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Trastuzumab combined with chemotherapy is the first-line treatment for advanced HER2-positive gastric cancer, but it still suffers from limited therapeutic efficiency and serious side effects, which are usually due to the poor delivery efficiency and the drug resistance of tumor cells to the chemotherapeutic drugs. Herein, a type of ultrasound microbubble for simultaneous delivery of sonosensitizers and therapeutic antibodies to achieve targeting combination of sonodynamic therapy and antibody therapy of HER2-positive gastric cancer was constructed from pyropheophorbide-lipid followed by trastuzumab conjugation (TP MBs).

Our study aimed to identify ultrasound characteristics of benign thyroid degenerative nodules and reveal the correlation between their sizes and 2017 ACR Thyroid Imaging Reporting and Data System (TI-RADS) categories. A total of 174 thyroid degenerative nodules were divided into three groups: 0.5–1 cm group (70 nodules), 1–2 cm group (27 nodules), and > 2 cm group (77 nodules). The ultrasound appearance of each nodule was evaluated, and the ACR TI-RADS scores and levels of the nodules were also calculated and compared among the three groups. The ultrasound appearance of degenerative nodules of different sizes is diversified, and the 0.5–1 cm group tended to have more malignant features and higher TI-RADS scores and categories. The scatterplot of Spearman correlation showed a significant negative correlation between the nodule sizes and TI-RADS categories. The 2017 ACR TI-RADS, which recommends fine-needle aspiration according to the nodule size and category, is still useful in managing these nodules, and following the clinical recommendations of ACR TI-RADS is necessary.

Purpose To compare the diagnostic performance of double contrast-enhanced ultrasound (DCEUS) and multi-detector row computed tomography (MDCT) in the gross classification of gastric cancer (GC) preoperatively. Methods 54 patients with histology proved GC were included in this retrospective study. The sensitivity and specificity of DCEUS and MDCT for the gross classification of GC was calculated and compared. The area under the curve (AUC) from a receiver operating characteristic curve analysis was used to evaluate the difference of the diagnostic performance between these two methods. Results There were no significant differences between DCEUS and MDCT in terms of AUC for early gastric cancer (EGC), Borrmann I, II, III and Borrmann (III + IV) (P = 0.248, 0.317, 0.717, 0.464 and 0.594, respectively). The accuracy of DCEUS in diagnosing EGC, Borrmann I, II and Borrmann (III + IV) was higher than that of MDCT (96% vs 92%; 96% vs 94%; 87% vs 80%; 83% vs 73%), while in determining Borrmann III and IV, that of DCEUS was lower than that of MDCT (72% vs 74%; 89% vs 96%). Conclusion Considering the revolution in clinical decision, prognosis evaluation, safety and non-invasion aspects, DCEUS can be used as the main alternative method for Borrmann classification of GC preoperatively.

Preeclampsia is a progressive and severe cardiovascular disorder in pregnant women. To determine the potential significance of ophthalmic Doppler parameters in preeclamptic women and to provide evidence-based hints for clinical practice and scientific investigation. We searched PubMed, Embase, Web of Science, and the Cochrane Library till July 31, 2022. Pooled standardized mean difference (SMD) with 95% confidence intervals (CIs) were calculated using the random effects model. Heterogeneity across included studies was evaluated utilizing the Q test and I

Ultrasound is widely used in biomedical engineering and has applications in conventional diagnosis and drug delivery. Recent advances in ultrasound-induced drug delivery have been summarized previously in several reviews that have primarily focused on the fabrication of drug delivery carriers. This review discusses the mechanisms underlying ultrasound-induced drug delivery and factors affecting delivery efficiency, including the characteristics of drug delivery carriers and ultrasound parameters. Firstly, biophysical effects induced by ultrasound, namely thermal effects, cavitation effects, and acoustic radiation forces, are illustrated. Secondly, the use of these biophysical effects to enhance drug delivery by affecting drug carriers and corresponding tissues is clarified in detail. Thirdly, recent advances in ultrasound-triggered drug delivery are detailed. Safety issues and optimization strategies to improve therapeutic outcomes and reduce side effects are summarized. Finally, current progress and future directions are discussed.

OBJECTIVES The purpose of this study was to compare the sensitivity and specificity of double contrast-enhanced ultrasound (CEUS) and multidetector computed tomography (MDCT) in the preoperative tumor staging of gastric cancer (GC) to stratify patients for suitable treatment. METHODS Fifty-four patients with GC proved by histologic findings were included. The sensitivity and specificity of double CEUS and MDCT for tumor staging were calculated and compared. The differences between these methods were evaluated by using the area under the curve (AUC) from a receiver operating characteristic curve analysis. RESULTS There were no significant differences in AUC values for T1 and T2 stages between double CEUS and MDCT (P = .190 and .256, respectively). However, the sensitivity of double CEUS in the detection of the T1 stage was higher than that of MDCT (88% versus 75%). The AUC values of MDCT for T3 and T4 stages were 0.833 and 0.905, which were both significantly higher than those of double CEUS (0.759 and 0.696; P

This article aims to introduce a novel anatomical scanning method which requires scanning according to varied anatomic positions of the appendix based on the widely used graded compression method. We suggest placing the probe longitudinally in the region of the terminal cecum and moving it laterally to explore the sub-cecal appendix. The probe should be placed transversely on the medial side of the cecum to explore the pre-ileal appendix or post-ileal appendix. Placing the probe perpendicularly along external iliac vessels can help explore the pelvic appendix. The probe should be placed transversely on the paracolic sulci, and moved along the paracolic sulci to observe the extra-peritoneal appendix. Using the cephalic end of the probe as a pivot, push and squeeze the cecum to make it move bilaterally as much as possible, in order to expose the retrocecal appendix behind the air-filled cecum. It is our belief that this anatomical scanning method will greatly improve appendix detection rate and diagnostic accuracy, and provide guidance for surgical localization.

Purpose. Developed a preoperative prediction model based on multimodality imaging to evaluate the probability of inferior vena cava (IVC) vascular wall invasion due to tumor infiltration. Materials and Methods. We retrospectively analyzed the clinical data of 110 patients with renal cell carcinoma (RCC) with level I-IV tumor thrombus who underwent radical nephrectomy and IVC thrombectomy between January 2014 and April 2019. The patients were categorized into two groups: 86 patients were used to establish the imaging model, and the data validation was conducted in 24 patients. We measured the imaging parameters and used logistic regression to evaluate the uni- and multivariable associations of the clinical and radiographic features of IVC resection and established an image prediction model to assess the probability of IVC vascular wall invasion. Results. In all of the patients, 46.5% (40/86) had IVC vascular wall invasion. The residual IVC blood flow (OR 0.170 [0.047-0.611]; P = 0.007 ), maximum coronal IVC diameter in mm (OR 1.203 [1.065-1.360]; P = 0.003 ), and presence of bland thrombus (OR 3.216 [0.870-11.887]; P = 0.080 ) were independent risk factors of IVC vascular wall invasion. We predicted vascular wall invasion if the probability was >42% as calculated by: Ln Pre / 1 − pre = 0.185 × maximum cornal IVC diameter + 1.168 × bland thrombus – 1.770 × residual IVC blood flow – 5.857 . To predict IVC vascular wall invasion, a rate of 76/86 (88.4%) was consistent with the actual treatment, and in the validation patients, 21/26 (80.8%) was consistent with the actual treatment. Conclusions. Our model of multimodal imaging associated with IVC vascular wall invasion may be used for preoperative evaluation and prediction of the probability of partial or segmental IVC resection.

To evaluate the diagnostic performance of contrast-enhanced ultrasound (CEUS) in differential diagnosis of inflammatory bowel disease (IBD) and colon cancer, we enrolled 51 patients with thickened bowel walls (13 with IBD and 38 with colon cancer). Ultrasound and CEUS were performed and both qualitative and quantitative features were analyzed. The intestinal wall stratification was preserved in 63.6% of the IBD group but in only 2.6% of the colon cancer group (p 0.01). On CEUS, disordered enhancement and heterogeneous enhancement were shown in only 9.1% and 0%, respectively, of the IBD group while in 94.7% and 78.9%, respectively, of the colon cancer group (p 0.01). For quantitative analysis, compared to IBD, colon cancer showed later enhancement and slower wash-out with less speed to reach peak intensity (p 0.05). In conclusion, CEUS may prove useful for the differential diagnosis of IBD and colon cancer, but more studies are required.

Objective criteria are currently not available for assessing the extent of ablation by high-intensity focused ultrasound (HIFU). A retrospective review was conducted in Chinese patients with late-stage pancreatic body carcinoma treated with 1 h/d intermittent HIFU at a single center. Clinical and procedure-related characteristics were examined in relation to tumor posterior depth. Clinically, tumor ablation was negatively correlated with posterior tumor depth, with a 1-cm increase in depth decreasing ablation by 30.7%. At a computed tomography (CT)-determined 7-cm posterior tumor depth (considered the critical value for the procedure), ablation sensitivity and specificity were 77.8% and 72.7%, respectively. Tumor ablation >30% in patients with a CT-determined posterior tumor depth ≤7 cm was 9.333 times better than that in patients with a CT-determined posterior tumor depth >7 cm. Adverse effects did not affect the efficacy of HIFU. Tumors with posterior depths

To evaluate the diagnostic performance of contrast-enhanced ultrasound (CEUS) in differential diagnosis of gastric cancer and gastritis, with histological results as reference standard. From September 2011 to August 2014, 82 patients (50 males and 32 females; mean age ± SD, 59.5 ± 15.0 years; range 19–91 years) with gastric cancer or gastritis were included in this Ethics Committee-approved prospective study. Conventional ultrasonography (US) and CEUS were applied to distinguish the two lesions, and both qualitative and quantitative features were evaluated. Of the 82 histopathologic-proven lesions, 58 were cancer and 24 were gastritis. For US, the gastric wall stratification was not preserved in about one-third of cancer (21/58, 36.2%) compared with gastritis (0/24, 0%) (p

Nanoparticles (NPs)-based diagnosis and phototherapy are emerging as the cutting-edge technologies for detection and treatment of cancer but their applications are still limited since insufficient and heterogeneous NPs accumulation in cancer often causes recurrence. To overcome these limitations, multifunctional microbubbles (MBs) were constructed with 1, 1-dioctadecyl-3, 3, 3, 3-tetramethylindotricarbocyanine iodide (DiR) and porphyrin grafted lipid (PGL). Both DiR and PGL self-assembled as microbubbles, the as-designed PGL-DiR MBs possess remarkably high drug loading contents (5.8% PGL and 10.38% DiR) and stable co-delivery drug combinations. In vivo experiments showed PGL-DiR MBs could serve as an excellent ultrasound contrast agent to enhance ultrasound imaging greatly for identifying the location and size of the tumors. Upon exposure to ultrasound, in situ conversion of PGL-DiR MBs into nanoparticles resulted in a remarkable increase in fluorescence intensity (~5 folds) in tumor compared with PGL-DiR NPs, validating the enhanced tumor accumulation and cellular uptake of therapeutic agents. PGL-DiR MBs showed complete tumor ablation without recurrence in vivo, while PGL-DiR NPs showed only 72.6% tumor growth inhibition at the same dose. We believe that PGL-DiR MBs will soon reach their full potential as an important class of phototherapeutic formulations and will contribute to remarkable advances in cancer treatments.

To determine the utility of the long-to-short diameter ratio (L/S ratio) and other sonographic features in the differentiation of pleomorphic adenoma (PA) and Warthin's tumour (WT) of the salivary gland.From 2003 to 2013, 100 patients with 100 PAs and WTs were included in this ethics committee-approved retrospective study. For each lesion, B-mode sonographic and colour Doppler images were obtained and the L/S ratios were calculated. Surgical excision and histopathological examination were accomplished in all cases. Differences between the L/S ratio and other sonographic features for PA and WT were evaluated.Of the 100 salivary tumours, 80 were located in the parotid (37 PAs and 43 WTs), and 20 were in the submandibular gland (19 PAs and one WT). In the parotid, the L/S ratio was 1.38±0.21 for PA and 1.73±0.46 for WT. The L/S ratio of the WTs was higher than that of the PAs (p0.001). Applying a cut-off of 1.519, the sensitivity, specificity, and accuracy for differentiation of PA and WT in the parotid were 69.8%, 81.1%, and 75%, respectively; however, the accuracy dropped to 42.9% in diagnosing masses with ≥50% macroscopic cystic structures. When those masses were excluded, the accuracy rose to 78.1%.The L/S ratio when used with other ultrasound features aids differentiation between PA and WT in the parotid gland; however, masses with macroscopic cystic structures ≥50% should not be judged by this parameter.

The minimally invasive high-intensity focused ultrasound (HIFU) therapy is thermal ablation treatment for late-stage pancreatic carcinoma with widely recognized safety and effectiveness, but there are currently no instant assessment methods for its ablation effect. It is vital to find a real-time high-sensitive assessment method. This research aims to dynamically observe the variation rules of ultrasound reflection intensity, analyze the correlation between ultrasound reflection intensity and tumor ablation ratio, and find out the value of ultrasound reflection intensity in prognosis of HIFU ablation effect. HIFU intermittent therapies were retrospectively analyzed for 31 subjects with late-stage pancreatic carcinoma from March 2007 to December 2009 in the study. The variation rules of the ultrasound reflection intensity during HIFU therapy were summarized and the correlation between ultrasound reflection intensity and tumor ablation ratio was analyzed based on the tumor ablation ratio indicated by CT scanning. The conclusion is that variation of ultrasound reflection intensity can be used for initial assessment of tumor ablation in HIFU therapy and early prognosis of overall HIFU ablation, providing important clinical basis for improving safety and effectiveness of HIFU therapy. Ultrasound can work as a real-time imaging instrument for observation of HIFU ablation effect in treating late-stage pancreatic carcinoma.