Publications by authors named "Fajin Dong"

28 Publications

  • Page 1 of 1

Diagnostic performance of elastography for breast non-mass lesions: A systematic review and meta-analysis.

Eur J Radiol 2021 Oct 2;144:109991. Epub 2021 Oct 2.

Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen 518020, Guangdong, China. Electronic address:

Purpose: This systematic review and meta-analysis aimed to evaluate the diagnostic performance of ultrasound elastography in the differentiation of benign and malignant breast non-mass lesions (NMLs).

Methods: PubMed, Cochrane Library, and Embase databases were searched for eligible studies up to end of June 2021. The diagnostic performance of elastography for NMLs was investigated using pooled sensitivity and specificity, likelihood ratio, diagnostic odds ratio (DOR), post-test probability, and the area under hierarchical summary receiver operating characteristic curve (HSROC).

Results: Eleven studies involving 812 NMLs (malignant 414) were included. The pooled sensitivity, specificity, DOR, positive likelihood ratio, and negative likelihood of elastography for the differentiation of benign and malignant breast NMLs were 79% (95 %CI: 71-85), 86% (95 %CI: 79-91), 23.32 (95 %CI: 13.38-40.66), 5.67 (95 %CI: 3.79-8.47), and 0.24 (95 %CI: 0.17-0.34), respectively. No significant publication bias existed. The area under the HSROC curve was 90% (95 %CI: 87-92). Fagan plots demonstrated good clinical utility. However, substantial heterogeneity existed. Country, measurement index, and number of lesions served as potential sources of heterogeneity.

Conclusions: The results of this study suggest that elastography has high diagnostic accuracy in differentiating between malignant and benign NMLs. Elastography can be a feasible and non-invasive tool for breast NMLs.
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http://dx.doi.org/10.1016/j.ejrad.2021.109991DOI Listing
October 2021

Metanephric adenoma: association between the imaging features of contrast-enhanced ultrasound and clinicopathological characteristics.

Gland Surg 2021 Aug;10(8):2490-2499

Department of Ultrasound, The Second Clinical Medical College, Jinan University (Shenzhen People's Hospital), Shenzhen, China.

Background: This study aimed to improve the understanding of metanephric adenoma (MA) by retrospective analysis of contrast-enhanced ultrasound (CEUS) findings and clinicopathological characteristics of MAs.

Methods: Gray-scale ultrasound (US) and CEUS findings of 7 adult MA patients, confirmed by postoperative pathology, were summarized via collection of clinicopathological and ultrasonographic imaging data, including tumor location, size, echo intensity, color flow, presence or absence of calcification, and liquefactive necrosis, contrast-enhanced pattern, enhancement characteristics, and contrast wash-out compared with adjacent parenchyma, and the presence or absence of a pseudocapsule. Histopathological analyses, including hematoxylin and eosin (HE) and immunohistochemical (IHC) staining, were conducted with the EnVision method.

Results: All 7 participants were female, aged 29-73 years (mean age, 54 years), with flank pain (3/7). All tumors were solid (7/7) with sizes of 2.0-5.0 cm (mean diameter, 3.07 cm), including 4 in the left kidney, 3 in the right kidney, 2 in the renal pelvis, and 5 in the renal parenchyma. On the gray-scale US, MA was shown as hypoechoic (4/7), slightly hyperechoic (2/7), isoechoic (1/7), and with a defined border. The morphology was regular and rounded (7/7), internal echogenicity was homogeneous (5/7), and no calcification was seen (7/7). The CEUS showed clear boundaries (7/7), homogeneous isodensity (5/7), with calcification (0/7), necrosis (2/11), heterogeneous hyperattenuation (2/7), pseudocapsule (2/7), and medullary phase fast wash-out (7/7). The surgical methods were radical nephrectomy (4/7) and partial nephrectomy (3/7). The duration of follow-up period for all participants was 3-74 months, and no local or distant recurrences were found. The IHC staining showed that most tumor cells were positive for WT1, cytokeratins AE1/AE3, vimentin, and CD57, and exhibited focal positivity for CK7, while negative for CD10, AMACR, and CK720. The proliferative index (Ki-67) was 2-3%.

Conclusions: On gray-scale US, MA appears as a solid nodule with a well-defined boundary, regular morphology, and homogeneous echogenicity; CEUS shows slow progression and slightly lower homogeneous enhancement and fast wash-out in the medullary phase. These findings may provide insight into the progression of MA and aid in the development of diagnostic and therapeutic strategies.
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http://dx.doi.org/10.21037/gs-21-437DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8411086PMC
August 2021

Development and validation of a nomogram based on multiparametric magnetic resonance imaging and elastography-derived data for the stratification of patients with prostate cancer.

Quant Imaging Med Surg 2021 Jul;11(7):3252-3262

Department of Ultrasound, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China.

Background: This study sought to develop and validate a nomogram combining the elastographic Q-analysis score (EQS), the Prostate Imaging Reporting and Data System (PI-RADS) score, and clinical parameters for the stratification of patients with prostate cancer (PCa).

Methods: A retrospective study was conducted of 375 patients with 375 lesions who underwent volume-navigation transrectal ultrasound (TRUS) and multiparametric magnetic resonance imaging (MP-MRI)-fusion targeted biopsies between April 2017 and January 2020. Based on a multivariate logistic regression model, a nomogram was created to assess any PCa and high-risk PCa [Gleason score (GS) ≥4+3] using data from patients diagnosed between April 2017 and June 2019 (n=271), and was validated in patients diagnosed after July 2019 (n=104). The nomogram's performance was evaluated based on its discrimination, calibration, and clinical usefulness.

Results: The areas under the curve (AUCs) of the nomogram for predicting any PCa and high-risk PCa were 0.949 [95% confidence interval (CI), 0.921 to 0.978] and 0.936 (95% CI, 0.906 to 0.965), respectively, in the training cohort, and 0.946 (95% CI, 0.894 to 0.997) and 0.971 (95% CI, 0.9331 to 1), respectively, in the validation cohort. The nomogram was well calibrated, and no significant difference was found between the predicted and observed probabilities. A decision curve analysis (DCA) for the nomogram with and without the EQS showed that the threshold probability of for any PCa was <67%.

Conclusions: The nomogram that combined elastography-derived and MP-MRI data was more clinically useful than the model based on PI-RADS and clinical parameters alone. Our nomogram could aid urologists to make decisions and avoid unnecessary biopsies.
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http://dx.doi.org/10.21037/qims-20-978DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8250010PMC
July 2021

Elastography for the differential diagnosis of malignant versus benign testicular lesions: a meta-analysis.

Ultrasonography 2021 Oct 2;40(4):465-473. Epub 2021 Feb 2.

Department of Ultrasound, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China.

Purpose: The aim of this study was to evaluate the value of elastography in the differential diagnosis of benign versus malignant testicular lesions.

Methods: The PubMed, Cochrane Library, and Embase databases were searched for relevant studies. The diagnostic accuracy of elastography was evaluated using pooled sensitivity, specificity, likelihood ratio, post-test probability, diagnostic odds ratio, and by summarizing the area under the hierarchical summary receiver operating characteristic (HSROC) curve.

Results: Seven studies with 568 lesions were included. The pooled sensitivity and specificity were 87% (95% confidence interval [CI], 81% to 92%) and 81% (95% CI, 65% to 90%), respectively. The pooled estimates of the positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 4.48 (95% CI, 2.37 to 8.47), 0.16 (95% CI, 0.10 to 0.25), and 28.11 (95% CI, 11.39 to 69.36), respectively. The area under the HSROC curve was 90% (95% CI, 88% to 93%).

Conclusion: Elastography is useful for assessing the stiffness of testicular lesions and for differentiating benign from malignant lesions. Elastography can be an effective supplement to conventional ultrasonography.
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http://dx.doi.org/10.14366/usg.20191DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8446503PMC
October 2021

The study of antiviral drugs targeting SARS-CoV-2 nucleocapsid and spike proteins through large-scale compound repurposing.

Heliyon 2021 Mar 1;7(3):e06387. Epub 2021 Mar 1.

Integrated Chinese and Western Medicine Postdoctoral Research Station, Jinan University, Guangzhou, 510632, China.

Contributing to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) clinical treatment, a drug library encompassing approximately 3,142 clinical-stage or FDA-approved small molecules is profiled to identify the candidate therapeutic inhibitors targeting nucleocapsid protein (N) and spike protein (S) of SARS-CoV-2. 16 screened candidates with higher binding affinity are evaluated via virtual screening. Comparing to those under trial/temporarily used antivirus drugs (i.e., umifenovir, lopinavir), ceftriaxone, cefotaxime, and cefuroxime show higher binding affinities to the N-terminal domain of N protein (N-NTD), C-terminal domain of N protein (N-CTD), and receptor-binding domain of S protein (S-RBD). Cefotaxime and cefuroxime have high binding affinities towards S-RBD with angiotensin-converting enzyme 2 (ACE2) complex via influence the critical interface sites at the interface of S-RBD (Arg, Tyr, Trp, Gly, Phe, Asnand Tyr) and ACE2 (Asn, His, Glu, Asp, Lys, Ala, Ala, Gln, Pro, Phe and Arg) complex.
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http://dx.doi.org/10.1016/j.heliyon.2021.e06387DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7919521PMC
March 2021

Ultrasound molecular imaging-guided tumor gene therapy through dual-targeted cationic microbubbles.

Biomater Sci 2021 Apr 17;9(7):2454-2466. Epub 2021 Feb 17.

Shenzhen Medical Ultrasound Engineering Center, Department of Ultrasonography, Shenzhen People's Hospital, Second Clinical Medical College of Jinan University, First Clinical Medical College of Southern University of Science and Technology, Shenzhen 518020, China.

The success of gene therapy depends largely on the development of gene vectors and effective gene delivery systems. It has been demonstrated that cationic microbubbles can be loaded with negatively charged plasmid DNA and thus improve gene transfection efficiency. In this study, we developed dual-targeting cationic microbubbles conjugated with iRGD peptides(Cyclo(Cys-Arg-Gly-Asp-Lys-Gly-Pro-Asp-Cys)) and CCR2 (chemokine (C-C motif) receptor 2) antibodies (MB) for ultrasound molecular imaging and targeted tumor gene therapy. The ultrasound molecular imaging experiments showed that there were significantly enhanced ultrasound molecular imaging signals in the tumor that received MB, compared with those that received MB, MB, or MB. As a therapy plasmid, pGPU6/GFP/Neo-shAKT2, carrying an expression cassette for the human AKT2 RNA interference sequence, was used. Our results demonstrated that MB had a significantly higher gene transfection efficiency than MB, MB, or MB under ultrasound irradiation, resulting in much lower AKT2 protein expression and stronger tumor growth inhibition effects in vivo and in vitro. In conclusion, our study demonstrated a novel gene delivery system via MB for ultrasound molecular-imaging-guided gene therapy of breast cancer.
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http://dx.doi.org/10.1039/d0bm01857kDOI Listing
April 2021

One step further into the blackbox: a pilot study of how to build more confidence around an AI-based decision system of breast nodule assessment in 2D ultrasound.

Eur Radiol 2021 Jul 6;31(7):4991-5000. Epub 2021 Jan 6.

The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, and The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, No. 107 Wenhuaxi Road, Jinan, 250012, People's Republic of China.

Objectives: To investigate how a DL model makes decisions in lesion classification with a newly defined region of evidence (ROE) by incorporating "explainable AI" (xAI) techniques.

Methods: A data set of 785 2D breast ultrasound images acquired from 367 females. The DenseNet-121 was used to classify whether the lesion is benign or malignant. For performance assessment, classification results are evaluated by calculating accuracy, sensitivity, specificity, and receiver operating characteristic for experiments of both coarse and fine regions of interest (ROIs). The area under the curve (AUC) was evaluated, and the true-positive, false-positive, true-negative, and false-negative results with breakdown in high, medium, and low resemblance on test sets were also reported.

Results: The two models with coarse and fine ROIs of ultrasound images as input achieve an AUC of 0.899 and 0.869, respectively. The accuracy, sensitivity, and specificity of the model with coarse ROIs are 88.4%, 87.9%, and 89.2%, and with fine ROIs are 86.1%, 87.9%, and 83.8%, respectively. The DL model captures ROE with high resemblance of physicians' consideration as they assess the image.

Conclusions: We have demonstrated the effectiveness of using DenseNet to classify breast lesions with limited quantity of 2D grayscale ultrasound image data. We have also proposed a new ROE-based metric system that can help physicians and patients better understand how AI makes decisions in reading images, which can potentially be integrated as a part of evidence in early screening or triaging of patients undergoing breast ultrasound examinations.

Key Points: • The two models with coarse and fine ROIs of ultrasound images as input achieve an AUC of 0.899 and 0.869, respectively. The accuracy, sensitivity, and specificity of the model with coarse ROIs are 88.4%, 87.9%, and 89.2%, and with fine ROIs are 86.1%, 87.9%, and 83.8%, respectively. • The first model with coarse ROIs is slightly better than the second model with fine ROIs according to these evaluation metrics. • The results from coarse ROI and fine ROI are consistent and the peripheral tissue is also an impact factor in breast lesion classification.
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http://dx.doi.org/10.1007/s00330-020-07561-7DOI Listing
July 2021

Development and validation of a nomogram for predicting prostate cancer in men with prostate-specific antigen grey zone based on retrospective analysis of clinical and multi-parameter magnetic resonance imaging/transrectal ultrasound fusion-derived data.

Transl Androl Urol 2020 Oct;9(5):2179-2191

Department of Ultrasound, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology (Shenzhen People's Hospital), Shenzhen Medical Ultrasound Engineering Center, Shenzhen, China.

Background: Urologists face a dilemma when deciding whether prostate biopsy is required for patients with prostate-specific antigen (PSA) levels in the grey zone (4 to 10 ng/mL).

Methods: We retrospectively analyzed data from consecutive patients with PSA levels in grey zone, who underwent targeted multiparametric magnetic resonance imaging (MP-MRI)/transrectal ultrasound (TRUS) fusion biopsy with elastography between November 2017 and December 2019 in our hospital. The patientse data including age, PSA, fPSA (free PSA), fPSA/PSA, PSA density (PSAD), prostate volume, elastography Q-analysis score (EQS), and prostate imaging-reporting and data system (PI-RADS) score were collected. The nomogram was built using logistic regression and the final cohort of patients was randomly divided into a training cohort (70%) and a validation cohort (30%) by R software. The models were evaluated by receiver operating characteristic curve (ROC) analysis and calibration curve analysis. The nomogram was constructed from the best model.

Results: The final study cohort consisted of 155 patients (training cohort, 109 patients; validation cohort, 46 patients) with PSA in the grey zone, of which 36 patients were pathologically diagnosed with PCa. The EQS model, -EQS model, +EQS model were built. The +EQS model that consisted of fPSA/PSA, EQS, and PI-RADS score had the best PCa diagnostic accuracy (development and validation, 0.783 and 0.781) and probability score (development and validation, 0.939 . 0.622). The new nomogram based on this model was constructed, in which fPSA/PSA ratio had the largest impact, followed by PI-RADS and EQS.

Conclusions: Elastography and pre-biopsy MP-MRI has clinical significance for patients with PSA in the grey zone. The new nomogram, which is based on pre biopsy data including serological analysis, PI-RADS score, and EQS, can be helpful for clinical decision-making to avoid unnecessary biopsy.
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http://dx.doi.org/10.21037/tau-20-1154DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7658138PMC
October 2020

Accuracy of transvaginal ultrasound for diagnosis of deep infiltrating endometriosis in the uterosacral ligaments: Systematic review and meta-analysis.

J Gynecol Obstet Hum Reprod 2021 Mar 22;50(3):101953. Epub 2020 Oct 22.

Department of Ultrasound, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical College of Jinan University, Shenzhen People's Hospital, Shenzhen, 518020, PR China. Electronic address:

Objectives: To review the diagnostic accuracy of transvaginal ultrasound (TVS) in the preoperative detection of uterosacral ligaments (USL) in patients with clinical suspicion of deep infiltrating endometriosis (DIE).

Methods: Extensive searches were conducted in PubMed, EMBASE and Cochrane libraries to search studies published between January 1989 and September 2, 2019. The inclusion criteria were the preoperative assessment of USL endometriosis by TVS in patients with clinically suspected DIE, using laparoscopy and histological results as the reference standard. The assessment of research quality uses preferred reporting items, including the System Review and Meta Analysis (PRISMA) guidelines, as well as the quality assessment of diagnostic accuracy study 2 (QUADAS-2) tools.

Results: During our advanced search, 7562 studies were identified. Finally, 11 of which were recognized as qualified and incorporated into this study. The pooled sensitivity, specificity, positive probability ratio (LR+) and negative probability ratio(LR-) of TVS for detecting DIE in the USL were 65 %(95 %CI:43-83), 92 %(95 %CI:84-96), 7.80 (95 %CI:4.7-13.0) and 0.38(95 %CI:0.22-0.66), respectively. There was significant heterogeneity in sensitivity (I: 97.40 %; Cochran Q, 385.09; P<0.001) and specificity (I, 93.89 %; Cochran Q, 163.75; P < 0.001).

Conclusion: TVS provides an excellent comprehensive diagnostic performance for DIE of the USL. However, further research is required to improve the diagnostic quality.
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http://dx.doi.org/10.1016/j.jogoh.2020.101953DOI Listing
March 2021

Avulsion fractures of the scaphoid and triquetrum in a 15 year- old male.

J Clin Orthop Trauma 2020 Jul-Aug;11(4):678-681. Epub 2020 Mar 21.

Department of Radiology, University of Miami/Jackson Memorial Hospital, Miami, FL, USA.

Avulsion fractures of the perilunate ligaments occur in isolation, and multiple fractures are typically not seen in the same carpus. We present a case of a 15-year-old male who injured his wrist during football practice. He presented without wrist dislocation or deformity. Radiographs demonstrated avulsion fractures to the proximal pole of the scaphoid and proximal radial aspect of the triquetrum. The patient was immobilized with an upper extremity thumb spica cast; however, there was persistent non-union of both fractured segments. Magnetic resonance imaging confirmed avulsions at the site of the scapholunate and lunotriquetral ligaments, with both ligaments relatively intact. At the last follow-up, one year after the initial injury, the patient had a normal clinical exam, with no pain and full wrist range of motion despite fracture non-union at both locations. This is a unique injury with an unclear mechanism and complicated management.
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http://dx.doi.org/10.1016/j.jcot.2020.03.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355064PMC
March 2020

Transcription/Expression of KLRB1 Gene as A Prognostic Indicator in Human Esophageal Squamous Cell Carcinoma.

Comb Chem High Throughput Screen 2020 ;23(7):667-674

The First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen 518020, Guangdong, China.

Aim And Objective: Esophageal squamous cell carcinoma (ESCC) is the most prevalent type of cancer with worldwide distribution and dismal prognosis despite ongoing efforts to improve treatment options. Therefore, it is essential to determine the prognostic factors for ESCC.

Methods And Results: We determined KLRB1 to be a prognostic indicator of human ESCC. KLRB1 was expressed at low levels in ESCC patients. Based on the risk score, patients were divided into high and low-risk groups. High-risk patients showed a poor survival rate. The prediction model based on the N stage, sex, and KLRB1 was significantly better than that based on the N stage and sex. The modified prediction model showed a robust ROC curve with an AUC value of 0.973. The knockdown of KLRB1 inhibited the growth of human ESCC cells. KLRB1 regulated Akt, mTOR, p27, p38, NF-κB, Cyclin D1, and JNK signaling, which was consistent with the result of GSEA.

Conclusion: KLRB1 is a potential prognostic marker for human ESCC patients.
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http://dx.doi.org/10.2174/1386207323666200517114154DOI Listing
June 2021

The role of grey-scale ultrasound in the diagnosis of adhesive capsulitis of the shoulder: a systematic review and meta-analysis.

Med Ultrason 2020 Sep 14;22(3):305-312. Epub 2020 Apr 14.

Department of Ultrasound, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical College of Jinan University, Shenzhen Medical Ultrasond Engineering Center, Shenzhen People's Hospital.

Aims: In this systematic review and meta-analysis, we discuss the value of grey-scale ultrasonography (US) in diagnosing adhesive capsulitis of the shoulder (ACS).

Material And Methods: We retrieved relevant studies from PubMed, Cochrane Library, and Embase before 8 April 2019. We selected 7 studies concerning 446 patients (490 shoulders) that used grey-scale US to diagnose ACS and magnetic resonance imaging (MRI) or arthroscopy as the reference standard. We assessed the diagnostic accuracy of US on the basis of combined sensitivity, specificity, likelihood ratio (LR), and the area under the summary receiver operating characteristic (SROC) curve (AUC).

Results: The combined sensitivity, specificity, positive LR and negative LR were found to be 88% (95%CI: 74-95), 96% (95%CI: 88-99), 23.89 (95%CI: 6.31-90.51) and 0.12 (95%CI: 0.05-0.29), respectively. The AUC was 0.97 (95%CI: 0.96-0.98). ACS was diagnosed on the basis of four US features: coracohumeral ligament thickening, inferior capsule/axillary recess capsule thickening, rotator interval abnormality, and restriction of the range of motion. The corresponding sensitivities were 64.4 (95%CI: 48.8-78.1), 82.1 (95%CI: 73.8-88.7), 82.6 (95%CI: 74.1-89.2) and 94.3 (95%CI: 84.3-98.8), respectively, and specificities were 88.9 (95%CI: 76.0-96.3), 95.7 (95%CI: 90.3-98.6), 93.9 (95%CI: 89.8-96.7), and 90.9 (95%CI: 75.7-98.1), respectively.

Conclusions: Our meta-analysis showed that grey-scale US plays a significant role in the diagnosis of ACS. Because of its high sensitivity and specificity, US can be added to the existing clinical diagnosis program.
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http://dx.doi.org/10.11152/mu-2430DOI Listing
September 2020

Diagnostic performance of ultrasound for rotator cuff tears: a systematic review and meta-analysis.

Med Ultrason 2020 May 16;22(2):197-202. Epub 2020 Feb 16.

Department of Ultrasound, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical College of Jinan University, Shenzhen Medical Ultrasond Engineering Center,Shenzhen People's Hospital, Shenzhen ,China.

Aim: Rotator cuff (RC) tears are considered to be the main reason for shoulder pain. Although ultrasound is a useful method to detect it, its effectiveness when diagnosing RC tears has been a heated discussion. Therefore, we aimed at evaluating RC tears' ultrasound accuracy by conducting a systemically review and pooled comprehensive analysis.

Materials And Methods: Relevant articles up to May 2018 were searched from the Cochrane Library, Embase, and Pubmed databases. Either arthroscopy or magnetic resonance imaging (MRI) was considered as a reference standard. The results were estimated by pooled-sensitivity (P-SEN), pooled-specificity (P-SPE), pooled-diagnostic odds ratio (P-DOR), pooled-likelihood ratio+ (PLR+), pooled-likelihood ratio- (P-LR-), and the area under the summary receiver operating characteristic (SROC).

Result: We selected seven prospective studies in accordance with the inclusion criteria that covered 554 rotator cuff tears in 868 patients. The P-SEN, P-SPE, P-LR+, P-LR-, P-DOR, area under the SROC curve of diagnostic performance of ultrasound for RC and post-test probability were 95% (95% CI: 88 - 98), 72% (95% CI: 61 - 81), 3.41 (95% CI: 2.40 - 4.84), 0.08 (95% CI: 0.03 - 0.16), 45.31 (95% CI: 21.04 - 97.59), 89% (95% CI: 0.86 - 0.91), and 46% and 2%, respectively.

Conclusion: Our metaanalysis demonstrates that ultrasound has a high efficiency for RC tears' diagnosis. It can be a promising method in patients with suspected RC tears because of its high sensitivity, specificity and diagnostic accuracy.
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http://dx.doi.org/10.11152/mu-2352DOI Listing
May 2020

Knockdown of Thymidine Kinase 1 Suppresses Cell Proliferation, Invasion, Migration, and Epithelial-Mesenchymal Transition in Thyroid Carcinoma Cells.

Front Oncol 2019 29;9:1475. Epub 2020 Jan 29.

Department of Ultrasound, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical College of Jinan University, Shenzhen, China.

Patients with advanced thyroid carcinoma have poor prognosis with low overall survival. Unfortunately, the underlying mechanisms of thyroid carcinoma progression remain unclear. The elevated expression of thymidine kinase 1 (TK1) has been implicated in the progression of thyroid carcinoma, while the role of TK1 in thyroid carcinoma progression has not been explored. The present study aimed to determine the role TK1 in the progression of thyroid cancer and to explore the underlying molecular mechanisms. In this study, it was found that serum TK1 levels were markedly increased in the patients with thyroid nodules. Further online data mining showed that TK1 expression was upregulated in thyroid carcinoma tissues, and higher expression of TK1 was correlated with shorter disease-free survival of patients with thyroid carcinoma. Silencing of TK1 suppressed cell proliferation, invasion, migration, and epithelial-mesenchymal transition, and also induced cell apoptosis in the thyroid carcinoma cell lines. Animal studies showed that TK1 knockdown inhibited tumor growth of thyroid carcinoma cells. Importantly, miR-34a-5p was found to be downregulated in the thyroid carcinoma cells. Furthermore, miR-34a-5p targeted the 3' untranslated region of TK1 and suppressed the expression of TK1 in thyroid carcinoma cell lines. In summary, first, these results demonstrated the upregulation of TK1 in thyroid nodules and thyroid carcinoma tissues; second, TK1 promoted thyroid carcinoma cell proliferation, invasion, and migration; lastly, TK1 was negatively regulated by miR-34a-5p. Our study may provide novel insights into the role of TK1 in regulating thyroid carcinoma progression.
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http://dx.doi.org/10.3389/fonc.2019.01475DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7000458PMC
January 2020

Promoter hypermethylation of the CFTR gene as a novel diagnostic and prognostic marker of breast cancer.

Cell Biol Int 2020 Feb 10;44(2):603-609. Epub 2019 Dec 10.

The First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, 518020, Guangdong, China.

Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer-related deaths among women. New biomarkers with definite diagnostic and prognostic efficacy are urgently needed. Here, we showed that the promoter of the cystic fibrosis transmembrane conductance regulator (CFTR) was hypermethylated in breast cancer. The messenger RNA level of CFTR was downregulated in breast cancer. Notably, all 19 breast cancer patients with hypermethylated CFTR were diagnosed with invasive carcinoma. Moreover, CFTR was upregulated in decitabine (10 μM) treated breast cancer cells. Overexpression of CFTR inhibited cell growth whereas knockdown of CFTR promoted cell invasion. In the tissue array analysis, the CFTR protein level decreased significantly in breast cancer and low CFTR protein level correlated with poor survival with a P-value of 0.034. Thus, promoter hypermethylation of the CFTR gene might be a novel diagnostic marker of breast cancer.
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http://dx.doi.org/10.1002/cbin.11260DOI Listing
February 2020

Clinical Value of the Elastographic Q-Analysis Score in Assisting Real-Time Elastography-Guided Prostate Biopsy: A Retrospective Study of 125 Patients.

J Ultrasound Med 2020 Jan 1;39(1):83-87. Epub 2019 Jul 1.

Department of Ultrasound, First Affiliated Hospital of the Southern University of Science and Technology, Second Clinical College of Jinan University, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital, Shenzhen, China.

Objectives: This study aimed to evaluate the clinical value of the elastographic Q-analysis score (EQS) in assisting real-time elastography- and transrectal US-guided prostate biopsy.

Methods: A total of 125 patients with 301 lesions were enrolled in this study; all were confirmed by pathologic results. The patients underwent transrectal US and elastographic examinations before biopsy. Elastographic Q-analysis score analysis software was used for measuring the mean EQS of the elastic images. First, the suspicious regions on elastography underwent biopsy. Then 12-core systematic prostate biopsy was performed. An EQS curve was used to calculate the mean EQS, and a receiver operating characteristic curve was drawn to find the cutoff point for the EQS to predict prostate cancer.

Results: Of the 301 lesions in this study, 125 were malignant, and 176 were benign. The mean EQS values of benign and malignant lesions ± SD were 1.47 ± 0.75 and 2.98 ± 1.06, respectively. The difference was statistically significant (P < .05). The area under the receiver operating characteristic curve was 0.87. When the cutoff point was 1.95 for diagnosing malignant and benign lesions, the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio were 83.5%, 84.4%, 76.8%, 89.2%, 5.35, and 0.20.

Conclusions: The EQS could be used as a way to predict benign and malignant lesions and thus could serve as guidance for adding targeted biopsy.
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http://dx.doi.org/10.1002/jum.15075DOI Listing
January 2020

Lumbrical Tear in Major League Baseball Player Throwing 4-Seam Fastballs: A Case Report.

JBJS Case Connect 2019 Apr-Jun;9(2):e0115

Department of Radiology, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, Florida.

Case: We present the case of a major league pitcher with persistent finger pain, loss of pitch control, and loss of pitch velocity after an injury during a game. This pitcher only throws fastballs and prefers to only use a 4-seam technique. On examination of the affected hand, it is found that he had tenderness along the palmar iinterosseous near the base of the third metacarpal and no tenderness along the distribution of the flexor digitorum profundus (FDP) tendon. The patient had full range of motion of the third digit. Magnetic resonance imaging revealed partial thickness tears of the second and third lumbricals.

Discussion: Proposed injury was secondary to the 4-seam fastball technique, which pulls apart the FDP of the second and third digit, as well as the FDP of third and fourth digit. This increases the distance between the origins of the second and third lumbricals, leading to strain and tearing. The increased pitch count of the player also may have contributed to the injury. After rest and gradual tossing program, the pitcher was able to return to a preinjury level of function at 6 weeks. One year out from injury, the patient continued to pitch and remained pain free.
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http://dx.doi.org/10.2106/JBJS.CC.18.00115DOI Listing
June 2020

Evaluation of the Performance of the Ultrasound (US) Elastographic Q-Analysis Score Combined With the Prostate Imaging Reporting and Data System for Malignancy Risk Stratification in Prostate Nodules Based on Transrectal US-Magnetic Resonance Imaging Fusion Imaging.

J Ultrasound Med 2019 Nov 1;38(11):2991-2998. Epub 2019 Apr 1.

Department of Ultrasound, Second Clinical College of Jinan University, First Affiliated Hospital of the Southern University of Science and Technology, Shenzhen People's Hospital, Shenzhen, China.

Objectives: This study retrospectively evaluated the prognostic performance of the ultrasound elastographic Q-analysis score (EQS) combined with the Prostate Imaging Reporting and Data System (PI-RADS) for malignancy risk stratification in prostate nodules based on transrectal ultrasound-magnetic resonance imaging fusion imaging.

Methods: Sixty-two patients who were suspected to have PCa between October 2017 and May 2018 in our hospital were retrospectively evaluated. The performance of the EQS and PI-RADS was evaluated by patients' receiver operating characteristic curves in differentiating malignant and benign prostate nodules. The combination of the EQS and PI-RADS methods for prostate imaging was evaluated.

Results: Sixty-two prostate nodules in 62 patients were included. All of the patients underwent biopsy; 29 cases were prostate cancer, and the rest were benign prostate lesions. Both the EQS and PI-RADS were significantly higher in malignant nodules than in benign nodules. The sensitivity, specificity, area under the curve, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value, and Youden index of an EQS cutoff of 2.05 were 86.2%, 81.8%, 85.9%, 4.73, 0.169, 80.6%, 87.1%, and 68%, respectively. The corresponding numbers for a PI-RADS cutoff of 4 were 82.7%, 69.7%, 84.2%, 2.72, 0.25, 70.6%, 82.1%, and 52.4%. The "tandem" method had a higher diagnostic specificity (87.9%), positive likelihood ratio (6.55), and positive predictive value (85.1%). The "parallel" method had a higher diagnostic sensitivity (96.5%), negative likelihood ratio (0.06), and negative predictive value (95.2%).

Conclusions: both the EQS and PI-RADS had good diagnostic performance in differentiating between malignant and benign prostate lesions. The combination of the EQS and PI-RADS improved the diagnostic performance to a certain degree.
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http://dx.doi.org/10.1002/jum.15005DOI Listing
November 2019

A Preliminary Comparative Study of Young's Modulus Versus Shear Modulus in the Diagnosis of Breast Cancer.

Ultrasound Q 2019 Mar;35(1):88-92

Department of Ultrasound, Shenzhen Medical Ultrasound Engineering Center, and.

Purpose: The purpose of this study was to compare the diagnostic value of Young's modulus (E) and shear modulus (G) in the differential diagnosis of benign and malignant breast masses using sound touch elastography (STE) and to explore the relationship between G and E in breast lesions.

Methods: A total of 96 consecutive women with 110 pathologically confirmed breast masses were included. All masses were detected by conventional and STE ultrasound. Emean, Emax, Emin, ESD, Gmean, Gmax, Gmin, and GSD were determined and evaluated for evidence of significant differences between benign and malignant breast masses. Receiver operator characteristics were used to compare the diagnostic efficacy of E and G and to determine the G cutoff value that would aid in the differential diagnosis of breast cancer.

Results: Emean, Emax, ESD, Gmean, Gmax, and GSD in cases of malignant breast masses were significantly higher than those in cases of benign masses (P < 0.05). There was no significant difference between Emin and Gmin (P = 0.565). In applying the Emean, Emax, ESD, Gmean, Gmax, and GSD to the receiver operator characteristics: (1) the area under the curve (AUC) of Gmean and Gmax is greater than the AUC of Emean and Emax, and the AUC of ESD is equal to the AUC of GSD. (2) The sensitivity and specificity were highest when the Gmean was 10.14 kPa. They were 84.1% and 80.3% respectively. (3) The sensitivity and specificity were highest when the Gmax was 52.20 kPa. They were 88.6% and 87.9% respectively.

Conclusions: These preliminary results of STE evaluation of breast masses suggest that the diagnostic value of G is greater than E. Furthermore, STE is a valuable tool in the differential diagnosis of breast lesions.
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http://dx.doi.org/10.1097/RUQ.0000000000000434DOI Listing
March 2019

Screening Breast Lesions Using Shear Modulus and Its 1-mm Shell in Sound Touch Elastography.

Ultrasound Med Biol 2019 03 9;45(3):710-719. Epub 2019 Jan 9.

Department of Ultrasound, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical College of Jinan University, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital, Shenzhen, China. Electronic address:

The aim of the study described here was to screen breast lesions using either or both shear modulus (G) and its 1-mm shell (S) in sound touch elastography through a retrospective study of 209 consecutive women with breast lesions. The ability of G and S data to differentiate between malignant and benign lesions was evaluated using the receiver operating characteristic (ROC) curve. The optimal cutoff point, sensitivity, specificity, positive likelihood ratio (LR+) and negative likelihood ratio (LR-) were calculated. Then, the parameters were pooled to determine the area under the summary receiver operating curve (AUSROC). The pooled sensitivity (PSen), pooled specificity (PSpe), pooled LR+ (PLR+), pooled LR- (PLR-) and diagnostic score (DS) were calculated. Pathologic examination results were used as the reference. In total, 209 patients with 155 benign and 54 malignant lesions were enrolled. For G, G and G, the cutoff values were 35.15 kPa (p = 0.0001), 10.18 kPa (p = 0.0001) and 5.18 kPa (p = 0.0001), respectively. For S, S and S, the cutoff values were 40.94 kPa (p = 0.001), 13.12 kPa (p = 0.0001) and 7.97 kPa (p = 0.0001), respectively. There were no significant differences in G and S between benign and malignant lesions. For the pooled six parameters, the PSen, PSpe, PLR+, PLR-, DS and AUSROC were 86% (95% confidence interval: 82%-89%), 82% (80%-85%), 4.90 (4.24-5.68), 0.17 (0.13-0.22), 3.36 (3.00-3.72) and 91% (88-93%), respectively. The G and S parameters of sound touch elastography could provide valuable data for the evaluation of breast lesions. Additionally, use of multiple parameters or combined use of the six parameters may be more effective in the evaluation of breast lesions.
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http://dx.doi.org/10.1016/j.ultrasmedbio.2018.11.013DOI Listing
March 2019

Diagnostic Performance of Multimodal Sound Touch Elastography for Differentiating Benign and Malignant Breast Masses.

J Ultrasound Med 2019 Aug 28;38(8):2181-2190. Epub 2018 Dec 28.

Department of Ultrasound, Second Clinical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China.

Objectives: Evaluating the value of screening breast masses by separate or combined use of multimodal Sound Touch Elastography.

Methods: Women with 159 masses (mean size, 14.86 ± 6.57 mm; range, 5.30-30.00 mm) were enrolled in the study. The pathology results were adopted as diagnostic standards. The abilities of Young's modulus (E), shear modulus (G), and shear wave (C) to differentiate malignant and benign breast masses based on receiver operating characteristic curves were evaluated, and the optimal cutoff values were obtained. Sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were calculated. Then, the values were combined to perform an overall analysis of Sound Touch Elastography using evidence-based medicine, construct forest plots, and calculate areas under the summary receiver operating characteristic curves, pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic scores.

Results: A total of 159 masses with a mean size of 14.86 ± 6.57 mm (range, 5.30-30.00 mm) were included. For the various parameters, the diagnostic values were as follows: G  > E  > C  > C  > E  > G  > E  > G  > C . There were no significant differences in E , G , or C . When the 9 parameters were combined, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic scores and areas under the summary receiver operating characteristic curves were 84% (95% confidence interval [CI], 79%-88%), 82% (95% CI, 80%-84%), 4.75 (95% CI, 4.15-5.43), 0.20 (95% CI, 0.15-0.25), 3.19 (95% CI, 2.84-3.54) and 90.2% (95% CI, 87%-92%), respectively.

Conclusions: Sound Touch Elastography can be recognized as a new ultrasound-based diagnostic method for differentiation between benign and malignant breast masses.
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http://dx.doi.org/10.1002/jum.14915DOI Listing
August 2019

Diagnostic Performance of Multiple Sound Touch Elastography for Differentiating Benign and Malignant Thyroid Nodules.

Front Pharmacol 2018 26;9:1359. Epub 2018 Nov 26.

Department of Ultrasound, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital, Shenzhen, China.

This study evaluated the ability of Sound Touch Elastography (STE) to distinguish malignant from benign thyroid nodules by quantifying tumor stiffness using the elastic ratio (EI) and shear modulus (G). Eighty-six patients with 86 nodules were enrolled in this study. There were 24/86 (27.90%) thyroid papillary carcinomas (TPC) and 62/86 (72.10%) benign nodules. The mean EI was significantly lower in TPCs than in benign nodules. The EI area under the receiver operating characteristic curve (ROC) was 80%. The EI cutoff value for TPCs was 0.215%. The sensitivity (Sen), specificity (Spe), positive likelihood ratio (LR+), and negative likelihood ratio (LR-) were 71%, 73%, 2.58, and 0.40, respectively. , , and were significantly higher in TPCs than in benign nodules. There were no significant differences in . Compared with other G parameters, with an optimal cutoff value of 15.82 kPa had the highest AUROC value (84%). The Sen, Spe, LR+, and LR- were 79.17%, 79.03%, 3.776, and 0.261, respectively. We pooled the EI, , , and and the pooled-Sen, Spe, LR+, LR-, diagnostic odds ratio and odds ratio, and area under the summary ROC were 79%, 71%, 2.73, 0.29, 2.23, 9.29, and 82%, respectively. STE could be a new ultrasound diagnostic method for evaluating benign and malignant thyroid nodules.
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http://dx.doi.org/10.3389/fphar.2018.01359DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6275196PMC
November 2018

Nicotine induces endothelial dysfunction and promotes atherosclerosis via GTPCH1.

J Cell Mol Med 2018 11 9;22(11):5406-5417. Epub 2018 Aug 9.

The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health; The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China.

Smoking is a major preventable risk factor for atherosclerosis. However, the causative link between cigarette smoke and atherosclerosis remains to be established. The objective of this study is to characterize the role of GTP cyclohydrolase 1 (GTPCH1), the rate-limiting enzyme for de novo tetrahydrobiopterin (BH4) synthesis, in the smoking-accelerated atherosclerosis and the mechanism involved. In vitro, human umbilical vein endothelial cells were treated with nicotine, a major component of cigarette smoke, which reduced the mRNA and protein levels of GTPCH1 and led to endothelial dysfunction. GTPCH1 overexpression or sepiapterin could attenuate nicotine-reduced nitric oxide and -increased reactive oxygen species levels. Mechanistically, human antigen R (HuR) bound with the adenylateuridylate-rich elements of the GTPCH1 3' untranslated region and increased its stability; nicotine inhibited HuR translocation from the nucleus to cytosol, which downregulated GTPCH1. In vivo, nicotine induced endothelial dysfunction and promoted atherosclerosis in ApoE mice, which were attenuated by GTPCH1 overexpression or BH4 supplement. Our findings may provide a novel and promising approach to atherosclerosis treatment.
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http://dx.doi.org/10.1111/jcmm.13812DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201367PMC
November 2018

The diagnostic accuracy of B-mode ultrasound in detecting meniscal tears: a systematic review and pooled meta-analysis.

Med Ultrason 2018 May;20(2):164-169

Department of Ultrasonography, Second Clinical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China.

Aim: To evaluate the diagnostic accuracy of meniscal tears using B-mode ultrasound and high-frequency linear probe by conducting a systematic review and pooled meta-analysis.

Material And Methods: The Cochrane library, Embase, and Pubmed were searched for relevant studies up to 29 July 2017. The arthroscopy was used as the reference standard. The results were estimated by pooled sensitivity, specificity, diagnostic odds ratio, likelihood ratio, and the area under the summary receiver operating characteristic (SROC).

Results: Seven prospective studies met the selection criteria, comprising 321meniscal tears from 472 patients. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the SROC curve were 88.80% (95%CI: 82.83-92.87), 84.66% (95%CI: 75.89-90.64), 5.79(95%CI: 3.66-9.15), 0.13 (95%CI: 0.09-0.20), and 43.74 (95%CI: 24.01-79.68), respectively. The area under the SROC curve was 93% (95%CI: 91-95).

Conclusions: This meta-analysis indicates that 2-dimensional ultrasound is useful, and could be routinely used for estimating meniscal injuries in the human knee joint.
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http://dx.doi.org/10.11152/mu-1252DOI Listing
May 2018

The role of ultrasonography in the diagnosis of anterior cruciate ligament injury: A systematic review and meta-analysis.

Eur J Sport Sci 2018 May 21;18(4):579-586. Epub 2018 Feb 21.

b Department of Ultrasound , The Second Clinical Medical College of Jinan University & Shenzhen People's Hospital , Shenzhen , People's Republic of China.

To evaluate the value of ultrasonography in the diagnosis of anterior cruciate ligament injury (ACL injury) by conducting a systematic review and meta-analysis. A literature search was carried out in the Cochrane Library, Embase, Pubmed databases and included studies prior to April 2017. Based on inclusion and exclusion criteria, studies evaluating ultrasound to diagnose ACL injury were selected. MRI, arthroscopy and clinical-follow were considered the reference standards. The diagnostic accuracy of ultrasound was assessed using a combination of sensitivity, specificity, likelihood ratio (LR), post-test probability, diagnostic odds ratio (DOR) and by summarizing the area under the receiver operating characteristic (SROC) curve. A total of 4 studies involving 246 patients were eventually included in the analysis. In these four studies, the combined sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, post-test probability and DOR were 90.0% (95% CI: 77-96), 97% (95% CI: 90-99), 31.08 (95% CI: 8.75-110.41), 0.11 (95% CI: 0.05-0.24), 89% (3%) and 288.81 (95% CI: 78.51-1062.48), respectively. The area under the SROC curve was 0.98 (95% CI: 0.97-0.99). Our meta-analysis showed that ultrasound can play an important role in the diagnosis of ACL injury. Because of its high sensitivity, high specificity and high diagnostic ability, ultrasound should be a part of the standard diagnostic work-up of an ACL injury.
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http://dx.doi.org/10.1080/17461391.2018.1436196DOI Listing
May 2018

Three-dimensional echocardiographic measurements using automated quantification software for big data processing.

J Xray Sci Technol 2017 ;25(2):313-321

Department of Ultrasound, Shenzhen People's Hospital, The Second Affiliated Hospital of Medical College of Jinan University, Shenzhen, China.

Objective: To compare a full-automated software to quantify 3D transthoracic echocardiography namely, 3DE-HM (three-dimensional echocardiography HeartModel, Philips Healthcare) with the traditional manual quantitative method (3DE-manual) for assessing volumes of left atrial and ventricular volumes, and left ventricular ejection fraction (LVEF).

Methods: 3D full volume images acquired from 156 subjects were collected and divided into 3 groups, which include 70 normal control cases (Group A), 17 patients with left ventricular remodeling after acute myocardial infarction (AMI) (Group B), and 69 patients with left atrial remodeling secondary to hypertension (Group C). The 3DE-HM method was used to quantify left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left atrial end-systolic volume (LAESV), and left ventricular ejection fraction (LVEF), respectively. The results were compared with those obtained with the 3DE-manual method for correlation and consistency analyses. The reproducibility of the 3DE-HM method was also evaluated.

Results: There was a high correlation between LVEDV, LVESV, LAESV and LVEF values obtained with the 3DE-HM method and those obtained using the 3DE-manual method (r = 0.72 to 0.97). The correlation was strongest for Group B, patients with left ventricular remodeling post-AMI also demonstrated the greatest degree of morphologic changes. There was a significant difference in all parameters measured with the 3DE-HM method in different groups (P < 0.05). The difference in the measurements of LVEDV and LVESV between the two methods was greatest in patients in Group B compared with patients with hypertension-induced left ventricular remodeling (Group C) and in normal controls (Group A) (P < 0.05). Lastly, the difference in the measurement of LAESV between the two methods was greater in patients with hypertension-induced left ventricular remodeling (Group C) than that in the control group (Group A) (P < 0.05). The post-processing time of the 3DE-HM data was significantly shorter than that using the 3DE-manual method (P < 0.05). There was no significant variability in repeated measurements at different time points using the 3DE-HM method either between subjects in different groups or within the same subject.

Conclusion: 3DE-HM is a quick and feasible method for left ventricular quantification and is clinically applicable for evaluating patients with left atrial and left ventricular remodeling.
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http://dx.doi.org/10.3233/XST-17262DOI Listing
January 2018

Shear wave elastography imaging for detecting malignant lesions of the liver: a systematic review and pooled meta-analysis.

Med Ultrason 2017 Jan;19(1):16-22

Department of Personnel, Second Clinical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China.

Aim: To investigate the clinical utility of shear wave elastography (SWE) imaging in the identification of malignant and benign lesions of the liver lesions by conducting a meta-analysis.

Material And Methods: The Cochrane library, Embase and Pubmed were searched for relevant studies with publication data through February 2016. Studies evaluating the diagnostic accuracy of SWE in the identification of malignant and benign lesions of the liver using SWE technology were selected. The cytology, histology or clinical imaging was used as the reference standard. The pooled sensitivity, specificity, diagnostic odds ratio, likelihood ratio, and the area under hierarchical summary receiver operating characteristic curve (HSROC) were used to examine the diagnostic accuracy.

Results: A total of 9 cohort studies involving 1046 liver lesions (malignant 679) from 968 patients were identified. All of the 9 studies were prospective studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of SWE in differentiating malignant and benign liver lesions were 82.2% (95% CI: 73.4-88.5), 80.2% (95% CI: 73.3-85.7), 4.159 (95% CI: 2.899-5.966), 0.222 (95% CI: 0.140-0.352), and 18.749 (95% CI: 8.746-40.195), respectively. The area under the HSROC curve was 87% (95% CI: 84-90).

Conclusions:  This meta-analysis indicates that SWE is useful in evaluating the stiffness of liver lesions and in differentiating between malignant and benign lesions. Due to the high sensitivity, specificity, and diagnostic odds ratio, SWE can be considered as a useful complement to conventional ultrasonography.
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http://dx.doi.org/10.11152/mu-925DOI Listing
January 2017

Clinical value of contrast-enhanced ultrasound in differentiating benign and malignant focal liver lesions.

J Huazhong Univ Sci Technolog Med Sci 2007 Dec;27(6):703-5

Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.

To explore the clinical value of contrast-enhanced ultrasound (CEUS) in differentiating benign and malignant focal liver lesions (FLLs) with SonoVue, CEUS was used to examine 113 patients with focal liver lesions (FLLs) in our hospital during July 2005 to December 2006. All the patients underwent contrast-enhanced CT (CECT) or contrast-enhanced MRI (CEMRI). Except for patients with focal fatty sparings (n=18) and with hemangiomas (n=8), all the patients were confirmed by operation or ultrasonic-guided liver puncture biopsy. A sulfur hexafluoride gas-based contrast agent was used with a MI of 0.15 to 0.17. Forty-eight cases of malignant FLLs, including 30 hepatocellular carcinomas (HCCs), 2 cholangiocarcinomas and 16 metastatic tumors, were detected. Seventy-eight cases of benign FLLs, including 33 hemangiomas, 9 focal nodular hyperplasias (FNHs), 19 focal fatty sparings, 5 abscesses, 7 regenerative nodules and 2 inflammatory pseudo-tumor, were involved. The contrast pattern of benign and malignant FLLs was quite different. CEUS has higher specificity and sensitivity than conventional ultrasound in differentiating benign and malignant FLLs.
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http://dx.doi.org/10.1007/s11596-007-0622-zDOI Listing
December 2007
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