retrospective study was performed to evaluate the usefulness of scrotal ultrasound imaging (SU) and radionuclide scrotal imaging (RSI) in 43 patients (pts), age: 16-75. Twenty-two of them complained of scrotal pain; 18 had a scrotal mass; and 4 had a history of trauma. The final diagnoses were conformed by surgery (n = 21) and long-term follow-up (n = 22) and included 4 late phase and 1 early testicular torsion (TT), 11 acute epididymitis (AE), 4 subacute epididymitis (SE), 5 malignant tumors, 3 testicular atrophy, 2 intratesticular hematomas, 10 hydroceles or other cystic lesions, and miscellaneous. In pts with scrotal pain, 3/4 with late phase TT were correctly diagnosed, while one pt with early TT and 11/15 with AE or SE were not diagnosed by SU. All of them were correctly diagnosed with RSI except one with scrotal cyst. SU was able to separate cystic masses (n = 10) from solid masses (n = 6), but cannot separate malignant from benign lesions. SU was excellent in detecting 19 hydroceles and 2 intratesticular hematomas, while 3 lesions < 1 cm. were not seen in RSI. The authors concluded that SU is useful in pts with scrotal mass to separate solid from cystic lesions. However, SU is unable to differentiate the acute epididymitis from early testicular torsion. In pts with acute scrotal pain, SU is not helpful and RSI should still be the first study performed.

  9. Medical Ultrasound Video Coding with H.265/HEVC Based on ROI Extraction.

    PubMed

    Wu, Yueying; Liu, Pengyu; Gao, Yuan; Jia, Kebin

    2016-01-01

    High-efficiency video compression technology is of primary importance to the storage and transmission of digital medical video in modern medical communication systems. To further improve the compression performance of medical ultrasound video, two innovative technologies based on diagnostic region-of-interest (ROI) extraction using the high efficiency video coding (H.265/HEVC) standard are presented in this paper. First, an effective ROI extraction algorithm based on image textural features is proposed to strengthen the applicability of ROI detection results in the H.265/HEVC quad-tree coding structure. Second, a hierarchical coding method based on transform coefficient adjustment and a quantization parameter (QP) selection process is designed to implement the otherness encoding for ROIs and non-ROIs. Experimental results demonstrate that the proposed optimization strategy significantly improves the coding performance by achieving a BD-BR reduction of 13.52% and a BD-PSNR gain of 1.16 dB on average compared to H.265/HEVC (HM15.0). The proposed medical video coding algorithm is expected to satisfy low bit-rate compression requirements for modern medical communication systems.

  10. Medical Ultrasound Video Coding with H.265/HEVC Based on ROI Extraction

    PubMed Central

    Wu, Yueying; Liu, Pengyu; Gao, Yuan; Jia, Kebin

    2016-01-01

    High-efficiency video compression technology is of primary importance to the storage and transmission of digital medical video in modern medical communication systems. To further improve the compression performance of medical ultrasound video, two innovative technologies based on diagnostic region-of-interest (ROI) extraction using the high efficiency video coding (H.265/HEVC) standard are presented in this paper. First, an effective ROI extraction algorithm based on image textural features is proposed to strengthen the applicability of ROI detection results in the H.265/HEVC quad-tree coding structure. Second, a hierarchical coding method based on transform coefficient adjustment and a quantization parameter (QP) selection process is designed to implement the otherness encoding for ROIs and non-ROIs. Experimental results demonstrate that the proposed optimization strategy significantly improves the coding performance by achieving a BD-BR reduction of 13.52% and a BD-PSNR gain of 1.16 dB on average compared to H.265/HEVC (HM15.0). The proposed medical video coding algorithm is expected to satisfy low bit-rate compression requirements for modern medical communication systems. PMID:27814367

  11. Diagnostic value and disease evaluation significance of abdominal ultrasound inspection for neonatal necrotizing enterocolitis

    PubMed Central

    Wang, Li; Li, Yinghui; Liu, Jian

    2016-01-01

    Objective: To summarize abdominal plain X-rays and ultrasound characteristics of 144 cases of Neonatal Necrotizing Enterocolitis (NEC) and to analyze diagnostic value and disease evaluation significance of abdominal ultrasound inspection for NEC. Methods: Clinical data of 144 NEC patients were retrospectively analyzed from February 2014 to December 2015. The patients were divided into suspected NEC group (N=74) and confirmed NEC group (N=70) according to amended Bell-NEC classification and diagnostic criteria. Meanwhile, we divided them into internal medicine treatment group (N=95) and surgery/death group (N=49) according to clinical prognosis and took records of their clinical manifestations, laboratory inspection results and abdominal plain X-rays and ultrasound characteristics. Results: For confirmed NEC group, the detection rate of portal venous gas (PVG) and dilatation of intestine by abdominal ultrasound was obviously higher than by plain X-rays (P<0.05). Abdominal ultrasound inspection revealed that the incidence rate of dilatation of intestine, bowel wall thickening and ascites (acoustic transmission difference) of the surgery/death group was higher than that of the internal medicine treatment group by comparing risk ratio (RR) and 95% confidence interval (CI) of RR; the difference was statistically significant (P<0.05). The abdominal plain X-rays inspection only showed the result that dilatation of intestine and free intraperitoneal air was more often found in the surgery/death group (P<0.05). Conclusion: Compared with abdominal plain X-rays, abdominal ultrasound has certain clinical value and offers more advantages in some aspects; therefore, it can be considered as the reference index in prediction of clinical prognosis. PMID:27882031

  12. Effects of diagnostic ultrasound-targeted microbubble destruction on permeability of normal liver in rats.

    PubMed

    Yang, Dan; Tan, Kai-Bin; Gao, Yun-Hua; Liu, Hong; Yang, Wei-Xiao

    2012-12-01

    This work investigated the effect of diagnostic ultrasound-targeted microbubble destruction (UTMD) on the permeability of normal liver tissue and the safety of this technique. One hundred and four rats were divided into four groups: the control group, the microbubble-only (MB) group, the ultrasound-only (US) group, and the ultrasound-targeted microbubble destruction group (UTMD). The permeabilities of capillaries and cell membranes were determined using Evans blue and lanthanum nitrate as tracers, respectively. The amount of Evans blue was approximately fourfold higher in the UTMD group than in the control, MB-only, and US-only groups (all P<0.01). Evans blue extravasation, visualized as red fluorescence, was detectable by laser confocal scanning microscopy in the parenchyma only in the UTMD group. Lanthanum nitrate-tracing transmission electron microscopy examination indicated that intracellular lanthanum was detectable in the cytoplasm only in the UTMD group. Blood chemical analysis indicated that the effect of diagnostic ultrasound-targeted microbubble destruction on the rats' serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels was transient and recoverable and that this technique had no obvious effect on renal function. Cellular swelling was observed in liver cells in the UTMD group at 0.5 h, but this swelling was no longer apparent after 1 week. These results suggest that diagnostic ultrasound-targeted microbubble destruction can increase the capillary and cell membrane permeabilities in normal liver tissue without a significant increase in hepatic and renal toxicity. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. A survey of medical diagnostic imaging technologies

    SciTech Connect

    Heese, V.; Gmuer, N.; Thomlinson, W.

    1991-10-01

    The fields of medical imaging and medical imaging instrumentation are increasingly important. The state-of-the-art continues to advance at a very rapid pace. In fact, various medical imaging modalities are under development at the National Synchrotron Light Source (such as MECT and Transvenous Angiography.) It is important to understand how these techniques compare with today`s more conventional imaging modalities. The purpose of this report is to provide some basic information about the various medical imaging technologies currently in use and their potential developments as a basis for this comparison. This report is by no means an in-depth study of the physics and instrumentation of the various imaging modalities; instead, it is an attempt to provide an explanation of the physical bases of these techniques and their principal clinical and research capabilities.

  14. A survey of medical diagnostic imaging technologies

    SciTech Connect

    Heese, V.; Gmuer, N.; Thomlinson, W.

    1991-10-01

    The fields of medical imaging and medical imaging instrumentation are increasingly important. The state-of-the-art continues to advance at a very rapid pace. In fact, various medical imaging modalities are under development at the National Synchrotron Light Source (such as MECT and Transvenous Angiography.) It is important to understand how these techniques compare with today's more conventional imaging modalities. The purpose of this report is to provide some basic information about the various medical imaging technologies currently in use and their potential developments as a basis for this comparison. This report is by no means an in-depth study of the physics and instrumentation of the various imaging modalities; instead, it is an attempt to provide an explanation of the physical bases of these techniques and their principal clinical and research capabilities.

  15. [Diagnostic value of ultrasound-guided core needle biopsy for soft tissue tumors].

    PubMed

    Na, Jia; Fang, Zhi-wei; Zhao, Ai-lian; Li, Ji-you

    2013-03-01

    To study the diagnostic value and pitfalls of ultrasound-guided core needle biopsy (CNB) of soft tissue tumors. One hundred and six cases of CNB specimens encountered during the period from 2007 to 2012 were enrolled into the study. The pathologic diagnosis using CNB was compared with that using surgical specimens. Diagnostic accuracy was analyzed using Chi-square test, with respect to the histologic pattern (such as spindle cell and myxoid), biologic behavior (benign versus malignant) and immunohistochemical results. The 59 cases of sarcoma were subdivided into three grades according to FNCLCC grading system. Histologic diagnosis could be made in 84.0% (89/106) cases. Thirteen cases were non-diagnostic on CNB. There were 4 cases on CNB showing diagnostic discrepancy with surgical specimens. Four cases of "benign lesions" on CNB found to be myxoid liposarcoma and lipoma-like liposarcoma upon resection. In general, myxoid pattern (9/17) seen on CNB showed less diagnostic correlation with surgical specimens, as compared to spindle cell and other histologic patterns (P < 0.01). The rate of diagnostic correlation was 79.7% (49/59) for the 59 cases of sarcoma studied, with grade 2 and grade 3 sarcoma showing better correlation (in contrast to 7/17 for grade 1 sarcoma) (P < 0.01). Comparative analysis showed no significant difference between benign/borderline tumors and sarcomas. The application of immunohistochemical study did not result in significant improvement in diagnostic accuracy on CNB. Ultrasound-guided CNB is a reliable tool in pathologic diagnosis of soft tissue tumors and shows a high accuracy rate especially for high-grade sarcoma. Tumors with myxoid pattern, lipomatous tumors and grade 1 sarcomas are associated with lower diagnostic accuracy on CNB. Correlation with clinicoradiologic findings would also be helpful in diagnostic evaluation and surgical planning.

  16. Sherlock Holmes's Methods of Deductive Reasoning Applied to Medical Diagnostics

    PubMed Central

    Miller, Larry

    1985-01-01

    Having patterned the character of Sherlock Holmes after one of his professors, Sir Arthur Conan Doyle, himself a physician, incorporated many of the didactic qualities of the 19th century medical diagnostician into the character of Holmes. In this paper I explore Holmes's techniques of deductive reasoning and their basis in 19th and 20th century medical diagnostics. PMID:3887762

  17. Sherlock Holmes' methods of deductive reasoning applied to medical diagnostics.

    PubMed

    Miller, L

    1985-03-01

    Having patterned the character of Sherlock Holmes after one of his professors, Sir Arthur Conan Doyle, himself a physician, incorporated many of the didactic qualities of the 19th century medical diagnostician into the character of Holmes. In this paper I explore Holmes's techniques of deductive reasoning and their basis in 19th and 20th century medical diagnostics.

  18. The Diagnostic Value of Pelvic Ultrasound in Girls with Central Precocious Puberty.

    PubMed

    Lee, Sang Heon; Joo, Eun Young; Lee, Ji-Eun; Jun, Yong-Hoon; Kim, Mi-Young

    2016-01-01

    The gonadotropin-releasing hormone (GnRH) stimulation test is the gold standard for differentiating central precocious puberty (CPP) from exaggerated thelarche (ET). Because of this test's limitations, previous studies have clarified the clinical and laboratory factors that predict CPP. The present study investigated the early diagnostic significance of pelvic ultrasound in girls with CPP. The GnRH stimulation test and pelvic ultrasound were performed between March 2007 and February 2015 in 192 girls (aged <8 years) with signs of early puberty and advanced bone age. Ninety-three of 192 patients (48.4%) were diagnosed as having CPP and the others (51.6%) as having ET. The CPP group had higher uterine volumes (4.31±2.79 mL) than did the ET group (3.05±1.97 mL, p=0.03). No significant differences were found in other ultrasonographic parameters. By use of receiver operating characteristic curve analysis, the most predictive parameter for CPP was a uterine volume of least 3.30 mL, with an area under the curve of 0.659 (95% confidence interval: 0.576-0.736). The CPP group had significantly higher uterine volumes than did the ET group, but there were no reliable cutoff values in pelvic ultrasound for differentiating between CPP and ET. Pelvic ultrasound should be combined with clinical and laboratory tests to maximize its diagnostic value for CPP.

  19. Psychomotor skills in medical ultrasound imaging: an analysis of the core skill set.

    PubMed

    Nicholls, Delwyn; Sweet, Linda; Hyett, Jon

    2014-08-01

    Sonographers use psychomotor skills to perform medical ultrasound examinations. Psychomotor skills describe voluntary movements of the limb, joints, and muscles in response to sensory stimuli and are regulated by the motor neural cortex in the brain. We define a psychomotor skill in relation to medical ultrasound imaging as "the unique mental and motor activities required to execute a manual task safely and efficiently for each clinical situation." Skills in clinical ultrasound practice may be open or closed; most skills used in medical ultrasound imaging are open. Open skills are both complex and multidimensional. Visuomotor and visuospatial psychomotor skills are central components of medical ultrasound imaging. Both types of skills rely on learners having a visual exemplar or standard of performance with which to reference their skill performance and evaluate anatomic structures. These are imperative instructional design principles when teaching psychomotor skills.

  20. The future of medical diagnostics: review paper

    PubMed Central

    2011-01-01

    While histopathology of excised tissue remains the gold standard for diagnosis, several new, non-invasive diagnostic techniques are being developed. They rely on physical and biochemical changes that precede and mirror malignant change within tissue. The basic principle involves simple optical techniques of tissue interrogation. Their accuracy, expressed as sensitivity and specificity, are reported in a number of studies suggests that they have a potential for cost effective, real-time, in situ diagnosis. We review the Third Scientific Meeting of the Head and Neck Optical Diagnostics Society held in Congress Innsbruck, Innsbruck, Austria on the 11th May 2011. For the first time the HNODS Annual Scientific Meeting was held in association with the International Photodynamic Association (IPA) and the European Platform for Photodynamic Medicine (EPPM). The aim was to enhance the interdisciplinary aspects of optical diagnostics and other photodynamic applications. The meeting included 2 sections: oral communication sessions running in parallel to the IPA programme and poster presentation sessions combined with the IPA and EPPM posters sessions. PMID:21861912

  1. Understanding depression in medical patients. Part I: Diagnostic considerations.

    PubMed

    Wool, M S

    1990-01-01

    Little attention has been devoted to integrating theoretical conceptions of depression when considering patients with medical illness. This is more true of the social work literature than the psychiatric, in which medical formulations and treatment of depression gain primary focus. This paper presents an approach for understanding the phenomenon of depression in medical patients. It incorporates a theoretical perspective on the mechanism of depression relevant to social work intervention. Topics reviewed include diagnostic criteria for depression in the medically ill, organic factors in depression, and psychosocial theory of depression applied to medical patients. A second part of this paper will provide case examples and recommendations for social work intervention.

  2. Ultrasound

    MedlinePlus

    Ultrasound is a type of imaging. It uses high-frequency sound waves to look at organs and ... liver, and other organs. During pregnancy, doctors use ultrasound to view the fetus. Unlike x-rays, ultrasound ...

  3. Managing waiting times in diagnostic medical imaging

    PubMed Central

    Nuti, Sabina; Vainieri, Milena

    2012-01-01

    Objective This paper aims to analyse the variation in the delivery of diagnostic imaging services in order to suggest possible solutions for the reduction of waiting times, increase the quality of services and reduce financial costs. Design This study provides a logic model to manage waiting times in a regional context. Waiting times measured per day were compared on the basis of the variability in the use rates of CT and MRI examinations in Tuscany for the population, as well as on the basis of the capacity offered with respect to the number of radiologists available. The analysis was performed at the local health authority level to support the decision-making process of local managers. Setting Diagnostic imaging services, in particular the CT and MRI examinations. The study involved all the 12 local health authorities that provide services for 3.7 million inhabitants of the Italian Tuscany Region. Primary and secondary outcome measures Participants: the study uses regional administrative data on outpatients and survey data on inpatient diagnostic examinations in order to measure productivity. Primary and secondary outcome measures The study uses the volumes per 1000 inhabitants, the days of waiting times and the number of examinations per radiologist. Variability was measured using the traditional SD measures. Results A significant variation in areas considered homogeneous in terms of age, gender or mortality may indicate that the use of radiological services is not optimal and underuse or overuse occurs and that there is room for improvement in the service organisation. Conclusions Considering that there is a high level of variability among district use rates and waiting times, this study provides managers with a specific tool to find the cause of the problem, identify a possible solution, assess the financial impact and initiate the eventual reduction of waste. PMID:23242480

  4. Establishing an Ultrasound Curriculum in Undergraduate Medical Education: How Much Time Does It Take?

    PubMed

    Siegel-Richman, Yonaton; Kendall, John

    2017-09-06

    Over the years, the use of ultrasound in the medical profession has become a common occurrence. As a result, many medical schools are considering an ultrasound curriculum for first- and second-year medical students. The question posed by many of these programs is how much time and effort are required to establish such a curriculum. We at the University of Colorado School of Medicine sought to quantify the resources and time required. We conducted a cohort study that analyzed the time spent teaching, as well as the types of instructors (eg, faculty, resident, and peer student) that contributed to our ultrasound curriculum. The study population consisted of instructors who participated in the curriculum during the 2014-2015 academic year. We analyzed the amount of time that facilitators spent teaching and tabulated these data using their specialty. Our data revealed that within an academic year, a combined total of 484 hours were spent teaching ultrasound to first- and second-year medical students combined. A total of 6 days were required to teach ultrasound to first-year medical students, and a total of 5 days were required for second-year medical students. It required 1 instructor for every 8 students, and most the faculty who volunteered time were from the field of emergency medicine, followed by family medicine and radiology. We describe the number of hours and instructors required to implement an ultrasound curriculum for undergraduate medical education. © 2017 by the American Institute of Ultrasound in Medicine.

  5. [Quality of praenatal diagnostic ultrasound - comparison of sonographically detected foetal anomalies with diagnostic findings verified post-partum in Switzerland].

    PubMed

    Stiller, R; Huch, R; Huch, A; Zimmermann, R

    2001-10-01

    Comparison of all praenatally detected cases of foetal anomalies to actual diagnostic findings post partum during a one year period in Switzerland. A retrospective questionnaire-based evaluation including the 5 university hospitals and 6 large hospitals in Switzerland as a population-based study. Analysis of all foetal anomalies detected praenatally by ultrasound in the year of 1995 in these centres. 347 cases have been included in the study. 89 % of cases were detected using screening methods. (2/3) were referred by obstetrical practitioners and GPs. 62 % of the pregnancies were completed and 33 % terminated, while the rest resulted in abortion or stillbirth. In terminated pregnancies there was a 82 % agreement between praenatal and postmortem findings. Sonographic results and clinical/post-mortem diagnosis were in agreement about the presence of major foetal anomalies in 18 % of cases. Additional minor anomalies unperceived by sonography, however, were seen post mortem. There was no false positive case. Without ultrasound screening almost 90 % of anomalies would have been missed due to the absence of clinical symptoms. The Swiss two-step system for praenatal ultrasound screening, based on screening scans done by the obstetrician and GP in practice, or residents in the public outpatient clinics respectively, and the detailed scan done by a subspecialized perinatologist shows excellent results especially in the subgroup of terminated pregnancies.

  6. Advances in transducers and techniques for diagnostic ultrasound

    NASA Astrophysics Data System (ADS)

    Szabo, Thomas L.

    2004-01-01

    Until recently, diagnostic imaging systems have remained stable with familiar modes to be measured. Emerging technologies are changing the measurement landscape rapidly. New developments are reviewed as well as those in research to examine the possible measurement challenges of the future. Improved focusing and steering are available with 1.5 D, multiple subaperture arrays, fully populated and sparse 2D arrays, and CMUT arrays. Encoded excitation pulses provide unique consideration. High frequency and special purpose arrays stretch the present limits of measurement bandwidth and resolution. Special auxiliary pulses and pulse sequences are being proposed for controlling, manipulating and destroying contrast agents and specially formulated therapeutic contrast agents. Improved harmonic imaging can involve multiple phased pulses as well as types of encoding. Active tissue characterization methods may include a means for tissue deformation as well as aberration correction. Imaging systems are undergoing a dramatic revolution in terms of their architecture, complexity, miniaturization and the role of software in image formation. These developments will be examined in terms of field distribution, pressure levels, pulse sequencing, waveforms and measurement

  7. Ultrasound techniques in the evaluation of the mediastinum, part 2: mediastinal lymph node anatomy and diagnostic reach of ultrasound techniques, clinical work up of neoplastic and inflammatory mediastinal lymphadenopathy using ultrasound techniques and how to learn mediastinal endosonography

    PubMed Central

    Jenssen, Christian; Annema, Jouke Tabe; Clementsen, Paul; Cui, Xin-Wu; Borst, Mathias Maximilian

    2015-01-01

    Ultrasound imaging has gained importance in pulmonary medicine over the last decades including conventional transcutaneous ultrasound (TUS), endoscopic ultrasound (EUS), and endobronchial ultrasound (EBUS). Mediastinal lymph node (MLN) staging affects the management of patients with both operable and inoperable lung cancer (e.g., surgery vs. combined chemoradiation therapy). Tissue sampling is often indicated for accurate nodal staging. Recent international lung cancer staging guidelines clearly state that endosonography should be the initial tissue sampling test over surgical staging. Mediastinal nodes can be sampled from the airways [endobronchial ultrasound combined with transbronchial needle aspiration (EBUS-TBNA)] or the esophagus [endoscopic ultrasound fine needle aspiration (EUS-FNA)]. EBUS and EUS have a complementary diagnostic yield and in combination virtually all MLNs can be biopsied. Additionally endosonography has an excellent yield in assessing granulomas in patients suspected of sarcoidosis. The aim of this review in two integrative parts is to discuss the current role and future perspectives of all ultrasound techniques available for the evaluation of mediastinal lymphadenopathy and mediastinal staging of lung cancer. A specific emphasis will be on learning mediastinal endosonography. Part 1 deals with an introduction into ultrasound techniques, MLN anatomy and diagnostic reach of ultrasound techniques and part 2 with the clinical work up of neoplastic and inflammatory mediastinal lymphadenopathy using ultrasound techniques and how to learn mediastinal endosonography. PMID:26623120

  8. SMPTE Test Pattern For Certification Of Medical Diagnostic Display Devices

    NASA Astrophysics Data System (ADS)

    Lisk, Kenneth G.

    1984-08-01

    Since the invention of x-rays by Wilhelm Conrad Roentgen, rapid advances have been made in the radiological detection of body abnormalities. This was very evident in the 1960's and 70's when the marriage of computers to radiology gave birth to a new generation of imaging modalities such as computerized tomography, ultrasound, digital radiographic imaging, nuclear medicine, and nuclear magnetic resonance. Many of these devices employ digital computer techniques for signal manipulation, and the resultant analog diagnostic images are displayed on television monitors for viewing and on imaging cathode-ray tubes for a photographic hard copy.

  9. Precision imaging-its impact on image quality and diagnostic confidence in breast ultrasound examinations.

    PubMed

    Safina, Alfiya; Lau, Louisa; Brennan, Patrick; Mello-Thoms, Claudia; Kench, Peter; Ryan, Elaine; McEntee, Mark; Rickard, Mary

    2015-10-01

    To determine the effect of noise-reducing innovation-precision imaging (PI)-on image quality and diagnostic efficacy in breast ultrasound. The study, which assessed four levels of PI from zero to three, consisted of two parts: image quality assessment and diagnostic efficacy evaluation. For the first part, 247 sets of ultrasound images displayed at each PI level were evaluated by 6 experienced breast imaging observers, by rating image quality using visual grading analysis on a 1-4 scale. For the diagnostic efficacy part 51 breast lesions were displayed at each PI level and scored 1-6 to generate a receiver operating characteristic (ROC) curve. These images were evaluated by radiologists and sonographers. Analyses were performed using non-parametric Friedman and Wilcoxon signed rank tests and a multireader multicase methodology. Statistically, higher scores of image quality were observed with increased levels of PI than with the zero setting (p < 0.001). The ROC analysis did not demonstrate any significant change in diagnostic efficacy, with mean scores for all observers being 0.79, 0.80, 0.81 and 0.81 for settings zero, one, two and three, respectively. This study suggested a perceived improvement in image quality with increasing levels of PI; however, no changes in diagnostic efficacy were noted. The importance of looking at the impact of new imaging technologies in a multifaceted way is emphasized. To our knowledge, this is the first article investigating the impact of the PI algorithm on ultrasound image quality and breast lesion characterization.

  10. Mammotome biopsy under ultrasound control in the diagnostics and treatment of nodular breast lesions - own experience.

    PubMed

    Kibil, Wojciech; Hodorowicz-Zaniewska, Diana; Kulig, Jan

    2012-05-01

    Mammotome biopsy is an effective, minimally invasive, novel technique used in the verification of breast lesions.The aim of the study was to assess the value of ultrasound-guided vacuum-assisted core needle biopsy (mammotome biopsy) in the diagnostics and treatment of nodular breast lesions, considering own data.Material and methods. Analysis comprised 1183 mammotome biopsies under ultrasound control performed in 1177 female patients during the period between 2000 and 2010, at the Regional Clinic for Early Diagnostics and Treatment of Breast Lesions, I Chair and Department of General Surgery, Jagiellonian University, Collegium Medicum.Results. The average patient age amounted to 41.7 years. The size of the investigated lesions ranged between 4 and 65 mm (mean - 12 mm). The histopathological examination result was as follows: fibrocystic lesions (n=285), adenofibroma (n=477), adenosis sclerosans (n=188), hyperplasia without atypy (n=58), phyllode tumor (n=2), papilloma (n=14), hamartoma (n=1), atypical hyperplasia (n=25), in situ ductal carcinoma (n=4), in situ lobular carcinoma (n=5), infiltrating ductal carcinoma (n=114), infiltrating lobular carcinoma (n=4), non-diagnostic result (n=6). The histopathological diagnosis was obtained in 99.5% of cases. Patients diagnosed with atypical hyperplasia or cancer were qualified for surgery, according to accepted standards. The presence of a hematoma was the most common complication after the biopsy, observed in 16.5% of patients.Conclusions. The obtained results confirmed the high value of ultrasound-guided biopsies in the diagnostics of nodular breast lesions. The method is safe, minimally invasive, with few complications, providing a good cosmetic effect. In case of benign lesions with a diameter of less than 15 mm the mammotome biopsy enables to completely excise the lesions, being an alternative to open surgical biopsies. The mammotome biopsy should become the method of choice considering the diagnostics of nodular

  11. Automated assessment of joint synovitis activity from medical ultrasound and power doppler examinations using image processing and machine learning methods.

    PubMed

    Cupek, Rafal; Ziębiński, Adam

    2016-01-01

    Rheumatoid arthritis is the most common rheumatic disease with arthritis, and causes substantial functional disability in approximately 50% patients after 10 years. Accurate measurement of the disease activity is crucial to provide an adequate treatment and care to the patients. The aim of this study is focused on a computer aided diagnostic system that supports an assessment of synovitis severity. This paper focus on a computer aided diagnostic system that was developed within joint Polish-Norwegian research project related to the automated assessment of the severity of synovitis. Semiquantitative ultrasound with power Doppler is a reliable and widely used method of assessing synovitis. Synovitis is estimated by ultrasound examiner using the scoring system graded from 0 to 3. Activity score is estimated on the basis of the examiner's experience or standardized ultrasound atlases. The method needs trained medical personnel and the result can be affected by a human error. The porotype of a computer-aided diagnostic system and algorithms essential for an analysis of ultrasonic images of finger joints are main scientific output of the MEDUSA project. Medusa Evaluation System prototype uses bone, skin, joint and synovitis area detectors for mutual structural model based evaluation of synovitis. Finally, several algorithms that support the semi-automatic or automatic detection of the bone region were prepared as well as a system that uses the statistical data processing approach in order to automatically localize the regions of interest. Semiquantitative ultrasound with power Doppler is a reliable and widely used method of assessing synovitis. Activity score is estimated on the basis of the examiner's experience and the result can be affected by a human error. In this paper we presented the MEDUSA project which is focused on a computer aided diagnostic system that supports an assessment of synovitis severity.

  12. Automated assessment of joint synovitis activity from medical ultrasound and power doppler examinations using image processing and machine learning methods

    PubMed Central

    Ziębiński, Adam

    2016-01-01

    Objectives Rheumatoid arthritis is the most common rheumatic disease with arthritis, and causes substantial functional disability in approximately 50% patients after 10 years. Accurate measurement of the disease activity is crucial to provide an adequate treatment and care to the patients. The aim of this study is focused on a computer aided diagnostic system that supports an assessment of synovitis severity. Material and methods This paper focus on a computer aided diagnostic system that was developed within joint Polish–Norwegian research project related to the automated assessment of the severity of synovitis. Semiquantitative ultrasound with power Doppler is a reliable and widely used method of assessing synovitis. Synovitis is estimated by ultrasound examiner using the scoring system graded from 0 to 3. Activity score is estimated on the basis of the examiner’s experience or standardized ultrasound atlases. The method needs trained medical personnel and the result can be affected by a human error. Results The porotype of a computer-aided diagnostic system and algorithms essential for an analysis of ultrasonic images of finger joints are main scientific output of the MEDUSA project. Medusa Evaluation System prototype uses bone, skin, joint and synovitis area detectors for mutual structural model based evaluation of synovitis. Finally, several algorithms that support the semi-automatic or automatic detection of the bone region were prepared as well as a system that uses the statistical data processing approach in order to automatically localize the regions of interest. Conclusions Semiquantitative ultrasound with power Doppler is a reliable and widely used method of assessing synovitis. Activity score is estimated on the basis of the examiner’s experience and the result can be affected by a human error. In this paper we presented the MEDUSA project which is focused on a computer aided diagnostic system that supports an assessment of synovitis severity

  13. Soft-Tissue Tumor Contrast Enhancement Patterns: Diagnostic Value and Comparison Between Ultrasound and MRI.

    PubMed

    Gruber, Leonhard; Loizides, Alexander; Luger, Anna K; Glodny, Bernhard; Moser, Patrizia; Henninger, Benjamin; Gruber, Hannes

    2017-02-01

    The purpose of this study was to assess and compare contrast-enhanced ultrasound and MRI patterns in the diagnosis of soft-tissue masses. Two hundred fifty-five consecutively registered patients with histologically confirmed soft-tissue masses were included in this retrospective study. The diagnostic properties of four predefined contrast enhancement (CE) patterns were assessed, and logistic regression analysis was performed to determine the correlation between diagnosis and CE pattern, lesion size, and patient age and sex. The influence of lesion size on the occurrence of inhomogeneous CE patterns in malignancies was also determined. Homogeneous CE patterns were highly specific for benignity, and inhomogeneous CE was moderately specific for malignancy in both ultrasound and MRI. A combination of homogeneous and inhomogeneous CE patterns led to 88.3% and 88.7% sensitivity, 66.7% and 59.7% specificity, 73.4% and 68.2% correct classification, 54.6% and 47.8% positive predictive value, 92.6% and 92.7% negative predictive value, 2.65 and 2.20 positive likelihood ratio, and 0.18 and 0.19 negative likelihood ratio for contrast-enhanced ultrasound and contrast-enhanced MRI. Cases with homogeneous CE in either ultrasound or MRI also were predominantly benign. The occurrence of inhomogeneous CE in malignant lesions increased with size. CE patterns in ultrasound and MRI offer additional information about the differentiation of an unknown soft-tissue mass. The results of this study showed that homogeneous or absent CE was specific for benign differentiation and that heterogeneous CE was linked to malignancy. The routine analysis of CE patterns should increase diagnostic reliability in unclear soft-tissue masses.

  14. A Randomized Trial of Diagnostic Ultrasound to Improve Outcomes in Focal Neuropathies

    PubMed Central

    Cartwright, Michael S.; Griffin, Leah P.; Dowlen, Hugh; Bargoil, Jessica M.; Caress, James B.; Li, Zhongyu J.; DeFranzo, Anthony J.; Wiesler, Ethan R.; Tuohy, Christopher J.; Balakrishnan, Nikhil; Molnar, Joseph A.; Baute, Vanessa; Koman, L. Andrew; Poehling, Gary G.; Walker, Francis O.

    2015-01-01

    Introduction Neuromuscular ultrasound is valid, reliable, and accurate, but it is not known if combining it with electrodiagnostic studies leads to better outcomes in individuals with focal neuropathies. Methods 120 individuals with focal neuropathy based on history, examination, and electrodiagnosis were enrolled. All underwent neuromuscular ultrasound and were randomized to either have their ultrasound results sent to the referring physician or not. Outcomes were assessed at 6 months by evaluators blinded to group assignment. Results The Overall Disability Sum Score and 7 of 8 domains of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) showed more improvement in the “report sent” group, though only the general health perception domain was significant (P = 0.005). Conclusions Most 6-month outcomes did not reach statistical significance between the 2 groups. However, the “report sent” group had trends toward better outcomes with significance reached in the general health perception domain of the SF-36. PMID:26296394

  15. A specialized framework for medical diagnostic knowledge-based systems.

    PubMed

    Lanzola, G; Stefanelli, M

    1992-08-01

    For a knowledge-based system (KBS) to exhibit an intelligent behavior, it must be endowed with knowledge enabling it to represent the expert's strategies. The elicitation task is inherently difficult for strategic knowledge, because strategy is often tacit, and, even when it has been made explicit, it is not an easy task to describe it in a form which may be directly translated and implemented into a program. This paper describes a Specialized Framework for Medical Diagnostic Knowledge-Based Systems that can help an expert in the process of building KBSs in a medical domain. The framework is based on an epistemological model of diagnostic reasoning which has proven to be helpful in describing the diagnostic process in terms of the tasks that it is composed of. It allows a straightforward modeling of diagnostic reasoning at the knowledge level by the domain expert, thus helping to convey domain-dependent strategies into the target KBS.

  16. Plasmonic nanoprobes: from chemical sensing to medical diagnostics and therapy

    NASA Astrophysics Data System (ADS)

    Vo-Dinh, Tuan; Fales, Andrew M.; Griffin, Guy D.; Khoury, Christopher G.; Liu, Yang; Ngo, Hoan; Norton, Stephen J.; Register, Janna K.; Wang, Hsin-Neng; Yuan, Hsiangkuo

    2013-10-01

    This article provides an overview of the development and applications of plasmonics-active nanoprobes in our laboratory for chemical sensing, medical diagnostics and therapy. Molecular Sentinel nanoprobes provide a unique tool for DNA/RNA biomarker detection both in a homogeneous solution or on a chip platform for medical diagnostics. The possibility of combining spectral selectivity and high sensitivity of the surface-enhanced Raman scattering (SERS) process with the inherent molecular specificity of nanoprobes provides an important multiplex diagnostic modality. Gold nanostars can provide an excellent multi-modality platform, combining two-photon luminescence with photothermal therapy as well as Raman imaging with photodynamic therapy. Several examples of optical detection using SERS and photonics-based treatments are presented to illustrate the usefulness and potential of the plasmonic nanoprobes for theranostics, which seamlessly combines diagnostics and therapy.

  17. Diagnostic library support system for medical practice.

    PubMed

    Grams, R R; Massey, J K; Hickey, S; Jin, Z M

    1985-12-01

    Here is a tragic case where the diagnosis was missed on three separate occasions over a 19-month period. Both terminal conditions are treatable and potentially separable if discovered and aggressively managed. It is not the intent of this presentation to criticize the evaluation of this patient, but rather to point out the need and, also, the potential benefits of an alternate approach, which could have significantly changed the course of this particular patient's evaluation. We have conducted similar analyses with other CPC cases with almost equivalent specificity. These same evaluations have been performed in a real clinical setting with live patient data. What we have learned so far we think will be extremely helpful in extending the potential application of this technology: A text-based decision support tool is only as good as its practitioner. It takes practice and training to learn to use this system effectively. There are many traps in logic, and the use of words and terms within the text must be understood to effectively utilize this tool. There are shortcuts in logical analysis which we mentally use all the time but which cannot be accepted using this system (e.g., you must not rely on your memory or any specific associations to circumvent the system). The system will only become clinically relevant when the entire field of medicine is included in the data base. This is one of our current limitations with only two-thirds of the Merck medical text available for reference. This makes it difficult to apply to a general medical problem since we are not sure which direction the case might take, and often these are multisystem diseases or problems that put us at a severe disadvantage if we don't have the necessary data base. The structure and integrity of the data base are critical to the success of the system. Since numbers are ubiquitous, these cannot be used for key word elements. Techniques must be introduced to create word-oriented numbers that can be

  18. Conditionally Increased Acoustic Pressures in Nonfetal Diagnostic Ultrasound Examinations Without Contrast Agents: A Preliminary Assessment.

    PubMed

    Nightingale, Kathryn R; Church, Charles C; Harris, Gerald; Wear, Keith A; Bailey, Michael R; Carson, Paul L; Jiang, Hui; Sandstrom, Kurt L; Szabo, Thomas L; Ziskin, Marvin C

    2015-07-01

    The mechanical index (MI) has been used by the US Food and Drug Administration (FDA) since 1992 for regulatory decisions regarding the acoustic output of diagnostic ultrasound equipment. Its formula is based on predictions of acoustic cavitation under specific conditions. Since its implementation over 2 decades ago, new imaging modes have been developed that employ unique beam sequences exploiting higher-order acoustic phenomena, and, concurrently, studies of the bioeffects of ultrasound under a range of imaging scenarios have been conducted. In 2012, the American Institute of Ultrasound in Medicine Technical Standards Committee convened a working group of its Output Standards Subcommittee to examine and report on the potential risks and benefits of the use of conditionally increased acoustic pressures (CIP) under specific diagnostic imaging scenarios. The term "conditionally" is included to indicate that CIP would be considered on a per-patient basis for the duration required to obtain the necessary diagnostic information. This document is a result of that effort. In summary, a fundamental assumption in the MI calculation is the presence of a preexisting gas body. For tissues not known to contain preexisting gas bodies, based on theoretical predications and experimentally reported cavitation thresholds, we find this assumption to be invalid. We thus conclude that exceeding the recommended maximum MI level given in the FDA guidance could be warranted without concern for increased risk of cavitation in these tissues. However, there is limited literature assessing the potential clinical benefit of exceeding the MI guidelines in these tissues. The report proposes a 3-tiered approach for CIP that follows the model for employing elevated output in magnetic resonance imaging and concludes with summary recommendations to facilitate Institutional Review Board (IRB)-monitored clinical studies investigating CIP in specific tissues. © 2015 by the American Institute of

  19. Diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal staging in lung cancer*

    PubMed Central

    Fernández-Bussy, Sebastián; Labarca, Gonzalo; Canals, Sofia; Caviedes, Iván; Folch, Erik; Majid, Adnan

    2015-01-01

    OBJECTIVE: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive diagnostic test with a high diagnostic yield for suspicious central pulmonary lesions and for mediastinal lymph node staging. The main objective of this study was to describe the diagnostic yield of EBUS-TBNA for mediastinal lymph node staging in patients with suspected lung cancer. METHODS: Prospective study of patients undergoing EBUS-TBNA for diagnosis. Patients ≥ 18 years of age were recruited between July of 2010 and August of 2013. We recorded demographic variables, radiological characteristics provided by axial CT of the chest, location of the lesion in the mediastinum as per the International Association for the Study of Lung Cancer classification, and definitive diagnostic result (EBUS with a diagnostic biopsy or a definitive diagnostic method). RESULTS: Our analysis included 354 biopsies, from 145 patients. Of those 145 patients, 54.48% were male. The mean age was 63.75 years. The mean lymph node size was 15.03 mm, and 90 lymph nodes were smaller than 10.0 mm. The EBUS-TBNA method showed a sensitivity of 91.17%, a specificity of 100.0%, and a negative predictive value of 92.9%. The most common histological diagnosis was adenocarcinoma. CONCLUSIONS: EBUS-TBNA is a diagnostic tool that yields satisfactory results in the staging of neoplastic mediastinal lesions. PMID:26176519

  20. Clinical ultrasound in the ICU: changing a medical paradigm.

    PubMed

    Álvarez-Fernández, J A; Núñez-Reiz, A

    2016-05-01

    In recent decades there has been an evolution from the traditional paradigm of sporadic ultrasound performed by radiologists and cardiologists in the ICU to clinical ultrasound performed by intensivists as an extension of patient evaluation rather than as a complementary test. Such clinical ultrasound aims to diagnose and treat the patient directly. All ultrasound modalities could be interesting in the ICU, either helping in decision making or guiding procedures. Clinical ultrasound training should include all the possibilities of ultrasound, and the tutelage of other trained intensivists and other specialists with more experience should be available at all times. Training should be phased into basic, advanced and expert levels, with adjustment to the contents of the CoBaTrICE Project and the recommendations of the SEMICYUC. Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  1. Diagnostic ultrasound estimates of muscle mass and muscle quality discriminate between women with and without sarcopenia

    PubMed Central

    Ismail, Catheeja; Zabal, Johannah; Hernandez, Haniel J.; Woletz, Paula; Manning, Heather; Teixeira, Carla; DiPietro, Loretta; Blackman, Marc R.; Harris-Love, Michael O.

    2015-01-01

    Introduction: Age-related changes in muscle mass and muscle tissue composition contribute to diminished strength in older adults. The objectives of this study are to examine if an assessment method using mobile diagnostic ultrasound augments well-known determinants of lean body mass (LBM) to aid sarcopenia staging, and if a sonographic measure of muscle quality is associated with muscle performance. Methods: Twenty community-dwelling female subjects participated in the study (age = 43.4 ± 20.9 years; BMI: 23.8, interquartile range: 8.5). Dual energy X-ray absorptiometry (DXA) and diagnostic ultrasound morphometry were used to estimate LBM. Muscle tissue quality was estimated via the echogenicity using grayscale histogram analysis. Peak force was measured with grip dynamometry and scaled for body size. Bivariate and multiple regression analyses were used to determine the association of the predictor variables with appendicular lean mass (aLM/ht2), and examine the relationship between scaled peak force values and muscle echogenicity. The sarcopenia LBM cut point value of 6.75 kg/m2 determined participant assignment into the Normal LBM and Low LBM subgroups. Results: The selected LBM predictor variables were body mass index (BMI), ultrasound morphometry, and age. Although BMI exhibited a significant positive relationship with aLM/ht2 (adj. R2 = 0.61, p < 0.001), the strength of association improved with the addition of ultrasound morphometry and age as predictor variables (adj. R2 = 0.85, p < 0.001). Scaled peak force was associated with age and echogenicity (adj. R2 = 0.53, p < 0.001), but not LBM. The Low LBM subgroup of women (n = 10) had higher scaled peak force, lower BMI, and lower echogenicity values in comparison to the Normal LBM subgroup (n = 10; p < 0.05). Conclusions: Diagnostic ultrasound morphometry values are associated with LBM, and improve the BMI predictive model for aLM/ht2 in women. In addition, ultrasound proxy measures of muscle quality are more

  2. Computerized Diagnostic Assistant for the Automatic Detection of Pneumothorax on Ultrasound: A Pilot Study.

    PubMed

    Summers, Shane M; Chin, Eric J; Long, Brit J; Grisell, Ronald D; Knight, John G; Grathwohl, Kurt W; Ritter, John L; Morgan, Jeffrey D; Salinas, Jose; Blackbourne, Lorne H

    2016-03-01

    Bedside thoracic ultrasound (US) can rapidly diagnose pneumothorax (PTX) with improved accuracy over the physical examination and without the need for chest radiography (CXR); however, US is highly operator dependent. A computerized diagnostic assistant was developed by the United States Army Institute of Surgical Research to detect PTX on standard thoracic US images. This computer algorithm is designed to automatically detect sonographic signs of PTX by systematically analyzing B-mode US video clips for pleural sliding and M-mode still images for the seashore sign. This was a pilot study to estimate the diagnostic accuracy of the PTX detection computer algorithm when compared to an expert panel of US trained physicians. This was a retrospective study using archived thoracic US obtained on adult patients presenting to the emergency department (ED) between 5/23/2011 and 8/6/2014. Emergency medicine residents, fellows, attending physicians, physician assistants, and medical students performed the US examinations and stored the images in the picture archive and communications system (PACS). The PACS was queried for all ED bedside US examinations with reported positive PTX during the study period along with a random sample of negatives. The computer algorithm then interpreted the images, and we compared the results to an independent, blinded expert panel of three physicians, each with experience reviewing over 10,000 US examinations. Query of the PACS system revealed 146 bedside thoracic US examinations for analysis. Thirteen examinations were indeterminate and were excluded. There were 79 true negatives, 33 true positives, 9 false negatives, and 12 false positives. The test characteristics of the algorithm when compared to the expert panel were sensitivity 79% (95 % CI [63-89]) and specificity 87% (95% CI [77-93]). For the 20 images scored as highest quality by the expert panel, the algorithm demonstrated 100% sensitivity (95% CI [56-100]) and 92% specificity (95% CI

  3. Alteration of Bacterial Antibiotic Sensitivity After Short-Term Exposure to Diagnostic Ultrasound

    PubMed Central

    Mortazavi, Seyed Mohammad Javad; Darvish, Leili; Abounajmi, Mohammad; Zarei, Samira; Zare, Tahereh; Taheri, Mohammad; Nematollahi, Samaneh

    2015-01-01

    Background Many pathogenic bacteria show different levels of antibiotic resistance. Furthermore, a lot of hospital-acquired infections are caused by highly resistant or multidrug-resistant Gram-negative bacteria. According to WHO, patients with drug-resistant infections have higher morbidity and mortality. Moreover, patients infected with bacteria that are resistant to antibiotics considerably consume more healthcare resources. Objectives In this study, we explored a physical method of converting drug-resistant bacteria to drug-sensitive ones. Materials and Methods This is an in vitro case-control study, performed at the Ionizing and Non-ionizing Radiation Protection Research Center (INIRPRC), Shiraz University of Medical Sciences (SUMS), Shiraz, Iran in 2014. All experiments were carried out using Gram-negative bacteria Klebsiella pneumonia and E. coli and Gram-positive Staphylococcus aureus and Streptococcus group A, isolated from hospitalized patients. The bacterial strains were obtained from the Persian Type Culture Collection, IROST, Iran (Klebsiella pneumonia PTCC 1290) and Bacteriology Department of Shahid Faghihi Teaching Hospital, Shiraz, Iran (E. coli, Staphylococcus aureus, and Streptococcus group A). The bacteria in culture plates were exposed to diagnostic ultrasound using a MyLab70XVG sonography system for 5 minutes. Then, the bacteria were cultured on Mueller-Hinton agar and incubated at 35°C for 18 hours. Finally, antibiotic susceptibility test was performed and the inhibition zone in both control and exposed groups were measured. Three replicate agar plates were used for each test and the inhibition zones of the plates were recorded. Results Compared with the results obtained from unexposed bacteria, statistically significant variations of sensitivity to antibiotics were found in some strains after short-term exposure. In particular, we found major differences (making antibiotic-resistant bacteria susceptible or vice versa) in the diameters of

  4. Porphyria or Catatonia: Diagnostic Dilemma on the Medical Wards.

    PubMed

    Kurkjian, Natalie; Tucker, Phebe

    2016-01-01

    A 24-year-old Caucasian female, DD, was admitted to the medical service at an academic hospital with symptoms of weakness in bilateral lower extremities, falls, headaches, and altered mental status. Psychiatry was consulted to evaluate for psychiatric causes of her symptoms. This case presented a diagnostic challenge as the patient's identified symptoms changed almost daily, depending on what practitioner or medical service she encountered. In this study, we discuss the differential diagnoses, tests and treatments the patient received, with a review of literature helping differentiate between diagnostic parameters.

  5. Medical Student Core Clinical Ultrasound Milestones: A Consensus Among Directors in the United States.

    PubMed

    Dinh, Vi Am; Lakoff, Daniel; Hess, Jamie; Bahner, David P; Hoppmann, Richard; Blaivas, Michael; Pellerito, John S; Abuhamad, Alfred; Khandelwal, Sorabh

    2016-02-01

    Many medical schools are implementing point-of-care ultrasound in their curricula to help augment teaching of the physical examination, anatomy, and ultimately clinical management. However, point-of-care ultrasound milestones for medical students remain unknown. The purpose of this study was to formulate a consensus on core medical student clinical point-of-care ultrasound milestones across allopathic and osteopathic medical schools in the United States. Directors who are leading the integration of ultrasound in medical education (USMED) at their respective institutions were surveyed. An initial list of 205 potential clinical ultrasound milestones was developed through a literature review. An expert panel consisting of 34 USMED directors across the United States was used to produce consensus on clinical ultrasound milestones through 2 rounds of a modified Delphi technique, an established anonymous process to obtain consensus through multiple rounds of quantitative questionnaires. There was a 100% response rate from the 34 USMED directors in both rounds 1 and 2 of the modified Delphi protocol. After the first round, 2 milestones were revised to improve clarity, and 9 were added on the basis of comments from the USMED directors, resulting in 214 milestones forwarded to round 2. After the second round, only 90 milestones were found to have a high level of agreement and were included in the final medical student core clinical ultrasound milestones. This study established 90 core clinical milestones that all graduating medical students should obtain before graduation, based on consensus from 34 USMED directors. These core milestones can serve as a guide for curriculum deans who are initiating ultrasound curricula at their institutions. The exact method of implementation and competency assessment needs further investigation. © 2016 by the American Institute of Ultrasound in Medicine.

  6. Clinical benefits of combined diagnostic three-dimensional digital breast tomosynthesis and ultrasound imaging

    NASA Astrophysics Data System (ADS)

    Varjonen, Mari; Pamilo, Martti; Raulisto, Leena

    2005-04-01

    Our goal is to evaluate diagnostic digital breast tomosynthesis and ultrasound imaging clinical value in detecting and diagnosing early stage breast cancers. Determine if fusion imaging would decrease the number of biopsies and reduce further patient workup otherwise required to establish a definitive diagnosis. This paper presents the clinical results based on the study conducted at Helsinki University Central Hospital. Presentation demonstrates clinical dual modality images and results. Tomosynthesis of amorphous selenium based full field digital mammography system will be also presented. Forty asymptomatic women enrolled in the study based on prior identification of suspicious findings on screening mammograms where the possibility of breast cancer could not be excluded. Abnormal screening mammogram findings included tumor-like densities, parenchymal asymmetries and architectural distortions. Eight women were operated and 32 were not referred for surgery. Those cases, which were operated, three lesions represented ductal carcinoma in situ, two ductal carcinomas, one atypical ductal hyperplasia, one fibroadenoma and one radial scar. The 32 not operated cases revealed to be benign or superimposition of normal parenchymal breast tissue. The cases were returned to biennial screening. Ultrasound did not show clearly any lesions, but using tomosynthesis and ultrasound together we were able to analyze and locate the lesions exactly. Special tomosynthesis improves overall lesion detection and analysis. The value of tomosynthesis and ultrasound fusion imaging will be to provide additional clinical information in order to improve decision making accuracy to either confirm or exclude a suspected abnormality and in particular detect small breast cancers.

  7. Non-invasive estimation of temperature using diagnostic ultrasound during HIFU therapy

    NASA Astrophysics Data System (ADS)

    Georg, O.; Wilkens, V.

    2017-03-01

    The use of HIFU for thermal ablation of human tissues requires safe real-time monitoring of the lesion formation during the treatment to avoid damage of the surrounding healthy tissues and to control temperature rise. Besides MR imaging, several methods have been proposed for temperature imaging using diagnostic ultrasound, and echoshift estimation (using speckle tracking) is the most promising and commonly used technique. It is based on the thermal dependence of the ultrasound echo that accounts for two different physical phenomena: local change in speed of sound and thermal expansion of the propagating medium due to changes in temperature. In our experiments we have used two separate transducers: HIFU exposure was performed using a 1.06 MHz single element focusing transducer of 64 mm aperture and 63.2 mm focal length; the ultrasound diagnostic probe of 11 MHz operated in B-mode for image guidance. The temperature measurements were performed in an agar-based tissue-mimicking phantom. To verify the obtained results, numerical modeling of the acoustic and temperature fields was carried out using KZK and Pennes Bioheat equations, as well as measurements with thermocouples were performed.

  8. Diagnostic Ultrasound High Mechanical Index Impulses Restore Microvascular Flow in Peripheral Arterial Thromboembolism

    PubMed Central

    Porter, Thomas R.; Radio, Stanley; Lof, John; Everbach, Carr; Powers, Jeffry E.; Vignon, Francois; Shi, William T.; Xie, Feng

    2016-01-01

    We sought to explore mechanistically how intermittent high mechanical index (MI) diagnostic ultrasound impulses restore microvascular flow. Thrombotic microvascular obstruction was created in the rat hindlimb muscle of 36 rats. A diagnostic transducer confirmed occlusion with low MI imaging during an intravenous microbubble infusion. This same transducer was used to intermittently apply an MI that produced stable or inertial (IC) cavitation for 10 minutes through a tissue mimicking phantom. A nitric oxide (NO) inhibitor L-NAME was pre-administered in six rats. Plateau microvascular contrast intensity quantified skeletal microvascular blood volume (MBV), and post mortem staining examined for perivascular hemorrhage. Intermittent IC impulses produced the greatest recovery of MBV (p<0.0001; ANOVA). NO inhibition did not affect the skeletal MBV improvement, but did result in more perivascular hemorrhage. IC inducing pulses from a diagnostic transducer can reverse microvascular obstruction following acute arterial thromboembolism. NO may prevent unwanted bioeffects from these IC pulses. PMID:27083977

  9. Robotics in the Diagnostic Medical Laboratory

    PubMed Central

    Corrigan, Gilbert E.

    1981-01-01

    An analysis is presented of the role and utility of robotic technology in the examination of patient materials from the bedside to the reporting of results. Each phase of laboratory workflow from sample collection to sample preparation to analysis to data review and reporting of results is affected. The utility factors for robotics in the medical laboratory such as personnel safety, reduction of environmental hazard, standardization of technique, standardized turnaround time, and analytical readiness are evaluated. Negative factors including lack of capital for outlay, unimportance of response time and limited biomechanical capabilities are discussed. The generic methods for materials analysis by multiple analytical devices is outlined following the pattern of linear or circumferential patterns.

  10. Diagnostic Medical Imaging in Pediatric Patients and Subsequent Cancer Risk.

    PubMed

    Mulvihill, David J; Jhawar, Sachin; Kostis, John B; Goyal, Sharad

    2017-06-20

    The use of diagnostic medical imaging is becoming increasingly more commonplace in the pediatric setting. However, many medical imaging modalities expose pediatric patients to ionizing radiation, which has been shown to increase the risk of cancer development in later life. This review article provides a comprehensive overview of the available data regarding the risk of cancer development following exposure to ionizing radiation from diagnostic medical imaging. Attention is paid to modalities such as computed tomography scans and fluoroscopic procedures that can expose children to radiation doses orders of magnitude higher than standard diagnostic x-rays. Ongoing studies that seek to more precisely determine the relationship of diagnostic medical radiation in children and subsequent cancer development are discussed, as well as modern strategies to better quantify this risk. Finally, as cardiovascular imaging and intervention contribute substantially to medical radiation exposure, we discuss strategies to enhance radiation safety in these areas. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  11. Medical ultrasound: imaging of soft tissue strain and elasticity

    PubMed Central

    Wells, Peter N. T.; Liang, Hai-Dong

    2011-01-01

    After X-radiography, ultrasound is now the most common of all the medical imaging technologies. For millennia, manual palpation has been used to assist in diagnosis, but it is subjective and restricted to larger and more superficial structures. Following an introduction to the subject of elasticity, the elasticity of biological soft tissues is discussed and published data are presented. The basic physical principles of pulse-echo and Doppler ultrasonic techniques are explained. The history of ultrasonic imaging of soft tissue strain and elasticity is summarized, together with a brief critique of previously published reviews. The relevant techniques—low-frequency vibration, step, freehand and physiological displacement, and radiation force (displacement, impulse, shear wave and acoustic emission)—are described. Tissue-mimicking materials are indispensible for the assessment of these techniques and their characteristics are reported. Emerging clinical applications in breast disease, cardiology, dermatology, gastroenterology, gynaecology, minimally invasive surgery, musculoskeletal studies, radiotherapy, tissue engineering, urology and vascular disease are critically discussed. It is concluded that ultrasonic imaging of soft tissue strain and elasticity is now sufficiently well developed to have clinical utility. The potential for further research is examined and it is anticipated that the technology will become a powerful mainstream investigative tool. PMID:21680780

  12. Medical ultrasound: imaging of soft tissue strain and elasticity.

    PubMed

    Wells, Peter N T; Liang, Hai-Dong

    2011-11-07

    After X-radiography, ultrasound is now the most common of all the medical imaging technologies. For millennia, manual palpation has been used to assist in diagnosis, but it is subjective and restricted to larger and more superficial structures. Following an introduction to the subject of elasticity, the elasticity of biological soft tissues is discussed and published data are presented. The basic physical principles of pulse-echo and Doppler ultrasonic techniques are explained. The history of ultrasonic imaging of soft tissue strain and elasticity is summarized, together with a brief critique of previously published reviews. The relevant techniques-low-frequency vibration, step, freehand and physiological displacement, and radiation force (displacement, impulse, shear wave and acoustic emission)-are described. Tissue-mimicking materials are indispensible for the assessment of these techniques and their characteristics are reported. Emerging clinical applications in breast disease, cardiology, dermatology, gastroenterology, gynaecology, minimally invasive surgery, musculoskeletal studies, radiotherapy, tissue engineering, urology and vascular disease are critically discussed. It is concluded that ultrasonic imaging of soft tissue strain and elasticity is now sufficiently well developed to have clinical utility. The potential for further research is examined and it is anticipated that the technology will become a powerful mainstream investigative tool.

  13. The impact of sound speed errors on medical ultrasound imaging.

    PubMed

    Anderson, M E; McKeag, M S; Trahey, G E

    2000-06-01

    The results of a quantitative study of the impact of sound speed errors on the spatial resolution and amplitude sensitivity of a commercial medical ultrasound scanner are presented in the context of their clinical significance. The beamforming parameters of the scanner were manipulated to produce sound speed errors ranging over +/-8% while imaging a wire target and an attenuating, speckle-generating phantom. For the wire target, these errors produced increases in lateral beam width of up to 320% and reductions in peak echo amplitude of up to 10.5 dB. In the speckle-generating phantom, these errors produced increases in speckle intensity correlation cell area of up to 92% and reductions in mean speckle brightness of up to 5.6 dB. These results are applied in statistical analyses of two detection tasks of clinical relevance. The first is of low contrast lesion detectability, predicting the changes in the correct decision probability as a function of lesion size, contrast, and sound speed error. The second is of point target detectability, predicting the changes in the correct decision probability as function of point target reflectivity and sound speed error. Representative results of these analyses are presented and their implications for clinical imaging are discussed. In general, sound speed errors have a more significant impact on point target detectability over lesion detectability by these analyses, producing up to a 22% reduction in correct decisions for a typical error.

  14. Theme-based teaching of point-of-care ultrasound in undergraduate medical education.

    PubMed

    Amini, Richard; Stolz, Lori Ann; Gross, Austin; O'Brien, Kathleen; Panchal, Ashish Raman; Reilly, Kevin; Chan, Lisa; Drummond, Brian Scott; Sanders, Arthur; Adhikari, Srikar

    2015-08-01

    A handful of medical schools have developed formal curricula to teach medical students point-of-care ultrasound; however, no ideal method has been proposed. The purpose of this study was to assess an innovative theme-based ultrasound educational model for undergraduate medical education. This was a single-center cross-sectional study conducted at an academic medical center. The study participants were 95 medical students with minimal or no ultrasound experience during their third year of training. The educational theme for the ultrasound session was "The evaluation of patients involved in motor vehicle collisions." This educational theme was carried out during all components of the 1-day event called SonoCamp: asynchronous learning, the didactic lecture, the skills stations, the team case challenge and the individual challenge stations. Assessment consisted of a questionnaire, team case challenge, and individual challenges. A total of 89 of 95 (94 %) students who participated in SonoCamp responded, and 92 % (87 of 95) completed the entire questionnaire before and after the completion of SonoCamp. Ninety-nine percent (95 % CI, 97-100 %) agreed that training at skill stations helped solidify understanding of point-of-care ultrasound. Ninety-two percent (95 % CI, 86-98 %) agreed that theme-based learning is an engaging learning style for point-of-care ultrasound. All students agreed that having a team exercise is an engaging way to learn point-of-care ultrasound; and of the 16 groups, the average score on the case-based questions was 82 % (SD + 28). The 1-day, theme-based ultrasound educational event was an engaging learning technique at our institution which lacks undergraduate medical education ultrasound curriculum.

  15. Integration of Medical Imaging Including Ultrasound into a New Clinical Anatomy Curriculum

    ERIC Educational Resources Information Center

    Moscova, Michelle; Bryce, Deborah A.; Sindhusake, Doungkamol; Young, Noel

    2015-01-01

    In 2008 a new clinical anatomy curriculum with integrated medical imaging component was introduced into the University of Sydney Medical Program. Medical imaging used for teaching the new curriculum included normal radiography, MRI, CT scans, and ultrasound imaging. These techniques were incorporated into teaching over the first two years of the…

  16. Integration of Medical Imaging Including Ultrasound into a New Clinical Anatomy Curriculum

    ERIC Educational Resources Information Center

    Moscova, Michelle; Bryce, Deborah A.; Sindhusake, Doungkamol; Young, Noel

    2015-01-01

    In 2008 a new clinical anatomy curriculum with integrated medical imaging component was introduced into the University of Sydney Medical Program. Medical imaging used for teaching the new curriculum included normal radiography, MRI, CT scans, and ultrasound imaging. These techniques were incorporated into teaching over the first two years of the…

  17. The role of ultrasound and nuclear medicine methods in the preoperative diagnostics of primary hyperparathyroidism

    PubMed Central

    Cacko, Marek; Królicki, Leszek

    2015-01-01

    Primary hyperparathyroidism (PH) represents one of the most common endocrine diseases. In most cases, the disorder is caused by parathyroid adenomas. Bilateral neck exploration has been a widely used treatment method for adenomas since the 20's of the twentieth century. In the last decade, however, it has been increasingly replaced by a minimally invasive surgical treatment. Smaller extent, shorter duration and lower complication rate of such a procedure are emphasized. Its efficacy depends on a precise location of parathyroid tissue during the preoperative imaging. Scintigraphy and ultrasound play a major role in the diagnostic algorithms. The efficacy of both methods has been repeatedly verified and compared. The still-current guidelines of the European Association of Nuclear Medicine (2009) emphasize the complementary role of scintigraphy and ultrasonography in the preoperative diagnostics in patients with primary hyperparathyroidism. At the same time, attempts are made to improve both these techniques by implementing new study protocols or innovative technologies. Publications have emerged in the recent years in the field of ultrasonography, whose authors pointed out the usefulness of elastography and contrast media. Nuclear medicine studies, on the other hand, focus mainly on the assessment of new radiotracers used in the positron emission tomography (PET). The aim of this article is to present, based on literature data, the possibilities of ultrasound and scintigraphy in the preoperative diagnostics in patients with primary hyperparathyroidism. Furthermore, the main directions in the development of imaging techniques in PH patients were evaluated. PMID:26807297

  18. The role of ultrasound and nuclear medicine methods in the preoperative diagnostics of primary hyperparathyroidism.

    PubMed

    Nieciecki, Michał; Cacko, Marek; Królicki, Leszek

    2015-12-01

    Primary hyperparathyroidism (PH) represents one of the most common endocrine diseases. In most cases, the disorder is caused by parathyroid adenomas. Bilateral neck exploration has been a widely used treatment method for adenomas since the 20's of the twentieth century. In the last decade, however, it has been increasingly replaced by a minimally invasive surgical treatment. Smaller extent, shorter duration and lower complication rate of such a procedure are emphasized. Its efficacy depends on a precise location of parathyroid tissue during the preoperative imaging. Scintigraphy and ultrasound play a major role in the diagnostic algorithms. The efficacy of both methods has been repeatedly verified and compared. The still-current guidelines of the European Association of Nuclear Medicine (2009) emphasize the complementary role of scintigraphy and ultrasonography in the preoperative diagnostics in patients with primary hyperparathyroidism. At the same time, attempts are made to improve both these techniques by implementing new study protocols or innovative technologies. Publications have emerged in the recent years in the field of ultrasonography, whose authors pointed out the usefulness of elastography and contrast media. Nuclear medicine studies, on the other hand, focus mainly on the assessment of new radiotracers used in the positron emission tomography (PET). The aim of this article is to present, based on literature data, the possibilities of ultrasound and scintigraphy in the preoperative diagnostics in patients with primary hyperparathyroidism. Furthermore, the main directions in the development of imaging techniques in PH patients were evaluated.

  19. An Interview with Medical Diagnostics Scientist Bernhard Weigl

    ERIC Educational Resources Information Center

    Sullivan, Megan

    2010-01-01

    Medical diagnostics help us evaluate a range of disorders, such as cancer and infectious diseases. In the United States and other developed countries, doctors have access to advanced equipment and laboratories that provide reliable diagnoses. As a result, when we are sick, we feel confident that we will get the treatment we need. Unfortunately,…

  20. An Interview with Medical Diagnostics Scientist Bernhard Weigl

    ERIC Educational Resources Information Center

    Sullivan, Megan

    2010-01-01

    Medical diagnostics help us evaluate a range of disorders, such as cancer and infectious diseases. In the United States and other developed countries, doctors have access to advanced equipment and laboratories that provide reliable diagnoses. As a result, when we are sick, we feel confident that we will get the treatment we need. Unfortunately,…

  1. A Course in Diagnostic Test Evaluation for Senior Medical Students.

    ERIC Educational Resources Information Center

    Goldenberg, Kim; And Others

    1989-01-01

    A group of medical students at Wright State University School of Medicine developed and participated in a one-month elective on selecting and interpreting diagnostic tests. Tests and diseases were reviewed, recorded and published by the students as a reference manual for their later use during clinical rotations. (MLW)

  2. A specialized framework for Medical Diagnostic Knowledge Based Systems.

    PubMed

    Lanzola, G; Stefanelli, M

    1991-01-01

    To have a knowledge based system (KBS) exhibiting an intelligent behavior, it must be endowed even with knowledge able to represent the expert's strategies, other than with domain knowledge. The elicitation task is inherently difficult for strategic knowledge, because strategy is often tacit, and, even when it has been made explicit, it is not an easy task to describe it in a form that may be directly translated and implemented into a program. This paper describes a Specialized Framework for Medical Diagnostic Knowledge Based Systems able to help an expert in the process of building KBSs in a medical domain. The framework is based on an epistemological model of diagnostic reasoning which has proved to be helpful in describing the diagnostic process in terms of the tasks by which it is composed of.

  3. Ultrasound in the Diagnostics of Metaphyseal Forearm Fractures in Children: A Systematic Review and Cost Calculation.

    PubMed

    Katzer, Christoph; Wasem, Jürgen; Eckert, Kolja; Ackermann, Ole; Buchberger, Barbara

    2016-06-01

    Metaphyseal forearm fractures are a common occurrence in childhood accounting up to 20% of all pediatric fractures. The standard diagnostic procedure is an x-ray scan. Sonographic examinations could be an alternative that avoids exposition to ionizing radiation and possibly reduces pain, time, and costs. This is a systematic review of clinical studies evaluating ultrasound as a possible alternative to radiographs in diagnosing metaphyseal forearm fractures in children. A systematic literature research for diagnostic studies and reviews was conducted in EMBASE, MEDLINE, and the Cochrane Library in May 2013 and updated in May 2014. In addition, reference lists of publications included were scanned. Outcome parameters were diagnostic accuracy, costs, examination time, and the assessment of pain. The study population is defined as children, because forearm fractures are very common in this age group and the impact of radiation on younger patients is greater than that on adults. Methodological quality of the studies has been assessed with Quality Assessment of Diagnostic Accuracy Studies-2. In addition, we carried out a cost center accounting. Eight diagnostic studies and 2 reviews were included in the analysis. The risk of bias of 4 studies was low; and of the other 4 ones, it was moderate. Critical aspects were missing or inaccurate blinding and insufficient descriptions of the study protocol, especially the order of examinations.Twenty-six to 115 patients within the age of 0 to 21 years were included in the studies. Sensitivity ranged from 64% to 100% and specificity did between 73% and 100%. Sensitivity was in six studies and specificity was in seven studies higher than 90%.Chaar-Alvarez et al reported an average time reduction of 25 minutes by using sonography instead of x-ray and a reduction of pain from 1.7 to 1.2 points on a visual analog scale (0-5 points). In 2 other studies, all patients reported pain-free sonographic examinations. The results of the cost

  4. Conditionally Increased Acoustic Pressures in Nonfetal Diagnostic Ultrasound Examinations Without Contrast Agents: A Preliminary Assessment

    PubMed Central

    Nightingale, Kathryn R.; Church, Charles C.; Harris, Gerald; Wear, Keith A.; Bailey, Michael R.; Carson, Paul L.; Jiang, Hui; Sandstrom, Kurt L.; Szabo, Thomas L.; Ziskin, Marvin C.

    2016-01-01

    The mechanical index (MI) has been used by the US Food and Drug Administration (FDA) since 1992 for regulatory decisions regarding the acoustic output of diagnostic ultrasound equipment. Its formula is based on predictions of acoustic cavitation under specific conditions. Since its implementation over 2 decades ago, new imaging modes have been developed that employ unique beam sequences exploiting higher-order acoustic phenomena, and, concurrently, studies of the bioeffects of ultrasound under a range of imaging scenarios have been conducted. In 2012, the American Institute of Ultrasound in Medicine Technical Standards Committee convened a working group of its Output Standards Subcommittee to examine and report on the potential risks and benefits of the use of conditionally increased acoustic pressures (CIP) under specific diagnostic imaging scenarios. The term “conditionally” is included to indicate that CIP would be considered on a per-patient basis for the duration required to obtain the necessary diagnostic information. This document is a result of that effort. In summary, a fundamental assumption in the MI calculation is the presence of a preexisting gas body. For tissues not known to contain preexisting gas bodies, based on theoretical predications and experimentally reported cavitation thresholds, we find this assumption to be invalid. We thus conclude that exceeding the recommended maximum MI level given in the FDA guidance could be warranted without concern for increased risk of cavitation in these tissues. However, there is limited literature assessing the potential clinical benefit of exceeding the MI guidelines in these tissues. The report proposes a 3-tiered approach for CIP that follows the model for employing elevated output in magnetic resonance imaging and concludes with summary recommendations to facilitate Institutional Review Board (IRB)-monitored clinical studies investigating CIP in specific tissues. PMID:26112617

  5. Strain elastography of abnormal axillary nodes in breast cancer patients does not improve diagnostic accuracy compared with conventional ultrasound alone.

    PubMed

    Park, Young Mi; Fornage, Bruno D; Benveniste, Ana Paula; Fox, Patricia S; Bassett, Roland L; Yang, Wei Tse

    2014-12-01

    The purpose of this study was to determine the diagnostic value of strain elastography (SE) alone and in combination with gray-scale ultrasound in the diagnosis of benign versus metastatic disease for abnormal axillary lymph nodes in breast cancer patients. Patients with breast cancer and axillary lymph nodes suspicious for metastatic disease on conventional ultrasound who underwent SE of the suspicious node before ultrasound-guided fine-needle aspiration biopsy (FNAB) were included in this study. On conventional ultrasound, the long- and short-axis diameters, long-axis-to-short-axis ratio, cortical echogenicity, thickness, and evenness were documented. The nodal vascularity was assessed on power Doppler imaging. Elastograms were evaluated for the percentage of black (hard) areas in the lymph node, and the SE-ultrasound size ratio was calculated. Two readers assessed the images independently and then in consensus in cases of disagreement. ROC AUCs were calculated for conventional ultrasound, SE, and both methods combined. Interreader reliability was assessed using kappa statistics. A total of 101 patients with 104 nodes were examined; 35 nodes were benign, and 69 had metastases. SE alone showed a significantly lower AUC (62%) than did conventional ultrasound (92%) (p<0.001). There was no difference between the AUC of conventional ultrasound and the AUC of the combination of conventional ultrasound and SE (93%) (p=0.16). Interreader reliability was moderate for all variables (κ≥0.60) except the SE-ultrasound size ratio (κ=0.35). Added SE does not improve the diagnostic ability of conventional ultrasound when evaluating abnormal axillary lymph nodes.

  6. A nondestructive diagnostic method based on swept-frequency ultrasound transmission-reflection measurements

    NASA Astrophysics Data System (ADS)

    Bramanti, Mauro

    1992-08-01

    A nondestructive diagnostic technique is proposed to measure depth and thickness of unwanted inclusions inside laminate-type materials (gaps, delaminations, and cracks, for example). The method is based on the frequency-domain analysis of transmission and reflection coefficient measured on the material under test when it is irradiated by a CW ultrasound beam whose frequency varies over a suitable frequency range. By measuring the frequency distance between two adjacent minima in the attenuation and reflection coefficients the thickness and depth of the inclusion can be obtained. A practical implementation of the technique is suggested, and the first experimental results obtained by a laboratory setup are reported.

  7. Nonlinear elastic wave NDE I : nonlinear resonant ultrasound spectroscopy (NRUS) and slow dynamics diagnostics (SDD)

    SciTech Connect

    Johnson, Paul; Sutin, A.

    2004-01-01

    The nonlinear elastic response of materials (e.g., wave mixing, harmonic generation) is much more sensitive to the presence of damage than the linear response (e.g., wavespeed, dissipation). An overview of the four primary Nonlinear Elastic Wave Spectroscopy (NEWS) methods used in nonlinear damage detection are presented in this and the following paper. Those presented in this paper are Nonlinear Resonant Ultrasound Spectroscopy (NRUS), based on measurement of the nonlinear response of one or more resonant modes in a test sample, and Slow Dynamics Diagnostics (SDD), manifest by an alteration in the material dissipation and elastic modulus after application of relatively high-amplitude wave that slowly recovers in time.

  8. The Resolution Integral – a tool for characterising the performance of diagnostic ultrasound scanners

    PubMed Central

    Inglis, Scott; Pye, Stephen D

    2014-01-01

    In this paper, we describe how the resolution integral can be used as a tool for characterising the grey-scale imaging of diagnostic ultrasound scanners. The definitions of resolution integral, characteristic resolution and depth of field are discussed in relation to grey-scale imaging performance, together with a method of measuring these parameters using the Edinburgh Pipe Phantom. We show how the characteristic resolution and depth of field can be used to quantify the differences between transducers designed for different applications and how they are useful in identifying and quantifying changes in the performance of individual transducers. PMID:27433191

  9. Effects of ultrasound implementation on physical examination learning and teaching during the first year of medical education.

    PubMed

    Dinh, Vi Am; Frederick, Jon; Bartos, Rebekah; Shankel, Tamara M; Werner, Leonard

    2015-01-01

    Increasing emphasis has been placed on point-of-care ultrasound in medical school. The overall effects of ultrasound curriculum implementation on the traditional physical examination skills of medical students are still unknown. We studied the effects on the Objective Standardized Clinical Examination (OSCE) scores of year 1 medical students before and after ultrasound curriculum implementation. An ultrasound curriculum was incorporated into the physical diagnosis course for year 1 medical students in the 2012-2013 academic year. We performed a prospective observational study comparing traditional OSCE scores of year 1 medical students exposed to the ultrasound curriculum (post-ultrasound) versus historic year 1 medical student controls (pre-ultrasound) with no ultrasound exposure. Questionnaire data were also obtained from year 1 medical students and physical diagnosis faculty to assess attitudes toward ultrasound implementation. The final overall OSCE scores were graded with a 5-point Likert-type scale from unsatisfactory to outstanding. There was a significant increase in outstanding scores in the post-ultrasound compared to the pre-ultrasound group (27.0% versus 10.9%; P< .001). The post-ultrasound group had significantly (P< .05) increased first-time pass rates on blood pressure measurements, the abdominal examination, and professionalism. Student and physical diagnosis faculty questionnaire data showed an overall positive response, with most agreeing or strongly agreeing that ultrasound should be included in the future year 1 medical student curriculum. Ultrasound implementation into a physical diagnosis curriculum for year 1 medical students is feasible and may improve their overall traditional physical examination skills. © 2015 by the American Institute of Ultrasound in Medicine.

  10. Current and Prospective Use of Musculoskeletal Diagnostic Ultrasound Imaging at Chiropractic Teaching Institutions: A Worldwide Survey of Diagnostic Imaging Staff.

    PubMed

    Henderson, Rogan E A; Walker, Bruce F; Young, Kenneth J

    2017-03-01

    The purpose of this study was to survey the use of musculoskeletal diagnostic ultrasound imaging (MSK-DUSI) at chiropractic educational programs worldwide and to elicit opinions of academic diagnostic imaging staff of its prospective use at their teaching institutions. An electronic questionnaire was delivered in 2014 using SurveyMonkey and notifications were disseminated by e-mail to 127 diagnostic imaging staff at chiropractic programs worldwide. The questionnaire consisted of 27 items using multiple-choice, Likert-type, and open-ended questions. Descriptive statistics were used for basic demographic data and the results of the numerical scales used in each item. Fifty-nine respondents (46.5%) from 24 (24/41) chiropractic programs returned questionnaires. The reported use of MSK-DUSI at chiropractic programs is low (n = 5/24); however, respondents from 9 institutions stated that it is planned to be implemented. Few respondents stated they had formal MSK-DUSI qualifications (4/59); however, 7 respondents stated they were in the process of becoming certified. Most respondents expressed an interest in the prospect of incorporating MSK-DUSI at their chiropractic program. Sixty-five percent stated that chiropractic programs should provide MSK-DUSI training to chiropractic students, and 75% of respondents stated that chiropractic programs should be providing accredited postgraduate MSK-DUSI courses. The current use of MSK-DUSI among chiropractic programs that responded to this survey is low. The opinions of diagnostic imaging staff who responded suggest a positive attitude to its use and possible growth in its use if foundational work, including gaining funding, accreditation, and acceptance of within the scope of chiropractic practice, is undertaken.

  11. Diagnostic imaging over the last 50 years: research and development in medical imaging science and technology.

    PubMed

    Doi, Kunio

    2006-07-07

    Over the last 50 years, diagnostic imaging has grown from a state of infancy to a high level of maturity. Many new imaging modalities have been developed. However, modern medical imaging includes not only image production but also image processing, computer-aided diagnosis (CAD), image recording and storage, and image transmission, most of which are included in a picture archiving and communication system (PACS). The content of this paper includes a short review of research and development in medical imaging science and technology, which covers (a) diagnostic imaging in the 1950s, (b) the importance of image quality and diagnostic performance, (c) MTF, Wiener spectrum, NEQ and DQE, (d) ROC analysis, (e) analogue imaging systems, (f) digital imaging systems, (g) image processing, (h) computer-aided diagnosis, (i) PACS, (j) 3D imaging and (k) future directions. Although some of the modalities are already very sophisticated, further improvements will be made in image quality for MRI, ultrasound and molecular imaging. The infrastructure of PACS is likely to be improved further in terms of its reliability, speed and capacity. However, CAD is currently still in its infancy, and is likely to be a subject of research for a long time.

  12. Using ultrasound to teach anatomy in the undergraduate medical curriculum: an evaluation of the experiences of tutors and medical students.

    PubMed

    Patten, Debra

    2015-02-01

    This paper describes the experiences of staff and students at two UK medical schools, who introduced portable ultrasound (PU) as an imaging technology to deliver clinical anatomy teaching and to aid skill development in interpretation of cross-sectional anatomy (CSA). A sonographer contributed to curriculum design and teaching, but mostly anatomy tutors delivered the teaching. This case study method evaluates staff and student perspectives on the ultrasound-based anatomy teaching. Quantitative data and qualitative data were collected and analysed. Staff were positive about the experience. They described their expectations for students and solutions for practical issues regarding the teaching, but were concerned about their competency in scanning and wanted bespoke training for sonoanatomy teaching. Curriculum development was accelerated through engagement with a sonographer and an ultrasound champion. Students were extremely positive about their experience; they valued the expertise of a sonographer who taught more challenging sonoanatomy, but were equally positive regarding teaching sessions led by well-trained anatomy tutors who taught more simple sonoanatomy. Students affirmed most tutors' expectations that ultrasound could reinforce existing anatomical knowledge, added clinical contextualisation, but not that use of ultrasound (US) assisted in interpreting CSA. Students valued the introduction to the technology and found sonoimage interpretation challenging, but not insurmountable. Students wanted more instruction on ultrasound physics, an expansion of ultrasound curriculum, with smaller groups and opportunities to scan volunteers. These data support the case for the use of PU to deliver anatomy teaching and to prime medical students for later clinical encounters with PU.

  13. Low complex subspace minimum variance beamformer for medical ultrasound imaging.

    PubMed

    Deylami, Ali Mohades; Asl, Babak Mohammadzadeh

    2016-03-01

    Minimum variance (MV) beamformer enhances the resolution and contrast in the medical ultrasound imaging at the expense of higher computational complexity with respect to the non-adaptive delay-and-sum beamformer. The major complexity arises from the estimation of the L×L array covariance matrix using spatial averaging, which is required to more accurate estimation of the covariance matrix of correlated signals, and inversion of it, which is required for calculating the MV weight vector which are as high as O(L(2)) and O(L(3)), respectively. Reducing the number of array elements decreases the computational complexity but degrades the imaging resolution. In this paper, we propose a subspace MV beamformer which preserves the advantages of the MV beamformer with lower complexity. The subspace MV neglects some rows of the array covariance matrix instead of reducing the array size. If we keep η rows of the array covariance matrix which leads to a thin non-square matrix, the weight vector of the subspace beamformer can be achieved in the same way as the MV obtains its weight vector with lower complexity as high as O(η(2)L). More calculations would be saved because an η×L covariance matrix must be estimated instead of a L×L. We simulated a wire targets phantom and a cyst phantom to evaluate the performance of the proposed beamformer. The results indicate that we can keep about 16 from 43 rows of the array covariance matrix which reduces the order of complexity to 14% while the image resolution is still comparable to that of the standard MV beamformer. We also applied the proposed method to an experimental RF data and showed that the subspace MV beamformer performs like the standard MV with lower computational complexity.

  14. Injectable microbubbles as contrast agents for diagnostic ultrasound imaging: the key role of perfluorochemicals.

    PubMed

    Schutt, Ernest G; Klein, David H; Mattrey, Robert M; Riess, Jean G

    2003-07-21

    Ultrasonography has, until recently, lacked effective contrast-enhancing agents. Micrometer-sized gas bubbles that resonate at a diagnostic frequency are ideal reflectors for ultrasound. However, simple air bubbles, when injected into the blood stream, disappear within seconds through the combined effects of Laplace pressure, blood pressure, and exposure to ultrasound energy. Use of fluorocarbon vapor, by extending the persistence of microbubbles in vivo from seconds to minutes, propelled contrast ultrasonography into clinical practice. Imaging techniques that selectively suppress tissue, but not microbubble signal, further increase image contrast. Approved products consist of C3F8 or SF6 microbubbles, and N2 microbubbles osmotically stabilized with C6F14. These agents allow the detection and characterization of cardiovascular abnormalities and solid organ lesions, such as tumors. By providing higher quality images, they improve the accuracy and confidence of disease diagnosis, and can play a decisive role in clinical decision making. New objectives include agents that target specific cells for the molecular imaging of disease, and drug and gene delivery, including ultrasound-triggered delivery.

  15. Development of distance accuracy measurement program for quality control of diagnostic ultrasound system

    NASA Astrophysics Data System (ADS)

    Kim, Yon-Min; Kim, Moon-Chan; Han, Dong-Kyoon; Cho, Jae-Hwan; Kim, Sang-Hyun

    2013-12-01

    Evaluating the performance of a diagnostic ultrasound system is important. Above all, establishing standards for such evaluations in an objective and systematic way is critical. However, quality control is currently measured based on subjective judgment of an observer. Against this background, this study intended to suggest quantified and objective data that would enable inter-observer variation to be overcome. Five radiological technologists used an ATS-539 multi-purpose ultrasound phantom to conduct measurements in the predetermined method. A digital imaging and communications in medicine (DICOM) standard image was obtained in an ultrasound system by using a self-developed software to measure the accuracy of the distance before the 95% confidence interval was calculated. In order to examine the accuracy of the distance in longitudinal and transverse measurements, we conducted t-tests to evaluate the significance for the results of quality control that was performed manually for the past one year and for the results of quality control that was performed by using software with the same equipment. For the longitudinal and the transverse measurements, the 95% confidence intervals were 100.96-101.29 mm and 83.18-84.26 mm, respectively. The computerized longitudinal measurement showed no significant difference from the manual measurement ( p > 0.05). The results of measurements using of software showed a higher reproducibility.

  16. Ultrasound assessment of subcutaneous compressibility: a potential adjunctive diagnostic tool in eosinophilic fasciitis.

    PubMed

    Kissin, Eugene Y; Garg, Amit; Grayson, Peter C; Dubreuil, Maureen; Vradii, Diana; York, Michael; Simms, Robert W

    2013-10-01

    Eosinophilic fasciitis (EF) is an autoimmune, fibrotic disorder described initially with scleroderma-like skin changes where deep soft tissue sampling that includes fascia is frequently felt to be necessary to confirm the diagnosis. The objective of this study was to distinguish forearm involvement by EF from other fibrosing diseases and from control subjects with normal skin and fascia using B-mode ultrasound. A cross-sectional study over a 4-year period in which clinically involved forearm skin of consecutive patients with EF (n = 12), diabetic cheiroarthropathy (n = 8), diffuse systemic sclerosis (n = 23), and control subjects (n = 8) was evaluated by 12-MHz, B-mode ultrasound for degree of subcutaneous tissue compressibility, and this finding was compared with the criterion standard of clinical diagnostic criteria for each disease process. Subcutaneous compressibility in EF was significantly reduced when compared with diffuse systemic sclerosis and with control subjects. Subcutaneous thinning was observed in some patients with EF (4/12), diabetic cheiroarthropathy (4/8), and diffuse systemic sclerosis (6/23), but not in control subjects. Diabetic cheiroarthropathy and diffuse systemic sclerosis patients with subcutaneous thinning had less than 20% subcutaneous compressibility, whereas only 1 of 12 EF patients had compressibility of more than 20% regardless of subcutaneous thinning. A 12-MHz, B-mode ultrasound may be used to measure subcutaneous compressibility, thereby serving as an adjunct tool in distinguishing EF from diffuse systemic sclerosis, especially when tissue sampling is less feasible or when the result of tissue sampling is equivocal.

  17. [Modern aspects of forensic medical diagnostics of the craniocerebral injury].

    PubMed

    Pigolkina, E Iu; Dorosheva, Zh V; Sidorovich, Iu V; Bychkov, A A

    2012-01-01

    The authors report the results of the investigations of craniocerebral injuries (CCI) including crystallographic studies of brain liquor obtained after the injury and non-traumatic pathological processes. The additional forensic medical criteria for the severity of craniocerebral injuries have been developed and the objective signs of CCI determined to be used for diagnostic purposes in the cases with concomitant diseases and also in the subjects of advanced and declining age. The diagnostic methods for the elucidation of the nature of chronic subdural hematomas and the estimation of the time of their formation have been improved.

  18. Linear tracking for 3-D medical ultrasound imaging.

    PubMed

    Huang, Qing-Hua; Yang, Zhao; Hu, Wei; Jin, Lian-Wen; Wei, Gang; Li, Xuelong

    2013-12-01

    As the clinical application grows, there is a rapid technical development of 3-D ultrasound imaging. Compared with 2-D ultrasound imaging, 3-D ultrasound imaging can provide improved qualitative and quantitative information for various clinical applications. In this paper, we proposed a novel tracking method for a freehand 3-D ultrasound imaging system with improved portability, reduced degree of freedom, and cost. We designed a sliding track with a linear position sensor attached, and it transmitted positional data via a wireless communication module based on Bluetooth, resulting in a wireless spatial tracking modality. A traditional 2-D ultrasound probe fixed to the position sensor on the sliding track was used to obtain real-time B-scans, and the positions of the B-scans were simultaneously acquired when moving the probe along the track in a freehand manner. In the experiments, the proposed method was applied to ultrasound phantoms and real human tissues. The results demonstrated that the new system outperformed a previously developed freehand system based on a traditional six-degree-of-freedom spatial sensor in phantom and in vivo studies, indicating its merit in clinical applications for human tissues and organs.

  19. Computational Diagnostic: A Novel Approach to View Medical Data.

    SciTech Connect

    Mane, K. K.; Börner, K.

    2007-01-01

    A transition from traditional paper-based medical records to electronic health record is largely underway. The use of electronic records offers tremendous potential to personalize patient diagnosis and treatment. In this paper, we discuss a computational diagnostic tool that uses digital medical records to help doctors gain better insight about a patient's medical condition. The paper details different interactive features of the tool which offer potential to practice evidence-based medicine and advance patient diagnosis practices. The healthcare industry is a constantly evolving domain. Research from this domain is often translated into better understanding of different medical conditions. This new knowledge often contributes towards improved diagnosis and treatment solutions for patients. But the healthcare industry lags behind to seek immediate benefits of the new knowledge as it still adheres to the traditional paper-based approach to keep track of medical records. However recently we notice a drive that promotes a transition towards electronic health record (EHR). An EHR stores patient medical records in digital format and offers potential to replace the paper health records. Earlier attempts of an EHR replicated the paper layout on the screen, representation of medical history of a patient in a graphical time-series format, interactive visualization with 2D/3D generated images from an imaging device. But an EHR can be much more than just an 'electronic view' of the paper record or a collection of images from an imaging device. In this paper, we present an EHR called 'Computational Diagnostic Tool', that provides a novel computational approach to look at patient medical data. The developed EHR system is knowledge driven and acts as clinical decision support tool. The EHR tool provides two visual views of the medical data. Dynamic interaction with data is supported to help doctors practice evidence-based decisions and make judicious choices about patient

  20. Comparison of Diagnostic Performance of Semi-Quantitative Knee Ultrasound and Knee Radiography with MRI: Oulu Knee Osteoarthritis Study

    PubMed Central

    Podlipská, Jana; Guermazi, Ali; Lehenkari, Petri; Niinimäki, Jaakko; Roemer, Frank W.; Arokoski, Jari P.; Kaukinen, Päivi; Liukkonen, Esa; Lammentausta, Eveliina; Nieminen, Miika T.; Tervonen, Osmo; Koski, Juhani M.; Saarakkala, Simo

    2016-01-01

    Osteoarthritis (OA) is a common degenerative musculoskeletal disease highly prevalent in aging societies worldwide. Traditionally, knee OA is diagnosed using conventional radiography. However, structural changes of articular cartilage or menisci cannot be directly evaluated using this method. On the other hand, ultrasound is a promising tool able to provide direct information on soft tissue degeneration. The aim of our study was to systematically determine the site-specific diagnostic performance of semi-quantitative ultrasound grading of knee femoral articular cartilage, osteophytes and meniscal extrusion, and of radiographic assessment of joint space narrowing and osteophytes, using MRI as a reference standard. Eighty asymptomatic and 79 symptomatic subjects with mean age of 57.7 years were included in the study. Ultrasound performed best in the assessment of femoral medial and lateral osteophytes, and medial meniscal extrusion. In comparison to radiography, ultrasound performed better or at least equally well in identification of tibio-femoral osteophytes, medial meniscal extrusion and medial femoral cartilage morphological degeneration. Ultrasound provides relevant additional diagnostic information on tissue-specific morphological changes not depicted by conventional radiography. Consequently, the use of ultrasound as a complementary imaging tool along with radiography may enable more accurate and cost-effective diagnostics of knee osteoarthritis at the primary healthcare level. PMID:26926836

  1. Comparison of Diagnostic Performance of Semi-Quantitative Knee Ultrasound and Knee Radiography with MRI: Oulu Knee Osteoarthritis Study.

    PubMed

    Podlipská, Jana; Guermazi, Ali; Lehenkari, Petri; Niinimäki, Jaakko; Roemer, Frank W; Arokoski, Jari P; Kaukinen, Päivi; Liukkonen, Esa; Lammentausta, Eveliina; Nieminen, Miika T; Tervonen, Osmo; Koski, Juhani M; Saarakkala, Simo

    2016-03-01

    Osteoarthritis (OA) is a common degenerative musculoskeletal disease highly prevalent in aging societies worldwide. Traditionally, knee OA is diagnosed using conventional radiography. However, structural changes of articular cartilage or menisci cannot be directly evaluated using this method. On the other hand, ultrasound is a promising tool able to provide direct information on soft tissue degeneration. The aim of our study was to systematically determine the site-specific diagnostic performance of semi-quantitative ultrasound grading of knee femoral articular cartilage, osteophytes and meniscal extrusion, and of radiographic assessment of joint space narrowing and osteophytes, using MRI as a reference standard. Eighty asymptomatic and 79 symptomatic subjects with mean age of 57.7 years were included in the study. Ultrasound performed best in the assessment of femoral medial and lateral osteophytes, and medial meniscal extrusion. In comparison to radiography, ultrasound performed better or at least equally well in identification of tibio-femoral osteophytes, medial meniscal extrusion and medial femoral cartilage morphological degeneration. Ultrasound provides relevant additional diagnostic information on tissue-specific morphological changes not depicted by conventional radiography. Consequently, the use of ultrasound as a complementary imaging tool along with radiography may enable more accurate and cost-effective diagnostics of knee osteoarthritis at the primary healthcare level.

  2. [Differential diagnostic value of real-time tissue elastography and three dimensional ultrasound imaging in breast lumps].

    PubMed

    Li, M H; Liu, Y; Liu, L S; Li, P X; Chen, Q

    2016-05-24

    To investigate the real-time tissue elastography and 3D contrast-enhanced ultrasonography(CEUS) in breast lumps differential diagnostic value. A total of 126 patients (180 lumps) with breast mass were retrospectively analyzed from December 2012 to December 2014 in Tumor Hospital Affiliated To Xinjiang Medical University.All patients were divided into three groups by using stratified random method.Each group was detected by real-time tissue elastography, 3D CEUS and two joint inspection.Each group of 42 cases (60 lumps) was confirmed by the pathological results as gold standard.Diagnostic sensitivity, specificity and coincidence rate of different methods were compared. The benign masses of ultrasound contrast showed the punctate, linear and nodular enhancement, and the border of enhancement was smooth.The malignant tumors were mainly dominated by uneven and high enhancement. There was no statistical difference in sensitivity, specificity and coincidence rate between elastography group and 3D CEUS group (64.7% vs 73.5%, 69.2% vs 76.9%, 66.7% vs 75.0%, all P>0.05). The sensitivity, specificity and coincidence rate of two joint inspection group were higher than those of elastography group and 3D CEUS group, the differences were statistically significant (97.1%, 92.3% and 98.3% , all P<0.05). 3D CEUS combined with real-time tissue elastography is of high value in the diagnosis of breast masses.

  3. In Vivo Gas Body Efficacy for Glomerular Capillary Hemorrhage Induced by Diagnostic Ultrasound in Rats

    PubMed Central

    Miller, Douglas L.; Dou, Chunyan; Wiggins, Roger C.

    2009-01-01

    Glomerular capillary hemorrhage (GCH) in rat kidney provided a model for assessing in vivo gas body efficacy in diagnostic or therapeutic applications of ultrasound. Two diagnostic ultrasound machines were utilized: one monitored the harmonic B-mode contrast-enhancement of the left kidney and the other exposed the right kidney for GCH production. Definity contrast agent was infused at 1, 2, 5 or 10 μl/kg/min and infusion durations were 30, 60, 120 or 300 s. Exposure of the right kidney was at a peak rarefactional pressure amplitude of 2.3 MPa at 1.5 MHz. The circulating dose was estimated with a simple model of agent dilution and gas body loss. For 300 s infusion at 5 μl/kg/min, the left kidney image brightness increased to a plateau with an estimated 6.4±1.3 μl/kg circulating dose with no GCH in histological sections. Exposure of the right kidney with a 1 s image interval reduced the estimated circulating dose to 1.3±0.3 μl/kg and induced 68.4 % GCH. Dose and duration increases gave rapidly diminishing treatment effectiveness per gas body. The effective in vivo agent dose in rats can be reduced greatly due to high gas body destruction in the small animal, complicating predictions for similar conditions of human treatment. PMID:19709948

  4. Application of Contrast-Enhanced Ultrasound in Cystic Pancreatic Lesions Using a Simplified Classification Diagnostic Criterion

    PubMed Central

    Fan, Zhihui; Yan, Kun; Wang, Yanjie; Qiu, Jianxing; Wu, Wei; Yang, Lei; Chen, Minhua

    2015-01-01

    Objective. Classification diagnosis was performed for cystic pancreatic lesions using ultrasound (US) and contrast-enhanced ultrasound (CEUS) to explore the diagnostic value of CEUS by comparison with enhanced CT. Methods. Sixty-four cases with cystic pancreatic lesions were included in this study. The cystic lesions of pancreas were classified into four types by US, CEUS, and CT: type I unilocular cysts; type II microcystic lesions; type III macrocystic lesions; and type IV cystic lesions with solid components or irregular thickening of the cystic wall or septa. Results. Eighteen type I, 7 type II, 10 type III, and 29 type IV cases were diagnosed by CT. The classification results by US were as follows: 6 type I; 5 type II; 4 type III; and 49 type IV cases. Compared with the results by enhanced CT, the kappa value was 0.36. Using CEUS, 15, 6, 12, and 31 cases were diagnosed as types I–IV, respectively. The kappa value was 0.77. Conclusion. CEUS has obvious superiority over US in the classification diagnostic accuracy in cystic pancreatic lesions and CEUS results showed substantial agreement with enhanced CT. CEUS could contribute to the differential diagnosis of cystic pancreatic diseases. PMID:26090467

  5. Diagnostic sensitivity of ultrasound, radiography and computed tomography for gender determination in four species of lizards.

    PubMed

    Di Ianni, Francesco; Volta, Antonella; Pelizzone, Igor; Manfredi, Sabrina; Gnudi, Giacomo; Parmigiani, Enrico

    2015-01-01

    Gender determination is frequently requested by reptile breeders, especially for species with poor or absent sexual dimorphism. The aims of the current study were to describe techniques and diagnostic sensitivities of ultrasound, radiography, and computed tomography for gender determination (identification of hemipenes) in four species of lizards. Nineteen lizards of known sex, belonging to four different species (Pogona vitticeps, Uromastyx aegyptia, Tiliqua scincoides, Gerrhosaurus major) were prospectively enrolled. With informed owner consent, ultrasound, noncontrast CT, contrast radiography, and contrast CT (with contrast medium administered into the cloaca) were performed in conscious animals. Imaging studies were reviewed by three different operators, each unaware of the gender of the animals and of the results of the other techniques. The lizard was classified as a male when hemipenes were identified. Nineteen lizards were included in the study, 10 females and nine males. The hemipenes were seen on ultrasound in only two male lizards, and appeared as oval hypoechoic structures. Radiographically, hemipenes filled with contrast medium appeared as spindle-shaped opacities. Noncontrast CT identified hemipenes in only two lizards, and these appeared as spindle-shaped kinked structures with hyperattenuating content consistent with smegma. Hemipenes were correctly identified in all nine males using contrast CT (accuracy of 100%). Accuracy of contrast radiography was excellent (94.7%). Accuracy of ultrasound and of noncontrast CT was poor (64.3% and 63.1%, respectively). Findings from the current study supported the use of contrast CT or contrast radiography for gender determination in lizards. © 2014 American College of Veterinary Radiology.

  6. Development of a portable therapeutic and high intensity ultrasound system for military, medical, and research use.

    PubMed

    Lewis, George K; Olbricht, William L

    2008-11-01

    We have developed a portable high power ultrasound system with a very low output impedance amplifier circuit (less than 0.3 Omega) that can transfer more than 90% of the energy from a battery supply to the ultrasound transducer. The system can deliver therapeutic acoustical energy waves at lower voltages than those in conventional ultrasound systems because energy losses owing to a mismatched impedance are eliminated. The system can produce acoustic power outputs over the therapeutic range (greater then 50 W) from a PZT-4, 1.54 MHz, and 0.75 in diameter piezoelectric ceramic. It is lightweight, portable, and powered by a rechargeable battery. The portable therapeutic ultrasound unit has the potential to replace "plug-in" medical systems and rf amplifiers used in research. The system is capable of field service on its internal battery, making it especially useful for military, ambulatory, and remote medical applications.

  7. Development of a portable therapeutic and high intensity ultrasound system for military, medical, and research use

    NASA Astrophysics Data System (ADS)

    Lewis, George K.; Olbricht, William L.

    2008-11-01

    We have developed a portable high power ultrasound system with a very low output impedance amplifier circuit (less than 0.3 Ω) that can transfer more than 90% of the energy from a battery supply to the ultrasound transducer. The system can deliver therapeutic acoustical energy waves at lower voltages than those in conventional ultrasound systems because energy losses owing to a mismatched impedance are eliminated. The system can produce acoustic power outputs over the therapeutic range (greater then 50 W) from a PZT-4, 1.54 MHz, and 0.75 in diameter piezoelectric ceramic. It is lightweight, portable, and powered by a rechargeable battery. The portable therapeutic ultrasound unit has the potential to replace "plug-in" medical systems and rf amplifiers used in research. The system is capable of field service on its internal battery, making it especially useful for military, ambulatory, and remote medical applications.

  8. Diagnostic Accuracy of Ultrasound B scan using 10 MHz linear probe in ocular trauma;results from a high burden country

    PubMed Central

    Shazlee, Muhammad Kashif; Ali, Muhammad; SaadAhmed, Muhammad; Hussain, Ammad; Hameed, Kamran; Lutfi, Irfan Amjad; Khan, Muhammad Tahir

    2016-01-01

    Objective: To study the diagnostic accuracy of Ultrasound B scan using 10 MHz linear probe in ocular trauma. Methods: A total of 61 patients with 63 ocular injuries were assessed during July 2013 to January 2014. All patients were referred to the department of Radiology from Emergency Room since adequate clinical assessment of the fundus was impossible because of the presence of opaque ocular media. Based on radiological diagnosis, the patients were provided treatment (surgical or medical). Clinical diagnosis was confirmed during surgical procedures or clinical follow-up. Results: A total of 63 ocular injuries were examined in 61 patients. The overall sensitivity was 91.5%, Specificity was 98.87%, Positive predictive value was 87.62 and Negative predictive value was 99%. Conclusion: Ultrasound B-scan is a sensitive, non invasive and rapid way of assessing intraocular damage caused by blunt or penetrating eye injuries. PMID:27182245

  9. Finite difference modelling of the temperature rise in non-linear medical ultrasound fields.

    PubMed

    Divall, S A; Humphrey, V F

    2000-03-01

    Non-linear propagation of ultrasound can lead to increased heat generation in medical diagnostic imaging due to the preferential absorption of harmonics of the original frequency. A numerical model has been developed and tested that is capable of predicting the temperature rise due to a high amplitude ultrasound field. The acoustic field is modelled using a numerical solution to the Khokhlov-Zabolotskaya-Kuznetsov (KZK) equation, known as the Bergen Code, which is implemented in cylindrical symmetric form. A finite difference representation of the thermal equations is used to calculate the resulting temperature rises. The model allows for the inclusion of a number of layers of tissue with different acoustic and thermal properties and accounts for the effects of non-linear propagation, direct heating by the transducer, thermal diffusion and perfusion in different tissues. The effect of temperature-dependent skin perfusion and variation in background temperature between the skin and deeper layers of the body are included. The model has been tested against analytic solutions for simple configurations and then used to estimate temperature rises in realistic obstetric situations. A pulsed 3 MHz transducer operating with an average acoustic power of 200 mW leads to a maximum steady state temperature rise inside the foetus of 1.25 degrees C compared with a 0.6 degree C rise for the same transmitted power under linear propagation conditions. The largest temperature rise occurs at the skin surface, with the temperature rise at the foetus limited to less than 2 degrees C for the range of conditions considered.

  10. Exhaled breath analysis: physical methods, instruments, and medical diagnostics

    NASA Astrophysics Data System (ADS)

    Vaks, V. L.; Domracheva, E. G.; Sobakinskaya, E. A.; Chernyaeva, M. B.

    2014-07-01

    This paper reviews the analysis of exhaled breath, a rapidly growing field in noninvasive medical diagnostics that lies at the intersection of physics, chemistry, and medicine. Current data are presented on gas markers in human breath and their relation to human diseases. Various physical methods for breath analysis are described. It is shown how measurement precision and data volume requirements have stimulated technological developments and identified the problems that have to be solved to put this method into clinical practice.

  11. [Forensic-medical diagnostics of doping cases in sports].

    PubMed

    Khodasevich, L S; Kuzin, S G; Khodasevich, A L

    2013-01-01

    The present review of the literature is focused on the problem of forensic-medical diagnostics of doping cases in sports, with special reference to the main classes of pharmaceutical products forbidden for use by the International Olympic Committee. The main causes of death among the athletes as a result of using doping substances are considered. Much attention is given to adverse reactions induced by long-time intake of anabolic steroids many of which can be identified at autopsy.

  12. A New Methodology to Design Distributed Medical Diagnostic Centers

    DTIC Science & Technology

    2001-10-25

    METHODOLOGY TO DESIGN DISTRIBUTED MEDICAL DIAGNOSTIC CENTERS P. A. Baziana,. E. I. Karavatselou, D. K. Lymberopoulos, D. N. Serpanos Department of...Electrical and Computer Engineering, University of Patras, Patras, Hellas This paper introduces a new methodology for DDC design by controlling the above...TSPs) to design and support cooperative schemes among RUs and DUs in form of DDCs [2]. This paper introduces a global methodology for such a DDC’s

  13. Email for communicating results of diagnostic medical investigations to patients.

    PubMed

    Meyer, Barbara; Atherton, Helen; Sawmynaden, Prescilla; Car, Josip

    2012-08-15

    As medical care becomes more complex and the ability to test for conditions grows, pressure on healthcare providers to convey increasing volumes of test results to patients is driving investigation of alternative technological solutions for their delivery. This review addresses the use of email for communicating results of diagnostic medical investigations to patients. To assess the effects of using email for communicating results of diagnostic medical investigations to patients, compared to SMS/ text messaging, telephone communication or usual care, on outcomes, including harms, for health professionals, patients and caregivers, and health services. We searched: the Cochrane Consumers and Communication Review Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1 2010), MEDLINE (OvidSP) (1950 to January 2010), EMBASE (OvidSP) (1980 to January 2010), PsycINFO (OvidSP) (1967 to January 2010), CINAHL (EbscoHOST) (1982 to February 2010), and ERIC (CSA) (1965 to January 2010). We searched grey literature: theses/dissertation repositories, trials registers and Google Scholar (searched July 2010). We used additional search methods: examining reference lists and contacting authors. Randomised controlled trials, quasi-randomised trials, controlled before and after studies and interrupted time series studies of interventions using email for communicating results of any diagnostic medical investigations to patients, and taking the form of 1) unsecured email 2) secure email or 3) web messaging. All healthcare professionals, patients and caregivers in all settings were considered. Two review authors independently assessed the titles and abstracts of retrieved citations. No studies were identified for inclusion. Consequently, no data collection or analysis was possible. No studies met the inclusion criteria, therefore there are no results to report on the use of email for communicating results of diagnostic medical

  14. Formulation and acoustic studies of a new phase-shift agent for diagnostic and therapeutic ultrasound.

    PubMed

    Sheeran, Paul S; Luois, Samantha; Dayton, Paul A; Matsunaga, Terry O

    2011-09-06

    Recent efforts in the area of acoustic droplet vaporization with the objective of designing extravascular ultrasound contrast agents has led to the development of stabilized, lipid-encapsulated nanodroplets of the highly volatile compound decafluorobutane (DFB). We developed two methods of generating DFB droplets, the first of which involves condensing DFB gas (boiling point from -1.1 to -2 °C) followed by extrusion with a lipid formulation in HEPES buffer. Acoustic droplet vaporization of micrometer-sized lipid-coated droplets at diagnostic ultrasound frequencies and mechanical indices were confirmed optically. In our second formulation methodology, we demonstrate the formulation of submicrometer-sized lipid-coated nanodroplets based upon condensation of preformed microbubbles containing DFB. The droplets are routinely in the 200-300 nm range and yield microbubbles on the order of 1-5 μm once vaporized, consistent with ideal gas law expansion predictions. The simple and effective nature of this methodology allows for the development of a variety of different formulations that can be used for imaging, drug and gene delivery, and therapy. This study is the first to our knowledge to demonstrate both a method of generating ADV agents by microbubble condensation and formulation of primarily submicrometer droplets of decafluorobutane that remain stable at physiological temperatures. Finally, activation of DFB nanodroplets is demonstrated using pressures within the FDA guidelines for diagnostic imaging, which may minimize the potential for bioeffects in humans. This methodology offers a new means of developing extravascular contrast agents for diagnostic and therapeutic applications. © 2011 American Chemical Society

  15. A randomized trial of diagnostic ultrasound to improve outcomes in focal neuropathies.

    PubMed

    Cartwright, Michael S; Griffin, Leah P; Dowlen, Hugh; Bargoil, Jessica M; Caress, James B; Li, Zhongyu J; Defranzo, Anthony J; Wiesler, Ethan R; Tuohy, Christopher J; Balakrishnan, Nikhil; Molnar, Joseph A; Baute, Vanessa; Koman, L Andrew; Poehling, Gary G; Walker, Francis O

    2015-11-01

    Neuromuscular ultrasound is valid, reliable, and accurate, but it is not known whether combining it with electrodiagnostic studies leads to better outcomes in individuals with focal neuropathies. One hundred twenty individuals with focal neuropathy, based on history, examination, and electrodiagnosis, were enrolled in this study. All patients underwent neuromuscular ultrasound and were randomized to either have their ultrasound results sent to the referring physician or not have them sent. Outcomes were assessed at 6 months by evaluators blinded to group assignment. The Overall Disability Sum Score and 7 of 8 domains of the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) showed more improvement in the "report sent" group, although only the general health perception domain was significant (P = 0.005). Most 6-month outcomes did not reach statistical significance between the 2 groups. However, the "report sent" group had trends toward better outcomes, with significance being reached in the general health perception domain of the SF-36. © 2015 Wiley Periodicals, Inc.

  16. Diagnostic Ultrasound Impulses Improve Microvascular Flow in Patients With STEMI Receiving Intravenous Microbubbles.

    PubMed

    Mathias, Wilson; Tsutsui, Jeane M; Tavares, Bruno G; Xie, Feng; Aguiar, Miguel O D; Garcia, Diego R; Oliveira, Mucio T; Soeiro, Alexandre; Nicolau, Jose C; Lemos, Pedro A; Rochitte, Carlos E; Ramires, José A F; Kalil, Roberto; Porter, Thomas R

    2016-05-31

    Pre-clinical trials have demonstrated that, during intravenous microbubble infusion, high mechanical index (HMI) impulses from a diagnostic ultrasound (DUS) transducer might restore epicardial and microvascular flow in acute ST-segment elevation myocardial infarction (STEMI). The purpose of this study was to test the safety and efficacy of this adjunctive approach in humans. From May 2014 through September 2015, patients arriving with their first STEMI were randomized to either DUS intermittent HMI impulses (n = 20) just prior to emergent percutaneous coronary intervention (PCI) and for an additional 30 min post-PCI (HMI + PCI), or low mechanical index (LMI) imaging only (n = 10) for perfusion assessments before and after PCI (LMI + PCI). All studies were conducted during an intravenous perflutren lipid microsphere infusion. A control reference group (n = 70) arrived outside of the time window of ultrasound availability and received emergent PCI alone (PCI only). Initial epicardial recanalization rates prior to emergent PCI and improvements in microvascular flow were compared between ultrasound-treated groups. Median door-to-dilation times were 82 ± 26 min in the LMI + PCI group, 72 ± 15 min in the HMI + PCI group, and 103 ± 42 min in the PCI-only group (p = NS). Angiographic recanalization prior to PCI was seen in 12 of 20 HMI + PCI patients (60%) compared with 10% of LMI + PCI and 23% of PCI-only patients (p = 0.002). There were no differences in microvascular obstructed segments prior to treatment, but there were significantly smaller proportions of obstructed segments in the HMI + PCI group at 1 month (p = 0.001) and significant improvements in left ventricular ejection fraction (p < 0.005). HMI impulses from a diagnostic transducer, combined with a commercial microbubble infusion, can prevent microvascular obstruction and improve functional outcome when added to the contemporary PCI management of acute STEMI. (Therapeutic Use of Ultrasound in

  17. Curvelet based automatic segmentation of supraspinatus tendon from ultrasound image: a focused assistive diagnostic method.

    PubMed

    Gupta, Rishu; Elamvazuthi, Irraivan; Dass, Sarat Chandra; Faye, Ibrahima; Vasant, Pandian; George, John; Izza, Faizatul

    2014-12-04

    Disorders of rotator cuff tendons results in acute pain limiting the normal range of motion for shoulder. Of all the tendons in rotator cuff, supraspinatus (SSP) tendon is affected first of any pathological changes. Diagnosis of SSP tendon using ultrasound is considered to be operator dependent with its accuracy being related to operator's level of experience. The automatic segmentation of SSP tendon ultrasound image was performed to provide focused and more accurate diagnosis. The image processing techniques were employed for automatic segmentation of SSP tendon. The image processing techniques combines curvelet transform and mathematical concepts of logical and morphological operators along with area filtering. The segmentation assessment was performed using true positives rate, false positives rate and also accuracy of segmentation. The specificity and sensitivity of the algorithm was tested for diagnosis of partial thickness tears (PTTs) and full thickness tears (FTTs). The ultrasound images of SSP tendon were taken from medical center with the help of experienced radiologists. The algorithm was tested on 116 images taken from 51 different patients. The accuracy of segmentation of SSP tendon was calculated to be 95.61% in accordance with the segmentation performed by radiologists, with true positives rate of 91.37% and false positives rate of 8.62%. The specificity and sensitivity was found to be 93.6%, 94% and 95%, 95.6% for partial thickness tears and full thickness tears respectively. The proposed methodology was successfully tested over a database of more than 116 US images, for which radiologist assessment and validation was performed. The segmentation of SSP tendon from ultrasound images helps in focused, accurate and more reliable diagnosis which has been verified with the help of two experienced radiologists. The specificity and sensitivity for accurate detection of partial and full thickness tears has been considerably increased after segmentation when

  18. The importance of infection prevention and control in medical ultrasound

    PubMed Central

    Moshkanbaryans, Lia; Meyers, Craig; Ngu, Andrew

    2015-01-01

    Abstract Infection control and prevention is critical to delivering safe and high‐quality care to patients undergoing sonographic procedures. In Australia comprehensive standards for reprocessing of ultrasound probes are based on the AS/NZS, TGA and ASUM recommendations. These standards align with the US Centers for Disease Control and Prevention recommendations. However compliance to these guidelines is not ideal and there exists an unmet need for refinement of the guidelines relating to specific factors in clinical sonography. Significant microbiological evidence exists reflecting the increased risk of infection transmission specifically through inadequately reprocessed ultrasound probes. Studies have reported > 80% of transvaginal ultrasound probe handles are contaminated with disease causing pathogens since handle disinfection is omitted from standard reprocessing protocols. Significantly, it was recently discovered that widely‐used high level disinfectants referred to in guidelines are unable to kill HPV while it is becoming increasingly apparent that attention must be paid to the clinical sonography environment as a potential source of nosocomial pathogens. Ultrasound probe reprocessing guidelines and standards are comprehensive however the challenge is in general awareness and effective implementation into practice. As future research in this area is performed, guidelines will need to be amenable to revision to provide patients with the best standard of care. PMID:28191249

  19. Thyroid nodule sizes influence the diagnostic performance of TIRADS and ultrasound patterns of 2015 ATA guidelines: a multicenter retrospective study

    PubMed Central

    Xu, Ting; Gu, Jing-yu; Ye, Xin-hua; Xu, Shu-hang; Wu, Yang; Shao, Xin-yu; Liu, De-zhen; Lu, Wei-ping; Hua, Fei; Shi, Bi-min; Liang, Jun; Xu, Lan; Tang, Wei; Liu, Chao; Wu, Xiao-hong

    2017-01-01

    To evaluate the impact of thyroid nodule sizes on the diagnostic performance of thyroid imaging reporting and data system (TIRADS) and ultrasound patterns of 2015 American Thyroid Association (ATA) guidelines. Total 734 patients with 962 thyroid nodules were recruited in this retrospective study. All nodules were divided into three groups according to the maximal diameter (d < 10 mm, d = 10–20 mm and d > 20 mm). The ultrasound images were categorized based on TIRADS and ATA ultrasound patterns, respectively. A total of 931 (96.8%) and 906 (94.2%) patterns met the criteria for TIRADS and ATA ultrasound patterns. The AUC (0.849) and sensitivity (85.3%) of TIRADS were highest in d = 10–20 mm group. However, ATA had highest AUC (0.839) and specificity (89.8%) in d > 20 mm group. ATA ultrasound patterns had higher specificity (P = 0.04), while TI-RADS had higher sensitivity (P = 0.02). In nodules d > 20 mm, the specificity of ATA patterns was higher than TIRADS (P = 0.003). Our results indicated that nodule sizes may influence the diagnostic performance of TIRADS and ATA ultrasound patterns. The ATA patterns may yield higher specificity than TIRADS, especially in nodules larger than 20 mm. PMID:28233806

  20. Thyroid nodule sizes influence the diagnostic performance of TIRADS and ultrasound patterns of 2015 ATA guidelines: a multicenter retrospective study.

    PubMed

    Xu, Ting; Gu, Jing-Yu; Ye, Xin-Hua; Xu, Shu-Hang; Wu, Yang; Shao, Xin-Yu; Liu, De-Zhen; Lu, Wei-Ping; Hua, Fei; Shi, Bi-Min; Liang, Jun; Xu, Lan; Tang, Wei; Liu, Chao; Wu, Xiao-Hong

    2017-02-24

    To evaluate the impact of thyroid nodule sizes on the diagnostic performance of thyroid imaging reporting and data system (TIRADS) and ultrasound patterns of 2015 American Thyroid Association (ATA) guidelines. Total 734 patients with 962 thyroid nodules were recruited in this retrospective study. All nodules were divided into three groups according to the maximal diameter (d < 10 mm, d = 10-20 mm and d > 20 mm). The ultrasound images were categorized based on TIRADS and ATA ultrasound patterns, respectively. A total of 931 (96.8%) and 906 (94.2%) patterns met the criteria for TIRADS and ATA ultrasound patterns. The AUC (0.849) and sensitivity (85.3%) of TIRADS were highest in d = 10-20 mm group. However, ATA had highest AUC (0.839) and specificity (89.8%) in d > 20 mm group. ATA ultrasound patterns had higher specificity (P = 0.04), while TI-RADS had higher sensitivity (P = 0.02). In nodules d > 20 mm, the specificity of ATA patterns was higher than TIRADS (P = 0.003). Our results indicated that nodule sizes may influence the diagnostic performance of TIRADS and ATA ultrasound patterns. The ATA patterns may yield higher specificity than TIRADS, especially in nodules larger than 20 mm.

  1. Diagnostic utility of peripheral endobronchial ultrasound with electromagnetic navigation bronchoscopy in peripheral lung nodules.

    PubMed

    Chee, Alex; Stather, David R; Maceachern, Paul; Martel, Simon; Delage, Antoine; Simon, Mathieu; Dumoulin, Elaine; Tremblay, Alain

    2013-07-01

    This study aimed to investigate the diagnostic utility of peripheral endobronchial ultrasound (pEBUS) followed by as-needed electromagnetic navigation bronchoscopy (ENB) for sampling peripheral lung nodules. The study was a single-arm, prospective cohort study of patients with peripheral lung nodules. Peripheral lung lesion localization was initially performed using a pEBUS probe with guide sheath. If localization failed with pEBUS alone, ENB was used to help identify the lesion. Transbronchial biopsy, bronchial brush, transbronchial needle aspiration and bronchial washings were performed. Sixty patients were enrolled with average lesion size of 27 mm and mean pleural distance of 20 mm. Lesions were found with pEBUS alone in 75% of cases. The addition of ENB improved lesion localization to 93%. However, diagnostic yield for pEBUS alone and pEBUS with ENB were 43% and 50%, respectively. Factors predicting need for ENB use included smaller lesion size and absence of an air bronchus sign on computed tomography. ENB improves localization of lung lesions after unsuccessful pEBUS but is often not sufficient to ensure confirmation of a specific diagnosis. Technical improvements in sampling methods could improve the diagnostic yield. © 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.

  2. Point-of-Care Ultrasound in General Surgery Residency Training: A Proposal for Milestones in Graduate Medical Education Ultrasound.

    PubMed

    Beal, Eliza W; Sigmond, Benjamin R; Sage-Silski, Latifa; Lahey, Samantha; Nguyen, Victor; Bahner, David P

    2017-06-26

    The use of point-of-care ultrasound (US) in the clinical setting has undergone massive growth, although its incorporation into training and practice is variable. Surgeons are interested in using point-of-care US and can incorporate it effectively into clinical practice. However, the current state of point-of-care US training in general surgery is inadequate. The Accreditation Council for Graduate Medical Education introduced the Milestones Project to evaluate resident and fellow performance. Emergency medicine is the only specialty with a point-of-care US milestone. We have successfully implemented a US training program into our general surgery residency curriculum and now propose milestones in point-of-care US for all general surgery residents. © 2017 by the American Institute of Ultrasound in Medicine.

  3. American Medical Society for Sports Medicine (AMSSM) position statement: interventional musculoskeletal ultrasound in sports medicine.

    PubMed

    Finnoff, Jonathan T; Hall, Mederic M; Adams, Erik; Berkoff, David; Concoff, Andrew L; Dexter, William; Smith, Jay

    2015-02-01

    The use of diagnostic and interventional ultrasound has significantly increased over the past decade. A majority of the increased utilisation is by non-radiologists. In sports medicine, ultrasound is often used to guide interventions such as aspirations, diagnostic or therapeutic injections, tenotomies, releases and hydrodissections. Critically review the literature related to the accuracy, efficacy and cost-effectiveness of ultrasound-guided injections (USGIs) in major, intermediate and small joints; and soft tissues. Systematic review of the literature. USGIs are more accurate than landmark-guided injections (LMGIs; strength of recommendation taxonomy (SORT) Evidence Rating=A). USGIs are more efficacious than LMGIs (SORT Evidence Rating=B). USGIs are more cost-effective than LMGIs (SORT Evidence Rating=B). Ultrasound guidance is required to perform many new procedures (SORT Evidence Rating=C). The findings of this position statement indicate there is strong evidence that USGIs are more accurate than LMGI, moderate evidence that they are more efficacious and preliminary evidence that they are more cost-effective. Furthermore, ultrasound-guided (USG) is required to perform many new, advanced procedures and will likely enable the development of innovative USG surgical techniques in the future. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. Feasibility of a focused ultrasound training programme for medical undergraduate students.

    PubMed

    Wong, Ivan; Jayatilleke, Thilina; Kendall, Richard; Atkinson, Paul

    2011-03-01

    Although ultrasound is a core skill for many clinical specialties, UK medical schools are not currently required to teach this skill. The College of Emergency Medicine (CEM) has championed the use of ultrasound to answer focused clinical questions in emergency settings. We have designed and piloted an ultrasound training course for undergraduate medical students addressing one important indication: ultrasound assessment of the abdominal aorta. Fourteen clinical students, who had no prior experience of using ultrasound, received focused ultrasound training in the form of didactic instruction, a short bedside practical workshop and self-directed learning over a 20-day period. At the end of this period, the students were assessed by a structured viva and an observed structured clinical examination (OSCE) used for accreditation by the CEM. The primary endpoint was the number of students who passed the assessment. The secondary endpoint was the accuracy of the students' anatomical measurements. Thirteen of the 14 (93%) students completed the training and assessment. Eight of the 13 (62%) students passed both the viva and OSCE, and were deemed to have achieved the CEM standard. The measurements by the competent students were not statistically different from those of experienced practitioners. We have shown for the first time that it is feasible to train inexperienced undergraduate students to scan the abdominal aorta to a professional standard using a focused training course. It is time for the medical education community to address whether focused ultrasound training should accompany traditional clinical skills, such as using a stethoscope, in UK medical school curricula. © Blackwell Publishing Ltd 2011.

  5. Diagnostic value of FASH ultrasound and chest X-ray in HIV-co-infected patients with abdominal tuberculosis.

    PubMed

    Heller, T; Goblirsch, S; Bahlas, S; Ahmed, M; Giordani, M-T; Wallrauch, C; Brunetti, E

    2013-03-01

    In human immunodeficiency virus (HIV) co-infected tuberculosis (TB) patients with negative acid-fast bacilli smears, chest radiography (CXR) is usually the first imaging step in the diagnostic work-up. Ultrasound, also in the form of focused assessment with sonography for TB-HIV (FASH), is an additional imaging modality used to diagnose extra-pulmonary TB (EPTB). Findings from 82 patients with abdominal TB diagnosed by ultrasound were analysed and compared with CXR results. Enlarged abdominal lymph nodes were seen in 75.6% of the patients, spleen abscesses in 41.2% and liver lesions in 30.6%. CXR showed a miliary pattern in 21.9% of the patients; 26.8% of the CXR had no radiological changes suggestive of pulmonary TB. This patient group would benefit from ultrasound in diagnostic algorithms for HIV-associated EPTB.

  6. The Role of Anthropomorphic Phantoms in Diagnostic Ultrasound Imaging for Disease Characterization (abstract)

    NASA Astrophysics Data System (ADS)

    Cannon, L. M.; King, D. M.; Browne, J. E.

    2009-04-01

    An anthropomorhic phantom is an object that can mimic a region of the human anatomy. Anthropomorphic phantoms have a variety of roles in diagnostic ultrasound. These roles include quality assurance testing of ultrasound machines, calibration and testing of new imaging techniques, training of sonographers, and-most importantly-use as a tool to obtain a better understanding of disease progression in the relevant anatomy. To be anthropomorphic a phantom must accurately mimic the body in terms of its ultrasonic and mechanical properties, as well as anatomically. The acoustic properties are speed of sound, attenuation, and backscatter. The mechanical properties are elasticity and density. Phantoms are constructed from tissue-mimicking materials (TMMs). TMMs are prepared from a variety of ingredients, such as gelatine, agar, safflower oil, and glass beads. These ingredients are then boiled and cooled under controlled conditions to produce a solid TMM. To determine if the TMM has the correct acoustic properties, acoustic measurements are performed using a scanning acoustic macroscope. Mechanical measurements are also performed to test the elasticity and density properties. TMMs with the correct properties are subsequently put through a series of moulding procedures to produce the anthropomorphic phantom.

  7. Diagnostic X-ray and ultrasound exposure and risk of childhood cancer.

    PubMed Central

    Shu, X. O.; Jin, F.; Linet, M. S.; Zheng, W.; Clemens, J.; Mills, J.; Gao, Y. T.

    1994-01-01

    In a population-based case-control study of 642 childhood cancer cases and the same number of matched controls in Shanghai, China, we evaluated the relationship between diagnostic X-ray (preconception, pre- and post-natal) and antenatal ultrasound exposure and the subsequent risk of developing three major types of childhood cancer (acute leukaemia, lymphoma and brain tumours) and all childhood neoplasms combined. Consistent with previous studies, prenatal X-ray exposure was found to be associated with an 80% increased risk of childhood cancers, although the estimation was based on 4% and 2% exposed cases and controls and was only marginally statistically significant (P = 0.08). Post-natal X-ray exposure was also linked with a small elevation in the risk of all cancers and the major categories of malignancies in children. Little evidence, however, was found to relate parental preconception X-ray exposure with the subsequent cancer risk in offspring, regardless of the exposure window and the anatomical site of X-ray exposures. This study adds further to the growing literature indicating that antenatal ultrasound exposure is probably not associated with an increased risk of childhood cancer. PMID:8080742

  8. Multifeature analysis of an ultrasound quantitative diagnostic index for classifying nonalcoholic fatty liver disease

    PubMed Central

    Liao, Yin-Yin; Yang, Kuen-Cheh; Lee, Ming-Ju; Huang, Kuo-Chin; Chen, Jin-De; Yeh, Chih-Kuang

    2016-01-01

    Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease related to metabolic syndrome. This study applied an integrated analysis based on texture, backscattering, and attenuation features in ultrasound imaging with the aim of assessing the severity of NAFLD. Ultrasound radiofrequency data obtained from 394 clinical cases were analyzed to extract three texture features (autocorrelation, sum average, and sum variance), the signal-to-noise ratio (SNR), and the slope of the center-frequency downshift (CFDS slope). The texture, SNR, and CFDS slope were combined to produce a quantitative diagnostic index (QDI) that ranged from 0 to 6. We trained the QDI using training data and then applied it to test data to assess its utility. In training data, the areas (AUCs) under the receiver operating characteristic curves for NAFLD and severe NAFLD were 0.81 and 0.84, respectively. In test data, the AUCs were 0.73 and 0.81 for NAFLD and severe NAFLD, respectively. The QDI was able to distinguish severe NAFLD and a normal liver from mild NAFLD, and it was significantly correlated with metabolic factors. This study explored the potential of using the QDI to supply information on different physical characteristics of liver tissues for advancing the ability to grade NAFLD. PMID:27734972

  9. The Role of Anthropomorphic Phantoms in Diagnostic Ultrasound Imaging for Disease Characterization

    SciTech Connect

    Cannon, L. M.; King, D. M.; Browne, J. E.

    2009-04-19

    An anthropomorhic phantom is an object that can mimic a region of the human anatomy. Anthropomorphic phantoms have a variety of roles in diagnostic ultrasound. These roles include quality assurance testing of ultrasound machines, calibration and testing of new imaging techniques, training of sonographers, and--most importantly--use as a tool to obtain a better understanding of disease progression in the relevant anatomy. To be anthropomorphic a phantom must accurately mimic the body in terms of its ultrasonic and mechanical properties, as well as anatomically. The acoustic properties are speed of sound, attenuation, and backscatter. The mechanical properties are elasticity and density. Phantoms are constructed from tissue-mimicking materials (TMMs). TMMs are prepared from a variety of ingredients, such as gelatine, agar, safflower oil, and glass beads. These ingredients are then boiled and cooled under controlled conditions to produce a solid TMM. To determine if the TMM has the correct acoustic properties, acoustic measurements are performed using a scanning acoustic macroscope. Mechanical measurements are also performed to test the elasticity and density properties. TMMs with the correct properties are subsequently put through a series of moulding procedures to produce the anthropomorphic phantom.

  10. Diagnostic yield of endoscopic ultrasound in patients with hypoglicemia and insulinoma suspected

    PubMed Central

    Téllez-Ávila, Félix Ignacio; Acosta-Villavicencio, Gladys Yolanda; Chan, Carlos; Hernández-Calleros, Jorge; Uscanga, Luis; Valdovinos-Andraca, Francisco; Ramírez-Luna, Miguel Ángel

    2015-01-01

    Background and Objectives: Noninvasive imaging techniques have shown limitations to identify insulinomas. In few studies reported so far, endoscopic ultrasound (EUS) has proven to be able to locate lesions. The aim of this study was to compare the performance of computed tomography versus EUS for the detection of insulinomas. Materials and Methods: In a retrospective manner prospectively collected data were analyzed. Patients with hypoglucemia and hyperinsulinemia were included. Diagnostic yield was measured in relationship to sensitivity, specificity, positive predictive value, negative predictive value and accuracy. Surgical specimens were considered the gold standard. Results: Sensitivity, positive predictive value, and accuracy of EUS was 100%, 95.4% and 95.4%, respectively. In the case of CT the sensitivity was 60%, specificity 100%, positive predictive value 100%, negative predictive value 7%, and accuracy were 68%. Conclusions: EUS is useful in the preoperative assessment of patients with hypoglycemia and serum hyperinsulinemia. PMID:25789285

  11. Diagnostic ultrasound is unable to enhance the rate of neoplastic transformation in cultured mammalian cells.

    PubMed

    Tolsma, S S; Madsen, E L; Chmiel, J; Martin, A O; Bouck, N P

    1991-11-01

    The ability of diagnostic pulsed ultrasound to induce heritable genetic damage of the type that could result in neoplasia was assayed using BHK21/cl 13 hamster cells or normal human fibroblasts as targets. Using an exposure apparatus carefully designed to minimize beam attenuation and reflection, cavitation, and heating, cells were exposed from 20 seconds to 40 minutes either to clinical machines operating at maximum power, or to a highly focused nonclinical transducer at 2900 W/cm2, or to 200 shocks from a lithotripter. No evidence of an increase in the frequency of neoplastically transformed BHK cells or in the frequency of mutant human cells was seen over those found in matched sham-exposed controls.

  12. Sophisticated radiology in otolaryngology. II. Diagnostic imaging: non-roentgenographic (non x-ray) modalities (ultrasound, nuclear medicine, thermography).

    PubMed

    Noyek, A M; Holgate, R C; Wortzman, G; Greyson, N D; Miskin, M; Simor, I S; Steinhardt, M I; Kazdan, M S

    1977-01-01

    Newer forms of radiologic diagnostic imaging now include non-roentgenographic modalities such as ultrasound, nuclear medicin, and thermography, all of which can be applied to otolaryngology. It is the purpose of this presentation to demonstrate these modalities, and indicate their clinical application, yet in its earliest stages, to otolaryngology.

  13. Diagnostic and prognostic values of contrast-enhanced ultrasound in breast cancer: a retrospective study

    PubMed Central

    Zhao, Yi-Xuan; Liu, Shuang; Hu, Yan-Bing; Ge, Yan-Yan; Lv, Dong-Mei

    2017-01-01

    This study aimed to explore the diagnostic and prognostic values of contrast-enhanced ultrasound (CEUS) in breast cancer. Between September 2009 and October 2011, a total of 143 breast cancer patients and 161 healthy people were selected as case group and control group, respectively. After the identification of lesions by conventional ultrasound, all patients underwent CEUS. The CEUS images were analyzed, and time–intensity curves (TICs) were obtained. Hematoxylin–eosin and immunohistochemistry staining was performed on tissue specimens, according to which the expressions of estrogen receptor (ER), c-erb-B2, p53, and Ki-67 were measured. Multivariate logistic regression analysis was used to compare CEUS and TIC parameters between the two groups. Compared with the control group, cancer patients showed high enhancement, heterogeneous enhancement or defects in the central region, expansion of lesion diameter after enhancement and crab-like blur lesion edges. The peak intensity (PI), relative start time of enhancement, relative PI, and relative area under the curve in the case group were significantly higher than those in the control group. Logistic analysis showed that the uniformity of enhancement, expansion of lesion diameter, and relative PI were significant diagnostic parameters of breast cancer, with area under the curve being 0.798, 0.776, and 0.919, respectively. There were strong associations between CEUS characteristics and expressions of prognostic factors in breast cancer: the heterogeneous enhancement was common in c-erb-B2-positive tumors; the centripetal enhancement occurred more in ER-negative tumors; perforator vessels were often seen in tumors at high histological grade; perfusion defects were common in ER-negative, c-erb-B2-positive, and Ki-67-positive tumors. CEUS is a useful tool for the early diagnosis and prognosis of breast cancer. PMID:28260926

  14. Enzyme immunoassays and related procedures in diagnostic medical virology

    PubMed Central

    Kurstak, Edouard; Tijssen, Peter; Kurstak, Christine; Morisset, Richard

    1986-01-01

    This review article describes several applications of the widely used enzyme immunoassay (EIA) procedure. EIA methods have been adapted to solve problems in diagnostic virology where sensitivity, specificity, or practicability is required. Concurrent developments in hybridoma and conjugation methods have increased significantly the use of these assays. A general overview of EIA methods is given together with typical examples of their use in diagnostic medical virology; attention is drawn to possible pitfalls. Recent advances in recombinant DNA technology have made it possible to produce highly specific nucleic acid probes that have a sensitivity approximately 100 times greater than that of EIA. Some applications of these probes are described. Although the non-labelled nucleic acid probes for use in the field are not as refined as non-labelled immunoassays, their range of applications is expected to expand rapidly in the near future. ImagesFig. 4 PMID:3533302

  15. Agreement Between an Automated Volume Breast Scanner and Handheld Ultrasound for Diagnostic Breast Examinations.

    PubMed

    Barr, Richard G; DeVita, Robert; Destounis, Stamatia; Manzoni, Federica; De Silvestri, Annalisa; Tinelli, Carmine

    2017-06-01

    To compare the agreement and interobserver variability of diagnostic handheld ultrasound (US) and a single volume on an automated breast volume scanner (ABVS) and to determine whether there was a significant difference if the ABVS was used by a sonographer or mammographic technologist. Ninety patients scheduled for diagnostic US examinations were randomized to either handheld US or the ABVS first. The AVBS was randomized between a sonographer and a mammographic technologist performing the study. The studies were blinded, randomized, and read by 2 radiologists. The lesion with the highest Breast Imaging Reporting and Data System (BI-RADS) score was used in the analysis. Final diagnoses were made by core biopsy or follow-up for 2 years. Lesions included 9 malignant and 81 benign. The 90 patients had a mean age ± SD of 53.1 ± 16.3 years. The κ value for agreement between the ABVS and handheld US was 0.831 (95% confidence interval, 0.744-0.925), whereas the global agreement for a 7-point BI-RADS score was 0.488 (0.372-0.560). The agreement between the ABVS and handheld US was nearly the same when the ABVS was used by a mammographic technologist (κ = 0.858 [0.723-0.963]) or sonographer (κ = 0.803 [0.596-1.000]; P = .47). The areas under the receiver operating characteristic curves for characterization by the ABVS were 0.91 (0.84-0.96) for reader 1 and 0.91 (0.83-0.96) for reader 2; those for handheld US were 0.91 (0.84-0.96) for reader 1 and 0.83 (0.74-0.90) for reader 2, with no statistical difference. The agreement based on pathologic images was κ = 0.831 (0.718-0.944); for handheld US, κ = 0.795 (0.623-0.967); and for the AVBS, κ = 0.869 (0.725-1.000). Performing a single-view diagnostic ABVS examination has good agreement with a handheld diagnostic US workup. There is no difference if the ABVS is used by a sonographer or mammographic technologist. © 2017 by the American Institute of Ultrasound in Medicine.

  16. Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration in various lung diseases

    PubMed Central

    Ortakoylu, Mediha Gonenc; Iliaz, Sinem; Bahadir, Ayse; Aslan, Asuman; Iliaz, Raim; Ozgul, Mehmet Akif; Urer, Halide Nur

    2015-01-01

    Objective: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a new method for the diagnosis and staging of lung disease, and its use is increasing worldwide. It has been used as a means of diagnosing lung cancer in its initial stages, and there are data supporting its use for the diagnosis of benign lung disease. The aim of this study was to share our experience with EBUS-TBNA and discuss its diagnostic value. Methods: We retrospectively analyzed the results related to 159 patients who underwent EBUS-TBNA at our pulmonary medicine clinic between 2010 and 2013. We recorded the location and size of lymph nodes seen during EBUS. Lymph nodes that appeared to be affected on EBUS were sampled at least twice. We recorded the diagnostic results of EBUS-TBNA and (for cases in which EBUS-TBNA yielded an inconclusive diagnosis) the final diagnoses after further investigation and follow-up. Results: We evaluated 159 patients, of whom 89 (56%) were male and 70 (44%) were female. The mean age was 54.6 ± 14.2 years among the male patients and 51.9 ± 11.3 years among the female patients. Of the 159 patients evaluated, 115 (84%) were correctly diagnosed by EBUS. The diagnostic accuracy of EBUS-TBNA was 83% for benign granulomatous diseases and 77% for malignant diseases. Conclusions: The diagnostic value of EBUS-TBNA is also high for benign pathologies, such as sarcoidosis and tuberculosis. In patients with mediastinal disorders, the use of EBUS-TBNA should be encouraged, primarily because it markedly reduces the need for mediastinoscopy. PMID:26578131

  17. Ultrasound and stethoscope as tools in medical education and practice: considerations for the archives

    PubMed Central

    Fakoya, Francis A; du Plessis, Maira; Gbenimacho, Ikechi B

    2016-01-01

    Objectives In recent years, the use and portability of ultrasound has threatened the utility of the stethoscope, with many debating and even advocating its replacement. The authors set out to assess opinions in this regard among faculty within a medical school and specifically within an anatomy department where ultrasound is incorporated into the curriculum from the first term. Methods A debate was elicited during a biweekly Anatomy Journal Club session and was centered on three published papers presented. Several questions were raised regarding the possible replacement of stethoscope – the value of early exposure to students as well as how ultrasound and stethoscope should be considered by physicians, students, and teachers. Results The general consensus was that the stethoscope should not be replaced but should be used in conjunction with emerging portable ultrasound. Caution was given that technology could “overcomplicate” diagnosis and lead to increased tests resulting in increased cost of care. In terms of exposing students to ultrasound, just as the stethoscope requires practice to use effectively, so does the ultrasound and should be introduced as early on as possible. As is the case with the stethoscope, students may not initially appreciate all the finer details on ultrasound; however, continual use would improve skill. Conclusion The stethoscope should always remain part of the physical examination and ultrasound should be used in addition to, not replacement of. As technology advances the need for apprenticeship, training increases and students of the medical profession should be exposed to these technologies as early as possible. Hence, it is not yet time to archive the stethoscope. Perhaps never. PMID:27471420

  18. Use of antihypertensive medications and diagnostic tests among privately-insured adolescents and young adults with primary vs. secondary hypertension

    PubMed Central

    Yoon, Esther Y.; Cohn, Lisa; Freed, Gary; Rocchini, Albert; Kershaw, David; Ascione, Frank; Clark, Sarah

    2014-01-01

    Purpose To compare the use of antihypertensive medications and diagnostic tests among adolescents and young adults with primary vs. secondary hypertension Methods We conducted retrospective cohort analysis of claims data for adolescents and young adults (12–21 years) with ≥ 3 years of insurance coverage (≥ 11 months/year) in a large private managed care plan during 2003–2009 with diagnosis of primary hypertension or secondary hypertension. We examined their use of antihypertensive medications and identified demographic characteristics and presence of obesity-related comorbidities. For the subset receiving antihypertensive medications, we examined their diagnostic test use (echocardiograms, renal ultrasounds, and electrocardiograms (EKG)). Results Study sample included 1232 adolescents and young adults; 84% had primary hypertension and 16% had secondary hypertension. Overall prevalence rate of hypertension was 2.6%. One-quarter (28%) with primary hypertension had ≥1 antihypertensive medication whereas 65% with secondary hypertension had ≥1 antihypertensive medication. Leading prescribers of antihypertensives for subjects with primary hypertension were primary care physicians (PCP) (80%) whereas antihypertensive medications were equally prescribed by PCPs (43%) and subspecialists (37%) for subjects with secondary hypertension. Conclusions The predominant hypertension diagnosis among adolescents and young adults is primary hypertension. Antihypertensive medication use was higher among those with secondary hypertension compared to those with primary hypertension. Further study is needed to determine treatment effectiveness and patient outcomes associated with differential treatment patterns used for adolescents and young adults with primary vs. secondary hypertension. PMID:24492018

  19. Early Innovative Immersion: A Course for Pre-Medical Professions Students Using Point-of-Care Ultrasound.

    PubMed

    Smalley, Courtney M; Browne, Vaughn; Kaplan, Bonnie; Russ, Brian; Wilson, Juliana; Lewiss, Resa E

    2016-12-01

    In preparing for medical school admissions, premedical students seek opportunities to expand their medical knowledge. Knowing what students seek and what point-of-care ultrasound offers, we created a novel educational experience using point-of-care ultrasound. The innovation has 3 goals: (1) to use point-of-care ultrasound to highlight educational concepts such as the flipped classroom, simulation, hands-on interaction, and medical exposure; (2) to work collaboratively with peers; and (3) to expose premedical students to mentoring for the medical school application process. We believe that this course could be used to encourage immersive innovation with point-of-care ultrasound, progressive education concepts, and preparation for medical admissions. © 2016 by the American Institute of Ultrasound in Medicine.

  20. 3D freehand ultrasound for medical assistance in diagnosis and treatment of breast cancer: preliminary results

    NASA Astrophysics Data System (ADS)

    Torres, Fabian; Fanti, Zian; Arambula Cosío, F.

    2013-11-01

    Image-guided interventions allow the physician to have a better planning and visualization of a procedure. 3D freehand ultrasound is a non-invasive and low-cost imaging tool that can be used to assist medical procedures. This tool can be used in the diagnosis and treatment of breast cancer. There are common medical practices that involve large needles to obtain an accurate diagnosis and treatment of breast cancer. In this study we propose the use of 3D freehand ultrasound for planning and guiding such procedures as core needle biopsy and radiofrequency ablation. The proposed system will help the physician to identify the lesion area, using image-processing techniques in the 3D freehand ultrasound images, and guide the needle to this area using the information of position and orientation of the surgical tools. We think that this system can upgrade the accuracy and efficiency of these procedures.

  1. Ultrasound

    MedlinePlus Videos and Cool Tools

    ... baby's development in the uterus. Ultrasound uses inaudible sound waves to produce a two-dimensional image of the baby while inside the mother's uterus. The sound waves bounce off solid structures in the body ...

  2. Ultrasound

    MedlinePlus

    ... called multiples) To screen for birth defects, like spina bifida or heart defects . Screening means seeing if your ... example, if the ultrasound shows your baby has spina bifida, she may be treated in the womb before ...

  3. Ultrasound

    MedlinePlus

    ... a pregnant woman and assess her fetus Diagnose gallbladder disease Evaluate flow in blood vessels Guide a ... For some ultrasound exams, such as of the gallbladder, your doctor may ask that you not eat ...

  4. Do Anesthetic Techniques Influence the Threshold for Glomerular Capillary Hemorrhage induced in Rats by Contrast Enhanced Diagnostic Ultrasound?

    PubMed Central

    Miller, Douglas L.; Lu, Xiaofang; Fabiilli, Mario; Dou, Chunyan

    2016-01-01

    Objectives Glomerular capillary hemorrhage (GCH) can be induced by ultrasonic cavitation during contrast enhanced diagnostic ultrasound (CEDUS), an important nonthermal ultrasound bioeffect. Recent studies of pulmonary ultrasound exposure have shown that thresholds for another nonthermal bioeffect of ultrasound, pulmonary capillary hemorrhage, is strongly influenced by whether or not xylazine is included in the specific anesthetic technique. Methods In this study, anesthesia with ketamine only was compared to ketamine plus xylazine for the induction of GCH in rats by 1.6 MHz intermittent diagnostic ultrasound with contrast agent (similar to Definity). GCH was measured as a percentage of glomeruli with hemorrhage found in histological sections for groups of rats scanned at different peak rarefactional pressure amplitudes. Results There was a significant difference between the magnitude of the GCH between the two anesthetics at 2.3 MPa with 45.6 % GCH for ketamine only, increasing to 63.2 % GCH for ketamine plus xylazine anesthesia (P<0.001). However, the thresholds for the two anesthesia methods were virtually identical at 1.0 MPa, based on linear regression of the exposure response data. Conclusions Therefore, thresholds for CEDUS induced injury of the microvasculature appears to be minimally affected by anesthesia methods. PMID:26764276

  5. Diagnostic performance of multi-organ ultrasound with pocket-sized device in the management of acute dyspnea.

    PubMed

    Sforza, Alfonso; Mancusi, Costantino; Carlino, Maria Viviana; Buonauro, Agostino; Barozzi, Marco; Romano, Giuseppe; Serra, Sossio; de Simone, Giovanni

    2017-06-19

    The availability of ultra-miniaturized pocket ultrasound devices (PUD) adds diagnostic power to the clinical examination. Information on accuracy of ultrasound with handheld units in immediate differential diagnosis in emergency department (ED) is poor. The aim of this study is to test the usefulness and accuracy of lung ultrasound (LUS) alone or combined with ultrasound of the heart and inferior vena cava (IVC) using a PUD for the differential diagnosis of acute dyspnea (AD). We included 68 patients presenting to the ED of "Maurizio Bufalini" Hospital in Cesena (Italy) for AD. All patients underwent integrated ultrasound examination (IUE) of lung-heart-IVC, using PUD. The series was divided into patients with dyspnea of cardiac or non-cardiac origin. We used 2 × 2 contingency tables to analyze sensitivity, specificity, positive predictive value and negative predictive value of the three ultrasonic methods and their various combinations for the diagnosis of cardiogenic dyspnea (CD), comparing with the final diagnosis made by an independent emergency physician. LUS alone exhibited a good sensitivity (92.6%) and specificity (80.5%). The highest accuracy (90%) for the diagnosis of CD was obtained with the combination of LUS and one of the other two methods (heart or IVC). The IUE with PUD is a useful extension of the clinical examination, can be readily available at the bedside or in ambulance, requires few minutes and has a reliable diagnostic discriminant ability in the setting of AD.

  6. Mechanisms for Induction of Pulmonary Capillary Hemorrhage by Diagnostic Ultrasound: Review and Consideration of Acoustical Radiation Surface Pressure.

    PubMed

    Miller, Douglas L

    2016-12-01

    Diagnostic ultrasound can induce pulmonary capillary hemorrhage (PCH) in rats and other mammals. This phenomenon represents the only clearly demonstrated biological effect of (non-contrast enhanced) diagnostic ultrasound and thus presents a uniquely important safety issue. However, the physical mechanism responsible for PCH remains uncertain more than 25 y after its discovery. Experimental research has indicated that neither heating nor acoustic cavitation, the predominant mechanisms for bioeffects of ultrasound, is responsible for PCH. Furthermore, proposed theoretical mechanisms based on gas-body activation, on alveolar resonance and on impulsive generation of liquid droplets all appear unlikely to be responsible for PCH, owing to unrealistic model assumptions. Here, a simple model based on the acoustical radiation surface pressure (ARSP) at a tissue-air interface is hypothesized as the mechanism for PCH. The ARSP model seems to explain some features of PCH, including the approximate frequency independence of PCH thresholds and the dependence of thresholds on biological factors. However, ARSP evaluated for experimental threshold conditions appear to be too weak to fully account for stress failure of pulmonary capillaries, gauging by known stresses for injurious physiologic conditions. Furthermore, consideration of bulk properties of lung tissue suggests substantial transmission of ultrasound through the pleura, with reduced ARSP and potential involvement of additional mechanisms within the pulmonary interior. Although these recent findings advance our knowledge, only a full understanding of PCH mechanisms will allow development of science-based safety assurance for pulmonary ultrasound.

  7. Value of the correct diagnostic pathway through conventional imaging (mammography and ultrasound) in evaluating breast disease.

    PubMed

    Pistolese, C A; Perretta, T; Cossu, E; Della Gatta, F; Giura, S; Simonetti, G

    2011-06-01

    This study evaluated the role of the correct diagnostic pathway through conventional imaging in evaluating breast disease. Six hundred patients aged between 35 and 75 years were enrolled in the study. All patients underwent detailed history and clinical examination, ultrasound (US) and mammography. US scans were repeated after mammography. All suspicious lesions were studied by cytological and histological characterisation and magnetic resonance (MR) imaging. The first US scan showed 147 solid lesions, 67 lesions characterised by posterior acoustic shadowing and 193 areas of heterogeneous echostructure. The second US scan, performed after mammography, confirmed 123/147 solid nodular lesions, 53/67 lesions characterised by posterior acoustic shadowing and 183/193 areas of heterogeneous echostructure; it also showed 13 nodular lesions not seen on the first scan and two cases of nodular lesions with irregular calcifications. Our experience suggests that US not performed in conjunction with mammography gives rise to incorrect diagnostic interpretations (either false positive or false negative results). The detection rate of the US scan performed after mammography increases from 4.16% to 5.5%.

  8. Secondary signs may improve the diagnostic accuracy of equivocal ultrasounds for suspected appendicitis in children.

    PubMed

    Partain, Kristin N; Patel, Adarsh; Travers, Curtis; McCracken, Courtney E; Loewen, Jonathan; Braithwaite, Kiery; Heiss, Kurt F; Raval, Mehul V

    2016-10-01

    Ultrasound (US) is the preferred imaging modality for evaluating appendicitis. Our purpose was to determine if including secondary signs (SS) improve diagnostic accuracy in equivocal US studies. Retrospective review identified 825 children presenting with concern for appendicitis and with a right lower quadrant (RLQ) US. Regression models identified which SS were associated with appendicitis. Test characteristics were demonstrated. 530 patients (64%) had equivocal US reports. Of 114 (22%) patients with equivocal US undergoing CT, those with SS were more likely to have appendicitis (48.6% vs 14.6%, p<0.001). Of 172 (32%) patients with equivocal US admitted for observation, those with SS were more likely to have appendicitis (61.0% vs 33.6%, p<0.001). SS associated with appendicitis included fluid collection (adjusted odds ratio (OR) 13.3, 95% confidence interval (CI) 2.1-82.8), hyperemia (OR=2.0, 95%CI 1.5-95.5), free fluid (OR=9.8, 95%CI 3.8-25.4), and appendicolith (OR=7.9, 95%CI 1.7-37.2). Wall thickness, bowel peristalsis, and echogenic fat were not associated with appendicitis. Equivocal US that included hyperemia, a fluid collection, or an appendicolith had 96% specificity and 88% accuracy. Use of SS in RLQ US assists in the diagnostic accuracy of appendicitis. SS may guide clinicians and reduce unnecessary CT and admissions. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Applications of ultrasound to veterinary diagnostics in a veterinary teaching hospital.

    PubMed

    Miller, C W; Wingfield, W E; Boon, J A

    1982-01-01

    Animal patients at Colorado State University's Veterinary Teaching Hospital as well as beagles at the Collaborative Radiological Health Laboratory (CRHL) have been routinely evaluated using a variety of ultrasonic procedures that are commonplace in human medicine. The results from these clinical investigations have provided diagnostic information which in many cases has not been available using other clinical testing methods. Dogs, cats, horses, and cattle have been the primary animals evaluated, but more exotic subjects such as rabbits, ferrets, goats, and armadillos have also been examined. Standard M mode echocardiographic and classic contact scanning have been used to evaluate the heart and abdominal-pelvic areas respectively. Recently, real time scanning has been added to our capabilities for evaluating animal subjects. These clinical studies, while obviously adding to veterinary diagnostics have also become an exciting new area in the veterinary teaching program. Ultrasound has shown potential in a variety of studies employing animal models, i.e., aging effects on the heart in beagles and anthracycline-induced myocardial dysfunction in rabbits.

  10. Indeterminate adnexal masses at ultrasound: effect of MRI imaging findings on diagnostic thinking and therapeutic decisions.

    PubMed

    Chilla, Bianka; Hauser, Nik; Singer, Gad; Trippel, Mafalda; Froehlich, Johannes M; Kubik-Huch, Rahel A

    2011-06-01

    To determine the impact of MRI including DWI on therapeutic decision-making and costs in the work-up of patients with a indeterminate adnexal mass on ultrasound. Thirty-eight patients with indeterminate ovarian lesions scheduled for surgery were included in this prospective study. In a questionnaire, the surgeon characterised the lesions based on a morphological score and determined the surgical procedure. The assessment was re-evaluated knowing MR findings and correlated with the final diagnosis. A cost-benefit analysis of MRI was performed. The impact of including DWI in the MR protocol was assessed. MRI provided major diagnostic information in 11/38 cases (28.9%) resulting in abstention from surgery in 5 cases; moderate additional information was recorded in 10/38 (26.3%) patients. Overall a net cost saving (3'676 EUR) was achieved. DWI did not show a significant difference between benign and malignant lesions. Teratomas yielded significantly lower mean ADC values (0.597 × 10(-3) mm(2)/s) compared with all other adnexal lesions (1.812 × 10(-3) mm(2)/s); the mean ADC values in endometrioma (1.387 × 10(-3) mm(2)/s) were significantly lower than in other cystic lesions (2.372 × 10(-3) mm(2)/s). Inclusion of MRI in the diagnostic algorithm of the indeterminate adnexal mass allows better differentiation of ovarian lesions resulting in a change of therapeutic decision-making with net cost savings.

  11. Quantitative diagnostic method for biceps long head tendinitis by using ultrasound.

    PubMed

    Huang, Shih-Wei; Wang, Wei-Te

    2013-01-01

    To investigate the feasibility of grayscale quantitative diagnostic method for biceps tendinitis and determine the cut-off points of a quantitative biceps ultrasound (US) method to diagnose biceps tendinitis. Design. Prospective cross-sectional case controlled study. Outpatient rehabilitation service. A total of 336 shoulder pain patients with suspected biceps tendinitis were recruited in this prospective observational study. The grayscale pixel data of the range of interest (ROI) were obtained for both the transverse and longitudinal views of the biceps US. A total of 136 patients were classified with biceps tendinitis, and 200 patients were classified as not having biceps tendinitis based on the diagnostic criteria. Based on the Youden index, the cut-off points were determined as 26.85 for the transverse view and 21.25 for the longitudinal view of the standard deviation (StdDev) of the ROI values, respectively. When the ROI evaluation of the US surpassed the cut-off point, the sensitivity was 68% and the specificity was 90% in the StdDev of the transverse view, and the sensitivity was 81% and the specificity was 73% in the StdDev of the longitudinal view to diagnose biceps tendinitis. For equivocal cases or inexperienced sonographers, our study provides a more objective method for diagnosing biceps tendinitis in shoulder pain patients.

  12. Quantitative Diagnostic Method for Biceps Long Head Tendinitis by Using Ultrasound

    PubMed Central

    Huang, Shih-Wei; Wang, Wei-Te

    2013-01-01

    Objective. To investigate the feasibility of grayscale quantitative diagnostic method for biceps tendinitis and determine the cut-off points of a quantitative biceps ultrasound (US) method to diagnose biceps tendinitis. Design. Prospective cross-sectional case controlled study. Setting. Outpatient rehabilitation service. Methods. A total of 336 shoulder pain patients with suspected biceps tendinitis were recruited in this prospective observational study. The grayscale pixel data of the range of interest (ROI) were obtained for both the transverse and longitudinal views of the biceps US. Results. A total of 136 patients were classified with biceps tendinitis, and 200 patients were classified as not having biceps tendinitis based on the diagnostic criteria. Based on the Youden index, the cut-off points were determined as 26.85 for the transverse view and 21.25 for the longitudinal view of the standard deviation (StdDev) of the ROI values, respectively. When the ROI evaluation of the US surpassed the cut-off point, the sensitivity was 68% and the specificity was 90% in the StdDev of the transverse view, and the sensitivity was 81% and the specificity was 73% in the StdDev of the longitudinal view to diagnose biceps tendinitis. Conclusion. For equivocal cases or inexperienced sonographers, our study provides a more objective method for diagnosing biceps tendinitis in shoulder pain patients. PMID:24385888

  13. Ultrasound-based teaching of cardiac anatomy and physiology to undergraduate medical students.

    PubMed

    Hammoudi, Nadjib; Arangalage, Dimitri; Boubrit, Lila; Renaud, Marie Christine; Isnard, Richard; Collet, Jean-Philippe; Cohen, Ariel; Duguet, Alexandre

    2013-10-01

    Ultrasonography is a non-invasive imaging modality that offers the opportunity to teach living cardiac anatomy and physiology. The objectives of this study were to assess the feasibility of integrating an ultrasound-based course into the conventional undergraduate medical teaching programme and to analyse student and teacher feedback. An ultrasound-based teaching course was implemented and proposed to all second-year medical students (n=348) at the end of the academic year, after all the conventional modules at our faculty. After a brief theoretical and practical demonstration, students were allowed to take the probe and use the ultrasound machine. Students and teachers were asked to complete a survey and were given the opportunity to provide open feedback. Two months were required to implement the entire module; 330 (95%) students (divided into 39 groups) and 37 teachers participated in the course. Student feedback was very positive: 98% of students agreed that the course was useful; 85% and 74% considered that their understanding of cardiac anatomy and physiology, respectively, was improved. The majority of the teachers (97%) felt that the students were interested, 81% agreed that the course was appropriate for second-year medical students and 84% were willing to participate to future sessions. Cardiac anatomy and physiology teaching using ultrasound is feasible for undergraduate medical students and enhances their motivation to improve their knowledge. Student and teacher feedback on the course was very positive. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  14. Integration of medical imaging including ultrasound into a new clinical anatomy curriculum.

    PubMed

    Moscova, Michelle; Bryce, Deborah A; Sindhusake, Doungkamol; Young, Noel

    2015-01-01

    In 2008 a new clinical anatomy curriculum with integrated medical imaging component was introduced into the University of Sydney Medical Program. Medical imaging used for teaching the new curriculum included normal radiography, MRI, CT scans, and ultrasound imaging. These techniques were incorporated into teaching over the first two years of the program as a part of anatomy practical sessions, in addition to dedicated lectures and tutorials given by imaging specialists. Surveys were conducted between 2009 and 2012 to evaluate the student acceptance of the integration. Students were asked to rate individual activities as well as provide open-ended comments. The number of students who responded to the surveys varied from 40% to 98%. Over 90% of the respondents were satisfied with the overall quality of teaching in the anatomy units. In summary, 48% to 63% of the responding students thought that the specialist imaging lectures helped them learn effectively; 72% to 77% of students thought that the cross-sectional practical sessions helped them to better understand the imaging modalities of CT, MRI, and ultrasound; 76% to 80% of students considered hands-on ultrasound session to be useful in understanding the application of ultrasound in abdominal imaging. The results also revealed key similarities and differences in student perceptions of the new integrated curriculum for students with both a high and low prior exposure to anatomy. Further evaluation will aid in refining the integrated medical imaging program and providing its future direction. © 2014 American Association of Anatomists.

  15. Ultrasound criteria and guided fine-needle aspiration diagnostic yields in small animal peritoneal, mesenteric and omental disease.

    PubMed

    Feeney, Daniel A; Ober, Christopher P; Snyder, Laura A; Hill, Sara A; Jessen, Carl R

    2013-01-01

    Peritoneal, mesenteric, and omental diseases are important causes of morbidity and mortality in humans and animals, although information in the veterinary literature is limited. The purposes of this retrospective study were to determine whether objectively applied ultrasound interpretive criteria are statistically useful in differentiating among cytologically defined normal, inflammatory, and neoplastic peritoneal conditions in dogs and cats. A second goal was to determine the cytologically interpretable yield on ultrasound-guided, fine-needle sampling of peritoneal, mesenteric, or omental structures. Sonographic criteria agreed upon by the authors were retrospectively and independently applied by two radiologists to the available ultrasound images without knowledge of the cytologic diagnosis and statistically compared to the ultrasound-guided, fine-needle aspiration cytologic interpretations. A total of 72 dogs and 49 cats with abdominal peritoneal, mesenteric, or omental (peritoneal) surface or effusive disease and 17 dogs and 3 cats with no cytologic evidence of inflammation or neoplasia were included. The optimized, ultrasound criteria-based statistical model created independently for each radiologist yielded an equation-based diagnostic category placement accuracy of 63.2-69.9% across the two involved radiologists. Regional organ-associated masses or nodules as well as aggregated bowel and peritoneal thickening were more associated with peritoneal neoplasia whereas localized, severely complex fluid collections were more associated with inflammatory peritoneal disease. The cytologically interpretable yield for ultrasound-guided fine-needle sampling was 72.3% with no difference between species, making this a worthwhile clinical procedure.

  16. Beamforming through regularized inverse problems in ultrasound medical imaging.

    PubMed

    Szasz, Teodora; Basarab, Adrian; Kouame, Denis

    2016-09-13

    Beamforming in ultrasound imaging has significant impact on the quality of the final image, controlling its resolution and contrast. Despite its low spatial resolution and contrast, delay-and-sum is still extensively used nowadays in clinical applications, due to its real-time capabilities. The most common alternatives are minimum variance method and its variants, which overcome the drawbacks of delay-and-sum, at the cost of higher computational complexity that limits its utilization in real-time applications. In this paper, we propose to perform beamforming in ultrasound imaging through a regularized inverse problem based on a linear model relating the reflected echoes to the signal to be recovered. Our approach presents two major advantages: i) its flexibility in the choice of statistical assumptions on the signal to be beamformed (Laplacian and Gaussian statistics are tested herein) and ii) its robustness to a reduced number of pulse emissions. The proposed framework is flexible and allows for choosing the right trade-off between noise suppression and sharpness of the resulted image. We illustrate the performance of our approach on both simulated and experimental data, with in vivo examples of carotid and thyroid. Compared to delay-and-sum, minimimum variance and two other recently published beamforming techniques, our method offers better spatial resolution, respectively contrast, when using Laplacian and Gaussian priors.

  17. A prospective evaluation of ultrasound as a diagnostic tool in acute microcrystalline arthritis.

    PubMed

    Zufferey, Pascal; Pascal, Zufferey; Valcov, Roxana; Fabreguet, Isabelle; Dumusc, Alexandre; Omoumi, Patrick; So, Alexander

    2015-07-22

    The performance of ultrasound (US) in the diagnosis of acute gouty (MSU) arthritis and calcium pyrophosphate (CPP) arthritis is not yet well defined. Most studies evaluated US as the basis for diagnosing crystal arthritis in already diagnosed cases of gout and few prospective studies have been performed. One hundred nine consecutive patients who presented an acute arthritis of suspected microcrystalline arthritis were prospectively included. All underwent an US of the symptomatic joints(s) and of knees, ankles and 1(st) metatarsopalangeal (MTP) joints by a rheumatologist "blinded" to the clinical history. 92 also had standard X-rays. Crystal identification was the gold standard. Fifty-one patients had MSU, 28 CPP and 9 had both crystals by microscopic analysis. No crystals were detected in 21. One had septic arthritis. Based on US signs in the symptomatic joint, the sensitivity of US for both gout and CPP was low (60% for both). In gout, the presence of US signs in the symptomatic joint was highly predictive of the diagnosis (PPV = 92%). When US diagnosis was based on an examination of multiple joints, the sensitivity for both gout and CPP rose significantly but the specificity and the PPV decreased. In the absence of US signs in all the joints studied, CPP arthritis was unlikely (NPV = 87%) particularly in patients with no previous crisis (NPV = 94%). X-ray of the symptomatic joints was confirmed to be not useful in diagnosing gout and was equally sensitive or specific as US in CPP arthritis. Arthrocenthesis remains the key investigation for the diagnosis of microcrystalline acute arthritis. Although US can help in the diagnostic process, its diagnostic performance is only moderate. US should not be limited to the symptomatic joint. Examination of multiple joints gives a better diagnostic sensitivity but lower specificity.

  18. Diagnostic value of blood clot core during endobronchial ultrasound-guided transbronchial needle aspirate.

    PubMed

    Amin, Emily N; Russell, Christopher D; Shilo, Konstantin; Islam, Shaheen; Wood, Karen L

    2013-06-01

    Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is being increasingly used in the sampling of pulmonary masses and mediastinal lymphadenopathy. The blood clot core (BCC) often obtained during EBUS-TBNA may not be a true core and therefore may not be submitted for histological analysis. The frequency in which the blood clot core is positive in patients with negative cytology undergoing EBUS-TBNA is not known. The purpose of this study was to evaluate the diagnostic role of the blood clot core obtained during EBUS-TBNA. An Institutional Review Board-approved retrospective chart review was performed from January through September 2011 for all patients who underwent EBUS-TBNA at The Ohio State University. The data collection included cytology and histology results for each procedure. Blood clot cores obtained from the EBUS-TBNA needle were sent in formalin for histological examination. Seventy patients underwent EBUS-TBNA and 51 (72.8 %) patients had procedures that yielded a BCC for histology and aspirate for cytology. Forty-nine percent of patients with a BCC were diagnosed with malignancy. Of those with a BCC obtained, five (9.8 %) patients diagnosed with malignancy were done so based only on the results of blood clot core alone with negative cytology. Blood clot cores obtained at EBUS-TBNA contain diagnostic material and should be subjected histopathological examination. When blood clot cores are sent for analysis, there is the potential to spare up to 10 % of patients more invasive diagnostic biopsy procedures.

  19. Errors and mistakes in the ultrasound diagnostics of the liver, gallbladder and bile ducts.

    PubMed

    Walas, Maria Krystyna; Skoczylas, Krzysztof; Gierbliński, Ireneusz

    2012-12-01

    Ultrasonography is the most widespread imaging technique used in the diagnostics of the pathologies concerning the organs in the abdominal cavity. Similarly to other diagnostic tools, errors may occur in ultrasound examinations. They generally result from inappropriate techniques, which do not conform to current standards, or erroneous interpretation of obtained images. A significant portion of mistakes is caused by inappropriate quality of the apparatus, the presence of sonographic imaging artifacts, unfavorable anatomic variants or improper preparation of the patient for the examination. This article focuses on the examiner-related errors. They concern the evaluation of the liver size, echostructure and arterial and venous vascularization as well as inappropriate interpretation of the liver anatomic variants and the vascular and ductal structures localized inside of it. Furthermore, the article presents typical mistakes made during the diagnosis of the most common gallbladder and bile duct diseases. It also includes helpful data concerning differential diagnostics of the described pathologies of the liver, gallbladder and bile ducts. The article indicates the most frequent sources of mistakes as well as false negative and false positive examples which result from these errors. What is more, the norms used in the liver, gallbladder and bile duct evaluations are presented as well as some helpful guidelines referring to the exam techniques and image interpretation, which allows for reducing the error-making risk. The article has been prepared on the basis of the report published in 2005 by the Polish experts in the field of ultrasonography and extended with the latest findings obtained from the pertinent literature.

  20. Errors and mistakes in the ultrasound diagnostics of the liver, gallbladder and bile ducts

    PubMed Central

    Walas, Maria Krystyna; Gierbliński, Ireneusz

    2012-01-01

    Ultrasonography is the most widespread imaging technique used in the diagnostics of the pathologies concerning the organs in the abdominal cavity. Similarly to other diagnostic tools, errors may occur in ultrasound examinations. They generally result from inappropriate techniques, which do not conform to current standards, or erroneous interpretation of obtained images. A significant portion of mistakes is caused by inappropriate quality of the apparatus, the presence of sonographic imaging artifacts, unfavorable anatomic variants or improper preparation of the patient for the examination. This article focuses on the examiner-related errors. They concern the evaluation of the liver size, echostructure and arterial and venous vascularization as well as inappropriate interpretation of the liver anatomic variants and the vascular and ductal structures localized inside of it. Furthermore, the article presents typical mistakes made during the diagnosis of the most common gallbladder and bile duct diseases. It also includes helpful data concerning differential diagnostics of the described pathologies of the liver, gallbladder and bile ducts. The article indicates the most frequent sources of mistakes as well as false negative and false positive examples which result from these errors. What is more, the norms used in the liver, gallbladder and bile duct evaluations are presented as well as some helpful guidelines referring to the exam techniques and image interpretation, which allows for reducing the error-making risk. The article has been prepared on the basis of the report published in 2005 by the Polish experts in the field of ultrasonography and extended with the latest findings obtained from the pertinent literature. PMID:26673428

  1. Biorisk Assessment of Medical Diagnostic Laboratories in Nigeria

    PubMed Central

    Oladeinde, Bankole Henry; Omoregie, Richard; Odia, Ikponmwonsa; Osakue, Eguagie Osareniro; Imade, Odaro Stanley

    2013-01-01

    Background The aim of this study was to assess public and private medical diagnostic laboratories in Nigeria for the presence of biosafety equipment, devices, and measures. Methods A total of 80 diagnostic laboratories in biosafety level 3 were assessed for the presence of biosafety equipment, devices, and compliance rate with biosafety practices. A detailed questionnaire and checklist was used to obtain the relevant information from enlisted laboratories. Results The results showed the presence of an isolated unit for microbiological work, leak-proof working benches, self-closing doors, emergency exits, fire extinguisher(s), autoclaves, and hand washing sinks in 21.3%, 71.3%, 15.0%, 1.3%, 11.3%, 82.5%, and 67.5%, respectively, of all laboratories surveyed. It was observed that public diagnostic laboratories were significantly more likely to have an isolated unit for microbiological work (p = 0.001), hand washing sink (p = 0.003), and an autoclave (p ≤ 0.001) than private ones. Routine use of hand gloves, biosafety cabinet, and a first aid box was observed in 35.0%, 20.0%, and 2.5%, respectively, of all laboratories examined. Written standard operating procedures, biosafety manuals, and biohazard signs on door entrances were observed in 6.3%, 1.3%, and 3.8%, respectively, of all audited laboratories. No biosafety officer(s) or records of previous spills, or injuries and accidents, were observed in all diagnostic laboratories studied. Conclusion In all laboratories (public and private) surveyed, marked deficiencies were observed in the area of administrative control responsible for implementing biosafety. Increased emphasis on provision of biosafety devices and compliance with standard codes of practices issued by relevant authorities is strongly advocated. PMID:23961333

  2. Biorisk assessment of medical diagnostic laboratories in Nigeria.

    PubMed

    Oladeinde, Bankole Henry; Omoregie, Richard; Odia, Ikponmwonsa; Osakue, Eguagie Osareniro; Imade, Odaro Stanley

    2013-06-01

    The aim of this study was to assess public and private medical diagnostic laboratories in Nigeria for the presence of biosafety equipment, devices, and measures. A total of 80 diagnostic laboratories in biosafety level 3 were assessed for the presence of biosafety equipment, devices, and compliance rate with biosafety practices. A detailed questionnaire and checklist was used to obtain the relevant information from enlisted laboratories. The results showed the presence of an isolated unit for microbiological work, leak-proof working benches, self-closing doors, emergency exits, fire extinguisher(s), autoclaves, and hand washing sinks in 21.3%, 71.3%, 15.0%, 1.3%, 11.3%, 82.5%, and 67.5%, respectively, of all laboratories surveyed. It was observed that public diagnostic laboratories were significantly more likely to have an isolated unit for microbiological work (p = 0.001), hand washing sink (p = 0.003), and an autoclave (p ≤ 0.001) than private ones. Routine use of hand gloves, biosafety cabinet, and a first aid box was observed in 35.0%, 20.0%, and 2.5%, respectively, of all laboratories examined. Written standard operating procedures, biosafety manuals, and biohazard signs on door entrances were observed in 6.3%, 1.3%, and 3.8%, respectively, of all audited laboratories. No biosafety officer(s) or records of previous spills, or injuries and accidents, were observed in all diagnostic laboratories studied. In all laboratories (public and private) surveyed, marked deficiencies were observed in the area of administrative control responsible for implementing biosafety. Increased emphasis on provision of biosafety devices and compliance with standard codes of practices issued by relevant authorities is strongly advocated.

  3. A new direct pixel-based focusing method for medical ultrasound imaging: preliminary results

    NASA Astrophysics Data System (ADS)

    Lee, YuHwa; Piao, Chunsheng; Kim, TaeWan; Chang, Jin Ho; Song, Tai-Kyong; Yoo, Yangmo

    2011-03-01

    In medical ultrasound imaging, scan conversion is used to geometrically transform polar coordinate ultrasound data into Cartesian raster data for display. In scan conversion, Moiré undersampling artifacts can be avoided by using various interpolation techniques such as nearest neighbor and bilinear. However, this interpolation-based scan conversion introduces blurring of fine details in ultrasound images. In this paper, a new beamforming technique, named compounded direct pixel beamforming (CDPB), is proposed to remove blurring artifacts from scan conversion. In CDPB, receive focusing is performed directly on each display pixel in Cartesian coordinates with raw radio-frequency (RF) data from two adjacent transmit firings so that artifacts from scan conversion can be substantially removed. To evaluate the proposed CDPB method, 64-channel pre-beamformed RF data were captured by a commercial ultrasound machine (SA-9900, Medison Corp., Seoul, Korea) from a tissue mimicking phantom (ATS Laboratories, Bridgeport, CT, USA). To quantify the performance of the proposed method, the information entropy contrast (IEC) value was measured. From the experiments, the proposed method provided IEC improvement by 2.8 over the conventional scan conversion method. These results indicate that the proposed new beamforming method could be used for enhancing the image quality in medical ultrasound imaging.

  4. Implementation of a 4-Year Point-of-Care Ultrasound Curriculum in a Liaison Committee on Medical Education-Accredited US Medical School.

    PubMed

    Wilson, Sean P; Mefford, Jason M; Lahham, Shadi; Lotfipour, Shahram; Subeh, Mohammad; Maldonado, Gracie; Spann, Sophie; Fox, John C

    2017-02-01

    The established benefits of point-of-care ultrasound have given rise to multiple new and innovative curriculums to incorporate ultrasound teaching into medical education. This study sought to measure the educational success of a comprehensive and integrated 4-year point-of-care ultrasound curriculum. We integrated a curriculum consisting of traditional didactics combined with asynchronous learning modules and hands-on practice on live models with skilled sonographers into all 4 years of education at a Liaison Committee on Medical Education-accredited US Medical School. Each graduating student was administered an exit examination with 48 questions that corresponded to ultrasound milestones. Ninety-five percent (n = 84) of fourth-year medical students completed the exit examination. The mean score was 79.5% (SD, 10.2%), with mean scores on the ultrasound physics and anatomy subsections being 77.1% (SD, 11.0%) and 85.9% (SD, 21.0%), respectively. A comprehensive 4-year point-of-care ultrasound curriculum integrated into medical school may successfully equip graduating medical students with a fundamental understanding of ultrasound physics, anatomy, and disease recognition. © 2016 by the American Institute of Ultrasound in Medicine.

  5. Diagnostic Accuracy of Contrast-Enhanced Ultrasound Enhancement Patterns for Thyroid Nodules

    PubMed Central

    Zhang, Yan; Luo, Yu-kun; Zhang, Ming-bo; Li, Jie; Li, Junlai; Tang, Jie

    2016-01-01

    Background The aim of this study was to investigate the accuracy of contrast-enhanced ultrasound (CEUS) enhancement patterns in the assessment of thyroid nodules. Material/Methods A total of 158 patients with suspected thyroid cancer underwent conventional ultrasound (US) and CEUS examinations. The contrast enhancement patterns of the lesions, including the peripheries of the lesions, were assessed by CEUS scans. The relationship between the size of the lesions and the degree of enhancement was also studied. US- and/or CEUS-guided biopsy was used to obtain specimens for histopathological diagnosis. Results The final data included 148 patients with 157 lesions. Seventy-five patients had 82 malignant lesions and 73 patients had 75 benign lesions. Peripheral ring enhancement was seen in 40 lesions. The differences of enhancement patterns and peripheral rings between benign and malignant nodules were significant (p=0.000, 0.000). The diagnostic sensitivity, specificity, and accuracy for malignant were 88%, 65.33%, and 88.32%, respectively, for CEUS, whereas they were 98.33%, 42.67%, and 71.97%, respectively, for TC by conventional US. The misdiagnosis rate by conventional US was 57.33% and 34.67% by CEUS (p=0.005). With regard to the size of lesions, a significant difference was found between low-enhancement, iso-enhancement, high-enhancement, iso-enhancement with no-enhancement area and no-enhancement (p=0.000). Conclusions In patients with suspicious US characteristics, CEUS had high specificity and contributed to establishing the diagnosis. Therefore, CEUS could avoid unnecessary biopsy. PMID:27916971

  6. Acquisition and Long-term Retention of Bedside Ultrasound Skills in First-Year Medical Students.

    PubMed

    Steinmetz, Peter; Oleskevich, Sharon; Lewis, John

    2016-09-01

    The purpose of this study was to assess bedside ultrasound skill acquisition and retention in medical students after completion of the first year of a new undergraduate bedside ultrasound curriculum at McGill University. Skill acquisition was assessed in first-year medical students (n = 195) on completion of their bedside ultrasound instruction. Instruction included 6 clinically based 60-minute practical teaching sessions evenly spaced throughout the academic year. Students' ability to meet course objectives was measured according to a 4-point Likert rating scale. Evaluations were performed by both instructors and the students themselves. Retention of skill acquisition was evaluated 8 months later on a year-end practical examination. The mean percentage ± SD of students assigned a rating of "strongly agree" or "agree" by instructors was 98% ± 0.4% for all 6 teaching sessions (strongly agree, 52% ± 3%; agree, 46% ± 3%). According to student self-evaluations, the mean percentage of students assigned a rating of strongly agree was significantly greater than the percentage assigned by instructors for all teaching sessions (86% ± 2% versus 52% ± 3%; P < .0005). Evaluation of skill retention on the year-end examination showed that 91% ± 2% of students were assigned a rating of strongly agree or agree for their ability to demonstrate skills learned 8 months previously. Ninety-five percent of students reported that bedside ultrasound improved their understanding of anatomy for all 6 teaching sessions (mean, 95% ± 0.01%). These results demonstrate that first-year medical students show acquisition and long-term retention of basic ultrasound skills on completion of newly implemented bedside ultrasound instruction.

  7. A new method for tracking organ motion on diagnostic ultrasound images

    SciTech Connect

    Kubota, Yoshiki Matsumura, Akihiko; Fukahori, Mai; Minohara, Shin-ichi; Yasuda, Shigeo; Nagahashi, Hiroshi

    2014-09-15

    Purpose: Respiratory-gated irradiation is effective in reducing the margins of a target in the case of abdominal organs, such as the liver, that change their position as a result of respiratory motion. However, existing technologies are incapable of directly measuring organ motion in real-time during radiation beam delivery. Hence, the authors proposed a novel quantitative organ motion tracking method involving the use of diagnostic ultrasound images; it is noninvasive and does not entail radiation exposure. In the present study, the authors have prospectively evaluated this proposed method. Methods: The method involved real-time processing of clinical ultrasound imaging data rather than organ monitoring; it comprised a three-dimensional ultrasound device, a respiratory sensing system, and two PCs for data storage and analysis. The study was designed to evaluate the effectiveness of the proposed method by tracking the gallbladder in one subject and a liver vein in another subject. To track a moving target organ, the method involved the control of a region of interest (ROI) that delineated the target. A tracking algorithm was used to control the ROI, and a large number of feature points and an error correction algorithm were used to achieve long-term tracking of the target. Tracking accuracy was assessed in terms of how well the ROI matched the center of the target. Results: The effectiveness of using a large number of feature points and the error correction algorithm in the proposed method was verified by comparing it with two simple tracking methods. The ROI could capture the center of the target for about 5 min in a cross-sectional image with changing position. Indeed, using the proposed method, it was possible to accurately track a target with a center deviation of 1.54 ± 0.9 mm. The computing time for one frame image using our proposed method was 8 ms. It is expected that it would be possible to track any soft-tissue organ or tumor with large deformations and

  8. Interfacial rheology of encapsulated microbubble contrast agents for medical ultrasound

    NASA Astrophysics Data System (ADS)

    Sarkar, Kausik

    2002-11-01

    Intravenous encapsulated microbubble contrast agents (1-10 mu) have become an established clinical tool for enhancing ultrasound sensitivity. Bubbles enhance contrast due to their high scattering cross-sections relative to those of rigid particles. The high values result from the large difference in density and compressibility. Furthermore, they act as damped mass-spring systems with enhanced resonant signal near their natural frequency. Most contrast agents are made with an encapsulating shell that prevents their premature dissolution. Free bubbles can last only a fraction of a second, whereas persistence requirements for a bubble to successfully reach from peripheral veins, where they are injected, to end-organs via heart is 12-27 seconds. Different contrast agents differ in the materials, structure and properties of their shells. We will present a model of the surface rheology of the shell. It will be compared with the currently available models of the shell. Preliminary results of the encapsulated bubble dynamics will be provided.

  9. Medical diagnostics by laser-based analysis of exhaled breath

    NASA Astrophysics Data System (ADS)

    Giubileo, Gianfranco

    2002-08-01

    IMany trace gases can be found in the exhaled breath, some of them giving the possibility of a non invasive diagnosis of related diseases or allowing the monitoring of the disease in the course of its therapy. In the present lecture the principle of medical diagnosis based on the breath analysis will be introduced and the detection of trace gases in exhaled breath by high- resolution molecular spectroscopy in the IR spectral region will be discussed. A number of substrates and the optical systems for their laser detection will be reported. The following laser based experimental systems has been realised in the Molecular Spectroscopy Laboratory in ENEA in Frascati for the analysis of specific substances in the exhaled breath. A tuneable diode laser absorption spectroscopy (TDLAS) appartus for the measurement of 13C/12C isotopic ratio in carbon dioxide, a TDLAS apparatus for the detection of CH4 and a CO2 laser based photoacoustic system to detect trace ethylene at atmospheric pressure. The experimental set-up for each one of the a.m. optical systems will be shown and the related medical applications will be illustrated. The concluding remarks will be focuses on chemical species that are of major interest for medical people today and their diagnostic ability.

  10. [Acceptability and quality of abdominal ultrasound studies requested by medical professionals].

    PubMed

    Caballería, Llorenç; Pera, Guillem; Rodríguez, Lluís; Casas, José Darío; Miranda, Dolores; Auladell, M Antònia; Buezo, Isabel; Expósito, Carmen; Arteaga, Ingrid; Torán, Pere

    2016-10-01

    To evaluate the acceptability/quality of abdominal ultrasound studies requested by primary care physicians in Barcelona; to develop ultrasound guidelines and assess their impact on acceptability. 2-phase study, one retrospective, descriptive phase evaluating the acceptability/quality of requests (pre-intervention phase) and another to assess the impact of guidelines on acceptability/quality (post-intervention phase). Requests for ultrasound studies from January-June 2010 from 10 primary care centers and the same number of requests from the same centers after the intervention. Pre-intervention phase: reason for consultation and request; presence of diagnostic orientation; results of ultrasound; acceptability/quality of the request. design guidelines using the nominal group technique, dissemination of guidelines in the same centers. Post-intervention phase: three months after dissemination analyze the same number of requests assessing the same variables included in the pre-intervention phase. Pre-intervention phase: 1,063 requests, 52.4% women, mean age 52±16years (range 11-94). Post-intervention phase: 1,060 requests, 57.6% women, mean age 54±17years (range 6-91). Main reasons for requests: abdominal pain/discomfort 38.3% (pre-intervention) and 43.1% (post-intervention). Diagnostic orientation in 14.5% (pre-intervention) and 40.8% (post-intervention). Normal ultrasound results in 46.0% (pre-intervention) and 42.3% (post-intervention). Good quality of requests in 42.7% (pre-intervention) and 46.5% (post-intervention). Acceptability of ultrasound: 70.5% (pre-intervention) and 94.1% (post-intervention). The better the quality of the request, the better the acceptability of the studies and the greater the number of pathological conditions identified. Guidelines for ultrasound improve the quality of requests, diagnostic orientation and acceptability of the studies. Copyright © 2016 Elsevier España, S.L.U. y AEEH y AEG. All rights reserved.

  11. Forward-backward generalized sidelobe canceler beamforming applied to medical ultrasound imaging

    NASA Astrophysics Data System (ADS)

    Li, Jiake; Chen, Xiaodong; Wang, Yi; Chen, Xiaoshuai; Yu, Daoyin

    2017-01-01

    For adaptive ultrasound imaging, accurate estimation of the covariance matrix is of great importance, and it has a fundamental influence on the performance of the adaptive beamformer. In this paper, a new forward-backward generalized sidelobe canceler (FBGSC) approach is proposed for medical ultrasound imaging, which uses forward and backward subaperture averaging to accurate estimate the covariance matrix. And resulted from accurate estimating of covariance matrix, FBGSC can achieve better lateral resolution and contrast without preprocessing algorithms. Field II is applied to obtain the simulated echo data of scattering points and a circular cyst. Beamforming responses of scattering points show that FBGSC can improve the lateral resolution by 55.7% and 66.6% compared with synthetic aperture (SA) and delay-and-sum (DS), respectively. Similarly, the simulated results of circular cyst show that FBGSC can obtain better beamforming responses than traditional adaptive beamformers. Finally, an experiment is conducted based on the real echo data of a medical ultrasound system. Results demonstrate that the FBGSC can improve the imaging quality of medical ultrasound imaging system, with lower computational demand and higher reliability.

  12. MO-AB-210-03: Workshop [Advancements in high intensity focused ultrasound

    SciTech Connect

    Lu, Z.

    2015-06-15

    The goal of this ultrasound hands-on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound. HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well-defined regions of necrosis. This completely non-invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands-on demonstrations with on-site instructors at separate stations. The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations of the techniques. Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high-intensity focused ultrasound and in diagnostic ultrasound QC. Learning Objectives: Learn ultrasound physics and safety for HIFU applications through live demonstrations Get an overview of the state-of-the art in HIFU technologies and equipment Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools List of supporting vendors for HIFU and diagnostic ultrasound QC hands-on workshop: Philips Healthcare Alpinion Medical Systems Verasonics, Inc Zonare Medical Systems, Inc Computerized Imaging Reference Systems (CIRS), Inc. GAMMEX, Inc., Cablon Medical BV Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant 5R25NS

  13. MO-AB-210-01: Ultrasound Imaging and Therapy-Hands On Workshop

    SciTech Connect

    Lu, Z.

    2015-06-15

    The goal of this ultrasound hands-on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound. HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well-defined regions of necrosis. This completely non-invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands-on demonstrations with on-site instructors at separate stations. The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations of the techniques. Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high-intensity focused ultrasound and in diagnostic ultrasound QC. Learning Objectives: Learn ultrasound physics and safety for HIFU applications through live demonstrations Get an overview of the state-of-the art in HIFU technologies and equipment Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools List of supporting vendors for HIFU and diagnostic ultrasound QC hands-on workshop: Philips Healthcare Alpinion Medical Systems Verasonics, Inc Zonare Medical Systems, Inc Computerized Imaging Reference Systems (CIRS), Inc. GAMMEX, Inc., Cablon Medical BV Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant 5R25NS

  14. MO-AB-210-02: Ultrasound Imaging and Therapy-Hands On Workshop

    SciTech Connect

    Sammet, S.

    2015-06-15

    The goal of this ultrasound hands-on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound. HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well-defined regions of necrosis. This completely non-invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands-on demonstrations with on-site instructors at separate stations. The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations of the techniques. Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high-intensity focused ultrasound and in diagnostic ultrasound QC. Learning Objectives: Learn ultrasound physics and safety for HIFU applications through live demonstrations Get an overview of the state-of-the art in HIFU technologies and equipment Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools List of supporting vendors for HIFU and diagnostic ultrasound QC hands-on workshop: Philips Healthcare Alpinion Medical Systems Verasonics, Inc Zonare Medical Systems, Inc Computerized Imaging Reference Systems (CIRS), Inc. GAMMEX, Inc., Cablon Medical BV Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant 5R25NS

  15. MIIP: a web-based platform for medical image interpretation training and evaluation focusing on ultrasound

    NASA Astrophysics Data System (ADS)

    Lindseth, Frank; Nordrik Hallan, Marte; Schiller Tønnessen, Martin; Smistad, Erik; Vâpenstad, Cecilie

    2017-03-01

    Introduction: Medical imaging technology has revolutionized health care over the past 30 years. This is especially true for ultrasound, a modality that an increasing amount of medical personal is starting to use. Purpose: The purpose of this study was to develop and evaluate a platform for improving medical image interpretation skills regardless of time and space and without the need for expensive imaging equipment or a patient to scan. Methods, results and conclusions: A stable web application with the needed functionality for image interpretation training and evaluation has been implemented. The system has been extensively tested internally and used during an international course in ultrasound-guided neurosurgery. The web application was well received and got very good System Usability Scale (SUS) scores.

  16. Distributed network, wireless and cloud computing enabled 3-D ultrasound; a new medical technology paradigm.

    PubMed

    Meir, Arie; Rubinsky, Boris

    2009-11-19

    Medical technologies are indispensable to modern medicine. However, they have become exceedingly expensive and complex and are not available to the economically disadvantaged majority of the world population in underdeveloped as well as developed parts of the world. For example, according to the World Health Organization about two thirds of the world population does not have access to medical imaging. In this paper we introduce a new medical technology paradigm centered on wireless technology and cloud computing that was designed to overcome the problems of increasing health technology costs. We demonstrate the value of the concept with an example; the design of a wireless, distributed network and central (cloud) computing enabled three-dimensional (3-D) ultrasound system. Specifically, we demonstrate the feasibility of producing a 3-D high end ultrasound scan at a central computing facility using the raw data acquired at the remote patient site with an inexpensive low end ultrasound transducer designed for 2-D, through a mobile device and wireless connection link between them. Producing high-end 3D ultrasound images with simple low-end transducers reduces the cost of imaging by orders of magnitude. It also removes the requirement of having a highly trained imaging expert at the patient site, since the need for hand-eye coordination and the ability to reconstruct a 3-D mental image from 2-D scans, which is a necessity for high quality ultrasound imaging, is eliminated. This could enable relatively untrained medical workers in developing nations to administer imaging and a more accurate diagnosis, effectively saving the lives of people.

  17. [Contrast-enhanced Ultrasound in Diagnostic Imaging of Muscle Injuries: Perfusion Imaging in the Early Arterial Phase].

    PubMed

    Hotfiel, T; Carl, H D; Swoboda, B; Engelhardt, M; Heinrich, M; Strobel, D; Wildner, D

    2016-03-01

    Ultrasound is a standard procedure widely used in the diagnostic investigation of muscle injuries and widely described in the literature. Its advantages include rapid availability, cost effectiveness and the possibility to perform a real-time dynamic examination with the highest possible spatial resolution. In the diagnostic work-up of minor lesions (muscle stiffness, muscle strain), plain ultrasound has so far been inferior to MRI. The case presented by us is an example of the possibilities offered by contrast-enhanced ultrasound (CEUS) in the imaging of muscle injuries compared with plain B-mode image ultrasound and MRI imaging of the affected region. This case report is about a high-performance football player who sustained a muscle injury. He underwent an ultrasound examination (S 2000, 9L4 Probe, Siemens, Germany), which was performed simultaneously in the conventional and contrast-enhanced mode at the level of the lesion. An intravenous bolus injection of 4.8 ml of intravascular contrast agent (SonoVue(®), Bracco, Italy) was given via a cubital intravenous line. After that, the distribution of contrast agent was visualised in the early arterial phase. In addition, a plain magnetic resonance imaging scan of both thighs was performed for reference. On conventional ultrasound, the lesion was not clearly distinguishable from neighbouring tissue, whereas contrast-enhanced ultrasound demonstrated a well delineated, circumscribed area of impaired perfusion with hypoenhancement compared with the surrounding muscles at the clinical level of the lesion in the arterial wash-in phase (0-30 sec, after intravenous administration). The MRI scan revealed an edema signal with perifascial fluid accumulation in the corresponding site. The use of intravascular contrast agent enabled the sensitive detection of a minor injury by ultrasound for the first time. An intramuscular edema seen in the MRI scan showed a functional arterial perfusion impairment on ultrasound, which was

  18. In-vitro comparison of time-domain, frequency-domain and wavelet ultrasound parameters in diagnostics of cartilage degeneration.

    PubMed

    Kaleva, E; Saarakkala, S; Töyräs, J; Nieminen, H J; Jurvelin, J S

    2008-01-01

    Quantitative ultrasound imaging (QUI) is a promising preclinical method for detecting early osteoarthrotic (OA) changes in articular cartilage. The aim of this study was to compare time-domain, frequency-domain and wavelet transform (WT) QUI parameters in terms of their performance in revealing degenerative changes in cartilage in vitro. Mankin score and Cartilage Quality Index (CQI) were used as a reference for quantifying cartilage degeneration. Intact (n = 11, Mankin score = 0) and spontaneously degenerated (n = 21, Mankin score = 1-10, mean = 4) osteochondral samples (diameter 19 mm) from bovine patellae, prepared and scanned with an ultrasound instrument in our earlier study, were further analyzed. Ultrasound reflection coefficient (R), integrated reflection coefficient (IRC) and ultrasound roughness index (URI) for cartilage surfaces were obtained from our earlier study. In the present study, maximum magnitude (MM) and echo duration (ED) for the cartilage surface were determined from the WT analysis. All ultrasound (US) parameters were capable of distinguishing intact and degenerated cartilage groups (p < 0.01, Mann-Whitney U test). Significant correlations were established between all QUI parameters and CQI or Mankin score (p < 0.01, Spearman's correlation test). The receiver operating characteristic (ROC) analysis indicated that the simple time-domain parameters (R and URI) were diagnostically as sensitive and specific as the more complex frequency-domain (IRC) or WT (MM, ED) parameters. Although QUI shows significant potential for OA diagnostics, complex signal processing techniques may provide only limited additional benefits for diagnostic performance compared with simple time-domain methods. However, certain technical challenges must be met before any of these methods can be used clinically.

  19. [Protection of medical diagnostic laboratory workers against biohazards].

    PubMed

    Kozajda, Anna; Szadkowska-Stańczyk, Irena

    2011-01-01

    Medical diagnostic laboratories form a particular occupational environment, in which workers have contact with patients and potentially infectious biological materials thus it should be acknowledged that it poses a significantly increased risk to health of laboratory workers. The risk directly depends on the kind of microbes present in a biological material and natural resistance to infections of individual workers. Therefore, the adopted technical and organizational solutions, properly worked out and obeyed procedures assuring safety work with biological material and microbes and properly trained laboratory staff play an essential role in reducing the risk. The risk of contact with microbes among laboratory workers is higher in Poland than in a number of other countries because hermetic devices for diagnostic analyzes and safety blood sampling systems are not always in use. The most important methods of infectious diseases prevention among laboratory workers are to protect them against direct contact with biological material, to apply vaccinations and to implement proper post-exposure procedures. Appropriate qualifications and habits of workers are of relevance to prevent infections in laboratories. A difficult financial situation of health care in Poland and other economic reasons can significantly increase the risk of infections and endanger health and safety of laboratory workers. It is necessary to develop practical instructions aimed at improving occupational safety to protect this occupational group against harmful effects of biological agents.

  20. The future of novel diagnostics in medical mycology.

    PubMed

    Teles, Fernando; Seixas, Jorge

    2015-04-01

    Several fungal diseases have become serious threats to human health and life, especially upon the advent of human immunodeficiency virus/AIDS epidemics and of other typical immunosuppressive conditions of modern life. Accordingly, the burden posed by these diseases and, concurrently, by intensive therapeutic regimens against these diseases has increased worldwide. Existing and available rapid tests for point-of-care diagnosis of important fungal diseases could enable the limitations of current laboratory methods for detection and identification of medically important fungi to be surpassed, both in low-income countries and for first-line diagnosis (screening) in richer countries. As with conventional diagnostic methods and devices, former immunodiagnostics have been challenged by molecular biology-based platforms, as a way to enhance the sensitivity and shorten the assay time, thus enabling early and more accurate diagnosis. Most of these tests have been developed in-house, without adequate validation and standardization. Another challenge has been the DNA extraction step, which is especially critical when dealing with fungi. In this paper, we have identified three major research trends in this field: (1) the application of newer biorecognition techniques, often applied in analytical chemistry; (2) the development of new materials with improved physico-chemical properties; and (3) novel bioanalytical platforms, allowing fully automated testing. Keeping up to date with the fast technological advances registered in this field, primarily at the proof-of-concept level, is essential for wise assessment of those that are likely to be more cost effective and, as already observed for bacterial and viral pathogens, may provide leverage to the current tepid developmental status of novel and improved diagnostics for medical mycology. © 2015 The Authors.

  1. Preoperative Ultrasound Guided Fine Needle Aspiration Cytology of Ovarian Lesions- Is It a Rapid and Effective Diagnostic Modality?

    PubMed Central

    Datta, Saikat; Chaudhuri, Snehamay; Paul, Prabir Chandra; Khandakar, Binny; Mandal, Sonali

    2016-01-01

    Introduction The deep seated ovarian lesions unapproachable by unguided aspiration cytology were easily done under ultrasound guidance. It gave a before hand cytological diagnosis of the lesion to the surgeon determining the modality of treatment for the patient. Aim To find the diagnostic accuracy of the method of ultrasound guided cytological assessment of ovarian lesion. Materials and Methods The study was conducted as a prospective observational study over a period of one year, in hospital setting, where ultrasound guided fine needle aspiration had been used to aspirate ovarian lesions, giving a rapid cytological diagnosis. In 43 sample cases, aspiration of fluid done from ovarian lesions were followed by cyto-centrifugation and staining by May-Grunwald-Giemsa (MGG) and Papanicolaou (Pap) stain providing a cytological opinion regarding benign/malignant nature of the lesion and further categorization. Later the cytological diagnosis was compared with final histopathological diagnosis, taking it as a gold standard. Results The overall sensitivity, specificity, and diagnostic accuracy of ultrasound guided aspiration and cytological analysis were high, 96%, 76.92% and 89.47% respectively as calculated by comparing the cytological diagnosis with histological diagnosis, taking it as gold standard. Conclusion This method has evolved as a highly sensitive, rapid, simple and effective modality for screening and as well as accurate preoperative diagnosis of ovarian lesions. PMID:27134878

  2. Acoustic holography as a metrological tool for characterizing medical ultrasound sources and fields.

    PubMed

    Sapozhnikov, Oleg A; Tsysar, Sergey A; Khokhlova, Vera A; Kreider, Wayne

    2015-09-01

    Acoustic holography is a powerful technique for characterizing ultrasound sources and the fields they radiate, with the ability to quantify source vibrations and reduce the number of required measurements. These capabilities are increasingly appealing for meeting measurement standards in medical ultrasound; however, associated uncertainties have not been investigated systematically. Here errors associated with holographic representations of a linear, continuous-wave ultrasound field are studied. To facilitate the analysis, error metrics are defined explicitly, and a detailed description of a holography formulation based on the Rayleigh integral is provided. Errors are evaluated both for simulations of a typical therapeutic ultrasound source and for physical experiments with three different ultrasound sources. Simulated experiments explore sampling errors introduced by the use of a finite number of measurements, geometric uncertainties in the actual positions of acquired measurements, and uncertainties in the properties of the propagation medium. Results demonstrate the theoretical feasibility of keeping errors less than about 1%. Typical errors in physical experiments were somewhat larger, on the order of a few percent; comparison with simulations provides specific guidelines for improving the experimental implementation to reduce these errors. Overall, results suggest that holography can be implemented successfully as a metrological tool with small, quantifiable errors.

  3. Acoustic holography as a metrological tool for characterizing medical ultrasound sources and fields

    PubMed Central

    Sapozhnikov, Oleg A.; Tsysar, Sergey A.; Khokhlova, Vera A.; Kreider, Wayne

    2015-01-01

    Acoustic holography is a powerful technique for characterizing ultrasound sources and the fields they radiate, with the ability to quantify source vibrations and reduce the number of required measurements. These capabilities are increasingly appealing for meeting measurement standards in medical ultrasound; however, associated uncertainties have not been investigated systematically. Here errors associated with holographic representations of a linear, continuous-wave ultrasound field are studied. To facilitate the analysis, error metrics are defined explicitly, and a detailed description of a holography formulation based on the Rayleigh integral is provided. Errors are evaluated both for simulations of a typical therapeutic ultrasound source and for physical experiments with three different ultrasound sources. Simulated experiments explore sampling errors introduced by the use of a finite number of measurements, geometric uncertainties in the actual positions of acquired measurements, and uncertainties in the properties of the propagation medium. Results demonstrate the theoretical feasibility of keeping errors less than about 1%. Typical errors in physical experiments were somewhat larger, on the order of a few percent; comparison with simulations provides specific guidelines for improving the experimental implementation to reduce these errors. Overall, results suggest that holography can be implemented successfully as a metrological tool with small, quantifiable errors. PMID:26428789

  4. Diagnostic Value of Ultrasound in Detection of Biliary Tract Complications After Liver Transplantation

    PubMed Central

    Potthoff, Andrej; Hahn, Anreas; Kubicka, Stefan; Schneider, Andrea; Wedemeyer, Jochen; Klempnauer, Juergen; Manns, Michael; Gebel, Michael; Boozari, Bita

    2013-01-01

    Background Biliary complications are significant source of morbidity after liver transplantation (LT). Cholangiography is the gold standard for diagnosis and specification of biliary complications. Objectives Detailed analyses of ultrasound (US) as a safe imaging method in this regard are still lacking. Therefore we analyzed systematically the diagnostic value of US in these patients. Patients and Methods Retrospectively, 128 liver graft recipients and their clinical data were analyzed. All patients had a standardized US examination. The findings of US were compared to cholangiographic results in 42 patients. Following statistical analyses were performed: descriptive statistics, sensitivity, specificity, positive and negative predictive values (PPV, NPV). Results 42 patients had 54 different biliary complications (Anastomotic stenosis (AS) n = 33, ischemic type biliary lesions (ITBL) n = 18 and leakage n = 3). US detected n = 22/42 (52%) patients with biliary complications. The sensitivity, specificity, PPV and NPV of US were: 61%, 100%, 100%, 79% (95CI, 36-86%) for ITBL and 24%, 100, 100%, 31% (95CI, 9-46 %) for AS, respectively. Conclusions US examination had no false positive rate. Therefore, it may be helpful as a first screening modality. But for the direct diagnosis of the biliary complication US is not sensitive enough. PMID:23483295

  5. Surfactant-stabilized contrast agent on the nanoscale for diagnostic ultrasound imaging.

    PubMed

    Wheatley, Margaret A; Forsberg, Flemming; Dube, Neal; Patel, Mihir; Oeffinger, Brian E

    2006-01-01

    Ultrasound contrast agents (CA) are generally micron-sized stabilized gas bubbles, injected IV. However, to penetrate beyond the vasculature and accumulate in targets such as tumors, CA must be an order of magnitude smaller. We describe a method of achieving nanometer-sized, surfactant-stabilized CA by differential centrifugation. High g force was shown to destroy bubble integrity. Optimal conditions (300 rpm for 3 min) produced an agent with a mean diameter of 450 nm, which gave 25.5 dB enhancement in vitro at a dose of 10 microL/mL, with a 13 min half-life. In vivo, the CA produced excellent power Doppler and grey-scale pulse inversion harmonic images at low acoustic power when administered. In vivo dose-response curves obtained in three rabbits showed enhancement between 20 and 25 dB for dosages above 0.025 mL/kg. These results encourage further investigation of the possible diagnostic and therapeutic benefits of using nanoparticles as CA, including passive targeting and accumulation in tumors.

  6. Analysis of flash echo from contrast agent for designing optimal ultrasound diagnostic systems.

    PubMed

    Kamiyama, N; Moriyasu, F; Mine, Y; Goto, Y

    1999-03-01

    Microbubble-based contrast agents can enhance echoes in areas of low blood flow, but the bubbles are extremely sensitive and collapse easily when exposed to ultrasound (US) irradiation. An experimental study of bubble collapse was carried out to design new functions for US diagnostic systems to detect echoes from microbubbles more efficiently. For contrast agent (Levovist) solution, a high-intensity, but momentary, echo (flash echo), was observed in the first frame image after a several-second suspension of transmission, but was not seen in the second frame image. These "flash echo" signals were analyzed and categorized based on microscopic observation, and the results showed that the longevity of the microbubbles was reduced by conditions such as B-mode imaging. Next, a numerical simulation of the bubbles in liquid was performed under the same conditions as in the in vitro experiment. The results showed that even bubbles less than 1 microm in diameter expand and collapse within one pulse drive, which would generate flash echoes. The flash echo imaging system described here permits flexible intermittent scanning with variable intervals, with a variable number of frames at the trigger, and with simultaneous monitoring at low power output. Animal experiments were also conducted to evaluate the system. As the interval between frames was increased, the flash echoes gradually increased, and perfusion in the parenchyma was clearly observed with an interval of 4 s.

  7. Strong reflector-based beamforming in ultrasound medical imaging.

    PubMed

    Szasz, Teodora; Basarab, Adrian; Kouamé, Denis

    2016-03-01

    This paper investigates the use of sparse priors in creating original two-dimensional beamforming methods for ultrasound imaging. The proposed approaches detect the strong reflectors from the scanned medium based on the well known Bayesian Information Criteria used in statistical modeling. Moreover, they allow a parametric selection of the level of speckle in the final beamformed image. These methods are applied on simulated data and on recorded experimental data. Their performance is evaluated considering the standard image quality metrics: contrast ratio (CR), contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR). A comparison is made with the classical delay-and-sum and minimum variance beamforming methods to confirm the ability of the proposed methods to precisely detect the number and the position of the strong reflectors in a sparse medium and to accurately reduce the speckle and highly enhance the contrast in a non-sparse medium. We confirm that our methods improve the contrast of the final image for both simulated and experimental data. In all experiments, the proposed approaches tend to preserve the speckle, which can be of major interest in clinical examinations, as it can contain useful information. In sparse mediums we achieve a highly improvement in contrast compared with the classical methods.

  8. A perspective on high-frequency ultrasound for medical applications

    NASA Astrophysics Data System (ADS)

    Mamou, Jonathan; Aristizába, Orlando; Silverman, Ronald H.; Ketterling, Jeffrey A.

    2010-01-01

    High-frequency ultrasound (HFU, >15 MHz) is a rapidly developing field. HFU is currently used and investigated for ophthalmologic, dermatologic, intravascular, and small-animal imaging. HFU offers a non-invasive means to investigate tissue at the microscopic level with resolutions often better than 100 μm. However, fine resolution is only obtained over the limited depth-of-field (˜1 mm) of single-element spherically-focused transducers typically used for HFU applications. Another limitation is penetration depth because most biological tissues have large attenuation at high frequencies. In this study, two 5-element annular arrays with center frequencies of 17 and 34 MHz were fabricated and methods were developed to obtain images with increased penetration depth and depth-of-field. These methods were used in ophthalmologic and small-animal imaging studies. Improved blood sensitivity was obtained when a phantom mimicking a vitreous hemorrhage was imaged. Central-nervous systems of 12.5-day-old mouse embryos were imaged in utero and in three dimensions for the first time.

  9. Photoionization sensors for non-invasive medical diagnostics

    NASA Astrophysics Data System (ADS)

    Mustafaev, Aleksandr; Rastvorova, Iuliia; Khobnya, Kristina; Podenko, Sofia

    2016-09-01

    The analysis of biomarkers can help to identify the significant number of diseases: lung cancer, tuberculosis, diabetes, high levels of stress, psychosomatic disorders etc. To implement continuous monitoring of the state of human health, compact VUV photoionization detector with current-voltage measurement is designed by Saint-Petersburg Mining University Plasma Research Group. This sensor is based on the patented method of stabilization of electric parameters - CES (Collisional Electron Spectroscopy). During the operation at atmospheric pressure VUV photoionization sensor measures the energy of electrons, produced in the ionization with the resonance photons, whose wavelength situated in the vacuum ultraviolet (VUV). A special software was developed to obtain the second-order derivative of the I-U characteristics, taken by the VUV sensor, to construct the energy spectra of the characteristic electrons. VUV photoionization detector has an unique set of parameters: small size (10*10*1 mm), low cost, wide range of recognizable molecules, as well as accuracy, sufficient for using this instrument for the medical purposes. This device can be used for non-invasive medical diagnostics without compromising the quality of life, for control of environment and human life. Work supported by Foundation for Assistance to Small Innovative Enterprises in Science and Technology.

  10. Novel x-ray optics for medical diagnostic techniques

    NASA Astrophysics Data System (ADS)

    Kuyumchyan, A.; Arvanian, V.; Kuyumchyan, D.; Aristov, V.; Shulakov, E.

    2009-08-01

    A new hard X - ray hologram with using crystal Fresnel zone plates (ZP) has been described. An image of Fourier hologram for hard X- ray is presented. X-ray phase contrast methods for medical diagnostics techniques are presented. We have developed an X-ray microscope, based on micro focus source which is capable of high resolution phasecontrast imaging and holograms. We propose a new imaging technique with the x-ray energy 8 keV. The method is expected to have wide applications in imaging of low absorbing samples such as biological and medical tissue. We used FIB to reproduction three dimension structures of damaged spinal cord of rat before and after combined treatment with NT3 and NR2D. PUBLISHER'S NOTE 12/16/09: This SPIE Proceedings paper has been updated with an erratum correcting several issues throughout the paper. The corrected paper was published in place of the earlier version on 9/1/2009. If you purchased the original version of the paper and no longer have access, please contact SPIE Digital Library Customer Service at CustomerService@SPIEDigitalLibrary.org for assistance.

  11. The accuracy of diagnostic ultrasound imaging for musculoskeletal soft tissue pathology of the extremities: a comprehensive review of the literature.

    PubMed

    Henderson, Rogan E A; Walker, Bruce F; Young, Kenneth J

    2015-01-01

    Musculoskeletal diagnostic ultrasound imaging (MSK-DUSI) has been growing outside the traditional radiology speciality. Increased use of this technology has been reported in several healthcare settings, however an apparent gap in the knowledge of the accuracy of this diagnostic technology indicated a review was warranted. We undertook a structured review of the literature to assess the accuracy of MSK-DUSI for the diagnosis of musculoskeletal soft tissue pathology of the extremities. An electronic search of the National Library of Medicine's PubMed database (1972 to mid-2014) was conducted. All relevant systematic reviews of diagnostic studies, all diagnostic studies published after the date of the latest systematic reviews and relevant diagnostic studies outside the scope the systematic reviews that directly compared the accuracy of MSK-DUSI (the index test) to an appropriate reference standard for the target condition were included. A fundamental appraisal of the methodological quality of studies was completed. The individual sensitivity, specificity and likelihood ratio data were extracted and entered into diagnostic accuracy tables. A total of 207 individual studies were included. The results show that MSK-DUSI has acceptable diagnostic accuracy for a wide spectrum of musculoskeletal conditions of the extremities. However, there is a lack of high quality prospective experimental studies in this area and as such clinicians should interpret the results with some caution due to the potential for overestimation of diagnostic accuracy.

  12. The Singular Value Filter: A General Filter Design Strategy for PCA-Based Signal Separation in Medical Ultrasound Imaging

    PubMed Central

    Lin, Dan; Hossack, John A.

    2012-01-01

    A general filtering method, called the singular value filter (SVF), is presented as a framework for principal component analysis (PCA) based filter design in medical ultrasound imaging. The SVF approach operates by projecting the original data onto a new set of bases determined from PCA using singular value decomposition (SVD). The shape of the SVF weighting function, which relates the singular value spectrum of the input data to the filtering coefficients assigned to each basis function, is designed in accordance with a signal model and statistical assumptions regarding the underlying source signals. In this paper, we applied SVF for the specific application of clutter artifact rejection in diagnostic ultrasound imaging. SVF was compared to a conventional PCA-based filtering technique, which we refer to as the blind source separation (BSS) method, as well as a simple frequency-based finite impulse response (FIR) filter used as a baseline for comparison. The performance of each filter was quantified in simulated lesion images as well as experimental cardiac ultrasound data. SVF was demonstrated in both simulation and experimental results, over a wide range of imaging conditions, to outperform the BSS and FIR filtering methods in terms of contrast-to-noise ratio (CNR) and motion tracking performance. In experimental mouse heart data, SVF provided excellent artifact suppression with an average CNR improvement of 1.8 dB (P < 0.05) with over 40% reduction (P < 0.05) in displacement tracking error. It was further demonstrated from simulation and experimental results that SVF provided superior clutter rejection, as reflected in larger CNR values, when filtering was achieved using complex pulse-echo received data and non-binary filter coefficients. PMID:21693416

  13. The singular value filter: a general filter design strategy for PCA-based signal separation in medical ultrasound imaging.

    PubMed

    Mauldin, F William; Lin, Dan; Hossack, John A

    2011-11-01

    A general filtering method, called the singular value filter (SVF), is presented as a framework for principal component analysis (PCA) based filter design in medical ultrasound imaging. The SVF approach operates by projecting the original data onto a new set of bases determined from PCA using singular value decomposition (SVD). The shape of the SVF weighting function, which relates the singular value spectrum of the input data to the filtering coefficients assigned to each basis function, is designed in accordance with a signal model and statistical assumptions regarding the underlying source signals. In this paper, we applied SVF for the specific application of clutter artifact rejection in diagnostic ultrasound imaging. SVF was compared to a conventional PCA-based filtering technique, which we refer to as the blind source separation (BSS) method, as well as a simple frequency-based finite impulse response (FIR) filter used as a baseline for comparison. The performance of each filter was quantified in simulated lesion images as well as experimental cardiac ultrasound data. SVF was demonstrated in both simulation and experimental results, over a wide range of imaging conditions, to outperform the BSS and FIR filtering methods in terms of contrast-to-noise ratio (CNR) and motion tracking performance. In experimental mouse heart data, SVF provided excellent artifact suppression with an average CNR improvement of 1.8 dB with over 40% reduction in displacement tracking error. It was further demonstrated from simulation and experimental results that SVF provided superior clutter rejection, as reflected in larger CNR values, when filtering was achieved using complex pulse-echo received data and non-binary filter coefficients.

  14. Diagnostic performance of automated breast ultrasound as a replacement for a hand-held second-look ultrasound for breast lesions detected initially on magnetic resonance imaging.

    PubMed

    Chae, Eun Young; Shin, Hee Jung; Kim, Hyun Ji; Yoo, Hyunkyung; Baek, Seunghee; Cha, Joo Hee; Kim, Hak Hee

    2013-12-01

    To evaluate the diagnostic performance of automated breast ultrasound (ABUS) after breast magnetic resonance imaging (MRI) as a replacement for hand-held second-look ultrasound (HH-SLUS), we evaluated 58 consecutive patients with breast cancer who had additional suspicious lesions on breast MRI. All patients underwent HH-SLUS and ABUS. Three breast radiologists evaluated the detectability, location, characteristics and conspicuity of lesions on ABUS. We also evaluated inter-observer variability and compared the results with HH-SLUS results. Eighty additional suspicious lesions were identified on breast MRI. Fifteen of the 80 lesions (19%) were not detected on HH-SLUS. Eight of the 15 lesions (53%) were detected on ABUS, whereas the remaining 7 were not detected on ABUS. Among the 65 lesions detected on HH-SLUS, only 3 lesions were not detected on ABUS. The intra-class correlation coefficients for lesion location and size all exceeded 0.70, indicating high reliability. Moderate to fair agreement was found for mass shape, orientation, margin and Breast Imaging Reporting and Data System (BI-RADS) final assessment. Therefore, ABUS can reliably detect additional suspicious lesions identified on breast MRI and may help in the decision on biopsy guidance method (US vs. MRI) as a replacement tool for HH-SLUS. Copyright © 2013 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  15. Integration of a Low-Cost Introductory Ultrasound Curriculum Into Existing Procedural Skills Education for Preclinical Medical Students.

    PubMed

    Maloney, Lauren; Zach, Kristen; Page, Christopher; Tewari, Neera; Tito, Matthew; Seidman, Peggy

    2017-02-01

    We evaluated integration of an introductory ultrasound curriculum into our existing mandatory procedural skills program for preclinical medical students. Phantoms consisting of olives, pimento olives, and grapes embedded in opaque gelatin were developed. Four classes encouraged progressive refinement of phantom-scanning and object identification skills. Students improved their ability to identify hidden objects, although each object type achieved a statistically significant improvement in correct identification at different time points. The total phantom cost per student was $0.76. Our results suggest that short repeated experiences scanning simple, low-cost ultrasound phantoms confer basic ultrasound skills. © 2016 by the American Institute of Ultrasound in Medicine.

  16. Fetal evaluation for transport by ultrasound performed by air medical teams: A case series.

    PubMed

    Polk, James D; Merlino, James I; Kovach, Betty L; Mancuso, Charlene; Fallon, William F

    2004-01-01

    The air medical team has limited options when evaluating the obstetrical patient and assessing fetal health during air transport to a high-risk obstetrical unit. Traditionally, physical examination and a Doppler stethoscope have been used to determine fetal heart rates and movement. However, with the advent of portable ultrasound technology, new information about the mother and child are available to the air medical crew. The Fetal Evaluation for Transport with Ultrasound (FETUS) is a screening examination that consists of an evaluation of the fetal heart rate, position, and movement and general condition of the placenta. The examination can be repeated in flight with no acoustic distortion from rotor noise. The additional information can be advantageous when transport decisions need to be made or when conditions do not allow Doppler stethoscope use.

  17. Time efficiency and diagnostic agreement of 2-D versus 3-D ultrasound acquisition of the neonatal brain.

    PubMed

    Romero, Javier M; Madan, Neil; Betancur, Ilda; Ciobanu, Adrian; Murphy, Erin; McCullough, Danielle; Grant, P Ellen

    2014-08-01

    The purpose of this study was to compare acquisition time efficiency and diagnostic agreement of neonatal brain ultrasound (US) scans obtained with a 3-D volume US acquisition protocol and the conventional 2-D acquisition protocol. Ninety-one consecutive premature neonatal brain ultrasound scans were prospectively performed on 59 neonates with the conventional 2-D acquisition protocol. Immediately after the 2-D study, a coronal 3-D ultrasound volume was acquired and later reconstructed into axial and sagittal planes. All 59 neonates were imaged in the neonatal intensive care unit to rule out intracranial hemorrhage. Total time for 2-D and 3-D acquisition protocols was recorded, and a two-tailed t-test was used to determine if study durations differed significantly. One pediatric neuroradiologist reviewed the reformatted 3-D images, tomographic ultrasound images. Results were compared with the clinical interpretation of the 2-D conventional study. The mean scanning time for the 2-D US acquisition protocol was 10.56 min (standard deviation [SD] = 7.11), and that for the 3-D volume US acquisition protocol was 1.48 min (SD = 0.59) (p ≤ 0.001). Inter-observer agreement revealed k values of 0.84 for hydrocephalus, 0.80 for germinal matrix hemorrhage/intraventricular hemorrhage, 0.74 for periventricular leukomalacia and 0.91 for subdural collection, hence near-perfect to substantial agreement between imaging protocols. There was a significant decrease in acquisition time for the 3-D volume ultrasound acquisition protocol compared with the conventional 2-D US protocol (p = <0.001), without compromising the diagnostic quality compared with a conventional 2-D US imaging protocol.

  18. Development of polymer 'chips' used in medical diagnostics

    SciTech Connect

    Brush, Zachary G; Schultz, Laura M; Vanness, Justin W; Farinholt, Kevin M; Sarles, Stephen; Leo, Donald

    2011-01-26

    In recent years, there has been growing interest in creating bio-inspired devices that feature artificial bilayer lipid membranes (BLM), or lipid bilayers. These membranes can be tailored to mimic the structure and transport properties of cellular walls and can be used to selectively transport ions and other species between aqueous volumes. One application of this research is the formation of a standardized BLM contained within a portable and disposable housing for use in medical diagnostics. This concept utilizes a flexible polymer 'chip' that has internal compartments for housing both an organic solvent and an aqueous solution, which contains phospholipid molecules, proteins, and specific analyte molecules. The formation of a BLM within the chip enables integration of the chip into an electronic reader to perform diagnostic measurements of the sample. A key element of the bilayer formation process requires a single aqueous volume to first be separated into multiple volumes such that it can then be reattached to form a bilayer at the interface. This process, called the regulated attachment method, relies on the geometry of the deformable 'chip' to separate and reattach the aqueous contents held inside by opening and closing an aperture that divides adjacent compartments through the application of mechanical force. The purpose of this research is to develop an optimized chip that provides a controllable method for initially separating the aqueous phase via dynamic excitation. This study focuses on two specific aspects: designing an efficient excitation method for separating the aqueous volume, and optimizing the geometry of the chip to decrease the required input energy and better target the location and duration of the separation. Finite Element (FE) models are used to optimize the chip geometry and to identify suitable excitation signals. A series of experimental studies are also presented to validate the FE models.

  19. Development of polymer 'chips' used in medical diagnostics

    SciTech Connect

    Brush, Zachary G; Schultz, Laura M; Vanness, Justin W; Farinholt, Kevin M; Sarles, Stephen; Leo, Donald

    2010-11-03

    In recent years, there has been growing interest in creating bio-inspired devices that feature artificial bilayer lipid membranes (BLM), or lipid bilayers. These membranes can be tailored to mimic the structure and transport properties of cellular walls and can be used to selectively transport ions and other species between aqueous volumes. One application of this research is the formation of a standardized BLM contained within a portable and disposable housing for use in medical diagnostics. This concept utilizes a flexible polymer 'chip' that has internal compartments for housing both an organic solvent and an aqueous solution, which contains phospholipid molecules, proteins, and specific analyte molecules. The formation of a BLM within the chip enables integration of the chip into an electronic reader to perform diagnostic measurements of the sample. A key element of the bilayer formation process requires a single aqueous volume to first be separated into multiple volumes such that it can then be reattached to form a bilayer at the interface. This process, called the regulated attachment method, relies on the geometry of the deformable 'chip' to separate and reattach the aqueous contents held inside by opening and closing an aperture that divides adjacent compartments through the application of mechanical force. The purpose of this research is to develop an optimized chip that provides a controllable method for initially separating the aqueous phase via dynamic excitation. This study focuses on two specific aspects: designing an efficient excitation method for separating the aqueous volume, and optimizing the geometry of the chip to decrease the required input energy and better target the location and duration of the separation. Finite Element (FE) models are used to optimize the chip geometry and to identify suitable excitation signals. A series of experimental studies are also presented to validate the FE models.

  20. Enhanced Homing Ability and Retention of Bone Marrow Stromal Cells to Diabetic Nephropathy by Microbubble-Mediated Diagnostic Ultrasound Irradiation.

    PubMed

    Wang, Gong; Zhuo, Zhongxiong; Yang, Bin; Wu, Shengzheng; Xu, Yali; Liu, Zheng; Tan, Kaibin; Xia, Hongmei; Wang, Xiaoyan; Zou, Linru; Gan, Ling; Gao, Yunhua

    2015-11-01

    Bone marrow stromal cell (BMSC) transplantation can successfully treat diabetic nephropathy (DN), but the lack of a specific homing place for intravenously injected cells limits the effective implementation of stem cell therapies. The migration and survival of transplanted BMSCs are determined by inflammatory reactions in the local kidney micro-environment. We tested the hypothesis that microbubble-mediated diagnostic ultrasound irradiation could provide a suitable micro-environment for BMSC delivery and retention in DN therapy. In this study, red fluorescent protein-labeled BMSCs were administered combined with microbubbles to streptozotocin-induced DN rats 4 wk after diabetes onset. We observed enhanced BMSC homing and retention in microbubble-mediated diagnostic ultrasound-irradiated kidneys compared with the contralateral kidneys on days 1 and 3 post-treatment. The results from immunohistochemical analysis, Western blot and enzyme-linked immunosorbent assay indicated that the local and transient expression of various chemo-attractants (i.e., cytokines, integrins and trophic factors) found to promote BMSC homing was much higher than observed in non-treated kidneys. The local capillary endothelium rupture observed by transmission electron microscopy may account for local micro-environment changes. Histopathologic analysis revealed no signs of kidney damage. These results confirmed that renal micro-environment changes caused by appropriate microbubble-mediated diagnostic ultrasound irradiation may promote BMSC homing ability to the diabetic kidney without renal toxicity and cell damage. This non-invasive and effective technique may be a promising method for BMSC transplantation therapy. Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. All rights reserved.

  1. Agreement of clinical measurements of liver size with ultrasound when performed by medical students.

    PubMed

    Hunter, Selena A; Brimble, Justin; Weatherall, Mark; Galletly, Duncan C

    2014-11-07

    The accuracy of physical examination techniques in detecting liver disease is unclear. We sought to determine the perceived location of the lower liver border via scratch, percussion, palpation and ballottement with novice medical student examiners, compared with ultrasound localisation. Five novice medical students learnt four liver examination techniques and measured the lower liver border in 19 healthy volunteers. The difference between the examination technique and ultrasound (bias) and limits of agreement of each method were estimated by mixed linear models and shown using Bland-Altman- like plots. All techniques had similar bias for the lower liver border, between 1.6 and 1.9 cm superior to the ultrasound measurement. Percussion had the smallest variability with increasing liver size. Limits of agreement were wide for all techniques, smallest for palpation (6.04 cm) and largest for scratch (7.2 cm) compared to the mean liver distance of 8 cm. Conclusion There was no difference in bias between the scratch, percussion, palpation and ballottement techniques regarding the lower liver border. All techniques had very wide limits of agreement, although palpation had the smallest. Liver size examination by novice medical students in healthy subjects is unreliable. Further research is needed using examiners with a different level of expertise and participants of varying body habitus and confirmed liver disease.

  2. A comparison of medical record with billing diagnostic information associated with ambulatory medical care.

    PubMed Central

    Studney, D R; Hakstian, A R

    1981-01-01

    The degree of similarity between diagnostic information furnished with claims and that simultaneously entered into the medical record was estimated for 1,215 private office visits in British Columbia, Canada. For each visit, claim card and chart diagnoses were compared by having three independent internists (blinded to source and type of the data) make judgments about each diagnostic pair. The judges were highly consistent internally and their judgments were stable over time. In 40 per cent of cases chart and claims data were judged dissimilar, and in 38 per cent of cases claims data were judged more valuable as a reflection of the primary problem treated. The degree of judged similarity of chart and claims data correlated significantly and negatively with physician workload, income, and judges' preference for the billing card diagnosis. We conclude that in using claims data to determine the content of ambulatory visits, independent validation of such data may be important. PMID:7457683

  3. Design strategy and implementation of the medical diagnostic image support system at two large military medical centers

    NASA Astrophysics Data System (ADS)

    Smith, Donald V.; Smith, Stan M.; Sauls, F.; Cawthon, Michael A.; Telepak, Robert J.

    1992-07-01

    The Medical Diagnostic Imaging Support (MDIS) system contract for federal medical treatment facilities was awarded to Loral/Siemens in the Fall of 1991. This contract places ''filmless'' imaging in a variety of situations from small clients to large medical centers. The MDIS system approach is a ''turn-key'', performance based specification driven by clinical requirements.

  4. Use of cadaver models in point-of-care emergency ultrasound education for diagnostic applications.

    PubMed

    Zaia, Brita E; Briese, Beau; Williams, Sarah R; Gharahbaghian, Laleh

    2012-10-01

    As the use of bedside emergency ultrasound (US) increases, so does the need for effective US education. To determine 1) what pathology can be reliably simulated and identified by US in human cadavers, and 2) feasibility of using cadavers to improve the comfort of emergency medicine (EM) residents with specific US applications. This descriptive, cross-sectional survey study assessed utility of cadaver simulation to train EM residents in diagnostic US. First, the following pathologies were simulated in a cadaver: orbital foreign body (FB), retrobulbar (RB) hematoma, bone fracture, joint effusion, and pleural effusion. Second, we assessed residents' change in comfort level with US after using this cadaver model. Residents were surveyed regarding their comfort level with various US applications. After brief didactic sessions on the study's US applications, participants attempted to identify the simulated pathology using US. A post-lab survey assessed for change in comfort level after the training. Orbital FB, RB hematoma, bone fracture, joint effusion, and pleural effusion were readily modeled in a cadaver in ways typical of a live patient. Twenty-two residents completed the pre- and post-lab surveys. After training with cadavers, residents' comfort improved significantly for orbital FB and RB hematoma (mean increase 1.6, p<0.001), bone fracture (mean increase 2.12, p<0.001), and joint effusion (1.6, p<0.001); 100% of residents reported that they found US education using cadavers helpful. Cadavers can simulate orbital FB, RB hematoma, bone fracture, joint effusion, and pleural effusion, and in our center improved the comfort of residents in identifying all but pleural effusion. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Diagnostic accuracy of abdominal ultrasound in the screening of esophageal varices in patients with cirrhosis.

    PubMed

    Sort, Pau; Muelas, Magdalena; Isava, Alvaro; Llaó, Jordina; Porta, Francesc; Puig, Ignasi; Domínguez-Curell, Claudia; Esteve, Enrique; Yanguas, Carles; Vida, Francesc

    2014-12-01

    Abdominal ultrasound (US) may provide data on the presence of esophageal varices in cirrhosis. We assess the diagnostic accuracy of this procedure. Retrospective recording of clinical data was carried out in cirrhotic patients who underwent abdominal US and upper gastrointestinal endoscopy. We compared patients with and without large varices and assessed the value of US in predicting the presence of these lesions as well as other significant variables. Of the 353 patients included, 123 (35%) had esophageal varices. The presence of US signs of portal hypertension independently predicted the existence of esophageal varices with a sensitivity of 87.9%, a specificity of 34.9%, a positive predictive value of 40.6%, and a negative predictive value of 85.1%, which could increase to 91.5% if the patient presented plasma albumin and platelet concentrations above the mean values (3.1 g/dl and 122×10 cells/l, respectively). Plasma albumin and platelet concentrations were the two other variables with independent predictive capacity. Applying these selection criteria, up to 30% of screening endoscopies may not be necessary, and up to 43% in patients with compensated cirrhosis. In patients with decompensated cirrhosis, however, US does not have predictive capacity. The results obtained are comparable with those reported for transient elastography. Abdominal US is a highly reliable technique for detecting patients with a low risk of presenting esophageal varices. Its use may avoid up to 43% of screening endoscopies in patients with compensated cirrhosis. The results obtained are similar to those observed using transient elastography.

  6. Safety Assurance in Obstetrical Ultrasound

    PubMed Central

    Miller, Douglas L

    2008-01-01

    Safety assurance for diagnostic ultrasound in obstetrics began with a tacit assumption of safety allowed by a federal law enacted in 1976 for then-existing medical ultrasound equipment. The implementation of the 510(k) pre-market approval process for diagnostic ultrasound resulted in the establishment of guideline upper limits for several examination categories in 1985. The obstetrical category has undergone substantial evolution from initial limits (I. e., 46 mW/cm2 spatial peak temporal average (SPTA) intensity) set in 1985. Thermal and mechanical exposure indices, which are displayed on-screen according to an Output Display Standard (ODS), were developed for safety assurance with relaxed upper limits. In 1992, with the adoption of the ODS, the allowable output for obstetrical ultrasound was increased both in terms of the average exposure (e. g. to a possible 720 mW/cm2 SPTA intensity) and of the peak exposure (via the Mechanical Index). There has been little or no subsequent research with the modern obstetrical ultrasound machines to systematically assess potential risks to the fetus using either relevant animal models of obstetrical exposure or human epidemiology studies. The assurance of safety for obstetrical ultrasound therefore is supported by three ongoing means: (I) review of a substantial but uncoordinated bioeffect research literature, (ii) the theoretical evaluation of diagnostic ultrasound exposure in terms of thermal and nonthermal mechanisms for bioeffects, and (iii) the skill and knowledge of professional sonographers. At this time, there is no specific reason to suspect that there is any significant health risk to the fetus or mother from exposure to diagnostic ultrasound in obstetrics. This assurance of safety supports the prudent use of diagnostic ultrasound in obstetrics by trained professionals for any medically indicated examination. PMID:18450141

  7. Towards the unification of inference structures in medical diagnostic tasks.

    PubMed

    Mira, J; Rives, J; Delgado, A E; Martínez, R

    1998-01-01

    The central purpose of artificial intelligence applied to medicine is to develop models for diagnosis and therapy planning at the knowledge level, in the Newell sense, and software environments to facilitate the reduction of these models to the symbol level. The usual methodology (KADS, Common-KADS, GAMES, HELIOS, Protégé, etc) has been to develop libraries of generic tasks and reusable problem-solving methods with explicit ontologies. The principal problem which clinicians have with these methodological developments concerns the diversity and complexity of new terms whose meaning is not sufficiently clear, precise, unambiguous and consensual for them to be accessible in the daily clinical environment. As a contribution to the solution of this problem, we develop in this article the conjecture that one inference structure is enough to describe the set of analysis tasks associated with medical diagnoses. To this end, we first propose a modification of the systematic diagnostic inference scheme to obtain an analysis generic task and then compare it with the monitoring and the heuristic classification task inference schemes using as comparison criteria the compatibility of domain roles (data structures), the similarity in the inferences, and the commonality in the set of assumptions which underlie the functionally equivalent models. The equivalences proposed are illustrated with several examples. Note that though our ongoing work aims to simplify the methodology and to increase the precision of the terms used, the proposal presented here should be viewed more in the nature of a conjecture.

  8. Targeted diagnostic magnetic nanoparticles for medical imaging of pancreatic cancer.

    PubMed

    Rosenberger, I; Strauss, A; Dobiasch, S; Weis, C; Szanyi, S; Gil-Iceta, L; Alonso, E; González Esparza, M; Gómez-Vallejo, V; Szczupak, B; Plaza-García, S; Mirzaei, S; Israel, L L; Bianchessi, S; Scanziani, E; Lellouche, J-P; Knoll, P; Werner, J; Felix, K; Grenacher, L; Reese, T; Kreuter, J; Jiménez-González, M

    2015-09-28

    Highly aggressive cancer types such as pancreatic cancer possess a mortality rate of up to 80% within the first 6months after diagnosis. To reduce this high mortality rate, more sensitive diagnostic tools allowing an early stage medical imaging of even very small tumours are needed. For this purpose, magnetic, biodegradable nanoparticles prepared using recombinant human serum albumin (rHSA) and incorporated iron oxide (maghemite, γ-Fe2O3) nanoparticles were developed. Galectin-1 has been chosen as target receptor as this protein is upregulated in pancreatic cancer and its precursor lesions but not in healthy pancreatic tissue nor in pancreatitis. Tissue plasminogen activator derived peptides (t-PA-ligands), that have a high affinity to galectin-1 have been chosen as target moieties and were covalently attached onto the nanoparticle surface. Improved targeting and imaging properties were shown in mice using single photon emission computed tomography-computer tomography (SPECT-CT), a handheld gamma camera, and magnetic resonance imaging (MRI). Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Contrast-enhanced ultrasound in ovarian tumors – diagnostic parameters: method presentation and initial experience

    PubMed Central

    MAXIM, ANITA-ROXANA; BADEA, RADU; TAMAS, ATILLA; TRAILA, ALEXANDRU

    2013-01-01

    The aim of this paper is to discuss and illustrate the use of contrast-enhanced ultrasound in evaluating ovarian tumors compared to conventional ultrasound, Doppler ultrasound and the histopathological analysis and suggest how this technique may best be used to distinguish benign from malignant ovarian masses. We present the method and initial experience of our center by analyzing the parameters used in contrast-enhanced ultrasound in 6 patients with ovarian tumors of uncertain etiology. For examination we used a Siemens ultrasound machine with dedicated contrast software and the contrast agent SonoVue, Bracco. The patients underwent conventional ultrasound, Doppler ultrasound and i.v. administration of the contrast agent. The parameters studied were: inflow of contrast (rise time), time to peak enhancement, mean transit time. The series of patients is part of an extensive prospective PhD study aimed at elaborating a differential diagnosis protocol for benign versus malignant ovarian tumors, by validating specific parameters for contrast-enhanced ultrasound. Although the method is currently used with great success in gastroenterology, urology and senology, its validation in gynecology is still in the early phases. Taking into consideration that the method is minimally invasive and much less costly that CT/MRI imaging, demonstrating its utility in oncologic gynecology would be a big step in preoperative evaluation of these cases. PMID:26527912

  10. A Tactile Sensor for Ultrasound Imaging Systems

    PubMed Central

    Peng, Yiyan; Shkel, Yuri M.; Hall, Timothy J.

    2015-01-01

    Medical ultrasound systems are capable of monitoring a variety of health conditions while avoiding invasive procedures. However this function is complicated by ultrasound contrast of the tissue varying with contact pressure exerted by the probe. The knowledge of the contact pressure is beneficial for a variety of screening and diagnostic procedures involving ultrasound. This paper introduces a solid-state sensor array which measures the contact pressure distribution between the probe and the tissue marginally affecting the ultrasound imaging capabilities. The probe design utilizes the dielectrostriction mechanism which relates the change in dielectric properties of the sensing layer to deformation. The concept, structure, fabrication, and performance of this sensor array are discussed. The prototype device is highly tolerant to overloads (>1 MPa tested) and provides stress measurements in the range of 0.14 to 10 kPa. Its loss of ultrasound transmissivity is less 3dB at 9 MHz ultrasound frequency. This performance is satisfactory for clinical and biomedical research in ultrasound image formation and interpretation, however for commercial product, a higher ultrasound transmissivity is desired. Directions for improving the sensor ultrasound transparency and electrical performance are discussed. The sensor array described in this paper has been developed specifically for ultrasound diagnosis during breast cancer screening. However, the same sensing mechanism, similar configuration and sensor array structure can be applied to other applications involving ultrasound tools for medical diagnostics. PMID:26880870

  11. A Tactile Sensor for Ultrasound Imaging Systems.

    PubMed

    Peng, Yiyan; Shkel, Yuri M; Hall, Timothy J

    2016-02-15

    Medical ultrasound systems are capable of monitoring a variety of health conditions while avoiding invasive procedures. However this function is complicated by ultrasound contrast of the tissue varying with contact pressure exerted by the probe. The knowledge of the contact pressure is beneficial for a variety of screening and diagnostic procedures involving ultrasound. This paper introduces a solid-state sensor array which measures the contact pressure distribution between the probe and the tissue marginally affecting the ultrasound imaging capabilities. The probe design utilizes the dielectrostriction mechanism which relates the change in dielectric properties of the sensing layer to deformation. The concept, structure, fabrication, and performance of this sensor array are discussed. The prototype device is highly tolerant to overloads (>1 MPa tested) and provides stress measurements in the range of 0.14 to 10 kPa. Its loss of ultrasound transmissivity is less 3dB at 9 MHz ultrasound frequency. This performance is satisfactory for clinical and biomedical research in ultrasound image formation and interpretation, however for commercial product, a higher ultrasound transmissivity is desired. Directions for improving the sensor ultrasound transparency and electrical performance are discussed. The sensor array described in this paper has been developed specifically for ultrasound diagnosis during breast cancer screening. However, the same sensing mechanism, similar configuration and sensor array structure can be applied to other applications involving ultrasound tools for medical diagnostics.

  12. Breast cancer: determining the genetic profile from ultrasound-guided percutaneous biopsy specimens obtained during the diagnostic workups.

    PubMed

    López Ruiz, J A; Zabalza Estévez, I; Mieza Arana, J A

    2016-01-01

    To evaluate the possibility of determining the genetic profile of primary malignant tumors of the breast from specimens obtained by ultrasound-guided percutaneous biopsies during the diagnostic imaging workup. This is a retrospective study in 13 consecutive patients diagnosed with invasive breast cancer by B-mode ultrasound-guided 12 G core needle biopsy. After clinical indication, the pathologist decided whether the paraffin block specimens seemed suitable (on the basis of tumor size, validity of the sample, and percentage of tumor cells) before sending them for genetic analysis with the MammaPrint® platform. The size of the tumors on ultrasound ranged from 0.6cm to 5cm. In 11 patients the preserved specimen was considered valid and suitable for use in determining the genetic profile. In 1 patient (with a 1cm tumor) the pathologist decided that it was necessary to repeat the core biopsy to obtain additional samples. In 1 patient (with a 5cm tumor) the specimen was not considered valid by the genetic laboratory. The percentage of tumor cells in the samples ranged from 60% to 70%. In 11/13 cases (84.62%) it was possible to do the genetic analysis on the previously diagnosed samples. In most cases, regardless of tumor size, it is possible to obtain the genetic profile from tissue specimens obtained with ultrasound-guided 12 G core biopsy preserved in paraffin blocks. Copyright © 2015 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  13. The role of ultrasound-guided triamcinolone injection in the treatment of de Quervain's disease: treatment and a diagnostic tool?

    PubMed

    Hajder, E; de Jonge, M C; van der Horst, C M A M; Obdeijn, M C

    2013-12-01

    The purpose of this study was to describe the technique and usefulness of ultrasound-guided intrasheath injection of triamcinolone in the treatment of de Quervain's disease (dQD). Our study was retrospective in design. Seventy-one wrists of 62 patients who were treated with an ultrasound-guided triamcinolone injection for dQD were included. A literature search was performed to compare our results. In the literature we found supportive evidence that accurate injection of triamcinolone in the first dorsal compartment of the wrist is important for a good outcome. In this retrospective study we found that treatment with ultrasound-guided injections of triamcinolone is both safe and effective. After two injections, 91% of the patients had good long-term results, which is a higher cure rate than found in most other studies. Furthermore, we found that Finkelstein's test can give a false positive result. Therefore, ultrasound should not only be considered to improve the treatment outcome, but can also be useful as a diagnostic tool in the management of de Quervain's disease. Copyright © 2013. Published by Elsevier SAS.

  14. Non-invasive assessment of negative pressure wound therapy using high frequency diagnostic ultrasound: oedema reduction and new tissue accumulation.

    PubMed

    Young, Stephen R; Hampton, Sylvie; Martin, Robin

    2013-08-01

    Tissue oedema plays an important role in the pathology of chronic and traumatic wounds. Negative pressure wound therapy (NPWT) is thought to contribute to active oedema reduction, yet few studies have showed this effect. In this study, high frequency diagnostic ultrasound at 20 MHz with an axial resolution of 60 µm was used to assess the effect of NPWT at - 80 mmHg on pressure ulcers and the surrounding tissue. Wounds were monitored in four patients over a 3-month period during which changes in oedema and wound bed thickness (granulation tissue) were measured non-invasively. The results showed a rapid reduction of periwound tissue oedema in all patients with levels falling by a mean of 43% after 4 days of therapy. A 20% increase in the thickness of the wound bed was observed after 7 days due to new granulation tissue formation. Ultrasound scans through the in situ gauze NPWT filler also revealed the existence of macrodeformation in the tissue produced by the negative pressure. These preliminary studies suggest that non-invasive assessment using high frequency diagnostic ultrasound could be a valuable tool in clinical studies of NPWT. © 2012 The Authors. International Wound Journal © 2012 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

  15. Use of antihypertensive medications and diagnostic tests among privately insured adolescents and young adults with primary versus secondary hypertension.

    PubMed

    Yoon, Esther Y; Cohn, Lisa; Freed, Gary; Rocchini, Albert; Kershaw, David; Ascione, Frank; Clark, Sarah

    2014-07-01

    To compare the use of antihypertensive medications and diagnostic tests among adolescents and young adults with primary versus secondary hypertension. We conducted retrospective cohort analysis of claims data for adolescents and young adults (12-21 years of age) with ≥3 years of insurance coverage (≥11 months/year) in a large private managed care plan during 2003-2009 with diagnosis of primary hypertension or secondary hypertension. We examined their use of antihypertensive medications and identified demographic characteristics and the presence of obesity-related comorbidities. For the subset receiving antihypertensive medications, we examined their diagnostic test use (echocardiograms, renal ultrasounds, and electrocardiograms). The study sample included 1,232 adolescents and young adults; 84% had primary hypertension and 16% had secondary hypertension. The overall prevalence rate of hypertension was 2.6%. One quarter (28%) with primary hypertension had one or more antihypertensive medications, whereas 65% with secondary hypertension had one or more antihypertensive medications. Leading prescribers of antihypertensives for subjects with primary hypertension were primary care physicians (80%), whereas antihypertensive medications were equally prescribed by primary care physicians (43%) and sub-specialists (37%) for subjects with secondary hypertension. The predominant hypertension diagnosis among adolescents and young adults is primary hypertension. Antihypertensive medication use was higher among those with secondary hypertension compared with those with primary hypertension. Further study is needed to determine treatment effectiveness and patient outcomes associated with differential treatment patterns used for adolescents and young adults with primary versus secondary hypertension. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  16. Medical diagnostics with mobile devices: Comparison of intrinsic and extrinsic sensing.

    PubMed

    Kwon, L; Long, K D; Wan, Y; Yu, H; Cunningham, B T

    2016-01-01

    We review the recent development of mobile detection instruments used for medical diagnostics, and consider the relative advantages of approaches that utilize the internal sensing capabilities of commercially available mobile communication devices (such as smartphones and tablet computers) compared to those that utilize a custom external sensor module. In this review, we focus specifically upon mobile medical diagnostic platforms that are being developed to serve the need in global health, personalized medicine, and point-of-care diagnostics.

  17. A comparison of the millon behavioral medical diagnostic and millon behavioral health inventory with medical populations.

    PubMed

    Wise, Edward A; Streiner, David L

    2010-12-01

    There is a lack of normative data on broadband omnibus types of personality tests with medical populations. In fact, the only two tests normed on medical populations are the Millon Behavioral Medicine Diagnostic (MBMD) and the Millon Behavioral Health Inventory (MBHI). The internal consistency, test-retest reliabilities, and validity studies of these instruments are reviewed and compared in an effort to aid clinicians in discerning their relative psychometric strengths and weaknesses. Due to the lack of validity studies with the MBMD and the fact that reliability limits the ceiling of validity coefficients, the MBMD has yet to meet the challenges it was designed to meet. Implications for practice are addressed. © 2010 Wiley Periodicals, Inc.

  18. Thyroid ultrasound

    PubMed Central

    Chaudhary, Vikas; Bano, Shahina

    2013-01-01

    Thyroid ultrasonography has established itself as a popular and useful tool in the evaluation and management of thyroid disorders. Advanced ultrasound techniques in thyroid imaging have not only fascinated the radiologists but also attracted the surgeons and endocrinologists who are using these techniques in their daily clinical and operative practice. This review provides an overview of indications for ultrasound in various thyroid diseases, describes characteristic ultrasound findings in these diseases, and illustrates major diagnostic pitfalls of thyroid ultrasound. PMID:23776892

  19. Pilot Point-of-Care Ultrasound Curriculum at Harvard Medical School: Early Experience.

    PubMed

    Rempell, Joshua S; Saldana, Fidencio; DiSalvo, Donald; Kumar, Navin; Stone, Michael B; Chan, Wilma; Luz, Jennifer; Noble, Vicki E; Liteplo, Andrew; Kimberly, Heidi; Kohler, Minna J

    2016-11-01

    Point-of-care ultrasound (POCUS) is expanding across all medical specialties. As the benefits of US technology are becoming apparent, efforts to integrate US into pre-clinical medical education are growing. Our objective was to describe our process of integrating POCUS as an educational tool into the medical school curriculum and how such efforts are perceived by students. This was a pilot study to introduce ultrasonography into the Harvard Medical School curriculum to first- and second-year medical students. Didactic and hands-on sessions were introduced to first-year students during gross anatomy and to second-year students in the physical exam course. Student-perceived attitudes, understanding, and knowledge of US, and its applications to learning the physical exam, were measured by a post-assessment survey. All first-year anatomy students (n=176) participated in small group hands-on US sessions. In the second-year physical diagnosis course, 38 students participated in four sessions. All students (91%) agreed or strongly agreed that additional US teaching should be incorporated throughout the four-year medical school curriculum. POCUS can effectively be integrated into the existing medical school curriculum by using didactic and small group hands-on sessions. Medical students perceived US training as valuable in understanding human anatomy and in learning physical exam skills. This innovative program demonstrates US as an additional learning modality. Future goals include expanding on this work to incorporate US education into all four years of medical school.

  20. Conformal drug delivery and instantaneous monitoring based on an inverse synthesis method at a diagnostic ultrasound platform

    NASA Astrophysics Data System (ADS)

    Xu, Shanshan; Zong, Yujin; Liu, Xiaodong; Lu, Mingzhu; Wan, Mingxi

    2017-03-01

    In this paper, based on a programmable diagnostic ultrasound scanner, a combined approach was proposed, in which a variable-sized focal region wherein the acoustic pressure is above the ultrasound contrast agents (UCA) fragmentation threshold is synthesized by reasonably matching the excitation voltage and the transmit aperture of the linear array at 5MHz, the UCAs' temporal and spatial distribution before and after the microbubbles fragmentation is monitored using the plane-wave transmission and reception at 400Hz and, simultaneously, the broadband noise emission during the microbubbles fragmentation is extracted using the backscattering of focused release bursts (destruction pulse) themselves on the linear array. Then, acquired radio frequency (RF) data are processed to draw parameters which can be correlated with the indicator of broadband noise emission level, namely inertial cavitation dose (ICD) and microbubble fragmentation efficiency, namely decay rate of microbubbles.

  1. Technical Note: Development of a combined molecular breast imaging/ultrasound system for diagnostic evaluation of MBI-detected lesions.

    PubMed

    O'Connor, Michael K; Morrow, Melissa M; Tran, Thuy; Hruska, Carrie B; Conners, Amy L; Hunt, Katie N

    2017-02-01

    The purpose of this study was to perform a pilot evaluation of an integrated molecular breast imaging/ultrasound (MBI/US) system designed to enable, in real-time, the registration of US to MBI and diagnostic evaluation of breast lesions detected on MBI. The MBI/US system was constructed by modifying an existing dual-head cadmium zinc telluride (CZT)-based MBI gamma camera. The upper MBI detector head was replaced with a mesh panel, which allowed an ultrasound probe to access the breast. An optical tracking system was used to monitor the location of the ultrasound transducer, referenced to the MBI detector. The lesion depth at which ultrasound was targeted was estimated from analysis of previously acquired dual-head MBI datasets. A software tool was developed to project the US field of view onto the current MBI image. Correlation of lesion location between both modalities with real-time MBI/US scanning was confirmed in a breast phantom model and assessed in 12 patients with a breast lesion detected on MBI. Combined MBI/US scanning allowed for registration of lesions detected on US and MBI as validated in phantom experiments. In patient studies, successful registration was achieved in 8 of 12 (67%) patients, with complete registration achieved in seven and partial registration achieved in one patient. In 4 of 12 (37%) patients, lesion registration was not achieved, partially attributed to uncertainty in lesion depth estimates from MBI. The MBI/US system enabled successful registration of US to MBI in over half of patients studied in this pilot evaluation. Future studies are needed to determine if real-time, registered US imaging of MBI-detected lesions may obviate the need to proceed to more expensive procedures such as contrast-enhanced breast MRI for diagnostic workup or biopsy of MBI findings. © 2016 American Association of Physicists in Medicine.

  2. Multi-line transmission combined with minimum variance beamforming in medical ultrasound imaging.

    PubMed

    Rabinovich, Adi; Feuer, Arie; Friedman, Zvi

    2015-05-01

    Increasing medical ultrasound imaging frame rate is important in several applications such as cardiac diagnostic imaging, where it is desirable to be able to examine the temporal behavior of fast phases in the cardiac cycle. This is particularly true in 3-D imaging, where current frame rate is still much slower than standard 2-D, B-mode imaging. Recently, a method that increases frame rate, labeled multi-line transmission (MLT), was reintroduced and analyzed. In MLT scanning, the transmission is simultaneously focused at several directions. This scan mode introduces artifacts that stem from the overlaps of the receive main lobe with the transmit side lobes of additional transmit directions besides the one of interest. Similar overlaps occur between the transmit main lobe with receive side lobes. These artifacts are known in the signal processing community as cross-talk. Previous studies have concentrated on proper transmit and receive apodization, as well as transmit directions arrangement in the transmit event, to reduce the cross-talk artifacts. This study examines the possibility of using adaptive beamforming, specifically, minimum variance (MV) and linearly constrained minimum variance (LCMV) beamforming, to reduce the cross-talk artifacts, and maintain or even improve image quality characteristics. Simulation results, as well as experimental phantom and in vivo cardiac data, demonstrate the feasibility of reducing cross-talk artifacts with MV beamforming. The MV and LCMV results achieve superior spatial resolution, not only over other MLT methods with data-independent apodization, but even over that of single-line transmission (SLT) without receive apodization. The MV beamformer is shown to be less sensitive to wider transmit profiles required to reduce the transmit crosstalk artifacts. MV beamforming, combined with the wider transmit profiles, can provide a good approach for MLT scanning with reduced cross-talk artifacts, without compromising spatial

  3. The Effect of a Full Bladder on Proportions of Diagnostic Ultrasound Studies in Children with Suspected Appendicitis.

    PubMed

    Ross, Marshall; Selby, Sasha; Poonai, Naveen; Liu, Helena; Minoosepehr, Shabnam; Boag, Graham; Eccles, Robin; Thompson, Graham

    2016-11-01

    We examined the effect of a full bladder on proportions of diagnostic ultrasound (US) studies in children with suspected appendicitis. We also examined the effect of a full bladder on proportions of fully visualized ovaries on US in children with suspected appendicitis. We conducted a retrospective health record review of children aged 2-17 years presenting to a tertiary pediatric emergency department (ED) with suspected appendicitis who had an ultrasound performed. We compared proportions of diagnostic US studies in children with full and sub-optimally filled bladders. We also compared proportions of ovarian visualization in females with full and sub-optimally filled bladders. 678 children were included in our final analysis. The proportion of diagnostic US studies did not vary significantly between groups with a full (132/283, 47%, 95% confidence interval [CI] 38%-56%) or sub-optimally filled bladder (205/395, 52%, 95% CI 47%-57%)(p=0.17). Rates of ovarian visualization were higher in females with a full bladder (196/205, 96%, 95% CI 93%-99%) compared to those with a sub-optimally filled bladder (180/223, 81%, 95% CI 76%-86%) (p<0.01). Administrators and clinical decision makers should consider removing routine bladder filling practice from current pediatric appendicitis protocols in males and in pre-pubertal females where ovarian pathology is not suspected. Selective bladder filling prior to US should be performed in females when ovarian pathology is suspected.

  4. Cancer among medical diagnostic x-ray workers in China

    SciTech Connect

    Wang, J.X.; Boice, J.D. Jr.; Li, B.X.; Zhang, J.Y.; Fraumeni, J.F. Jr.

    1988-05-04

    Cancer incidence among 27,011 diagnostic x-ray workers was compared to that of 25,782 other medical specialists employed between 1950 and 1980 in China. X-ray workers had a 50% higher risk of developing cancer than the other specialists (relative risk (RR) = 1.5; 95% CI = 1.3-1.7). Leukemia was strongly linked to radiation work (RR = 3.5, n = 30). Cancers of the breast (RR = 1.4, n = 11), thyroid (RR = 2.1, n = 7), and skin (RR = 1.5, n = 6) were increased among x-ray workers employed for 10 or more years. High risks of cancers of the esophagus (RR = 3.5, n = 15) and liver (RR = 2.4, n = 48) were not consistent with a radiation effect since risk did not vary by duration of employment. This finding suggested that some differences might exist between groups of hospital workers in social class, alcohol intake, dietary habits, and other risk factors. No excess lung cancer (RR = 0.9, n = 22) or multiple myeloma (n = 0) was observed. Significant excesses of leukemia and cancers of the breast and thyroid occurred among x-ray workers first employed prior to 1960 when radiation exposures in China were high. In fact, it was not uncommon for employees to be given time off from x-ray work because their wbc count was severely depressed. These data indicated that repeated exposure to x-rays over many years can increase the risk of leukemia and several other tumors but apparently not that of lung cancer.

  5. Spatial Prediction Filtering of Acoustic Clutter and Random Noise in Medical Ultrasound Imaging.

    PubMed

    Shin, Junseob; Huang, Lianjie

    2017-02-01

    One of the major challenges in array-based medical ultrasound imaging is the image quality degradation caused by sidelobes and off-axis clutter, which is an inherent limitation of the conventional delay-and-sum (DAS) beamforming operating on a finite aperture. Ultrasound image quality is further degraded in imaging applications involving strong tissue attenuation and/or low transmit power. In order to effectively suppress acoustic clutter from off-axis targets and random noise in a robust manner, we introduce in this paper a new adaptive filtering technique called frequency-space (F-X) prediction filtering or FXPF, which was first developed in seismic imaging for random noise attenuation. Seismologists developed FXPF based on the fact that linear and quasilinear events or wavefronts in the time-space (T-X) domain are manifested as a superposition of harmonics in the frequency-space (F-X) domain, which can be predicted using an auto-regressive (AR) model. We describe the FXPF technique as a spectral estimation or a direction-of-arrival problem, and explain why adaptation of this technique into medical ultrasound imaging is beneficial. We apply our new technique to simulated and tissue-mimicking phantom data. Our results demonstrate that FXPF achieves CNR improvements of 26% in simulated noise-free anechoic cyst, 109% in simulated anechoic cyst contaminated with random noise of 15 dB SNR, and 93% for experimental anechoic cyst from a custom-made tissue-mimicking phantom. Our findings suggest that FXPF is an effective technique to enhance ultrasound image contrast and has potential to improve the visualization of clinically important anatomical structures and diagnosis of diseased conditions.

  6. [Value of ultrasound in diagnostic and follow-up of chronic inflammatory bowel diseases].

    PubMed

    Kinkel, Horst; Michels, Guido; Jaspers, Natalie

    2015-01-01

    Transabdominal ultrasound as an easy to use, accurate, cost-effective and pleasant method has emerged as one of the most important imaging techniques in daily routine. Ultrasound is efficient for the diagnosis and differentiation of chronic inflammatory bowel diseases (IBD). For monitoring disease activity and severity as well as identifying complications (stenosis, abscess and fistula) high-resolution ultrasonography with Doppler techniques and contrast-enhanced ultrasonography (CEUS) is well suited. Perineal ultrasound and extravascular CEUS can give important information for clinical management of patients with IBD. The aim of this article is to give an updated overview about the clinical applications of ultrasound in the diagnosis and followup of patients with IBD.

  7. [Role of ultrasound diagnostics in evaluating of adaptational changes in heart in miners].

    PubMed

    Ibraev, S A; Koĭgel'dinova, Sh S

    2003-01-01

    Ultrasound examination of cardiovascular system covered apparently healthy coal miners with consideration of service under exposure to coal rock dust. Findings are increased blood velocity, higher pressure gradient and average pulmonary artery pressure, thicker front wall of right ventricle.

  8. Introducing First-Year Medical Students to Early Diagnostic Hypotheses

    ERIC Educational Resources Information Center

    Taylor, P. J.; And Others

    1978-01-01

    A method of instruction in gynecology is described that encouraged the formulation of early diagnostic hypotheses, an important part of clinical problem-solving. Students were given a set of clinical clues to help them make broad diagnostic hypotheses. Student ability, results, and student perceptions of the course are provided. (Author/LBH)

  9. Molecular diagnostics: the changing culture of medical microbiology.

    PubMed

    Bullman, Susan; Lucey, Brigid; Sleator, Roy D

    2012-01-01

    Diagnostic molecular biology is arguably the fastest growing area in current laboratory-based medicine. Growth of the so called 'omics' technologies has, over the last decade, led to a gradual migration away from the 'one test, one pathogen' paradigm, toward multiplex approaches to infectious disease diagnosis, which have led to significant improvements in clinical diagnostics and ultimately improved patient care.

  10. Mapping the different methods adopted for diagnostic imaging instruction at medical schools in Brazil

    PubMed Central

    Chojniak, Rubens; Carneiro, Dominique Piacenti; Moterani, Gustavo Simonetto Peres; Duarte, Ivone da Silva; Bitencourt, Almir Galvão Vieira; Muglia, Valdair Francisco; D'Ippolito, Giuseppe

    2017-01-01

    Objective To map the different methods for diagnostic imaging instruction at medical schools in Brazil. Materials and Methods In this cross-sectional study, a questionnaire was sent to each of the coordinators of 178 Brazilian medical schools. The following characteristics were assessed: teaching model; total course hours; infrastructure; numbers of students and professionals involved; themes addressed; diagnostic imaging modalities covered; and education policies related to diagnostic imaging. Results Of the 178 questionnaires sent, 45 (25.3%) were completed and returned. Of those 45 responses, 17 (37.8%) were from public medical schools, whereas 28 (62.2%) were from private medical schools. Among the 45 medical schools evaluated, the method of diagnostic imaging instruction was modular at 21 (46.7%), classic (independent discipline) at 13 (28.9%), hybrid (classical and modular) at 9 (20.0%), and none of the preceding at 3 (6.7%). Diagnostic imaging is part of the formal curriculum at 36 (80.0%) of the schools, an elective course at 3 (6.7%), and included within another modality at 6 (13.3%). Professors involved in diagnostic imaging teaching are radiologists at 43 (95.5%) of the institutions. Conclusion The survey showed that medical courses in Brazil tend to offer diagnostic imaging instruction in courses that include other content and at different time points during the course. Radiologists are extensively involved in undergraduate medical education, regardless of the teaching methodology employed at the institution. PMID:28298730

  11. Mapping the different methods adopted for diagnostic imaging instruction at medical schools in Brazil.

    PubMed

    Chojniak, Rubens; Carneiro, Dominique Piacenti; Moterani, Gustavo Simonetto Peres; Duarte, Ivone da Silva; Bitencourt, Almir Galvão Vieira; Muglia, Valdair Francisco; D'Ippolito, Giuseppe

    2017-01-01

    To map the different methods for diagnostic imaging instruction at medical schools in Brazil. In this cross-sectional study, a questionnaire was sent to each of the coordinators of 178 Brazilian medical schools. The following characteristics were assessed: teaching model; total course hours; infrastructure; numbers of students and professionals involved; themes addressed; diagnostic imaging modalities covered; and education policies related to diagnostic imaging. Of the 178 questionnaires sent, 45 (25.3%) were completed and returned. Of those 45 responses, 17 (37.8%) were from public medical schools, whereas 28 (62.2%) were from private medical schools. Among the 45 medical schools evaluated, the method of diagnostic imaging instruction was modular at 21 (46.7%), classic (independent discipline) at 13 (28.9%), hybrid (classical and modular) at 9 (20.0%), and none of the preceding at 3 (6.7%). Diagnostic imaging is part of the formal curriculum at 36 (80.0%) of the schools, an elective course at 3 (6.7%), and included within another modality at 6 (13.3%). Professors involved in diagnostic imaging teaching are radiologists at 43 (95.5%) of the institutions. The survey showed that medical courses in Brazil tend to offer diagnostic imaging instruction in courses that include other content and at different time points during the course. Radiologists are extensively involved in undergraduate medical education, regardless of the teaching methodology employed at the institution.

  12. Feasibility and Diagnostic Accuracy of Point-of-Care Abdominal Sonography by Pocket-Sized Imaging Devices, Performed by Medical Residents.

    PubMed

    Kjesbu, Ingunn E; Laursen, Christian B; Graven, Torbjørn; Holden, Hans Martin; Rømo, Bjørnar; Newton Andersen, Garrett; Mjølstad, Ole Christian; Lassen, Annmarie; Dalen, Håvard

    2017-06-01

    We aimed to study the feasibility and diagnostic performance of bedside ultrasound by examination of the liver, gallbladder, kidneys, and abdominal aorta performed by medical residents with limited experience in ultrasound, on emergency admissions using pocket-sized imaging devices (PSIDs). A total of 199 patients admitted acutely to the medical department at the non-university Levanger Hospital, Norway, during the period from April 4 to June 23, 2011, were consecutively included. Six medical residents, selected by drawing, examined these patients with a PSID at admission. Reference imaging was performed and/or judged at the Department of Radiology. Each resident performed a median of 28 examinations (interquartile range 24-46). Imaging of the kidneys and liver were feasible in 85 and 82% of the cases, and the corresponding values for the gallbladder and abdominal aorta were 79 and 50%, respectively. The sensitivity of medical residents to detect organ pathology with the aid of PSID, ranged between 54% (95% confidence interval [CI]: 29-77%) and 74% (95% CI: 51-88%). Assessment of the aortic dimension showed moderate correlation, with r = 0.38. Examination by PSID by inexperienced residents may allow for early detection of abdominal pathology, but do not appear to be accurate enough to rule out pathology in the abdominal organs. © 2017 by the American Institute of Ultrasound in Medicine.

  13. Diagnostics barriers and innovations in rural areas: insights from junior medical doctors on the frontlines of rural care in Peru.

    PubMed

    Anticona Huaynate, Cynthia Fiorella; Pajuelo Travezaño, Monica Jehnny; Correa, Malena; Mayta Malpartida, Holger; Oberhelman, Richard; Murphy, Laura L; Paz-Soldan, Valerie A

    2015-10-05

    Worldwide, rural communities face barriers when accessing health services. In response, numerous initiatives have focused on fostering technological innovations, new management approaches and health policies. Research suggests that the most successful innovations are those involving stakeholders at all levels. However, there is little evidence exploring the opinions of local health providers that could contribute with further innovation development and research. The aims of this study were to explore the perspectives of medical doctors (MDs) working in rural areas of Peru, regarding the barriers impacting the diagnostic process, and ideas for diagnostic innovations that could assist them. Data gathered through three focus group discussions (FGG) and 18 individual semi-structured interviews (SSI) with MDs who had completed their medical service in rural areas of Peru in the last two years were analyzed using thematic analysis. Three types of barriers emerged. The first barrier was the limited access to point of care (POC) diagnostic tools. Tests were needed for: i) the differential diagnosis of malaria vs. pneumonia, ii) dengue vs. leptospirosis, iii) tuberculosis, iv) vaginal infections and cervical cancer, v) neurocysticercosis, and vi) heavy metal toxicity. Ultrasound was needed for the diagnosis of obstetric and intra-abdominal conditions. There were also health system-related barriers such as limited funding for diagnostic services, shortage of specialists, limited laboratory services and access to telecommunications, and lack of institutional support. Finally, the third type of barriers included patient related-barriers to follow through with diagnostic referrals. Ideas for innovations proposed included POC equipment and tests, and telemedicine. MDs at primary health facilities in rural Peru face diagnostic challenges that are difficult to overcome due to a limited access to diagnostic tools. Referrals to specialized facilities are constrained by deficiencies

  14. Alternatives to ultrasound for follow-up after medication abortion: a systematic review.

    PubMed

    Grossman, Daniel; Grindlay, Kate

    2011-06-01

    Requiring a follow-up visit with ultrasound evaluation to confirm completion after medication abortion can be a barrier to providing the service. The PubMed (including MEDLINE), Cochrane Central Register of Controlled Trials and POPLINE databases were systematically searched in October and November 2009 for studies related to alternative follow-up modalities after first-trimester medication abortion to diagnose ongoing pregnancy or retained gestational sac. We calculated the sensitivity, specificity, positive predictive value and negative predictive value compared with ultrasound or clinician's exam. We also calculated the proportion of cases in each study with a positive screening test. Our search identified eight articles. The most promising modalities included serum human chorionic gonadotropin measurements, standardized assessment of women's symptoms combined with low-sensitivity urine pregnancy testing and telephone consultation. These follow-up modalities had sensitivities ≥90%, negative predictive values ≥99% and proportions of "screen-positives" ≤33%. Alternatives to routine in-person follow-up visits after medication abortion are accurate at diagnosing ongoing pregnancy. Additional research is needed to demonstrate the accuracy, acceptability and feasibility of alternative follow-up modalities in practice, particularly of home-based urine testing combined with self-assessment and/or clinician-assisted assessment. Copyright © 2011 Elsevier Inc. All rights reserved.

  15. Medical physics: some recollections in diagnostic X-ray imaging and therapeutic radiology.

    PubMed

    Gray, J E; Orton, C G

    2000-12-01

    Medical physics has changed dramatically since 1895. There was a period of slow evolutionary change during the first 70 years after Roentgen's discovery of x rays. With the advent of the computer, however, both diagnostic and therapeutic radiology have undergone rapid growth and changes. Technologic advances such as computed tomography and magnetic resonance imaging in diagnostic imaging and three-dimensional treatment planning systems, stereotactic radiosurgery, and intensity modulated radiation therapy in radiation oncology have resulted in substantial changes in medical physics. These advances have improved diagnostic imaging and radiation therapy while expanding the need for better educated and experienced medical physics staff.

  16. The Use of Enteric Contrast Media for Diagnostic CT, MRI, and Ultrasound in Infants and Children: A Practical Approach.

    PubMed

    Callahan, Michael J; Talmadge, Jennifer M; MacDougall, Robert; Buonomo, Carlo; Taylor, George A

    2016-05-01

    Enteric contrast media are commonly administered for diagnostic cross-sectional imaging studies in the pediatric population. The purpose of this manuscript is to review the use of enteric contrast media for CT, MRI, and ultrasound in infants, children, and adolescents and to share our experiences at a large tertiary care pediatric teaching hospital. The use of enteric contrast material for diagnostic imaging in infants and children continues to evolve with advances in imaging technology and available enteric contrast media. Many principles of enteric contrast use in pediatric imaging are similar to those in adult imaging, but important differences must be kept in mind when imaging the gastrointestinal tract in infants and children, and practical ways to optimize the imaging examination and the patient experience should be employed where possible.

  17. The Maastricht Ultrasound Shoulder pain trial (MUST): ultrasound imaging as a diagnostic triage tool to improve management of patients with non-chronic shoulder pain in primary care.

    PubMed

    Ottenheijm, Ramon P G; Joore, Manuela A; Walenkamp, Geert H I M; Weijers, René E; Winkens, Bjorn; Cals, Jochen W L; de Bie, Rob A; Dinant, Geert-Jan

    2011-07-08

    Subacromial disorders are considered to be one of the most common pathologies affecting the shoulder. Optimal therapy for shoulder pain (SP) in primary care is yet unknown, since clinical history and physical examination do not provide decisive evidence as to the patho-anatomical origin of the symptoms. Optimal decision strategies can be furthered by applying ultrasound imaging (US), an accurate method in diagnosing SP, demonstrating a clear relationship between diagnosis and available therapies. Yet, the clinical cost-effectiveness of applying US in the management of SP in primary care has not been studied. The aim of this paper is to describe the design and methods of a trial assessing the cost-effectiveness of ultrasound imaging as a diagnostic triage tool to improve management of primary care patients with non-chronic shoulder pain. This randomised controlled trial (RCT) will involve 226 adult patients with suspected subacromial disorders recruited by general practitioners. During a Qualification period of two weeks, patients receive care as usual as advised by the Dutch College of General Practitioners, and patients are referred for US. Patients with insufficient improvement qualify for the RCT. These patients are then randomly assigned to the intervention or the control group. The therapies used in both groups are the same (corticosteroid injections, referral to a physiotherapist or orthopedic surgeon) except that therapies used in the intervention group will be tailored based on the US results. Ultrasound diagnosed disorders include tendinopathy, calcific tendinitis, partial and full thickness tears, and subacromial bursitis. The primary outcome is patient-perceived recovery at 52 weeks, using the Global Perceived Effect questionnaire. Secondary outcomes are disease specific and generic quality of life, cost-effectiveness, and the adherence to the initial applied treatment. Outcome measures will be assessed at baseline, 13, 26, 39 and 52 weeks after

  18. The Maastricht Ultrasound Shoulder pain trial (MUST): Ultrasound imaging as a diagnostic triage tool to improve management of patients with non-chronic shoulder pain in primary care

    PubMed Central

    2011-01-01

    Background Subacromial disorders are considered to be one of the most common pathologies affecting the shoulder. Optimal therapy for shoulder pain (SP) in primary care is yet unknown, since clinical history and physical examination do not provide decisive evidence as to the patho-anatomical origin of the symptoms. Optimal decision strategies can be furthered by applying ultrasound imaging (US), an accurate method in diagnosing SP, demonstrating a clear relationship between diagnosis and available therapies. Yet, the clinical cost-effectiveness of applying US in the management of SP in primary care has not been studied. The aim of this paper is to describe the design and methods of a trial assessing the cost-effectiveness of ultrasound imaging as a diagnostic triage tool to improve management of primary care patients with non-chronic shoulder pain. Methods/Design This randomised controlled trial (RCT) will involve 226 adult patients with suspected subacromial disorders recruited by general practitioners. During a Qualification period of two weeks, patients receive care as usual as advised by the Dutch College of General Practitioners, and patients are referred for US. Patients with insufficient improvement qualify for the RCT. These patients are then randomly assigned to the intervention or the control group. The therapies used in both groups are the same (corticosteroid injections, referral to a physiotherapist or orthopedic surgeon) except that therapies used in the intervention group will be tailored based on the US results. Ultrasound diagnosed disorders include tendinopathy, calcific tendinitis, partial and full thickness tears, and subacromial bursitis. The primary outcome is patient-perceived recovery at 52 weeks, using the Global Perceived Effect questionnaire. Secondary outcomes are disease specific and generic quality of life, cost-effectiveness, and the adherence to the initial applied treatment. Outcome measures will be assessed at baseline, 13, 26, 39

  19. A 10.5 cm ultrasound link for deep implanted medical devices.

    PubMed

    Mazzilli, Francesco; Lafon, Cyril; Dehollain, Catherine

    2014-10-01

    A study on ultrasound link for wireless energy transmission dedicated to deeply implanted medical devices is presented. The selection of the frequency to avoid biological side effects (e.g., cavitations), the choice of the power amplifier to drive the external transducers and the design of the rectifier to maximize the energy extraction from the implanted transducer are described in details. The link efficiency is characterized in water using a phantom material for a transmitter-receiver distance of 105 mm, transducers active area of 30 mm × 96 mm and 5 mm × 10 mm, respectively, and a system efficiency of 1.6% is measured.

  20. A high-performance measurement method for artery intimamedia thickness in medical ultrasound images

    NASA Astrophysics Data System (ADS)

    Jin, Jing; Wang, Yan; Gao, Xin; Wang, Qi

    2010-11-01

    A high-performance measurement method for the artery intima-media thickness (IMT) in medical ultrasound images is proposed. The scheme mainly consists of two parts. The first part is the detection process, including adaptive gray stretching for image enhancing, gradient transforming to restrain the over-segmentation, and the watershed algorithm for edge extraction. The intima can be detected automatically and exactly. The second part, combined with regional positioning and boundary fitting stages, is used to measure the IMT. Experimental results show that the proposed scheme can yield a good measurement result, and the calculation time can satisfy the practical requirement.

  1. Verifying the effectiveness of medical abortion; ultrasound versus hCG testing.

    PubMed

    Fiala, Christian; Safar, Peter; Bygdeman, Marc; Gemzell-Danielsson, Kristina

    2003-08-15

    The combination of mifepristone and misoprostol is an established method for termination of pregnancy. However, there is no general agreement about how best to evaluate the treatment outcome. In 217 women with an unwanted pregnancy below 49 days of amenorrhoea, ultrasound examination and serum hCG test were performed before treatment and at follow-up. Treatment was successful in 98.2%. At follow-up their hCG dropped to a mean of 3% (S.D. 3) of initial levels and the endometrium measured a mean of 10 mm (S.D. 4). Interpretation of endometrium was difficult in some cases because of inhomogeneous structure. Using hCG was reliable in 98.5% of successful abortions. For ultrasound the corresponding figure was 89.8% for the cases with a confirmed intrauterine pregnancy before treatment but only 66% if all pregnancies were included. Measuring serum hCG before treatment and at follow-up is more effective than ultrasound to confirm a successful medically induced abortion in early pregnancy.

  2. Ultrasound-guided diagnostic breast biopsy methodology: retrospective comparison of the 8-gauge vacuum-assisted biopsy approach versus the spring-loaded 14-gauge core biopsy approach

    PubMed Central

    2011-01-01

    Background Ultrasound-guided diagnostic breast biopsy technology represents the current standard of care for the evaluation of indeterminate and suspicious lesions seen on diagnostic breast ultrasound. Yet, there remains much debate as to which particular method of ultrasound-guided diagnostic breast biopsy provides the most accurate and optimal diagnostic information. The aim of the current study was to compare and contrast the 8-gauge vacuum-assisted biopsy approach and the spring-loaded 14-gauge core biopsy approach. Methods A retrospective analysis was done of all ultrasound-guided diagnostic breast biopsy procedures performed by either the 8-gauge vacuum-assisted biopsy approach or the spring-loaded 14-gauge core biopsy approach by a single surgeon from July 2001 through June 2009. Results Among 1443 ultrasound-guided diagnostic breast biopsy procedures performed, 724 (50.2%) were by the 8-gauge vacuum-assisted biopsy technique and 719 (49.8%) were by the spring-loaded 14-gauge core biopsy technique. The total number of false negative cases (i.e., benign findings instead of invasive breast carcinoma) was significantly greater (P = 0.008) in the spring-loaded 14-gauge core biopsy group (8/681, 1.2%) as compared to in the 8-gauge vacuum-assisted biopsy group (0/652, 0%), with an overall false negative rate of 2.1% (8/386) for the spring-loaded 14-gauge core biopsy group as compared to 0% (0/148) for the 8-gauge vacuum-assisted biopsy group. Significantly more (P < 0.001) patients in the spring-loaded 14-gauge core biopsy group (81/719, 11.3%) than in the 8-gauge vacuum-assisted biopsy group (18/724, 2.5%) were recommended for further diagnostic surgical removal of additional tissue from the same anatomical site of the affected breast in an immediate fashion for indeterminate/inconclusive findings seen on the original ultrasound-guided diagnostic breast biopsy procedure. Significantly more (P < 0.001) patients in the spring-loaded 14-gauge core biopsy group (54

  3. Ultrasound-guided diagnostic breast biopsy methodology: retrospective comparison of the 8-gauge vacuum-assisted biopsy approach versus the spring-loaded 14-gauge core biopsy approach.

    PubMed

    Povoski, Stephen P; Jimenez, Rafael E; Wang, Wenle P

    2011-08-11

    Ultrasound-guided diagnostic breast biopsy technology represents the current standard of care for the evaluation of indeterminate and suspicious lesions seen on diagnostic breast ultrasound. Yet, there remains much debate as to which particular method of ultrasound-guided diagnostic breast biopsy provides the most accurate and optimal diagnostic information. The aim of the current study was to compare and contrast the 8-gauge vacuum-assisted biopsy approach and the spring-loaded 14-gauge core biopsy approach. A retrospective analysis was done of all ultrasound-guided diagnostic breast biopsy procedures performed by either the 8-gauge vacuum-assisted biopsy approach or the spring-loaded 14-gauge core biopsy approach by a single surgeon from July 2001 through June 2009. Among 1443 ultrasound-guided diagnostic breast biopsy procedures performed, 724 (50.2%) were by the 8-gauge vacuum-assisted biopsy technique and 719 (49.8%) were by the spring-loaded 14-gauge core biopsy technique. The total number of false negative cases (i.e., benign findings instead of invasive breast carcinoma) was significantly greater (P = 0.008) in the spring-loaded 14-gauge core biopsy group (8/681, 1.2%) as compared to in the 8-gauge vacuum-assisted biopsy group (0/652, 0%), with an overall false negative rate of 2.1% (8/386) for the spring-loaded 14-gauge core biopsy group as compared to 0% (0/148) for the 8-gauge vacuum-assisted biopsy group. Significantly more (P < 0.001) patients in the spring-loaded 14-gauge core biopsy group (81/719, 11.3%) than in the 8-gauge vacuum-assisted biopsy group (18/724, 2.5%) were recommended for further diagnostic surgical removal of additional tissue from the same anatomical site of the affected breast in an immediate fashion for indeterminate/inconclusive findings seen on the original ultrasound-guided diagnostic breast biopsy procedure. Significantly more (P < 0.001) patients in the spring-loaded 14-gauge core biopsy group (54/719, 7.5%) than in the 8

  4. Role of pelvic ultrasound simulation.

    PubMed

    Arya, Sushila; Mulla, Zuber D; Kupesic Plavsic, Sanja

    2017-10-10

    Pelvic ultrasound is a critical diagnostic imaging tool in obstetrics and gynaecology. Training opportunities in transvaginal ultrasound have not kept pace with the demand among learners because of the increased complexity of modern ultrasound technology and duty-hour restrictions. Ultrasound simulation training has the potential to overcome this gap. Training opportunities in transvaginal ultrasound have not kept pace with the demand OBJECTIVE: Our study aimed to determine the usefulness, applicability and attitudes toward pelvic ultrasound simulation training among residents, sonographers and practising doctors. Pelvic ultrasound simulation activity using high-fidelity virtual reality ultrasound simulators lasted 4 hours and consisted of three modules: abnormal uterine bleeding, adnexal masses and bleeding in pregnancy. All learners completed a pre- and post-encounter quiz, and an anonymous post-simulation survey on the relevance of ultrasound simulation to clinical learning, and its usefulness to improve scanning performance and interpretation skills. Thirty-one participants attended the workshop, and 28 (90.3%) of them responded to the survey. Five respondents agreed and 23 strongly agreed that pelvic ultrasound simulation applies to their clinical ultrasound practice, and seven of them agreed and 21 strongly agreed that their performance of ultrasound and interpretation skills will be improved following their simulation training. The average post-activity knowledge score for all three topics significantly increased (paired Student's t-test, p < 0.0001). All 28 respondents believe that ultrasound simulation is a useful complement to learning with real patients, with the potential to improve their pelvic ultrasound performance, interpretation skills and clinical reasoning. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  5. Initially non-diagnostic ultrasound-guided fine needle aspiration cytology of thyroid nodules: value and management.

    PubMed

    Chung, Jin; Youk, Ji Hyun; Kim, Jeong-Ah; Kwak, Jin Young; Kim, Eun-kyung; Ryu, Young Hoon; Son, Eun Ju

    2012-03-01

    Ultrasound (US)-guided fine needle aspiration cytology (FNAC) is an accurate, reliable, and simple method to identify a thyroid nodule as benign or malignant. However, non-diagnostic cytology results for thyroid nodules are a major limitation of US-guided FNAC. To investigate the incidence of thyroid cancer among cases with non-diagnostic results on FNAC and to provide suggestions for the management of thyroid nodules that are initially non-diagnostic by FNAC according to ultrasonographic findings. From July 2006 to December 2009, 10,317 thyroid nodules in 6684 consecutive patients underwent US-guided FNAC at our institute. Among these, 871 thyroid nodules (8.4%) were diagnosed as non-diagnostic on initial cytologic evaluation and 196 underwent a second or third FNAC. Twenty-seven thyroid nodules (18.9%) underwent surgery, while 116 thyroid nodules were cytologically confirmed as benign with no remarkable change on follow-up US were included. We retrospectively reviewed the US findings for a total of 143 thyroid nodules (123 benign nodules and 20 malignant nodules). The US features that we compared included composition, echogenicity, margin, calcifications, shape, and underlying echogenicity. In total, thyroid cancer was diagnosed in 20 nodules (14.0%). The size of the nodule was significantly associated with malignancy (P < 0.05). Most of the sonographically probable benign nodules were found to be benign (97.6%). Suspicious nodules on US were thyroid cancer in 43.2% of cases. Marked hypoechogenicity, microlobulated or irregular margin, microcalcifications, and taller-than-wide shape were significant US findings that correlated with malignancy (P < 0.05). The diagnostic performance of ultrasound for initially non-diagnostic thyroid nodules was as follows: sensitivity of 90.0%, specificity of 65.0%, positive predictive value of 29.5%, and negative predictive value of 97.6%. In terms of management of thyroid nodules with non-diagnostic FNAC cytology, US evaluation

  6. The nonlinear dynamics of microbubble contrast agents used in medical ultrasound

    NASA Astrophysics Data System (ADS)

    Reddy, Anil J.

    Microbubbles are used as contrast agents in diagnostic ultrasound, and as transport agents or to engender physical effects in therapeutic ultrasound. The distinguishing characteristic of bubbles is their small size, on the order of microns, which allows them to traverse the smallest capillaries in the human body. Furthermore, when subject to acoustic forcing (ultrasound), the oscillations of bubbles become highly nonlinear, leading to a unique echo characteristic. Bubble echo improves the clinician's ability to distinguish between blood carrying contrast agent from the surrounding tissue. Present ultrasound techniques, however, do not take full advantage of the nonlinear properties of oscillating microbubbles. In this work, a novel method to maximize the bubble echo, thereby improving image quality, is suggested. Pulse-inversion imaging is utilized as a means of filtering out the linear echo of surrounding tissue. A norm is defined for the nonlinear bubble echo and it is shown how the norm may be maximized, given a limit on ultrasound intensity, by optimizing the acoustic pulse shape using optimal control theory. The optimization is performed for a single bubble of a particular size. The optimal pulse yields a several-fold increase in the echo norm over conventional pulse driving. It is also shown that the optimal pulse effectively maximizes the echo of a bubble cloud with mean size equal to that of the single bubble. Increased bubble response comes as a result of severe radial collapse, which in turn drives the translation dynamics of the bubble. These motions have been observed by others in experiment, but have, up this point, been inadequately explained. The erratic translation of a bubble is found to be intimately coupled to the radial dynamics, especially in the case of violent oscillations. The assumption of spherical symmetry is relaxed and it is considered how bubble translation can be a mechanism for shape instability, thereby leading to bubble destruction

  7. Unexplained common bile duct dilatation with normal serum liver enzymes: diagnostic yield of endoscopic ultrasound and follow-up of this condition.

    PubMed

    Bruno, Mauro; Brizzi, Rosario F; Mezzabotta, Lavinia; Carucci, Patrizia; Elia, Chiara; Gaia, Silvia; Mengozzi, Giulio; Romito, Alessandrina V; Eloubeidi, Mohamad A; Rizzetto, Mario; De Angelis, Claudio

    2014-09-01

    There is scant literature about common bile duct (CBD) dilatation with normal liver function tests (LFTs). The aims of this study were to assess the diagnostic yield of endoscopic ultrasound (EUS) in patients with CBD dilatation, normal LFTs, and prior inconclusive imaging tests, and to assess the natural history of these subjects. We retrospectively reviewed our EUS database for patients referred for evaluation of CBD dilatation, normal LFTs, and prior inconclusive imaging. We excluded patients with a prior endoscopic retrograde cholangiopancreatography or a history of biliary obstruction, pancreatitis, or jaundice. Follow-up data were retrieved from medical records or by calling the general practitioners, referring specialists, patients, or their closest relatives. A total of 57 patients were enrolled. The mean CBD diameter was 12.5±3.6 mm. The majority of patients (50.8%) were asymptomatic. Abnormal EUS findings were recorded in 12 (21%) subjects: 6 patients had a periampullary diverticulum, 2 had ampullary adenoma, 2 had signs of chronic pancreatitis, 1 had a cancer of the pancreatic head, and 1 had a 7 mm CBD stone. Neither age, sex, prior cholecystectomy, clinical presentation, CBD diameter, nor a dilated main pancreatic duct were predictors of abnormal EUS findings. None of the patients complained of biliary symptoms or showed abnormal LFTs on long-term follow-up. CBD dilatation with normal liver chemistry is not always a benign condition. Even when prior imaging tests are negative, EUS may allow to diagnose conditions overlooked by standard diagnostic imaging.

  8. Ultrasound Elastography Combined With BI-RADS-US Classification System: Is It Helpful for the Diagnostic Performance of Conventional Ultrasonography?

    PubMed

    Hao, Shao-Yun; Jiang, Qiong-Chao; Zhong, Wen-Jing; Zhao, Xin-Bao; Yao, Ji-Yi; Li, Lu-Jing; Luo, Bao-Ming; Ou, Bing; Zhi, Hui

    2016-06-01

    To evaluate the additive diagnostic performance of ultrasound elastography (UE) to ultrasound (US) with the 2003 or 2013 Breast Imaging Reporting and Data System (BI-RADS)-US classification systems for the differentiation of benign and malignant breast lesions. From June 2010 to December 2012, 738 women with 770 breast lesions were recruited into this retrospective study. Breast lesions were evaluated separately by US, UE, and both. US assessment was based on the 2003 or 2013 BI-RADS-US, and UE assessment was based on a previously reported 5-point scale. Diagnostic performance of US, UE, and both was compared. Before category 4 lesions were subdivided, the area under the receiver operating characteristic curve (AUC) for US, UE, and both were, respectively, 0.735, 0.877, 0.878 (P < .01). When subcategories of 4 lesions were considered, the AUC for US, UE, and both were, respectively, 0.865, 0.877, and 0.883 (P > .05). Adding UE to analysis of 4A lesions can decrease the percentages of malignancy to 2.56%. When the 2003 BI-RADS was considered, UE could give US some help in differentiating breast lesions. However, when the 2013 BI-RADS was considered, UE gave little help to US, although it reduced unnecessary biopsies of benign category 4A lesions. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Exploring the Case for a Global Alliance for Medical Diagnostics Initiative

    PubMed Central

    Mugambi, Melissa L.; Palamountain, Kara M.; Gallarda, Jim; Drain, Paul K.

    2017-01-01

    In recent years, the private and public sectors have increased investments in medical diagnostics for low- and middle-income countries (LMICs). Despite these investments, numerous barriers prevent the adoption of existing diagnostics and discourage the development and introduction of new diagnostics in LMICs. In the late 1990s, the global vaccine community had similar challenges, as vaccine coverage rates stagnated and the introduction of new vaccines was viewed as a distraction to delivering existing vaccines. To address these challenges, the international community came together and formed the Global Alliance for Vaccines Initiative (GAVI). Sixteen years after the formation of GAVI, we see evidence of a healthier global vaccine landscape. We discuss how GAVI’s four guiding principles (product, health systems strengthening, financing and market shaping) might apply to the advancement of medical diagnostics in LMICs. We present arguments for the international community and existing organizations to establish a Global Alliance for Medical Diagnostics Initiative (GAMDI). PMID:28134750

  10. Exploring the Case for a Global Alliance for Medical Diagnostics Initiative.

    PubMed

    Mugambi, Melissa L; Palamountain, Kara M; Gallarda, Jim; Drain, Paul K

    2017-01-26

    In recent years, the private and public sectors have increased investments in medical diagnostics for low- and middle-income countries (LMICs). Despite these investments, numerous barriers prevent the adoption of existing diagnostics and discourage the development and introduction of new diagnostics in LMICs. In the late 1990s, the global vaccine community had similar challenges, as vaccine coverage rates stagnated and the introduction of new vaccines was viewed as a distraction to delivering existing vaccines. To address these challenges, the international community came together and formed the Global Alliance for Vaccines Initiative (GAVI). Sixteen years after the formation of GAVI, we see evidence of a healthier global vaccine landscape. We discuss how GAVI's four guiding principles (product, health systems strengthening, financing and market shaping) might apply to the advancement of medical diagnostics in LMICs. We present arguments for the international community and existing organizations to establish a Global Alliance for Medical Diagnostics Initiative (GAMDI).

  11. An Experiential Learning Model Facilitates Learning of Bedside Ultrasound by Preclinical Medical Students.

    PubMed

    Shokoohi, Hamid; Boniface, Keith; Kaviany, Parisa; Armstrong, Paige; Calabrese, Kathleen; Pourmand, Ali

    2016-01-01

    To examine the effects of an experiential learning model of ultrasound training on preclinical medical students' knowledge and practice of Focused Assessment with Sonography for Trauma (FAST) examination. The study was conducted in 2 phases. In phase 1, first- and second-year medical students participated in a 45-minute didactic presentation and subsequent 1-hour hands-on practice followed by 3-5 precepted FAST examinations in the emergency department. A pretest or posttest design was used to examine the participants' knowledge interpreting ultrasound images of the FAST examination. In phase 2, students performed FAST scans on patients with abdominal complaints under the supervision of emergency ultrasound faculty over a 1-year period. The participants were scored based on window acquisition, quality of images, accuracy of FAST scan interpretation, confidence level rated by participant, and supervising attending physician. In phase 1, 68 novice medical students participated in 11 training sessions offered over a 1-year period. Students showed significant improvement in basic ultrasound and abdominal anatomy knowledge. The mean score improved from a pretest score of 5.8 of 10 (95% CI: 5.3-6.2) to a posttest score of 7.3 of 10 (95% CI: 7-7.6). The students also demonstrated a significant improvement in FAST image interpretation (pretest of 6.2 [95% CI: 5.9-6.6] and posttest of 7.6 [95% CI: 7.1-7.9]). In phase 2, 22 students performed 304 FAST examinations on patients. At the beginning of their training when they performed less than 10 FAST scans, students were able to complete the right upper quadrant view in 88.9%, left upper quadrant view in 69.7%, subxiphoid in 64.7%, and pelvic view in 70% of scans. Across all views of the FAST examination, increasing level of practice was associated with improvement in successfully completing the examination. The absolute increase in the proportion experiencing success in the right upper quadrant view was 1.6%, 3.6%, and 6

  12. Enhancing awareness of the diagnostic medical sonography professions: a high school outreach program.

    PubMed

    Merton, Daniel A

    2011-08-01

    The purpose of this project was to develop a presentation that can be used to increase the number of high school students who recognize diagnostic medical sonography (DMS) professions as career alternatives and will consider pursuing DMS careers. An interactive program was developed that includes a digital presentation, question-and-answer session, and scanning demonstration. The program was presented to students at their high schools. Handout materials were provided, and a questionnaire was distributed to obtain feedback regarding the program's content and effectiveness. Refinements to the program were made based on feedback. A Student t test was used to determine the statistical significance of changes in students' level of knowledge about DMS and their interest in pursuing a DMS career before and after the program. The student-preferred component of the program was assessed by 1-way analysis of variance. Six programs were provided to a total of 148 high school students. Of 120 students who returned questionnaires, 90% indicated that their level of knowledge of DMS increased after the program, and 60% indicated that their level of interest in pursuing a DMS career had increased. The increases in both knowledge and interest were statistically significant (P < .0001). Forty-nine percent of students indicated that the scanning demonstration was the most interesting aspect of the program. This program was very well received by students and teachers. It significantly improved students' knowledge about DMS and their interest in pursuing a DMS career. Presentation materials used in this program are available to DMS professionals who would like to provide similar programs to students in their geographic areas. The PowerPoint presentation and related documents can be downloaded from the American Institute of Ultrasound in Medicine's website at http://www.aium.org/misc/dms.aspx.

  13. Pilot Point-of-Care Ultrasound Curriculum at Harvard Medical School: Early Experience

    PubMed Central

    Rempell, Joshua S.; Saldana, Fidencio; DiSalvo, Donald; Kumar, Navin; Stone, Michael B.; Chan, Wilma; Luz, Jennifer; Noble, Vicki E.; Liteplo, Andrew; Kimberly, Heidi; Kohler, Minna J.

    2016-01-01

    Introduction Point-of-care ultrasound (POCUS) is expanding across all medical specialties. As the benefits of US technology are becoming apparent, efforts to integrate US into pre-clinical medical education are growing. Our objective was to describe our process of integrating POCUS as an educational tool into the medical school curriculum and how such efforts are perceived by students. Methods This was a pilot study to introduce ultrasonography into the Harvard Medical School curriculum to first- and second-year medical students. Didactic and hands-on sessions were introduced to first-year students during gross anatomy and to second-year students in the physical exam course. Student-perceived attitudes, understanding, and knowledge of US, and its applications to learning the physical exam, were measured by a post-assessment survey. Results All first-year anatomy students (n=176) participated in small group hands-on US sessions. In the second-year physical diagnosis course, 38 students participated in four sessions. All students (91%) agreed or strongly agreed that additional US teaching should be incorporated throughout the four-year medical school curriculum. Conclusion POCUS can effectively be integrated into the existing medical school curriculum by using didactic and small group hands-on sessions. Medical students perceived US training as valuable in understanding human anatomy and in learning physical exam skills. This innovative program demonstrates US as an additional learning modality. Future goals include expanding on this work to incorporate US education into all four years of medical school. PMID:27833681

  14. A sequential decision-theoretic model for medical diagnostic system.

    PubMed

    Li, Aiping; Jin, Songchang; Zhang, Lumin; Jia, Yan

    2015-01-01

    Although diagnostic expert systems using a knowledge base which models decision-making of traditional experts can provide important information to non-experts, they tend to duplicate the errors made by experts. Decision-Theoretic Model (DTM) is therefore very useful in expert system since they prevent experts from incorrect reasoning under uncertainty. For the diagnostic expert system, corresponding DTM and arithmetic are studied and a sequential diagnostic decision-theoretic model based on Bayesian Network is given. In the model, the alternative features are categorized into two classes (including diseases features and test features), then an arithmetic for prior of test is provided. The different features affect other features weights are also discussed. Bayesian Network is adopted to solve uncertainty presentation and propagation. The model can help knowledge engineers model the knowledge involved in sequential diagnosis and decide evidence alternative priority. A practical example of the models is also presented: at any time of the diagnostic process the expert is provided with a dynamically updated list of suggested tests in order to support him in the decision-making problem about which test to execute next. The results show it is better than the traditional diagnostic model which is based on experience.

  15. Doppler diagnostics of laser-ablated biotissues: fundamentals, equipment, and medical testing

    NASA Astrophysics Data System (ADS)

    Ul'yanov, V. A.; Panchenko, V. Ya.; Geinitz, A. V.; Reshetov, I. V.; Varev, G. A.

    2006-09-01

    New method of Doppler diagnostics based on autodyne effect for diagnostics and control of laser-tissue evaporation by radiation of high-frequency pumped waveguide CO II laser is developed. This method is used for creation of feed-back for smart CO II laser surgical system of "Lancet" series. The results of medical testing of the smart laser surgical system are presented.

  16. [Evaluation of medical diagnostic tests: application of Bayes theorem, ROC-curve and Kappa-test] .

    PubMed

    Lugosi, L; Molnár, I

    2000-07-30

    With the technical improvement of the sensitivity and specificity of the medical diagnostic tests the principles and methods of statistical analysis of the tests are in developing too. The technical development of the diagnostic tests and the exact statistical evaluation of the data will improve the reliability and effectiveness of the decisions for medical interventions. Application, statistical evaluation and interpretation of the Bayes theorem, ROC curve and Kappa test are presented.

  17. The delay multiply and sum beamforming algorithm in ultrasound B-mode medical imaging.

    PubMed

    Matrone, Giulia; Savoia, Alessandro Stuart; Caliano, Giosue; Magenes, Giovanni

    2015-04-01

    Most of ultrasound medical imaging systems currently on the market implement standard Delay and Sum (DAS) beamforming to form B-mode images. However, image resolution and contrast achievable with DAS are limited by the aperture size and by the operating frequency. For this reason, different beamformers have been presented in the literature that are mainly based on adaptive algorithms, which allow achieving higher performance at the cost of an increased computational complexity. In this paper, we propose the use of an alternative nonlinear beamforming algorithm for medical ultrasound imaging, which is called Delay Multiply and Sum (DMAS) and that was originally conceived for a RADAR microwave system for breast cancer detection. We modify the DMAS beamformer and test its performance on both simulated and experimentally collected linear-scan data, by comparing the Point Spread Functions, beampatterns, synthetic phantom and in vivo carotid artery images obtained with standard DAS and with the proposed algorithm. Results show that the DMAS beamformer outperforms DAS in both simulated and experimental trials and that the main improvement brought about by this new method is a significantly higher contrast resolution (i.e., narrower main lobe and lower side lobes), which turns out into an increased dynamic range and better quality of B-mode images.

  18. A qualitative study of women's decision to view or not view an ultrasound image before early medication abortion.

    PubMed

    Cappiello, Joyce; Merrell, Joy; Rentschler, Dorothy

    2014-01-01

    Transvaginal ultrasounds are commonly performed for gestational dating of pregnancy before a medication abortion. This paper presents findings regarding women's perspectives on viewing the gestational dating ultrasound image, which arose from a study exploring women's medication abortion experience. By providing women the opportunity to talk about their medication abortion experience through open-ended interviews, women reported their experience of viewing or not viewing the ultrasound in detail, which to date has been underexplored. A constructivist, grounded theory approach was used. The purposive sample consisted of 18 women in the United States who experienced a medication abortion in the preceding 4 months. Not all women wanted to view the ultrasound; however, they all wanted a choice. Women wanted to view the image to confirm health and fertility, satisfy curiosity, and process their decision regarding the pregnancy. None of the women stated that they wanted to view the image as a prerequisite to making their decision to terminate the pregnancy; rather, viewing was a way to process their decision. Women wanted a choice of whether to view the ultrasound image because they felt it was their right to decide whether to access this aspect of their personal health information. They wanted providers to engage in a dialogue about viewing the image or not and to respect their decision. Providers need to be appropriately prepared to offer women the choice to view and to support women in their decision. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  19. The combination of pulsed acousto-optic imaging and B-mode diagnostic ultrasound for three-dimensional imaging in ex vivo biological tissue

    NASA Astrophysics Data System (ADS)

    Sui, Lei; Murray, Todd W.; Roy, Ronald A.

    2006-02-01

    A multimode imaging system, producing conventional ultrasound (US) and acousto-optic (AO) images, has been developed and used to detect optical absorbers buried in excised biological tissue. A commercially-available diagnostic ultrasound imaging transducer is used to both generate B-mode ultrasound images and as a pump for AO imaging. Due to the fact that the steered and focused beam used for US imaging and the US source for pumping the AO image are generated from the same ultrasound probe, the acoustical and optical images are intrinsically co-registered. AO imaging is performed using short ultrasound pulse trains at a frequency of 5 MHz. The phase-modulated light emitted from the interaction region is detected using a photorefractive-crystal based interferometry system. Experimental results have previously been presented for the two-dimensional imaging in tissue-mimicking phantoms. In this paper, we report further experimental developments demonstrating three-dimensional fusion of B-mode ultrasound imaging and pulsed acousto-optic imaging in excised biological tissue (~2 cm thick). By mechanically scanning the ultrasound transducer array in a direction perpendicular to its imaging plane, both the acoustical and optical properties of an embedded target are obtained in three dimensions. The results suggest that AO imaging could be used to supplement conventional B-mode ultrasound imaging with optical contrast, and the multimode imaging system may find application in the detection and diagnosis of cancer.

  20. Assessing the Oldness and Capacity of Radiography and Ultrasound Equipments in Tehran University of Medical Sciences

    PubMed Central

    Salamati, Payman; Ghanaati, Hossein; Ghasemzadeh, Shahram; Jalali, Amir Hossein

    2013-01-01

    Background Maintenance of imaging equipment is a very important part of the management of all medical imaging centers. Objectives To assess the oldness and capacity of radiography and ultrasound equipment in Tehran University of Medical Sciences. Materials and Methods The study was performed in 16 hospitals, 4 faculties and three healthcare centers of Tehran University of Medical Sciences. We evaluated all the X-ray equipment (including the simple plain and dental, panorex, mammography, fluoroscopy and C-arm X-Ray devices) and also simple and Doppler ultrasound machines in terms of the type and usage of the device, production year, quantity of utilization, location, brand and current condition. Results Among fixed X-ray systems, 15 were currently in use, two were junk, two were damaged, and one was not utilized. The mean (SD) of the usage of these was 2151 (2230) cliché/month, and the mean (SD) of the oldness was 16.9 (13.6) years. The oldness of radiography equipment in our study was more than 20 years in 16, between 11 and 20 in 46, and less than 10 years in 76 devices. The mean (SD) usage (patients/month) of simple and color Doppler devices were 234.1 (365.2) and 597.5 (505.3), respectively. The oldness of ultrasonography equipment in our study was more than 11 years in 12 and less than 10 years in 55 devices. We found that 22 (15.9%) of the radiography systems and two (3%) of the ultrasonography systems had been used for more than 20 years. Conclusion Radiology equipment in Tehran University of Medical Sciences have potential capacity, but they need repair, and better maintenance and management and application of standards for the imaging system needs organized supervisory mechanisms. PMID:24348608

  1. Molecular diagnostics in medical microbiology: yesterday, today and tomorrow.

    PubMed

    van Belkum, Alex

    2003-10-01

    Clinical microbiology is clearly on the move, and various new diagnostic technologies have been introduced into laboratory practice over the past few decades. However, Henri D Isenberg recently stated that molecular biology techniques promised to revolutionise the diagnosis of infectious disease, but that, to date, this promise is still in its infancy. Molecular diagnostics have now surpassed these early stages and have definitely reached puberty. Currently, a second generation of automated molecular approaches is already within the microbiologists' reach. Quantitative amplification tests in combination with genomics, transcriptomics, proteomics and related methodologies will pave the way to further enhancement of innovative microbial detection and identification.

  2. Diagnostic algorithm: how to make use of new 2D, 3D and 4D ultrasound technologies in breast imaging.

    PubMed

    Weismann, C F; Datz, L

    2007-11-01

    The aim of this publication is to present a time saving diagnostic algorithm consisting of two-dimensional (2D), three-dimensional (3D) and four-dimensional (4D) ultrasound (US) technologies. This algorithm of eight steps combines different imaging modalities and render modes which allow a step by step analysis of 2D, 3D and 4D diagnostic criteria. Advanced breast US systems with broadband high frequency linear transducers, full digital data management and high resolution are the actual basis for two-dimensional breast US studies in order to detect early breast cancer (step 1). The continuous developments of 2D US technologies including contrast resolution imaging (CRI) and speckle reduction imaging (SRI) have a direct influence on the high quality of three-dimensional and four-dimensional presentation of anatomical breast structures and pathological details. The diagnostic options provided by static 3D volume datasets according to US BI-RADS analogue assessment, concerning lesion shape, orientation, margin, echogenic rim sign, lesion echogenicity, acoustic transmission, associated calcifications, 3D criteria of the coronal plane, surrounding tissue composition (step 2) and lesion vascularity (step 6) are discussed. Static 3D datasets offer the combination of long axes distance measurements and volume calculations, which are the basis for an accurate follow-up in BI-RADS II and BI-RADS III lesions (step 3). Real time 4D volume contrast imaging (VCI) is able to demonstrate tissue elasticity (step 5). Glass body rendering is a static 3D tool which presents greyscale and colour information to study the vascularity and the vascular architecture of a lesion (step 6). Tomographic ultrasound imaging (TUI) is used for a slice by slice documentation in different investigation planes (A-,B- or C-plane) (steps 4 and 7). The final step 8 uses the panoramic view technique (XTD-View) to document the localisation within the breast and to make the position of a lesion simply

  3. Early life exposure to diagnostic radiation and ultrasound scans and risk of childhood cancer: case-control study

    PubMed Central

    Simpson, Jill; Neta, Gila; Berrington de Gonzalez, Amy; Ansell, Pat; Linet, Martha S; Ron, Elaine; Roman, Eve

    2011-01-01

    Objective To examine childhood cancer risks associated with exposure to diagnostic radiation and ultrasound scans in utero and in early infancy (age 0-100 days). Design Case-control study. Setting England and Wales. Participants 2690 childhood cancer cases and 4858 age, sex, and region matched controls from the United Kingdom Childhood Cancer Study (UKCCS), born 1976-96. Main outcome measures Risk of all childhood cancer, leukaemia, lymphoma, and central nervous system tumours, measured by odds ratios. Results Logistic regression models conditioned on matching factors, with adjustment for maternal age and child’s birth weight, showed no evidence of increased risk of childhood cancer with in utero exposure to ultrasound scans. Some indication existed of a slight increase in risk after in utero exposure to x rays for all cancers (odds ratio 1.l4, 95% confidence interval 0.90 to 1.45) and leukaemia (1.36, 0.91 to 2.02), but this was not statistically significant. Exposure to diagnostic x rays in early infancy (0-100 days) was associated with small, non-significant excess risks for all cancers and leukaemia, as well as increased risk of lymphoma (odds ratio 5.14, 1.27 to 20.78) on the basis of small numbers. Conclusions Although the results for lymphoma need to be replicated, all of the findings indicate possible risks of cancer from radiation at doses lower than those associated with commonly used procedures such as computed tomography scans, suggesting the need for cautious use of diagnostic radiation imaging procedures to the abdomen/pelvis of the mother during pregnancy and in children at very young ages. PMID:21310791

  4. Diagnostic Accuracy of Central Venous Catheter Confirmation by Bedside Ultrasound Versus Chest Radiography in Critically Ill Patients: A Systematic Review and Meta-Analysis.

    PubMed

    Ablordeppey, Enyo A; Drewry, Anne M; Beyer, Alexander B; Theodoro, Daniel L; Fowler, Susan A; Fuller, Brian M; Carpenter, Christopher R

    2017-04-01

    We performed a systematic review and meta-analysis to examine the accuracy of bedside ultrasound for confirmation of central venous catheter position and exclusion of pneumothorax compared with chest radiography. PubMed, Embase, Cochrane Central Register of Controlled Trials, reference lists, conference proceedings and ClinicalTrials.gov. Articles and abstracts describing the diagnostic accuracy of bedside ultrasound compared with chest radiography for confirmation of central venous catheters in sufficient detail to reconstruct 2 × 2 contingency tables were reviewed. Primary outcomes included the accuracy of confirming catheter positioning and detecting a pneumothorax. Secondary outcomes included feasibility, interrater reliability, and efficiency to complete bedside ultrasound confirmation of central venous catheter position. Investigators abstracted study details including research design and sonographic imaging technique to detect catheter malposition and procedure-related pneumothorax. Diagnostic accuracy measures included pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio. Fifteen studies with 1,553 central venous catheter placements were identified with a pooled sensitivity and specificity of catheter malposition by ultrasound of 0.82 (0.77-0.86) and 0.98 (0.97-0.99), respectively. The pooled positive and negative likelihood ratios of catheter malposition by ultrasound were 31.12 (14.72-65.78) and 0.25 (0.13-0.47). The sensitivity and specificity of ultrasound for pneumothorax detection was nearly 100% in the participating studies. Bedside ultrasound reduced mean central venous catheter confirmation time by 58.3 minutes. Risk of bias and clinical heterogeneity in the studies were high. Bedside ultrasound is faster than radiography at identifying pneumothorax after central venous catheter insertion. When a central venous catheter malposition exists, bedside ultrasound will identify four out of every five earlier than

  5. Feasibility of ultrasound-guided peripheral nerve block catheters for pain control on pediatric medical missions in developing countries.

    PubMed

    Mariano, Edward R; Ilfeld, Brian M; Cheng, Gloria S; Nicodemus, Hector F; Suresh, Santhanam

    2008-07-01

    Continuous peripheral nerve blocks (CPNB) are effective for postoperative pain management in children in the hospital and at home. CPNB techniques are particularly advantageous when compared with systemic or oral opioids on medical missions to unfamiliar environments with minimal monitoring capacity. In addition, ultrasound-guidance facilitates the placement of perineural catheters in anesthetized children even in the absence of commercially packaged regional anesthesia equipment. We present a series of successful cases employing ultrasound-guided CPNB for postoperative analgesia on medical missions and discuss the impact of this technology on present and future patients in underserved countries.

  6. Diagnostic Yield of Medical Thoracoscopy in Undiagnosed Pleural Effusion

    PubMed Central

    Kiani, Arda; Karimi, Mahmoud; Samadi, Katayoun; Sheikhy, Kambiz; Farzanegan, Behrooz; Pour Abdollah, Mihan; Jamaati, Hamidreza; Jabardarjani, Hamid Reza; Masjedi, Mohammad Reza

    2015-01-01

    Background: One of the most common indications for pleuroscopy is undiagnosed pleural effusion, which comprises about 25% of all cases of pleural effusions, which remain undiagnosed despite primary tests. Pleuroscopy was performed for the first time in Iran in Masih Daneshvari hospital located in Tehran. The aim of this study was to assess the diagnostic yield of pleuroscopy performed in this center in Iran. Materials and Methods: Three-hundred patients with undiagnosed pleural effusions were enrolled in this study. For all patients, primary tests including pleural effusion analysis, cytology and closed pleural biopsy (if needed) were conducted and all of them were inconclusive. The semirigid thoracoscopy (pleuroscopy) was performed for all patients for diagnostic purposes. Results: Eighty-seven percent of the peluroscopies were diagnostic and 67% of them were diagnosed as malignancy while the rest were diagnosed as tuberculosis. Only 11 patients developed minor complications. Conclusion: In conclusion, pleuroscopy is a safe procedure when performed by a skilled and experienced practitioner; it has a high diagnostic yield and results in only minor complications. PMID:27114723

  7. Diagnostic Error in Medical Education: Where Wrongs Can Make Rights

    ERIC Educational Resources Information Center

    Eva, Kevin W.

    2009-01-01

    This paper examines diagnostic error from an educational perspective. Rather than addressing the question of how educators in the health professions can help learners avoid error, however, the literature reviewed leads to the conclusion that educators should be working to induce error in learners, leading them to short term pain for long term…

  8. Contrast-enhanced ultrasound in combination with color Doppler ultrasound can improve the diagnostic performance of focal nodular hyperplasia and hepatocellular adenoma.

    PubMed

    Kong, Wen-Tao; Wang, Wen-Ping; Huang, Bei-Jian; Ding, Hong; Mao, Feng; Si, Qin

    2015-04-01

    The aim of our study was to evaluate the value of combining color Doppler ultrasound (CDUS) with contrast-enhanced ultrasound (CEUS) in identifying and comparing features of focal nodular hyperplasia (FNH) and hepatocellular adenoma (HCA). Thirty-eight patients with FNH (n = 28) or HCA (n = 10), whose diagnoses were later confirmed by pathology, were examined with conventional ultrasonography and CEUS between 2010 and 2013. Two doctors blinded to the pathology results independently reviewed the conventional ultrasound and CEUS images and then reached a consensus through discussion. The following parameters evaluated for all lesions included vascularity pattern on CDUS or CEUS, enhancement characteristics on CEUS and the presence of a central scar. Statistical analysis was performed with the independent sample t-test and Fisher exact test. On CDUS, FNH was characterized by the presence of abundant blood flow signals exhibiting dendritic (53.6%, 15/28) and spoke-wheel (28.6%, 8/28) patterns, whereas blood flow signal of HCA was slightly less than FNH and often showed subcapsular short rod-like (50%, 5/10) appearance. On CEUS, the most common arterial enhancement pattern was centrifugal or homogeneous enhancement in FNH (both, 12/28, 42.9%) and homogeneous enhancement in HCA (6/10, 60%). Spoke-wheel arteries, feeding artery and central scar were detected in 5 (17.9%), 8 (28.6%) and 5 (17.9%) of 28 FNHs. Hypo-echogenic pattern during delayed phase was more common in HCA (60%, 6/10) than in FNH (3/28, 10.7%) (p = 0.010). A total of 25 (25/38, 65.8%) lesions were correctly assessed using CDUS in combination with CEUS, whereas the number decreased to 15 (15/38, 39.5%) when CDUS was used alone (p = 0.038). The areas under the ROC curves before and after CEUS administration were 0.768 and 0.879, respectively. In conclusion, CEUS in combination with CDUS improve the diagnostic performance of FNH and HCA. Blood signal of HCA was less than FNH on CDUS. The differences of

  9. Solid hypo-echoic thyroid nodules on ultrasound: the diagnostic value of acoustic radiation force impulse elastography.

    PubMed

    Xu, Jun-Mei; Xu, Hui-Xiong; Xu, Xiao-Hong; Liu, Chang; Zhang, Yi-Feng; Guo, Le-Hang; Liu, Lin-Na; Zhang, Jin

    2014-09-01

    The aim of the study described here was to evaluate the diagnostic performance of acoustic radiation force impulse (ARFI) elastography in the differential diagnosis between benign and malignant solid hypo-echoic thyroid nodules (SHTNs) on ultrasound. In this retrospective study, 183 histologically proven SHTNs in 159 patients were enrolled. Conventional US, as well as Virtual Touch tissue imaging (VTI) and Virtual Touch tissue quantification (VTQ) of ARFI elastography, was performed on each nodule. The VTI features of SHTNs were divided into six grades, where higher grades represent harder tissue. VTQ was expressed as shear wave velocity, where higher shear wave velocity values indicate stiffer tissue. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Youden index for ultrasound and ARFI were assessed. The 183 pathologically proven SHTNs included 117 benign and 66 malignant lesions. Nodules classified as VTI grades IV to VI were more frequently malignant (49/66, 74.2%) than benign (10/117, 8.5%) (p < 0.001). The mean shear wave velocity of VTQ for malignant SHTNs (mean ± standard deviation, 4.65 ± 2.68 m/s; range, 1.36-9 m/s) was significantly higher than that for benign SHTNs (2.34 ± 0.85 m/s, 0-5.7 m/s) (p < 0.001). The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Youden index were 27.3%-84.8%, 13.7%-89.7%, 39.3%-69.4%, 35.7%-60%, 61.5%-78.5%, and -0.015 to 0.37 for ultrasound; 68.2%, 76.9%, 73.8%, 62.5%, 81.1% and 0.451 for VTQ; and 74.2%, 91.5%, 85.2%, 83.1%, 86.3% and 0.657 for VTI, respectively. ARFI elastography performed at a superior level, compared with conventional ultrasound, in the differential diagnosis between malignant and benign SHTNs. The diagnostic performance of VTI is higher than that of VTQ.

  10. Goal-Directed Ultrasound for the Diagnosis of Long-Bone Fractures by Crew Medical Officer Analogs

    NASA Technical Reports Server (NTRS)

    Marshburn, Thomas H.; Legome, Eric; Li, James; Melton, Shannon; Sargsyan, Ashot; Noble, Vickie; Sims, Carrie; Thomsen, Todd; Peralta, Ruben; Briggs, Sue

    2002-01-01

    Current construction activities on-board the International space Station (ISS) may increase fracture incidence in space, and ultrasound (US) is the only tm-board diagnostic imaging capability. The clinical utility of US in identifying long-bone fractures is un1aowe, particularly using non-radiologist operators. We sought to determine the accuracy of US in identifying fractures of the humerus and femur, as performed by emergency medicine physicians and surgeons with minimal experience in ultrasound image acquisition and interpretation, after a standardized taming session.

  11. Evaluation of lymph node status after neoadjuvant chemotherapy in breast cancer patients: comparison of diagnostic performance of ultrasound, MRI and ¹⁸F-FDG PET/CT.

    PubMed

    You, S; Kang, D K; Jung, Y S; An, Y-S; Jeon, G S; Kim, T H

    2015-08-01

    To evaluate the diagnostic performance of ultrasound, MRI and fluorine-18 fludeoxyglucose positron emission tomography (¹⁸F-FDG PET)/CT for the diagnosis of metastatic axillary lymph node (ALN) after neoadjuvant chemotherapy (NAC) and to find out histopathological factors affecting the diagnostic performance of these imaging modalities. From January 2012 to November 2014, 191 consecutive patients with breast cancer who underwent NAC before surgery were retrospectively reviewed. We included 139 patients with ALN metastasis that was confirmed on fine needle aspiration or core needle biopsy at initial diagnosis. After NAC, 39 (28%) patients showed negative conversion of ALN on surgical specimens of sentinel lymph node (LN) or ALN. The sensitivity of ultrasound, MRI and PET/CT was 50% (48/96), 72% (70/97) and 22% (16/73), respectively. The specificity of ultrasound, MRI and PET/CT was 77% (30/39), 54% (21/39) and 85% (22/26), respectively. The Az value of combination of ultrasound and PET/CT was the highest (0.634) followed by ultrasound (0.626) and combination of ultrasound, MRI and PET/CT (0.617). The size of tumour deposit in LN and oestrogen receptor was significantly associated with the diagnostic performance of ultrasound (p < 0.001 and p = 0.009, respectively) and MRI (p = 0.045 and p = 0.036, respectively). The percentage diameter decrease, size of tumour deposit in LN, progesterone receptor, HER2 and histological grade were significantly associated with the diagnostic performance of PET/CT (p = 0.023, p = 0.002, p = 0.036, p = 0.044 and p = 0.008, respectively). On multivariate logistic regression analysis, size of tumour deposit within LN was identified as being independently associated with diagnostic performance of ultrasound [odds ratio, 13.07; 95% confidence interval (CI), 2.95-57.96] and PET/CT (odds ratio, 6.47; 95% CI, 1.407-29.737). Combination of three imaging modalities showed the highest sensitivity, and PET

  12. Diagnostic accuracy of contrast-enhanced ultrasound for the differential diagnosis of hepatocellular carcinoma: ESCULAP versus CEUS-LI-RADS.

    PubMed

    Schellhaas, Barbara; Görtz, Ruediger S; Pfeifer, Lukas; Kielisch, Christian; Neurath, Markus F; Strobel, Deike

    2017-09-01

    A comparison is made of two contrast-enhanced ultrasound (CEUS) algorithms for the diagnosis of hepatocellular carcinoma (HCC) in high-risk patients: Erlanger Synopsis of Contrast-enhanced Ultrasound for Liver lesion Assessment in Patients at Risk (ESCULAP) and American College of Radiology Contrast-Enhanced Ultrasound-Liver Imaging Reporting and Data System (ACR-CEUS-LI-RADSv.2016). Focal liver lesions in 100 high-risk patients were assessed using both CEUS algorithms (ESCULAP and CEUS-LI-RADSv.2016) for a direct comparison. Lesions were categorized according to size and contrast enhancement in the arterial, portal venous and late phases.For the definite diagnosis of HCC, categories ESCULAP-4, ESCULAP-Tr and ESCULAP-V and CEUS-LI-RADS-LR-5, LR-Tr and LR-5-V were compared. In addition, CEUS-LI-RADS-category LR-M (definitely/probably malignant, but not specific for HCC) and ESCULAP-category C [intrahepatic cholangiocellular carcinoma (ICC)] were compared.Histology, CE-computed tomography and CE-MRI served as reference standards. The reference standard among 100 lesions included 87 HCCs, six ICCs and seven non-HCC-non-ICC-lesions. For the diagnosis of HCC, the diagnostic accuracy of CEUS was significantly higher with ESCULAP versus CEUS-LI-RADS (94.3%/72.4%; p<0.01). Sensitivity, specificity and positive predictive value (PPV) and negative predictive value for ESCULAP/CEUS-LI-RADS were 94.3%/72.4%; 61.5%/69.2%; 94.3%/94%; and 61.5%/27.3%, respectively.The diagnostic accuracy for ICC (LR-M/ESCULAP-C) was identical with both algorithms (50%), with higher PPV for ESCULAP-C versus LR-M (75 vs. 50%). CEUS-based algorithms contribute toward standardized assessment and reporting of HCC-suspect lesions in high-risk patients. ESCULAP shows significantly higher diagnostic accuracy, sensitivity and negative predictive value with no loss of specificity compared with CEUS-LI-RADS. Both algorithms have an excellent PPV. Arterial hyperenhancement is the key feature for the

  13. Diagnostic radiography and adult acute myeloid leukaemia: an interview and medical chart review study

    PubMed Central

    Pogoda, J M; Nichols, P W; Ross, R K; Stram, D O; Thomas, D C; Preston-Martin, S

    2011-01-01

    Background: Aetiology of acute myeloid leukaemia (AML) is not well understood, perhaps because of its distinct subtypes. High-dose ionising radiation is a known risk factor, but less is known about risk from low-dose exposure such as from diagnostic radiography. Methods: Subjects were 412 matched case-control pairs. Ten-year subject histories of diagnostic radiography were based on interview and medical records. Results: There was no convincing association between AML risk and ionising radiation exposure from diagnostic imaging procedures, either for AML overall or for any AML subtype. Conclusion: The association between diagnostic radiography and AML risk remains uncertain. PMID:21522150

  14. Engineering considerations for integrating laser angioplasty with ultrasound diagnostics in a single device

    NASA Astrophysics Data System (ADS)

    Passafaro, James D.; Zalesky, Paul J.

    1990-07-01

    The application of direct laser energy for the ablation of atherosclerotic plaque has been investigated extensively. It has been recognized that the need for an onboard guidance capability which can direct the laser energy is essential for controlled plaque removal. Intravascular ultrasound represents one approach for identifying diseased tissue and directing laser therapy. The design of a catheter with combined laser and ultrasound capabilities is discussed. The design considers the optical and acoustical requirements. In addition, vascular anatomical constraints and their impact on the mechanical aspects of the device configuration are considered. The optical considerations dictate safe and predictable high energy laser transmission. The acoustic requirements consider material properties and ultrasonic beam resolution. The vascular anatomy imposes constraints on maximum catheter size and it requires a means for conventional delivery of the device to the targeted lesion.

  15. Eigenspace-Based Generalized Sidelobe Canceler Beamforming Applied to Medical Ultrasound Imaging

    PubMed Central

    Li, Jiake; Chen, Xiaodong; Wang, Yi; Li, Wei; Yu, Daoyin

    2016-01-01

    The use of a generalized sidelobe canceler (GSC) can significantly improve the lateral resolution of medical ultrasound systems, but the contrast improvement isn’t satisfactory. Thus a new Eigenspace-based generalized sidelobe canceler (EBGSC) approach is proposed for medical ultrasound imaging, which can improve both the lateral resolution and contrast of the system. The weight vector of the EBGSC is obtained by projecting the GSC weight vector onto a vector subspace constructed from the eigenstructure of the covariance matrix, and using the new weight vector instead of the GSC ones leads to reduced sidelobe level and improved contrast. Simulated and experimental data are used to evaluate the performance of the proposed method. The Field II software is applied to obtain the simulated echo data of scattering points and circular cysts. Imaging of scattering points show that EBGSC has the same full width at half maximum (FWHM) as GSC, while the lateral resolution improves by 35.3% and 52.7% compared with synthetic aperture (SA) and delay-and-sum (DS), respectively. Compared with GSC, SA and DS, EBGSC improves the peak sidelobe level (PSL) by 23.55, 33.11 and 50.38 dB, respectively. Also the cyst contrast increase by EBGSC was calculated as 16.77, 12.43 and 26.73 dB, when compared with GSC, SA and DS, respectively. Finally, an experiment is conducted on the basis of the complete echo data collected by a medical ultrasonic imaging system. Results show that the proposed method can produce better lateral resolution and contrast than non-adaptive beamformers. PMID:27483272

  16. Eigenspace-Based Generalized Sidelobe Canceler Beamforming Applied to Medical Ultrasound Imaging.

    PubMed

    Li, Jiake; Chen, Xiaodong; Wang, Yi; Li, Wei; Yu, Daoyin

    2016-07-28

    The use of a generalized sidelobe canceler (GSC) can significantly improve the lateral resolution of medical ultrasound systems, but the contrast improvement isn't satisfactory. Thus a new Eigenspace-based generalized sidelobe canceler (EBGSC) approach is proposed for medical ultrasound imaging, which can improve both the lateral resolution and contrast of the system. The weight vector of the EBGSC is obtained by projecting the GSC weight vector onto a vector subspace constructed from the eigenstructure of the covariance matrix, and using the new weight vector instead of the GSC ones leads to reduced sidelobe level and improved contrast. Simulated and experimental data are used to evaluate the performance of the proposed method. The Field II software is applied to obtain the simulated echo data of scattering points and circular cysts. Imaging of scattering points show that EBGSC has the same full width at half maximum (FWHM) as GSC, while the lateral resolution improves by 35.3% and 52.7% compared with synthetic aperture (SA) and delay-and-sum (DS), respectively. Compared with GSC, SA and DS, EBGSC improves the peak sidelobe level (PSL) by 23.55, 33.11 and 50.38 dB, respectively. Also the cyst contrast increase by EBGSC was calculated as 16.77, 12.43 and 26.73 dB, when compared with GSC, SA and DS, respectively. Finally, an experiment is conducted on the basis of the complete echo data collected by a medical ultrasonic imaging system. Results show that the proposed method can produce better lateral resolution and contrast than non-adaptive beamformers.

  17. Nonlinear effects in ultrasound fields of diagnostic-type transducers used for kidney stone propulsion: Characterization in water

    NASA Astrophysics Data System (ADS)

    Karzova, M.; Cunitz, B.; Yuldashev, P.; Andriyakhina, Y.; Kreider, W.; Sapozhnikov, O.; Bailey, M.; Khokhlova, V.

    2015-10-01

    Newer imaging and therapeutic ultrasound technologies require higher in situ pressure levels compared to conventional diagnostic values. One example is the recently developed use of focused ultrasonic radiation force to move kidney stones and residual fragments out of the urinary collecting system. A commercial diagnostic 2.3 MHz C5-2 array probe is used to deliver the acoustic pushing pulses. The probe comprises 128 elements equally spaced at the 55 mm long convex cylindrical surface with 38 mm radius of curvature. The efficacy of the treatment can be increased by using higher intensity at the focus to provide stronger pushing force; however, nonlinear acoustic saturation can be a limiting factor. In this work nonlinear propagation effects were analyzed for the C5-2 transducer using a combined measurement and modeling approach. Simulations were based on the 3D Westervelt equation; the boundary condition was set to match the focal geometry of the beam as measured at a low power output. Focal waveforms simulated for increased output power levels were compared with the fiber-optic hydrophone measurements and were found in good agreement. It was shown that saturation effects do limit the acoustic pressure in the focal region of the transducer. This work has application to standard diagnostic probes and imaging.

  18. Nonlinear effects in ultrasound fields of diagnostic-type transducers used for kidney stone propulsion: Characterization in water

    SciTech Connect

    Karzova, M.; Cunitz, B.; Kreider, W.; Bailey, M.; Yuldashev, P.; Andriyakhina, Y.; Sapozhnikov, O.; Khokhlova, V.

    2015-10-28

    Newer imaging and therapeutic ultrasound technologies require higher in situ pressure levels compared to conventional diagnostic values. One example is the recently developed use of focused ultrasonic radiation force to move kidney stones and residual fragments out of the urinary collecting system. A commercial diagnostic 2.3 MHz C5-2 array probe is used to deliver the acoustic pushing pulses. The probe comprises 128 elements equally spaced at the 55 mm long convex cylindrical surface with 38 mm radius of curvature. The efficacy of the treatment can be increased by using higher intensity at the focus to provide stronger pushing force; however, nonlinear acoustic saturation can be a limiting factor. In this work nonlinear propagation effects were analyzed for the C5-2 transducer using a combined measurement and modeling approach. Simulations were based on the 3D Westervelt equation; the boundary condition was set to match the focal geometry of the beam as measured at a low power output. Focal waveforms simulated for increased output power levels were compared with the fiber-optic hydrophone measurements and were found in good agreement. It was shown that saturation effects do limit the acoustic pressure in the focal region of the transducer. This work has application to standard diagnostic probes and imaging.

  19. WE-D-18C-01: Art of Imaging: Diagnostic Ultrasound Image Artifacts

    SciTech Connect

    Zagzebski, J; Lu, Z

    2014-06-15

    Assumptions followed during construction of B-mode and color flow images are that the pulse-echo transit time can be converted to reflector depth through uniform tissue models, echoes originate only from locations along the transmit-receive axes of pulse propagation, and first order correction schemes adequately account for acoustic wave attenuation and absorption. The latter allows the display brightness to encode tissue echogenicity. This course will challenge participants to identify imaging artifacts whose origins stem from the more complex and realistic propagating and scattering conditions common in clinical ultrasound. Speckle, a very common artifact but a clinically employed feature, originates from simultaneous echoes from diffuse scatterers and is a result of coherent detection of signals. One of the most bothersome artifacts are those due to reverberations especially that originating from superficial tissue interfaces. Methods to overcome these will be discussed. This presentation also will describe and illustrate speed of sound, refraction, enhancement, shadowing, mirroring, beam width, beam-forming, and slice thickness artifacts. All are useful examples of limitations introduced by acoustic waves propagating through complex tissue paths. New formats for physician board certification exams are demanding the inclusion of image-based examples of ultrasound physics. Instructors' knowledge of, and access to examples of ultrasound artifacts are important in this effort. The presentation will incorporate an audience response system to challenge participants in correct identification of some of these artifacts. Learning Objectives: Review basic mechanisms for producing ultrasound images. Identify the etiology of speckle, reverberation noise, beam width and slice thickness artifacts, and artifacts associated with pulse propagation. Discuss methods that reduce the impact of artifacts OR employ artifacts effectively to facilitate clinical diagnosis.

  20. Consistency check of diagnostic ultrasound transducer arrays using tissue-equivalent phantoms

    NASA Astrophysics Data System (ADS)

    Wolter, Steffen; Kopp, Andreas; Liebscher, Eckhard; Rosenfeld, Eike

    2012-05-01

    Measurements at two different types of Phantoms - a classic thread phantom and a 3D cyst phantom - were carried out to assess the technical quality of ultrasound B-scan systems. Using statistical methods we examined whether the phantoms are suitable for a consistency test of the transducer arrays. Based on simulated transducer failures it was found that in particular the detection of local of element failures in arrays turned out to be problematic.

  1. The Future of Medical Diagnostics: Large Digitized Databases

    PubMed Central

    Kerr, Wesley T.; Lau, Edward P.; Owens, Gwen E.; Trefler, Aaron

    2012-01-01

    The electronic health record mandate within the American Recovery and Reinvestment Act of 2009 will have a far-reaching affect on medicine. In this article, we provide an in-depth analysis of how this mandate is expected to stimulate the production of large-scale, digitized databases of patient information. There is evidence to suggest that millions of patients and the National Institutes of Health will fully support the mining of such databases to better understand the process of diagnosing patients. This data mining likely will reaffirm and quantify known risk factors for many diagnoses. This quantification may be leveraged to further develop computer-aided diagnostic tools that weigh risk factors and provide decision support for health care providers. We expect that creation of these databases will stimulate the development of computer-aided diagnostic support tools that will become an integral part of modern medicine. PMID:23012584

  2. Examining Shifts in Medical Students' Microanalytic Motivation Beliefs and Regulatory Processes during a Diagnostic Reasoning Task

    ERIC Educational Resources Information Center

    Cleary, Timothy J.; Dong, Ting; Artino, Anthony R., Jr.

    2015-01-01

    This study examined within-group shifts in the motivation beliefs and regulatory processes of second-year medical students as they engaged in a diagnostic reasoning activity. Using a contextualized assessment methodology called self-regulated learning microanalysis, the authors found that the 71 medical student participants showed statistically…

  3. Simple fractal method of assessment of histological images for application in medical diagnostics

    PubMed Central

    2010-01-01

    We propose new method of assessment of histological images for medical diagnostics. 2-D image is preprocessed to form 1-D landscapes or 1-D signature of the image contour and then their complexity is analyzed using Higuchi's fractal dimension method. The method may have broad medical application, from choosing implant materials to differentiation between benign masses and malignant breast tumors. PMID:21134258

  4. A De-Identification Pipeline for Ultrasound Medical Images in DICOM Format.

    PubMed

    Monteiro, Eriksson; Costa, Carlos; Oliveira, José Luís

    2017-05-01

    Clinical data sharing between healthcare institutions, and between practitioners is often hindered by privacy protection requirements. This problem is critical in collaborative scenarios where data sharing is fundamental for establishing a workflow among parties. The anonymization of patient information burned in DICOM images requires elaborate processes somewhat more complex than simple de-identification of textual information. Usually, before sharing, there is a need for manual removal of specific areas containing sensitive information in the images. In this paper, we present a pipeline for ultrasound medical image de-identification, provided as a free anonymization REST service for medical image applications, and a Software-as-a-Service to streamline automatic de-identification of medical images, which is freely available for end-users. The proposed approach applies image processing functions and machine-learning models to bring about an automatic system to anonymize medical images. To perform character recognition, we evaluated several machine-learning models, being Convolutional Neural Networks (CNN) selected as the best approach. For accessing the system quality, 500 processed images were manually inspected showing an anonymization rate of 89.2%. The tool can be accessed at https://bioinformatics.ua.pt/dicom/anonymizer and it is available with the most recent version of Google Chrome, Mozilla Firefox and Safari. A Docker image containing the proposed service is also publicly available for the community.

  5. Fluorocarbon compounds in MRI diagnostics and medical therapy