Search Results (178)

Background: Acne scarring presents a significant esthetic and psychological concern, commonly classified into atrophic and hypertrophic types. Effectively managing these lesions often involves the use of therapeutic strategies such as laser treatments, dermabrasion, and fillers. This study investigates the efficacy of 1550 nm erbium glass laser therapy in the treatment of atrophic acne scars through a quantitative assessment. Material and Methods: Participants with mild to moderate atrophic acne scars received two sessions of fractional erbium glass laser therapy at one-month intervals. Skin density and epidermal thickness were measured using a high-frequency ultrasound device (DUB SkinScanner), while the Antera 3D imaging system facilitated a comprehensive analysis of skin parameters, including texture, volumetric depressions, and pigmentation. Results: The use of this therapy led to significant improvements across multiple parameters. Skin density and epidermal thickness increased. Significant reductions were observed in fold depth, pore volume, and depression volume, indicating enhanced smoothness and minimized scar appearance. Improvements in texture roughness and pigmentation contributed to a visually coherent skin surface. Conclusions: Fractional erbium glass laser therapy effectively ameliorates the appearance of atrophic acne scars by increasing skin density, reducing dermal depressions, and improving texture and pigmentation uniformity. The Antera 3D system and high-frequency ultrasound device demonstrated high efficacy in capturing subtle changes, supporting its value in clinical applications for optimizing treatment parameters. Full article

Background/Objectives: High-frequency ultrasound (HFUS) has been reported to be useful for the diagnosis of cutaneous diseases; however, its two-dimensional nature limits the value both in quantitative and qualitative evaluation. Three-dimensional (3D) visualization might help overcome the weakness of the currently existing HFUS. Methods: 3D-HFUS was newly developed and applied to various skin tumors and inflammatory hair diseases to assess its validity and advantages for dermatological use. Results: Three-dimensional images were successfully obtained from skin tumors, including basal cell carcinoma, subungual squamous cell carcinoma, Bowen’s disease, and malignant melanoma, as well as inflammatory hair loss diseases including alopecia areata in different disease phases and lichen planopilaris. Vertical and horizontal images were generated from the original 3D image data and assessed in comparison with histopathological and/or dermoscopic images. By additionally obtaining horizontal data, lateral tumor margins at any depth were visualized in tumors. In inflammatory hair loss diseases, signs potentially associated with disease activity and pathology were detected. In addition, horizontal evaluation helped grasp hair cycle status and hair follicle densities. Conclusions: These findings suggested that this novel technology holds promise as a robust noninvasive tool to diagnose and evaluate various cutaneous diseases. Full article

Background/Objectives: Hidrocystomas, eccrine and apocrine, are rare cystic lesions that form benign tumors of the sweat glands. This study aimed to describe the clinical features of hidrocystomas and evaluate the role of non-invasive imaging techniques, including dermoscopy, Line-field Confocal Optical Coherence Tomography (LC-OCT), Reflectance Confocal Microscopy (RCM), and Ultra-High-Frequency Ultrasound (UHFUS), in their diagnosis. Methods: In total, seven cases of hidrocystomas were collected from the Dermatologic Clinic of the University of Siena, Italy. Predefined dermoscopic, LC-OCT, RCM, and UHFUS features were retrospectively described. Results: Overall, hidrocystomas were located on the face, mainly presenting as blue/purple-bluish translucent papules (71%). Dermoscopic examination revealed a homogeneous purple-bluish color (71%), white pale halo (71%), and shiny globules at the periphery (57%). LC-OCT identified a hyporeflective cupoliform round structure in the dermis with a bright and thick contour, while UHFUS showed a round structure in the dermis filled with hypoechoic content. Conclusions: Non-invasive imaging techniques could significantly enhance the diagnostic accuracy of hidrocystomas, aid in differentiation from other lesions, and minimize unnecessary biopsies. Full article

Background/Objectives: Non-obstructive azoospermia (NOA) is a severe form of male infertility characterized by the absence of sperm in the ejaculate due to impaired spermatogenesis. Testicular sperm extraction (TESE) combined with intracytoplasmic sperm injection is the primary treatment, but success rates are unpredictable, causing significant emotional and financial burdens. Traditional clinical and hormonal predictors have shown inconsistent reliability. This review aims to evaluate current and emerging non-invasive preoperative predictors of successful sperm retrieval in men with NOA, highlighting promising biomarkers and their potential clinical applications. Methods: A comprehensive literature review was conducted, examining studies on clinical and hormonal factors, imaging techniques, molecular biology biomarkers, and genetic testing related to TESE outcomes in NOA patients. The potential role of artificial intelligence and machine learning in enhancing predictive models was also explored. Results: Traditional predictors such as patient age, body mass index, infertility duration, testicular volume, and serum hormone levels (follicle-stimulating hormone, luteinizing hormone, inhibin B) have limited predictive value for TESE success. Emerging non-invasive biomarkers—including anti-Müllerian hormone levels, inhibin B to anti-Müllerian hormone ratio, specific microRNAs, long non-coding RNAs, circular RNAs, and germ-cell-specific proteins like TEX101—show promise in predicting successful sperm retrieval. Advanced imaging techniques like high-frequency ultrasound and functional magnetic resonance imaging offer potential but require further validation. Integrating molecular biomarkers with artificial intelligence and machine learning algorithms may enhance predictive accuracy. Conclusions: Predicting TESE outcomes in men with NOA remains challenging using conventional clinical and hormonal parameters. Emerging non-invasive biomarkers offer significant potential to improve predictive models but require validation through large-scale studies. Incorporating artificial intelligence and machine learning could further refine predictive accuracy, aiding clinical decision-making and improving patient counseling and treatment strategies in NOA. Full article

Objectives: Actinic keratoses (AKs) are one of the most common reasons for consultation in the elderly population. This study aimed to assess the efficacy of 5-ALA PDT in AK treatment using high-frequency ultrasonography (HFUS) to evaluate skin layer changes during therapy. Methods: In our study, we included 44 AK patients aged 53 to 89 years. All patients had lesions clinically evaluated with the Olsen and AKASI scale. HFUS imaging was performed on seemingly healthy skin and lesions before and at 4, 8, and 12 weeks of therapy. Ultrasound markers such as skin thickness, echogenicity, and pixel intensity were measured. 5-ALA was applied under occlusion for 3 h. After removing the occlusive dressing, 5-ALA was removed with a saline solution and a directed therapy with a BF-200 lamp. Full follow-ups of 56 markers of suitable quality were selected. Results: The thickness of SLEB significantly decreased in the following weeks compared to the pre-therapy results, reaching its lowest values after 12 weeks. The average pixel intensity significantly increased in each skin layer after therapy (p < 0.01). For SLEB, there were statistically significant differences in LEP, MEP and contrast. The AKASI score before and after treatment was determined for the 39 patients who underwent follow-up at week 12. The median AKASI score was 3.2 (1.2–8.6) before treatment and 0.6 (0–2.8) after. Conclusions: According to the literature data, this is the first study describing the ALA-PDT treatment efficacy in different AK severities evaluated in HFUS. HFUS provides a valuable non-invasive tool for monitoring the efficacy of PDT in AK treatment, showing significant improvements in skin texture and structure. Full article

The objective of this work is to address the need for versatile and effective tissue characterization in abdominal ultrasound diagnosis using a simpler system. We evaluated the backscattering coefficient (BSC) of several tissue-mimicking phantoms utilizing three different ultrasonic probes: a single-element transducer, a linear array probe for clinical use, and a laboratory-made annular array probe. The single-element transducer, commonly used in developing fundamental BSC evaluation methods, served as a benchmark. The linear array probe provided a clinical comparison, while the annular array probe was tested for its potential in high-frequency and high-resolution ultrasonic observations. Our findings demonstrate that the annular array probe meets clinical demands by providing accurate BSC measurements, showcasing its capability for high-frequency and high-resolution imaging with a simpler, more versatile system. Full article

Background/Objectives: Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous neuroendocrine malignancy characterized by its propensity for rapid growth and early regional and distant metastasis. Given its potentially lethal nature, accurate and timely diagnosis of MCC is of utmost importance. This review aims to describe non-invasive imaging methods that can serve as additional tools in the examination of MCC. Methods: In this narrative review, we describe the up-to-date spectrum of non-invasive skin-imaging methods that can serve as additional tools in the examination of MCC based on the available literature. Dermoscopy might enhance the clinical diagnosis of MCC, facilitate differentiation from other benign and malignant tumors, and help optimize the treatment plan. New imaging technologies might also provide useful information at a sub-macroscopic level and support clinical diagnosis. These techniques include high-frequency ultrasound (HFUS), reflectance confocal microscopy (RCM) and optical coherence tomography (OCT). Results: Clinically, MCC typically presents as a rapidly growing, red, purple or skin-colored painless and firm nodule. Diagnosis is usually established with histopathological assessment and immunohistochemistry. However, dermoscopy and new imaging technologies might enhance the clinical diagnosis of MCC, facilitate differentiation from other benign and malignant tumors, and help optimize the treatment plan. Full article

Ultrasound is a versatile and well-established technique using sound waves with frequencies higher than the upper limit of human hearing. Typically, therapeutic and diagnosis ultrasound operate in the frequency range of 500 kHz to 15 MHz with greater depth of penetration into the body. However, to achieve improved spatial resolution, high-frequency ultrasound (>15 MHz) was recently introduced and has shown promise in various fields such as high-resolution imaging for the morphological features of the eye and skin as well as small animal imaging for drug and gene therapy. In addition, high-frequency ultrasound microbeam stimulation has been demonstrated to manipulate single cells or microparticles for the elucidation of physical and functional characteristics of cells with minimal effect on normal cell physiology and activity. Furthermore, integrating machine learning with high-frequency ultrasound enhances diagnostics, including cell classification, cell deformability estimation, and the diagnosis of diabetes and dysnatremia using convolutional neural networks (CNNs). In this paper, current efforts in the use of high-frequency ultrasound from imaging to stimulation as well as the integration of deep learning are reviewed, and potential biomedical and cellular applications are discussed. Full article

Background/Objectives: Focused ultrasound (FUS) and microbubble (MB) exposure is a promising technique for targeted drug delivery to the brain; however, refinement of protocols suitable for large-volume treatments in a clinical setting remains underexplored. Methods: Here, the impacts of various sonication parameters on blood–brain barrier (BBB) permeability enhancement and tissue damage were explored in rabbits using a clinical-prototype hemispherical phased array developed in-house, with real-time 3D MB cavitation imaging for exposure calibration. Initial experiments revealed that continuous manual agitation of MBs during infusion resulted in greater gadolinium (Gd) extravasation compared to gravity drip infusion. Subsequent experiments used low-dose MB infusion with continuous agitation and a low burst repetition frequency (0.2 Hz) to mimic conditions amenable to long-duration clinical treatments. Results: Key sonication parameters—target level (proportional to peak negative pressure), number of bursts, and burst length—significantly affected BBB permeability enhancement, with all parameters displaying a positive relationship with relative Gd contrast enhancement (p < 0.01). Even at high levels of BBB permeability enhancement, tissue damage was minimal, with low occurrences of hypointensities on T2*-weighted MRI. When accounting for relative Gd contrast enhancement, burst length had a significant impact on red blood cell extravasation detected in histological sections, with 1 ms bursts producing significantly greater levels compared to 10 ms bursts (p = 0.03), potentially due to the higher pressure levels required to generate equal levels of BBB permeability enhancement. Additionally, albumin and IgG extravasation correlated strongly with relative Gd contrast enhancement across sonication parameters, suggesting that protein extravasation can be predicted from non-invasive imaging. Conclusions: These findings contribute to the development of safer and more effective clinical protocols for FUS + MB exposure, potentially improving the efficacy of the approach. Full article

Echocardiography is a reliable and non-invasive method for assessing cardiac structure and function in both clinical and experimental settings, offering valuable insights into disease progression and treatment efficacy. The successful application of echocardiography in murine models of disease has enabled the evaluation of disease severity, drug testing, and continuous monitoring of cardiac function in these animals. However, there is insufficient standardization of echocardiographic measurements for smaller animals. This article aims to address this gap by providing a guide and practical tips for the appropriate acquisition and analysis of echocardiographic parameters in adult rats, which may also be applicable in other small rodents used for scientific purposes, like mice. With advancements in technology, such as ultrahigh-frequency ultrasonic transducers, echocardiography has become a highly sophisticated imaging modality, offering high temporal and spatial resolution imaging, thereby allowing for real-time monitoring of cardiac function throughout the lifespan of small animals. Moreover, it allows the assessment of cardiac complications associated with aging, cancer, diabetes, and obesity, as well as the monitoring of cardiotoxicity induced by therapeutic interventions in preclinical models, providing important information for translational research. Finally, this paper discusses the future directions of cardiac preclinical ultrasound, highlighting the need for continued standardization to advance research and improve clinical outcomes to facilitate early disease detection and the translation of findings into clinical practice. Full article

Consuming an unbalanced diet and being overweight represent a global health problem in young people and adults of both sexes, and may lead to metabolic syndrome. The diet-induced obesity (DIO) model in the C57BL/6J mouse substrain that mimics the gradual weight gain in humans consuming a “Western-type” (WD) diet is of great interest. This study aims to characterize this animal model, using high-frequency ultrasound imaging (HFUS) as a complementary tool to longitudinally monitor changes in the liver, heart and kidney. Long-term WD feeding increased mice body weight (BW), liver/BW ratio and body condition score (BCS), transaminases, glucose and insulin, and caused dyslipidemia and insulin resistance. Echocardiography revealed subtle cardiac remodeling in WD-fed mice, highlighting a significant age–diet interaction for some left ventricular morphofunctional parameters. Qualitative and parametric HFUS analyses of the liver in WD-fed mice showed a progressive increase in echogenicity and echotexture heterogeneity, and equal or higher brightness of the renal cortex. Furthermore, renal circulation was impaired in WD-fed female mice. The ultrasound and histopathological findings were concordant. Overall, HFUS can improve the translational value of preclinical DIO models through an integrated approach with conventional methods, enabling a comprehensive identification of early stages of diseases in vivo and non-invasively, according to the 3Rs. Full article

Filler injections in the upper face pose significant challenges due to its complex anatomy and proximity to vascular structures. High-frequency Doppler ultrasound offers real-time visualization of facial anatomy, improving both safety and aesthetic outcomes. This paper presents a detailed overview of the ultrasonographic anatomy of the temples, forehead, and glabella, along with reproducible, ultrasound-guided filler injection techniques for these areas. We use two scanning techniques previously described: “scan before injecting” and “scan while injecting”, applicable to subdermal, interfascial, and supraperiosteal planes in the temporal region, as well as the glabella, forehead, and supraorbital region. Ultrasound guidance for filler injections in the upper face can enhance procedural efficacy and safety. By integrating real-time imaging, practitioners can navigate the intricate vascular anatomy more effectively, thereby minimizing the risk of complications. This study highlights the need for ongoing research and continuous education to further refine these techniques and improve patient outcomes. Full article

The pitting qualities of lymphoedema tissue change with disease progression. However, little is known about the underlying tissue response to the pitting test or the tissue characteristics that enhance or resist indentation. The pitting test is currently unstandardised, and the influence of test technique on pitting outcomes is unknown. Understanding how tissue reacts to applied pressure will build evidence for the standardisation of the pitting test. Ninety pitting test sites from fifteen women with unilateral breast cancer-related lymphoedema were evaluated using high-frequency ultrasound (HFUS), bioelectrical impedance spectroscopy (BIS), and limb volume measures. Three sites on each lymphoedema and non-lymphoedema arm were subject to a 60-s (s) staged pitting test, with changes in tissue features captured with ultrasound imaging before, throughout, and after the pitting test. Pitting qualities of tissues varied greatly, with lymphoedema sites pitting more frequently (p < 0.001) with greater depth (p < 0.001) and requiring a longer recovery time (p = 0.002) than contralateral unaffected tissue. Pitting is not solely attributable to oedema volume. Non-structural and structural characteristics of dermal and subcutaneous layers also influence tissue responses to sustained pressure. To enhance the validity and reliability of pitting assessment, a 60 s staged pitting test with an observation of tissue recovery is recommended for lymphoedema presentations. Full article

Background: Primary cutaneous lymphoma (PCL) is a rare form of extranodal non-Hodgkin’s lymphoma characterized by malignant lymphocytes confined to the skin. Accurate diagnosis and staging are crucial for optimal management, yet radiological literature on imaging PCL remains limited. This study aims to delineate the imaging characteristics of PCLs using high and ultra-high frequency ultrasound (UHFUS) and proposes a classification system based on ultrasound findings. Methods: A cohort of 88 individuals with suspected PCL underwent high-resolution ultrasound (HRUS) and color Doppler examination of lesions. Lesions were categorized based on sonographic appearance, and subsequent histopathological assessment confirmed the diagnosis. Results: Ultrasound imaging revealed distinct patterns for primary cutaneous T-cell lymphomas (PCTCL) and primary cutaneous B-cell lymphomas (PCBCL), with characteristic features such as hypoechoic nodules, pseudonodular lesions, and dermal infiltration. Histopathological analysis confirmed the ultrasound findings, supporting the proposed classification system. Conclusions: Ultrasonography, particularly UHFUS, offers valuable insights into the imaging characteristics of primary cutaneous lymphomas, aiding the accurate diagnosis and assessment of treatment response. The proposed classification system based on ultrasound findings enhances the diagnostic approach to PCLs, and paves the way for improved patient care and management strategies. Full article

Background: Technology allows us to predict a histopathological diagnosis, but the high costs prevent the large-scale use of these possibilities. The current liberal indication for surgery in benign thyroid conditions led to a rising frequency of incidental thyroid carcinoma, especially low-risk papillary micro-carcinomas. Methods: We selected a cohort of 148 patients with thyroid nodules by ultrasound characteristics and investigated them by fine needle aspiration cytology (FNAC)and prospective BRAF collection for 70 patients. Also, we selected 44 patients with thyroid nodules using semi-quantitative functional imaging with an oncological, ^99mTc-methoxy-isobutyl-isonitrile (^99mTc-MIBI) radiotracer. Results: Following a correlation with final histopathological reports in patients who underwent thyroidectomy, we introduced the results in a machine learning program (AI) in order to obtain a pattern. For semi-quantitative functional visual pattern imaging, we found a sensitivity of 33%, a specificity of 66.67%, an accuracy of 60% and a negative predicting value (NPV) of 88.6%. For the wash-out index (WOind), we found a sensitivity of 57.14%, a specificity of 50%, an accuracy of 70% and an NPV of 90.06%.The results of BRAF in FNAC included 87.50% sensitivity, 75.00% specificity, 83.33% accuracy, 75.00% NPV and 87.50% PPV. The prevalence of malignancy in our small cohort was 11.4%. Conclusions: We intend to continue combining preoperative investigations such as molecular detection in FNAC, ^99mTc-MIBI scanning and AI training with the obtained results on a larger cohort. The combination of these investigations may generate an efficient and cost-effective diagnostic tool, but confirmation of the results on a larger scale is necessary. Full article