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Bladder Cancer: Sonographic Evaluation Method With Fly Thru Technology
S62
Ultrasound in Medicine and Biology
microbubbles in vivo, it is difficult to enhance the density of microbubbles near the desired target area. Methods: To control the local concentration of microbubbles, the primary and secondary acoustic forces were introduced, where the former propels microbubbles to the vessel wall and the latter forms aggregation of microbubbles. Here we have examined with not only single element transducers but also a matrix array transducer, which can produce multiple focal points of continuous wave and steer them. Also artificial blood vessels, which include multiple bifurcations, were used. Microbubbles has a shell made of poly(vinyl chloride) with average diameter of 4 mm. Main Results: As the result, wider acoustic field has an advantage to trap microbubbles, where higher concentration of acoustic energy does not result more aggregation. The dispersion of acoustic energy is important because there was a relation in the trapping performance to the acoustic area in flow and concentration. Importance of the Conclusions: We have confirmed that there is a relation in the trapping performance to the acoustic area in flow and concentration.
PD.13.006 Bladder Cancer: Sonographic Evaluation Method With Fly Thru Technology A. C. Gomes, T. N. Oliveira, L. Barreto, M. J. D’Avila, R. Franc¸a, I. Clausius, M. C. Chammas, A. Crippa, M. Dall’Oglio, M. Srougi, G. G. Cerri Hospital Das Clinicas De S~ao Paulo - Inrad - Faculdade De Medicina DA USP Brief Description of the Purpose of the Study: Bladder cancer is the most common malignancy of the urinary system and the ninth in malignancy. Cystoscopy is the gold standard for detection of bladder cancer. Cystoscopy computed tomography seeks to reproduce the benefits of a direct examination in the evaluation of bladder cancer without instrumentation. Methods: The aim of this study was to determine the diagnostic performance of the method fly thru in patients with bladder cancer, assessing the size, shape and contour of the lesion, estimating its distance to the ureteral and urethral meatus. Twenty patients with a history of bladder cancer underwent conventional cystoscopy, and then fly thru examined by technology, with equipment Toshiba Aplio 500. The proper preparation of the patient only included the maximum bladder filling. Image acquisition was performed by experienced professionals in the field of ultrasound in urology, with specific training on the technology in question. The estimated time of sonographic examination was 20 minutes on average. Main Results: Statistical analysis of the results showed that the method is effective for three-dimensional visualization of the lesions (size, shape, contours and distance of ureteral and urethral meatus). Importance of the Conclusions: We conclude that this new technology may be useful in monitoring and surgical planning.
PD.13.007 Acoustic Radiation Force Impulse Elastography (ARFI) Assessment of Chronic Pancreatitis T. N. Oliveira, L. Barreto, M. J. D’Avila, R. Franc¸a, I. Clausius, M. C. Chammas, G. G. Cerri Hospital Das Clınicas - Inrad- Faculdade De Medicina DA USP Brief Description of the Purpose of the Study: Endoscopic ultrasonography or real-time elastography has been applied for the diagnosis of chronic pancreatitis. Acoustic radiation force impulse (ARFI) imaging is another tissue strain imaging technology, and recent techno-
Volume 39, Number 5S, 2013 logical advances have enabled quantification of the stiffness of some tissues by measuring the shear wave velocity (SWV) during routine B-mode ultrasonography. Methods: ARFI elastography was performed in 10 healthy volunteers and 10 patients with chronic pancreatitis. SWV was measured in the head, body, and tail of the pancreas. Main Results: SWV in patients with chronic pancreatitis was significantly higher than that in healthy volunteers in each part of the pancreas, although the measurement was difficult in the tail of the pancreas. Importance of the Conclusions: ARFI elastography of the pancreas showed high elasticity in chronic pancreatitis compared to findings in the normal pancreas. This modality is feasible to use for the diagnosis of chronic pancreatitis.
PD.13.008 Computer-Assisted Analysis of Ultrasonographic Features of Calcified Thyroid Nodules J. S. Park, K. G. Kim, Y. J. Lee Hanyang University, College of Medicine, Seoul, Republic of Korea Brief Description of the Purpose of the Study: to determine computerized US features of calcified thyroid nodules that are useful in the differentiation between malignant and benign lesions. Methods: Digital US images of 99 pathologically-proven thyroid nodules with calcifications (malignant: benign 5 78: 21) were evaluated. We designed and implemented a CAA scheme to quantitatively analyze the 24 US features of the calcified thyroid nodules based in two categories: morphology and calcification. We performed Student’s t-test and discriminant analysis and generated receiver operating characteristic (ROC) curves and the corresponding areas under the curve (AUC) in order to compare morphology, calcification and combined features. Main Results: Among the 24 analyzed features, 10/12 (83.3%) morphology and 7/12 (58.3%) calcification features showed significant differences between malignant and benign thyroid nodules (p , 0.05). The AUC values for morphology, calcification and combined features were 0.81 (95% CI, 0.75-0.86), 0.79 (95% CI, 0.73-0.84), and 0.86 (95% CI, 0.81-0.91), respectively. The combined features showed a significantly higher AUC value than morphology or calcification features alone (p , 0.05). Importance of the Conclusions: Combined morphology and calcification features from CAA had a significantly higher diagnostic performance in differentiating malignant from benign calcified thyroid nodules when compared to the use of morphology or calcification features alone.
PD.13.009 Fibrosis Quantification in Chronic Liver Disease: A Comparative Study Using Two Different Elastographic Technologies Vibration Controlled Transient Elastography Shear Wave Elastography (VCTE - SWE) P. Zoumpoulis, I. Mastorakou, I. Theotokas, C. H. Kranidioti, K. Pahou, L. Kaklamanis, E. Panteleakou, E. Vafeiadi Hellenic Society of Ultrsound In Medicine and Biology Brief Description of the Purpose of the Report: To assess two different methods of liver elastography: Vibration Controlled Transient Elastography (VCTE-Fibroscan) and Shear Wave Elastography (SWE) in the study of liver fibrosis in chronic liver disease and cirrhosis. Medical History: In this prospective study two different populations were included: A population with normal liver function as tested using clinical history and biochemical results (liver enzymes) (N1560) and a population in different stages of chronic liver disease of various causes
Ultrasound in Medicine and Biology
microbubbles in vivo, it is difficult to enhance the density of microbubbles near the desired target area. Methods: To control the local concentration of microbubbles, the primary and secondary acoustic forces were introduced, where the former propels microbubbles to the vessel wall and the latter forms aggregation of microbubbles. Here we have examined with not only single element transducers but also a matrix array transducer, which can produce multiple focal points of continuous wave and steer them. Also artificial blood vessels, which include multiple bifurcations, were used. Microbubbles has a shell made of poly(vinyl chloride) with average diameter of 4 mm. Main Results: As the result, wider acoustic field has an advantage to trap microbubbles, where higher concentration of acoustic energy does not result more aggregation. The dispersion of acoustic energy is important because there was a relation in the trapping performance to the acoustic area in flow and concentration. Importance of the Conclusions: We have confirmed that there is a relation in the trapping performance to the acoustic area in flow and concentration.
PD.13.006 Bladder Cancer: Sonographic Evaluation Method With Fly Thru Technology A. C. Gomes, T. N. Oliveira, L. Barreto, M. J. D’Avila, R. Franc¸a, I. Clausius, M. C. Chammas, A. Crippa, M. Dall’Oglio, M. Srougi, G. G. Cerri Hospital Das Clinicas De S~ao Paulo - Inrad - Faculdade De Medicina DA USP Brief Description of the Purpose of the Study: Bladder cancer is the most common malignancy of the urinary system and the ninth in malignancy. Cystoscopy is the gold standard for detection of bladder cancer. Cystoscopy computed tomography seeks to reproduce the benefits of a direct examination in the evaluation of bladder cancer without instrumentation. Methods: The aim of this study was to determine the diagnostic performance of the method fly thru in patients with bladder cancer, assessing the size, shape and contour of the lesion, estimating its distance to the ureteral and urethral meatus. Twenty patients with a history of bladder cancer underwent conventional cystoscopy, and then fly thru examined by technology, with equipment Toshiba Aplio 500. The proper preparation of the patient only included the maximum bladder filling. Image acquisition was performed by experienced professionals in the field of ultrasound in urology, with specific training on the technology in question. The estimated time of sonographic examination was 20 minutes on average. Main Results: Statistical analysis of the results showed that the method is effective for three-dimensional visualization of the lesions (size, shape, contours and distance of ureteral and urethral meatus). Importance of the Conclusions: We conclude that this new technology may be useful in monitoring and surgical planning.
PD.13.007 Acoustic Radiation Force Impulse Elastography (ARFI) Assessment of Chronic Pancreatitis T. N. Oliveira, L. Barreto, M. J. D’Avila, R. Franc¸a, I. Clausius, M. C. Chammas, G. G. Cerri Hospital Das Clınicas - Inrad- Faculdade De Medicina DA USP Brief Description of the Purpose of the Study: Endoscopic ultrasonography or real-time elastography has been applied for the diagnosis of chronic pancreatitis. Acoustic radiation force impulse (ARFI) imaging is another tissue strain imaging technology, and recent techno-
Volume 39, Number 5S, 2013 logical advances have enabled quantification of the stiffness of some tissues by measuring the shear wave velocity (SWV) during routine B-mode ultrasonography. Methods: ARFI elastography was performed in 10 healthy volunteers and 10 patients with chronic pancreatitis. SWV was measured in the head, body, and tail of the pancreas. Main Results: SWV in patients with chronic pancreatitis was significantly higher than that in healthy volunteers in each part of the pancreas, although the measurement was difficult in the tail of the pancreas. Importance of the Conclusions: ARFI elastography of the pancreas showed high elasticity in chronic pancreatitis compared to findings in the normal pancreas. This modality is feasible to use for the diagnosis of chronic pancreatitis.
PD.13.008 Computer-Assisted Analysis of Ultrasonographic Features of Calcified Thyroid Nodules J. S. Park, K. G. Kim, Y. J. Lee Hanyang University, College of Medicine, Seoul, Republic of Korea Brief Description of the Purpose of the Study: to determine computerized US features of calcified thyroid nodules that are useful in the differentiation between malignant and benign lesions. Methods: Digital US images of 99 pathologically-proven thyroid nodules with calcifications (malignant: benign 5 78: 21) were evaluated. We designed and implemented a CAA scheme to quantitatively analyze the 24 US features of the calcified thyroid nodules based in two categories: morphology and calcification. We performed Student’s t-test and discriminant analysis and generated receiver operating characteristic (ROC) curves and the corresponding areas under the curve (AUC) in order to compare morphology, calcification and combined features. Main Results: Among the 24 analyzed features, 10/12 (83.3%) morphology and 7/12 (58.3%) calcification features showed significant differences between malignant and benign thyroid nodules (p , 0.05). The AUC values for morphology, calcification and combined features were 0.81 (95% CI, 0.75-0.86), 0.79 (95% CI, 0.73-0.84), and 0.86 (95% CI, 0.81-0.91), respectively. The combined features showed a significantly higher AUC value than morphology or calcification features alone (p , 0.05). Importance of the Conclusions: Combined morphology and calcification features from CAA had a significantly higher diagnostic performance in differentiating malignant from benign calcified thyroid nodules when compared to the use of morphology or calcification features alone.
PD.13.009 Fibrosis Quantification in Chronic Liver Disease: A Comparative Study Using Two Different Elastographic Technologies Vibration Controlled Transient Elastography Shear Wave Elastography (VCTE - SWE) P. Zoumpoulis, I. Mastorakou, I. Theotokas, C. H. Kranidioti, K. Pahou, L. Kaklamanis, E. Panteleakou, E. Vafeiadi Hellenic Society of Ultrsound In Medicine and Biology Brief Description of the Purpose of the Report: To assess two different methods of liver elastography: Vibration Controlled Transient Elastography (VCTE-Fibroscan) and Shear Wave Elastography (SWE) in the study of liver fibrosis in chronic liver disease and cirrhosis. Medical History: In this prospective study two different populations were included: A population with normal liver function as tested using clinical history and biochemical results (liver enzymes) (N1560) and a population in different stages of chronic liver disease of various causes