Mindray (China)

Biopsy of cervical level IV lymph nodes is clinically important but technically challenging because the available needle corridor is often short and adjacent to major cervical vessels. Although core needle biopsy is generally preferred when preserved tissue architecture and ancillary studies are required, ultrasound-guided semiautomatic side-cut needles (US-SABN) and ultrasound-guided modified Menghini needles (US-MMT) have not been directly compared in this anatomically constrained setting. We retrospectively analyzed 290 consecutive patients who underwent ultrasound-guided biopsy of cervical level IV lymph nodes between January 2019 and August 2024 at two tertiary centers. The primary endpoint was sample adequacy. Secondary endpoints included specimen length, use of immunohistochemistry, and procedure-related complications graded according to the CIRSE classification. Categorical variables were compared using Pearson's chi-square test or Fisher's exact test, as appropriate, and continuous variables were compared using the Mann-Whitney U test. Sample adequacy was similar between US-MMT and US-SABN (94.9% [167/176] vs. 93.0% [106/114]; P = 0.676). Use of immunohistochemistry was also similar (52.3% [92/176] vs. 55.3% [63/114]; P = 0.705). US-MMT yielded longer tissue cores than US-SABN (median, 15.0mm [IQR, 10.0-20.0] vs. 10.0mm [IQR, 7.0-15.0]; P < 0.001). Complication rates were low in both groups (1.1% [2/176] vs. 1.8% [2/114]; P = 0.647), and all complications were minor, self-limited hematomas (CIRSE grade 1). In exploratory within-device analyses, specimen length varied by operator experience. US-MMT and US-SABN achieved comparable sample adequacy and low complication rates for biopsy of cervical level IV lymph nodes. Although US-MMT yielded longer tissue cores, this did not translate into differences in sample adequacy, use of immunohistochemistry, or complication rates. Findings from subgroup analyses stratified by operator experience are hypothesis-generating and require prospective validation.

This study aimed to investigate the joint and independent associations of type 2 diabetes (T2DM) and body mass index (BMI) with arterial stiffness using carotid ultrasound-based measures. This retrospective, matched cross-sectional study enrolled 255 participants, including people with T2DM (n=129) and Control group (diabetes-free, n=126). The control group was matched to the T2DM group based on age (±5 years), sex, and BMI category. People with T2DM were diagnosed according to World Health Organization criteria and classified into three BMI-based categories: lean (BMI<25 kg/m2, n=48), overweight (BMI=25-29.9 kg/m2, n=44) and obese (BMI≥30 kg/m2, n=37). Carotid intima-media thickness (IMT) and pulse wave velocity (PWV) were determined using sample images. Univariable and multivariable logistic regression models were used to evaluate the associations between BMI, T2DM and arterial stiffness, adjusted for potential confounders such as age, systolic blood pressure and lipid profiles. Interaction terms tested multiplicative effects. Compared to people with diabetes-free, those with T2DM had significantly greater IMT and PWV impairments (P<0.001). An increasing BMI category was associated with progressive IMT and PWV increase in people with T2DM (P<0.001). Multi-variable analysis revealed that BMI category had strong associations with carotid IMT (Standardize β 0.715, 95% CI: 113.4, 174.7) and PWV (Standardize β 0.544, 95% CI: 0.81, 1.73), indicating the progressive impact of BMI on arterial stiffness. No interaction was observed between T2DM and BMI (IMT: P-interaction=0.95; PWV: P-interaction=0.56), indicating independent effects. This study demonstrates additive but non-synergistic effects of T2DM and BMI on arterial stiffness, with BMI driving the majority of vascular impairment. However, the cross-sectional design precludes causal inferences. The findings underscore the clinical relevance of weight management in people with T2DM.

Accurate cross-modality cardiac image segmentation is essential for effectively diagnosing and treating heart disease. Different imaging modalities help to determine suitable pre-procedure planning. However, most methods face the difficulty of spatial-temporal confounding, where the anatomy element and modality element of cardiac images are intertwined across both spatial and temporal dimensions. It is derived from the imaging diversity and structure diversity of cardiac images. The spatial-temporal confounding hinders knowledge transfer between cardiac images on different modalities. In this paper, we propose a novel dynamic causal learning (DCL) to solve spatial-temporal confounding. The DCL explores multi-dimensional causal intervention to consider not only the causal relationship between images and labels, but also the causality in time dimension and space dimension. It integrates historical optimal interventions and facilitates the transfer of this knowledge across temporal contexts. In addition, the DCL utilizes the diffusion mechanism to further ensure that the extracted anatomy element remains causal invariant, improving model performance across multiple imaging modalities. Extensive experiments on cross-modality cardiac images (MR, CT, and US) demonstrate the effectiveness of the DCL (mean Dice = 0.951), outperforming other advanced segmentation methods. DCL is freely accessible at https://github.com/asdww0721ww/DCL.

Abstract Background Type 2 diabetes mellitus (T2DM) is associated with a spectrum of liver disorders, ranging from nonalcoholic fatty liver disease to fibrosis and hepatocellular carcinoma. Early detection of hepatic changes is critical for risk stratification and management. Sound Touch Viscosity Imaging (STVi) allows noninvasive quantification of both tissue elasticity and viscosity, potentially providing complementary information beyond conventional stiffness measurements. This study aimed to evaluate the diagnostic value of liver viscosity as a biomarker in patients with T2DM. Methods 99 patients with T2DM and 73 healthy controls underwent liver assessment using STVi. Measurements of hepatic elasticity and viscosity were obtained under standardized protocols. Laboratory and demographic data were collected. Statistical analyses included Mann–Whitney U tests, Student’s t-tests, receiver operating characteristic (ROC) curve analysis, and multivariate logistic regression to assess the diagnostic performance of elasticity, viscosity, and their combination. Correlation between viscosity and elasticity was evaluated using Spearman analysis. Results T2DM patients showed significantly elevated liver viscosity (1.54 ± 0.36 Pa·s) and elasticity (7.37 ± 2.07 kPa) compared to controls (P &lt; 0.001). Viscosity and elasticity were positively correlated (r = 0.683, P &lt; 0.001). ROC analysis revealed superior diagnostic performance for viscosity (AUC = 0.836) over elasticity (AUC = 0.774), with the combined model yielding an AUC of 0.89. Multivariate analysis identified viscosity, ALT, and age as independent predictors of T2DM. Conclusions Liver viscosity serves as a sensitive biomarker for early liver alterations in T2DM, outperforming stiffness alone. Ultrasound-based viscosity imaging holds promise for non-invasive screening and risk stratification of liver injury in diabetic populations.

Percutaneous image-guided thermal ablation (IGTA) is increasingly utilized for the management of primary and metastatic lung tumors. Several academic societies across various countries have issued clinical practice guidelines, opinion statements, and recommendations for IGTA in the treatment of lung tumors. However, unresolved conceptual and practical challenges persist, underscoring the need for a more comprehensive consensus on the safe and effective application of IGTA, particularly in Asian countries. Consequently, the guideline committee of the Asian Conference on Tumor Ablation (ACTA) established a dedicated working group to develop recommendations for the clinical use of IGTA in lung tumors. Through a thorough analysis of current literature and key clinical questions, the ACTA working group identified 10 critical issues, including indications, modality selection, technical considerations, and management of complications. Following extensive discussions and iterative revisions, experts from Asia-Pacific countries have formulated a consensus to guide clinical practice.

BackgroundThe accurate monitoring of chronic kidney disease (CKD) progression is clinically challenging, as conventional shear wave elastography (SWE) only evaluates tissue stiffness by focusing solely on quantifying tissue elasticity, and this parameter is influenced by hemodynamic fluctuations. Sound touch viscosity imaging (STVi) addresses these limitations by simultaneously quantifying both elasticity and viscosity, providing a comprehensive biomechanical profile that better reflects the complex pathophysiology of CKD. This dual-parameter approach enables more reliable disease staging and progression monitoring. This study aimed to investigate whether STVi-derived viscosity parameters outperformed conventional elasticity measurements in CKD diagnosis and staging, establish clinically applicable cut-off values for viscosity to stratify CKD severity, and explore the pathophysiological correlation between viscoelastic properties and renal fibrosis.MethodsIn total, 127 CKD patients [staged G1–G5 under the Kidney Disease: Improving Global Outcomes (KDIGO) criteria] and 84 healthy controls (HCs) were prospectively enrolled in this study. Ultrasound viscoelastic imaging was performed using Mindray Resona A20 systems with standardized protocols. Renal viscosity [pascal-seconds (Pa·s)] and elasticity (kPa) were measured simultaneously through Voigt model-based shear wave dispersion analysis. Histopathological correlation was established via image-guided biopsies.ResultsThe viscosity parameters showed superior diagnostic performance compared to the elasticity measurements. At the optimal cut-off value of 1.66 Pa·s, the area under the curve (AUC) for the right kidney was 0.95 [95% confidence interval (CI): 0.92–0.99] (sensitivity 94.4%, specificity 96.2%). The viscosity values showed a strong correlation with pathological grading (Spearman’s r=0.82, P<0.001) and displayed characteristic stage-dependent progression from G1 (1.71±0.11 Pa·s) to G5 (2.36±0.21 Pa·s), with a notable plateau observed between stages 4 and 5 (left kidney: P=0.87; right kidney: P=0.74). The bilateral consistency of the measurements (intraclass correlation coefficient >0.90) and the significantly higher diagnostic accuracy for detecting inflammatory changes (AUC 0.95 vs. 0.73 for elasticity, P<0.001) suggested that viscosity is a more comprehensive biomarker than conventional elasticity parameters.ConclusionsSTVi imaging provides a novel, non-invasive biomarker for assessing renal fibrosis in CKD that outperforms conventional SWE. The established cut-off values and characteristic progression patterns offer clinically actionable thresholds for early detection and staging. Future multicenter studies should be conducted to validate these findings across diverse populations and etiologies.

Abstract Background Natriuretic peptides (NPs), including B-type NP (BNP) and N-terminal-proBNP (NT-proBNP), are widely used as cardiac function biomarkers, reflecting cardiac stretching. Both BNP and NT-proBNP measurements are globally accepted and used in clinical practice for the diagnosis of acute and chronic heart failure (HF), risk stratification, and monitoring therapeutic response. Although BNP and NT-proBNP have similar physiological values, they still differ in terms of clinical and laboratory applications. For example, BNP is less susceptible to renal function compared with NT-proBNP, yet it is highly unstable that can be rapidly digested, losing its immunologic activity in blood. Conventional sandwich BNP immunoassays use two antibodies targeting two different epitopes. Longer distances between epitopes increase the probability of proteolytic degradation. Therefore, specifically designing an antibody pair combination that targets the epitope without enzymatic degradation risk is highly valuable for laboratory practice. Methods The new BNP assay was designed based on the SES-BNPTM (Single Epitope Sandwich). Firstly, the stability of BNP molecules in both blood-based matrix and synthetic-based matrix was evaluated. Secondly, sample stability with different patient plasma samples was evaluated under different temperature conditions. Thirdly, a comprehensive evaluation of analytical performance of this new BNP assay was conducted, including the sensitivity (LoB, LoD, LoQ), specificity, precision, etc. Results Different forms of BNP molecules could stay stable under room temperature within eight hours or under 2-8? within 24 hours. Compared with commercial BNP assays, sample stability for plasma samples from different patients increased from four to eight hours under room temperature and from 12 to 24 hours under 2-8C. Furthermore, the new BNP assay demonstrated excellent analytical sensitivity, where the LOB, LOD, LOQ are 1.00, 2.00, 3.00 pg/mL, respectively. Total imprecision near the threshold of non-CHF population (100 ng/L) was &amp;lt; 5%. No cross-reactivity or interference from endogenous interferents was observed. Conclusion By combining with SES-BNPTM, a new BNP assay was developed to improve sample stability during storage. Stability of BNP molecules in both plasma matrix and in synthetic buffer matrix increased, and would be more convenient during laboratory practice. Through a comprehensive evaluation, this new BNP assay was demonstrated to be highly sensitive, specific and with high precision.