scholarly journals Is ultrasound elastography adding value in diagnosis of focal hepatic lesions? Our experience in a single-center study

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Doaa M. Emara ◽  
Mohamed M. El Shafei ◽  
Ahmed El-Gendi ◽  
Amany A. Yousif
Keyword(s):  
Strain Ratio ◽  
Ultrasound Elastography ◽  
University Hospital ◽  
Radiology Department ◽  
Benign Lesions ◽  
Grey Scale ◽  
Focal Hepatic Lesions ◽  
Malignant Lesions ◽  
The Mean ◽  
Hepatic Lesions

Abstract Background The aim of this study was to assess the use of ultrasound elastography in differentiating hepatic lesions in order to increase the sensitivity and specificity of grey-scale ultrasound. Methods This study included 104 patients who were referred to the radiology department at Alexandria Main University Hospital for focal hepatic lesions detected by grey-scale ultrasound and were recommended to undergo further evaluation by ultrasound elastography. All studied patients were subjected to the following: (1) grey-scale ultrasound and ultrasound elastography using semiquantitative technique and (2) triphasic MDCT of the liver. MRI was done in 11 patients with malignant lesions; further confirmation with histopathological assessment was conducted. Results Benign lesions showed a low strain ratio, while malignant lesions showed a high strain ratio. The mean ratio in the benign lesions was 1.08 ± 0.40, while the mean ratio in the malignant lesions was 4.14 ± 1.25. The cut-off value used to diagnose the malignant lesions and differentiate these lesions from the benign lesions was 1.7, which had a sensitivity of 100%, specificity of 93.10%, PPV of 97.40% and NPV of 100%. Conclusion Ultrasound elastography is a promising non-invasive, non-contrast technique that can be added to routine grey-scale sonographic examinations of the liver to characterize hepatic lesions.

scholarly journals The Evaluation of Benign Acute Childhood Myositis by Ultrasound Elastography

2019 ◽  
Vol 6 (9) ◽  
pp. 205-209
Author(s):  
Gülay Güngör ◽  
Olcay Güngör
Keyword(s):  
Muscle Thickness ◽  
Strain Ratio ◽  
Muscle Stiffness ◽  
Ultrasound Elastography ◽  
Radiology Department ◽  
Control Group ◽  
Healthy Children ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Objective:   Herein, we aimed to determine the diagnostic contribution of ultrasound elastography (UE) technique to the assessment of muscle stiffness in pediatric patients with myositis. Material and Methods: This study enrolled 16 patients who presented to our hospital’s Pediatric Neurology Outpatient Clinic with the complaint of inability to walk and who had a clinical presentation of benign acute childhood myositis (BACM). The patients were referred to the Radiology Department to undergo muscle ultrasonography (USG), where they underwent UE of the gastrocnemius muscle (GCM). Results: Children with myositis and healthy children are similar age (7.06 ± 1.52 year (5–11) vs. 7.00 ± 1.59 year (5–11) year) (P: 0.908) and body mass index (BMI) (20.04 ± 1.58 (18.6–24.2) vs. 22.08 ± 1.43 (19.9–24.4) (P: 0.946). The mean serum creatine kinase (CK) was measured as 1520.3 ± 1163.6 U/L (min: 456,  max:4100) in children with myositis. In the children with myositis, the thickness of the medial and lateral GCM increased compared with that in control group (medial; 18.15 ± 3.02 mm vs 13.10 ± 2.26 mm, p<0.001, lateral; 13.51 ± 3.07 mm vs 9.34 ± 1.86 mm, p<0.001). The medial and lateral GCM ratio in group 1 was slight bigger than that in group 2 (medial; 1.10 ± 0.37 vs 1.00 ± 0.34, p: 0.274, lateral; 1.22 ± 0.44 vs 1.10 ± 0.29, p: 0.243). GCM strain values were mildly elevated in patients with myositis compared to controls. Conclusion: In the children with myositis, the thickness of the medial and lateral GCM increased compared with that in control group. GCM strain ratio values were slightly higher in myositis patients compared to the control group. We think that the increase in muscle thickness values is mainly secondary to the edema seen in myositis. In addition, UE is a clinically applicable quantitative analysis for changes in myositis.

scholarly journals The Value of Ultrasound Elastography in Diffuse Thyroid Disease among a Sample of Iraqi Population

2021 ◽  
Vol 9 (B) ◽  
pp. 1647-1653
Author(s):  
Hiba Mohammed Abdulwahid ◽  
Lubna Ali Hussien ◽  
Areege Mustafa Kamal
Keyword(s):  
Thyroid Disease ◽  
Clinical Symptoms ◽  
Strain Ratio ◽  
Thyroid Diseases ◽  
Ultrasound Elastography ◽  
Radiology Department ◽  
Medical City ◽  
Healthy Control ◽  
The Mean

Abstract Background: Early detection of many thyroid disorders is essential in the management. Ultrasound elastography is beneficial in the assessment of diffuse thyroid diseases.      Aim of study: To assess the role of ultrasound strain elastography in the diagnosis of diffuse non nodular thyroid disease in comparison to healthy controls and in the characterization and differentiation of the types of diffuse thyroid diseases. Patients and methods: It is a prospective analytic study performed in the Radiology Department of Oncology Teaching Hospital/Medical city Complex in Baghdad during the period from 1st of December 2019 to 30th of June, 2020 on convenient sample of 25 patients with diffuse thyroid disease, in addition to a sample of 25 healthy control persons. The diagnosis of diffuse thyroid diseases was made by combination of clinical symptoms, laboratory investigations and thyroid ultrasound. Results: The mean elastography strain ratio (1.36) of patients with diffuse thyroid disease was significantly higher than (0.82) mean of elastography strain ratio for healthy control persons (p<0.001). The acceptable cutoff elastography strain ratio in the diagnosis of diffuse thyroid disease was 0.89 with validity results (80% sensitivity, 70% specificity and 75% accuracy). The mean elastography strain ratio for patients with Hashimotos thyroiditis was significantly higher than the strain ratio of patients with Graves disease (p=0.002). Conclusions: The ultrasound elastography is useful in the assessment and characterization of diffuse thyroid disease. The ultrasound elastography strain ratio value is helpful in differentiation between different diffuse thyroid diseases especially between Hashimotos thyroiditis and Graves's disease

scholarly journals Apparent diffusion coefficient for differentiating between benign and malignant hepatic focal lesions

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sherif Abugamra ◽  
Aya Yassin ◽  
Asmaa Saber Mostafa Abdel-Rehim ◽  
Dina Sayed Sheha
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Focal Lesion ◽  
Benign Lesions ◽  
Focal Lesions ◽  
Significant Difference ◽  
Apparent Diffusion ◽  
Malignant Lesions ◽  
The Mean

Abstract Background The aim of this study was to prospectively evaluate the role of diffusion weight MRI (DWI) in the characterization of hepatic focal lesions by using apparent diffusion coefficient (ADC). Thirty patients (18 women, 12 men; mean age 48.5 years) with hepatic focal lesions were included in this study. Patients underwent DW MR imaging with the SPLICE sequence. ADC of each focal lesion carcinoma was calculated from DW MR Images obtained with low and high b values. ADCs were compared among pathological types of focal lesions. Results Among the 30 patients included in the study, 46 focal lesions were detected. Twenty-four lesions were metastatic lesions from primary cancer, 7 lesions were hepatocellular carcinoma (HCC), 9 lesions were hemangiomas, and 6 lesions were simple cysts. There was highly significant difference between the mean ADC of the malignant lesions (metastasis and HCC) and the mean ADC of benign lesions (hemangiomas and cysts). The ADC of malignant lesion was much less than that of benign lesion. The mean ADC of malignant lesions (n = 31) was 0.73 ± 0.19 × 10−3 mm2/s, and the mean ADC of benign lesions (n = 15) was 1.94 ± 0.68 × 10−3 mm2/s (p value < 0.001). There was no significant difference between the cysts and hemangiomas. There was no statistically significant difference between the metastases and hepatocellular carcinoma. Conclusion ADCs values were able to differentiate benign from malignant lesions. ADC should be considered in the work up of patients with hepatic focal lesions.

Role of MRI in Detecting and Characterizing Small Hepatic Focal Lesions

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Rania Ali Maarouf ◽  
Ali Haggag Ali ◽  
Mahmoud Abdelatif Onsy
Keyword(s):  
Tumor Staging ◽  
Left Lobe ◽  
Diagnostic Process ◽  
Liver Imaging ◽  
Focal Lesions ◽  
Focal Hepatic Lesions ◽  
Malignant Lesions ◽  
Hepatic Lesions ◽  
The Right

Abstract Background Despite the recent advances in liver imaging, the detection and characterization of small hepatic focal lesions is still a real challenge. Particularly in cancer patients where the characterization of a small HFL as thus the precise tumor staging is critical for optimal treatment planning. Aim of the Work To explore the effectiveness, and hence the clinical utility, of MRI detection and characterization of small focal hepatic lesions either only discovered on MRI or as a further work up of CT/US-indeterminate lesions. Patients and Methods We reviewed our database for individuals who underwent liver MR imaging between March 2018 and March 2019 for the evaluation of small hepatic lesions that were discovered for the first time or had been previously visualized on routinely performed CT and had been considered indeterminate. Results The present study included 44 patients of which 26 were males (59.1%) and 18 were females (40.9%). The age range of the study group was 19 to 77 years. The mean age for Malignant lesions was 51 years. The right lobe of liver was involved in 23 cases (52.3%), left lobe in 5 cases (11.4%) and both lobes in 16 cases (36.4%). There were 30 (68.18%) benign, 13 (29.54%) malignant lesions and 1 (2.3%) indeterminate, hemangiomas were predominant in benign lesions whereas hepatocellular carcinomas were predominant in malignant lesions. N'TRI could characterize 92% cases. Conclusion The diagnostic process of small hepatic focal lesions, either detection or characterization or both, continues to represent a challenge. Contrast-enhanced MR can accurately detect and characterize majority of small hepatic focal lesions.

scholarly journals Prevalence of c-myc expression in breast lesions associated with microcalcifications detected by routine mammography

2009 ◽  
Vol 127 (2) ◽  
pp. 66-70 ◽  
Author(s):  
Renato Coimbra Mazzini ◽  
Simone Elias ◽  
Afonso Celso Pinto Nazário ◽  
Cláudio Kemp ◽  
Ângela Flávia Logullo
Keyword(s):  
Breast Imaging ◽  
Ductal Carcinoma ◽  
Percutaneous Biopsy ◽  
Screening Mammography ◽  
University Hospital ◽  
Premalignant Lesions ◽  
Breast Lesions ◽  
Benign Lesions ◽  
Cross Sectional ◽  
Malignant Lesions

CONTEXT AND OBJECTIVE: Genetic abnormalities in cell proliferation-regulating genes have been described in premalignant lesions. The aims here were to evaluate c-myc protein expression in non-palpable breast lesions associated with microcalcifications, detected by screening mammography, and to compare these results with histopathological, clinical and epidemiological variables. DESIGN AND SETTING: Analytical cross-sectional study, with retrospective data collection, in a university hospital in São Paulo. METHODS: Seventy-nine female patients who underwent routine mammography between 1998 and 2004 were studied. Lesions classified by the Breast Imaging Reporting and Data System (BI-RADS) as 4 or 5 underwent percutaneous biopsy using a large-core needle. Ninety-eight lesions were studied anatomopathologically. Paraffin blocks properly representing the lesions were selected for immunohistochemical analyses using the streptavidin-biotin-peroxidase technique with monoclonal mouse c-myc antibodies. RESULTS: Among the 98 lesions, 29 (29.6%) contained malignant neoplasia; 40 (40.8%) had a positive immunohistochemical reaction for c-myc. When the groups were divided between lesions without atypias versus atypical lesions plus malignant lesions, 31.03% of the 58 lesions without atypias were positive for c-myc and 55% of the 40 malignant and atypical lesions (P = 0.018). Comparing the atypical lesions with ductal carcinoma in situ versus the benign lesions without atypias, c-myc was present in 51.61% of the 31 atypical lesions and 31.03% of the benign lesions without atypias (P = 0.057). CONCLUSION: C-myc protein was more frequently expressed in atypical and malignant lesions than in benign lesions without atypias. C-myc expression correlated with the presence of atypias (P = 0.018).

scholarly journals Can apparent diffusion coefficient (ADC) distinguish breast cancer from benign breast findings? A meta-analysis based on 13 847 lesions

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Alexey Surov ◽  
Hans Jonas Meyer ◽  
Andreas Wienke
Keyword(s):  
Diffusion Coefficient ◽  
Meta Analysis ◽  
Mean Value ◽  
Breast Lesions ◽  
Benign Lesions ◽  
B Values ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Malignant Lesions ◽  
The Mean

Abstract Background The purpose of the present meta-analysis was to provide evident data about use of Apparent Diffusion Coefficient (ADC) values for distinguishing malignant and benign breast lesions. Methods MEDLINE library and SCOPUS database were screened for associations between ADC and malignancy/benignancy of breast lesions up to December 2018. Overall, 123 items were identified. The following data were extracted from the literature: authors, year of publication, study design, number of patients/lesions, lesion type, mean value and standard deviation of ADC, measure method, b values, and Tesla strength. The methodological quality of the 123 studies was checked according to the QUADAS-2 instrument. The meta-analysis was undertaken by using RevMan 5.3 software. DerSimonian and Laird random-effects models with inverse-variance weights were used without any further correction to account for the heterogeneity between the studies. Mean ADC values including 95% confidence intervals were calculated separately for benign and malign lesions. Results The acquired 123 studies comprised 13,847 breast lesions. Malignant lesions were diagnosed in 10,622 cases (76.7%) and benign lesions in 3225 cases (23.3%). The mean ADC value of the malignant lesions was 1.03 × 10− 3 mm2/s and the mean value of the benign lesions was 1.5 × 10− 3 mm2/s. The calculated ADC values of benign lesions were over the value of 1.00 × 10− 3 mm2/s. This result was independent on Tesla strength, choice of b values, and measure methods (whole lesion measure vs estimation of ADC in a single area). Conclusion An ADC threshold of 1.00 × 10− 3 mm2/s can be recommended for distinguishing breast cancers from benign lesions.

scholarly journals Value of magnetic resonance spectroscopy in assessment of adnexal lesions

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Rania S. M. Ibrahim ◽  
Marwa Sh. Abd El Fattah ◽  
Zeinab M. Metwally ◽  
Lamiaa A. S. Eldin
Keyword(s):  
Diagnostic Performance ◽  
Malignant Tumors ◽  
Mean Value ◽  
Resonance Spectroscopy ◽  
Benign Lesions ◽  
1H Mrs ◽  
Conventional Mri ◽  
Malignant Lesions ◽  
The Mean

Abstract Background The purpose of this study is to investigate the role of proton MR spectroscopy (1H-MRS) in the characterization and diagnosis of ovarian lesions. Results From October 2015 to October 2017, a total of 57 female patients (65 adnexal lesions; 8 cases were bilateral) were included. The examined lesions were classified according to their histopathological findings, (37 (57%) benign lesions, 4 (6%) borderline lesions, and 24 (37%) malignant lesions). The mean choline/creatinine (CHO/Cr) ratio was 1.29 ± 0.98 SD for malignant lesions, while the mean value in borderline lesions was 0.63 ± 0.15 SD, and the mean value for the benign lesions was 0.65 ± 0.34. Therefore, the mean CHO/Cr ratio was much higher in malignant than in benign lesions, which was statistically significant (P ≤ 0.001) as well as between the borderline and invasive lesions (P = 0.05), but not between the benign and borderline lesions. The diagnostic performance of conventional MRI in diagnosing adnexal lesions was 100%, specificity was 76%, and accuracy was 86%. However, MRS individual diagnostic performances are the following: sensitivity 89%, specificity, and 100% with an accuracy of 95%. Conclusion MRS proved to be an accurate and efficient method for the analysis of adnexal lesions and in differentiation between benign and malignant tumors.

scholarly journals Qualitative and quantitative strain and shear wave elastography paradigm in differentiation of breast lesions

2022 ◽  
Vol 53 (1) ◽  
Author(s):  
Roaa M. A. Shehata ◽  
Mostafa A. M. El-Sharkawy ◽  
Omar M. Mahmoud ◽  
Hosam M. Kamel
Keyword(s):  
Shear Wave ◽  
Diagnostic Performance ◽  
Strain Ratio ◽  
Breast Lesions ◽  
Breast Masses ◽  
Significant Difference ◽  
Malignant Breast ◽  
Malignant Lesions ◽  
The Mean ◽  
Sensitivity Specificity

Abstract Background Breast cancer is the most common life-threatening cancer in women worldwide. A high number of women are going through biopsy procedures for characterization of breast masses every day and yet 75% of the pathological results prove these masses to be benign. Ultrasound (US) elastography is a non-invasive technique that measures tissue stiffness. It is convenient for differentiating benign from malignant breast tumors. Our study aims to evaluate the role of qualitative ultrasound elastography scoring (ES), quantitative mass strain ratio (SR), and shear wave elasticity ratio (SWER) in differentiation between benign and malignant breast lesions. Results Among 51 female patients with 77 histopathologically proved breast lesions, 57 breast masses were malignant and 20 were benign. All patients were examined by B-mode ultrasound then strain and shear wave elastographic examinations using ultrasound machine (Logiq E9, GE Medical Systems) with 8.5–12 MHz high-frequency probes. Our study showed that ES best cut-off point > 3 with sensitivity, specificity, PPV, NPP, accuracy was 94.7%, 85%, 94.7%, 85%, 90.9%, respectively, and AUC = 0.926 at P < 0.001, mass SR the best cut-off point > 4.6 with sensitivity, specificity, PPV, NPP, accuracy was 96.5%, 80%, 93.2%, 88.9%, 92.2%, respectively, and AUC = 0.860 at P < 0.001, SWER the best cut-off value > 4.9 with sensitivity, specificity, PPV, NPP and accuracy was 91.2%, 80%, 92.9%, 76.2%, 93.5%, respectively, and AUC = 0.890 at P < 0.001. The mean mass strain ratio for malignant lesions is 10.1 ± 3.7 SD and for solid benign lesions 4.7 ± 4.3 SD (p value 0.001). The mean shear wave elasticity ratio for malignant lesions is 10.6 ± 5.4 SD and for benign (solid and cystic) lesions 3.6 ± 4.2 SD. Using ROC curve and Youden index, the difference in diagnostic performance between ES, SR and SWER was not significant in differentiation between benign and malignant breast lesions and also was non-significant difference when comparing them with conventional US alone. Conclusion ES, SR, and SWER have a high diagnostic performance in differentiating malignant from benign breast lesions with no statistically significant difference between them.

scholarly journals Usefulness of contrast-enhanced ultrasound using perfluorobutanecontaining microbubbles as a planning for percutaneous biopsies of focal hepatic lesions: a prospective feasibility study

2019 ◽  
Vol 21 (2) ◽  
pp. 109 ◽  
Author(s):  
Sang Min Lee ◽  
Jung Hoon Kim ◽  
Hyun Kyung Yang ◽  
Hyo-Jin Kang ◽  
Joon Koo Han
Keyword(s):  
Target Lesion ◽  
Technical Failure ◽  
Mr Images ◽  
Point Scale ◽  
Focal Lesions ◽  
Technical Feasibility ◽  
Contrast Enhanced ◽  
Focal Hepatic Lesions ◽  
The Mean ◽  
Hepatic Lesions

Aims: To determine whether contrast-enhanced US using perfluorobutane-containing microbubbles (SEUS) would be helpful for planning a hepatic biopsy.Material and methods: This prospective study included 40 patients who planned to undergo hepatic biopsy for focal hepatic lesions. All patients underwent B-mode US followed by SEUS. The radiologist evaluated the number of detected lesions, presence of necrosis, conspicuity of target lesion and technical feasibility using 4-point scale. Technical failure and occurrence of change of the target were also assessed. Computer tomography (CT) or magnetic resonance (MR) images were the reference techniques. Results: The mean number of lesions detected on CT and MR images was 6.5±8.4. In 20 (50%) of 40 patients, more focal lesions were detected on SEUS. Targeted lesion was changed in sixpatients (15%) on SEUS. Mean number of detected lesions on SEUS was significantly higher comparing with B-US (5.1±6.2 vs. 2.8±3.8, p<0.001). Conspicuity of the targeted lesion was improved in 67.5% (27 of 40) on SEUS and significantly more visualized than B-US (3.6±0.8 vs. 2.8±0.9, p<0.001). In 7 more patients the necrosis within the lesion was visualized (17.5%) using SEUS. The technical feasibility on SEUS was significantly higher than B-US (2.3±1.0 vs. 3.3±0.9, p<0.001). Technical failure was observed in only one patient (2.5%).Conclusions: SEUS is a helpful technique for planning the hepatic biopsyin terms of detection, improving lesion conspicuity, tumor viable portion assessment and consequently higher operator confidence, compared with B-US.

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