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 Background To determine the benefit of contrast-enhanced ultrasound (CEUS) in the assessment of breast lesions. 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. Conclusions 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 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 Количественный анализ трансректального ультразвукового исследования с контрастным усилением в диагностике рака предстательной железы (индексы): предварительные результаты

2020 ◽  
pp. 12-25
Keyword(s):  
Prostate Cancer ◽  
Quantitative Analysis ◽  
Transit Time ◽  
Rise Time ◽  
Mean Transit Time ◽  
Contrast Enhanced Ultrasound ◽  
Time To Peak ◽  
Quantitative Parameters ◽  
Peak Intensity ◽  
Contrast Enhanced

Цель исследования - выявление наиболее информативных относительных количественных показателей (индексов) ТРУЗИ с КУ в диагностике РПЖ с использованием результатов прицельной биопсии под контролем ТРУЗИ. Материал и методы исследования: обследовано 75 пациентов с подозрением на рак предстательной железы по данным пальцевого ректального исследования и (или) повышением уровня общего простатспецифического антигена сыворотки крови. При этом обязательным условием было наличие гипоэхогенных очагов в периферической зоне предстательной железы. Всем пациентам проводилась системная и прицельная биопсия. Прицельная биопсия осуществлялась из гипоэхогенных очагов - зон интереса, которые были предварительно выбраны для количественного анализа контрастного усиления. В соответствии с морфологическими данными были выделены две группы очагов: 30 очагов в группе “РПЖ” (основная группа) и 45 очагов в группе “не РПЖ” (группа сравнения). ТРУЗИ выполнялись на аппарате Epiq 5 (Philips, Нидерланды) внутриполостным микроконвексным датчиком 4-10 МГц. Использовался ультразвуковой контрастный препарат Соновью (Bracco Swiss S.A., Швейцария). При анализе кривой “время-интенсивность” оценивались следующие безразмерностные индексы, представляющие собой отношение соответствующих абсолютных параметров в зоне интереса и эталонной зоне: индекс WIR (wash-in rate), индекс TTP (time to peak), индекс PI (peak intensity), индекс MTT (mean transit time), индекс TPH (time from peak to one half) и индекс RT (rise time). Результаты исследования: достоверные различия между группами получены по индексам WIR (P 0,0001), PI (P 0,0001), TTP (P = 0,0008) и RT (P = 0,0248). Тест “индекс PI > 1,174 - рак предстательной железы” характеризуется чувствительностью 83,3%, специфичностью 88,9%, предсказательной ценностью положительного теста 83,3%, предсказательной ценностью отрицательного теста 88,9%, AUC 0,910. Тест “индекс WIR > 1,432 - рак предстательной железы” характеризуется чувствительностью 76,7%, специфичностью 82,2%, предсказательной ценностью положительного теста 74,2%, предсказательной ценностью отрицательного теста 84,1%, AUC 0,808. Тест “индекс TTP ≤ 0,936 - рак предстательной железы” характеризуется чувствительностью 73,3%, специфичностью 66,7%, предсказательной ценностью положительного теста 59,5%, предсказательной ценностью отрицательного теста 78,9%, AUC 0,729. Определяется достоверная корреляция умеренной силы между суммой Глисона и индексом PI (rS = 0,394, P = 0,0311). Выводы: использование относительных параметров (индексов) количественного анализа трансректального ультразвукового исследования с контрастным усилением может привести к повышению эффективности прицельных биопсий. Индексы отличаются большей информативностью, чем абсолютные параметры. Ключевые слова: ультразвуковое исследование с контрастным усилением, количественный анализ, количественные относительные параметры, индексы, перфузия, предстательная железа, рак предстательной железы, contrast-enhanced ultrasound (CEUS), quantitative analysis, relative quantitative parameters, indices, perfusion, prostate, prostate cancer

scholarly journals Quantification of dynamic contrast-enhanced ultrasound (CEUS) in non-cystic breast lesions using external perfusion software

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ernst Michael Jung ◽  
Friedrich Jung ◽  
Christian Stroszczynski ◽  
Isabel Wiesinger
Keyword(s):  
Breast Cancer ◽  
Mean Transit Time ◽  
Scar Tissue ◽  
Surrounding Tissue ◽  
Breast Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Benign Lesions ◽  
Asymptomatic Patients ◽  
Contrast Enhanced ◽  
Malignant Lesions

AbstractThe aim of this present clinical pilot study is the display of typical perfusion results in patients with solid, non-cystic breast lesions. The lesions were characterized using contrast enhanced ultrasound (CEUS) with (i) time intensity curve analyses (TIC) and (ii) parametric color maps. The 24 asymptomatic patients included were genetically tested for having an elevated risk for breast cancer. At a center of early detection of familial ovary and breast cancer, those patients received annual MRI and grey-scale ultrasound. If lesions remained unclear or appeared even suspicious, those patients also received CEUS. CEUS was performed after intravenous application of sulfur hexafluoride microbubbles. Digital DICOM cine loops were continuously stored for one minute in PACS (picture archiving and communication system). Perfusion images and TIC analyses were calculated off-line with external perfusion software (VueBox). The lesion diameter ranged between 7 and 15 mm (mean 11 ± 3 mm). Five hypoechoic irregular lesions were scars, 6 lesions were benign and 12 lesions were highly suspicious for breast cancer with irregular enhancement at the margins and a partial wash out. In those 12 cases, histopathology confirmed breast cancer. All the suspicious lesions were correctly identified visually. For the perfusion analysis only Peak Enhancement (PE) and Area Under the Curve (AUC) added more information for correctly identifying the lesions. Typical for benign lesions is a prolonged contrast agent enhancement with lower PE and prolonged wash out, while scars are characterized typically by a reduced enhancement in the center. No differences (p = 0.428) were found in PE in the center of benign lesions (64.2 ± 28.9 dB), malignant lesions (88.1 ± 93.6 dB) and a scar (40.0 ± 17.0 dB). No significant differences (p = 0.174) were found for PE values at the margin of benign lesions (96.4 ± 144.9 dB), malignant lesions (54.3 ± 86.2 dB) or scar tissue (203.8 ± 218.9 dB). Significant differences (p < 0.001) were found in PE of the surrounding tissue when comparing benign lesions (33.6 ± 25.2 dB) to malignant lesions (15.7 ± 36.3 dB) and scars (277.2 ± 199.9 dB). No differences (p = 0.821) were found in AUC in the center of benign lesions (391.3 ± 213.7), malignant lesions (314.7 ± 643.9) and a scar (213.1 ± 124.5). No differences (p = 0.601) were found in AUC values of the margin of benign lesions (313.3 ± 372.8), malignant lesions (272.6 ± 566.4) or scar tissue (695.0 ± 360.6). Significant differences (p < 0.01) were found in AUC of the surrounding tissue for benign lesions (151.7 ± 127.8), malignant lesions (177.9 ± 1345.6) and scars (1091 ± 693.3). There were no differences in perfusion evaluation for mean transit time (mTT), rise time (RT) and time to peak (TTP) when comparing the center to the margins and the surrounding tissue. The CEUS perfusion parameters PE and AUC allow a very good assessment of the risk of malignant breast lesions and thus a downgrading of BI-RADS 4 lesions. The use of the external perfusion software (VueBox, Bracco, Milan, Italy) did not lead to any further improvement in the diagnosis of suspicious breast lesions and does appears not to have any additional diagnostic value in breast lesions.

scholarly journals Continuous Dynamic Registration of Microvascularization of Liver Tumors with Contrast-Enhanced Ultrasound

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Lukas Philipp Beyer ◽  
Benedikt Pregler ◽  
Isabel Wiesinger ◽  
Christian Stroszczynski ◽  
Philipp Wiggermann ◽  
...  
Keyword(s):  
Liver Tumors ◽  
Malignant Tumors ◽  
Regional Blood Flow ◽  
Late Phase ◽  
Diagnostic Value ◽  
Arterial Phase ◽  
Contrast Enhanced Ultrasound ◽  
Time To Peak ◽  
Contrast Enhanced ◽  
Significant Difference

Aim.To evaluate the diagnostic value of quantification of liver tumor microvascularization using contrast-enhanced ultrasound (CEUS) measured continuously from the arterial phase to the late phase (3 minutes).Material and Methods.We present a retrospective analysis of 20 patients with malignant (n=13) or benign (n=7) liver tumors. The tumors had histopathologically been proven or clearly identified using contrast-enhanced reference imaging with either 1.5 T MRI (liver specific contrast medium) or triphase CT and follow-up. CEUS was performed using a multifrequency transducer (1–5 MHz) and a bolus injection of 2.4 mL sulphur hexafluoride microbubbles. A retrospective perfusion analysis was performed to determine TTP (time-to-peak), RBV (regional blood volume), RBF (regional blood flow), and Peak.Results.Statistics revealed a significant difference (P<0.05) between benign and malignant tumors in the RBV, RBF, and Peak but not in TTP (P=0.07). Receiver operating curves (ROC) were generated for RBV, RBF, Peak, and TTP with estimated ROC areas of 0.97, 0.96, 0.98, and 0.76, respectively.Conclusion.RBV, RBF, and Peak continuously measured over a determined time period of 3 minutes could be of valuable support in differentiating malignant from benign liver tumors.

scholarly journals Количественный анализ трансректального ультразвукового исследования с контрастным усилением в диагностике рака предстательной железы (абсолютные параметры): предварительные результаты

2020 ◽  
pp. 13-26
Keyword(s):  
Prostate Cancer ◽  
Quantitative Analysis ◽  
Transit Time ◽  
Rise Time ◽  
Mean Transit Time ◽  
Contrast Enhanced Ultrasound ◽  
Time To Peak ◽  
Peak Intensity ◽  
Contrast Enhanced

Цель исследования - выявление наиболее информативных абсолютных количественных показателей трансректального ультразвукового исследования с контрастным усилением в диагностике рака предстательной железы. Обследовано 75 пациентов с подозрением на рак предстательной железы. Критериями включения являлись подозрительные результаты пальце вого ректального исследования и (или) повышение уровня общего простатспецифического антигена сыворотки крови при наличии подозрительных (гипоэхогенных) очагов в периферической зоне ПЖ, выявленных при серошкальном ТРУЗИ. Во всех случаях трансректальное ультразвуковое исследование с контрастным усилением было выполнено до установления окончательного диагноза. Ультразвуковые исследования выполнялись на аппарате Epiq 5 (Philips, Нидерланды) с помощью высокочастотного внутриполостного датчика, работающего в диапазоне частот 4-10 МГц. Использовался ультразвуковой контрастный препарат Соновью (Bracco Swiss S.A., Швейцария). Прицельная биопсия осуществлялась из гипоэхогенных очагов - зон интереса, которые были предварительно выбраны для количественного анализа контрастного усиления. В зависимости от результатов гистологического исследования материала, полученного при помощи прицельной биопсии, исследуемые очаги были распределены на две группы: основная группа (РПЖ), включающая верифицированный рак предстательной железы в зоне интереса (n = 30), и группа сравнения (не РПЖ), включающая отсутствие верификации рака предстательной железы в зоне интереса (n = 45). При анализе кривой “время-интенсивность” оценивались следующие параметры: 1) скорость нарастания (WIR (wash-in rate)) (дБ/с); 2) время до пика интенсивности (TTP (time to peak)) (с); 3) пиковая интенсивность (PI (peak intensity)) (дБ); 4) среднее время транзита (MTT (mean transit time)) (с); 5) время полувыведения (DT/2 (descending time/2)) (с); 6) время роста (RT (rise time)) (с). Достоверные различия в зонах интереса между группами получены по пара метрам WIR (P = 0,0026) и RT (P = 0,0047). Тест “WIR > 2,114 дБ/с - рак предстательной железы” характеризуется чувствительностью 50,0%, специфичностью 84,4%, предсказательной ценностью положительного теста 68,2%, предска зательной ценностью отрицательного теста 71,7%, AUC 0,706. Тест “RT ≤ 6,718 с - рак предстательной железы” характеризуется чувствительностью 70,0%, специфичностью 66,7%, предсказательной ценностью положительного теста 58,3%, предсказательной ценностью отрицательного теста 76,9%, AUC 0,694. Определяются достоверные корреляции суммы Глисона с WIR (rS = 0,521, P = 0,0032), TTP (rS = -0,503, P = 0,0046) и PI (rS = 0,378, P = 0,0393). Использование абсолютных параметров количественного анализа трансректального ультразвукового исследования с контрастным усилением может привести к повышению эффективности прицельных биопсий. Ключевые слова: трансректальное ультразвуковое исследование с контрастным усилением, количественный анализ, перфузия, предстательная железа, рак предстательной железы, contrast-enhanced ultrasound (CEUS), quantitative analysis, perfusion, prostate, prostate cancer

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