This study aimed to explore the ability of combination model of ultrasound radiomics score (Rad-score) and the thyroid imaging, reporting and data system by the American College of Radiology (ACR TI-RADS) in predicting benign and malignant thyroid nodules (TNs). Up to 286 radiomics features were extracted from ultrasound images of TNs. By using the lowest probability of classification error and average correlation coefficients (POE + ACC) and the least absolute shrinkage and selection operator (LASSO), we finally selected four features to establish Rad-score (Vertl-RLNonUni, Vertl-GLevNonU, WavEnLH-s4 and WavEnHL-s5). DeLong’s test and decision curve analysis (DCA) showed that the method of combining Rad-score and ACR TI-RADS had the best performance (the area under the receiver operating characteristic curve (AUC = 0.913 (95% confidence interval (CI), 0.881–0.939) and 0.899 (95%CI, 0.840–0.942) in the training group and verification group, respectively), followed by ACR TI-RADS (AUC = 0.898 (95%CI, 0.863–0.926) and 0.870 (95%CI, 0.806–0.919) in the training group and verification group, respectively), and followed by Rad-score (AUC = 0.750 (95%CI, 0.704–0.792) and 0.750 (95%CI, 0.672–0.817) in the training group and verification group, respectively). We concluded that the ability of ultrasound Rad-score to distinguish benign and malignant TNs was not as good as that of ACR TI-RADS, and the ability of the combination model of Rad-score and ACR TI-RADS to discriminate benign and malignant TNs was better than ACR TI-RADS or Rad-score alone. Ultrasound Rad-score might play a potential role in improving the differentiation of malignant TNs from benign TNs.

Introducción: La atrofia muscular es una de las complicaciones comunes en pacientes con hemodiálisis de mantenimiento (HDM) y tiene un mal pronóstico. Nuestro objetivo es estudiar la eficacia y fiabilidad de la ecografía en la evaluación de la sarcopenia en pacientes con HDM. Método: Los pacientes con HDM se dividieron en los grupos de sarcopenia y sin sarcopenia, de acuerdo con los criterios diagnósticos del Grupo de Trabajo de Asia sobre Sarcopenia (GTAS) 2019. Se realizó una ecografía de la cabeza medial izquierda del músculo gastrocnemio en pacientes con HDM y un grupo de control saludable para obtener los parámetros de grosor muscular (GM), ángulo de pluma (AP), longitud del haz (LH), área transversal (AT), intensidad de eco (IE), módulo de elasticidad (ME), velocidad de onda de corte (VOC) y velocidad microvascular (VM). Se compararon las diferencias en los parámetros de ultrasonido entre los diferentes grupos y se determinó el valor crítico adecuado para el diagnóstico de sarcopenia en pacientes con HDM. Resultados: Los niveles de GM, AT, AP y VM en el grupo con sarcopenia fueron menores que en el grupo sin sarcopenia y el grupo de control; mientras que la IE fue mayor, la LH en el grupo con sarcopenia fue menor que en el grupo sin sarcopenia, y el ME y la VOC en el grupo con sarcopenia fueron mayores que en el grupo control. El análisis de la curva característica de trabajo del sujeto mostró que el índice combinado de ultrasonido tenía un buen valor diagnóstico, con el modelo Y = 13,511 - 0,121 * GM - 0,609 * AT - 0,172 * AP + 0,011 * IE - 2,205 * VM (p < 0,05), con un valor de corte de 0,69. Conclusión: La ecografía multimodal es un método de examen por imágenes seguro, no invasivo e instantáneo que puede proporcionar información sobre la estructura, rigidez y perfusión muscular, y se espera que se convierta en una herramienta con potencial y prometedora para predecir la sarcopenia en pacientes con HDM. Introduction: Sarcopenia is one of the common complications in maintenance hemodialysis (MHD) patients and is associated with poor prognosis. We aimed to study the validity and reliability of ultrasound in the assessment of sarcopenia in MHD patients. Methods: MHD patients were categorized into the sarcopenia group and the non-sarcopenia group according to the diagnostic criteria of the Asian Working Group on Sarcopenia (AWGS) 2019. Ultrasonography of the left medial head of the gastrocnemius muscle was performed in MHD and healthy controls to obtain muscle thickness (MT), pinnation angle (PA), fascicle length (FL), cross-sectional area (CSA), echo intensity (EI), elastic modulus (E), shear wave velocity (SWV), and microvascular velocity (MV). Compare the differences in ultrasound parameters among different groups, and determine the cut-off values suitable for diagnosing sarcopenia in MHD patients. Results: The MT, CSA, PA, and MV in the sarcopenia group were lower than those in the non-sarcopenia group and the control group; while the EI was higher, the FL of the sarcopenia group was lower than that of the non-sarcopenia group, while the E and SWV of the sarcopenia group were higher than those of the control group. Receiver operating characteristic curve analyses indicated that ultrasound combined index had a good diagnostic value, model Y = 13.511 - 0.121 * MT - 0.609 * CSA - 0.172 * PA + 0.011 * EI - 2.205 * MV (p < 0.05), with a cut-off value of 0.69. Conclusions: Multi-modal ultrasound is a safe, non-invasive, and real-time imaging examination method, and can provide information on muscle structure, stiffness, and perfusion, which is expected to be a promising potential tool for predicting sarcopenia in MHD patients.

This study develops a novel multifunctional nanoplatform, modified polyethylene glycol–bismuth trioxide (mPEG-Bi ₂ O ₃ ), synthesized via vacuum ball milling followed by ultrasonic liquid-phase exfoliation and surface PEGylation, to enhance the synergistic effects of sonodynamic therapy (SDT) and radiotherapy (RT). Characterization revealed that mPEG-Bi ₂ O ₃ exhibits a thin-layered nanosheet structure (hydrodynamic size: 239.28 ± 4.32 nm; lattice spacing: 0.29 nm) and a zeta potential of −33.64 ± 0.80 mV. Notably, the nanoplatform demonstrated exceptional colloidal stability in physiologically relevant media, maintaining consistent size and surface charge over 7 d in serum-containing medium, which confirms the effectiveness of the PEG coating for biomedical applications. XPS analysis confirmed a mixed Bi ³⁺ /Bi ⁵⁺ oxidation state, and deconvolution of the O 1s spectrum quantified the oxygen vacancy content at 11.02%, confirming a defect-rich structure. Successful PEG grafting was verified by Fourier transform infrared spectroscopy and quantified by thermogravimetric analysis, showing a grafting content of ~13.59 wt %. Under low-intensity focused ultrasound (LIFU), mPEG-Bi ₂ O ₃ significantly enhanced reactive oxygen species generation, leading to a marked reduction in intracellular glutathione levels. In vitro cytotoxicity studies demonstrated favorable selectivity, with lower toxicity toward normal endothelial cells compared to 4T1 cancer cells, and the combination of mPEG-Bi ₂ O ₃ and LIFU induced apoptosis in 4T1 cells. In vivo studies showed that intravenous administration of mPEG-Bi ₂ O ₃ in tumor-bearing mice resulted in peak tumor accumulation at 24 h (0.17 ± 0.03 %ID/g), correlating with a significant 87.82% ± 4.77% reduction in tumor volume after 14 d of treatment when combined with LIFU and RT (10 Gy), superior to dual-modality treatments. Immune profiling indicated enhanced dendritic cell maturation, increased tumor-infiltrating CD8 ⁺ T cells, and reduced regulatory T cells, demonstrating immune microenvironment remodeling. Collectively, mPEG-Bi ₂ O ₃ presents a surface-engineered strategy for potent SDT-RT synergy with demonstrated biosafety, showing promising potential for solid tumor treatment.