Look at the images, look at the data — and at the limits.
Three things on this page: before-and-after cine loops of the same patient, the published data from Peking Union Medical College Hospital, and the complete literature of this field — including the study whose result runs against ours.
Before / after.
Same patient, same examination, same scanner. The two loops were recorded about four minutes apart.
Two cine loops from one routine examination in China, exported from the scanner without patient information; the scanner’s settings overlay is left as recorded. Trimmed and re-encoded for the web, otherwise unedited. Illustrative of how the acoustic window is established; not evidence of diagnostic performance.
Peking Union Medical College Hospital, 27 patients.
Published in Quantitative Imaging in Medicine and Surgery in 2024: 27 patients with 30 pancreatic cystic lesions were imaged before and after taking a grain-based oral enhancement agent.
The study was designed, conducted, analyzed and reported by the hospital, and funded by the hospital’s own clinical research program. AIMED’s parent company supplied the agent it used and had no other role — no funding, no authorship, no part in the design, the analysis or the writing. We state this plainly because that independence is the reason the result is worth citing at all.
| Satisfactory acoustic window | 30% before the agent, 80% after — 9/30 to 24/30 (P = 0.002) |
| Structural visualization score | Improved (P = 0.001) |
| Structures newly visible | Septa, wall thickness over 2 mm, papillary structures, calcifications and duct dilatation became observable after the agent in some lesions |
| Versus non-contrast MRI | In the 21 lesions also examined with MRI, the difference in visualization score did not reach statistical significance — median 1 versus 2 (P = 0.070) |
The authors’ own conclusion was a call for further work rather than a claim about the present technique: “Further research to improve visualization of PCLs on TAUS using oral contrast agents could result in TAUS being a potential alternative to MRI in the follow-up of PCLs in resource-limited situations.”
Ji J, Shi X, Xia Y, et al. Quant Imaging Med Surg 2024;14(8):5602–5609. doi:10.21037/qims-24-367. Supported by the National High Level Hospital Clinical Research Funding of Peking Union Medical College Hospital (2022-PUMCH-D-001).
What this study does not establish
It enrolled 27 patients at a single center and compared each patient with themselves before and after, without randomization. A difference that does not reach significance in 21 lesions is not evidence of equivalence — the point estimate favored MRI, and the study reported no formal agreement analysis. It did not compare the agent against plain water, or against simethicone and water with repositioning. It did not evaluate cancer detection, and it was a study of lesions already known to be there. Larger, controlled, multicenter work is what this field needs next.
Seven studies, including the one that disagrees with us.
These studies were published in the international literature and were conducted in Australia, the United States, Japan and China, each with the population, equipment and operators described in the publication. They are reported as published literature — not as performance claims for any product, and not as evidence of clinical benefit in any other setting.
| Study | Population | Intervention studied | What it found |
|---|---|---|---|
| Warren, J Clin Ultrasound 1978 | — | Liquid-filled stomach | First description of the liquid-filled stomach as an ultrasonic window to the upper abdomen |
| Lund, Radiology 1992 | — | Cellulose-based oral agent | Early description of cellulose agents for gastrointestinal ultrasound |
| Abu-Yousef, Radiology 2000 | n = 70 vs 70 | Simethicone + 500 mL degassed water + repositioning | Complete pancreatic tail visualization 79% vs 7%; window lasted about 10 minutes |
| Ishigami, Ultrasound Q 2014 | 38 healthy volunteers | Cellulose-coated agent vs simethicone + water | Simethicone and water with repositioning performed better in the supine position |
| Nakao, Eur J Radiol 2017 | n = 186 | Fluid ingestion + seated position | Cyst detection 92% vs 70%; pancreatic tail 67% vs 27% |
| Matsumoto, Intern Med 2024 | 20 healthy volunteers | 500 mL degassed water | Whole pancreas adequately visualized in 55% supine, 75% repositioned, 90% after water |
| Ji, Quant Imaging Med Surg 2024 | 27 patients, 30 lesions | Grain-based oral enhancement agent | Satisfactory acoustic window 30% → 80% (P = 0.002) |
These studies do not agree with one another, and the one that disagrees with us is in the table. Ishigami and colleagues found that simethicone with water and repositioning performed better than a cellulose-coated agent for pancreatic visualization in the supine position. That study used a different formulation family from ours, enrolled volunteers with normal pancreases, and assessed a single time point rather than a procedure spanning twenty minutes — but those are differences, not refutations, and the head-to-head trial that would settle the question has not been run.
Interested, or thinking about working together?
Research collaboration, distribution partnerships, or simply a conversation about the technology — all are welcome. We do not currently operate in North America, but we are open to the conversation.