Usefulness of High-Frequency Ultrasonography in the Diagnosis of Melanoma: Mini Review

High-frequency equipment is characterized by ultrasound probes with frequencies of over 10 MHz. At higher frequencies, the wavelength decreases, which determines a lower penetration of the ultrasound beam so as to offer a better evaluation of the surface structures. This explains the growing interest in ultrasound in dermatology. This review examines the state of the art of high-frequency ultrasound (HFUS) in the assessment of skin cancer to ensure the high clinical approach and provide the best standard of evidence on which to base clinical and policy decisions.

On the bandwidth and beam profile characteristics of a simple low frequency collimated ultrasound beam source

We numerically investigate the bandwidth and collimation characteristics of ultrasound beams generated by a simple collimated ultrasound beam source that consists of a piezoelectric disk operated near its radial mode resonances. We simulate the ultrasound beam generated in a fluid medium as a function of the excitation frequency for two cases: 1) free piezoelectric disk that corresponds to zero-traction along the lateral edge, and 2) fixed piezoelectric disk that corresponds to zero-displacement along the lateral edge. We present and discuss the physical mechanism underpinning the frequency-dependent collimation and bandwidth properties of the ultrasound beams. We observe that the collimated beam generated by the free disk repeatedly lengthens/shortens and also extends/retracts sidelobes with increasing frequency. Alternatively, fixing the piezoelectric disk results in a consistent beam profile shape across a broad range of frequencies. This facilitates generating broadband signals such as a Gaussian pulse or chirp, which are common in ultrasound imaging. Thus, the fixed piezoelectric disk finds application as a collimated ultrasound beam source in a wide range of applications including medical ultrasound imaging, scanning acoustic microscopy, sonar detection, and other nondestructive ultrasound inspection techniques.

Monitoring of cerebral high intensity transient signals during catheter interventions and surgery for congenital heart disease in infants using NeoDoppler

Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The Joint Research Committee between St. Olavs Hospital and the faculty of Medicine, NTNU. The Norwegian Association for Children with Congenital Heart Disease Research Foundation, FFHB Background There is a risk of gaseous- and solid micro embolus formation during transcatheter procedures (CATH) and surgery in children with congenital heart disease (CHD). Silent strokes during surgery or CATH may contribute to neurological impairment. NeoDoppler is a non-invasive ultrasound system based on plane wave transmissions to continuously monitor cerebral blood flow in infants with an open fontanelle. Gaseous- and solid micro embolus passing through the ultrasound beam create High Intensity Transient Signals (HITS) in the Doppler signal. Purpose We aimed to study the amount of HITS during CATH and surgery in infants using NeoDoppler. Methods The NeoDoppler probe operates at a frequency of 7.8 MHz. The frame rate is 300 fps and the beam covers a wide cylindrical area (10/35mm width/depth). The system displays a color M-mode Doppler and a spectrogram. The broad ultrasound beam permits prolonged scanning time of each event as the HITS move through the ultrasound beam. The high framerate and color M-mode allows for tracking of embolies in depth. In this study the NeoDoppler probe was attached to the anterior fontanelle of infants with CHD during CATH (n = 15) and cardiac surgery (n = 13). HITS were defined as high intensity signal creating skewed lines in the color M-mode Doppler moving away or towards the probe (blue/red) with a corresponding high intensity signal in the spectrogram. HITS were grouped into single HITS and HITS with curtain effect. Single HITS were defined as single skewed lines in the color M-mode Doppler and spectrogram. HITS with curtain effect were defined as skewed broad lines or multiple intensity increase lines in the color M-mode Doppler with corresponding intensity increase that filled the entire doppler curve. HITS with curtain effect are believed to represent numerous HITS that could not be separated from each other in the spectrogram. HITS were manually detected in an in-house MatLab application. Results The study group consisted of 28 infants (17 males) with different CHD who underwent CATH or surgery. The median age and weight was 96 days (range 3-240 days) and 5650 g (range 2400-8085 g). HITS were detected in 13/15 patients during CATH with a total of 392 HITS (Median 12, Range 0-149) and in all patients during surgery with a total of 772 HITS (Median 45, Range 11-150). The picture shows examples of single HITS (panel A) and HITS with curtain effect (panel B). One can appreciate the embolic trajectory pattern in depth over time in the color M-mode Display. Conclusion In this study we found that NeoDoppler enables detection of frequent HITS in patients with CHD undergoing surgery or CATH. NeoDoppler could become a useful tool to guide modifications of procedures, with aim to reduce the risk of silent stroke. However, further studies are needed to validate the technique. Abstract Figure.