Search

Compared with the upper limbs, sonographic tracking of peripheral nerves in the lower limbs is more challenging. The overlying muscles are larger, hindering visualization of the deeply embedded nerves by using a linear transducer. The use of a curvilinear transducer--providing an extended view with better penetration for the field of interest--may be useful for scanning the nerves in the hip and thigh. Application of the Doppler mode helps localization of the target nerve by identifying the accompanying vessels. Aiming to demonstrate the relevant tracking techniques, the present article comprises a series of ultrasound images and videos showing how to scan the nerves in the lower limb, that is, femoral, obturator, pudendal, lateral femoral cutaneous, sciatic, saphenous, sural, tibial, and peroneal nerves. [ABSTRACT FROM AUTHOR]

Objective: The purposes of this study were to determine the best cutoff value for bicipital peritendinous effusion (BPE) and to test its diagnostic performance as regards shoulders with and without rotator cuff pathology. Design: We reviewed the sonographic reports of 1352 patients with suspected shoulder disorders between January 201 1 and June 201 2. The associations between BPE and rotator cuff abnormalities were explored by logistic regression and adjusted for age, sex, affected side, and clinical diagnosis of frozen shoulder. The receiver operating characteristic curves were constructed to assess the ability of BPE to discriminate certain rotator cuff pathologies. Maximal Youden indexes were used to define the best cutoff points, which were later applied on the validation data set for its discriminative ability. Results: Sonographic findings of subscapularis tendinopathy, subdeltoid bur-sitis, supraspinatus full-thickness tear, and supraspinatus articular-sided partial-thickness tear were found to be associated with BPE. The cutoff values of BPE to differentiate those lesions were 1.0, 0.9, 1.5, and 1.5 mm, respectively. Validation of the diagnostic performance of BPE at defined thicknesses yielded good negative predictive values for the aforementioned rotator cuff abnormalities. Conclusions: Sonographically detected BPE seems to be in association with certain rotator cuff pathologies, and it can be utilized as an adjuvant finding to rule out such rotator cuff abnormalities. [ABSTRACT FROM AUTHOR]

The article focuses on a study related to dynamic ultrasonography of the intra-articular long head of the biceps tendon (LHBT) and superior labrum. It mentions LHBT appearing as a fibrillar hyperechoic band, coursing around the superior humeral head, and inserting on the triangular hyperechoic superior labrum. It states labral insertion of LHBT allows for evaluation of a superior labrum, anterior and posterior (SLAP) lesion alongwith video is presented for the whole procedure.

The article presents a case study of a 65-year-old man with sprained right wrist, who developed severe pain and swelling over the ulnar aspect of the wrist. It states that physical examination revealed tenderness between the ulnar styloid and proximal carpal bones. It mentions that power Doppler and dynamic imaging revealed triangular fibrocartilage complex (TFCC) injury, and distal ulnocarpal instability; and the patient was treated with a wrist splint and physical therapy.

The article presents a case study of a 43-year-old man who experienced hip pain. The patient underwent an ultrasound (US) examination after no improvement was shown with nonsteroidal anti-inflammatory treatment. Information regarding the diagnosis of avascular necrosis of the femoral head as iliopsoas bursa, the largest bursa located at the front of the hip joint and the iliopsoas muscle.

The article describes the case of a 59 year old painter presented with right-sided lateral wrist pain for 6 months before being diagnosed with de Quervain disease. An ultrasound (US) revealed swelling over the radial and dorsal side of his wrist and positive Finkelstein test. A third corticosteroid injection guided by US was performed particularly for the extensor pollicis brevis tendon and the patient had complete pain relief following 2 weeks of follow-up.

Objective: The performance of 18 F-FDG PET-based radiomics and deep learning in detecting pathological regional nodal metastasis (pN+) in resectable lung adenocarcinoma varies, and their use across different generations of PET machines has not been thoroughly investigated. We compared handcrafted radiomics and deep learning using different PET scanners to predict pN+ in resectable lung adenocarcinoma., Methods: We retrospectively analyzed pretreatment 18 F-FDG PET from 148 lung adenocarcinoma patients who underwent curative surgery. Patients were separated into analog (n = 131) and digital (n = 17) PET cohorts. Handcrafted radiomics and a ResNet-50 deep-learning model of the primary tumor were used to predict pN+ status. Models were trained in the analog PET cohort, and the digital PET cohort was used for cross-scanner validation., Results: In the analog PET cohort, entropy, a handcrafted radiomics, independently predicted pN+. However, the areas under the receiver-operating-characteristic curves (AUCs) and accuracy for entropy were only 0.676 and 62.6%, respectively. The ResNet-50 model demonstrated a better AUC and accuracy of 0.929 and 94.7%, respectively. In the digital PET validation cohort, the ResNet-50 model also demonstrated better AUC (0.871 versus 0.697) and accuracy (88.2% versus 64.7%) than entropy. The ResNet-50 model achieved comparable specificity to visual interpretation but with superior sensitivity (83.3% versus 66.7%) in the digital PET cohort., Conclusion: Applying deep learning across different generations of PET scanners may be feasible and better predict pN+ than handcrafted radiomics. Deep learning may complement visual interpretation and facilitate tailored therapeutic strategies for resectable lung adenocarcinoma., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: To investigate whether combining primary tumor and metastatic nodal glycolytic heterogeneity on 18 F-fluorodeoxyglucose PET ( 18 F-FDG PET) improves prognostic prediction in nonsmall cell lung cancer (NSCLC) with locoregional disease., Methods: We retrospectively analyzed 18 F-FDG PET-derived features from 94 patients who had undergone curative treatments for regional nodal metastatic NSCLC. Overall survival (OS) and progression-free survival (PFS) were analyzed using univariate and multivariate Cox regression models. We used the independent prognosticators to construct models to predict survival., Results: Combined entropy (entropy derived from the combination of the primary tumor and metastatic nodes) and age independently predicted OS (both P = 0.008) and PFS ( P = 0.007 and 0.050, respectively). At the same time, the Eastern Cooperative Oncology Group status was another independent risk factor for unfavorable OS ( P = 0.026). Our combined entropy-based models outperformed the traditional staging system (c-index = 0.725 vs. 0.540, P < 0.001 for OS; c-index = 0.638 vs. 0.511, P = 0.003 for PFS) and still showed prognostic value in subgroups according to sex, histopathology, and different initial curative treatment strategies., Conclusion: Combined primary tumor-nodal glycolytic heterogeneity independently predicted survival outcomes. In combination with clinical risk factors, our models provide better survival predictions and may enable tailored treatment strategies for NSCLC with locoregional disease., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: The total metabolic tumor volume (TMTV) measured from fluorine-18 fluorodeoxyglucose (18F-FDG) PET can be useful for determining the prognosis of patients with lymphoma. Stratifying patients into high- and low-TMTV risk groups requires a cutoff point, which is determined through the dichotomization method. This study investigated whether different TMTV dichotomization methods influenced survival prediction in patients with lymphoma., Methods: We retrospectively enrolled 129 patients with lymphoma who had undergone baseline 18F-FDG PET. TMTV was calculated using a fixed standardized uptake value threshold of 4.0. A total of six methods were employed to determine the optimal TMTV cutoff point using receiver-operating characteristic curve analyses, X-Tile bioinformatics software, and the Cutoff Finder web application. The prognostic performance of each method in survival prediction was examined., Results: The median (interquartile range) TMTV was 123 cm3 (21-335 cm3). The optimal TMTV cutoff values for predicting progression-free survival (PFS) and overall survival (OS) were in the range of 144-748 cm3. The cutoff points were used to dichotomize patients into two groups with distinct prognoses. All TMTV dichotomizations were significantly predictive of PFS and OS. The survival curves showed significant differences between the high- and low-TMTV groups. The C-indices of the survival models did not significantly differ in any of the dichotomizations., Conclusion: The prognostic significance of TMTV was maintained regardless of the methodological aspects of dichotomization. However, the optimal TMTV cutoff point varied according to the chosen dichotomization method. Care should be taken when establishing an optimal TMTV cutoff point for clinical use., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)