Engagement of sonographers performing pediatric appendiceal ultrasound through training in the scanning technique and awareness of secondary signs significantly improved the visualization rate and provided more meaningful findings to referrers.

Sonography is an important clinical tool in diagnosing appendicitis in children as it can obviate both exposure to potentially harmful ionising radiation from computed tomography scans and the need for unnecessary appendicectomies. This review examines the diagnostic accuracy of ultrasound in the identification of acute appendicitis, with a particular focus on the the utility of secondary sonographic signs as an adjunct or corollary to traditionally examined criteria. These secondary signs can be important in cases where the appendix cannot be identified with ultrasound and a more meaningful finding may be made by incorporating the presence or absence of secondary sonographic signs. There is evidence that integrating these secondary signs into the final ultrasound diagnosis can improve the utility of ultrasound in cases where appendicitis is expected, though there remains some conjecture about whether they play a more important role in negative or positive prediction in the absence of an identifiable appendix.

Introduction: Ultrasound is commonly used as a tool for investigation of acute appendicitis in children. The accuracy of ultrasound in appendicitis depends on the ability to visualise the appendix and the potential contribution from secondary signs. The study was a retrospective analysis of children referred for sonographic investigation of possible acute appendicitis at an Australian Methods: Radiology reports, ultrasound images and electronic medical records were evaluated for eligible patients. The ability to visualise the appendix and determine secondary sonographic signs was evaluated for diagnostic accuracy.Results: The study identified 457 eligible children, with the appendix visualised on ultrasound in 40.7% of cases. Using a binary diagnostic model that incorporated equivocal results, sensitivity of ultrasound to diagnose acute appendicitis was 88.1%, specificity 91.4% and accuracy 90.4%. Ultrasound was found to have a high negative predictive value (96.3%), and the presence of echogenic mesentery had a positive predictive value of 89.4%. Discussion:Our results compare favourably with other studies, but indicate the potential for improvement in accuracy and visualisation, with a future study incorporating new methods of categorising ultrasound findings currently being undertaken.Funding: This manuscript is based on research performed as part of a higher research degree at Queensland University of Technology (QUT), Brisbane, Australia. Conflict of interest: None.Sonography 3 87-94

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Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency–Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.

The integration of artificial intelligence (AI) technology within the health industry is increasing. This educational piece discusses the implementation of AI and its impact on sonography. The authors investigate how AI may influence the profession and provide examples of how ultrasound imaging may be enhanced and innovated by integrating AI technology. This article highlights challenges related to the application of AI and provides insight into how they could be addressed. The critical distinction between the role of a sonographer and the reporting specialist in the context of AI is highlighted as a key issue for those developing, researching, and evaluating AI systems. A key recommendation is for the sonography community to address ultrasound education, particularly how AI knowledge could be incorporated into university education. This is an important consideration that should be extended to practising professionals as they may be involved in evaluating the efficiency and methodologies used in new research that may incorporate AI technologies.

While computed tomography (CT) and magnetic resonance imaging (MRI) have established roles in evaluating Pott's puffy tumour, ultrasound can play a valuable role in identifying the condition, particularly in children. We present the case of a boy with a fluctuant forehead lump and headaches, where ultrasound was the first‐line imaging modality and expedited further investigations.

Sonographic measurement of the thyroid gland volume is a safe and reliable method for epidemiologic studies in iodine deficiency disorders. Several factors such as age, sex and anthropometric characteristics are known to be the determinants of thyroid gland size but the most widely studied is the effect of insufficient iodine intake. Low iodine intake induces enlargement of the thyroid gland known as goitre. The assessment of urinary iodine concentration alone is not reliable as it can vary daily within individuals. Urinary iodine concentration in conjunction with sonographic thyroid gland measurements is a widely used method of thyroid gland assessment. Establishment of normative thyroid volume is essential for the assessment of iodine deficiency disorders, and studies have been conducted in several countries. These studies have shown that thyroid gland volumes are likely population‐specific even in iodine‐sufficient countries limiting the effectiveness of international reference ranges. Based on currently available data of sonographic thyroid gland volume measurements and how they vary across populations of school children, this review argues for the establishment of population‐specific reference ranges in regions such as Australia, which are now considered iodine‐sufficient.