@misc{RinkKuenzelStrosczynskietal., author = {Rink, M and K{\"u}nzel, J and Strosczynski, C and Jung, F and Jung, EM}, title = {Smart scanning: automatic detection of superficially located lymph nodes using ultrasound - initial results}, series = {Fortschr R{\"o}ntgenstr Fortschritte auf dem Gebiet der R{\"o}ntgenstrahlen und der bildgebenden Verfahren}, volume = {2024}, journal = {Fortschr R{\"o}ntgenstr Fortschritte auf dem Gebiet der R{\"o}ntgenstrahlen und der bildgebenden Verfahren}, doi = {10.1055/a-2331-0951}, pages = {1 -- 7}, abstract = {Purpose Over the last few years, there has been an increasing focus on integrating artificial intelligence (AI) into existing imaging systems. This also applies to ultrasound. There are already applications for thyroid and breast lesions that enable AI-assisted sonography directly on the device. However, this is not yet the case for lymph nodes. Materials and Methods The aim was to test whether already established programs for AI-assisted sonography of breast lesions and thyroid nodules are also suitable for identifying and measuring superficial lymph nodes. For this purpose, the two programs were used as a supplement to routine ultrasound examinations of superficial lymph nodes. The accuracy of detection by AI was then evaluated using a previously defined score. If available, a comparison was made with cross-sectional imaging. Results The programs that were used are able to adequately detect lymph nodes in the majority of cases (78.6\%). Problems were caused in particular by a high proportion of echo-rich fat, blurred differentiation from the surrounding tissues and the occurrence of lymph node conglomerates. The available cross-sectional images did not contradict the classification of the lesion as a lymph node in any case. Conclusion In the majority of cases, the tested programs are already able to detect and measure superficial lymph nodes. Further improvement can be expected through specific training of the software. Further developments and studies are required to assess risk of malignancy.}, language = {en} } @misc{JungPleyerDropcoetal., author = {Jung, EM and Pleyer, L and Dropco, I and Kaiser, U and Yi, D and Stroszczynski, C and Jung, F}, title = {Dynamic Contrast Ultrasound Diagnostics (CEUS) of Liver Lesions and Post-treatment Control with A New High-resolution Examination Technique (HiFR) and Perfusion}, series = {Journal of Gastrointestinal \& Liver Diseases}, volume = {33}, journal = {Journal of Gastrointestinal \& Liver Diseases}, number = {3}, doi = {10.15403/jgld-5589}, pages = {362 -- 371}, abstract = {Background \& Aims: To evaluate, if high frame rate (HiFR) contrast-enhanced ultrasound (CEUS) and external perfusion analysis (VueBox®)can give answers on liver tumour diagnostics. Methods: A multifrequency probe (C1-6 /Resona R9) and 1-2.4 ml ultrasound contrast medium were used for CEUS up to 5-6 min. Independent analysis of DICOM-CINE files was performed, correlated to follow-up, computed tomography, magnetic resonance imaging, or histopathology. Results: In 110 patients the difference between marginal peak enhancement (PE) of malignant and benign leasions was significant. In the peripheral area, the AUCs were lower in malignant lesions (144.8±139.3) than in benign lesions (123.6±119.8). The mean transit time (mTT) was shorter in malignant lesions in the center. In the liver parenchyma, however, the mTT was significantly longer in malignant lesions (141.6±107.9s) than in benign lesions (128.8±138.6 s). The rise time (RT) was significantly shorter central (66.5±30.9s) and peripheral (72.8±35.1s) in malignant lesions than in benign lesions (114.33±159.58s). The wash in rate (WiR) in benign lesions was 848.3±2,563.7 rU in the center. Wash-out rate (WoR) in the center, peripheral and in the liver parenchyma showed a significantly lower wash-out in the malignant lesions. Conclusions: HiFR CEUS with perfusion analysis enables the assessment of focal, diffuse and postinterventional liver changes.}, language = {en} } @misc{JungWiesingerKaiseretal., author = {Jung, EM and Wiesinger, I and Kaiser, U and Jung, F}, title = {Initial experiences with dynamic, quality indicator-based multimodal tissue analysis (M-Ref) with parallel assessment of viscosity and shear wave elastography in liver parenchyma alterations}, series = {Clinical Hemorheology and Microcirculation}, volume = {88}, journal = {Clinical Hemorheology and Microcirculation}, number = {4}, doi = {10.3233/CH-248111}, pages = {419 -- 427}, abstract = {BACKGROUND AND OBJECTIVE: Modern ultrasound technology enables detailed tissue morphology analysis. A novel approach involves measuring viscoelasticity or viscosity. This pilot study investigates the potential of a novel high-end ultrasound system with dynamic quality indicators and the M-Ref tool. METHODS: Using a novel premium high-end ultrasound system (Resona A20/Mindray), comparative investigations were conducted on 52 patients, evaluating B-mode morphology, shear wave tissue elastography (STE), and viscosity (STVi) of the liver parenchyma. The study utilized a cohort of 25 healthy volunteers as a control group. The examinations were performed intercostally using a multifrequency convex probe SC7-1U (1-7 MHz) and breath-hold technique, ensuring that at least the highest or second-highest score in the dynamic quality control (5 stars) was achieved. Measurements were made in a color-coded region with a maximum 2 cm diameter and a depth of no more than 2 cm, avoiding bile ducts or blood vessels, at a depth up 2 cm from the liver capsule. RESULTS: A minimum of 10 measurements were taken for each parameter: liver steatosis (based on acoustic attenuation coefficient, USAT), viscosity (STVi), and shear wave elastography (STE) with correlation to fibrosis grade. Reference values for the control group were <1.4 m/s and <5 kPa for STE, with cirrhosis criteria defined as values >2.6 m/s and >15 kPa. For steatosis, values up to 0.5 dB/cm/MHz were considered normal, while values >0.8 dB/cm/MHz indicated fatty liver. Viscosity values <1.7 Pa.s were deemed normal, with >3.6 Pa.s indicating significant abnormality. Major causes of increased viscosity included severe steatosis, active hepatitis, hepatic tumors, or post-ablative states. In all cases, a high-quality indicator score (>93\%) was achieved with at least 4/5 top reference markers in green. CONCLUSIONS: This pilot study confirms the comprehensive capabilities of multimodal imaging for tissue characterization using B-mode, elastography, and new techniques for assessing viscoelasticity. However, extensive multicenter evaluations will be needed to definitively establish reference values specific to the type of transducer and equipment used.}, language = {en} }