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HCC has significantly improved outcomes when detected early. Guidelines recommend biannual surveillance with ultrasound (US) and/or AFP in at-risk individuals. This survey aimed to describe HCC surveillance adherence/practices amongst the NHS hospitals in the UK. An electronic survey was sent to 79 NHS hospitals via the British Association for the Study of the Liver distribution list. The responses were captured from July 2021 to January 2022. Centres were divided into hepato-pancreato-biliary (HPB) and non-HPB centres, depending on whether the hospital undertakes major liver surgeries. A total of 39 (49.3%) centres responded: 15 HPB and 24 non-HPB centres from across the UK. HCC surveillance eligibility criteria were universally applied, but heterogeneous approaches occur outside these criteria. Eighty per cent of patients undergoing surveillance were estimated to have cirrhosis. Eighty-five per cent of centres do 6-monthly US and AFP requested by clinicians and liver clinical nurse specialists. Compliance was estimated at 80% but not routinely audited. In most centres, general sonographers and/or radiologists perform surveillance US scans without a standard reporting template, although structured reporting was viewed as desirable by the majority. Poor views on US are approached heterogeneously, with patients variably offered ongoing US, CT, or MRI with different protocols. Most responding NHS hospitals follow 6-monthly HCC surveillance guidance. Data recording is variable, with limited routine data collection regarding compliance, yield, and quality. Surveillance US is mostly performed by non-HPB specialists without standardised reporting. There is an inconsistent approach to poor views with US surveillance. Even in a universal healthcare system such as NHS, which is free at the point of care, delivery of HCC surveillance has not improved over the last decade and remains variable.

ABSTRACT Objective: To determine the role of real time ultrasound B-scan in postoperative prognosis among patients with advanced cataract by documenting preoperative frequency of different posterior segment pathologies. Study Design: Cross-sectional study. Place and Duration of Study: Radiology Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Oct 2011. Methodology: The study utilized ultrasound eye, carried on the patients with closed eyes in supine position with ultrasound transmission gel applied to prevent transducer touching eyelid. Scan was performed in both sagittal and transverse plane. Results: A total of 336 patients were included in this study, with mean age of 56.92±12.89 years, 162(48.21%) male rest female. Cataracts were found in 144 (42.86%) left eyes and 154 (45.83%) right eyes. Mature cataract was seen in 292 (86.9%) patients, while 32(9.52%) had traumatic and 304(90.47%) had non-traumatic cataract. In non-traumatic cataract, retinal detachment (RD) was in 14(4.6%) patients, vitreous detachment (VD) in 13(4.3%) and vitreous detachment/hemorrhage in 21(6.9%) patients. Optic disc cupping was seen in 6(2.0%) non-traumatic cases and other pathologies were seen in 7(2.3%) patients having nontraumatic and 3(9.38%) patients having traumatic cataract. Conclusion: Preoperative posterior segment evaluation with ultrasound in patients with dense cataract can be used to detect pathologies that may influence the surgical strategy and postoperative visual prognosis.

Objective: First trimester ultrasound (US) screening has become part of antenatal care. The aim of this study was to explore pregnant women’s perceptions of the information given and experiences of first trimester nuchal translucency (NT) screening and to identify the background factors in a woman’s biography that influence her information needs and experiences of NT screening. Methods: This study was a descriptive, prospective survey which involved collecting information from the participants by using a questionnaire and took place in a public hospital in Athens. The sample consisted of 510 consecutive, unselected pregnant women of gestational age between 11 and 14 weeks, who had attended a nuchal translucency (NT) screening. Results: The majority of women felt that they had received either a limited or intermediate amount of information about the US screening and stated that they would have liked to receive more information. However, most of them (98%) answered that their expectations were fulfilled. 82% felt that the US examination was a positive experience, while 16% felt that US examination was a stressful experience. Furthermore, higher rates of positive experiences were observed among women with a higher educational level and greater satisfaction with the information received (χ 2 (d.f.=6) = 29.411, p = 0.000, χ 2 (d.f.=3) = 30.171, p = 0.000 respectively). Most women had wished to undertake NT screening to ensure that the fetus was healthy and without any defects and believed that a US examination should be performed at every antenatal visit. Conclusion: This study shows that most women lack information, specifically about the purposes and the diagnostic limitations of NT screening. Health professionals should therefore dedicate more time to discussing with women, and provide appropriate and understandable information tailored to the educational level of women and should emphasize the indications, purposes and limitations of US screening.

Establishing prediction models of pregnancy outcomes for recurrent pregnancy loss women at specific gestational weeks will provide patients and physicians with more precise information, ultimately leading to time and cost savings associated with unnecessary revisits. Therefore, our aim was to develop a prediction model for first trimester pregnancy loss in RPL patients. We used ultrasound indices during the first trimester of pregnancy in combination with demographic characteristics and commonly used serum markers. The independent risk factors for each week were as follows: age and P in the fifth week; age, mGSD and CRL in the sixth week; age, hCG and CRL in the seventh week; CRL in the eighth week; mGSD and CRL in ninth week. The corresponding AUC was 0.671, 0.796, 0.872, 0.871, 0.813, respectively. There is a linear relationship between age and first trimester pregnancy loss. hCG < 69,636.6 mIU/ml was associated with a higher risk of pregnancy loss in the seventh gestation week. An mGSD < 18.3 mm, adjusted for age, BMI, and previous pregnancy loss in the sixth week, was linked to an increased risk of first trimester pregnancy loss. A small CRL measurement (less than 2.4 mm, 9.9 mm, 16.9 mm, and 18.6 mm) in the sixth, seventh, eighth and ninth week was closely correlated with higher risk of first trimester pregnancy loss. Furthermore, an mGSD < 33.3 mm and > 48.3 mm in ninth gestational week was associated with a higher risk of pregnancy loss. These models and thresholds may help physicians and patients make more informed decisions together. Further studies are needed to confirm the results.

Background/Objectives: We aimed to determine the reliability of simple ultrasound (US) markers and CA-125 measurements in diagnosing peri- and postmenopausal ovarian masses. Methods: The study was conducted in a retrospective setting. The preoperative imaging properties of peri- (PEM) and postmenopausal (POM) ovarian cysts were examined. Based on ultrasound findings, lesions were categorized as either (1) simple cysts, defined as unilocular, anechoic structures without solid components, or (2) complex cysts, characterized by any deviation from this morphology. Imaging characteristics, mass size, and demographic data were matched with histology and CA125 levels. Results: In total, 379 cystic structures (PEM: N = 195, average age: 45.6 years; range: 40–54 years, POM: N = 184, average age 61.2 years; range: 41–88 years) were analyzed. In the PEM group, there were 75 simple (Ø < 5 cm N = 32, Ø ≥ 5 cm N = 43) and 122 complex cysts (Ø < 5 cm N = 29, Ø ≥ 5 cm, N = 93), while in the POM group, 49 simple (Ø < 5 cm N = 9, Ø ≥ 5 cm N = 40) and 135 complex cysts (Ø < 5 cm N = 15, Ø ≥ 5 cm N = 120) were found. In the PEM group, malignancy was detected in complex cysts larger than 5 cm (N = 16, 17.58%). In the POM group, malignancy was present in 40 cases, and 3 of them proved to be smaller than 5 cm. The majority of cysts were functional (54.36%) in the PEM group. In the POM group, serous cysts were the most frequent (38.04%), followed by malignant (21.74%) and mucinous cysts (13.04%). CA125 was elevated in 66 of 217 cases (30.41%); only 23 were malignant (NPV: 0.95, PPV: 0.35). Conclusions: Functional cysts are frequently found among perimenopausal ovarian cysts, with malignancy occurring exclusively in complex cysts exceeding 5 cm in diameter. However, complex cysts of any size carry a significant risk of malignancy in menopause, thus, surgery is recommended. Simple cysts can be followed by serial scans in both groups. CA-125 does not give added value to the detection of malignancy in perimenopausal patients. However, in postmenopausal complex morphology cysts larger than 5 cm, it may give added value to the suspicion of malignancy.

To conduct a systematic literature review of the current evidence on the effect of diabetes mellitus on gastric volume observed during a preoperative ultrasound examination. Using the results of this systematic literature review, a meta-analysis was performed to investigate whether there was an association between diabetes mellitus and an increased risk of presenting with a high-risk stomach (gastric volume associated with an increased risk of pulmonary aspiration). Review article and meta-analysis. Review of published literature. A total of 3366 patients underwent surgery. Gastric ultrasound examination. Data for the meta-analysis and literature review were collected from the PubMed/Medline, Embase, Web of Science, and Google Scholar databases of the National Library of Medicine from the date of inception to January 2023. All included studies measured the gastric antral cross-sectional area and/or gastric residual volume in patients with diabetes and those without diabetes. The data utilized in the meta-analysis included all studies that evaluated the incidence of high-risk stomachs based on ultrasonographic measurements of the gastric antral cross-sectional area or gastric residual volume. Most collated studies revealed that diabetes mellitus was associated with increased antral cross-sectional area and gastric residual volume. A meta-analysis of published reports indicated that patients with diabetes have an increased rate of high-risk stomachs. Diabetes mellitus is associated with an increased rate of high-risk stomachs. The authors recommend large prospective trials to ascertain the safety of the current fasting guidelines for patients with diabetes undergoing surgery. •Ultrasonography is an easy test to measure gastric volume in the preoperative area.•Diabetic patients have increased gastric residual volume compared to non-diabetics.•Diabetes mellitus is associated with increased incidence of high-risk stomach.

In this contribution, we approached a new aspect in robotic applications. We investigated human–machine modeling for remote ultrasound scan equipment. While robotic systems for ultrasound scan applications with remote operations have been widely studied, in this research, remote force-feedback control was tested. The goal is for the human operator to receive, as physical input, the correct force perception transmitted by the remote ultrasound scan equipment in analyzing the body of the patient. Two principal aspects were investigated. The first was an artificial body model to receive the control signals from the remote equipment. The second aspect was to study a suitable feedback control law that attempts to compensate for the uncertainty between the artificial body and the patient’s body, while also taking into account the transmission delay. Therefore, the task was to give the operator relevant information while considering the force effect; thus, providing a reliable and efficient platform in order to work in remote conditions with ultrasound scan equipment.

Accurate categorisation of the upward rotation of the foetal cerebellar vermis continues to pose diagnostic challenges in prenatal medicine. Recently, a new parameter of the posterior fossa (PF), known as the vermian-crest angle (VCA), has been evaluated using three-dimensional ultrasound (3D-US) and prenatal magnetic resonance imaging (MRI). This study aimed to evaluate the performance of the VCA in categorizing PF anomalies using 3D-US and to determine its level of agreement with MRI. We conducted a cohort study involving confirmed cases of PF anomalies. We measured the VCA using 3D-US and compared our data with previously published reference values obtained through both 3D-US and MRI. For statistical analysis, we employed univariate analysis of variance (ANOVA) followed by Tukey's post-hoc test, receiver operating characteristic (ROC) curve analysis, and the intraclass correlation coefficient (ICC). We identified 53 foetuses at a mean gestational age (GA) of 24.5 (SD 5.45) weeks with Blake's pouch cyst (BPC) ( = 11), Dandy-Walker malformation (DWM) ( = 9), mega cisterna magna (MCM) ( = 22), and vermian hypoplasia (VH) ( = 11). Compared to published reference values, the VCA was significantly increased in DWMs (mean 130.6°, SD 16.75°; ≤ 0.01) and BPCs (mean 91.00°, SD 19.73°; ≤ 0.05). A VCA > 80.1° distinguished BPCs and DWMs from other PF anomalies, while a VCA > 107° differentiated BPCs from DWMs. When comparing subgroups with published MRI data, we found good agreement between 3D-US and MRI (ICC = 0.71) (95% CI: 0.55-0.87). The VCA may be helpful in categorising PF anomalies using 3D-US, particularly BPC and DWM. The good agreement with MRI measurements reinforces the synergy of these tools in the diagnostic work-up.

Although ultrasound (US) scan or diagnosis became widely employed in the 20th century, it still plays a crucial part in modern medical diagnostics, serving as a diagnostic tool or a therapy process guide. This review provides information on current wearable technologies and applications used in external ultrasound scanning. It offers thorough explanations that could help build upon any project utilizing wearable external US devices. It touches on several aspects of US scanning and reviews basic medical procedure concepts. The paper starts with a detailed overview of ultrasound principles, including the propagation speed of sound waves, sound wave interactions, image resolution, transducers, and probe positioning. After that, it explores wearable external US mounts and wearable external US transducers applied for sonograph purposes. The subsequent section tackles artificial intelligence methods in wearable US scanners. Finally, future external US scan directions are reported, focusing on hardware and software.

Abstract PurposeTo assess the optic nerve pial diameter (ONPD) in patients with primary open-angle glaucoma (POAG) using standardized A-scan ultrasound and to evaluate the correlation between the ONPD and structural, vascular optic nerve head features and visual field parameters in glaucomatous eyes.MethodsIn this prospective study, we enrolled 126 eyes of 63 POAG patients and 124 eyes of 62 healthy controls. In all subjects, the ONPD was evaluated by means of A-scan ultrasound. Spectral domain (SD)-OCT was used to assess ganglion cell complex (GCC), retinal nerve fiber layer (RNFL), thicknesses, and the optic nerve head (ONH) morphology. OCTA measured the vessel density (VD) of radial peripapillary capillary (RPC) plexus.ResultsThe ONPD showed a statistically significant reduction in POAG group with respect to controls (p < 0.001). SD-OCT and OCTA parameters showed a significant impairment in patient group with respect to controls (p < 0.001). The ONH analysis revealed significantly lower values in rim area (p = 0.009) and an increased cup-to-disc area ratio (p = 0.013) and cup volume (p < 0.001) in patients with respect to controls. Significant correlations were shown in POAG group between ONPD and RPC plexus (p = 0.006). Moreover, significant correlation was also found between ONPD and structural SD-OCT parameters (p = 0.001) and between ONPD and visual field parameters (p = 0.001).ConclusionsThe standardized A-scan ultrasound measurements of the ONPD showed a significant correlation with structural and vascular glaucomatous changes measured by means of SD-OCT and OCTA. These results confirm the diagnostic reliability of the ultrasound evaluation in glaucoma optic neuropathy.