scholarly journals Navigated ultrasound-based image guidance during resection of gliomas: practical utility in intraoperative decision-making and outcomes

2021 ◽  
Vol 50 (1) ◽  
pp. E14
Author(s):  
Prakash Shetty ◽  
Ujwal Yeole ◽  
Vikas Singh ◽  
Aliasgar Moiyadi
Keyword(s):  
Decision Making ◽  
Predictive Value ◽  
Intraoperative Imaging ◽  
False Negative ◽  
Intraoperative Ultrasound ◽  
Image Resolution ◽  
Related Factors ◽  
Resection Control ◽  
Navigated Ultrasound ◽  
Eloquent Location

OBJECTIVEIntraoperative imaging is increasingly being used for resection control in diffuse gliomas, in which the extent of resection (EOR) is important. Intraoperative ultrasound (iUS) has emerged as a highly effective tool in this context. Navigated ultrasound (NUS) combines the benefits of real-time imaging with the benefits of navigation guidance. In this study, the authors investigated the use of NUS as an intraoperative adjunct for resection control in gliomas.METHODSThe authors retrospectively analyzed 210 glioma patients who underwent surgery using NUS at their center. The analysis included intraoperative decision-making, diagnostic accuracy, and operative outcomes, particularly EOR and related factors influencing this.RESULTSUS-defined gross-total resection (GTR) was achieved in 57.6% of patients. Intermediate resection control scans were evaluable in 115 instances. These prompted a change in the operative decision in 42.5% of cases (the majority being further resection of unanticipated residual tumor). Eventual MRI-defined GTR rates were similar (58.6%), although the concordance between US and MRI was 81% (170/210 cases). There were 21 false positives and 19 false negatives with NUS, resulting in a sensitivity of 78%, specificity of 83%, positive predictive value of 77%, and negative predictive value of 84%. A large proportion of patients (13/19 patients, 68%) with false-negative results eventually had near-total resections. Tumor resectability, delineation, enhancement pattern, eloquent location, and US image resolution significantly influenced the GTR rate, though only resectability and eloquent location were significant on multivariate analysis.CONCLUSIONSNUS is a useful intraoperative adjunct for resection control in gliomas, detecting unanticipated tumor residues and positively influencing the course of the resection, eventually leading to higher resection rates. Nevertheless, resection is determined by the innate resectability of the tumor and its relationship to eloquent location, reinforcing the need to combine iUS with functional mapping techniques to optimize resections.

Test of a Noninvasive Instrument for Measuring Hemoglobin Concentration

1989 ◽  
Vol 5 (4) ◽  
pp. 659-667 ◽  
Author(s):  
Constanza I. Sanchez-Carrillo ◽  
Teresita de Jesus Ramirez-Sanchez ◽  
Marcela Zambrana-Castañeda- ◽  
Beatrice J. Selwyn
Keyword(s):  
Decision Making ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
False Negative ◽  
Hemoglobin Concentration ◽  
Reliability Test ◽  
Intraobserver Variability ◽  
Hemoglobin Content ◽  
False Negatives ◽  
Sensitivity Specificity

A colorimetric instrument for the noninvasive quantification of hemoglobin, designed using color shades resembling those observed in the conjunctiva, was tested. The instrument's colors are contrasted against the color of the conjunctiva to measure hemoglobin content. Sensitivity, specificity, negative predictive value, and false-negative value were estimated to test the instrument's accuracy; kappa coefficients were used to estimate inter- and intraobserver variability. Physician field evaluations of conjunctiva color for the screening of anemia, reported in the literature, have had sensitivities and specificities as high as 70%. Readings with the instrument demonstrated a 63% sensitivity, 72% specificity, and 38% false negatives for screening hemoglobin values of less than or equal to 13 g/dl. The interobserver kappa coefficients for three pairs of readers were good to excellent for the same hemoglobin screening value. Statistically significant differences were noted, however, between observers during the reliability test. The instrument can be used by unskilled personnel to improve their decision-making about whom to send for futher care or for supplementation with iron.

scholarly journals A Targeted Folate Receptor-α Near-infrared Fluorescent Agent Used for in Vitro Diagnosis of Endometrial Cytology

2020 ◽  
Author(s):  
Dongxin Liang ◽  
Xiaoqian Tuo ◽  
Lanbo Zhao ◽  
Kailu Zhang ◽  
Yiran Wang ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Efficient Method ◽  
Predictive Value ◽  
Near Infrared ◽  
Folate Receptor ◽  
Intraoperative Imaging ◽  
False Negative ◽  
Endometrial Cytology ◽  
In Vitro Diagnosis

Abstract Background Endometrial cancer is the second-most prevalent cancer after breast cancer. Endometrial cytology test is a new diagnosis method for endometrial lesions. However, some unresolved issues limited the application of endometrial cytology test (ECT) in early diagnosis and screening of endometrial cancer. Evidence suggests that FRα is overexpressed in various solid tumors such as endometrial cancer, breast carcinoma, ovarian cancer and so on. Based on the expression of FR-α, the agent used in intraoperative imaging, FRα-targeting antibody drugs and diagnosis were developed previously. Nevertheless, research regarding agents used in the diagnosis of endometrial cancer is rarely carried out yet. Methods To obtain a promising and efficient method for in vitro and screening diagnosis of endometrial cytology, we performed the synthesis and evaluation of the new near-infrared targeting fluorescent dye folic acid-ZW800-1 (ZW-FA) and to explore its potential feasibility for in vitro diagnosis of endometrial cancer. Characterisation and Folate receptor-α (FR-α) targeting verification of ZW-FA were performed first and 92 patients were recruited, after liquid-based cytology preparations, during a 15-month period. ZW-FA and Hematoxylin-Eosin (H&E) staining were performed on all cytological slides successively; the histological diagnoses were regarded as the gold standard for ROC curve analysis. Results The cut-off value of ZW-FA fluorescence intensity is 62.9745; the sensitivity (Se), specificity (Sp), false-negative rate (FNR), false-positive rate (FPR), positive predictive value (PV+) percentage and negative predictive value (PV–) of the ZW-FA method are 84.6%, 85.2%, 15.4%,14.8%, 93.2% and 69.7%, respectively. Conclusions ZW-FA is potentially efficient for in vitro diagnosis of endometrial lesions based on the FR-α expression level of different endometrial lesions. This research offers a promising and efficient method for in vitro and screening diagnosis of endometrial cytology. Trial registration: ChiCTR1800020123. Registered December 15, 2018.

scholarly journals Correlation of Biomarkers and Frozen Section Diagnosis with Paraffin Histopathological Diagnosis in Suspected Ovarian Cancer

2019 ◽  
Vol 4 ◽  
pp. 67-71
Author(s):  
Tanushri Mukherjee ◽  
Soma Mukherjee ◽  
Parikshit Sanyal ◽  
Vikram Bharadwaj ◽  
S Sampath ◽  
...  
Keyword(s):  
Decision Making ◽  
Predictive Value ◽  
Frozen Section ◽  
False Negative ◽  
Paraffin Section ◽  
Histopathological Diagnosis ◽  
Diagnostic Dilemma ◽  
Ovarian Cancers ◽  
Frozen Section Diagnosis ◽  
Malignant Lesions

Introduction: Ovarian cancers pose diagnostic dilemma and is problematic for decision making for the gynecological oncologist as well as the pathologist. The use of intra-operative frozen section can aid significantly in decision making and assist in choosing the correct operative path once a mass lesion of ovaries is discovered. Materials and Methods: Over a two-year period, 50 cases of Suspected Ovarian cancers were examined by intra- operative frozen section as well as followed up with histopathology in paraffin sections. Results were categorized in two strata—benign and malignant. Results: A comparison between frozen-section diagnosis and findings on paraffin section showed that the sensitivity of frozen section in diagnosis of malignant lesions is 97.14%, with specificity 93.33%, positive predictive value 97.14% and negative predictive value 93.33%. Among 50 cases, one case was reported as false positive and one was reported as false negative. Conclusion: Intra-operative frozen section is a highly sensitive and specific modality for the diagnosis of malignant lesions of the ovary.

Shuntogram utility in predicting future shunt failures

2021 ◽  
pp. 1-5
Author(s):  
Ariana Adamski ◽  
Michael W. O’Brien ◽  
Matthew A. Adamo
Keyword(s):  
Decision Making ◽  
Statistical Analysis ◽  
Predictive Value ◽  
Clinical Decision Making ◽  
False Negative ◽  
False Negative Rate ◽  
Medical Decision ◽  
Shunt Revision ◽  
Shunt Failure ◽  
Negative Rate

OBJECTIVE Shunt failure remains a challenging diagnosis for neurosurgeons, particularly when patient symptoms suggest shunt malfunction but radiographic evidence is lacking. In such situations, shuntograms are sometimes employed to guide medical decision-making. In this study, the authors aimed to investigate the utility of shuntograms in aiding patient management, particularly in terms of a negative result. METHODS This retrospective single-institution series comprises patients who underwent a shuntogram procedure to evaluate shunt patency over a roughly 6-year period. The medical records of patients were reviewed to determine the findings of the shuntogram procedure, the type of obstruction, and whether a subsequent operation for a shunt revision took place either within 30 days or up to 1 year after the procedure. Statistical analysis was completed by calculating the sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of the shuntogram as compared with the revision surgery. RESULTS Of the 98 patients who underwent a shuntogram, 95 patients were included in the statistical analysis. A ventriculoperitoneal shunt was assessed in 81% of patients (77/95). The PPV of the procedure was 100%. The NPV for predicting a subsequent shunt revision within 30 days was 68.3% (false-negative rate of 31.7%) or within 365 days was 61.2% (false-negative rate of 38.8%). The sensitivity and specificity of the shuntogram were 55.8% and 100% within 30 days and 51.9% and 100% within 365 days, respectively. The most common intervention at the time of surgery following a negative shuntogram was a valve replacement in 38.5% of patients (10/26). CONCLUSIONS With an NPV of 68.3% for predicting revision within 30 days in our series of 95 patients, shuntograms remained a useful tool in the clinical decision-making process when evaluating potential shunt failure.

scholarly journals Direct navigated 3D ultrasound for resection of brain tumors: a useful tool for intraoperative image guidance

2016 ◽  
Vol 40 (3) ◽  
pp. E5 ◽  
Author(s):  
Aliasgar V. Moiyadi ◽  
Prakash Shetty
Keyword(s):  
Brain Tumors ◽  
Intraoperative Imaging ◽  
False Negative ◽  
Residual Tumor ◽  
3D Ultrasound ◽  
Ultrasound Scan ◽  
Diffuse Infiltration ◽  
Postoperative Imaging ◽  
Eloquent Areas ◽  
Resection Control

OBJECTIVE Navigated 3D ultrasound is a novel intraoperative imaging adjunct permitting quick real-time updates to facilitate tumor resection. Image quality continues to improve and is currently sufficient to allow use of navigated ultrasound (NUS) as a stand-alone modality for intraoperative guidance without the need for preoperative MRI. METHODS The authors retrospectively analyzed cases involving operations performed at their institution in which a 3D ultrasound navigation system was used for control of resection of brain tumors in a “direct” 3D ultrasound mode, without preoperative MRI guidance. The usefulness of the ultrasound and its correlation with postoperative imaging were evaluated. RESULTS Ultrasound was used for resection control in 81 cases. In 53 of these 81 cases, at least 1 intermediate scan (range 1–3 intermediate scans) was obtained during the course of the resection, and in 50 of these 53 cases, the result prompted further resection. In the remaining 28 cases, intermediate scans were not performed either because the first ultrasound scan performed after resection was interpreted as showing no residual tumor (n = 18) and resection was terminated or because the surgeon intentionally terminated the resection prematurely due to the infiltrative nature of the tumor and extension of disease into eloquent areas (n = 10) and the final ultrasound scan was interpreted as showing residual disease. In an additional 20 cases, ultrasound navigation was used primarily for localization and not for resection control, making the total number of NUS cases where radical resection was planned 101. Gross-total resection (GTR) was planned in 68 of these 101 cases and cytoreduction in 33. Ultrasound-defined GTR was achieved in 51 (75%) of the cases in which GTR was planned. In the remaining 17, further resection had to be terminated (despite evidence of residual tumor on ultrasound) because of diffuse infiltration or proximity to eloquent areas. Of the 33 cases planned for cytoreduction, NUS guidance facilitated ultrasound-defined GTR in 4 cases. Overall, ultrasound-defined GTR was achieved in 50% of cases (55 of 111). Based on the postoperative imaging (MRI in most cases), GTR was achieved in 58 cases (53%). Final (postresection) ultrasonography was documented in 78 cases. The findings were compared with the postoperative imaging to ascertain concordance in detecting residual tumor. Overall concordance was seen in 64 cases (82.5%), positive concordance was seen in 33 (42.5%), and negative in 31 (40%). Discordance was seen in 14 cases—with ultrasound yielding false-positive results in 7 cases and false-negative results in 7 cases. Postoperative neurological worsening occurred in 15 cases (13.5%), and in most of these cases, it was reversible by the time of discharge. CONCLUSIONS The results of this study demonstrate that 3D ultrasound can be effectively used as a stand-alone navigation modality during the resection of brain tumors. The ability to provide repeated, high-quality intraoperative updates is useful for guiding resection. Attention to image acquisition technique and experience can significantly increase the quality of images, thereby improving the overall utility of this modality.

Kegunaan Informasi Akuntansi dalam Pengambilan Keputusan Internal oleh Unit Akuntansi Kuasa Pengguna Anggaran (UAKPA)

2017 ◽  
Vol 2 (4) ◽  
pp. 73-91
Author(s):  
Karno Pandu Wibowo
Keyword(s):  
Decision Making ◽  
Accounting Information ◽  
Information Use ◽  
External Factors ◽  
Accrual Accounting ◽  
Related Factors ◽  
Internal Factors ◽  
Level Of Use ◽  
Accrual Basis ◽  
Cash Basis

This study aims to determine the usefulness level of accounting information (on cash basis and accrual basis) in central goverment agencies internal decision-making process. In addition, this study also aims to determine the influence of the organization’s external factors, the organization's internal factors and Individual Actor’s Characteristic Related Factors on the level of use of accounting information in central goverment agencies internal decision making.The research show that  level of accrual accounting information use in the context of internal decision making is high. In addition it showed differences between  level of cash-based accounting information use and accrual-based accounting information use. This study also addressed that the organization’s external factors, the organization's internal factors and individual actor’s characteristic related factors significantly influence both level of accounting information use  on cash basis and accrual basis in the internal decision-making. Except for the organization’s external factors  did not significantly affect the level of accrual accounting information use  in the internal decision-making.   Abstrak Penelitian ini bertujuan untuk mengetahui tingkat kegunaan informasi akuntansi (berbasis kas dan akrual) dalam proses pengambilan keputusan internal Unit Akuntansi Kuasa Pengguna Anggaran (UAKPA). Selain itu penelitian ini juga bertujuan untuk mengetahui pengaruh faktor eksternal organisasi, faktor internal organisasi dan faktor karakteristik individu pengguna terhadap tingkat penggunaan informasi akuntansi dalam pengambilan keputusan internal Unit Akuntansi Kuasa Pengguna Anggaran (UAKPA).Temuan peneliti menunjukan bahwa tingkat penggunaan informasi akuntansi berbasis akrual tinggi dalam rangka pengambilan keputusan internal. Selain itu penelitian menunjukan adanya perbedaan tingkat penggunaan antara informasi akutansi berbasis kas dan informasi akutansi berbasis akrual. Penelitian juga menujukan bahwa faktor eksternal organisasi, faktor internal organisasi dan faktor karakteristik individu pengguna berpengaruh signifikan terhadap tingkat penggunaan informasi akuntansi (berbasis kas dan akrual) dalam pengambilan keputusan internal. Kecuali untuk faktor eksternal organisasi tidak berpengaruh signifikan terhadap tingkat penggunaan informasi akuntansi akrual dalam pengambilan keputusan internal.

scholarly journals Development of a prognostic tool: based on risk factors for tooth loss after active periodontal therapy

2021 ◽  
Author(s):  
Sonja Rahim-Wöstefeld ◽  
Dorothea Kronsteiner ◽  
Shirin ElSayed ◽  
Nihad ElSayed ◽  
Peter Eickholz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Decision Making ◽  
Tooth Loss ◽  
Treatment Plan ◽  
Periodontal Therapy ◽  
Outcome Variable ◽  
Individual Treatment ◽  
Risk Indicator ◽  
Related Factors ◽  
Prognostic Tool

Abstract Objectives The aim of this study was to develop a prognostic tool to estimate long-term tooth retention in periodontitis patients at the beginning of active periodontal therapy (APT). Material and methods Tooth-related factors (type, location, bone loss (BL), infrabony defects, furcation involvement (FI), abutment status), and patient-related factors (age, gender, smoking, diabetes, plaque control record) were investigated in patients who had completed APT 10 years before. Descriptive analysis was performed, and a generalized linear-mixed model-tree was used to identify predictors for the main outcome variable tooth loss. To evaluate goodness-of-fit, the area under the curve (AUC) was calculated using cross-validation. A bootstrap approach was used to robustly identify risk factors while avoiding overfitting. Results Only a small percentage of teeth was lost during 10 years of supportive periodontal therapy (SPT; 0.15/year/patient). The risk factors abutment function, diabetes, and the risk indicator BL, FI, and age (≤ 61 vs. > 61) were identified to predict tooth loss. The prediction model reached an AUC of 0.77. Conclusion This quantitative prognostic model supports data-driven decision-making while establishing a treatment plan in periodontitis patients. In light of this, the presented prognostic tool may be of supporting value. Clinical relevance In daily clinical practice, a quantitative prognostic tool may support dentists with data-based decision-making. However, it should be stressed that treatment planning is strongly associated with the patient’s wishes and adherence. The tool described here may support establishment of an individual treatment plan for periodontally compromised patients.

scholarly journals NESTROFT—A Cost-Effective Mass Screening Tool for the Detection of β-Thalassemia Carrier Status in Anemic Pregnant Women: A Step Toward Reducing the National Disease Burden

2021 ◽  
Author(s):  
Manasi Gosavi ◽  
Ramesh Chavan ◽  
M. B. Bellad
Keyword(s):  
Pregnant Women ◽  
Effective Mass ◽  
Mass Screening ◽  
Predictive Value ◽  
Screening Tool ◽  
Hematological Parameters ◽  
False Negative ◽  
Cost Effective ◽  
Mean Corpuscular Hemoglobin ◽  
Carrier Status

Abstract Introduction β-Thalassemias are inherited hemoglobinopathies commonly encountered in practice. With chances of a promising cure being rare, the prevention of births with this disorder should assume priority, especially in low-resource countries. This can be achieved by the implementation of a mass screening program that is reliable and, at the same time, cost-effective. Objectives This study focuses on the utility of Naked Eye Single Tube Red Cell Osmotic Fragility Test (NESTROFT) as a mass screening tool to detect thalassemia carriers. Hematological parameters that may predict carrier status were also evaluated. Materials and Methods Hemoglobin estimation was performed on all consented pregnant women. If the patient was found to have hemoglobin < 11 g/dL, the blood sample was subjected to other routine hematological tests along with peripheral smear examination. NESTROFT was performed using 0.36% saline solution. Confirmation was done using high-performance liquid chromatography (HPLC). Statistical Analysis Data obtained were tabulated using version 21 of the Statistical Package for Social Sciences. Means, standard deviations, and percentages were used to describe the sample. Chi-square test and Students’ “t” test were used to identify differences between the groups. Results Of 441 pregnant women enrolled, 206 were found to be anemic. Nineteen (9.2%) of the anemic pregnant women were detected to be carriers of hemoglobinopathies. Among the hematological parameters, mean red blood cell count and reticulocyte count were higher, while mean corpuscular hemoglobin concentration was lower in carriers. Also, carriers were more likely to present with microcytic hypochromic anemia. NESTROFT showed a sensitivity of 84.21%, specificity of 96.25%, a positive predictive value of 69.56%, and a negative predictive value of 98.36%. A false-positive result was seen in 3.74% of the tests, while a false negative result was seen in 15.78% of the tests. Conclusions NESTROFT (0.36%) can be used as a simple and cost-effective mass screening tool for the detection of carrier status. This should be followed by confirmation using HPLC or hemoglobin electrophoresis.

Exercise induced reduction in myocardial work predicts significant coronary artery disease in patients with false negative stress echocardiography

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.L Chilingaryan ◽  
L.G Tunyan ◽  
K.G Adamyan ◽  
P.H Zelveyan ◽  
L.R Tumasyan ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Predictive Value ◽  
Stress Echocardiography ◽  
False Negative ◽  
Funding Source ◽  
Concentric Hypertrophy ◽  
Constructive Work ◽  
Artery Disease ◽  
Isovolumic Relaxation

Abstract   Stress echocardiography (SE) is a reliable technique for the diagnosis of coronary artery disease (CAD) with high sensitivity and specificity. However in patients with small left ventricular (LV) cavity caused by marked concentric hypertrophy the sensitivity of SE is low. We assumed that in patients with false negative SE evaluation of global myocardial work (GW) might detect significant CAD. Methods 238 patents with chest pain (98 female, mean age 61±5 years) without history of CAD were referred to SE for CAD confirmation. 94 (39.5%) patients had negative SE and were enrolled in our study for re-examination. Age and gender matched 50 healthy subjects served as controls. GW index (GWI) was obtained from pressure-strain loops composed from speckle tracking analysis indexed to brachial systolic blood pressure. Global constructive work (GCW) as the sum of positive work due to myocardial shortening during systole and negative work due to lengthening during isovolumic relaxation, global wasted work (GWW) as energy loss by myocardial lengthening in systole and shortening in isovolumic relaxation, and GW efficiency (GWE) as the percentage ratio of constructive work to the sum of constructive work and wasted work were measured after submaximal treadmill SE at the heart rate of 100–110 beats per minute (109±11 s after SE) using EchoPac software by blinded experienced echocardiographer. All patients were referred to coronary angiography after re-examination. Results 42 (44.7%) patients had lower GWI values than the lowest limit of GWI value in controls. These patients had significant reduction in GWI, compared with remaining 52 patients in whom GWI did not differ from those of controls (GWI 1897±112 mmHg% vs 2518±243 mmHg%, p&lt;0.01). GCW, GWE and GWW were comparable between patients with or without reduced GWI (GCW 2283±107mmHg% vs 2321±110 mmHg%, p=NS; GWE 96.9±1.1% vs 97.4±1.2%, p=NS; GWW 57±3 mmHg% vs 53±4 mmHg%, p=NS). 28 (66.7%) of 42 patients with GWI reduction and 8 (15.0%) of 52 patients without GWI reduction had at least one vessel significant CAD. GWI had sensitivity, specificity, and accuracy in detection of CAD 78%, 76%, 77% respectively with 67% positive predictive value, and 85% negative predictive value. 29 (80.5%) patients out of 36 with significant CAD had concentric increase in LVMi compared with true negative SE patients (83±6 g/m2 vs 71±4 g/m2, p&lt;0.01). GWI was the predictor of significant CAD (area under the curve 0.793). Conclusion GWI extends diagnostic power of conventional SE in detection of CAD, especially in patients with smaller LV cavity due to concentric hypertrophy when sensitivity of conventional SE is low. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Committee of Sience at Ministry of Education of Republic of Armenia

Validity of ultrasound arterial wall vascularization for assessment of vascular inflammation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
W Sato ◽  
Y Kobayashi ◽  
M Otaka ◽  
M Unuma ◽  
T Yamanaka ◽  
...  
Keyword(s):  
Carotid Stenosis ◽  
Predictive Value ◽  
Arterial Wall ◽  
Carotid Arteries ◽  
Vascular Inflammation ◽  
False Negative ◽  
Intraplaque Hemorrhage ◽  
Funding Source ◽  
Negative Finding ◽  
18F Fdg

Abstract Background Vascular inflammation plays a fundamental role in most vascular diseases including atherosclerosis and vasculitis syndrome, in which arterial wall vascularization (AWV) frequently develops. Visualization of AWV is informative in detecting the vascular inflammation but is challenging. A new ultrasound technique (superb micro-vascular imaging [SMI]) allows the detection of extremely low-velocity flows. We examined an availability of SMI for assessment of the instability of atherosclerotic plaques and the activity of Takayasu arteritis (TA). Methods and results The study consists of two independent and consecutive parts A and B, examined in carotid stenosis (A) and TA (B), respectively. In part A, 12 patients with symptomatic severe carotid stenosis (CS group) scheduled for carotid endarterectomy were enrolled. In six of 12 patients, preoperative ultrasonography with SMI showed intraplaque neovascularization at the plaque shoulder. Postoperatively, histopathology confirmed the neovessels at the corresponding sites of visualized AWV. SMI had a sensitivity of 67%, specificity of 90% for detection of AWV in CS group. In SMI analysis, false positive findings were caused by motion artifact and arterial wall calcification, and a false negative finding is attributed by intraplaque hemorrhage. In part B, 10 patients with TA were enrolled. All patients underwent 18F-FDG-PET/CT, and its vascular uptake were compared with AWV detected by SMI. Bilateral common carotid arteries (CCA), internal carotid arteries and common iliac arteries were examined by SMI. Active vascular 18F-FDG uptake (max SUV &gt;2.1) were found at five sites in three patients, which were not significantly correlated with the prevalence of macaroni sign, increase in C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Of note, SMI revealed AWV at five sites corresponding to uptake of 18F-FDG, with a sensitivity/specificity of 100% and 98%, positive predictive value 71%, and a negative predictive value 100%. Conclusion SMI enables visualization of AWV at vulnerable plaque in CS patients and at 18F-FDG positive sites in TA patients. SMI has potential as a modality to detect the vascular inflammation. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Grant-in-Aid for Scientific Research, Japan

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