Breast cancer screening with mammography is less effective in women with dense breast tissue, prompting the use of ultrasound (US) imaging. While two- (2D) and three-dimensional (3D) US improve cancer detection, their low specificity leads to frequent unnecessary biopsies. Operator dependence on 2D US has led to the development of 3D automated breast volume scanners (ABVS), but challenges remain in distinguishing benign from malignant lesions. We developed a 3D photoacoustic and ultrasound (PAUS)–ABVS system that integrates a large field-of-view, 768-element transducer to improve diagnostic accuracy. In a clinical study of 61 patients with 36 benign and 30 malignant lesions, multispectral photoacoustic imaging was used to measure blood volume and oxygen saturation within lesions. When combined with standard US BI-RADS (breast imaging reporting and data system) scores, the system achieved a sensitivity of 96.7% and specificity of 66.7%. This performance matched the best outcomes of 2D PAUS and outperformed conventional US. Our results suggest that the PAUS-ABVS can support more accurate breast cancer diagnosis while reducing unnecessary biopsies.

최근 전 세계의 보건의료 환경은 감염병의 발생률 증가와 함께 신종 감염병 종류의 다양화로 위기상황을 경험하고 있다[1]. 우리나 라의 법정 감염병 발생현황도 2012년 91,936건에서 2017년 182,039건 으로 약 2배의 급속한 증가를 나타내고 있다[2]. 감염병은 질병회복 을 지연시키고 병원재원 기간을 연장시키므로 환자에게 의료비 부 담을 가중시킬 뿐만 아니라, 합병증 발생과 사망률을 증가시켜 궁 극적으로 정신적 고통을 안기고 삶의 질을 저하시킨다[3].

We present a back-to-back (BTB) structured, dual-mode ultrasonic device that incorporates a single-element 5.3 MHz transducer for high-intensity focused ultrasound (HIFU) treatment and a single-element 20.0 MHz transducer for high-resolution ultrasound imaging. Ultrasound image-guided surgical systems have been developed for lesion monitoring to ensure that ultrasonic treatment is correctly administered at the right locations. In this study, we developed a dual-element transducer composed of two elements that share the same housing but work independently with a BTB structure, enabling a mode change between therapy and imaging via 180-degree mechanical rotation. The optic fibers were embedded in the HIFU focal region of ex vivo chicken breasts and the temperature change was measured. Images were obtained in vivo mice before and after treatment and compared to identify the treated region. We successfully acquired B-mode and C-scan images that display the hyperechoic region indicating coagulation necrosis in the HIFU-treated volume up to a depth of 10 mm. The compact BTB dual-mode ultrasonic transducer may be used for subcutaneous thermal ablation and monitoring, minimally invasive surgery, and other clinical applications, all with ultrasound only.

SignificanceEndocavity ultrasound (US) imaging is a frequently employed diagnostic technique in gynecology and urology for the assessment of male and female genital diseases that present challenges for conventional transabdominal imaging. The integration of photoacoustic (PA) imaging with clinical US imaging has displayed promising outcomes in clinical research. Nonetheless, its application has been constrained due to size limitations, restricting it to spatially confined locations such as vaginal or rectal canals.AimThis study presents the development of a video-rate (20 Hz) endocavity PA/harmonic US imaging (EPAUSI) system.ApproachThe approach incorporates a commercially available endocavity US probe with a miniaturized laser delivery unit, comprised of a single large-core fiber and a line beamshaping engineered diffuser. The system facilitates real-time image display and subsequent processing, including angular energy density correction and spectral unmixing, in offline mode.ResultsThe spatial resolutions of the concurrently acquired PA and harmonic US images were measured at 318 μm and 291 μm in the radial direction, respectively, and 1.22 deg and 1.50 deg in the angular direction, respectively. Furthermore, the system demonstrated its capability in multispectral PA imaging by successfully distinguishing two clinical dyes in a tissue-mimicking phantom. Its rapid temporal resolution enabled the capture of kinetic dye perfusion into an ex vivo porcine ovary through the depth of porcine uterine tissue. EPAUSI proved its clinical viability by detecting pulsating hemodynamics in the male rat’s prostate in vivo and accurately classifying human blood vessels into arteries and veins based on sO2 measurements.ConclusionsOur proposed EPAUSI system holds the potential to unveil previously overlooked indicators of vascular alterations in genital cancers or endometriosis, addressing pressing requirements in the fields of gynecology and urology.

Cyclic di-guanosine monophosphate (c-di-GMP) is a ubiquitous second messenger that regulates distinct aspects of bacterial physiology. It is synthesized by diguanylate cyclases (DGCs) and hydrolyzed by phosphodiesterases (PDEs). To date, the activities of DGC and PDE are commonly assessed by phenotypic assays, mass spectrometry analysis of intracellular c-di-GMP concentration, or riboswitch-based fluorescent biosensors. However, some of these methods require cutting-edge equipment, which might not be available in every laboratory. Here, we report a new simple, convenient and cost-effective system to assess the function of DGCs and PDEs in E. coli. This system utilizes the high specificity of a riboswitch to c-di-GMP and its ability to regulate the expression of a downstream β-galactosidase reporter gene in response to c-di-GMP concentrations. In this protocol, we delineate the construction of this system and its use to assess the activity of DGC and PDE enzymes. Bio-protocol is an online peer-reviewed protocol journal. Its mission is to make life science research more efficient and reproducible by curating and hosting high quality, free access protocols.