Is there a sonographer effect? Sonographer as a source of variability for Shear Wave Elastography.

Aims: This study aims to estimate the degree of sonographers as a source of systematic variance for Shear Wave Elastography (SWE) values.

Materials And Methods: Two studies estimated variance in SWE measurements: 1) within-subjects and between-sonographer differences, and 2) between-sonographer differences alone. Both used a block design with six trained sonographers scanning six healthy liver volunteers using the same machine.

Microbubble Contrast-Enhanced Transcutaneous Ultrasound Enables Real-Time Spinal Cord Perfusion Monitoring Following Posterior Cervical Decompression.

Background: Ultrasound imaging is inexpensive, portable, and widely available. The development of a real-time transcutaneous spinal cord perfusion monitoring system would allow more precise targeting of mean arterial pressure goals following acute spinal cord injury (SCI). There has been no prior demonstration of successful real-time cord perfusion monitoring in humans.

Diagnostic Imaging and Medical Management of Acute Left-Sided Colonic Diverticulitis : A Systematic Review.

Background: Clinicians need to better understand the value of computed tomography (CT) imaging and nonsurgical treatment options to manage acute left-sided colonic diverticulitis.

Purpose: To evaluate CT imaging, outpatient treatment of uncomplicated diverticulitis, antibiotic treatment, and interventional radiology for patients with complicated diverticulitis.

Data Sources: MEDLINE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase, CINAHL, and ClinicalTrials.

Abnormal spinal cord motion at the craniocervical junction in hypermobile Ehlers-Danlos patients.

Objective: The craniocervical junction (CCJ) is anatomically complex and comprises multiple joints that allow for wide head and neck movements. The thecal sac must adjust to such movements. Accordingly, the thecal sac is not rigidly attached to the bony spinal canal but instead tethered by fibrous suspension ligaments, including myodural bridges (MDBs).

Inclusion of Thyroid Nodule Location in American College of Radiology TI-RADS Scoring: Impact on System Performance.

Emerging data suggest that the location of thyroid nodules influences malignancy risk. The purpose of this study was to explore the impact of including location in American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) scoring. Four of five revised scoring algorithms that added 1 or 2 points to higher-risk locations were associated with lowered accuracy due to lower specificity.

In Vivo Ultrasound Imaging of the Spinal Cord and Subarachnoid Space at the C1-C2 Level in Healthy Adult Subjects.

Ultrasound (US) imaging of the spinal canal is applied in early infants before formation of posterior spine bony elements. Here, we demonstrate for the first time in adult healthy subjects that excellent visualization of intrathecal structures at the level of C1-C2 is possible by transcutaneous US in flexion, extension, and neutral head positions through the soft tissue US window between C1-C2. We show with US that the posterior subarachnoid space increases significantly in head extension.

Effect of Decreasing the ACR TI-RADS Point Assignment for Punctate Echogenic Foci When They Occur in Mixed Solid and Cystic Thyroid Nodules.

Using the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS), this study sought to determine whether decreasing the point assignment for punctate echogenic foci in mixed solid and cystic nodules would reduce the number of benign mixed solid and cystic nodules that were biopsied and would not substantially increase the number of missed mixed carcinomas A multiinstitutional database of 3422 pathologically proven thyroid nodules was evaluated to identify all mixed solid and cystic nodules with punctate echogenic foci. We determined the numbers of mixed benign and malignant nodules that would receive ACR TI-RADS recommendations of fine-needle aspiration, follow-up, and no further evaluation if the points assigned to punctate echogenic foci were changed from 3 points to 1 or 2 points. A total of 287 mixed nodules were adequately characterized for evaluation.

Reclaiming Hands-on Ultrasound for Radiology With a Simulation-Based Ultrasound Curriculum for Radiology Residents.

Hands-on ultrasound training is included in the curriculum of many medical specialties and is increasingly incorporated into medical school curricula. Despite published curricula for ultrasound training in these specialties, there remains a dearth of such programs for radiology residency programs. At our institution, there has been a perceived decline in ultrasound scanning comfort and skill in trainees.

Analysis of Malignant Thyroid Nodules That Do Not Meet ACR TI-RADS Criteria for Fine-Needle Aspiration.

Compared with other guidelines, the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) has decreased the number of nodules for which fine-needle aspiration is recommended. The purpose of this study was to evaluate the characteristics of malignant nodules that would not be biopsied when the ACR TI-RADS recommendations are followed. We retrospectively reviewed a total of 3422 thyroid nodules for which a definitive cytologic diagnosis, a definitive histologic diagnosis, or both diagnoses as well as diagnostic ultrasound (US) examinations were available.

Thyroid Nodule Malignancy Risk Stratification Using a Convolutional Neural Network.

This study evaluates the performance of convolutional neural networks (CNNs) in risk stratifying the malignant potential of thyroid nodules alongside traditional methods such as American College of Radiology Thyroid Imaging Reporting and Data System (ACR TIRADS). The data set consisted of 651 pathology-proven thyroid nodules (500 benign, 151 malignant) from 571 patients collected at a single tertiary academic medical center. Each thyroid nodule consisted of two orthogonal views (sagittal and transverse) for a total of 1,302 grayscale images.

Liver Ultrasound Elastography: Review of Techniques and Clinical Applications.

Chronic liver disease remains a substantial worldwide problem. Accurate estimation of liver fibrosis is crucial for determining the stage of the disease, assessing the patient's prognosis and predicting treatment response. Staging hepatic fibrosis has traditionally been done with liver biopsy but clinical practice has been changing, partly because liver biopsy has several disadvantages: it is invasive; it is associated with rare but serious complications; and it is prone to sampling error representing a tiny portion of the total liver volume.

2D shear wave elastography: measurement acquisition and reliability criteria in noninvasive assessment of liver fibrosis.

Purpose: The objective was to evaluate the accuracy of 2D shear wave elastography (SWE) in predicting stages of liver fibrosis using five individual versus grouped measurements and different reliability criteria.

Materials And Methods: This is a prospective study of 109 patients who underwent hepatic 2D SWE (Canon Aplio 500) prior to liver biopsy for varied indications. Liver fibrosis was staged using the METAVIR scoring system (F = 0-4).

Image-Guided Cholecystostomy Tube Placement: Short- and Long-Term Outcomes of Transhepatic Versus Transperitoneal Placement.

Objective: Image-guided percutaneous cholecystostomy may be performed by a transhepatic or transperitoneal approach. We compared the short- and long-term outcomes of percutaneous cholecystostomy related to route of catheter placement.

Materials And Methods: A retrospective observational study of image-guided percutaneous cholecystostomy was performed from 2004 to 2016.

Comparison of Performance Characteristics of American College of Radiology TI-RADS, Korean Society of Thyroid Radiology TIRADS, and American Thyroid Association Guidelines.

Objective: The American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) provides guidelines to practitioners who interpret sonographic examinations of thyroid nodules. The purpose of this study is to compare the ACR TI-RADS system with two other well-established guidelines.

Materials And Methods: The ACR TI-RADS, the Korean Society of Thyroid Radiology (KSThR) Thyroid Imaging Reporting and Data System (TIRADS), and the American Thyroid Association guidelines were compared using 3422 thyroid nodules for which pathologic findings were available.

Does size matter? Kidney transplant donor size determines kidney function among living donors.

Background: Kidney donor outcomes are gaining attention, particularly as donor eligibility criteria continue to expand. Kidney size, a useful predictor of recipient kidney function, also likely correlates with donor outcomes. Although donor evaluation includes donor kidney size measurements, the association between kidney size and outcomes are poorly defined.

ACR Appropriateness Criteria Renal Transplant Dysfunction.

Renal transplantation is the treatment of choice in patients with end-stage renal disease because the 5-year survival rates range from 72% to 99%. Although graft survival has improved secondary to the introduction of newer immunosuppression drugs and the advancements in surgical technique, various complications still occur. Ultrasound is the first-line imaging modality for the evaluation of renal transplants in the immediate postoperative period and for long-term follow-up.

Multiinstitutional Analysis of Thyroid Nodule Risk Stratification Using the American College of Radiology Thyroid Imaging Reporting and Data System.

Objective: Guidelines for managing thyroid nodules are highly dependent on risk stratification based on sonographic findings. The purpose of this study is to evaluate the risk stratification system used by the American College of Radiology Thyroid Imaging Reporting and Data System (TIRADS).

Materials And Methods: Patients with thyroid nodules who underwent sonography and fine-needle aspiration were enrolled in a multiinstitutional study.

ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee.

Thyroid nodules are a frequent finding on neck sonography. Most nodules are benign; therefore, many nodules are biopsied to identify the small number that are malignant or require surgery for a definitive diagnosis. Since 2009, many professional societies and investigators have proposed ultrasound-based risk stratification systems to identify nodules that warrant biopsy or sonographic follow-up.

Optimizing modality selection for image-guided procedures: an analysis of the challenges to ultrasound guidance.

Introduction: Selection of the most appropriate modality for image guidance is essential for procedural success. We identified specific factors contributing to failure of ultrasound-guided procedures that were subsequently performed using CT guidance.

Materials And Methods: This single-center, retrospective study included 164 patients who underwent a CT-guided biopsy, aspiration/drainage, or ablation after initially having the same procedure attempted unsuccessfully with ultrasound guidance.

ACR Appropriateness Criteria Renal Cell Carcinoma Staging.

Renal cell carcinoma accounts for 2%-3% of all visceral malignancies. Preoperative imaging can provide important staging and anatomic information to guide treatment decisions. Size of the primary tumor and degree of local invasion, such as involvement of perinephric fat or renal sinus fat, and tumor thrombus in renal veins and inferior vena cava are important detriments to local staging of primary tumor.

Quantitative analysis of ultrasound images for computer-aided diagnosis.

We propose an adaptable framework for analyzing ultrasound (US) images quantitatively to provide computer-aided diagnosis using machine learning. Our preliminary clinical targets are hepatic steatosis, adenomyosis, and craniosynostosis. For steatosis and adenomyosis, we collected US studies from 288 and 88 patients, respectively, as well as their biopsy or magnetic resonanceconfirmed diagnosis.

Preoperative High-Resolution Ultrasound for the Assessment of Malignant Central Compartment Lymph Nodes in Papillary Thyroid Cancer.

Background: The identification and removal of malignant central compartment lymph nodes (MCLN) is important to minimize the risk of persistent or recurrent local disease in patients with papillary thyroid cancer (PTC). While the diagnostic accuracy of preoperative ultrasound for the assessment of lateral compartment node metastases is well recognized, its role in the identification of central compartment node metastases in patients with PTC is less established. This study delineates the utility of high-resolution ultrasound (HUS) for the assessment of MCLN in patients with PTC.