CONTENTS

Cover, Foreword and Content
2025, 9 (1): 1-1.
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Review Articles

Clinical Usefulness of Atrioventricular Coupling in Cardiovascular Disease

Yang Lan, Li Zhenyi, Chen Ya, Chen Anni, Wang Xinqi, Jin Lin, Li Zhaojun

2025, 9 (1): 1-9. DOI:10.37015/AUDT.2025.240060

Abstract ( 197 ) HTML ( 15 ) PDF ( 688KB ) ( 169 ) 　　

Atrioventricular Coupling (AV-Coupling) refers to the functional coordination between atrial and ventricular systole and diastole in the heart. Currently, the primary method for evaluating AV-Coupling is through the left atrioventricular coupling index (LACI), measured using imaging techniques. A higher LACI indicates a greater mismatch between the volumes of left atrium and left ventricle at the end of ventricular diastole, reflecting a more significant impairment of left AV-Coupling. AV-Coupling plays a vital role in the pathophysiology and progression of cardiovascular diseases. Therefore, early and accurate assessment of AV-Coupling is essential for evaluating a patient’s condition, guiding clinical decisions, stratifying risk, and determining prognosis. This review aims to summarize the physiological mechanisms and evaluation methods of AV-Coupling, as well as its clinical significance in various cardiovascular diseases.

Ultrasound Radiogenomics-based Prediction Models for Gene Mutation Status in Breast Cancer

Zhai Yue, Tan Dianhuan, Lin Xiaona, Lv Heng, Chen Yan, Li Yongbin, Luo Haiyu, Dan Qing, Zhao Chenyang, Xiang Hongjin, Zheng Tingting, Sun Desheng

2025, 9 (1): 10-20. DOI:10.37015/AUDT.2025.240010

Abstract ( 147 ) HTML ( 16 ) PDF ( 557KB ) ( 183 ) 　　

Ultrasound radiogenomics, an emerging field at the intersection of radiology and genomics, employs high-throughput methods to convert radiological images into high-dimensional data, which are then processed to extract and analyze radiomic features. These features, including shape, texture, and intensity variations, are correlated with specific genetic mutations such as TP53 and PIK3CA, critical for cancer progression and treatment response. By integrating clinical data with ultrasonic features, predictive models are developed using machine learning techniques, aiming to refine the capability to diagnose and personalize treatment plans for breast cancer patients. This approach reduces the need for invasive biopsies and medical costs for patients through a better understanding of the tumor’s biological behavior using ultrasound images. This review focuses on the application of ultrasound radiogenomics for predicting gene mutations in breast cancer, highlighting its transformative potential in clinical practice and discussing ongoing challenges and future directions in this field.

Advancements in the Application of Convolutional Neural Networks in Ultrasound Imaging for Breast Cancer Diagnosis and Treatment

An Zichen, Li Fan

2025, 9 (1): 21-31. DOI:10.37015/AUDT.2025.240009

Abstract ( 111 ) HTML ( 3 ) PDF ( 1240KB ) ( 145 ) 　　

Since 2020, breast cancer has held the highest incidence rate among cancers worldwide. Breast ultrasound (US) imaging technology plays a crucial role in the early diagnosis and intervention treatment of breast cancer patients. Deep learning (DL), as one of the most powerful machine learning techniques in the field of artificial intelligence (AI), has the ability to automatically select features from raw data, achieving remarkable advancements in breast US imaging. This review focuses on the application of convolutional neural networks (CNNs) within DL technology in the field of breast US. It summarizes the use of DL models in breast cancer screening and in preoperative prediction of molecular subtypes, response to neoadjuvant chemotherapy (NAC), and axillary lymph node (ALN) metastasis status. The review also identifies the data limitations of using CNN models in breast US and describes the development history and current applications of DL in breast cancer screening, diagnostic guidance, and prognostic prediction. Furthermore, it discusses the future research directions and potential challenges. Advancing the development of CNN technology in breast US, and improving the generalizability and reproducibility of these models, will significantly promote their translational application in clinical settings.

Advances in the Application of New Ultrasound Technology for the Diagnosis and Treatment of Lymphoma

Bao Rui, Chen Lu, Luo Yukun, Zhang Mingbo

2025, 9 (1): 32-40. DOI:10.37015/AUDT.2025.240025

Abstract ( 94 ) HTML ( 4 ) PDF ( 1271KB ) ( 126 ) 　　

Lymphoma is a common hematological malignancy with markedly increasing incidence. Its pathological types are complex and heterogeneous, and there are significant differences in treatment options and efficacy. Therefore, early and precise diagnosis, assessment of efficacy, and judgment of prognosis are key clinical problems. Ultrasound (US) has important clinical value in the diagnosis and treatment of lymphoma. This article reviews the progress made with new US technologies in improving the accuracy of diagnosis and staging of lymphoma, predicting the course of lymphoma, monitoring the progression of lesions during treatment, and assisting clinics in formulating accurate and effective treatment plans. In addition, we review the biological basis of US prediction of lymphoma and provide an outlook for future research directions.

Clinical Treatment Status of Papillary Thyroid Microcarcinoma

Liu Tong, Meng Kexin, Zhu Ying, Fan Fengjing, Wang Bei

2025, 9 (1): 41-46. DOI:10.37015/AUDT.2025.240027

Abstract ( 88 ) HTML ( 1 ) PDF ( 339KB ) ( 95 ) 　　

Papillary thyroid microcarcinoma (PTMC) is a subtype of papillary thyroid carcinoma (PTC) characterized by a diameter of less than 10 mm. While its incidence is on the rise, PTMC generally carries a favorable prognosis. Traditional surgical intervention remains the primary treatment method, widely recognized for its effectiveness. However, surgical procedures can lead to postoperative scarring and complications, posing challenges for patients. For some low-risk PTMC cases that exhibit long periods of non-progression, active surveillance has emerged as a viable treatment option. Thermal ablation technology, guided by ultrasound, has demonstrated comparable short-term efficacy to surgery but with smaller incisions and reduced costs, offering a new alternative for PTMC patients. Currently, the management strategies for PTMC exhibit considerable diversity, contributing to ongoing debates in treatment approaches. This paper provides a comprehensive summary and review of the primary therapies available today.

Application of Intraoperative Ultrasound in Robot-assisted Thrombectomy for Renal Cell Carcinoma

Zhu Jianing, Li Nan, Luo Yukun, Li Qiuyang

2025, 9 (1): 47-49. DOI:10.37015/AUDT.2025.240015

Abstract ( 79 ) HTML ( 1 ) PDF ( 504KB ) ( 100 ) 　　

Preoperative imaging is crucial for patients diagnosed with renal cell carcinoma presenting with thrombus. These individuals frequently exhibit a hypercoagulable state, raising the risk of thrombus progression or the formation of a new bland thrombus post-imaging and pre-surgery. Intraoperative ultrasound, employed under direct visualization, offers real-time, dynamic detection of thrombi, potentially influencing surgical decisions. This short review explores the utility of intraoperative ultrasound in robot-assisted thrombectomy for renal cell carcinoma, detailing its primary applications and added value in mitigating surgical risks for urologists.

Application of Low Intensity Ultrasound in the Treatment of Alzheimer’s Disease

Hong Fei, Xu Fei

2025, 9 (1): 50-55. DOI:10.37015/AUDT.2025.240007

Abstract ( 90 ) HTML ( 6 ) PDF ( 497KB ) ( 101 ) 　　

Alzheimer’s disease (AD) is a common neurodegenerative disease in clinical practice. The pathogenesis is still unclear, and there is no specific method. According to the current known pathological studies, AD biomarker TAU protein, phosphorylated tau and amyloid-β (Aβ) play an important role in the pathophysiological changes of AD. For pathological research, the development of low-intensity ultrasound (LIUS) provides another idea for the mechanism of AD treatment, which can better treat AD, regulate various factors specifically, and effectively treat AD by stimulating synapses and improving neurons. Based on this research background, this paper summarizes the role of AD biomarkers TAU protein, phosphorylated tau and amyloid protein in the occurrence and development of AD and the mechanism of pathological changes in the treatment of AD by low-intensity ultrasound, aiming to provide new insights into clarifying the pathological changes of AD biomarkers and the mechanism of LIUS in the treatment of AD. Given that the treatment for AD based on LIUS is still far from a complete cure, we will discuss the prospects for future development of LIUS to guide the treatment of AD.

Original Research

Is the Adventitial Vasa Vasorum in Vulnerable Carotid Plaques Increased or Decreased?

Wang Yixuan, Jin Lin, Chen Jianxiong, Yang Huixian, Shen Cuiqin, Xu Wenzhe, Shen Yuzhou, Huang Jun, Sun Liwan, Du Lianfang, Wang Bei, Li Fan, Li Zhaojun

2025, 9 (1): 56-64. DOI:10.37015/AUDT.2025.240043

Abstract ( 65 ) HTML ( 1 ) PDF ( 1706KB ) ( 70 ) 　　

Background Intraplaque neovascularization is a biomarker of vulnerable plaque. However, no data are available whether the increase in neovascularization within carotid plaques is a result of ischemia or an increase in adventitial vasa vasorum (VV).

Objective To evaluate the VV signal in carotid vulnerable plaques.

Methods Contrast-enhanced ultrasound (CEUS) examination was performed to examine changes in VV density in 47 patients with carotid plaque, and 21 patients received CT angiography (CTA) examination to assess the VV signal. In addition, a single-channel flow tissue model was fabricated for use in vitro studies to exclude pseudo-enhancement interferences in the distal wall of arteries by CEUS.

Results The intensities of adventitial VV behind carotid plaque were lower than that of adventitial VV at the same level adjacent to the plaque in both CEUS and CTA examinations (P < 0.05). In vitro study, the intensities of far wall increased as the microbubble concentration increased (P < 0.05). However, no significant differences of intensities of far wall were found between different thicknesses tubes at the concentration of microbubble concentrations of 0.3% and 0.5% (P ≥ 0.05).

Conclusion The formation of intraplaque neovascularization in carotid arteries is associated with the adventitial VV, and ischemia of VV may be a potential mechanism for intraplaque neovascularization.

Stroke Lesion Prediction by Bille-Viper-Segmentation with Tandem-MU-net Model

Beevi Fathima, N Santhi Dr, N Ramasamy Dr

2025, 9 (1): 65-78. DOI:10.37015/AUDT.2025.240011

Abstract ( 69 ) HTML ( 2 ) PDF ( 1599KB ) ( 60 ) 　　

Stroke is a critical condition marked by the death of brain cells due to inadequate blood flow, necessitating improved predictive models for stroke lesions. The accuracy and flexibility required to forecast and classify stroke lesions is lacking in current approaches, which compromise patient outcomes. To solve these issues, Bille-Viper-Segmentation with the Tandem-MU-Net Model is suggested as a solution for tissue damage detection problems. This study improves blood flow detection in stroke images by introducing the Bille-Viper-Segmentation method to overcome difficulties in recognizing tissue injury. This novel method effectively samples pixel data and analyzes fogging phases related to stroke lesions by utilizing a Deep Luxe Gauging Tree. Existing methods struggle with flexibility in varying conditions; thus, the Trans-Lucent-Rich Reprise Pattern recognition algorithm for precise identification of infected areas is introduced. Furthermore, the Focus View Algorithm is suggested, which incorporates features from infarcted regions to improve early detection of emerging lesions. Furthermore, the Tandem-MU-Net model is used to extract essential morphological features and categorize stroke types, including Hemorrhagic and Acute strokes, through an investigation of their neutral and ionic forms. The results show that the suggested model performs substantially better than existing methods, achieving an amazing accuracy rate of 75%, recall rate of 83%, F1 score of 98%, Dice score of 98%, and precision of 73%, all while operating effectively in a time frame of 250 seconds.

Sonographic Evaluation of the Obstetric Causes of Vaginal Bleeding During the First Trimester

Naveen Reddy Bandi, Ranjan Nayak Soumya, Jena Satyaswarup, Sahu Niranjan, Das Somadatta

2025, 9 (1): 79-83. DOI:10.37015/AUDT.2025.230039

Abstract ( 84 ) HTML ( 9 ) PDF ( 816KB ) ( 76 ) 　　

Objective Antenatal vaginal bleeding, particularly during the first trimester, is worrisome for obstetricians. The common causes are all types of abortions, including molar and ectopic pregnancies. The aim is to evaluate the obstetric causes of vaginal bleeding during the first trimester.

Methods The study population comprises 100 pregnant women with complaints of vaginal bleeding during their first trimester period. These patients were subjected to ultrasound examination to diagnose the causes of bleeding. Patients with 12 completed weeks of gestation and non-obstetrical causes of vaginal bleeding were excluded.

Results The study population of 18-34 years had complained of vaginal bleeding during their first trimester of pregnancy. Most 57% were in the age group of 20-24 years. Forty-two percent of the study population presented at ten weeks of amenorrhea. Out of 100 cases, the majority (58%) were diagnosed as threatened abortion, 31% cases were diagnosed as incomplete abortion, 4% cases were diagnosed as complete abortion, 2 (2%) cases each were diagnosed as ectopic gestation, inevitable and missed abortions, and 1 (1%) case diagnosed as Hydatidiform mole. Out of 100 patients, the gestational sac was seen in 75 (75%).

Conclusion Antenatal ultrasonography is helpful in accurate and early diagnosis of the causes of vaginal bleeding during the first trimester. This aids the obstetrician in selecting the best treatment planning and helps with prognosis prediction, establishing an accurate diagnosis in a few clinically misdiagnosed cases.

Biliary Atresia Treatment: Can Shear Wave Elastography Predict Kasai Procedure Outcomes?

Sekarsari Damayanti, Gema Ramadhan Muhammad, Rinaldhy Kshetra, Prihartono Joedo

2025, 9 (1): 84-91. DOI:10.37015/AUDT.2025.240005

Abstract ( 54 ) HTML ( 1 ) PDF ( 537KB ) ( 64 ) 　　

Objective Biliary atresia is a significant cause of neonatal pathological jaundice, demanding effective interventions such as the Kasai procedure to impede its advancement. Previous research highlights the potential of shear wave elastography for assessing liver fibrosis and the subsequent necessity for liver transplantation following Kasai procedure. This underlines the significance of our study in investigating shear wave elastography as a predictive tool for the success of Kasai procedure in biliary atresia patients.

Methods This retrospective case-control comparative study analyzed data from biliary atresia patients who underwent shear wave elastography ultrasound and the Kasai procedure at our center from 2020 to 2022. Successful Kasai outcomes formed the case group; unsuccessful, the control. We calculated the mean shear wave elastography values for each group and established a predictive Kasai success cut-off using SPSS for statistical analysis.

Results Twenty-one subjects, with 8 males and 13 females (median age: 82 days), were evaluated. Of the 21 subjects, 9 (42.9%) had successful Kasai outcomes, while 12 (57.1%) were unsuccessful. There are statistically different values between two groups, such as the shear wave elastography value (P = 0.001). The optimal cut-off point of shear wave elastography value to predict the success of Kasai procedure is 2.21 m/s or 14.4 kPa (sensitivity 88.9%, specificity 83.3%, accuracy 85.7%, PPV 87.65%, NPV 84.91%), with an AUC of 0.889 (95%CI = 0.75-1.00), OR = 10.50 (1.360-81.053).

Conclusion This study demonstrates shear wave elastography’s potential utility in predicting Kasai procedure success for biliary atresia patients, suggesting its role as a valuable prognostic tool.

Case Reports

The Diagnostic Pitfall of Lymphadenopathy: Ultrasonic Imaging Findings in a Case of Cat Scratch Lymphadenitis

Li Tiantian, Zhu Miao, Shen Dejuan, Qian Xiaoqin

2025, 9 (1): 92-95. DOI:10.37015/AUDT.2025.230053

Abstract ( 60 ) HTML ( 3 ) PDF ( 846KB ) ( 51 ) 　　

Lymphadenopathy is a common clinical disease, and ultrasonography is its primary preliminary diagnostic screening strategy. With an increase in house-raised pets, the annual incidence of cat scratch lymphadenitis is rising. After infection, the characteristics of the disease include abnormal lymph node enlargement in the local drainage, accompanied by low heat sweats, similar to clinical symptoms of malignant disease. The two-dimensional ultrasound results lack specificity. However, garland-like variation can be observed in the enhanced images, which can be used for the differential diagnosis of cat scratch lymphadenitis. In this case, we obtained the ultrasound and computed tomography images of a patient with cat scratch lymphadenitis and compared and analyzed them with the pathological data.