Perkinsnyholm5754

Cystic echinococcosis (CE) or hydatidosis (hydatid cysts) is an infection with a wide spectrum of manifestations, from symptomatic infection to fatal disease. Ultrasound (US) allows screening, diagnosis, differential diagnosis, treatment guidance and follow-up of CE under many circumstances. Hydatid cysts are predominantly observed in the liver. #link# Herewith we present a review to demonstrate established and innovative imaging features of CE of the hepatobiliary tract.Gastrointestinal ultrasound (GIUS) has been increasingly used for the management of gastrointestinal disorders due to its potentialities as a cheap, widely available and safe examination with comparable accuracy to other techniques such as Computed Tomography or Magnetic Resonance Imaging. However, some limitations have been stated to justify its underuse such as its dependency on the operator, small field of view and penetration and need of expertise. However, most of these limitations are inherent to any technique. The main problems with GIUS are lack of standardized definitions, adequate training programs and measures to assess the quality. The definition of universally applicable standardized measurements, the implementation of an internationally recognized curriculum as well as an agreed set of core competencies and the assessment of performance will hopefully overcome its potential limitations and implement its utilization universally in clinical practice.AimsThe present study aims to investigate the pain, anxiety and other factors that are associated with percutaneous computed tomography (CT)- and ultrasound (US)-guided biopsies of tumors.Material and MethodsThe study prospectively included 60 consecutive patients, of which 24 underwent CT-guided biopsies and 36 US-guided biopsies. The location of targeted tumors was within the thorax, abdomen, pelvis, and limbs. A questionnaire containing numerical rate scales (0-10) regarding procedural and post-procedural pain, anxiety, and other associated parameters was filled out by each patient 2-6 hours after the procedure. CT and ultrasound parameters were compared.  The two groups were then pooled together in order to compare pain scores per targeted organ and to analyze the parameters that were associated with pain.ResultsThere was no significant difference between the CT and US group with the exception of the positional discomfort, which was higher in the CT group (p=0.003). The average procedural pain score (2.0) was significantly higher than the post-procedural pain (1.3, p=0.006) and the phlebotomy pain (0.8, p less then 0.0001). There was no significant difference between the targeted organs with regards to the pain score. The factors that showed a positive correlation with the procedural pain were procedure-related anxiety (p=0.005), positional discomfort (p=0.01), and phlebotomy pain (p=0.0008). The pre interventional use of an analgesic was negatively correlated with the procedural pain (p=0.02).ConclusionsCT- and US- guided percutaneous biopsies are associated with low levels of pain that are generally well tolerated by patients irrespective of the targeted organ.AIM The objective of this study was to evaluate the diagnostic performance of second-look breast ultrasound (US) immediately after galactography in patients with nipple discharge. MATERIALS AND METHODS Between January 2010 and November 2018, 89 patients with nipple discharge were retrospectively analyzed. All patients were examined by galactography and US. US was performed twice, before and after galactography. Galactography, mammography and US findings were categorized according to the Breast Imaging Reporting and Data System (BI-RADS). The final diagnosis was established by histopathological examination. RESULTS Out of 89 patients, 25 (28.1%) patients had positive findings as evident by US before galactography. Forty-eight (53.9%) patients had positive findings as demonstrated by galactography. Fifty-nine (66.3%) patients had positive findings as evident by second-look US after galactography (13 patients with benign, 37 with borderline and 9 with malignant lesions). Second-look US after galactography showed the highest diagnostic accuracy (83.2%), sensitivity (95.8%) and negative predictive value (93.3%) for borderline and malignant lesions. For the detection of malignant lesions, secondlook US after galactography showed the highest sensitivity (90%) and negative predictive value (96.7%). Agreement between imaging and histological result using Bland-Altman analysis exhibited no significant difference between the size establishedby ultrasound and galactography. CONCLUSION The second-look US after galactography is a powerful diagnostic tool for the detection of lesions in patients with nipple discharge and demonstrates high diagnostic accuracy, sensitivity and negative predictive value.AIM This study proposes the combination of B-mode and color Doppler mode using Mutual Information including Canonical Correlation Analysis (MI-CCA) to improve breast cancer diagnosis. MATERIALS AND METHODS The dataset consisted of 53 benign lesions and 202 malignant lesions including B-mode, and color Doppler mode. Convolutional Neuron Networks (CNNs) was applied to automatically extract the features from breast ultrasound images. Then, Enpp-1-IN-1 -CCA was performed to fuse with maximized correlation. Finally, the classification model was built via the support vector machine technique to distinguish breast tumors. Diagnosis performances of single modes, combination modes, and other fusion strategies were compared. RESULTS The single B-mode obtained 90.92% accuracy, while the color Doppler mode obtained 97.16% accuracy. The MI-CCA fusion reveals a significant improvement with 98.80% accuracy. The results indicated that the fusion of two modes tended to offer a more accurate diagnosis than the single mode. In addition, the unsupervised-PCA was high (AUC 0.91, 95% CI [0.90, 0.91]) and no significant difference was observed with the unsupervised-CCA (AUC 0.90, 95% CI [0.84, 0.90]). The supervised-PCA was the lowest (AUC 0.93, 95% CI [0.91, 0.93] and no significant difference was observed with the supervised-CCA (AUC 0.95, 95% CI [0.91, 0.94]). The proposed MI-CCA was the highest performance (AUC 0.99, 95% CI [0.93, 0.99]). These results indicated that the supervised strategies tended to give a more accurate diagnosis than unsupervised strategies. CONCLUSION By using the combination of ultrasound modes, this approach achieves high performance compared with the single mode and other fusion strategies. Our methodology may be a beneficial tool for the early detection and diagnosis of breast cancer.