Browsing by Author "Bacariza, Jacobo"
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- Impact of ultrasound settings on lung vertical artefacts: an observational study in mechanically ventilated patientsPublication . Leote, João; Gonçalves, Andreia; Fonseca, Júlia; Loução, Ricardo; Dias, Maria Hermínia Monteiro Brites; Ribeiro, Maria Inês; Meireles, Ricardo; Varudo, Rita; Bacariza, Jacobo; Gonzalez, FilipeThe number of vertical artefacts (VAs) in lung ultrasound (LUS) impacts patients' clinical management. This study aimed to demonstrate the influence of ultrasound settings on the number of VAs in patients under invasive mechanical ventilation (IMV). Methods: Patients under IMV were recruited for LUS, including three breathing cycles with a motionless curvilinear probe on the thoracic region with the most VAs. Three experts in LUS were asked about the number of VAs at random, and blinded after altering the settings for a total of 20 test recordings per patient. The correlation between expert classifications was tested after grading the classifications. The number of VAs across clinicians was compared between baseline recordings and test condition recordings to determine statistical differences. Results: 29 patients were enrolled with a median Sequential Organ Failure Assessment score of 6 (interquartile range (IQR) 3). IMV was mainly due to stroke (n=10) and pneumonia (n=6). LUS was made between days 1 and 6 (IQR). Baseline recordings showed a median of 2±2 VAs in inspiration and a median of 1±2 in expiration from 3636 expert classifications, with a strong agreement among patients. A probe frequency of 8 MHz, artefact filtering, speckle reduction, and frame average reduced the median VA number by one. A power of -20 dB and a dynamic range of 32 dB abolished the VAs. A gain above 90% increased the median number of VAs by one. Conclusion: In this in vivo study, the LUS settings influenced the VA number in IMV patients, after controlling for physiological and operator confounders.
- Influence of ultrasound settings on laboratory vertical artifactsPublication . Leote, Joao; Muxagata, Tiago; Guerreiro, Diana; Francisco, Cláudia; Dias, Hermínia Brites; Loução, Ricardo; Bacariza, Jacobo; Gonzalez, FilipeObjective: The aim of the work described here was to analyze the relationship between the change in ultrasound (US) settings and the vertical artifacts' number, visual rating, and signal intensity METHODS: An in vitro phantom consisting of a damp sponge and gelatin mix was created to simulate vertical artifacts. Furthermore, several US parameters were changed sequentially (i.e., frequency, dynamic range, line density, gain, power, and image enhancement) and after image acquisition. Five US experts rated the artifacts for number and quality. In addition, a vertical artifact visual score was created to determine the higher artifact rating ("optimal") and the lower artifact rating ("suboptimal"). Comparisons were made between the tested US parameters and baseline recordings. Results: The expert intraclass correlation coefficient for the number of vertical artifacts was 0.694. The parameters had little effect on the "optimal" vertical artifacts but changed their number. Dynamic range increased the number of discernible vertical artifacts to 3 from 36 to 102 dB. Conclusion: The intensity did not correlate with the visual rating score. Most of the available US parameters did not influence vertical artifacts.
- To B or not to B-lines [editorial]Publication . Gonzalez, Filipe André; Bacariza, Jacobo; Leote, João; EchoCrit GroupWith great interest, we have read the paper from Boero et al. titled “Lung Ultrasound among Expert Operators: Scoring and Inter-rater Reliability Analysis (LESSON study), a secondary COWS study analysis from the ITALUS group”, which provides a focused evaluation of lung ultrasound (LUS). The author’s analysis reflects the increasing use of LUS as a valuable diagnostic and monitoring tool for assessing pulmonary conditions worldwide. The study is particularly noteworthy for emphasizing the inter-rater reliability of the LUS score among expert practitioners, whose assessments are crucial in determining the relevance of LUS in clinical practice. By analyzing data from skilled clinicians, the article highlights the reliability of the LUS score when labeling ultrasound (US) video clips recorded from patients with COVID-19 pneumonia]. This focus is valuable, as skilled performance can establish benchmarks to define training standards for clinical practice through LUS assessment standardization.
- Total signal intensity of ultrasound laboratory vertical artifacts: a semi-quantitative toolPublication . Leote, Joao; Loução, Ricardo; Aguiar, Madalena; Tavares, Mariana; Ferreira, Paloma; Muxagata, Tiago; Guerreiro, Diana; Dias, Hermínia Brites; Bacariza, Jacobo; Gonzalez, FilipeQuantitative approaches to improve lung ultrasound (LUS) vertical artifacts (VA) interpretation using total signal intensity (ITOT) are not widely available for clinical practice. In this study, we aimed to i) develop a mathematical algorithm to extract ITOT as a post-hoc LUS analysis and ii) confirm ITOT utility by conducting laboratory VA research using an in vitro model with different acoustic channels. The ITOT was extracted from static and conventional LUS imaging recorded from in vitro models after varying the amount of water content or the pores size of the phantom, compared to a control condition. The defined algorithm was able to calculate the ITOT from all phantoms. Mean ITOT showed statistically significantly different values across phantom categories. We demonstrate that ITOT may be able to differentiate the in vitro acoustic channels formed by increased water content from those with small size pores. However, the utility of this semi-quantitative tool in clinical practice or other LUS imaging data sets remains unclear.