Prospective Comparison of Oral Contrast-Enhanced Transabdominal Ultrasound Imaging With Contrast-Enhanced Computed Tomography in Pre-operative Tumor Staging of Gastric Cancer.

The aim of this prospective study was to compare the diagnostic accuracy of oral contrast-enhanced transabdominal ultrasound imaging (OCTU) with that of contrast-enhanced computed tomography (CT) for the pre-operative tumor staging of gastric cancer, with post-operative pathology as the standard. We included 108 cases of gastric cancer with simultaneous OCTU and enhanced CT pre-operative tumor staging diagnoses. Results were compared with post-operative pathology based on the eighth edition of the American Joint Committee on Cancer tumor-node-metastasis staging guidelines for gastric cancer. The accuracy of each tumor stage was obtained by comparing OCTU and enhanced CT diagnoses with post-operative pathology. The McNemar test was used to compare the overall accuracy of the two methods. There was no statistical difference in accuracy between OCTU (72.2%) and enhanced CT (75.9%, p = 0.644) for overall pre-operative tumor staging diagnosis. For stages T1 to T4, the accuracy rates of OCTU were 84.2%, 81.8%, 69.4% and 65.5%, respectively, and those for enhanced CT were 52.6%, 72.7%, 87.8% and 72.4%, respectively. OCTU is comparable to enhanced CT in the preoperative overall T-stage diagnosis of gastric cancer.

Statistical Confirmation of a Method of US Determination of Bone Age.

Background There is limited literature on conventional US to assess bone age. Purpose To determine the diagnostic performance of US in the assessment of abnormal bone age in Chinese children. Materials and Methods In this prospective study, children and young adults aged between birth and 19 years from a large provincial teaching hospital were enrolled from January to November 2020. Children without clinical diseases potentially affecting skeletal growth were included in the normal-value group. Children with clinically suspected growth disturbances who were undergoing bone age evaluation were included in the validation group. Ossification ratios (ie, the ratio of the height of the epiphyseal ossification center to the entire epiphysis, including the cartilaginous component) of the radius, ulna, and femur from all the children were measured using US. Ultrasonic skeletal maturity scores (ie, the summation of ossification ratios of the radius, ulna, and femur multiplied by 100) collected from children in the normal-value group were used for score-for-age curve fitting through Box-Cox power exponential distribution. Test performance characteristics for the ability of US to help diagnose abnormal bone age were determined using radiographic bone age as a reference standard. Statistically significant difference between groups was determined by using a paired-sample t test. Results A total of 1089 children (median age, 9 years [interquartile range, 3-14 years]; 578 boys) were enrolled, including 929 children (mean age, 8 years [interquartile range, 4-12 years]; 515 boys) in the normal-value group and 160 children (mean age, 9 years [interquartile range, 7-11 years]; 63 boys) in the validation group. Ultrasonic bone ages in the validation group were evaluated with use of the lists of normal score-for-age values. With radiographic bone age as a reference standard, US could help diagnose abnormal bone age with high sensitivity (93% [14 of 15 participants; 95% CI: 66, 100] for boys, 100% [14 of 14 participants; 95% CI: 73, 100] for girls) and specificity (98% [47 of 48 participants; 95% CI: 88, 100] for boys, 98% [81 of 83 participants; 95% CI: 91, 100] for girls). Conclusion The US scoring system established can be used to evaluate bone age with high sensitivity and specificity. Clinical trial registration no. ChiCTR1900027917 © RSNA, 2021 Online supplemental material is available for this article.

Summation of Ossification Ratios of Radius, Ulna and Femur: A New Parameter to Evaluate Bone Age by Ultrasound.

Radiographic bone age (BA) assessment is reviewer dependent or time consuming. We aimed to clarify the correlation between sonographic ossification ratios (ORs, the ratio of ossification center and epiphysis diameters) of bones and radiographic BA and then to develop a repeatable parameter for BA assessment by ultrasound. The distal ends of the radius and ulna, medial epicondyle of the femur, medial tibial condyle, medial malleolus and lateral malleolus in 271 consecutive patients (132 boys and 139 girls) aged 0.1-19.0 y were imaged by ultrasound. The ORs of these bones were measured sonographically. The highest Pearson correlation r was that between the sum of the ORs of radius, ulna and femur (RUF) calculated from ultrasound images and the radiographic BA (0.97 in boys and 0.96 in girls). The entire process of collecting data and calculating the ORs of RUF took 2.6 ± 0.6 min. The ORs of RUF obtained with ultrasound have potential as an easy-to-perform and efficient quantitative assessment of BA.

Potential Value of Conventional Ultrasound in Estimation of Bone Age in Patients from Birth to Near Adulthood.

We aimed to assess the relationship between standard bone age (BA) stratification obtained using plain radiography and that obtained using ultrasound determination of ossification ratio (OR) as a novelty in patients from birth to near adulthood. The ratio of diameters of the ossification center and epiphysis was calculated to evaluate the OR of bones. The ORs of the bones assigned to different weight coefficient were then summed as the skeletal maturity score (SMS). Pearson's correlation r between SMSs derived from ORs and BAs was 0.97 in girls (p < 0.001) and 0.97 in boys (p < 0.001), respectively. There are significant positive correlations between SMSs measured by conventional ultrasound imaging and BAs obtained by radiography of the hand and wrist in patients from birth to near adulthood. The scoring system may potentially provide a quantitative modality to estimate BA by conventional ultrasound.