RESUMO Objetivo: Este estudo avalia a relação entre a reflexão ultrassônica e a densidade óssea de 14 amostras cilíndricas de osso cortical bovino (3,0 cm de espessura). Métodos: Foi realizada a aquisição de 20 sinais de reflexão ultrassônica por amostra (passo de 2,0 mm), ao longo da superfície óssea. O Coeficiente de Reflexão Integrado (IRC) de cada sinal foi comparado por Tomografia Computadorizada Quantitativa (QCT). Resultados: Sete curvas de IRC e QCT apresentaram valor de Correlação R de Pearson acima de 0,5. Para curvas de correlação fraca, QCT e IRC apresentaram tendências semelhantes em vários segmentos. Conclusão: O IRC foi sensível à variação da densidade óssea. Nível de evidência: Estudo Experimental, Investigação de Exame Diagnóstico.

ABSTRACT Objective: This work evaluates the relationship between ultrasonic reflection and bone density from fourteen cylindrical bovine cortical bone samples (3.0-cm thick). Methods: Twenty US reflection signals per sample were acquired along the bone surface (2.0-mm step). The Integrated Reflection Coefficient (IRC) from each signal was compared to Quantitative Computed Tomography (QCT). Results: Seven IRC and QCT curves presented Pearson's Correlation R-values above 0.5. For weak correlation curves, QCT and IRC showed similar trends in several segments. Conclusion: IRC was sensitive to bone density variation. Level of Evidence: Experimental Study, Investigating a Diagnostic Test.

AbstractIntroduction: Ultrasound (US) is a nonionizing radiation capable of real time imaging at low cost. Its most attractive application is quantitative tissue characterization with the objective of differentiating normal tissues from diseased tissues. In this study, an automated method using singular spectrum analysis (SSA) to estimate the mean scatterer space (MSS) of US signals is proposed. Methods Entropy was used to determine the optimal number of components for the SSA. Subsequently, this number was compared with the results using a fixed number of components. A method based on the spectrum of the original signal was also used for comparison. The method was evaluated by using 24,000 simulated US signals, i.e., echoes and jitters backscattered from samples with different ratios of regular-to-irregular structure, as well as with 152 signals obtained from a phantom made of nylon wires. Results For the simulated signals, the proposed method for estimating the MSS presented results similar to the other methods that were tested. However, the magnitude-of-the-spectrum method loses the phase information, and hence, does not allow the characterization of irregular structures. For the signals recorded from the phantom, the methods using SSA and entropy achieved better results. Conclusion In this study, the combination of SSA with entropy to estimate the MSS of a periodic or quasi-periodic medium was proposed. The proposed method achieved similar or better results compared with two other methods found in the scientific literature. The novelty of the proposed method is the application of entropy as a quantitative criterion for selecting the SSA periodic components, allowing it to become independent of heuristic criteria.

Abstract Introduction Therapeutic ultrasound (TUS) is a widespread modality in physiotherapy, and the water bag technique is a coupling method employed in the presence of anatomical irregularities in the treatment area. The aim of the present study is to evaluate the acoustic attenuation of the water bag and its effectiveness as a TUS coupling agent. Methods The rated output powers (ROPs) of the TUS equipment were evaluated based on IEC 61689. Then, a radiation force balance was used to measure ROP with and without a water bag (latex and nitrile gloves filled with deionized water) between a TUS transducer and the cone-shaped target of the balance. Each experiment was performed five times for each nominal power (0.5, 1.0, 2.0, 3.0, 4.0, 5.0, 6.0, and 7.0 W) and in the following configurations: without the water bag (A), with nitrile gloves and with (B) and without (C) a height controller, and latex gloves with (D) and without (E) height controller. ROPs obtained in different media were compared. Results The highest relative error of ROP was 16.72% for 0.5 W. Although the power values of the equipment were within the range recommended by IEC, there was a significant difference between the ROP values measured with A and with B, C and D. Conclusion As intensity differences below 0.5 W/cm2 are considered clinically not relevant, conditions A, B, C, D, or E can be used interchangeably.

Abstract Introduction The use of tools for computer-aided diagnosis (CAD) has been proposed for detection and classification of breast cancer. Concerning breast cancer image diagnosing with ultrasound, some results found in literature show that morphological features perform better than texture features for lesions differentiation, and indicate that a reduced set of features performs better than a larger one. Methods This study evaluated the performance of support vector machines (SVM) with different kernels combinations, and neural networks with different stop criteria, for classifying breast cancer nodules. Twenty-two morphological features from the contour of 100 BUS images were used as input for classifiers and then a scalar feature selection technique with correlation was used to reduce the features dataset. Results The best results obtained for accuracy and area under ROC curve were 96.98% and 0.980, respectively, both with neural networks using the whole set of features. Conclusion The performance obtained with neural networks with the selected stop criterion was better than the ones obtained with SVM. Whilst using neural networks the results were better with all 22 features, SVM classifiers performed better with a reduced set of 6 features.

Abstract Introduction Various signal-processing techniques have been proposed to extract quantitative information about internal structures of tissues from the original radio frequency (RF) signals instead of an ultrasound image. The quantifiable parameter called the mean scatterer spacing (MSS) can be useful to detect changes in the quasi-periodic microstructure of tissues such as the liver or the spleen, using ultrasonic signals. Methods We evaluate and compare the performance of three classic methods of spectral estimation to calculate the MSS without operator intervention: Tufts-Kumaresan, SAC (Spectral Autocorrelation) and MUSIC (MUltiple SIgnal Classification). Initially the evaluations were performed with 10,000 signals simulated from a model in which the variables of interest are controlled, and then, real signals from sponge phantoms were used. Results For the simulated signals, the performance of all three methods decreased with increasing Ad or jitter levels. For the sponges, none of the methods accurately estimated the pore size. Conclusion For the simulated signals, Tufts-Kumaresan had the lowest performance, whereas SAC and MUSIC had similar results. For sponges, only Tufts-Kumaresan was able to detect the increase in the size of the pores of the sponge, although most often, it estimated sizes larger than expected.

PURPOSE: To determine the effectiveness of low-intensity therapeutic ultrasound (LITUS) on wound healing in rats with third-degree burns. METHODS: Twenty rats were divided into the Control Group that comprised four rats without third-degree burns that did not undergo LITUS, the Burned Group (BG), comprising eight rats with third-degree burns that did not undergo LITUS, and the Burned with Treatment Group (BTG), comprising eight rats with third-degree burns that were administered LITUS. LITUS began 24 h after injury and involved daily applications for 8 min at 0.1 W/cm2 for 14 days. RESULTS: The BTG lost less weight than the BG (Q=2.75; p<0.05). No visible differences were apparent among the groups' lesions on day 4. By the end of treatment, wound healing was more evident in the BTG. No statistically significant differences were found between the BG and the BTG in relation to the parameters measured using the histological changes in burn wound healing scoring system. CONCLUSION: The LITUS protocol applied to the animals with third-degree burns accelerated the formation of fibrin-leukocyte crusts and significantly reduced weight loss. However, burn wound healing was not accelerated.

INTRODUCTION: Ultrasound Transit-Time flowmeters are based on the fact that the time required for an ultrasound pulse to propagate through a given distance in a moving medium is a function of the vectorial sum of pulse propagation velocity and medium velocity. The most common application of this flowmeter in medicine is in the evaluation of blood flow in arteries and veins during heart vascular surgery. The present article describes the design, construction and evaluation of a flow phantom for transit-time flowmeters calibration. METHODS: Basically, it is a hydraulic circuit containing degassed and distilled water. In such a circuit, a constant differential water level is established between two columns that are interconnected by tubes with defined resistance, which determines a known flow rate. A basic theoretical model to estimate the system Reynolds Number and resistance was developed. RESULTS: A flow range between 4.43 �± 0.18 ml.min-1 and 106.88 �± 0.27 ml.min-1 was found to be compatible with physiological values in small vessels. The pressure range was between 0.20 �± 0.03 cmH2O and 12.53 �± 0.07 cmH2O, and the larger Reynolds Number was 1134.07. Experimental and theoretical resistance values were similar. CONCLUSION: A reproducible phantom was designed and built to be assembled with standard low-cost materials and is capable of generating adjustable and continuous flows that can be used to calibrate TTFM systems.

INTRODUCTION: Breast cancer has the second highest world's incidence rate, according to the Brazilian National Cancer Institute (INCa). Clinical examination and mammography are the best methods for early diagnosis. Computer-aided detection (CADe) and computer-aided diagnosis (CADx) systems are developed to improve mammographic diagnosis. Basically, CADx systems have three components: (i) segmentation, (ii) parameters extraction and selection, (iii) lesion classification. The first step for a CADx system is segmentation. METHODS: A microcalcification segmentation method is proposed, based on morphological operators, Otsu's Method and radiologists' knowledge. Pre-processing with top-hat operators improves contrast and reduces background noise. The Otsu's method automatically selects the best grey-level threshold to segment microcalcifications, obtaining binary images. Following, inferior reconstruction and morphological dilatation operators are applied to reconstruct lost structure details and fill small flaws in the segmented microcalcifications. Finally, the Canny edge detection is applied to identify microcalcifications contour candidates for each region-of-interest (ROI). Two experienced radiologists intervene in this semi-automatic method, firstly, selecting the ROI and, then, analyzing the segmentation result. The method was assessed in 1000 ROIs from 158 digital images (300 dpi, 8 bits). RESULTS: Considering the radiologists opinion, the rates of ROIs adequately segmented to establish a diagnosis hypothesis were 97.8% for one radiologist and 97.3% for the other. Using the Area Overlap Measure (AOM) and the 2136 microcalcifications delineated by an experienced radiologist as gold standards, the method achieved an average AOM of 0.64±0.14, being 0.56±0.09 for small microcalcifications and 0.66±0.13 for the large ones. Moreover, AOM was 0.64±0.13 for the benign and 0.64±0.14 for the malignant lesions with no statistical differences between them. CONCLUSION: Based on these findings, the proposed method could be used to develop a CADx system that could help early breast cancer detection.

O presente trabalho descreve o projeto e construção de um calorímetro diferencial com a finalidade de avaliar o aquecimento gerado por feixes ultrassônicos em níveis terapêuticos. O calorímetro consiste em duas câmaras cilíndricas de alumínio idênticas (de medição e de referência), preenchidas com um material mimetizador de tecido biológico (phantom). Cada câmara possui seis termopares tipo E (diâmetro 0,24 mm), posicionados ao longo do eixo central de propagação da onda, entre as profundidades 10-60 mm, distantes 10 mm entre si. Foi levantada a curva de potência e estimado o valor da área de radiação efetiva (ERA) dos dois transdutores utilizados. A partir destes dados, a intensidade efetiva foi determinada. Para avaliar o calorímetro, foi utilizado um equipamento de ultrassom de Fisioterapia, operando nas frequências nominais 1 e 3 MHz, modo contínuo, intensidades nominais 0,5; 1,0; 1,5 e 2,0 W.cm-2 e tempo de irradiação 180 segundos. Uma sequência de oito protocolos de medição foi realizada dez vezes. Para ambas as frequências, houve um declínio do aquecimento ao longo da profundidade e a região do "phantom" que mais aqueceu foi a que corresponde à profundidade de 10 mm, em todas as intensidades. O maior aquecimento ocorreu a 2,0 W.cm-2, com médias de 6,7 ± 1,0 ºC e 12,6 ± 1,2 ºC, a 1 MHz e 3 MHz, respectivamente. O calorímetro proposto mostrou-se útil na caracterização de feixes ultrassônicos aplicados em Fisioterapia, principalmente na identificação de possíveis máximos locais de temperatura (pontos quentes) que ocorrem ao longo do eixo principal do feixe.

The present work describes the project and construction of a differential calorimeter designed to evaluate the heating generated by ultrasound beam in therapeutic levels. The calorimeter consists of two identical aluminum cylindrical chambers (for measurement and reference) filled with biological tissue mimicking material (phantom). Each chamber is fitted with six thermocouples type E (0.24 mm diameter) disposed along the wave propagation central axis, between the depths of 10-60 mm, distant 10 mm from each other. The power curve and the value of the effective radiation area (ERA) of the two transducers were estimated. From these data, the effective intensity was determined. The calorimeter was tested by using an ultrasound equipment of Physiotherapy, operating at the frequencies 1 and 3 MHz, continuous mode, nominal intensities 0.5, 1.0, 1.5 and 2.0 W.cm-2 and irradiation time 180 seconds. A sequence of eight protocols of measurement was repeated 10 times. At both frequencies, there was a decline of heating along the depth and the phantom region that heated the most corresponded to 10 mm of depth, in all intensities employed. The greatest increase in temperature occurred after application of 2.0 W.cm-2, with averages of 6.7 ± 1.0 ºC and 12.6 ± 1.2 ºC, at 1 MHz and 3 MHz, respectively. The proposed calorimeter may be useful for identifying possible local temperature maxima (hot spots) that appear along the central axis beam.

A interpretação da imagem ultrassônica, por ocorrer de modo visual e qualitativa, traz uma variação inter e intra-observador importante. A adoção de métodos quantitativos é uma forma de diminuir esta dependência. Entre tais métodos está a quantificação do espaçamento médio entre espalhadores (Mean Scatterer Spacing - MSS), que pode ser útil para detectar mudanças na microestrutura quasi-periódica de tecidos como o hepático ou o esplênico. Neste trabalho foram avaliados três métodos clássicos de estimação espectral para cálculo do MSS (sem intervenção do operador): BURG, WIENER e MUSIC. O intuito é comparar suas potencialidades para a estimação automática de espaçamento médio de espalhadores ultrassônicos. Inicialmente as avaliações foram realizadas com 10.000 sinais simulados a partir de um modelo em que se tem controle das variáveis de interesse, e em seguida foram utilizados sinais reais de phantoms de fios de nylon imersos em água. O método de BURG não conseguiu estimar adequadamente o espaçamento em sinais de phantom, tendo apresentado resultados equivalentes aos outros métodos deste trabalho somente para sinais simulados. O método de WIENER para os sinais simulados apresentou resultados de menor percentual de acerto, ficando em segundo lugar, para os sinais dos phantoms. O método de subespaço MUSIC apresentou melhor desempenho global em relação a BURG e WIENER, com resultados de 100% de acerto para o phantom de fio de nylon de 1,2 mm e 91,45% para 0,8 mm considerando uma janela de acerto de 10%.

The interpretation of ultrasound imaging is essentially visual and qualitative, so there are important inter and intra-observer variations. Quantification methods aim at decreasing this dependency. Among those, the quantification of the Mean Scatterer Spacing (MSS) can be useful to detect changes in the microstructure of quasi-periodic tissues, such as liver or spleen. This study evaluated the following methods of spectral estimation for calculating the MSS (without requiring operator intervention): BURG, WIENER and MUSIC. The aim is to compare their potential for automatic estimation of MSS from ultrasonic scattering signals. Initially, the evaluation has been carried out using 10,000 simulated signals, with the aim of studying the behavior of the methods using a model in which the variables of interest can be controlled. Then, the methods have been applied to real signals of nylon phantoms immersed in water. The BURG method could not estimate the spacing of US phantom signals, presenting results similar to the other methods only for simulated signals. The WIENER method for the simulated signals was in second place in terms of percentage of success, when considering signals from the phantoms. The subspace method MUSIC had the best performance from all three methods.

A mamografia representa o melhor método de detecção precoce do câncer de mama, porém cerca de 10% a 30% das lesões mamárias são perdidas no rastreamento, devido a limitações próprias dos observadores humanos. A detecção auxiliada por computador (computer-aided detection - CAD) é uma tecnologia relativamente nova que tem sido implementada em alguns serviços de mamografia, com o intuito de prover uma dupla leitura. Estudos clínicos têm demonstrado que o CAD aumenta a sensibilidade de detecção do câncer da mama, por radiologistas, em até 21%. Um sistema CAD é útil em situações em que exista alta variabilidade interobservador, falta de observadores treinados, ou na impossibilidade de se realizar a dupla leitura com dois ou mais radiologistas. O objetivo desta revisão está baseado na necessidade de atualizar a comunidade médica acerca desta ferramenta, como um método auxiliar, quantitativo, não operador-dependente, e que visa a melhorar a qualidade do diagnóstico do câncer de mama.

Mammography is the best method for early detection of breast cancer. Nevertheless, approximately 10% to 30% of breast lesions are missed at screening due to limitations of human observers. Computer-aided detection (CAD) is a relatively new technology that has been implemented in some mammography services to allow a double reading of mammograms. Clinical studies have demonstrated that CAD increases the sensitivity by up to 21% in the detection of breast cancer by radiologists. A CAD system is useful in situations where there is a high interobserver variability, lack of trained observers, or impossibility to perform the double reading with two or more radiologists. The objective of the present review is based on the need to get the medical community acquainted with this tool as an auxiliary, quantitative and non-operator-dependent method, to improve the diagnosis of breast cancer.

OBJETIVO: Avaliar o desempenho de parâmetros morfométricos, calculados a partir do contorno de lesões de mama em ultrassonografias, na quantificação de suas características morfológicas e na distinção das categorias 2, 3, 4 e 5 do sistema de classificação ecográfica BI-RADS. MATERIAIS E MÉTODOS: A casuística é composta por 40 casos com registro ortogonal de pacientes submetidas à cirurgia. A partir das lesões segmentadas, foram calculados cinco parâmetros morfométricos para quantificar o contorno e a forma das lesões: razão de área, razão de superposição, valor residual normalizado, circularidade e razão entre largura e profundidade. A análise discriminante linear foi usada para selecionar os parâmetros mais significativos na distinção das características morfológicas das lesões, usando como figura de mérito a curva ROC. RESULTADOS: A razão de superposição foi capaz de diferenciar estatisticamente as lesões classificadas como BI-RADS 3 daquelas classificadas como BI-RADS 4 (a = 5%; p = 0,015), sendo, também, o parâmetro morfométrico que apresentou melhor desempenho na diferenciação entre lesões malignas e benignas. CONCLUSÃO: Este resultado indica que a análise morfométrica de lesões de mama em ultrassonografias tem potencial para auxiliar na distinção de pacientes que deveriam ser submetidas à biópsia, daquelas que poderiam manter controle por métodos de imagem.

OBJECTIVE: To assess the performance of morphometric parameters calculated from breast lesion contours at ultrasonography, in the quantification of morphological features and in the distinction among BI-RADS categories 2, 3, 4 and 5. MATERIALS AND METHODS: The present casuistry included 40 cases, with orthogonal imaging of patients submitted to surgery. Based on the lesions segmentation, the following five morphometric parameters were calculated: area ratio, overlap ratio, normalized residual value, circularity and depth-to-width ratio. Linear discriminant analysis was applied to select the best parameters, and ROC curve was utilized as figure of merit. RESULTS: Overlap ratio was able to statistically distinguish breast lesions classified as BI-RADS 3 from others classified as BI-RADS 4 (a = 5%; p = 0.015). Additionally, such parameter presented the best performance in the differentiation between malignant and benign breast lesions. CONCLUSION: These results indicate that morphometric analysis of breast lesions at ultrasonography seems to be helpful in distinguishing patients who should undergo biopsy from those to be followed-up only with imaging methods.