Evaluation of breast lesions by contrast enhanced ultrasound: Qualitative and quantitative analysis

2012 ◽  
Vol 81 (4) ◽  
pp. e444-e450 ◽  
Author(s):  
Caifeng Wan ◽  
Jing Du ◽  
Hua Fang ◽  
Fenghua Li ◽  
Lin Wang
Keyword(s):  
Quantitative Analysis ◽  
Breast Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Qualitative And Quantitative Analysis ◽  
Qualitative And Quantitative ◽  
Contrast Enhanced

scholarly journals Prospective evaluation of contrast-enhanced ultrasound of breast BI-RADS 3-5 lesions

2020 ◽  
Author(s):  
Janu Eva ◽  
Krikavova Lucie ◽  
Little Jirina ◽  
Dvorak Karel ◽  
Brancikova Dagmar ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Qualitative Analysis ◽  
Malignant Tumors ◽  
Blood Perfusion ◽  
Benign Tumors ◽  
Breast Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Benign Lesions ◽  
Time To Peak ◽  
Contrast Enhanced

Abstract Purpose: To determine the benefit of contrast-enhanced ultrasound (CEUS) in the assessment of breast lesions. Materials and Methods: A standardized contrast-enhanced ultrasound was performed in 230 breast lesions classified as BI-RADS category 3 to 5. All lesions were subjected to qualitative and quantitative analysis. MVI (MicroVascular Imaging) technique was used to derive qualitative analysis parameters; blood perfusion of the lesions was assessed (perfusion homogeneity, type of vascularization, enhancement degree). Quantitative analysis was conducted to estimate perfusion changes in the lesions within drawn regions of interest (ROI); parameters TTP (time to peak), PI (peak intensity), WIS (wash in slope), AUC (area under curve) were obtained from time intensity (TI) curves. Acquired data were statistically analyzed to assess the ability of each parameter to differentiate between malignant and benign lesions. The combination of parameters was also evaluated for the possibility of increasing the overall diagnostic accuracy. Biological nature of the lesions was verified by a pathologist. Benign lesions without histopathological verification (BI-RADS 3) were followed up for at least 24 months. Results: Out of 230 lesions, 146 (64%) were benign, 67 (29%) were malignant, 17 (7%) lesions were eliminated. Malignant tumors showed statistically significantly lower TTP parameters (sensitivity 77.6%, specificity 52.7%) and higher WIS values (sensitivity 74.6%, specificity 66.4%) than benign tumors. Enhancement degree also proved to be statistically well discriminating as 55.2% of malignant lesions had a rich vascularity (sensitivity 89.6% and specificity 48.6%). The combination of quantitative analysis parameters (TTP, WIS) with enhancement degree did not result in higher accuracy in distinguishing between malignant and benign breast lesions. Conclusion: We have demonstrated that contrast-enhanced breast ultrasound has the potential to distinguish between malignant and benign lesions. In particular, this method could help to differentiate lesions BI-RADS category 3 and 4 and thus reduce the number of core-cut biopsies performed in benign lesions. Qualitative analysis, despite its subjective element, appeared to be more beneficial. A combination of quantitative and qualitative analysis did not increase the predictive capability of CEUS.

scholarly journals Prospective evaluation of contrast-enhanced ultrasound of breast BI-RADS 3-5 lesions

2020 ◽  
Author(s):  
Janu Eva ◽  
Krikavova Lucie ◽  
Little Jirina ◽  
Dvorak Karel ◽  
Brancikova Dagmar ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Qualitative Analysis ◽  
Malignant Tumors ◽  
Blood Perfusion ◽  
Benign Tumors ◽  
Breast Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Benign Lesions ◽  
Time To Peak ◽  
Contrast Enhanced

Abstract Purpose: To determine the benefit of contrast-enhanced ultrasound (CEUS) in the assessment of breast lesions.Materials and Methods: A standardized contrast-enhanced ultrasound was performed in 230 breast lesions classified as BI-RADS category 3 to 5. All lesions were subjected to qualitative and quantitative analysis. MVI (MicroVascular Imaging) technique was used to derive qualitative analysis parameters; blood perfusion of the lesions was assessed (perfusion homogeneity, type of vascularization, enhancement degree). Quantitative analysis was conducted to estimate perfusion changes in the lesions within drawn regions of interest (ROI); parameters TTP (time to peak), PI (peak intensity), WIS (wash in slope), AUC (area under curve) were obtained from time intensity (TI) curves. Acquired data were statistically analyzed to assess the ability of each parameter to differentiate between malignant and benign lesions. The combination of parameters was also evaluated for the possibility of increasing the overall diagnostic accuracy. Biological nature of the lesions was verified by a pathologist. Benign lesions without histopathological verification (BI-RADS 3) were followed up for at least 24 months.Results: Out of 230 lesions, 146 (64%) were benign, 67 (29%) were malignant, 17 (7%) lesions were eliminated. Malignant tumors showed statistically significantly lower TTP parameters (sensitivity 77.6%, specificity 52.7%) and higher WIS values (sensitivity 74.6%, specificity 66.4%) than benign tumors. Enhancement degree also proved to be statistically well discriminating as 55.2% of malignant lesions had a rich vascularity (sensitivity 89.6% and specificity 48.6%). The combination of quantitative analysis parameters (TTP, WIS) with enhancement degree did not result in higher accuracy in distinguishing between malignant and benign breast lesions.Conclusion: We have demonstrated that contrast-enhanced breast ultrasound has the potential to distinguish between malignant and benign lesions. In particular, this method could help to differentiate lesions BI-RADS category 3 and 4 and thus reduce the number of core-cut biopsies performed in benign lesions. Qualitative analysis, despite its subjective element, appeared to be more beneficial. A combination of quantitative and qualitative analysis did not increase the predictive capability of CEUS.

scholarly journals Contrast-Enhanced Ultrasound Qualitative and Quantitative Characteristics of Parathyroid Gland Lesions

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 2
Author(s):  
Sergejs Pavlovics ◽  
Maija Radzina ◽  
Rita Niciporuka ◽  
Madara Ratniece ◽  
Madara Mikelsone ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Contrast Media ◽  
Parathyroid Gland ◽  
Predictive Value ◽  
Contrast Enhanced Ultrasound ◽  
Qualitative And Quantitative ◽  
Contrast Enhanced ◽  
Quantitative Characteristics ◽  
Parathyroid Lesions ◽  
Qualitative And Quantitative Characteristics

Background and Objectives: preoperative differentiation of enlarged parathyroid glands may be challenging in conventional B-mode ultrasound. The aim of our study was to analyse qualitative and quantitative characteristics of parathyroid gland lesions, using multiparametric ultrasound protocol—B-mode, Colour Doppler (CD), and contrast-enhanced ultrasound (CEUS)—and to evaluate correlation with morphology in patients with hyperparathyroidism (HPT). Materials and Methods: consecutive 75 patients with 88 parathyroid lesions and biochemically confirmed HPT prior to parathyroidectomy were enrolled in the prospective study. B-mode ultrasound, CD, and CEUS were performed with the subsequent qualitative and quantitative evaluation of acquired data. We used 1 mL or 2 mL of intravenous ultrasound contrast agent during the CEUS examination. Correlation with post-surgical morphology was evaluated. Results: seventy parathyroid adenomas were hypoechoic and well contoured with increased central echogenicity (44.3%), peripheral-central vascularization (47%), and polar feeding vessel (100%). Twelve hyperplasias presented with similar ultrasound appearance and were smaller in volume (p = 0.036). Hyperplasias had a tendency for homogenous, marked intense enhancement vs. peripherally enhanced adenomas with central wash-out in CEUS after quantitative analysis. No significant difference was observed in contrasting dynamics, regardless of contrast media volume use (1 mL vs. 2 mL). We achieved 90.9% sensitivity and 72.7% specificity, 93% positive predictive value (PPV), 87.3% negative predictive value (NPV), and 87.3% accuracy in the differentiation of parathyroid lesions prior to post-processing. In a quantitative lesion analysis, our sensitivity increased up to 98%, specificity 80%, PPV 98%, and NPV 80% with an accuracy of 96.4%. Conclusions: CEUS of parathyroid lesions shows potential in the differentiation of adenoma from hyperplasia, regardless of the amount of contrast media injected. The quantitative analysis improved the sensitivity and specificity of differentiation between parathyroid lesions. Hyperplasia was characterized by homogeneous enhancement, fast uptake, and homogeneous wash-out appearance; adenoma—by peripheral uptake, central wash-out, and reduced hemodynamics. The use of CEUS quantification methods are advised to improve the ultrasound diagnostic role in suspected parathyroid lesions.

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