Technology trends and applications of deep learning in ultrasonography: image quality enhancement, diagnostic support, and improving workflow efficiency

In this review of the most recent applications of deep learning to ultrasound imaging, the architectures of deep learning networks are briefly explained for the medical imaging applications of classification, detection, segmentation, and generation. Ultrasonography applications for image processing and diagnosis are then reviewed and summarized, along with some representative imaging studies of the breast, thyroid, heart, kidney, liver, and fetal head. Efforts towards workflow enhancement are also reviewed, with an emphasis on view recognition, scanning guide, image quality assessment, and quantification and measurement. Finally some future prospects are presented regarding image quality enhancement, diagnostic support, and improvements in workflow efficiency, along with remarks on hurdles, benefits, and necessary collaborations.

The Early Outcome of the Endovascular Subintimal Angioplasty for Chronic Critical Limb Ischemia in Infrainguinal Vascular Disease

PURPOSE: Elderly patients with infrainguinal vascular disease and chronic critical limb ischemia are poor surgical candidates. The purpose of this study was to evaluate the safety and efficacy of infrainguinal endovascular subintimal angioplasty as a primary treatment for chronic critical limb ischemia. METHOD: We evaluated patients with infrainguinal endovascular subintimal angioplasty, retrospectively. From August 2005 to October 2006, 10 limbs in 10 patients aged 70+/-9.30 years-old with critical limb ischemia received an infrainguinal endovascular subintimal angioplasty. The risk factors for arteriosclerosis obliterans were diabetes mellitus (8 cases, 80%), hypertension (5 cases, 50%), ischemic heart disease (3 cases, 30%), and stroke (2 cases, 20%). Seven out of 10 (70%) patients had chronic non-healing wounds. Among 10 patients, primary stent implantation (4 legs) or ballooning (9 legs) were performed. The patency was evaluated using computed tomographic angiography or duplex scanning with Doppler and the ankle-brachial index (ABI) measurement. RESULT: The primary procedure success rate was 100% (10 of 10). The restenosis rates at follow up at 7+/-4.8 months after the primary endovascular subintimal angioplasty was 10% (1 of 10). There were no major complications and no deaths. A 90% cumulative primary patency rate and a 90% cumulative limb salvage rate were observed as determined by the Kaplan-Meier analysis. CONCLUSION: Infrainguinal endovascular subintimal angioplasty may be feasible, safe and effective primary treatment for chronic critical limb ischemia with primary angiographic and clinical success, a low complication rate and a cumulative limb salvage rate comparable with surgical techniques. It may be a useful alternative in older patients with a high surgical risk.

Gastrointestinal Adenomatous Polyposis Associated with Small Cell Neuroendocrine Carcinoma of the Rectosigmoid: A case report

In adenomatous polyposis coli there are many colonic and extracolonic manifestations, and various combinations of these induce different clinical presentations and syndromes. We experienced a unique case of adenomatous polyposis of the large intestine and stomach in a 39-year-old man. In the colon, small cell neuroendocrine carcinoma rather than adenocarcinoma had developed, which did not contain adenomatous or carcinomatous foci. The adenomatous polyps in the colon were all small and sessile with no cancerous or precancerous change two years after the resection of the symptomatic gastric adenomas, even though the gastric adenomas were larger and showed dysplastic change. We think this case is another variant of adenomatous polyposis syndrome.