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Ultrasound-guided Microwave Ablation of Adenolymphoma of Parotid Gland: A Case Report
Xiaohui Ji, MD, Juanjuan Li, MD, Dongxia Gao, MD
Advanced Ultrasound in Diagnosis and Therapy    2022, 6 (1): 22-25.   DOI: 10.37015/AUDT.2021.200046
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Adenolymphoma is the second most common benign parotid tumor after pleomorphic adenoma. Although microwave ablation (MWA) has been proved to be effective for benign breast and thyroid nodules, there are few studies on ablation of adenolymphoma of parotid gland. An 82-year-old male with adenolymphoma of bilateral parotid gland treated with ultrasound-guided MWA. After 12 months of follow-up, the volume of bilateral parotid nodules was significantly reduced without recurrence and obvious complications. In conclusion, ultrasound-guided MWA is a safe and effective method for patients with parotid adenolymphoma who cannot tolerate surgery.

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Clinical Application of Ultrasound Tomography in Diagnosis of Musculoskeletal Diseases
Cong Wei, MD, Hui Zhang, PhD, Tao Ying, MD, Bing Hu, MD, Yini Chen, MD, Hongtao Li, MD, Qiude Zhang, PhD, Mingyue Ding, PhD, Jie Chen, MD, Ming Yuchi, PhD, Yuanyi Zheng, MD
Advanced Ultrasound in Diagnosis and Therapy    2024, 8 (1): 7-14.   DOI: 10.37015/AUDT.2024.230060
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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.

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Absent Blood Flow in the Testis on Color Doppler Ultrasound: The Causes, Differential Diagnosis and Clinical Value
Shun-Ping Chen, MD, Bin Chen, MD
Advanced Ultrasound in Diagnosis and Therapy    2020, 4 (3): 223-229.   DOI: 10.37015/AUDT.2020.190035
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Objectives: To investigate the causes, differential diagnosis, and clinical significance of absent blood flow (ABF) in the testis detected by color Doppler ultrasound (CDU) in acute scrotum.
Methods: A total of 263 patients with ABF in the testis detected by CDU in our hospital were reviewed retrospectively. However, only 111 patients who underwent surgery were included in this study. The ultrasonographic features of the testis and paratesticular tissue were analyzed. The surgical or surgical-pathologic results were taken as the reference standard to determine the causes of ABF in the testis.
Results: The causes of ABF in the testis were testicular torsion (n = 98, torsion group) and non-testicular torsion related diseases (n = 13, non-torsion group, including 8 testicular rupture, 3 epididymitis-orchitis combination with testicular necrosis, and 2 tumors). Tunica albuginea of the testis, diffuse enlarged epididymis, whirlpool sign, and internal echo of the testis were the better parameters for diagnosing the causes of ABF in the testis detected by CDU. And the accuracies of these approaches were 93.7%, 91%, 83.8%, and 81.1%, respectively. Whirlpool sign had a 100% positive predictive value (PPV), and disrupted tunica albuginea of the testis and diffuse enlarged epididymis each had 100% specificity for predicting testicular torsion. When the ultrasonographic findings were combined with these methods to determine the causes, the accuracy was 96.4% (107/111).
Conclusion: ABF in the testis detected by CDU is not always indicative of testicular torsion in acute scrotum; Analyzing ultrasound findings of the testis and paratesticular tissue can help with differential diagnosis of the causes of ABF in the testis and guide clinical decision-making.

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Ultrasonographic Identification of Muscle Atrophy in Hamstring Muscles after Anterior Cruciate Ligament Repair among Soccer Players: A Case-control Study
Sebastián Eustaquio Martín Pérez, MSc, Raúl Hernández García, PT, Alberto Brito Lorenzo, PT, Carlos Daniel Sabater Cruz, PT, Mario Herrera Pérez, PhD, Fidel Rodríguez Hernández, PhD, Kristin Briem, PhD, Isidro Miguel Martín Pérez, MD
Advanced Ultrasound in Diagnosis and Therapy    2023, 7 (4): 381-389.   DOI: 10.37015/AUDT.2023.230036
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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.

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Application Progress of Ultrasound Elastography in the Evaluation of Diabetic Peripheral Neuropathy
Siqi Zheng, MM, Min Bai, MM
Advanced Ultrasound in Diagnosis and Therapy    2024, 8 (1): 1-6.   DOI: 10.37015/AUDT.2024.230006
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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.

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Diagnostic Utility of Superb Microvascular Imaging of ultrasound Examinations to Evaluate Hepatic Ischemia-reperfusion Injury
Guoying Zhang, MD, Ying Tang, BS, Mingyang Wang, MD, Weina Kong, MD
Advanced Ultrasound in Diagnosis and Therapy    2024, 8 (1): 15-21.   DOI: 10.37015/AUDT.2024.230010
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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.

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Advances in Modern Clinical Ultrasound
Sriharsha Gummadi, MD, John Eisenbrey, PhD, Jingzhi Li, MD, Zhaojun Li, MD, Flemming Forsberg, PhD, Andrej Lyshchik, MD, Ji-Bin Liu, MD
Advanced Ultrasound in Diagnosis and Therapy    2018, 2 (2): 51-63.   DOI: 10.37015/AUDT.2018.180801
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Advances in modern clinical ultrasound include developments in ultrasound signal processing, imaging techniques and clinical applications. Improvements in ultrasound processing include contrast and high-fidelity ultrasound imaging to expand B-mode imaging and microvascular (or microluminal) discrimination. Similarly, volumetric sonography, automated or intelligent ultrasound, and fusion imaging developed from the innate limitations of planar ultrasound, including user-operator technical dependencies and complex anatomic spatial prerequisites. Additionally, ultrasound techniques and instrumentation have evolved towards expanding access amongst clinicians and patients. To that end, portability of ultrasound systems has become paramount. This has afforded growth into the point-of-care ultrasound and remote or tele-ultrasound arenas. In parallel, advanced applications of ultrasound imaging have arisen. These include high frequency superficial sonograms to diagnose dermatologic pathologies as well as various intra-cavitary or lesional interrogations by contrast-enhanced ultrasound. Properties such as realtime definition and ease-of-access have spurned procedural and interventional applications for vascular access. This narrative review provides an overview of these advances and potential future directions of ultrasound.

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State-of-the-Art and Development Trend of Interventional Ultrasound in China
Yang Qi, MD, Dengsheng Sun, MD, Linyao Wang, MD, Jie Yu, MD, Ping Liang, MD
Advanced Ultrasound in Diagnosis and Therapy    2023, 7 (4): 313-320.   DOI: 10.37015/AUDT.2023.230049
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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.

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Bedside Ultrasound in Assessment of 510 Severe and Critical Patients with COVID-19 Pneumonia in Wuhan, China
Bin Wang, MD, Li Zhang, MD, Danqing Zhang, MD, Hongliang Yuan, MD, Chun Wu, MD, Yongxing Zhang, MD, Lin He, MD, Rui Wang, MD, Jing Wang, MD, Mingxing Xie, MD, PhD
Advanced Ultrasound in Diagnosis and Therapy    2020, 4 (2): 60-66.   DOI: 10.37015/AUDT.2020.200018
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Objective: To discuss the value of bedside ultrasound in the diagnosis and treatment of 2019 novel coronavirus diseases (COVID-19).
Methods: Retrospective analysis of the results of bedside ultrasound of 510 patients with COVID-19 in our hospital was done from January 31, 2020 to March 4, 2020.
Results: (1) Among the 510 patients who underwent bedside ultrasound examination, a total of 327 (64.1%) underwent echocardiography, 494 (96.9%) underwent bilateral venous ultrasound examination of lower limbs, 86 (16.9%) underwent bilateral artery ultrasound examination of lower limbs, 48 (9.4%) underwent ultrasound examination of liver, gallbladder, spleen and pancreas, 26 (5.1%) underwent ultrasound examination of kidney, ureter and bladder, and the numbers of patients who underwent ultrasound examination of pericardium, pleural effusion, and peritoneal effusion were 16 (3.1%), 21 (4.1%), and 5 (1%), respectively. (2) Among the 327 patients who underwent bedside ultrasound examination of the heart, 96 (29.4%) showed results of positive for other abnormalities or complications, in which 31 (9.5%) had abnormal left ventricular wall motion, 42 (12.8%) were with valvular heart disease, 3 (0.9%) showed coronary heart disease, 19 (5.8%) showed the enlargement of right heart with pulmonary hypertension (PAH), and 1 (0.3%) had congenital heart disease. In addition, 6 of the 327 echocardiography patients showed negative results (no other abnormalities or complications), accounting for 1.8%. (3) Among the 494 patients who underwent bilateral venous examination of lower limbs, 182 (36.8%) had phlebothrombosis. Eighty-six (86) patients underwent bilateral artery examination of lower limbs, and 63 (73%) of them had positive results, in which 5 patients showed arterial occlusion and the other 57 patients showed atherosclerosis. (4) Thirty-three (33) patients underwent ultrasound examination of liver, gallbladder, spleen, and pancreas, and 23 (70%) of them showed positive results. Among the 26 patients who underwent the urological examination, 7 (26.9%) showed positive results. Additionally, there are 2 positive findings in 21 patients who underwent the examination of pleural effusion (9.5%), and 1 positive case in 5 patients who underwent the examination of abdominal effusion (20%).
Conclusion: Bedside ultrasound is important in the diagnosis and treatment of COVID-19. We hope to make better use of bedside ultrasound to help clinicians get accurate diagnosis and treatment strategies.

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Distributed Cloud-based Ultrasound Platform: Innovative Pathway to Develop Ultrasound Imaging System
Jianqiao Zhou, MD
Advanced Ultrasound in Diagnosis and Therapy    2022, 6 (1): 33-37.   DOI: 10.37015/AUDT.2022.220002
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The current medical ultrasound imaging device is mainly divided into console ultrasound device and portable ultrasound device. In this article, a new concept along with an innovative pathway to develop ultrasound imaging devices, namely distributed cloud-based ultrasound system (DCUS), was proposed. In DCUS, the ultrasound probes from multiple terminals are used to complete the transmission and reception as well as analog-to-digital conversion of ultrasonic signals, and upload the original radio frequency (RF) signals or in-phase and quadrature (IQ) signals to the cloud server through ultra-bandwidth high-speed communication technology, while the centralized cloud server platform finishes processing of ultrasonic signals and transmits and distributes ultrasound imaging to each related terminal in real time. Various artificial intelligence (AI) algorithms can also be deployed on the cloud-based platform to achieve AI-powered imaging optimization, protocol standardization, and assisted diagnosis. Thus, by utilizing new cloud-based platform and super-high transmission technology and combining the advantages of console ultrasound and portable ultrasound systems with flexibility, high imaging quality and intelligent features, DCUS could become whole new ultrasound system for medical imaging applications in foreseeable future.

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Benign Cystic Teratoma of Maldescended Ovary: a Rare Ultrasound Case Report
Ashraf Talaat Youssef, PhD
Advanced Ultrasound in Diagnosis and Therapy    2024, 8 (1): 29-31.   DOI: 10.37015/AUDT.2024.230035
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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.

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Identification of Differently Expressed miRNAs and Genes between Benign Prostatic Hyperplasia and Prostate Cancer
Yuqing Huang, MD, Cui Lei, BS, Xinyu Zhao, PhD, Jing Xiao, PhD, Xian-Quan Shi, PhD
Advanced Ultrasound in Diagnosis and Therapy    2024, 8 (1): 22-28.   DOI: 10.37015/AUDT.2024.230044
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Objective MicroRNAs (miRNAs) play important roles in various diseases’ development and progression. The aim of this study is to identify the differently expressed miRNAs (DEmiRNAs) and differently expressed genes (DEGs) between BPH and PCa.

Methods Selecting BPH and PCa tissues from GEO database (GSE118038 as test dataset; GSE30994 as validation dataset), we identified DEmiRNAs and DEGs between BPH and PCa using GEO2R online tool and “Deseq2” R package. We applied random forest method to select hub DEmiRNAs, combining age and BMI, to establish a nomogram model for BPH detection. Finally, GO and KEGG enrichment analyses were conducted to explore the underlying mechanisms and pathways of DEmiRNAs in BPH.

Results We found 26 DEmiRNAs between BPH and PCa, of which 21 DEmiRNAs were up-regulated and 5 DEmiRNAs were down-regulated. Via forest random method, we selected miR-636, miR-324-3p, miR-210-3p and miR-3615 as hub DEmiRNAs in BPH. Combing these four hub DEmiRNAs, age and BMI, we established a nomogram model to distinguish BPH from PCa. Through “miRWalk” online tool, we targeted 499 hub DEGs between BPH and PCa, and found most of genes enriched in muscle system process, muscle contraction, contractile fiber, myofibril, actin binding, passive transmembrane transporter activity, focal adhesion, axon guidance.

Conclusion Our results suggested that miR-636, miR-324-3p, miR-210-3p and miR-3615 might the hub DEmiRNAs between BPH and PCa, which may play a crucial role to distinguish BPH from PCa.

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Lung Ultrasonography in Diagnosis and Management of Novel Coronavirus (COVID-19) Pneumonia: Pearls and Pitfalls
Heng Xue, MD, Yao Zhang, MD, Ligang Cui, MD, Jing Han, MD
Advanced Ultrasound in Diagnosis and Therapy    2020, 4 (2): 57-59.   DOI: 10.37015/AUDT.2020.200030
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The purpose of this article is to review the use of lung ultrasonography (US) in the workup of COVID-19 pneumonia. The scanning protocol, normal US appearance of lung, major US features of COVID-19 pneumonia, diagnostic performance of lung US and potential pitfalls when explaining US results are descripted and discussed. Lung US is increasingly accepted as a useful tool in the workup of COVID-19 pneumonia. Certain US imaging features allow to confirm or rule out the diagnosis for clinical management; on other hand, most US findings are nonspecific with technical limitations. Thus, it is important to recognize these drawbacks since the ignorance of potential pitfalls of lung US may lead to over diagnosis or missed diagnosis.

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The Role of Ultrasound Shear Wave Dispersion Imaging in Evaluating Carotid Viscoelasticity:A Preliminary Study
Xianghong Luo, MD, Jianhui Zhang, MD, Sihui Shao, MD, Min Yan, MD, Rong Wu, MD, Lianfang Du, MD, Zhaojun Li, MD
Advanced Ultrasound in Diagnosis and Therapy    2019, 3 (3): 97-102.   DOI: 10.37015/AUDT.2019.190816
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Objective: To evaluate the carotid viscoelasticity using ultrasound shear wave dispersion imaging (USWD) and determine its feasibility.

Methods: Forty-five volunteers were recruited and divided into the group1 (≥50 years old) and group 2 (<50 years old). The shear wave elastic modulus (SWE-AR and SWE-PR) and shear wave dispersion indexes (SWD-AR and SWD-PR), which located at the anterior and posterior walls of the common carotid artery (CCA), were obtained by USWD, and compared with pulse wave velocity (PWV). Pearson correlation analysis was applied to analyze the related factors of viscoelasticity.

Results: Before and after body mass index, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were adjusted, SWE-AR, SWE-PR, SWD-AR and SWD-PR were all higher in the group 2 than those of group 1 (all P < 0.05). In all subjects, SWE was negatively correlated with age, SBP, DBP and PWV, respectively (r = -0.282, -0.374, -0.321, -0.256 and all P < 0.05). The SWD was negatively correlated with PWV in the group 1, while positively correlated with SBP in the group 2 (r=-0.393 and r=0.366, all P < 0.05).

Conclusion: The viscoelasticity of arterial wall can be assessed by USWD. It provides a new way to describe arterial disease for clinical study.

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ChatGPT Related Technology and Its Applications in the Medical Field
Tairui Zhang, BS, Linxue Qian, MD
Advanced Ultrasound in Diagnosis and Therapy    2023, 7 (2): 158-171.   DOI: 10.37015/AUDT.2023.230028
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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.

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A Non-Invasive Follicular Thyroid Cancer Risk Prediction System Based on Deep Hybrid Multi-feature Fusion Network
Yalin Wu, PhD, Qiaoli Ge, MM, Linyang Yan, PhD, Desheng Sun, MD
Advanced Ultrasound in Diagnosis and Therapy    2023, 7 (4): 373-380.   DOI: 10.37015/AUDT.2023.230023
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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.

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Point of Care Ultrasound Training in Military Medical Student Curriculum
Bradley Havins, MD, Michael Nguyen, MS, Ryan Becker, MS, Chusila Lee, MS, Siri Magadi, MS, Choi Heesun, DO
Advanced Ultrasound in Diagnosis and Therapy    2023, 7 (4): 401-404.   DOI: 10.37015/AUDT.2023.230003
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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.

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Clinical Application of Ultrasound in the Diagnosis and Treatment of Reninoma
Qiuyang Li, MD, Ying Zhang, MD, Yong Song, MD, Aitao Guo, MD, Nan Li, BS, Yukun Luo, MD, Jie Tang, MD
Advanced Ultrasound in Diagnosis and Therapy    2020, 4 (3): 211-216.   DOI: 10.37015/AUDT.2020.200013
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Objectives: To investigate the clinical value of ultrasound in the diagnosis and treatment of reninoma.
Methods: We retrospectively analyzed the ultrasound findings of 9 patients with reninoma confirmed by pathology after surgical resection in our hospital between September 2012 and August 2019. All patients underwent conventional preoperative ultrasonography. Three underwent contrast-enhanced ultrasound (CEUS) and 3 with complete endogenetic tumor underwent intraoperative ultrasonography.
Results: Of the 9 patients with conventional ultrasound, 7 had renal space-occupying lesions and 2 had missed diagnosis. A hypoechoic or hyperechoic solid mass with regular morphology, clear boundary, capsule, weak echo halo around the mass, incomplete thin strip color blood flow signal around the mass were shown in 7 cases. Color Doppler displayed color flow signal of the incomplete thin strip around the mass and arterial blood supply with an internal thin branch. In 3 patients (including 2 with missing diagnosis by conventional ultrasound) who underwent preoperative contrast-enhanced ultrasound, the reninoma manifested as low enhancement, and the perfusion pattern showed as slow wash-in and slow wash-out compared with normal renal cortex. In 3 patients (including 2 cases of missed diagnosis by conventional ultrasound) with completely endogenic reninoma, intraoperative ultrasound clearly showed the tumor characteristics, and all successfully underwent laparoscopic ultrasound-guided partial nephrectomy.
Conclusions: Preoperative conventional ultrasound combined with CEUS, and clinical features, are helpful for the qualitative diagnosis of reninoma. Laparoscopic partial resection is the first-choice treatment for reninoma. Intraoperative ultrasound can provide real-time imaging, accurately evaluate the tumor status, and provide important information for surgeons.

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Contrast-Enhanced Ultrasound LI-RADS: A Pictorial Review
Osama Mahmoud, BS, Ajay Makkena, BS, Corinne E. Wessner, MS, MBA, RDMS, Ji-Bin Liu, MD, John R. Eisenbrey, PhD, Andrej Lyshchik, MD, PhD
Advanced Ultrasound in Diagnosis and Therapy    2023, 7 (4): 321-332.   DOI: 10.37015/AUDT.2023.230041
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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.

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Application of Ultrasonography in the Diagnosis and Management of Papillary Thyroid Microcarcinoma
Kun Huang, MD, Ji-Bin Liu, MD
Advanced Ultrasound in Diagnosis and Therapy    2020, 4 (4): 284-290.   DOI: 10.37015/AUDT.2020.200001
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Thyroid carcinoma is the most common malignant tumor of the endocrine system. Nearly 90% of thyroid carcinomas are papillary type, of which many are thyroid papillary microcarcinoma (PTMC) with a maximum diameter≤1 cm. Highresolution ultrasound imaging plays an important role in evaluating PTMC and guiding biopsy for pathology as well as appropriate treatment. This review paper discusses the ultrasonography features of PTMC and explores the clinical value of ultrasonography with gene testing in the diagnosis and management of PTMC.

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Juvenile Granulosa Cell Tumor of the Testis: A Preoperative Approach of the Diagnosis with Ultrasound
Rodanthi Sfakiotaki, MS, Sergia Liasi, BM, Eleni Papaiakovou, BM, Irene Vraka, PhD, Marina Vakaki, PhD, Chrysoula Koumanidou, PhD
Advanced Ultrasound in Diagnosis and Therapy    2023, 7 (4): 409-411.   DOI: 10.37015/AUDT.2023.220038
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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.

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The Role of Ultrasonography in the Diagnosis of Systemic Sarcoidosis: a Case Report and Literature Review
Hui Li, MD, Nan Zheng, MD, Penglin Zou, MD, Chao Jia, MD, Long Liu, MD, Gang Li, MD, Ziqi Wang, MD, Rong Wu, MD, Lianfang Du, MD, Qiusheng Shi, MD
Advanced Ultrasound in Diagnosis and Therapy    2024, 8 (1): 32-38.   DOI: 10.37015/AUDT.2024.230054
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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.

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Recent Advances in Microbubble-Augmented Cancer Therapy
Mohamed Tantawi, MD, Ji-Bin Liu, MD, John R Eisenbrey, PhD
Advanced Ultrasound in Diagnosis and Therapy    2020, 4 (3): 155-168.   DOI: 10.37015/AUDT.2020.200055
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Contrast-enhanced ultrasound (CEUS) applications in cancer management have expanded over the past two decades. Through detection of vascularization and perfusion changes, CEUS provides a potentially reliable means of early prediction of response to different cancer therapies including systemic chemotherapy and locoregional therapies. Ultrasound-induced cavitation of contrast agents has a range of effects on the surrounding microenvironment. These effects can be manipulated to sensitize the tumors to radio- and chemotherapy, as well as achieve targeted delivery through drug-loaded contrast agents. Newer forms of drug carriers are being developed with improved drug-carrying capacity and tissue penetration. This review aims at providing a synopsis of the latest developments in CEUS’ use in oncologic therapy. While the majority of work described in this review is still in the pre-clinical phases, results have been encouraging and show potential translational benefit for cancer patients in the near future.

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Doppler-based Renal Resistive Index for Prediction of Acute Kidney Injury in Critically Ill Patients: A Systematic Review and Meta-analysis
Jianing Zhu, MD, Ying Zhang, MD, Xiaoming Li, MD, Qiuyang Li, MD, PHD, Yukun Luo, MD, PHD
Advanced Ultrasound in Diagnosis and Therapy    2021, 5 (3): 183-196.   DOI: 10.37015/AUDT.2021.210013
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Objectives: To determine the efficacy of Doppler-based renal resistive index (RRI) in the prediction of acute kidney injury (AKI) in critically ill patients.
Methods: A systematic review and meta-analysis of cohort studies was conducted. Relevant studies were identified in PubMed, Embase and Cochrane Library from inception to November 1, 2020, and reference lists of identified primary studies. Prospective studies that examined the diagnostic accuracy of RRI in AKI were included.
Results: Among the 126 articles identified, 18 were included, with a total of 1656 patients. Bivariate analysis yielded pooled sensitivity and specificity of 0.81 (95% CI 0.74-0.86) and 0.75 (95% CI 0.65-0.83), respectively. The summary positive likelihood ratio was 3.2 (95% CI 2.2-4.6), and negative likelihood ratio was 0.26 (95% CI 0.19-0.36).
Conclusion: Elevated RRI may be an early predictor of AKI in critically ill patients. Further large-scale prospective studies are needed to confirm the predictive efficacy and determine the performance and optimal cutoff value of RRI among the included studies.

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Robot-assisted Teleultrasound-guided Hemostasis and Hematoma Catheterization and Drainage for Osteoporosis Pelvic Fracture with Giant Hematoma and Active Bleeding
Keyan Li, MD, Ye Peng, MD, Yingying Chen, MD, Zhaoming Zhong, MD, Yulong Ma, MD, Tao Yao, MD, Lihai Zhang, MD, Faqin Lv, MD
Advanced Ultrasound in Diagnosis and Therapy    2023, 7 (4): 416-419.   DOI: 10.37015/AUDT.2023.230034
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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.

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Semi-supervised Learning for Real-time Segmentation of Ultrasound Video Objects: A Review
Jin Guo, MD, Zhaojun Li, PhD, Yanping Lin, PhD
Advanced Ultrasound in Diagnosis and Therapy    2023, 7 (4): 333-347.   DOI: 10.37015/AUDT.2023.230016
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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.

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Experience and Enlightenment of Handheld Ultrasound Applications in Multiple Scenarios Based on 5G Technology
Huihui Chai, MS, Xiaowan Bo, MD, Lehang Guo, MD, Chengzhong Peng, MD
Advanced Ultrasound in Diagnosis and Therapy    2023, 7 (4): 356-365.   DOI: 10.37015/AUDT.2023.230029
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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.

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CMUT/CMOS-based Butterfly iQ - A Portable Personal Sonoscope
Joyce Y Liu, BA, Jiajun Xu, MD, Flemming Forsberg, PhD, Ji-Bin Liu. MD, FAIUM
Advanced Ultrasound in Diagnosis and Therapy    2019, 3 (3): 115-118.   DOI: 10.37015/AUDT.2019.190819
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With the development of bioengineering technologies, medical ultrasound systems have evolved and advanced over the years, including the transition of ultrasound machines from analog devices to digital systems and improvements in transducer assembly from piezoelectric ceramics to single crystals. In the past several years, the further miniaturization of ultrasound units has become possible with the advancement of computer chip manufacturing and production. Most recently, a new handheld ultrasound system has been developed by the startup company Butterfly Network, using an innovative CMUT/CMOS-based probe technique. This paper will review the history, technology and features of this new device, as well as discuss its future potential as a personal sonoscope.

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Advances in Targeted Tumor Diagnosis and Therapy Based on Ultrasound-Responsive Nanodroplets
Yaqiong Li, PhD, Ruiqing Liu, MD, Shaobo Duan, MD, Lianzhong Zhang, MD
Advanced Ultrasound in Diagnosis and Therapy    2020, 4 (4): 273-283.   DOI: 10.37015/AUDT.2020.200043
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The ultrasound contrast agents currently used in clinics are microbubbles with a large particle size and short circulation time, and their approved clinical applications are limited to endovascular diagnosis and therapy only. The development of ultrasound-responsive nanodroplets (NDs) provides a new approach for extravascular diagnosis and therapy, especially for molecular imaging and targeted therapy of tumors. The NDs with a nano-scaled particle size and a liquid core can maintain their shape and initial diameter during injection, enhancing their EPR effects and facilitating the accumulation of NDs at the tumor site. When exposed to ultrasound, NDs can vaporize and exhibit contrast enhancement at the sites of interest. In addition, the destruction of microbubbles can provide a driving force to facilitate the release of drugs or genes from the microbubbles into target cells, allowing the NDs to act as drug carriers. The development of ultrasound-responsive NDs has shown rapid progress in recent years, while a variety of NDs with excellent properties have been fabricated for targeted diagnosis and drug delivery. In this article, the development of ultrasound-responsive NDs was reviewed in terms of their structure, phase transition properties, and applications in targeted tumor diagnosis and therapy.

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Application Value of Lung Ultrasound in Asymptomatic Patients with Confirmed COVID-19
Haidan Lin, MD, Bingqi Zhang, MD, Haiyan Kou, MD, Yuanyuan Zhao, MD, Keyan Li, MD, Dudu Wu, MD, Shiyue Zhao, MD, Liuqiong Ren, MD, Xingxi Lin, MD, Zihao Zhang, MD, Zhiye Chen, MD, Xuexia Shan, MD, Yuqing Huang, MD, Shengzheng Wu, MD, Faqin Lv, MD
Advanced Ultrasound in Diagnosis and Therapy    2020, 4 (2): 67-72.   DOI: 10.37015/AUDT.2020.200025
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Objective: To investigate the value of lung ultrasound (LUS) in asymptomatic patients with confirmed COVID-19.
Methods: A retrospective analysis was performed on nine patients in a designated isolation hospital in Sanya from February 22nd, 2020 to February 23rd, 2020. All patients were confirmed with COVID-19 pneumonia by PCR test, but none had the typical symptoms of COVID-19. All patients first underwent LUS examination and then chest computed tomography (CT) scanning. The application value of LUS in asymptomatic confirmed patients with COVID-19 was evaluated, compared with chest CT which was regarded as the golden standard.
Results: Among nine asymptomatic patients with COVID-19, there were two cases (22.22%) with abnormal ultrasonic manifestations, of which one (11.11%) showed a fusion B3-line in zone 5 of the right lung, and the other showed localized pulmonary consolidation in zone 6 of the left lung. The remaining seven cases (77.78%) showed no abnormal changes in LUS, but only clear pleura sliding sign and A-line. Chest CT showed abnormal changes in three cases (33.33%). Two of them (22.22%) showed flocculent high-density shadow at the base of both lungs (especially in the right lung), while the other case showed ground-glass opacity with thickened interlobular septal in the left lower lobe, involving the pleura. There were no abnormalities on chest CT of the remaining six cases (66.67%). The two (22.22%) LUS-positive patients were in complete coincidence with CT-positive patients. This study showed that the coincidence rate of the two examination methods was 88.89%. Taking chest CT as golden standard, the sensitivity, specificity, positive predictive value, negative predictive value, and Kappa value of lung ultrasound in the diagnosis of COVID-19 were 66.67%, 100%, 100%, 85.71%, and 0.727, respectively.
Conclusion: LUS can evaluate lung lesions in asymptomatic patients with COVID-19. Compared with chest CT, the diagnostic coincidence rate and diagnostic consistency of LUS are relatively higher. For this asymptomatic type of patient, ultrasound can be used as a diagnosis method, which can avoid the risk of radiation exposure in a short period of time. As a rapid and dynamic assessment method, LUS can cooperate with remote consultation to provide timely and accurate guidance for clinical diagnosis and treatment when necessary.

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Transthoracic Ultrasound Evaluation of Pulmonary Changes in COVID-19 Patients During Treatment Using Modified Protocols
Guorong Lyu, MD, Ying Zhang, MD, Guoliang Tan, MD
Advanced Ultrasound in Diagnosis and Therapy    2020, 4 (2): 79-83.   DOI: 10.37015/AUDT.2020.200020
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Objective: To investigate the feasibility of evaluating imaging changes pre-and post-treatment in Corona Virus Disease 2019 (COVID-19) patients by transthoracic pulmonary ultrasound.
Methods: A total of 8 patients diagnosed with severe or critical COVID-19 pneumonia were recruited, and then ultrasound scanning was performed to evaluate the pulmonary imaging changes pre- and post-treatment based on a modified ultrasonic Buda protocol. The correlation between chest high resolution computed tomography (HRCT) Warrick scoring and ultrasonic results was analyzed.
Results: The main manifestations of ultrasonic imaging in severe or critical COVID-19 patients were: (1) pleural thickening (8/8), blurry or irregular fragmentation (6/8), and discontinuous fragmentation (4/8); (2) pulmonary lesions: B-line sign (2/8), partial or complete fusion of B-line (white lung) (8/8), and pulmonary or subpleural small consolidation (C-line sign) in severe cases (3/8); and (3) rarely, pleural effusion or pulmonary gas cyst (1/8). The imaging results, which were evaluated followed by a modified Buda transthoracic pulmonary ultrasound protocol, were highly correlated with HRCT Warrick scoring (r = 0.715, P < 0.05). Meanwhile, both ultrasonic and HRCT imaging results were significantly improved with progressive COVID-19 treatment (P < 0.05).
Conclusion: The ultrasonic pulmonary imaging of COVID-19 patients manifested several characteristics. The modified Buda transthoracic pulmonary ultrasound protocol could be an alternative method to evaluate the pulmonary lesions in COVID-19 patients.

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Development of 4G CMUT (CMUT Linear SML44 probe)
Tsuyoshi Otake, Hiroki Tanaka, Akifumi Sako, Makoto Fukada, Kengo Imagawa, Masahiro Sato
Advanced Ultrasound in Diagnosis and Therapy    2020, 4 (4): 379-382.  
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In 2009, Hitachi commercialized “Mappie*1, the world’s first Capacitive Micro-machined Ultrasound Transducer (CMUT) using semiconductor based technology. It generated high quality diagnostic images of mammary glands, thanks to its broad-band characteristics[1]. This year, the 4th generation CMUT (4G CMUT) “SML44” has been brought to the market, achieved using advanced design and precise control of the fabrication process. When combined with new imaging technologies avail-able with the ARIETTA*2 850, the SML44, in addition to excellent image quality, offers commonly used modalities and func- tions such as Tissue Harmonic Imaging (THI), Color Flow Mapping (CFM), Real-time Tissue Elastography*3 (RTE), and Real-time Virtual Sonography*4 (RVS). This report introduces the latest technology adopted in the 4G CMUT design.

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Prenatal Ultrasound Diagnosis of Giant Cystic Meconium Peritonitis in Fetus Following in Vitro Fertilization: A Case Report
Yixin Zhang, MS, Yuli Zhao, MS, Yuwen Su, MS, Sen Wang, MS, Li Feng, MD
Advanced Ultrasound in Diagnosis and Therapy    2023, 7 (1): 42-46.   DOI: 10.37015/AUDT.2023.220005
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The incidence of giant cystic meconium peritonitis (GCMP) in pregnancies following artificial reproductive techniques is rare. We report the first case of GCMP following in vitro fertilization and embryo transfer in China. A 32-year-old woman with a history of bilateral salpingectomy due to ectopic pregnancy attended our in vitro fertilization and embryo transfer program. Meconium peritonitis, polyhydramnios, bowel dilatation, and intra-abdominal calcification were detected by ultrasound at 33 weeks of gestation. Cesarean section due to scarred uterus was performed at 35+1 weeks of gestation. A normal female infant with a distended abdomen was delivered. Emergency laparotomy was performed on the female infant because of the presence of a giant abdominal mass. A 0.2-cm perforation was found in the ileum. Enterostomy could not be performed due to the heavy adhesion. Prenatal diagnosis of meconium peritonitis is possible through careful ultrasonographic examination, and prognosis can be improved through early surgical intervention and intensive postoperative support.

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Solitary Necrotic Nodule of Liver with the Etiology of Parasite: A Report of Two Cases
Mingwei Sui, MD, Wenzhao Liang, MD, Ting Zhang, MD, Yang Bai, MD, Dezhi Zhang, MD
Advanced Ultrasound in Diagnosis and Therapy    2019, 3 (1): 18-21.   DOI: 10.37015/AUDT.2019.190804
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Solitary necrotic nodule of liver (SNNL) is a rare, benign lesion with an uncertain etiology. There are no typical diagnostic clinical or radiological features. The two patients we described underwent liver resection because it was not possible to exclude a malignancy on preoperative imaging. The histopathological findings suggest the SNNL may be parasitic in origin and find parasitic worm in the nodules.

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Novel Development of Ultrasound Tomography for Musculoskeletal Imaging
John R. Eisenbrey, PhD
Advanced Ultrasound in Diagnosis and Therapy    2024, 8 (1): 39-39.   DOI: 10.37015/AUDT.2024.240004
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Role of PCA in Offering Certifications and Other Related Services to POCUS Users Worldwide
Victor V Rao, MBBS, DMRD, RDMS, James A DellaValle, MD, MBA, Samantha Forcum, M.Ed, Jasmine Rockett, Hannah Mason, MA, PMP, Dale R. Cyr, MBA, CAE
Advanced Ultrasound in Diagnosis and Therapy    2020, 4 (3): 260-263.   DOI: 10.37015/AUDT.2020.200058
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The POCUS Certification Academy, a subdivision of Inteleos, a non-profit certification organization, is striving to promote global standards and international certifications in the field of POCUS to enhance clinician proficiency and ensure patient safety. By offering relevant rigorous assessments, developing continuing education requirements, and promoting the use of point-of-care ultrasound worldwide, the POCUS Certification Academy is laying the foundation for the highest global standards in POCUS credentialing.

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Point-of-Care Ultrasound: New Concepts and Future Trends
Yaoting Wang, MD, Huihui Chai, MD, Ruizhong Ye, MD, Jingzhi Li, MD, PhD, Ji-Bin Liu, MD, Chen Lin, Chengzhong Peng, MD
Advanced Ultrasound in Diagnosis and Therapy    2021, 5 (3): 268-276.   DOI: 10.37015/AUDT.2021.210023
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Ultrasound (US) technology, with major advances and new developments, has become an essential and first-line imaging modality for clinical diagnosis and interventional treatment. US imaging has evolved from one-dimensional, two-dimensional to three-dimensional display, and from static to real-time imaging, as well as from structural to functional imaging. Based on its portability and advanced digital imaging technique, US was first adopted by emergency medicine in the 1980s and gradually gained popularity among other specialists for clinical diagnosis and interventional treatment. Point-of-Care Ultrasound (POCUS) was then proposed as a new concept and developed for new uses, which greatly extended clinical US applications. Nowadays, artificial intelligence (AI), cloud computing, 5G network, robotics, and remote technologies are starting to be integrated into US equipment. US systems have gradually evolved to an intelligent terminal platform with powerful imaging and communication tools. In addition, specialized US machines tend to be more suitable and important to meet increasing demands and requirements by various clinical specialties and departments. In this article, we review current US technology and POCUS as new concepts and its future trends, as well as related technological developments and clinical applications.

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Intel® oneAPI Base Toolkit Helps SonoScape Optimize the Performance of Its S-Fetus 4.0 Obstetric Screening Assistant
Intel; Naizhang Feng, Guoyi Zhou
Advanced Ultrasound in Diagnosis and Therapy    2022, 6 (4): 238-244.  
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Application and Progress of Ultrasound Technology in Atherosclerosis
Qiaoer Gong, BS, Nianyu Xue, MS
Advanced Ultrasound in Diagnosis and Therapy    2023, 7 (1): 8-15.   DOI: 10.37015/AUDT.2023.220030
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Atherosclerosis (AS) is the main pathophysiological process behind CVD. Cardiovascular diseases caused by AS (such as stroke, coronary heart disease, etc.) are characterized by a high prevalence, high disability rate and high mortality, which greatly increase the burden on families and society. Thus, it is important to find AS as early as possible. When atherosclerosis occurs, the earliest sign of its structural and functional changes is arterial stiffness, and endothelial dysfunction is the key link. Arteriosclerosis is caused by the imbalance between collagen and elastin in the arteries. Elastin fibers gradually decrease, and stiffer collagen fibers increase, making the vessels less elastic. Endothelial dysfunction also affects the regulatory function of arterial vascular tension, and accelerates the remodeling of the vascular wall, to make blood vessels more rigid. Quantitative measurement of arterial stiffness and carotid intima-media thickness (CIMT) is an important tool for early detection of vascular lesions. At present, ultrasound technology including echo tracking (ET), wave intensity (WI), real-time shear wave elastography (SWE), ultrafast pulse wave velocity (ufPWV), shear wave dispersion (SWD), cardio-ankle vascular index (CAVI), arterial velocity pulse index and arterial pressure volume index (AVI and API) has the advantages of being noninvasive, real-time, economical and reproducible in the assessment of atherosclerosis, and is widely used in the early diagnosis of AS. Most importantly, the change in arterial hardness detected by traditional ultrasound technology precedes the change in intima-media thickness, suggesting that ultrasonic elasticity monitoring may be a more sensitive method of predicting AS and can find and prevent cardiovascular diseases earlier.

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Review on Image Inpainting using Intelligence Mining Techniques
V. Merin Shobi, MCA, MPhil , ME, F. Ramesh Dhanaseelan, MSc, MTech , PhD
Advanced Ultrasound in Diagnosis and Therapy    2023, 7 (4): 366-372.   DOI: 10.37015/AUDT.2023.230007
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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.

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