The Diagnostic Value of Multi-Modal Ultrasound on the Ovarian Serous Surface Papillary Borderline Tumor

Author(s):  
Lijun Xie ◽  
Xinxiu Liu ◽  
Min Chen ◽  
Haiying Li ◽  
Liyan Huang ◽  
...  

Abstract Background: Compared with epithelial ovarian cancer, borderline ovarian tumor has earlier onset age and better prognosis. Ovarian serous surface papillary borderline tumor (SSPBT) is a special subtype of ovarian serous borderline tumor, which is rare in clinic. It is easy to be misdiagnosed as malignant before operation. SSPBT usually occurs in women of childbearing age. The operation of preserving fertility can have a higher pregnancy rate. Therefore, preoperative ultrasound for qualitative diagnosis of SSPBT is of great significance in the selection of surgical methods and treatment. There are few reports on the imaging of SSPBT, and the multimodal ultrasound features of SSPBT combined with conventional ultrasound, two-dimensional and three-dimensional contrast-enhanced ultrasound have not been reported. The purpose of this article is to explore the multimodal ultrasonic characteristics of ovarian SSPBT, combining its clinical and pathological features.Result: The conventional ultrasound of ovarian SSPBT was characterized by large patchy substantial masses wrapped around the ovary.Large flaky dense fine anechoic areas could be seen in the parenchyma,accompanied by speckle strong echo with different degrees.Peritoneal implants were observed in 3 cases(60%)and ascites were found in 4 cases(80%).On further contrast-enhanced ultrasonography,with reference to the myometrium,the tumor on 2D-CEUS showed synchronous or delayed eccentric and inhomogeneous enhancement,and subsided earlier than the uterine wall.The tortuously running tumor trophoblast vessels from the periovarian of the affected side could be further observed clearly and stereospecially on 3D-CEUS.Angiographic rising time(RT),time to peak(TTP),peak intensity(PI),area under the curve(AUC)and half time of descending peak intensity(HT)were significantly different from those of the myometrium(P<0.05).The speckled strong echo observed by conventional ultrasound was correlated with the sand body of the fiber stalk axis in the papillary structure under pathological microscope,while the tortuosity and dilation of microvessels in the fibrous connective tissue axis was the pathological basis of their CEUS perfusion.Conclusion: There are characteristic manifestations of ovarian SSPBT on multimodal ultrasound,which are closely related to the pathological structure.Multimodal ultrasound has important reference value in the diagnosis of ovarian SSPBT.

Author(s):  
Yi Dong ◽  
Yijie Qiu ◽  
Daohui Yang ◽  
Lingyun Yu ◽  
Dan Zuo ◽  
...  

OBJECTIVE: To investigate the clinical value of dynamic contrast enhanced ultrasound (D-CEUS) in predicting the microvascular invasion (MVI) of hepatocellular carcinoma (HCC). PATIENTS AND METHODS: In this retrospective study, 16 patients with surgery and histopathologically proved HCC lesions were included. Patients were classified according to the presence of MVI: MVI positive group (n = 6) and MVI negative group (n = 10). Contrast enhanced ultrasound (CEUS) examinations were performed within a week before surgery. Dynamic analysis was performed by VueBox ® software (Bracco, Italy). Three regions of interests (ROIs) were set in the center of HCC lesions, at the margin of HCC lesions and in the surrounding liver parenchyma accordingly. Time intensity curves (TICs) were generated and quantitative perfusion parameters including WiR (wash-in rate), WoR (wash-out rate), WiAUC (wash-in area under the curve), WoAUC (wash-out area under the curve) and WiPi (wash-in perfusion index) were obtained and analyzed. RESULTS: All of HCC lesions showed arterial hyperenhancement (100 %) and at the late phase as hypoenhancement (75 %) in CEUS. Among all CEUS quantitative parameters, the WiAUC and WoAUC were higher in MVI positive group than in MVI negative group in the center HCC lesions (P <  0.05), WiAUC, WoAUC and WiPI were higher in MVI positive group than in MVI negative group at the margin of HCC lesions. WiR and WoR were significant higher in MVI positive group. CONCLUSIONS: D-CEUS with quantitative perfusion analysis has potential clinical value in predicting the existence of MVI in HCC lesions.


2021 ◽  
pp. 197140092199897
Author(s):  
Sarv Priya ◽  
Caitlin Ward ◽  
Thomas Locke ◽  
Neetu Soni ◽  
Ravishankar Pillenahalli Maheshwarappa ◽  
...  

Objectives To evaluate the diagnostic performance of multiple machine learning classifier models derived from first-order histogram texture parameters extracted from T1-weighted contrast-enhanced images in differentiating glioblastoma and primary central nervous system lymphoma. Methods Retrospective study with 97 glioblastoma and 46 primary central nervous system lymphoma patients. Thirty-six different combinations of classifier models and feature selection techniques were evaluated. Five-fold nested cross-validation was performed. Model performance was assessed for whole tumour and largest single slice using receiver operating characteristic curve. Results The cross-validated model performance was relatively similar for the top performing models for both whole tumour and largest single slice (area under the curve 0.909–0.924). However, there was a considerable difference between the worst performing model (logistic regression with full feature set, area under the curve 0.737) and the highest performing model for whole tumour (least absolute shrinkage and selection operator model with correlation filter, area under the curve 0.924). For single slice, the multilayer perceptron model with correlation filter had the highest performance (area under the curve 0.914). No significant difference was seen between the diagnostic performance of the top performing model for both whole tumour and largest single slice. Conclusions T1 contrast-enhanced derived first-order texture analysis can differentiate between glioblastoma and primary central nervous system lymphoma with good diagnostic performance. The machine learning performance can vary significantly depending on the model and feature selection methods. Largest single slice and whole tumour analysis show comparable diagnostic performance.


2020 ◽  
Vol 06 (03) ◽  
pp. E76-E86
Author(s):  
Diletta Cozzi ◽  
Simone Agostini ◽  
Elena Bertelli ◽  
Michele Galluzzo ◽  
Emanuela Papa ◽  
...  

AbstractConventional ultrasound imaging (US) is the first-line investigation in acute non-traumatic abdominal emergencies, but sometimes it needs further examinations, such as computed tomography (CT), to reach a certain diagnosis. Contrast-enhanced ultrasound (CEUS), through injection of contrast medium, may provide the radiologist with additional information that could not be investigated with baseline US. It could help reach a diagnosis and rapidly determine the proper therapy in an emergency setting. The purpose of this review is to explain and illustrate the various possibilities and limitations of CEUS in acute non-traumatic abdominal diseases, in particular acute inflammation, parenchymal infarcts, and hemorrhages.


2021 ◽  
pp. 028418512110258
Author(s):  
Lan Li ◽  
Tao Yu ◽  
Jianqing Sun ◽  
Shixi Jiang ◽  
Daihong Liu ◽  
...  

Background The number of metastatic axillary lymph nodes (ALNs) play a crucial role in the staging, prognosis and therapy of patients with breast cancer. Purpose To predict the number of metastatic ALNs in breast cancer via radiomics. Material and Methods We enrolled 197 patients with breast cancer who underwent dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). A total of 3386 radiomic features were extracted from the early- and delayed-phase subtraction images. To classify the number of metastatic ALNs, logistic regression was used to develop a radiomic signature and nomogram. Results The radiomic signature were constructed to distinguish the N0 group from the N+ (metastatic ALNs ≥ 1) group, which yielded area under the curve (AUC) values of 0.82 and 0.81 in the training and test group, respectively. Based on the radiomic signature and BI-RADS category, a nomogram was further developed and showed excellent predictive performance with AUC values of 0.85 and 0.89 in the training and test groups, respectively. Another radiomic signature was constructed to distinguish the N1 (1–3 ALNs) group from the N2–3 (≥4 metastatic ALNs) group and showed encouraging performance with AUC values of 0.94 and 0.84 in training and test group, respectively. Conclusions We developed a nomogram and a radiomic signature that can be used to predict ALN metastasis and distinguish the N1 from the N2-3 group. Both nomogram and radiomic signature may be potential tools to assist clinicians in assessing ALN metastasis in patients with breast cancer.


2019 ◽  
Vol 16 (6) ◽  
pp. 37-46
Author(s):  
Adina Cociorvei

AbstractAbdominal contrast enhanced ultrasound (CEUS) is a relatively new investigation method that combines conventional ultrasound with a small amount of intravenous contrast through a peripheral vein (usually the cubital vein). The contrast is made by very small gas microbubbles floating in a phospholipid suspension. The size of microbubbles are between 1-10 micrometers, being to large to go out of the vessels, but sufficiently small to stay into the capillaries, and this is the reason for they can be used as vascular tracers. So, it is possible to obtain images with microvessels inside of different organs in different vascular phases (arterial, portal, venous), images that are similar with the one obtained in CECT and CEMRI.The intravenous contrast used in CEUS eliminates trough the lungs, during expiration. These is the reason why the most important contraindication for using iv contrast is severe respiratory failure. Also, it is important that intravenous contrast is not allergenic, the percentage of allergic reaction being extremly small (0,001%).The most important advantages of CEUS are:• It can be safely used for the pacients that are allergic to intravenous contrast used in CECT and CEMRI;• It can be used in pacients with chronic kidney disease;Abdominal contrast enhanced ultrasound is used in day-to-day practice mainly for evaluation of hepatic lesions, but also for pancreatic, kidney, testis pathology, as well as for inflammatory bowel diseases.


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