Irreversible electroporation (IRE) is an innovative non-thermal ablation technique increasingly utilized in cancer treatment due to its unique operational principles and clinical advantages. As a novel interventional ultrasound technology, IRE has undergone extensive research, development, and practical application over the years. IRE ablation, particularly in conjunction with immunotherapy, has emerged as a significant modality in cancer treatment and related fields. This article aims to present the advancements in irreversible electroporation ablation for cancer through an examination of both basic research and clinical applications.

Cancer, one of the leading causes of global mortality, arises from dysregulated cellular processes that create an immunosuppressive tumor microenvironment (TME), promoting immune evasion and therapeutic resistance. While immunotherapy activates the immune system to combat tumors and provide durable benefits, its efficacy is often constrained by the hostile TME. Focused ultrasound (FUS) has emerged as a non-invasive, and precise therapeutic modality capable of mechanically or thermally ablating solid tumors. This review discusses the dual mechanisms of FUS—thermal ablation (T-HIFU) and mechanical disruption (M-HIFU, e.g., histotripsy)—and their role in modulating the TME. Specifically, it examines how FUS-induced immune activation can overcome immunosuppressive barriers, promote T-cell infiltration, and synergize with immunotherapy to improve outcomes in solid tumors, while also highlighting current challenges and future directions.

Objective Plantar fascia (PF) is a thick connective tissue on the plantar surface of the foot that plays a crucial role in maintaining the longitudinal arch. Plantar fasciitis, characterized by inflammation of the medial tuberosity of the calcaneus, is one of the most common causes of heel pain. Imaging is essential for accurate diagnosis, with ultrasonography widely applied to evaluate PF thickness, monitor therapeutic outcomes, and guide interventions. However, its application is limited by operator dependency. This study aimed to investigate the inter- and intra-rater reliability of musculoskeletal ultrasound in measuring PF thickness in patients with plantar fasciitis.
Methods In this cross-sectional analytical study, 40 participants were enrolled, including 26 females and 14 males. The reliability of PF measurements on different sides was assessed using Cronbach’s alpha and intraclass correlation coefficients (ICC).
Results A total of 40 participants (age range: 20-60 years) were included in the study. PF thickness in patients with plantar fasciitis measured by Observer 1 ranged from 3.8-6.9 mm (left) and 3.2-6.0 mm (right), whereas measurements by Observer 2 ranged from 2.9-7.1 mm (left) and 3.2-6.0 mm (right). Intra-rater reliability showed ICCs ranging from 0.618-0.857 for Observer 1 and 0.76-0.92 for Observer 2, indicating moderate (> 0.60) to excellent reliability.
Conclusion PF is a deep structure, and its visualization may be influenced by operator technique. Ultrasound measurement of tendon thickness shows good reliability in patients with established plantar fasciitis.

Objectives Conventional ultrasound (US) elastography lacks specificity in distinguishing benign from malignant breast lesions. This study employed US to assess breast tissue viscosity and elasticity. The primary objective was to evaluate the diagnostic performance of US-derived viscoelasticity parameters. Secondary objectives included investigating the consistency of parameters in the mechanical properties of breast tissue.
Materials and methods Two doctors independently measured the viscosity and elasticity of specific positions in the breasts of 20 health females for consistency assessment. Then the doctors selected region of interest (ROI) to measure viscoelasticity. ROI-1, ROI-2, and ROI-3 represent the tumor, peritumoral, and peripheral areas, respectively. The viscosity modulus and elasticity modulus of 3 ROIs were analyzed. The viscosity and elasticity parameters with the highest area under the curve (AUC) were selected as the optimal ones. Finally, elasticity and viscosity parameters were combined to assess their diagnostic performance in differentiating breast lesions.
Results US viscoelasticity parameters can be measured with high consistency. Among conventional US elasticity parameters, 1-Emax demonstrated the highest AUC (0.746) for differentiating benign and malignant breast lesions. In US viscoelasticity parameters, 2-Emax achieved the highest AUC of 0.801, while 2-Vmax showed the highest AUC of 0.835. The highest specificity (0.903) was observed when both 2-Emax and 2-Vmax exceeded their respective cutoff values (P < 0.05 for all).
Conclusion Quantitative ultrasound viscoelasticity parameters play a crucial role in breast cancer diagnosis, with tumor boundary parameters being particularly significant for cancer screening and prevention strategies.

Objective It is always a clinical challenge to identify neonatal pulmonary hypertension (NPH). Although the diagnostic gold standard of pulmonary hypertension (PH) is the true measurement of resting pulmonary arterial pressure (PAP) through cardiac catheterization, it is inappropriate for delicate newborns. Hence, echocardiography examination has become the most common inspection tool for NPH despite its limitations.
Methods After outlining the conventional echocardiographic parameters for detecting NPH and their drawbacks in newborns, this review mainly discussed the roles of two-dimensional speckle tracking echocardiography, including RV global longitudinal strain and segmental longitudinal strain, in the evaluation of NPH, hoping to provide more information for detecting NPH.
Results When combined with conventional echocardiographic parameters, RV longitudinal strain would be a great help for the evaluation of NPH. Furthermore, based on the preliminary research, our finding revealed that the magnitude of the apical segmental strain of RVFW was significantly lower, and the basal-to-apical strain ratio (Ratio bas/api) of RVFW was remarkably higher in infants with PH than those without PH.
Conclusion Based on the particularity of newborns, neonatal echocardiography is the preferred inspection method for NPH. It provides hemodynamic, morphological and functional information for evaluating NPH. RV longitudinal strain is sensitive to subtle changes of RV function and closely related to PH. It could be considered not only as the key factor affecting the prognosis of NPH but also as a potential index to detect and identify NPH.

Objective To improve infant outcomes and guide treatment decisions, early and accurate diagnosis of congenital abnormalities during pregnancy is crucial. Despite its excellent accuracy, chorionic villus sampling (CVS) has procedural dangers; sonography offers a non-invasive, safer substitute. With an emphasis on clinical value, safety, and diagnostic accuracy, this evaluation assesses how well sonography performs in identifying congenital diseases prior to 12 weeks of gestation when compared to CVS.
Methods A comprehensive review of the literature was conducted using databases such as Web of Science, PubMed, and Scopus. Studies published between 2015 and 2024 that examined the diagnostic sensitivity, specificity, and accuracy of sonography and CVS for congenital illness identification were included.
Results With a sensitivity of 85-90%, sonography shows excellent accuracy in identifying anatomical abnormalities such organ malformations and nuchal translucency. Although CVS has a 0.5-1% chance of miscarriage, it is still the gold standard for identifying chromosomal abnormalities with an accuracy of around 99%. Combining the two modalities reduces hazards while improving diagnostic accuracy.
Conclusion For low-risk populations in particular, sonography provides a dependable, non-invasive screening method for congenital abnormalities prior to 12 weeks. For high-risk instances that need genetic investigation, CVS is advised. Integration of both approaches could optimize prenatal diagnostic protocols.

Objective Aortic stenosis (AS), a prevalent valvular disease, demands accurate diagnosis. Current methods, notably Doppler echocardiography, face limitations like dynamic image challenges and reliance on cardiologist experience. To assess aortic stenosis, measuring the LVOT diameter is critical, as a 1 mm difference can result in a 10% variation in stroke volume. Accurate Doppler beam alignment and LVOT VTI measurement are also essential to avoid errors. Our study, utilizing the TMED 2 dataset, introduces a novel artificial intelligence program for precise aortic stenosis diagnosis. By leveraging AI, we aim to overcome existing constraints and significantly enhance diagnostic accuracy.
Methods a novel method that involves using convolutional neural networks (CNNs), were used to grade AS based on various views of transthoracic echocardiography (TTE) images from the TMED 2 dataset. This innovative method aimed to take advantage of CNN’s abilities to recognize detailed patterns in echocardiographic data, making AS diagnosis more accurate. We evaluated the performance of our CNN models using confusion metrics and the area under the receiver operator curve (AUROC).
Results Our CNN networks were trained on a dataset comprising view_and_diagnosis_labeled_set, which included 599 studies from 577 unique patients (some with multiple studies on distinct days). For classification, we chose three classes: no aortic stenosis, aortic stenosis, and mild aortic stenosis. The detection of aortic stenosis achieved an accuracy of 85.74%. External validation using three views (PLAX, PSAX, and A4C) of outpatient transthoracic echocardiograms demonstrated effective screening for AS, yielding respective AUROCs of 0.81, 0.88, and 0.48.
Conclusion Our novel CNN-based approach achieved an 85,74% accuracy in AS detection using diverse views from the TMED 2 dataset. External validation on outpatient echocardiograms demonstrated robust screening capabilities, with AUROCs of 0.81, 0.88, and 0.48 for PLAX, PSAX, and A4C views, respectively. These promising results suggest the potential of AI in improving AS diagnosis for clinical applications. Moving forward, our future endeavors will focus on addressing data imbalances and detecting the view of images, in addition to assessing the severity of aortic stenosis, to further refine and optimize our diagnostic approach.

Objective To compare fetal cardiac morphology and function between small-for-gestational-age (SGA) and appropriate-for-gestational-age (AGA) fetuses using two-dimensional speckle-tracking echocardiography (2D-STE), and to evaluate global longitudinal strain (GLS), global sphericity index (GSI), and fractional area change (FAC) in both ventricles with FetalHQ software.
Methods This cross-sectional observational study included 101 pregnant women, comprising 36 with SGA and 65 with AGA fetuses. Five- to fifteen-second four-chamber view (4CV) cine loops of the fetal heart were acquired and analysed using fetal heart quantification and speckle tracking (FetalHQ) software. GLS, GSI, and FAC of both left ventricle (LV) and right ventricle (RV) were measured.
Results SGA fetuses demonstrated significantly lower GSI values, consistent with a more globular cardiac shape. LV-FAC and RV-FAC were significantly lower in SGA compared with AGA fetuses, reflecting impaired systolic function. Both LV-GLS and RV-GLS values were significantly higher (less negative) in the SGA group, indicating early biventricular systolic dysfunction. These findings align with previously reported adaptive responses of the fetal myocardium to chronic hypoxia.
Conclusion The study highlights distinct alterations in fetal cardiac morphology and function between SGA and AGA groups. FetalHQ-based deformation analysis may potentially detect subclinical biventricular dysfunction in SGA fetuses before Doppler abnormalities become apparent, offering potential for earlier clinical intervention and closer monitoring.

Objective Uterine and ovarian development is influenced by both age and hormonal milieu. Sonographic assessment of normal pubertal and pre-puberty girls provides critical insights into the physiological trajectory of female gonadal maturation and its potential pathological deviations.
Methods This was a cross-sectional study conducted at Gilani Ultrasound Center, Lahore, Pakistan. The duration of the study was 9 months. Uterus length, width, height, volume, right/left ovary volume and Fundo/Cervical ratio were measured.
Results A total of 384 subjects were included in our study, categorizing them into pre-puberty (age 2-6 years), early puberty (age 7-11 years), and late puberty (age 12-18 years) groups. In the pre-puberty group (n = 111, mean age 4.29 ± 1.20 years), uterine measurements revealed a mean length of 2.95 cm, height of 0.97 cm, width of 1.41 cm, and volume of 4.82 cm³. The mean volumes of the right and left ovaries were 1.24 cm³ and 1.10 cm³, respectively, with a mean F/C ratio of 1.33. For the early puberty group (n = 99, mean age 9.15 ± 1.45 years), uterine measurements included a mean length of 4.03 cm, height of 1.22 cm, width of 1.80 cm, and volume of 12.37 cm³. In the late puberty group (n = 31, mean age 12.63 ± 1.21 years), uterine measurements showed a mean length of 5.29 cm, height of 1.82 cm, width of 2.65 cm, and volume of 31.11 cm³. The mean volumes of the right and left ovaries were 4.70 cm³ and 5.26 cm³, respectively, with a mean F/C ratio of 1.26.
Conclusion Uterine and ovarian dimensions, including volumes, correlate directly with age and pubertal status, except for the (Fundus/Cervical) ratio, which shows individual variability. This normative data could serve as a basis for the evaluation of Uterine and ovarian dimensions and volume in the local population.

Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications of diabetes, which can lead to neuropathic pain, foot ulcers, and even disability, and greatly reduces survival. Therefore, early diagnosis and prevention of DPN is of great importance to reduce symptoms and disability rate. Ultrasound elastography is a noninvasive method to evaluate changes in nerve tissue composition by obtaining the elastic modulus of tissue and visually displaying the stiffness in the form of images. This paper summarizes the application progress of ultrasound elastography in the evaluation of peripheral neuropathy in recent years, in order to provide reference for the future clinical application of large samples.

Interventional ultrasound (IUS) is an important branch of modern minimally invasive medicine that has been widely applied in clinical practice due to its unique techniques and advantages. As a relatively emerging field, IUS has progressed towards standardization, precision, intelligence, and cutting-edge directions alone with more than 40 years of development, which is becoming increasingly important techniques in clinical medicine. This article will briefly review the development and advancement of IUS for diagnosis and treatment in China in the era of precision medicine from the aspects of artificial intelligence, virtual navigation, molecular imaging, and nanotechnology.

The American College of Radiology has implemented the Liver Imaging Reporting and Data System (LI-RADS) to help detect, interpret, and guide the management of suspected lesions on surveillance imaging for hepatocellular carcinoma (HCC) in patients with cirrhosis. The classification of indeterminate nodules with a grading algorithm can be used for multiple imaging modalities (US, CT, and MRI) and incorporates multiple imaging features to appropriately classify observations with different likelihood of being HCC. Contrast-enhanced ultrasound (CEUS) LI-RADS has been fully implemented since 2017. The aim of this pictorial article is to provide a comprehensive review of CEUS LI-RADS utilization, discuss its advantages, and highlight areas for potential improvement.

ChatGPT is attracting widespread attention from all walks of life with its excellent multi-round dialogue ability and strong user intent understanding ability, triggering a new wave of artificial intelligence. From the perspective of technical analysis, this article sorts out the various related technologies used in the GPT (Generative Pre-training Transformer) series models as well as large-scale multimodal models, which are more powerful and perform better in multiple downstream tasks. Meanwhile, we guide users to use LLM (Large Language Model) along with GPT more scientifically to maximize their potential. Finally, we analyze the application prospect of the GPT as well as the large-scale multimodal models in the medical field, and the problems are discussed from the perspectives of the risks and limitations of large-scale models applied into the medical field.

Objective To evaluate the feasibility and capability of UT in detecting musculoskeletal system lesions in the limbs and to explore its image quality.

Materials and Methods The Institutional Review Board has approved this prospective single-center study. This study included participants with various musculoskeletal and neurologic disorders in the limbs who provided written consent from October 2022 to April 2023. In addition to other radiological examinations (X-rays, CT, or MRI) and conventional handheld ultrasound scans requested by clinicians based on the conditions, each participant also underwent UT scanning using our developed limb ultrasound imaging system during the same period. Four radiologists and ultrasound physicians with more than five years of experience in musculoskeletal diagnostics analyzed the two-dimensional and three-dimensional images of the examination area.

Results Overall, 50 participants were evaluated (mean age, 36 years ± 18 [SD]; 26 males). The conditions included musculoskeletal tumors (n = 10), postoperative follow-up of musculoskeletal tumors (n = 20), peripheral nerve disorders in the limbs (n = 10) and postoperative pain in orthopedic surgery (n = 10). In all UT images, the region of interest was completely displayed, and internal structures such as muscles and nerves were clearly visible. Compared to conventional ultrasound images, the reconstructed three-dimensional images intuitively displayed the relationship between the lesions and surrounding tissues. Furthermore, UT did not exhibit metal artifacts when observing soft tissues around metallic implants, providing more comprehensive soft tissue information and more intuitive stereoscopic images.

Conclusion Clinical results of the UT system have demonstrated its feasibility as an automated and standardized imaging technique for musculoskeletal imaging, providing a new imaging modality for the diagnosis of musculoskeletal diseases in the human body.

Objective To investigate the effectiveness of SMI in evaluating hepatic IRI and detecting its therapy response.

Methods Thirty rats were randomly divided into sham (n = 12), IRI (n = 12), and andrographolide pretreatment (n = 6) groups. SMI, pathological, and biochemical examinations were conducted for the sham and IRI groups at 4 (n = 6) and 24 h (n = 6) after reperfusion, respectively. Two ultrasonologists measured the vascular index (VI). The interobserver agreement was evaluated using the intraclass correlation coefficient (ICC). The rat liver parameters, including Suzuki's score, alanine aminotransferase (ALT), and aspartate aminotransferase (AST), were obtained at different time steps in each group. For the andrographolide pretreatment group, data were obtained at 24 h after reperfusion to further verify the advantage of VI. Parameters were analyzed for correlations and compared between each group at 4 and 24 h.

Results The ICC between two ultrasonologists who measured the VI was 0.912 (95%CI: 0.889-0.940). Suzuki's score and VI were negatively correlated (r = -0.504, P = 0.012). Compared with the sham group, the IRI group showed a significant decrease in the VI at 4 and 24 h after reperfusion [(24.78 ± 3.23) versus (20.22 ± 2.55); (22.67 ± 1.36) versus (19.27 ± 2.23), P < 0.05)]. The VI in the andrographolide pretreatment group was higher than that in the IRI group [(21.90 ± 1.47) versus (19.27 ± 2.23), P <0.05].

Conclusions The VI on SMI can be used as a noninvasive and sensitive index to evaluate hepatic IRI and detect its therapeutic response.

With the development of network technology and intelligent robot technology, Robot-assisted teleultrasound has played an important role in clinical fields. The application of real-time remote ultrasound technology has made the ultrasonic diagnosis break through the limitation of time and space distance, and solved the problem of shortage of medical resources to a certain extent. This article introduces the development and application basis of robot-assisted teleultrasound, summarizes the clinical application status, and discusses the advantages and limitations of its current application. In addition, we discuss the value in application scenario, interventional therapy and intracavitary ultrasound in the future.

Ultrasound is a commonly used imaging modality for breast cancer diagnosis and prognosis but suffers from false positives, false negatives and interobserver variability. Deep learning (DL), a subset of artificial intelligence, has the potential to improve the efficiency and accuracy of breast ultrasound. This article provides a comprehensive overview of DL applications for breast cancer diagnosis and treatment in ultrasound, including methodological descriptions of various DL models, and clinical applications on noise reduction, lesion localization, risk assessment, diagnosis, response evaluation and outcome prediction. Furthermore, the review highlights the importance of interpretability and small sample size learning of DL-based systems in clinical practice; specific recommendations for further expanding the clinical impact of DL-based systems are also provided.

Objectives To measure the CSA of the HST musculature measured with ultrasonography in soccer players undergoing ACLR and compare limb differences with healthy controls.

Methods A case-control study was performed with patients after anterior cruciate ligament repair (ACLR) and healthy controls in which cross-sectional areas (CSA) obtained using a model TE7 ultrasound machine (MINDRAY ®, USA) in B mode (4.2 to 13 MHz) with a multifrequency linear array transducer (L12-4S). Three CSA images were taken of the semitendinosus muscle (ST) and the long head of the biceps femoris (BFlh), at a distance of 30% and 70% of the ischial tuberosity insertion. Mean differences between groups were analyzed using SPSS v.20 (IBM®, USA), and statistical analyses were performed using non-parametric techniques to determine differences between groups (Student's t-test) and Cohen's correlation coefficient to quantify effect size.

Results 14 ACLR operated 17 ± 5.4 months ago and 12 healthy controls (W = 6; M = 20M; 24.5 ± 3.92 years; BMI = 25.1 ± 2.32 kg/m²) were recruited. There were differences between groups in CSA-ST70 (Post-ACLR = 1.43 ± 1.029 cm² vs Control 2.65 ± 0.664 cm², T Student = -3.68, 95% CI [-Inf, -0.648], P < 0. 001, ES = -1.418), but not in CSA-ST30 (Post-ACLR = 8.42 ± 1.596 cm² vs Control 9.16 ± 0.945 cm², T Student = -1.535; 95% CI [-Inf, -0.0793], P = 0. 068, ES = -0.5607), CSA-BFlh30 (Post-ACLR = 8.79 ± 1.47 cm² vs Control 8.87 ± 2.312 cm², T Student = -0.123; 95% CI [-Inf, 1.1049], P = 0.452, ES = -0. 049) or CSA-BFlh70 (Post-ACLR = 6.91 ± 1.011 cm² vs Control 7.01 ± 1.453 cm², T Student = -0.214; 95% CI [-Inf, 0.6795], P = 0.416, ES = -0.0783).

Conclusion Ultrasound measurement of the CSA can be an image marker to identify muscle weakness or atrophy that predicts functional loss early.

Early detection of vascular disease is fundamental to the prevention and treatment of systemic vascular lesions. The timely identification of vascular damage can be achieved by comprehensively assessing the structural anomaly and/or functional degeneration of the vasculature. The assessment may to some extent indicate the long-term detrimental effects of cardiovascular disease (CVD) risk factors on vascular health. A key aspect in the evaluation of vascular function is the measurement of arterial stiffness. In 2012, the arterial velocity-pulse index (AVI) and arterial pressure-volume index (API) were introduced, which are noninvasively measured with a brachial cuff, and can reflect the status of arterial stiffness in both the aorta and the brachial artery. A large number of relevant studies have demonstrated the strong associations between AVI/API and various CVD risk factors, underlining the substantial relevance of the indices in CVD risk assessment. In this review, we provide a systematic review of the progresses made in brachial cuff-based measurements of arterial stiffness. In addition, we summarize the results of the recent studies focused on exploring the associations of AVI/API with relevant risk factors as well as their roles in CVD assessment.

Real-time intelligent segmentation of ultrasound video object is a demanding task in the field of medical image processing and serves as an essential and critical step in image-guided clinical procedures. However, obtaining reliable and accurate medical image annotations often necessitates expert guidance, making the acquisition of large-scale annotated datasets challenging and costly. This presents obstacles for traditional supervised learning methods. Consequently, semi-supervised learning (SSL) has emerged as a promising solution, capable of utilizing unlabeled data to enhance model performance and has been widely adopted in medical image segmentation tasks. However, striking a balance between segmentation accuracy and inference speed remains a challenge for real-time segmentation. This paper provides a comprehensive review of research progress in real-time intelligent semi-supervised ultrasound video object segmentation (SUVOS) and offers insights into future developments in this area.

This paper reports a case of closed reduction internal fixation of pelvic fracture and minimally invasive hemostasis procedure and hematoma catheterization and drainage for the active pelvic bleeding site and giant hematoma, guided by a robot-assisted teleultrasound. In this case, the robot-assisted teleultrasound-guided minimally invasive interventional hemostasis and catheterization utilized a partial master-slave approach. It was preliminarily confirmed that robot-assisted teleultrasound-guided minimally invasive hemostasis and puncture catheterization for hematoma were accurate and effective. The robot-assisted teleultrasound overcomes the reliance on physician experience in ultrasound-guided interventional diagnostics and treatment, and promoting the use of minimally invasive "visualized" technology across any distance.

Cardiovascular disease (CVD) is one of the ten leading causes of death worldwide. Atherosclerotic disease, which can lead to myocardial infarction and stroke, is the main cause of CVD. The two main ultrasound image phenotypes used to monitor atherosclerotic load are carotid intima-media thickness (IMT) and plaque area (PA). Early segmentation and measurement methods were based on manual or threshold segmentation, snake models, etc. Usually, these methods are semi-automatic and have poor repeatability and accuracy. Segmentation of the carotid intima-media complex (IMC) and plaque in ultrasound based on artificial intelligence can achieve good accuracy. Compared with two-dimensional ultrasound, three-dimensional/four-dimensional ultrasound can provide spatial dynamic vascular information, which is helpful for doctors to evaluate. This study reviews the progress of artificial intelligence (AI) segmentation methods based on machine learning (ML) and deep learning (DL) used in the segmentation of the IMC and plaque as well as the 3D / 4D reconstruction of carotid ultrasound.

Objective Inpainting is a technique for fixing or removing undesired areas of an image.

Methods In present scenario, image plays a vital role in every aspect such as business images, satellite images, and medical images and so on.

Results and Conclusion This paper presents a comprehensive review of past traditional image inpainting methods and the present state-of-the-art deep learning methods and also detailed the strengths and weaknesses of each to provide new insights in the field.

The ovaries are normally situated on the lateral aspect of the uterus in a shallow depression called an ovarian fossa. Maldescended ovaries occur when the ovary has not been localized in an intrapelvic location. Maldescended ovaries can be found with a normal uterus and more often with Mullerian duct abnormalities. There is no established association between ovarian tumors and maldescended ovaries. The present case report is a very rare case of mature cystic teratoma of a maldescended right ovary located within the subhepatic region. To bring this into focus in cases with an abnormal dermoid cyst site in a female. The patient should be carefully evaluated for ovarian sites and the possibility of maldescended ovaries should be taken into account. The maldescended ovaries with complicated cysts or with tumor should be included in the differential diagnosis of causes of abdominal pain in females.

Objective A non-invasive assessment of the risk of benign and malignant follicular thyroid cancer is invaluable in the choice of treatment options. The extraction and fusion of multidimensional features from ultrasound images of follicular thyroid cancer is decisive in improving the accuracy of identifying benign and malignant thyroid cancer. This paper presents a non-invasive preoperative benign and malignant risk assessment system for follicular thyroid cancer, based on the proposed deep feature extraction and fusion of ultrasound images of follicular thyroid cancer.

Methods First, this study uses a convolution neural network (CNN) to obtain a global feature map of the image, and the fusion of global features cropped to local features to identify tumor images. Secondly, this tumour image is also extracted by googleNet and ResNet respectively to extract features and recognize the image. Finally, we employ an averaging algorithm to obtain the final recognition results.

Results The experimental results show that the method proposed in this study achieved 89.95% accuracy, 88.46% sensitivity, 91.30% specificity and an AUC value of 96.69% in the local dataset obtained from Peking University Shenzhen Hospital, all of which are far superior to other models.

Conclusion In this study, a non-invasive risk prediction system is proposed for ultrasound images of thyroid follicular tumours. We solve the problem of unbalanced sample distribution by means of an image enhancement algorithm. In order to obtain enough features to differentiate ultrasound images, a three-branched feature extraction network was designed in this study, and a balance of sensitivity and specificity is ensured by an averaging algorithm.

Objective This cross-sectional study was designed considering disagreements on the normal range of Median Nerve Cross-Sectional Area (MNCSA) and its association with age.

Methods In this cross-sectional descriptive study, the upper limbs of 98 healthy subjects (46 men and 52 women) were assessed bilaterally by sonography, and MNCSA was measured at the distal wrist crease.

Results Mean MNCSA values for subjects older and younger than 40 were 11.25 mm² and 10.21 mm², respectively. The results showed that the MNCSA significantly increased after 40 years of age.

Conclusion According to the present study's findings, advances in age can increase the MNCSA and affect the diagnostic accuracy of MNCSA measurement in CTS diagnosis.

Objective VaveHealth is a company that developed an app-based POCUS (Point of Care Ultrasound) education platform. Our objective is to provide educators with insights into novel approaches to medical education by comparing the platform to PowerPoint-based education, the standard and current technique used to instruct medical students in the United States.

Methods We used a non-inferiority study to assess if the app-based platform was not less efficacious than the current standard of PowerPoint-based education. Thirty-three military medical students were provided with app-based or PowerPoint-based education for instructions on performing a focused assessment with sonography for trauma (FAST exam). Physicians evaluated each image and assigned a score from 1-5. The final scores were the average of all views. In addition, a two-sample t-test of the final scores and each view of the FAST was used to measure whether the VaveHealth platform was non-inferior to a PowerPoint-based model.

Results Overall, the VaveHealth group had lower average scores on each view and a lower average total score. There was no statistically significant difference in overall scores (VaveHealth = 7.65, PowerPoint = 9.04, P = 0.07). Subgroup analysis showed no statistically significant difference in student performance in the views of the splenorenal recess (VaveHealth score = 1.60, PowerPoint score = 1.65, P = 0.42), hepatorenal recess (VaveHealth score = 2.45, PowerPoint score = 3.00, P = 0.11), and suprapubic (VaveHealth score = 2.10, PowerPoint score = 2.46, P = 0.23) regions. In the subxiphoid region, students in the VaveHealth had a statistically significantly lower average score (VaveHealth score = 1.70, PowerPoint score = 2.08, P = 0.04).

Conclusion VaveHealth education is not a viable alternative to traditional PowerPoint education for POCUS training based on the lower raw scores and statistically significantly lower scores on one of the views of the FAST exam.

ObjectiveThe objective of this study was to develop a sonographic technique using two-dimensional (2D) markers for detecting isolated fetal cleft palate (no cleft lip) and to evaluate the ability of 2D and three-dimensional (3D) sonography to image the normal and abnormal palate.

Methods Seventy-three fetuses with a high risk of cleft palate at 12-39 weeks of gestation were referred for specialist ultrasound. A detailed evaluation of the palate was performed through 2D ultrasound, which revealed the appearance of the palatine line in the sagittal plane; the palate and alveolar ridge in the coronal plane of the fetal face; the horizontal plate of the palatine bone in the axial maxillary plane; and the soft palate in the transverse plane of the cavum pharyngis. Subsequently, 3D ultrasound imaging of the palate was performed in all fetuses. Antenatal diagnoses were compared with postnatal findings or autopsy findings.

Results Visualization of 2D markers was accomplished in all fetuses, and 3D assessment was achieved in 97% of fetuses. Cleft palate was suspected in 16 cases (21.9%), among which 14 were suspected on the basis of both 2D and 3D evaluation, and two were suspected only on the basis of 3D evaluation. A normal palate was observed in 57 fetuses (78.1%). The mean gestational age was 27 weeks (range of 12 weeks to 39 weeks). All 16 fetuses with suspected cleft palate were confirmed by postnatal or autopsy findings, no false-positives were observed, and one case with a bifid uvula was missed among 57 fetuses with a presumed normal palate.

Conclusions The fetal palate can be evaluated with 2D markers and 3D sonography. The detection of isolated cleft palate is more sensitive when 2D markers are present in all four planes.

Sarcoidosis is a granulomatous disease of unknown etiology that can involve various organs and tissues. The clinical manifestations vary greatly, so it is difficult to make a clear diagnosis of sarcoidosis with just the clinical manifestation and imaging findings. The diagnosis and treatment of a patient with systemic sarcoidosis was reported: a 51-year-old woman presented with a dry cough. Computed tomography (CT), magnetic resonance imaging (MRI), and conventional ultrasonography (US) suggested miliary nodules and inflammatory changes in the lungs, there was mediastinal, retroperitoneal and hilar lymph node enlargement and uneven liver echo, respectively. Positron emission tomography/computed tomography (PET-CT) further suggested that the lesions were distributed throughout the body, including the lymph nodes and muscles of the extremities; thus, systemic lymphoma was considered. Finally, ultrasound-guided biopsy of different sites yielded the same histopathological findings: sarcoidosis. The sarcoidosis in this case is characterized by a large number of involved sites with a wide range, and a variety of imaging data were complete but failed to suggest a diagnosis. Finally, a clear histopathological result was obtained under the guidance of ultrasound. This article reviewed the relevant literature and concluded that ultrasound-guided puncture to obtain histopathological results is a simple and effective method for the diagnosis of sarcoidosis.

Appendiceal mucinous neoplasms are relatively rare. Following rupture of a mucinous neoplasms of the appendix, mucus can implant into the scrotum along the congenital or acquired inguinal space. We report a case of a testicular mucinous neoplasm with no preoperative abdominal lesions. Scrotal ultrasound showed an irregular mass in the right testis and inguinal area, with uneven echogenicity (stripe hyperechoic layered distribution) and no obvious blood flow signals. Ultrasound diagnosis was suspected as mucinous neoplasm. Postoperative pathology was confirmed to be low-grade mucinous neoplasm of the testis. Subsequently, the surgeon performed laparoscopic exploration and found that the appendix tumor had ruptured and the peritoneal cavity was implanted, and an appendectomy was performed. Postoperative pathology confirmed a low-grade appendix mucinous neoplasm. The evaluation and discovery of a scrotal mucinous neoplasm requires exploration of the appendix with ultrasound imaging. Even if the inner diameter of the appendix is normal but the presence of ascites, appendiceal mucinous neoplasms need to be considered.

In the digital age, the miniaturization of portable ultrasound equipment has brought both opportunities and challenges to the healthcare industry. Handheld ultrasound (HHU) devices are tablet or smartphone-sized scanners that are highly portable, have lower costs, produce no harmful side effects, and consume less power, making them suitable for use in different environments. HHU devices are primarily designed for new users of ultrasound scanners with varying backgrounds to evaluate different structures of the human body in various clinical settings. HHU applications based on Fifth-generation (5G) wireless network communication and artificial intelligence (AI) technology provide new healthcare solutions. The main application scenarios for HHU devices currently include in-hospital use, remote medical treatment, emergency rescue, and home monitoring. These scenarios allow for rapid image acquisition and real-time image interpretation, thereby improving the efficiency and quality of healthcare, reducing medical costs, and improving the allocation and utilization of medical resources. However, there remain some technical challenges and weaknesses such as device safety, data privacy, and network stability. With the continuous integration of AI technology, HHU applications will find wider use and promotion, bringing about more opportunities and challenges to the healthcare industry. This article reviews the application experience and insights of 5G technology in the field of HHU, aiming to provide fresh evidence and references for future research and applications.

Granulosa cell tumor of the testis is a rare intermediate stromal cell tumor that can be distinguished in adult and juvenile type. The juvenile type is commonly presented in infants less than a year old-most often during the first 6 months of life and can be associated with ambiguous genitalia and chromosomal anomalies. We report two cases of juvenile granulosa cell tumor (JGCT) of the testis diagnosed in the neonatal period and review the typical sonographic findings of this entity.

Objective The purpose of this study was to compare the diagnostic performance of virtual touch tissue quantification (VTTQ) combined with B-mode ultrasonograpgy (US), strain elastography (SE) combined with B-mode US and B-mode US alone in differentiating the properties of breast lesions.

Methods A retrospective database was queried for 283 healthy subjects and 100 consecutive patients with 130 breast lesions. All the cases were examined by B-mode US, VTTQ and SE. Histological diagnosis was used as the reference standard. The area under the receiver operating curve (AUC) values of each data set was compared.

Results Twenty-two lesions were determined as malignant and 108 as benign. The best cutoff point of VTTQ was 7.82 m/s. The AUC of B-mode US combined with VTTQ or SE was greater than that of B-mode US alone (0.913 or 0.918 vs. 0.797) (P = 0.007 and 0.012).

Conclusion Both VTTQ and SE could give help to B-mode US in distinguishing benign from malignant breast lesions about elastography values. There was no difference between them.

Objective Aimed to evaluate patients with essential hypertension (EH) using four-dimensional automatic left atrial quantification (4DLAQ) To assess the occurrence of EH.

Methods This study selected 80 patients with EH for the EH group and 36 healthy individuals for the control group. Various cardiac parameters, including left atrial diameter (LAD), interventricular septal thickness (IVST), left ventricular end-diastolic diameter (LVDD), left ventricular posterior wall thickness (LVPWT), early E-wave velocity of mitral valve diastole/mitral valve ring myocardial displacement velocity (E/e'), biplanar left ventricular ejection fraction (biplanLVEF), left atrial minimum volume (LAVmin), lateral left atrial maximum volume (LAVmax), left atrial presystolic volume (LAVpreA), left atrial ejection fraction obtained by two-dimensional echocardiography (LAEF), left atrial passive ejection fraction (LAPEF), left atrial active ejection fraction (LAAEF), left atrial reservoir longitudinal strain (LASr), left atrial catheter longitudinal strain (LAScd), left atrial systolic longitudinal strain (LASct), left atrial reservoir circular strain (LASr_c), left atrial catheter circular strain (LAScd_c), and left atrial systolic circular strain (LASct_c) were measured using 4DLAQ. Binary logistic regression was employed to analyze the effect of 4DLAQ strain parameters on EH. Receiver operating characteristic (ROC) curves were used to assess the predictive value of 4DLAQ strain parameters for EH.

Results Systolic blood pressure and diastolic blood pressure in the EH group were higher than those in the control group (P = 0.000 and 0.000, respectively). In the EH group, LAD, IVST, LVDD, LVPWT, E/e', LAVmin, LAVmax, and LAVpreA were significantly increased (P = 0.000, 0.000, 0.072, 0.000, 0.000, 0.001, 0.052, and 0.004, respectively), whereas biplanLVEF, LAEF, LAPEF, LAAEF, LASr, LAScd, LASct, LASr_c, LAScd_c, and LASct_c significantly decreased (P = 0.090, 0.000, 0.009, 0.064, 0.000, 0.000, 0.000, 0.000, 0.000, and 0.689, respectively). Bland-Altman plots were used to illustrate the relationship between variables and audience consensus. LASr and LAScd were identified as independent risk factors for EH. The area under the ROC curve (AUC) for LASr was 0.925, (95% confidence interval [CI] = 0.879-0.971) with a sensitivity of 80.00%, specificity of 94.44%, using a cut-off value of 20%. For LAScd, the AUC-ROC was 0.878 (95% CI = 0.818-0.939 with a sensitivity of 76.25%, specificity 86.11%, and using a critical value of -11%.

Conclusion LASr and LAScd exhibited superior predictive capabilities for EH, with LASr performing the best. This study fills a critical gap in left atrial research and holds significant clinical implications.

Objective This study aimed to evaluate the development of atherosclerosis in ApoE-deficient dogs fed with a high-fat diet (HFD) using vascular duplex ultrasonography (VDU).

Methods Thirty beagle dogs were enrolled, including 10 wild-type, 16 heterozygous (ApoE^-/+), and four homozygous (ApoE^-/-) mutant dogs. The dogs were categorized into either the normal diet (ND) or HFD group. Plasma lipids levles were tested at baseline and then after feeding the dog a different diet for 6 months. The carotid arteries, abdominal aorta (AO) and iliac arteries were examined using VDU. Artery sections of the ApoE^-/- dogs were analyzed.

Results After HFD, lipids especially triglycerides, total cholesterol and low-density lipoprotein (LDL) in the wild type and ApoE^-/+ dogs were significantly increased. Both the intima-media thickness (IMT) of the common carotid artery (CCA) and AO in the wild type and ApoE^-/+ dogs significantly increased. In the ApoE^-/+ dogs, the mean percentages increases in CCA-IMT and AO-IMT after HFD were higher than those in the ND dogs. The mean values of CCA-IMT and AO-IMT in the ApoE^-/-dogs increased to 2-2.5 folds after HFD. Histological analysis confirmed that the carotid and iliac arteries had advanced atherosclerotic lesions in the ApoE^-/- dogs.

Conclusions HFD may accelerate the development of atherosclerosis in ApoE-deficient dogs, which is an optimal large-animal model of atherosclerosis.

Gastroparesis (GP) is a gastric motility disorder characterized by delayed gastric emptying in the absence of mechanical obstruction. This expert consensus covers aspects of GP etiology (diabetes, surgery, drug-induced, idiopathic, scleroderma, etc.), symptomatology, diagnosis (scintigraphic imaging, ultrasound contrast meal assessment, and radiopaque marker gastric motility testing), and treatment (pharmacological therapy, nutritional support, traditional Chinese medicine, and interventions targeting the pylorus, such as endoscopic surgery and surgical procedures). GP significantly impacts patients' psychological well-being and quality of life, potentially leading to psychological disorders such as anxiety and depression, and also imposes a heavy economic burden on patients and society. Therefore, this expert consensus advocates for the establishment of a multidisciplinary team diagnosis and treatment model, which will further standardize and optimize the diagnosis and treatment process of GP in our country and is crucial for improving patients' therapeutic outcomes and quality of life.

Hepatocellular carcinoma (HCC), constituting 75-85% of primary liver cancer cases, ranks as the third leading cause of global cancer-related mortality. The early diagnosis of HCC is critical for determining optimal clinical therapeutic strategies. Radiofrequency ablation (RFA) has emerged as a preferred for managing early-stage HCC cases, primarily due to its less invasive nature, simplicity and safety. Advanced imaging for pre-operative evaluation of HCC has been increasingly used. Contrast-enhanced ultrasound (CEUS) has improved the clinical application of ultrasound (US) in HCC. It also provide more accurate informations for guiding RFA procedures. In the future, CEUS, through its convergence with emerging artificial intelligence (AI)-driven technologies, will play an even greater role in HCC management. This systematic review evaluates the utility of Sonazoid-enhanced contrast ultrasound (Sonazoid-CEUS), particularly its unique Kupffer phase imaging, in improving HCC diagnostic and optimizing RFA precision via real-time monitoring capabilities and prolonged imaging windows (up to 60 minutes).

Placenta is a vital organ of a unique circulatory system that allows the exchange of nutrients between maternal and fetal circulations, supporting fetal growth during pregnancy. The placental nutrient transfer capacity is precisely modulated by the signals originating from the fetus, mother, and placenta itself, thereby ensuring appropriate regulation of fetal growth. However, the abnormality of any link in this process may lead to the failure of the regulation, and thus the placenta can no longer meet the fetal demand, causing fetal growth restriction (FGR). This review investigates the morphological and functional alterations in the regulation of placental growth and development, as well as the uteroplacental circulation in human pregnancies complicated by FGR. Additionally, it discusses the ultrasound application in the assessment of placental insufficiency.

The integration of medical imaging and artificial intelligence (AI) has revolutionized interventional therapy of valvular heart diseases (VHD), owing to rapid development in multimodality imaging and healthcare big data. Medical imaging techniques, such as echocardiography, cardiovascular magnetic resonance (CMR) and computed tomography (CT), play an irreplaceable role in the whole process of pre-, intra- and post-procedural intervention of VHD. Different imaging techniques have unique advantages in different stages of interventional therapy. Therefore, single imaging technique can’t fully meet the requirements of complicated clinical scenarios. More importantly, a single intraoperative image provides only limited vision of the surgical field, which could be a potential source for unsatisfactory prognosis. Besides, the non-negligible inter- and intra-observer variability limits the precise quantification of heart valve structure and function in daily clinical practice. With the help of analysis clustered and regressed by big data and exponential growth in computing power, AI broken grounds in the interventional therapy of VHD, including preoperative planning, intraoperative navigation, and postoperative follow-up. This article reviews the state-of-the-art progress and directions in the application of AI for medical imaging in the interventional therapy of VHD.