Quantitative Analysis of Musculoskeletal Ultrasound ...downloads.hindawi.com/journals/bmri/2017/9694316.pdf · region in ultrasound images, computer aided diagnosis, which is of great

EditorialQuantitative Analysis of Musculoskeletal Ultrasound:Techniques and Clinical Applications

QingWang,1 Qing-Hua Huang,2 John T. W. Yeow,3

Mark R. Pickering,4 and Simo Saarakkala5

1 Institute of Medical Information, School of Biomedical Engineering, Southern Medical University, Guangzhou, China2South China University of Technology, Guangzhou, China3University of Waterloo, Waterloo, ON, Canada4The University of New South Wales, Canberra, ACT, Australia5University of Oulu, Oulu, Finland

Correspondence should be addressed to Qing Wang; [email protected]

Received 5 April 2017; Accepted 10 April 2017; Published 30 April 2017

Copyright © 2017 Qing Wang et al. This is an open access article distributed under the Creative Commons Attribution License,which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Musculoskeletal ultrasound is one of a number of muscu-loskeletal imaging modalities. It can be defined as an ultra-sound imaging technique for the diagnosis and treatment ofpatients with musculoskeletal disorders. In comparison withadvanced imaging modalities such as CT and MRI, advan-tages of ultrasound include the readily available bedside ultra-sound equipment, the relatively low cost of the exam pro-cedure, the capacity for dynamic evaluation of patients, andthe use of nonionizing radiation. Therefore, musculoskeletalultrasound has been widely adopted for many clinical appli-cations. Recent advances in musculoskeletal ultrasound haveprovided physicians with valuable information in applicationareas such as sports medicine, osteoarthritis, osteoporosis,musculoskeletal pain, and rehabilitation. The new findingsin these areas have also inspired novel signal and imageprocessing techniques that are developed to facilitate manypotential new clinical applications. Recently developed quan-titative ultrasound techniques are able to provide quantitativeassessment of the structure and function of musculoskeletaltissues. In addition, ultrasound biomicroscopy imaging withhigh-frequency probes is able to resolve finer imaging detailsof musculoskeletal tissues. In this issue readers will find 12high-quality, peer-reviewed articles that provide researchersfrom diverse backgrounds such as biomedical engineering,medical ultrasound, rehabilitation, and computational sci-ences with the state-of-the-art knowledge of this emerginginterdisciplinary research area.

In the review paper “A Review on Real-Time 3D Ultra-sound Imaging Technology” by the special issue editor Q.Huang and Z. Zeng, a comprehensive review on traditionallydesigned 3D ultrasound techniques as well as the mostadvanced real-time 3D imaging using parallel computinghardware and methods is provided. It summarizes the prosand cons of different data acquisition protocols, discussesthe algorithms of volume reconstruction, and introducesthe clinical applications including musculoskeletal examina-tions.

Ultrasound images of themusculoskeletal system providevisible information of the structure ofmusculoskeletal tissuesand organs such as muscles, tendons, ligaments, joints,and soft tissue. Ultrasonography is a useful tool to guidethe treatment of patients with musculoskeletal disorders.Ultrasound-guided techniques help physicians accuratelyinject treatment drugs into the target tissues to satisfy therequirements of a successful and safe therapy. In this specialissue, two papers introduce ultrasound-guided techniquesthat are applied in the treatment of musculoskeletal pain.Thepaper “Ultrasound-Guided versus Fluoroscopy-GuidedDeepCervical Plexus Block for the Treatment of CervicogenicHeadache” by Q. Wan et al. presents an ultrasound-guidedapproach to treating cervicogenic headache through injectionin deep cervical plexus block. Q. Wan et al. also introducean application of ultrasonography to guide the lumbar peri-radicular injection for patients with unilateral lower lumbar

HindawiBioMed Research InternationalVolume 2017, Article ID 9694316, 2 pageshttps://doi.org/10.1155/2017/9694316

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radicular pain in their paper entitled “Ultrasonography-Guided Lumbar Periradicular Injections forUnilateral Radic-ular Pain.” The ultrasound-guided approach is shown to be apotentially promising method for the pain treatment due toits convenience and efficacy.

Rehabilitation for musculoskeletal disorders needs accu-rate diagnosis and follow-up evaluation of the outcomes dur-ing a relative long-term physical exercise therapy procedure.In this special issue, there are four papers that report theapplications of musculoskeletal ultrasound in rehabilitation.In “Ultrasonographic Validation of Anatomical Landmarksfor Localization of the Tendon of the Long Head of BicepsBrachii,” S. Hou et al. introduce two anatomical landmarksfor localization of biceps tendon groove and validate thelocalizationwith ultrasonographicmeasurement.The reliablelocation of treatment andmonitoring plays an important rolein therapy and diagnosis for patients with musculoskeletaldisorders. L. Li and R. K. Tong introduce a combinedmethodof ultrasound imaging and biomechanical modeling for post-stroke muscular evaluation in their paper entitled “Com-bined Ultrasound Imaging and Biomechanical Modeling toEstimate Triceps Brachii Musculotendon Changes in StrokeSurvivors.” Based on the ultrasonic parameters, the subject-specific biomechanical model could predict the changes ofmusculotendon properties for patients after stroke. In thepaper “Ultrasonic Measurement of Dynamic Muscle Behav-ior for Poststroke Hemiparetic Gait” by X. Chen et al., theauthors developed a synchronized system for simultaneouslycollecting ultrasonography signals, EMG, and joint angleto dynamically analyze the functional and morphologicalchanges during muscle contraction. Ultrasonography can bedeemed as an alternative method for examination of themorphological changes for stroke patients. C.-Z. Wang etal. describe a novel ultrasound technique called “vibroultra-sound” that achieves the active stiffness of the muscles underisometric contraction. Their paper entitled “Age and SexEffects on the Active Stiffness of Vastus Intermedius underIsometric Contraction” investigates the relationship betweenmuscle stiffness and the contraction intensity and providesinsight into the age and sex bias in musculoskeletal studies.

Quantitative ultrasound, a recently developed promis-ing method, has been applied to quantitatively assess thestructure and function of musculoskeletal tissues. This spe-cial issue presents three quantitative ultrasound studies forevaluation of the tissues in musculoskeletal diseases. Thepaper “Early Detection of Tibial Cartilage Degradation andCancellous Bone Loss in an Ovariectomized Rat Model”by Y. Wang et al. proposes a quantitative high-frequencyultrasound approach for the early detection of rat tibial car-tilage degradation. This is a promising method to detect theearly degradation of articular cartilage induced by estrogenreduction in female osteoarthritis. T. Suzuki et al. present asemiquantitative evaluation of polymyalgia rheumatica andelderly-onset rheumatoid arthritis by power Doppler ultra-sound in their paper entitled “Semiquantitative Evaluationof Extrasynovial Soft Tissue Inflammation in the Shouldersof Patients with Polymyalgia Rheumatica and Elderly-OnsetRheumatoid Arthritis by Power Doppler Ultrasound.” It isindicated that power Doppler ultrasound can be a reliable

tool to semiquantitatively evaluate the inflammation of softtissues. The paper “Transverse and Oblique Long Bone Frac-ture Evaluation by Low Order Ultrasonic Guided Waves: ASimulation Study” by Y. Li et al. focuses on using ultrasound-guided waves to evaluate bone fracture and monitor itshealing. This simulated study shows that the ultrasound-guided waves have good potential for evaluation of bonefractures and their healing monitoring.

There are two papers that report novel techniques ofsignal and image processing to extract and analyze thetarget tissues in this special issue. The paper “A Novel Seg-mentation Approach Combining Region- and Edge-BasedInformation for Ultrasound Images” by Y. Luo et al. demon-strates a new segmentation algorithm based on an improvedmachine learning strategy for extracting lesions from ultra-sound images, for example, the breast and musculoskeletalultrasound images. With accurate extraction of the lesionregion in ultrasound images, computer aided diagnosis,which is of great help in routine musculoskeletal exami-nations in a clinical setting, can be easily conducted. Thepaper “Semianalytical Solution for the Deformation of anElastic Layer under an Axisymmetrically Distributed Power-Form Load: Application to Fluid-Jet-Induced Indentation ofBiological Soft Tissues” by M. Lu et al. presents an ultra-sound indentation method for analyzing the biomechanicalproperty of biological soft tissues. The clearer analysis of thebiomechanical properties provided by this technique wouldbe of great help in better understanding the function of themusculoskeletal tissues.

In summary, the 12 papers in the special issue report notonly new clinical studies of musculoskeletal ultrasound butalso recently developed ultrasound techniques for muscu-loskeletal tissue characterizations. We hope that this specialissue will help to promote further development of mus-culoskeletal ultrasound methodologies for various clinicalapplications. Improvement and advances in musculoskeletalultrasound may lead to better performance outcomes indiagnosis and treatment of patients with musculoskeletaldisorders. Musculoskeletal ultrasound provides quantitativeevaluation and dynamic monitoring and thus reduces thecost, duration, and overall impact of musculoskeletal dis-eases.

Acknowledgments

We would like to express our deepest gratitude to manyreviewers, whose professional comments guaranteed the highquality of the selected papers. In addition, we also would liketo express our appreciation to the editorial board membersfor their help and support throughout the preparation of thisspecial issue.

Qing WangQing-Hua HuangJohn T. W. Yeow

Mark R. PickeringSimo Saarakkala

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Quantitative Analysis of Musculoskeletal Ultrasound ...downloads.hindawi.com/journals/bmri/2017/9694316.pdf · region in ultrasound images, computer aided diagnosis, which is of great