title: Identification of implanted mesh after incisional hernia repair using an automated breast volume scanner.
abstract: OBJECTIVE
  This study aimed to evaluate the utility of an automated breast volume scanner (ABVS) versus handheld ultrasound (US) for identifying implanted mesh after incisional hernia repair.
  
  
  METHODS
  In vitro, the appearances of 3 samples of different flat mesh and a mesh plug on both ABVS and handheld US examinations were evaluated. In vivo, 97 patients received both ABVS and handheld US examinations in the incisional region. The frequency used for handheld US was 11 MHz. The presence of the previously implanted mesh in the incisional region was evaluated and compared between the US modalities. The identified results were confirmed by surgical findings.
  
  
  RESULTS
  In the in vitro study, the ABVS had more visualized and efficient imaging results for implanted mesh than handheld US. In the in vivo study, among 97 cases, 39 and 32 were identified as regions with mesh by the ABVS and handheld US, respectively. The ABVS had better identification performance than handheld US in terms of accuracy (94.8% versus 83.5%), sensitivity (90.5% versus 69.0%), and specificity (98.2% versus 94.5%). The κ values showed that handheld US had substantial agreement with surgical findings (κ = 0.78; 95% confidence interval, 0.66-0.90), whereas the ABVS had almost perfect agreement with surgical findings (κ = 0.93; 95% confidence interval, 0.86-1.00). More importantly, the ABVS could display the texture of lightweight mesh in the coronal plane. The specificity and sensitivity for mesh texture were 100.0% (55 of 55) and 94.4% (17 of 18), respectively.
  
  
  CONCLUSIONS
  The use of an ABVS may help identify the presence of implanted mesh after incisional hernia repair in some cases in which the implant is difficult to appreciate on handheld US imaging with an 11-MHz transducer.
authors.affiliation: Department of Electronic Engineering, Fudan University, Shanghai, China (J.W., Y.W., J.Y.); Department of Electronic Engineering, Yunnan University, Kunming, China (J.W.); Key Laboratory of Medical Imaging Computing and Computer-Assisted Intervention of Shanghai, Shanghai, China (Y.W.); and Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China (Y.C., Y.P., X.D., Z.Q.).
authors.forename: Jun
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Electronic Engineering, Fudan University, Shanghai, China (J.W., Y.W., J.Y.); Department of Electronic Engineering, Yunnan University, Kunming, China (J.W.); Key Laboratory of Medical Imaging Computing and Computer-Assisted Intervention of Shanghai, Shanghai, China (Y.W.); and Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China (Y.C., Y.P., X.D., Z.Q.). yywang@fudan.edu.cn.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Electronic Engineering, Fudan University, Shanghai, China (J.W., Y.W., J.Y.); Department of Electronic Engineering, Yunnan University, Kunming, China (J.W.); Key Laboratory of Medical Imaging Computing and Computer-Assisted Intervention of Shanghai, Shanghai, China (Y.W.); and Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China (Y.C., Y.P., X.D., Z.Q.).
authors.forename: Jinhua
authors.initials: J
authors.lastname: Yu
authors.affiliation: Department of Electronic Engineering, Fudan University, Shanghai, China (J.W., Y.W., J.Y.); Department of Electronic Engineering, Yunnan University, Kunming, China (J.W.); Key Laboratory of Medical Imaging Computing and Computer-Assisted Intervention of Shanghai, Shanghai, China (Y.W.); and Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China (Y.C., Y.P., X.D., Z.Q.).
authors.forename: Yue
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Electronic Engineering, Fudan University, Shanghai, China (J.W., Y.W., J.Y.); Department of Electronic Engineering, Yunnan University, Kunming, China (J.W.); Key Laboratory of Medical Imaging Computing and Computer-Assisted Intervention of Shanghai, Shanghai, China (Y.W.); and Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China (Y.C., Y.P., X.D., Z.Q.).
authors.forename: Yun
authors.initials: Y
authors.lastname: Pang
authors.affiliation: Department of Electronic Engineering, Fudan University, Shanghai, China (J.W., Y.W., J.Y.); Department of Electronic Engineering, Yunnan University, Kunming, China (J.W.); Key Laboratory of Medical Imaging Computing and Computer-Assisted Intervention of Shanghai, Shanghai, China (Y.W.); and Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China (Y.C., Y.P., X.D., Z.Q.).
authors.forename: Xuehong
authors.initials: X
authors.lastname: Diao
authors.affiliation: Department of Electronic Engineering, Fudan University, Shanghai, China (J.W., Y.W., J.Y.); Department of Electronic Engineering, Yunnan University, Kunming, China (J.W.); Key Laboratory of Medical Imaging Computing and Computer-Assisted Intervention of Shanghai, Shanghai, China (Y.W.); and Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China (Y.C., Y.P., X.D., Z.Q.).
authors.forename: Zhiying
authors.initials: Z
authors.lastname: Qiu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D000069290:Incisional Hernia / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013526:Surgical Mesh; D016217:Ultrasonography, Mammary
keywords: automated breast volume scanner; incisional hernia; mesh; point-of-care ultrasound