Citations

Increased arterial stiffness is an early indicator of various cardiovascular diseases (CVD). Arterial Dispersion Ultrasound Vibrometry (ADUV) employs acoustic radiation force to induce arterial wall motion, enabling estimation of arterial wave velocity (i.e., phase velocity). This study investigates the correlation between ADUV-derived wave velocity and traditional arterial stiffness metrics, including distensibility, compliance, and stiffness index in the right and left common carotid arteries (CCAs). In a cohort of 59 subjects, categorized as (a) confirmed CVD (n = 27), (b) individuals with cardiovascular risk factors (n = 20), and (c) healthy controls (n = 12), we assessed arterial wave velocity across the cardiac cycle, split into 10 stages, to capture variations in mechanical properties. Univariate analysis demonstrated a statistically significant inverse linear relationship between ADUV-derivedwave velocity and distensibility for the right CCA during the systolic phase (cardiac stages 3–5) and diastolic phase (cardiac stages 7–9) (−0.35 < ρ < −0.50, p < 0.02). The wave velocity showed associations with compliance in some of these phases. No significant correlations were observed between wave velocity and the stiffness index. Our findings provide insights into the clinical relevance of ADUV-derived wave velocity as a biomarker for arterial stiffness and its potential to complement or enhance traditional stiffness assessments.

Ultrasound wave-based elastography has emerged as a promising technique for measuring the mechanical properties of blood vessels in vivo. It is well known that blood flow modulates the velocity of the symmetric natural pulse wave, but little has been reported about how it may affect the velocity of induced waves using acoustic radiation force (ARF). We used a fluid–structure interaction model in FEBio to study the effect of flow in elastic tubes after applying a simulated ARF. We varied the vessel wall Young’s modulus (E = 200, 400, and 600 kPa) and wall thickness (WT = 0.5, 1.0, and 1.5 mm) and applied mean flow rates of ±500, 1000, and 1500 mm/s with either parabolic or plug flow using an inviscid fluid model. Analysis of the phase velocities reveals a flow dependence which diminishes with frequency. Plug flow produced greater changes in dispersion curves than parabolic flow. Thinner tubes are more sensitive to flow than thicker tubes. Increasing E tends to increase sensitivity to flow slightly. These results indicate that flow rate may be an important variable to consider when estimating vascular properties from wave-based acquisitions.

Dysarthric speech poses significant challenges for clinical assessment and diagnosis due to wide variability in the nature and severity of speech impairments associated with it. To address this, this study investigates the phonetic variations in different types of dysarthric speech using the deep learning model Phonet. Recordings of the word “Catastrophe” from 54 patients diagnosed with dysarthria were analyzed to extract posterior probabilities of consonants and vowels. The analysis revealed distinct posterior probability patterns for consonants and vowels across three types of dysarthria, indicating disorder-specific articulatory-based speech characteristics. Moreover, within each dysarthric group, variations in posterior probabilities aligned with the severity of rated articulation difficulty, reflecting nuanced intra-disease phonetic differences. These findings demonstrate Phonet’s ability to capture subtle speech variations and link them to both dysarthria type and severity. By quantifying these phonetic alterations, this study offers a novel and robust framework for objectively evaluating articulation difficulties in dysarthric speech. The results emphasize the clinical potential of Phonet as an advanced tool for improving the diagnosis and monitoring of dysarthria, paving the way for innovative applications in speech-based clinical assessments.

ABSTRACT Autoimmune pancreatitis (AIP) and pancreatic cancer share clinical and radiological features, making biopsy the only definitive way of differentiating them. Numerous reports in the literature describe the co-occurrence of AIP and pancreatic cancer either in a synchronous manner or metachronous manner raising the question of which condition predisposes to the other and whether a causal relationship exists between them. Studies suggest shared mechanisms, including K-ras mutations and tumor suppressor gene silencing. This case highlights the importance of long-term surveillance in AIP patients to monitor for malignancy.

Abstract Background and Aims There is a paucity of data on arrhythmia burden in patients with congenitally corrected transposition of the great arteries (ccTGAs). The present study sought to quantify the incidence of atrial arrhythmia (AA), ventricular arrhythmia (VA), and complete atrioventricular block (CAVB) in patients with ccTGA and identify associated factors. Methods An international, multi-centre, retrospective cohort study was conducted in 29 tertiary hospitals (six countries) between 1990 and 2018. Primary analyses consisted of determining the incidence of a combined outcome consisting of AA, VA, or CAVB, along with its individual components. Factors associated with the different types of arrhythmias were assessed by uni-variable and multi-variable Cox regression analyses. Results A total of 1131 patients with ccTGA were followed for 9.0 (interquartile range 4.0–17.2) years. Cumulative rates of the primary endpoint at 10, 15, and 20 years were 44.5%, 51.0%, and 58.8%, respectively. AA, VA, and CAVB occurred in 2.1, 1.4, and 2.0 cases per 100 person-years, respectively. In multi-variable analyses, surgery/intervention conferred a greater than three-fold higher risk of AA [hazard ratio (HR) 3.01, 95% confidence interval (CI) 1.90–4.78, P < .001]. Furthermore, surgery/intervention was significantly associated with a greater risk of VA (HR 1.73, 95% CI 0.98–3.05, P = .003) and CAVB (HR 3.65, 95% CI 2.20–6.05, P < .001). The left bundle branch block was associated with a higher risk of VA (HR 4.03, 95% CI 1.59–10.23, P = .003) and the right bundle branch block with a higher risk of CAVB (HR 3.71, 95% CI 1.81–7.63, P < .001). Conclusions The arrhythmia burden in patients with ccTGA is substantial, with a high incidence of AA, VA, and CAVB.

Ultrasound localization microscopy (ULM) enables imaging of the microvasculature at spatial resolutions surpassing the limits of conventional ultrasound, while maintaining comparable penetration depth. This super-resolution technique relies on the localization and tracking of individual microbubbles (MBs) administered into the bloodstream, providing detailed visualization of microvascular structures and functions. However, clinical implementation of ULM faces significant challenges, such as low signal-to-noise ratio (SNR), tissue motion artifacts, and prolonged acquisition times. In this presentation, we will discuss advancements aimed at achieving robust and reproducible clinical implementation of ULM through a series of technical innovations and optimizations. These include signal enhancement techniques to boost MB SNR, advanced algorithms for accurate MB localization and tracking at clinically relevant dosages, optimized data acquisition strategies tailored to clinical workflows, and the development of 3-D imaging capabilities. Through pilot preclinical and clinical studies, we demonstrate the feasibility and efficacy of ULM in various applications, including chronic kidney disease (CKD), kidney transplant, liver disease evaluation, and beyond, in both animal models and human subjects under clinical scanning conditions. These findings underscore the transformative potential of super-resolution ultrasound imaging as a diagnostic tool, paving the way for widespread clinical adoption.

Triple-negative breast cancer (TNBC) remains the most aggressive subtype of breast cancer, with a higher risk of recurrence in the early-stage setting compared to other subtypes. While TNBC is defined as breast cancer that lacks estrogen receptor and progesterone receptor expression and is without human epidermal growth factor receptor 2 (HER2) overexpression, it is increasingly recognized as a very heterogeneous disease. Utilization of neoadjuvant chemotherapy (NAC), with or without immunotherapy (depending on the clinical stage), has significantly improved clinical outcomes in early-stage TNBC (particularly in Stage II and III disease). Use of NAC offers the opportunity to de-escalate surgical treatment and evaluate treatment response, allowing for improved prognostication and further tailoring of post-operative systemic therapy. However, there continues to be a need for the personalization of systemic therapy strategies according to recurrence risk. More effective systemic therapies are still needed for patients who have poor response to NAC. Conversely, there remains a need for the identification of appropriate candidates for systemic therapy de-escalation, particularly given the potentially life-altering toxicities of current chemo-immunotherapy strategies. In this review the authors outline the current neoadjuvant paradigm for early-stage TNBC and emerging therapeutic strategies in this challenging disease state, along with questions that remain unanswered in the field.

Hepatocellular carcinoma (HCC) is a malignancy with a complex pathogenesis, course, and prognosis with increasing incidence. The most significant contributing factor to the development of HCC is the chronic process of inflammation and remodeling of the cirrhotic liver, in which the interaction between the tumor microenvironment (TME) and cancer cells plays a pivotal role. In recent years, increasing focus has been directed toward the role of platelets (PLTs) in mediating interactions between tumor cells and the TME and in the progression and spread of HCC, as well as other cancers. Due to their abundance in the bloodstream and intracellular granules rich in mediators facilitating their ability to modulate the immune system, PLTs play a significant role in carcinogenesis. In the context of HCC, the role of PLTs in the healing and regeneration processes of the liver has been recognized for some time. In recent years, there has been an increasing utilization of PLTs in prognostic models for patients with HCC. Given their role and the availability of clinical options that block PLTs’ action, clinical trials of platelet blockers in the adjunctive treatment of HCC are becoming increasingly common. However, further research, both preclinical and clinical, is necessary to fully elucidate the role of PLTs in HCC and their potential use as a therapeutic target. In this literature review, we summarize the current knowledge on PLTs in HCC and focus on their potential use in everyday clinical practice.

THIS year’s American Society of Clinical Oncology (ASCO) 2025 gastrointestinal (GI) sessions presented pivotal data across different GI cancers, reshaping standards of care in these malignancies. Herein, the authors highlight several key studies presented at this year’s meeting.

THE theme of this year’s American Society of Clinical Oncology (ASCO) Annual Meeting was ‘Driving Knowledge to Action: Building a Better Future’. This year’s annual meeting delivered on this theme with instant practice changing and practice informing presentations. Several highly anticipated breast cancer randomized clinical trials that could result in new indications were reported.