Dr. Roy Filly

Ultrasound
Ultrasound exams present interpretation challenges
Ultrasound requires a unique skill set, according to Dr. Roy Filly, who in this article describes some of the modality's challenges and how they can affect image interpretation. Fortunately, new technologies make it possible to utilize one of the unique aspects of ultrasound: its ability to capture dynamic images.
March 19, 2015
2015 03 19 17 11 23 383 Filly Roy 200
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Images of a 69-year-old man diagnosed with prostate cancer who had a history of endocrine therapy for two years. (a) The maximum intensity projection (MIP) image of F-18 FDG showed moderate radiotracer uptake in a thoracic vertebra. (e) The MIP image of Ga-68 DOTA-IBA demonstrated more lesions in the cervical vertebra and pelvis. (b) An osteoblastic lesion in the C3 vertebra right attachment (curved arrows) was negative on F-18 FDG (SUVmax = 2.0) and positive on Ga-68 DOTA-IBA (SUVmax = 8.7). (c) Another osteoblastic lesion in the T10 vertebra left side (arrowheads) was both positive on F-18 FDG (SUVmax = 5.2) and positive on Ga-68 DOTA-IBA (SUVmax = 35.0). (d) Osteoblastic lesions in bilateral ilium (dotted arrows and arrows) were negative on F-18 FDG (left: SUVmax = 1.4, right: SUVmax = 1.6) and positive on Ga-68 DOTA-IBA (left: SUVmax = 7.6, right: SUVmax = 8.7). Follow-up imaging three months later confirmed the presence of these bone metastases. Image and caption available for republishing under Creative Commons license (CC BY 4.0 DEED, Attribution 4.0 International) and courtesy of Scientific Reports.
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Ultrasound images depict a 56-year-old man with obesity (body mass index, 42) and steatosis (MRI-PDFF, 10.4%), who underwent ultrasound attenuation coefficient (AC) measurement due to participation in the present study. The unit displays color-coded confidence map (left) and AC map (on right) in side-by-side manner. The confidence map indicates quality of acquired AC signals and is set like traffic lights: green indicates good quality acquisition, yellow indicates warning, and red indicates low quality. Areas with low quality are left blank on the AC map. The image shows multiple circular ROIs placed at depths below the liver capsule of 2, 2.5, 3, and 4 cm. All ROIs are 3.5 cm in size. The confidence map threshold is set at 20%. AC measurements (in units of dB/cm/MHz) were extracted from all ROIs (excluding voxels without assigned color on the AC map) and decrease with greater ROI depth.
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