scholarly journals Differential Diagnosis of Parotid Gland Tumors: Role of Shear Wave Elastography

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Jan Heřman ◽  
Zuzana Sedláčková ◽  
Jaromír Vachutka ◽  
Tomáš Fürst ◽  
Richard Salzman ◽  
...  
Keyword(s):  
Parotid Gland ◽  
Shear Wave ◽  
Malignant Tumors ◽  
Shear Wave Elastography ◽  
Predictive Score ◽  
Cervical Lymph Nodes ◽  
Parotid Gland Tumors ◽  
Parotid Tumors ◽  
Malignant Lesions ◽  
Additional Value

Aim. To create a predictive score for the discrimination between benign and malignant parotid tumors using elastographic parameters and to compare its sensitivity and specificity with standard ultrasound. Methods. A total of 124 patients with parotid gland lesions for whom surgery was planned were examined using conventional ultrasound, Doppler examination, and shear wave elastography. Results of the examinations were compared with those ones of histology. Results. There were 96 benign and 28 malignant lesions in our cohort. Blurred tumor margin alone proved to be an excellent predictor of malignancy with the sensitivity of 79% and specificity of 97%. Enlarged cervical lymph nodes, tumor vascularisation, microcalcifications presence, homogeneous echogenicity, and bilateral occurrence also discriminated between benign and malignant tumors. However, their inclusion in a predictive model did not improve its performance. Elastographic parameters (the stiffness maxima and minima ratio being the best) also exhibited significant differences between benign and malignant tumors, but again, their inclusion did not significantly improve the predictive power of the blurred margin classifier. Conclusion. Even though elastography satisfactorily distinguishes benign from malignant lesions on its own, it hardly provides any additional value in evaluation of biological character of parotid gland tumors when used as an adjunct to regular ultrasound examination.

scholarly journals Multiparametric ultrasound diagnosis of metastatic and lymphoproliferative changes in lymph nodes in primary-multiple malignant tumors, including breast cancer and lymphoma

2019 ◽  
Vol 8 (4) ◽  
pp. 37-44 ◽  
Author(s):  
E. V. Kovaleva ◽  
T. Yu. Danzanova ◽  
G. T. Sinyukova ◽  
P. I. Lepedatu ◽  
E. A. Gudilina ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Differential Diagnosis ◽  
Lymph Nodes ◽  
Shear Wave ◽  
Malignant Tumors ◽  
Shear Wave Elastography ◽  
Doppler Imaging ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Multiparametric Ultrasound

In this article, based on two clinical examples, the possibilities of multiparametric ultrasound in the differential diagnosis of metastatic and lymphoproliferative changes in lymph nodes in primary-multiple malignant tumors, including breast cancer and lym - phoma, are evaluated. Multiparameteric ultrasound includes B-mode, color and energy Doppler imaging, strain elastography, shear wave elastography and contrast-enhanced ultrasound (CEUS). Standardization and reproducibility of these ultrasound techniques will allow to objectify the study, obtaining specific indicators of shear wave velocity in the zones of interest and specific signs of contrast enhancement, which can be used as impor tant differential diagnostic tool in oncology.

Comparison of peritumoral stromal tissue stiffness obtained by shear wave elastography between benign and malignant breast lesions

2018 ◽  
Vol 59 (10) ◽  
pp. 1168-1175 ◽  
Author(s):  
Hye Sun Park ◽  
Hee Jung Shin ◽  
Ki Chang Shin ◽  
Joo Hee Cha ◽  
Eun Young Chae ◽  
...  
Keyword(s):  
Shear Wave ◽  
Malignant Tumors ◽  
Shear Wave Elastography ◽  
Breast Cancers ◽  
Tissue Stiffness ◽  
Linear Arrangement ◽  
Luminal B ◽  
Tumor Subtypes ◽  
Stromal Tissue ◽  
Malignant Breast

Background Aggressive breast cancers produce abnormal peritumoral stiff areas, which can differ between benign and malignant lesions and between different subtypes of breast cancer. Purpose To compare the tissue stiffness of the inner tumor, tumor border, and peritumoral stroma (PS) between benign and malignant breast masses by shear wave elastography (SWE). Material and Methods We enrolled 133 consecutive patients who underwent preoperative SWE. Using OsiriX commercial software, we generated multiple 2-mm regions of interest (ROIs) in a linear arrangement on the inner tumor, tumor border, and PS. We obtained the mean elasticity value (Emean) of each ROI, and compared the Emean between benign and malignant tumors. Odds ratios (ORs) for prediction of malignancy were calculated. Subgroup analyses were performed among tumor subtypes. Results There were 85 malignant and 48 benign masses. The Emean of the tumor border and PS were significantly different between benign and malignant masses ( P < 0.05 for all). ORs for malignancy were 1.06, 1.08, 1.05, and 1.04 for stiffness of the tumor border, proximal PS, middle PS, and distal PS, respectively ( P < 0.05 for all). Malignant masses with a stiff rim were significantly larger than malignant masses without a stiff rim, and were more commonly associated with the luminal B and triple negative subtypes. Conclusion Stiffness of the tumor border and PS obtained by SWE were significantly different between benign and malignant masses. Malignant masses with a stiff rim were larger in size and associated with more aggressive pathologic subtypes.

The Potential of Shear Wave Elastography to Reduce Unnecessary Biopsies in Breast Cancer Diagnosis: An International, Diagnostic, Multicenter Trial

2021 ◽  
Author(s):  
Michael Golatta ◽  
André Pfob ◽  
Christopher Büsch ◽  
Thomas Bruckner ◽  
Zaher Alwafai ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Shear Wave ◽  
Cancer Diagnosis ◽  
Shear Wave Elastography ◽  
Breast Cancer Diagnosis ◽  
Multicenter Trial ◽  
Breast Ultrasound ◽  
Histopathologic Evaluation ◽  
International Data ◽  
Malignant Lesions

Abstract Purpose In this prospective, multicenter trial we evaluated whether additional shear wave elastography (SWE) for patients with BI-RADS 3 or 4 lesions on breast ultrasound could further refine the assessment with B-mode breast ultrasound for breast cancer diagnosis. Materials and Methods We analyzed prospective, multicenter, international data from 1288 women with breast lesions rated by conventional 2 D B-mode ultrasound as BI-RADS 3 to 4c and undergoing 2D-SWE. After reclassification with SWE the proportion of undetected malignancies should be < 2 %. All patients underwent histopathologic evaluation (reference standard). Results Histopathologic evaluation showed malignancy in 368 of 1288 lesions (28.6 %). The assessment with B-mode breast ultrasound resulted in 1.39 % (6 of 431) undetected malignancies (malignant lesions in BI-RADS 3) and 53.80 % (495 of 920) unnecessary biopsies (biopsies in benign lesions). Re-classifying BI-RADS 4a patients with a SWE cutoff of 2.55 m/s resulted in 1.98 % (11 of 556) undetected malignancies and a reduction of 24.24 % (375 vs. 495) of unnecessary biopsies. Conclusion A SWE value below 2.55 m/s for BI-RADS 4a lesions could be used to downstage these lesions to follow-up, and therefore reduce the number of unnecessary biopsies by 24.24 %. However, this would come at the expense of some additionally missed cancers compared to B-mode breast ultrasound (rate of undetected malignancies 1.98 %, 11 of 556, versus 1.39 %, 6 of 431) which would, however, still be in line with the ACR BI-RADS 3 definition (< 2 % of undetected malignancies).

scholarly journals Shear wave elastography in differentiating between benign and malignant cervical lymph nodes in patients with oral carcinoma

2019 ◽  
Vol 48 (6) ◽  
pp. 20180454 ◽  
Author(s):  
Yoshihiko Sasaki ◽  
Ichiro Ogura
Keyword(s):  
Elastic Modulus ◽  
Lymph Nodes ◽  
Shear Wave ◽  
Rank Correlation ◽  
Shear Wave Elastography ◽  
Oral Carcinoma ◽  
Cervical Lymph Nodes ◽  
Significance Level ◽  
Axial Diameter ◽  
Shear Elastic Modulus

Objectives: To evaluate shear wave elastography in differentiating between benign and malignant cervical lymph nodes in patients with oral carcinoma. Methods: 77 patients with oral squamous cell carcinoma were examined by B-mode and shear wave elastography with a 14 MHz linear transducer. The integrated shear wave elastography software allowed the operator to place regions of interest of various sizes within the elastography window, and automatically displayed shear elastic modulus data (kPa) for each region of interest. The relationship between size and shear elastic modulus of cervical lymph nodes was assessed by Pearson's rank correlation test. The shear elastic modulus of cervical lymph nodes in benign and malignant were evaluated using the Mann–Whitney U test. The analyses were used with a 5% significance level. Results: We plotted shear elastic modulus (X) against minimal axial diameter of cervical lymph nodes (Y), and observed a significant correlation [ Y = 0.091 X + 4.648 (R2 = 0.603, p = 0.000, N = 77)]. Furthermore, the shear elastic modulus of the malignant cervical lymph nodes (105.9 ± 5.2 kPa) was higher than that of benign (11.9 ± 4.4 kPa, p = 0.000). Conclusions: The shear wave elastography is an effective technique for the objectively and quantitatively diagnosis of cervical lymph node metastases of the oral carcinoma.

The value of quantitative shear wave elastography in differentiating the cervical lymph nodes in patients with thyroid nodules

2017 ◽  
Vol 45 (2) ◽  
pp. 251-259 ◽  
Author(s):  
Jun You ◽  
Juan Chen ◽  
Feixiang Xiang ◽  
Yue Song ◽  
Simai Khamis ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Shear Wave ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Cervical Lymph Nodes

scholarly journals Renal Ultrasound Elastography: A Review of the Previous Reports on Chronic Kidney Diseases

2021 ◽  
Vol 11 (20) ◽  
pp. 9677
Author(s):  
Takuji Iyama ◽  
Takaaki Sugihara ◽  
Tomoaki Takata ◽  
Hajime Isomoto
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Kidney Disease ◽  
Shear Wave ◽  
Malignant Tumors ◽  
Interstitial Fibrosis ◽  
Kidney Diseases ◽  
Shear Wave Elastography ◽  
Ultrasound Elastography ◽  
Renal Ultrasound

The early detection of a kidney injury is essential to protect against the progression of kidney damage owing to the progressive nature of chronic kidney disease. A renal biopsy is the gold standard for the assessment of pathological alterations such as interstitial fibrosis and glomerulosclerosis. However, there are concerns regarding potential complications including bleeding and a reduction in renal function. Ultrasound elastography is an ideal modality for assessing the alterations in various organs and diagnosing malignant tumors. This technique has the potential to help detect early changes in renal function and pathological alterations. However, the careful application and interpretation of this technique in the kidney is required because of its complex hemodynamics and architecture. Shear wave elastography is the most widely investigated technique among ultrasound elastography. This review aims to summarize the previous investigations of the kidney using shear wave elastography, particularly for renal malignancy, kidney transplantation, and chronic kidney disease. Additionally, we have highlighted the influencing factors concerning the practical measurement of renal elasticity.

scholarly journals Histogram analysis of dynamic contrast-enhanced magnetic resonance imaging in the differential diagnosis of parotid tumors

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shiyu Xiang ◽  
Jiliang Ren ◽  
Zhipeng Xia ◽  
Ying Yuan ◽  
Xiaofeng Tao
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Parotid Gland ◽  
Benign Tumors ◽  
Resonance Imaging ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced ◽  
Parotid Gland Tumors ◽  
Parotid Tumors ◽  
Contrast Enhanced

Abstract Objective Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) histograms were used to investigate whether their parameters can distinguish between benign and malignant parotid gland tumors and further differentiate tumor subgroups. Materials and methods A total of 117 patients (32 malignant and 85 benign) who had undergone DCE-MRI for pretreatment evaluation were retrospectively included. Histogram parameters including mean, median, entropy, skewness, kurtosis and 10th, 90th percentiles were calculated from time to peak (TTP) (s), wash in rate (WIR) (l/s), wash out rate (WOR) (l/s), and maximum relative enhancement (MRE) (%) mono-exponential models. The Mann–Whitney U test was used to compare the differences between the benign and malignant groups. The diagnostic value of each significant parameter was determined on Receiver operating characteristic (ROC) analysis. Multivariate stepwise logistic regression analysis was used to identify the independent predictors of the different tumor groups. Results For both the benign and malignant groups and the comparisons among the subgroups, the parameters of TTP and MRE showed better performance among the various parameters. WOR can be used as an indicator to distinguish Warthin’s tumors from other tumors. Warthin’s tumors showed significantly lower values on 10th MRE and significantly higher values on skewness TTP and 10th WOR, and the combination of 10th MRE, skewness TTP and 10th WOR showed optimal diagnostic performance (AUC, 0.971) and provided 93.12% sensitivity and 96.70% specificity. After Warthin’s tumors were removed from among the benign tumors, malignant parotid tumors showed significantly lower values on the 10th TTP (AUC, 0.847; sensitivity 90.62%; specificity 69.09%; P < 0.05) and higher values on skewness MRE (AUC, 0.777; sensitivity 71.87%; specificity 76.36%; P < 0.05). Conclusion DCE-MRI histogram parameters, especially TTP and MRE parameters, show promise as effective indicators for identifying and classifying parotid tumors. Entropy TTP and kurtosis MRE were found to be independent differentiating variables for malignant parotid gland tumors. The 10th WOR can be used as an indicator to distinguish Warthin’s tumors from other tumors.

scholarly journals The Role of Ultrasound and Shear-Wave Elastography in Evaluation of Cervical Lymph Nodes

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Jan Heřman ◽  
Zuzana Sedláčková ◽  
Tomáš Fürst ◽  
Jaromír Vachutka ◽  
Richard Salzman ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Shear Wave ◽  
Sensitivity And Specificity ◽  
Predictive Power ◽  
Shear Wave Elastography ◽  
Final Diagnosis ◽  
Neck Mass ◽  
Cervical Lymph Nodes ◽  
Axis Ratio ◽  
Ultrasound Parameters

Aim. To evaluate the prognostic value of ultrasound and shear-wave elastography (SWE) in diagnosing malignant cervical lymph nodes. Methods. A total of 99 patients with enlarged lymph nodes (99 lymph nodes presenting as a neck mass) were examined clinically with conventional ultrasound including Doppler examination and shear-wave elastography. The results of the examinations were compared with the final diagnosis. Results. There were 43 benign and 56 malignant lymph nodes in our cohort. Age and sex were significant predictors of malignancy. The standard ultrasound parameters—node size, long/short axis ratio, hilum, vascularization, and the presence of microcalcifications—were also statistically significant. Lymph node volume combined with age showed the best predictive power. The maximum stiffness found on SWE was also a significant predictor of malignancy. The combination of epidemiologic, classic ultrasound, and elastographic parameters yielded the highest sensitivity and specificity in the prediction of malignancy; however, the additional impact of elastographic parameters was low. Conclusion. A combination of epidemiologic and classic ultrasound parameters can discriminate between malignant and benign lymph nodes with satisfactory sensitivity and specificity. Examining the stiffness of lymph nodes by means of SWE does not add much new predictive power.

Malignant Epithelial Tumors of the Parotid Gland

2021 ◽  
pp. 213-232
Keyword(s):  
Parotid Gland ◽  
Cell Carcinoma ◽  
De Novo ◽  
Malignant Tumors ◽  
Large Cell Carcinoma ◽  
Low Grade ◽  
Parotid Tumors ◽  
Characteristic Features ◽  
Epithelial Myoepithelial Carcinoma ◽  
The Individual

Cancer of the parotid gland represents about 20% of all parotid tumors. It either occurs “de-novo” or “on top of pleomorphic adenoma.” There is no sex predilection, and the age of developing this cancer is usually above 50 years. Malignant tumors are as varied as their benign counterparts. Certain tumors are “low-grade” (polymorphous low-grade adenocarcinoma, acinic cell carcinoma, epithelial-myoepithelial carcinoma), while others are “high-grade” (salivary duct carcinoma, large cell carcinoma, and small cell carcinoma). The first echelon lymph node (LN) of metastases is the intra- and peri-glandular nodes. The next echelon is level II LNs. Hematogenous spread occurs very late and is mainly to the lungs and bones. However, adenoid cystic carcinoma tends to grow through peri-neural lymphatics with increased risk of nerve involvement, intra-cranial extension, and increased rate of recurrence. In this chapter, characteristic features and management of the individual types of malignant parotid tumors will be discussed.

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