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Introduction: Ultrasound is a resource commonly used in Physical Therapy. However, its inadequate application may produce insufficient heating or cause damage to biological tissues. Therefore, the knowledge on the optimum parameters for achieving the appropriate temperature, within safe limits, is necessary. Heat generation depends on equipment parameters and the physical properties of tissues. This study presented a software that simulates the energy and temperature variation in tissues over time, thus allowing users to view the heating patterns in tissues as a function of these parameters. Methods: The software was implemented based on the bioheat transfer equation for four layers (skin, fat, muscle and bone), in which the user can change the thickness and thermal or acoustic properties of these tissues. The intensity, frequency and time of application can also be chosen. Graphs showing the percentage energy absorption in relation to depth and the respective temperature variation per millimeter of tissue are presented. Results: Simulations were produced to give examples of situations of interest for therapy, by varying the time of application, thickness and ultrasound frequency. Differences in heating patterns are seen, especially at the interfaces. Conclusions: The software made it possible to study the heating of biological tissues by ultrasound and can be used both for teaching purposes and for planning heating doses for continuous waves. In the future, the software will be adapted, in order to estimate which dose should be regulated in the apparatus to maintain the desired temperature for the time chosen. Software available in: http://www.peb.ufrj.br/lus.htm. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate a new therapeutic option for the spasticity using ultrasound neuromodulation in an animal model of spastic cerebral palsy., Methods: Thirty-two adult male Wistar rats were randomly distributed in: negative control (NC); positive control (PC); untreated model (UTM); and treated model (TM). Rats in the control groups received sham surgery, and rats in the model groups received the spastic cerebral palsy model surgery. The rats' motor functions were evaluated by the Rotarod and CatWalk tests before and after surgery. PC and TM groups underwent ultrasonic neuromodulation by a physiotherapeutic ultrasound (intensity 0.1 W/cm2, at 1 MHz) continuous mode for 5 seconds, for seven days., Results: Twelve rats showed a spastic pattern (UTM = 6 and TM = 6), motor limitations (UTM = 6 and TM = 6), and ten had difficulty feeding (UTM = 5 and TM = 5). One UTM group rat could not recover its preoperative latency time, while the other rats in the model groups did. The speed at which the limbs swung reduced after surgery and increased in subsequent assessments, demonstrating greater instability and a deficit in locomotion balance., Conclusions: Results were not yet sufficient to assert ultrasound neuromodulation as a possible therapy for spasticity in spastic cerebral palsy in the parameters used, and more studies are necessary.

Thermal treatments that use ultrasound devices as a tool have as a key point the temperature control to be applied in a specific region of the patient's body. This kind of procedure requires caution because the wrong regulation can either limit the treatment or aggravate an existing injury. Therefore, determining the temperature in a region of interest in real-time is a subject of high interest. Although this is still an open problem, in the field of ultrasound analysis, the use of machine learning as a tool for both imaging and automated diagnostics are application trends. In this work, a data-driven approach is proposed to address the problem of estimating the temperature in regions of a B-mode ultrasound image as a supervised learning problem. The proposal consists in presenting a novel data modeling for the problem that includes information retrieved from conventional B-mode ultrasound images and a parametric image built based on changes in backscattered energy (CBE). Then, we compare the performance of classic models in the literature. The computational results presented that, in a simulated scenario, the proposed approach that a Gradient Boosting model would be able to estimate the temperature with a mean absolute error of around 0.5°C, which is acceptable in practical environments both in physiotherapic treatments and high intensity focused ultrasound (HIFU)., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest concerning the research, authorship, and/or publication of this article.

Breast ultrasound (BUS) image classification in benign and malignant classes is often based on pre-trained convolutional neural networks (CNNs) to cope with small-sized training data. Nevertheless, BUS images are single-channel gray-level images, whereas pre-trained CNNs learned from color images with red, green, and blue (RGB) components. Thus, a gray-to-color conversion method is applied to fit the BUS image to the CNN's input layer size. This paper evaluates 13 gray-to-color conversion methods proposed in the literature that follow three strategies: replicating the gray-level image to all RGB channels, decomposing the image to enhance inherent information like the lesion's texture and morphology, and learning a matching layer. Besides, we introduce an image decomposition method based on the lesion's structural information to describe its inner and outer complexity. These gray-to-color conversion methods are evaluated under the same experimental framework using a pre-trained CNN architecture named ResNet-18 and a BUS dataset with more than 3000 images. In addition, the Matthews correlation coefficient (MCC), sensitivity (SEN), and specificity (SPE) measure the classification performance. The experimental results show that decomposition methods outperform replication and learning-based methods when using information from the lesion's binary mask (obtained from a segmentation method), reaching an MCC value greater than 0.70 and specificity up to 0.92, although the sensitivity is about 0.80. On the other hand, regarding the proposed method, the trade-off between sensitivity and specificity is better balanced, obtaining about 0.88 for both indices and an MCC of 0.73. This study contributes to the objective assessment of different gray-to-color conversion approaches in classifying breast lesions, revealing that mask-based decomposition methods improve classification performance. Besides, the proposed method based on structural information improves the sensitivity, obtaining more reliable classification results on malignant cases and potentially benefiting clinical practice., (© 2023. International Federation for Medical and Biological Engineering.)

Introduction: Breast engorgement (BE) is a problem that affects many women, especially in the first days of breastfeeding, producing inflammatory symptoms. Nonpharmacological therapies are inexpensive, safe, and can produce symptom relief. Objective: This study aims to analyze the safety of therapeutic ultrasound regarding possible risks of overheating and the effects of its use alone and associated with lymphatic drainage (LD) in women. Material and Methods: Effectiveness is measured through thermography, visual analog scale, and six-point scale of BE. This is a nonrandomized clinical trial with a sample of 34 in the ultrasound group (G1), 28 in the ultrasound and LD group (G2), and 37 in the control group (G3). Results: The mean reduction for engorgement was 1.3 ± 0.8 to G1, 1.4 ± 1.0 to G2, and 1.2 ± 0.9 to G3 according to the six-point scale. The mean reduction for pain level was 3.6 ± 2.1 to G1, 4.0 ± 3.1 to G2, and 4.0 ± 2.2 to G3 according to the visual analogue scale. Conclusion: It was observed that all therapies were effective in reducing the level of engorgement, according to the six-point scale. However, combined ultrasound and LD therapy has been shown to be more effective in reducing the level of pain. Brazilian Registry of Clinical Trials (RBR-6btb6zz).

Previous works have shown the feasibility of temperature estimation during ultrasonic therapy using pulse-echo diagnostic ultrasound. These methods are based on the measurement of thermally induced changes in backscattered RF echoes due to thermal expansion and changes in ultrasonic velocity. They assume a joint contribution of these two parameters and a linear dependence with temperature. In this work, the contributions of velocity changes and thermal expansion to the evolution of the mean scatterer spacing of ex vivo bovine skeletal muscle tissue samples were decoupled. This was achieved by employing an experimental setup which allows measuring the absolute velocity value, using the through-transmission technique in a direct transmission configuration. The mean-scatterer spacing was estimated from spectral analysis of the backscattered signals obtained in pulse-echo mode. We propose a quadratic model of the thermal expansion coefficient to fit the evolution of the mean-scatterer spacing with temperature. The temperature increase estimated by the linear model, in the range of 29.5-47 °C, presents a percentage error (mean square error) of 11 %, while for the quadratic model the error is 4.8 %., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Introduction: Lung Ultrasonography (LUS) is a fast technique for the diagnosis of patients with respiratory syndromes. B-lines are seen in response to signal reverberations and amplifications into sites with peripheral lung fluid concentration or septal thickening. Mathematical models are commonly applied in biomedicine to predict biological responses to specific signal parameters., Objective: This study proposes a Finite-Element numerical model to simulate radio frequency ultrasonic lines propagated from normal and infiltrated lung structures. For tissue medium, a randomized inhomogeneous data method was used. The simulation implemented in COMSOL ® used Acoustic Pressure and Time-Explicit models, which are based on the discontinuous Galerkin method (dG)., Results: The RF signals, processed in MATLAB ® , resulted in images of horizontal A-lines and vertical B-lines, which were reasonably similar to real images., Discussion: The use of inhomogeneous materials in the model was good enough to simulate the scattering response, similar to others in the literature. The model is useful to study the impact of the lung infiltration characteristics on the appearance of LUS images.

Ultrasonic bone imaging is a complex task, primarily because of the low energy contained in the signals reflected from the internal bone structures. In this study, the reconstruction of a bone-mimicking phantom echographic image using time-domain topological energy (TDTE) is proposed. A TDTE image results from a combination of forward and adjoint fields. The first is a solution of a numerical model that reproduces the setup of the experimental data acquisition to the best extent possible. The second has similar characteristics, but the source term is the time-reversed residue between the forward field and signals obtained from the experiment. The acquisition-reconstruction system used a linear phased-array transducer with a 5 MHz center frequency to acquire the signals and was coupled with a k-wave toolbox to implement the numerical models and perform the image reconstruction. The results showed good agreement between the geometry of the real phantom and the ultrasonic images. However, thickness evaluation errors were observed, which may be due to incorrect assumptions about the velocity models throughout the medium, a priori assumed to be known. Thus, this method has shown promising results and should be applied to the real femoral neck as a long-term objective.

The performance of therapeutic ultrasonic (TUS) devices has a high degree of variability because of the fragility of the equipment (its transducer in particular) and its handling. These facts raise doubts about the effectiveness and safety of treatments employing such devices. Currently there is no simple way to adequately verify the performance of these devices. In our first experiments, we used a thermochromatic test body (typically a cylindrical plate 3.7 cm in diameter and 5.8 mm high) irradiated with therapeutic transducers driven by a standard radiofrequency (RF) generator. Results revealed a linear relationship between the thermal image areas, generated by the transducer's irradiation, and their respective effective radiation areas (ERAs), suggesting a good correlation. With five 3-MHz transducers, our group also observed the linear relationship using commercial TUS RF driving devices. In the present work, we used four 1-MHz transducers with their respective TUS RF driving devices and verified that there is a linear relationship between the thermal images and the ERAs at intensities of 1.0 ± 0.1 and 0.5 ± 0.05 W/cm 2 . The linear relationship obtained at both intensities confirms the suggestion that these thermochromatic test bodies can be used as the first evaluation of the ERAs and can monitor their changes with use. Moreover, if a previous assessment of the ERA and transducer intensities is performed, it is possible to follow the variation in ERA simply by monitoring the test body thermal stain., Competing Interests: Conflict of interest disclosure Potential competing interests do not exist., (Copyright © 2021 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

Objective: To analyze the types of computed tomography (CT) scanners most suitable for different hospital sizes and 'scenarios' (exam rates and structural/organizational changes), using discrete-event simulation models., Materials and Methods: CT exams were divided into stages, measured during on-site surveys at CT services in small and average size private hospitals. Ten devices in nine health units, five cities and two states of Brazil were studied to this end, and the following data were collected: Time spent in each stage for each type of exam; average monthly number of exams performed and general characteristics of exams. Three arrival rates were defined (103, 154 and 206 patients/day), representing expected demand for the studied units. From these parameters, six scenarios were simulated, consisting of changes in personnel and hospital structure (e.g., 'adding a changing room') in a base scenario (one CT, one changing room, no nursing assistance, arrival rate 1)., Results: It was possible to identify a scenario most useful for very large demands, such as large emergency hospitals in big cities, (a CT, nursing assistance and three changing rooms added to the base scenario). Another identified scenario was more adequate for small demands (adding a changing room to the base scenario)., Conclusion: Administrative/organizational measures are a very important factor in defining productivity in a hospital imaging sector. The focus of these measures should be on detecting bottlenecks and improving processes, regardless of the type of equipment used., (© 2021 John Wiley & Sons Ltd.)

The quantitative ultrasound technique was used to evaluate bone-mimicking phantoms; however, these phantoms do not mimic the intermediate stages of cortical bone healing. We propose using windshield glass as an original material to produce phantoms that mimic the characteristics of three different stages of cortical bone healing. This material was processed via a route that included breaking, grinding, compacting, drying, and sintering in four temperature groups: 625 °C, 645 °C, 657 °C, and 663 °C. The parameters evaluated were the ultrasonic longitudinal phase velocity (cL), corrected (αc) ultrasonic attenuation coefficient, and bulk density (ρs). The results showed that the mean values ofcL,αc,andρsvaried from 2, 398 to 4, 406 m·s -1 , 3 to 10 dB·cm -1 , and 1, 563 to 2, 089 kg·m -3 , respectively. The phantoms exhibited properties comparable with the three stages of cortical bone healing and can be employed in diagnostic and therapeutic studies using ultrasound., (© 2021 IOP Publishing Ltd.)

Supersonic shear imaging is a non-invasive technique used for detecting physiologic and pathologic changes in biological tissues. In this study, supersonic shear imaging was used to measure and compare shear wave speed (c s ) and normalized elastic modulus (E N ) values of skin with and skin without dermal striae (DS) in vivo. The values were measured at angles of 0°, 45°, 90° and 315° to the skin tension lines. In the presence of DS, a statistically significant reduction in the elasticity dermis was observed (p value <0.05). The mean values of c s and E N for STLs were higher in normal skin at 45° (4.26 ± 1.05 m/s and 56.23 ± 25.31 kPa) and 90° (4.26 ± 0.55 m/s and 54.91 ± 14.22 kPa), and those for DS were also higher at 45° (3.59 ± 0.72 m/s and 42.71 ± 27.97 kPa) and 90° (3.52 ± 0.65 m/s and 42.34 ± 31.68 kPa) than at other angles. Supersonic shear imaging was found to be a promising technique in the study of skin with DS. The data obtained in this study are expected to be relevant for future studies using shear wave elastography for the aforementioned purpose., (Copyright © 2020 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

Introduction: Ultrasonography has been used to understand the functional and biomechanical aspects of the lumbar multifidus muscle in vivo. To characterize the multifidus echogenicity, the peculiarities of their superficial and deep layers must be considered., Purpose: The present paper aimed to characterize the lumbar multifidus echo intensity (EI), in both superficial and deep layers, in ultrasonography images acquired in longitudinal and transversal orientations., Methods: Evaluator obtained two images in each side of the lumbar of the volunteer, who was lying on prone position. Ultrasonography images were taken with probe in transversal and longitudinal orientations. EI was estimated by means average value of the grayscale distribution histogram, by extracting from region of interest of the superficial and deep layer. All participants returned for a second test day. Two-way MANOVA test was applied to compare EI measurements, considering layers and side factors. The reliability and variability were analyzed by the intraclass correlation coefficient and standard error measurements (SEM), respectively. Two-way MANOVA found significant difference between the layers in the transversal and longitudinal images, but not between the sides., Results: Interdays reliability ranged of reasonable to excellent, and SEM values were lower than 17.08%. The superficial layer of the multifidus muscle showed higher EI values than the deeper one., Conclusions: These analyses can serve as a basis for future studies approaching multifidus of the people with low back pain.

The objective of this work is to assess, on metrological basis, the average grey-levels (AVGL) calculated from B-Mode images for estimating temperature variations non-invasively in different kinds of tissues. Thermal medicine includes several thermal therapies, being hyperthermia the most noted and well known. Recently, efforts have been made to understand the benefits of ultrasound hyperthermia at mild temperature levels, i.e., between 39 °C and 41 °C. Moreover, the best practices on ultrasound bio-effects research have been encouraged by recommending that temperature rise in the region of interest should be measured even when a thermal mechanism is not being tested. In this work, the average grey-levels (AVGL) calculated from B-Mode images were assessed for non-invasive temperature estimation in a porcine tissue sample containing two different tissue types, fat and muscle, with temperature varying from 35 °C to 41 °C. The sample was continuously imaged with an ultrasound scanner, and simultaneously the temperature was measured. The achieved results were assessed under the light of the measurement uncertainty in order to allow comparability among different ultrasound thermometry methods. The highest expanded uncertainty of estimating temperature variation using AVGL was determined as 0.68 °C., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background and Objective: The improvement in the appearance of the skin with dermal striae (DS) is currently eval-uated by invasive methods, such as biopsy. This study evaluates whether high-resolution ultrasound (HRUS) could be used to identify skin lesions in vivo caused by DS, using 2D images and measuring the thickness of the dermal layer., Methods: High-resolution ultrasound at frequencies of 20 and 30 MHz was used in this study in ten volunteers with DS. The thickness of the skin layers was estimated by tracing five vertical lines from epidermis (EP) to dermis (DE) and DE to hypodermis (H) surface., Results: The dermal lesions caused by striae appeared in ultrasonic images as poor echo areas. The average normal DE thickness varied from 1.07 to 1.65 mm, while the DE thickness with DS varied between 0.35 and 1.33 mm. A statistically significant reduction in the DE thickness was found (P-value < .05) in the presence of DS. The mean values of the EP thickness without and with DS were 0.12 ± 0.03 mm and 0.11 ± 0.02 mm, respec-tively. A total of 90.00% of the EP-related groups did not present the normal distribu-tion (P-value < .05)., Conclusions: High-resolution ultrasound permitted the visualization of the three skin layers and the dermal lesions caused by striae. The dermal layer thicknesses with striae were thinner than those without. Therefore, ultrasound 2D imaging has shown to be a promising and financially feasible tool to be used as a noninvasive diagnostic method for evaluating therapeutic protocols used in the treatment of these dermal conditions., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Stability and duration of ultrasonic phantoms are still subjects of research. This work presents a tissue-mimicking material (TMM) to evaluate high-intensity therapeutic ultrasound (HITU) devices, composed of gellan gum (matrix), microparticles (scatterers), and chemicals. The ultrasonic velocity and attenuation coefficient were characterized as a function of temperature (range 20 °C-85 °C). The nonlinear parameter B/A was determined by the finite amplitude insertion substitution (FAIS) method, and the shear modulus was determined by a transient elastography technique. The thermal conductivity and specific heat were determined by the line source method. The attenuation was stable for 60 days, and in an almost linear frequency dependence (0.51f 0.96  dB cm -1 ), at 20 °C (1-10 MHz). All other evaluated physical parameters are also close to typical soft tissue values. Longitudinal ultrasonic velocities were between 1.49 and 1.75 mm μs -1 , the B/A parameter was 7.8 at 30 °C, and Young's modulus was 23.4 kPa. The thermal conductivity and specific heat values were 0.7 W(m K) -1 and 4.7 kJ(kg K) -1 , respectively. Consistent temperature increases and thermal doses occurred under identical HITU exposures. Low cost, longevity, thermal stability, and thermal repeatability make TMM an excellent material for ultrasonic thermal applications. The TMM developed has the potential to assess the efficacy of hyperthermia devices and could be used to adjust the ultrasonic emission of HITU devices.

We describe the concept of a new imaging modality based on the tracking and dynamic modeling of local intensity changes (ICs) observed in conventional ultrasound images collected during a medium-temperature change. We computed the pixel-by-pixel IC from averaged B-mode images that exhibited different behaviors with varying temperature resulting from changes in the speed of sound, which consequently induce changes in the backscattered energy. Moreover, for each pixel, a first-order polynomial model was adjusted to the different temperature-dependent ICs. The representation of the polynomial angular parameter in 2D pixel space was used to obtain a parametric image. The results obtained by simulations and with real B-mode images indicated that this new ultrasound imaging modality was able to enhance the contrast and highlight structures that were poorly visible or even undetected in conventional images. A temperature change of 3°C was found to be sufficient to generate appropriate images with the proposed method. In addition, if a temperature change of 6°C was considered, the thermal dose, measured as the cumulative number of equivalent minutes at 43°C (CEM43°C), was 2.4 CEM43°C, which is a value that is considered safe according to the literature. We provide a proof-of-concept of a new imaging modality that opens new opportunities for the enhancement of ultrasound images and consequently contributes to improvements in ultrasound-based diagnoses. Our approach is based on images returned by commercial ultrasound scanners. Therefore, it can be implemented in any ultrasound system and is independent of specific ultrasound hardware and software data acquisition characteristics.

The purpose of this work was to obtain an anthropomorphic phantom with acoustic properties similar to those of breast tissue, possessing lactiferous duct-like structures, which would be a first for this type of phantom. Breast lesions usually grow in glandular tissues or lactiferous ducts. Shape variations in these structures are detectable by using ultrasound imaging. To increase early diagnosis, it is important to develop computer-aided diagnosis (CAD) systems and improve medical training. Using tissue-like materials that mimic known internal structures can help achieve both of these goals. However, most breast ultrasound phantoms described in the literature emulate only fat tissues and lesion-like masses. In addition, commercially available phantoms claim to be realistic, but do not contain lactiferous duct structures. In this work, we collected reference images from both breasts of ten healthy female volunteers aged between 20 and 30 years using a 10 MHz linear transducer of a B-mode medical ultrasound system. Histograms of the grey scale distribution of each tissue component of interest, the grey level means, and standard deviations of the regions of interest were obtained. Phantoms were produced using polyvinyl chloride plastisol (PVCP) suspensions. The lactiferous duct-like structures were prepared using pure PVCP. Solid scatterers, such as alumina (mesh #100) and graphite powders (mesh #140) were added to the phantom matrix to mimic glandular and fat tissue, respectively. The phantom duct-like structure diameters observed on B-mode images (1.92 mm ± 0.44) were similar to real measures obtained with a micrometer (2.08 mm ± 0.23). The phantom ducts are easy to produce and are largely stable for at least one year. This phantom allows the researchers to elaborate the structure at their will and may be used in training and as a reference for development of CAD systems., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Bone mineral density is an important parameter for the diagnosis of bone diseases, as well as for predicting fractures and treatment monitoring. Thus, the aim of the present study was to evaluate the potential of Quantitative Ultrasound (QUS) to monitor bone changes after calcium, phosphorus, and magnesium loss in rat femurs in vitro during a demineralization process. Four quantitative ultrasound parameters were estimated from bone surface echoes in eight femur diaphysis of rats. The echo signals were acquired during a decalcification process by Ethylenediaminetetraacetic Acid (EDTA). The results were compared to Quantitative Computed Tomography (QCT) and inductively coupled plasma optical emission spectrometry measurements for validation. Integrated Reflection Coefficient (IRC) reflection parameters and Frequency Slope of Reflection Transfer Function (FSRTF) during demineralization tended to decrease, while the backscattering parameter Apparent Integrated Backscatter (AIB) increased and Frequency Slope of Apparent Backscatter (FSAB) showed an oscillatory behavior with no defined trend. Results indicate a clear relation between demineralization and the corresponding decrease in the reflection parameters and increase in the scattering parameters. The trend analysis of the fall curve of the chemical elements showed a better relationship between IRC and QCT. It was possible to monitor bone changes after ions losses, through the QUS. Thus, it is an indication that the proposed protocol has potential to characterize bone tissue in animal models, providing consistent results towards standardization of bone characterization studies by QUS endorsing its use in humans.

The grey level of co-occurrence matrix (GLCM) is a texture analysis approach accounting for spatial distribution of the pixels from an image and can be a promising method for exercise-induced muscle damage (EIMD) studies. We followed up the time changes of two GLCM texture parameters and echo intensity (EI) on ultrasound images after eccentric contractions. Thirteen untrained women performed two sets of ten elbow flexions eccentric contractions. Ultrasound images were acquired at baseline and 24 h, 48 h, 72 h and 96 h after exercise. Two GLCM texture parameters were calculated for the brachialis muscle: contrast (CON) and correlation (COR). Peak torque, EI, muscle thickness (MT) and soreness were measured. The peak torque and soreness decreased immediately after the intervention in comparison with all the measures. MT increased immediately after the intervention remaining for 72 h (P<0·05). Significant increases (P<0·05) were observed for COR (48, 72 and 96 h) and EI only at 72 and 96 h. The increasing COR represents high similarity between grey levels, which could be observed on US images after few days on eccentric training for elbow flexors., (© 2017 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.)

This review aimed to describe the state of the art in muscle-tendon unit (MTU) assessment by supersonic shear wave imaging (SSI) elastography in states of muscle contraction and stretching, during aging, and in response to injury and therapeutic interventions. A consensus exists that MTU elasticity increases during passive stretching or contraction, and decreases after static stretching, electrostimulation, massage, and dry needling. There is currently no agreement regarding changes in the MTU due to aging and injury. Currently, the application of SSI for the purpose of diagnosis, rehabilitation, and physical training remains limited by a number of issues, including the lack of normative value ranges, the lack of consensus regarding the appropriate terminology, and an inadequate understanding of the main technical limitations of this novel technology.

Objective: This work evaluates the relationship between ultrasonic reflection and bone density from fourteen cylindrical bovine cortical bone samples (3.0-cm thick)., Methods: Twenty US reflection signals per sample were acquired along the bone surface (2.0-mm step). The Integrated Reflection Coefficient (IRC) from each signal was compared to Quantitative Computed Tomography (QCT)., Results: Seven IRC and QCT curves presented Pearson's Correlation R-values above 0.5. For weak correlation curves, QCT and IRC showed similar trends in several segments., Conclusion: IRC was sensitive to bone density variation. Level of Evidence: Experimental Study, Investigating a Diagnostic Test. , Competing Interests: All authors declare no potential conflict of interest related to this article.

The objective of this work is to propose an effective absorption coefficient (α effec ) as an empirical correction factor in the source term of the bioheat equation. The temperature rise in biological tissue due to ultrasound insonification is produced by energy absorption. Usually, the ultrasonic absorption coefficient (α A ) is used as a source term in the bioheat equation to quantify the temperature rise, and the effect of scattering is disregarded. The coefficient α effec includes the scattering contribution as an additional absorption term and should allow us to make a better estimation of the thermal dose (TD), which is important for clinical applications. We simulated the bioheat equation with the source term considering α A or α effec , and with heating provided by therapeutic ultrasound (1MHz, 2.0Wcm -2 ) for about 5.5min (temperature range 36-46°C). Experimental data were obtained in similar heating conditions for a bovine muscle tissue (ex vivo) and temperature curves were measured for depths 7, 30, 35, 40 and 45mm. The TD values from the experimental temperature curves at each depth were compared with the numerical solution of the bioheat equation with the classical and corrected source terms. The highest percentual difference between simulated and experimental TD was 42.5% when assuming the classical α A , and 8.7% for the corrected α effec . The results show that the effective absorption coefficient is a feasible parameter to improve the classical bioheat transfer model, especially for depths larger than the mean free propagation path., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: One goal of therapeutic ultrasound is enabling heat generation in tissue. Ultrasound application protocols typically neglect these processes of absorption and backscatter/reflection at the skin/fat, fat/muscle, and muscle/bone interfaces. The aim of this study was to investigate the heating process at interfaces close to the transducer and the bone with the aid of computer simulation and tissue-mimicking materials (phantoms)., Methods: The experimental setup consists of physiotherapeutic ultrasound equipment for irradiation, two layers of soft tissue-mimicking material, and one with and one without an additional layer of bone-mimicking material. Thermocouple monitoring is used in both cases. A computational model is used with the experimental parameters in a COMSOL® software platform., Results: The experimental results show significant temperature rise (42 °C) at 10 mm depth, regardless of bone layer presence, diverging 3 °C from the simulated values. The probable causes are thermocouple and transducer heating and interface reverberations. There was no statistical difference in the experimental results with and without the cortical bone for the central thermocouple of the first interface [ t (38) = -1.52; 95% CI = -0.85, 0.12; p  = 14]. Temperature rise (>6 °C) close to the bone layer was lower than predicted (>21 °C), possibly because without the bone layer, thermocouples at 30 mm make contact with the water bath and convection intensifies heat loss; this factor was omitted in the simulation model., Conclusions: This work suggests that more attention should be given to soft tissue layer interfaces in ultrasound therapeutic procedures even in the absence of a close bone layer.

Objective: This study evaluated the productivity of computed tomography (CT) models and characterized their simplest (entry-level) models' supply in the world market., Methods: CT exam times were measured in eight health facilities in the state of Rio de Janeiro, Brazil. Exams were divided into six stages: (1) arrival of patient records to the examination room; (2) patient arrival; (3) patient positioning; (4) data input prior to exam; (5) image acquisition; and (6) patient departure. CT exam productivity was calculated by dividing the total weekly working time by the total exam time for each model. Additionally, an internet search identified full-body CT manufacturers and their offered entry-level models., Results: The time durations of 111 CT exams were obtained. Differences among average exam times were not large, and they were mainly due to stages not directly related to data acquisition or image reconstruction. The survey identified that most manufacturers offer 2- to 4-slice models for Asia, South America, and Africa, and one offers single-slice models (Asia). In the USA, two manufacturers offer models below 16-slice., Conclusion: Productivity gains are not linearly related to "slice" number. It is suggested that the use of "shareable platforms" could make CTs cheaper, increasing their availability.