scholarly journals Differential Diagnosis of Breast Lesions in Dual-Energy Contrast-Enhanced Spectral Mammography

2021 ◽  
pp. 1-6
Author(s):  
Antonina V. Chernaya ◽  
Antonina V. Chernaya ◽  
Roksana H. Ulyanova ◽  
Petr V. Krivorotko ◽  
Sergey N. Novikov ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Contrast Enhancement ◽  
Diagnostic Performance ◽  
Dual Energy ◽  
Diagnostic Feature ◽  
Breast Lesions ◽  
Benign Lesions ◽  
Enhancement Pattern ◽  
Contrast Enhanced ◽  
Detailed Assessment

Background: Dual-energy contrast-enhanced spectral mammography (CESM) is one of the latest methods for breast lesions characterization, where structural and functional (i.e., vascularization) assessment are combined. Nowadays an interpretation of contrast-enhanced images is based only on the degree of contrast enhancement, but we propose a more detailed assessment of the structure of the hypervascular lesions by highlighting the contrast enhancement patterns. Purpose: To evaluate the diagnostic performance of contrast-enhanced spectral mammography (CESM) using the contrast enhancement patterns in malignant and benign lesions. Material and Methods: Study included 332 women examined from February 2018 to June 2020. The mean age of the women was 50 years. Of 428 lesions totally revealed, 172 (40.2%) were histologically verified as malignant and 256 (59.8%) as benign. We proposed 9 types of contrast enhancement patterns to describe lesions: reticular, granular, annular, diffuse-spherical, lacunar, cloud-like, heterogeneous-annular, point, cotton-like. Results: We showed that diagnostic performance of CESM increased sensitivity if an additional diagnostic feature of contrast enhancement pattern was used: sensitivity increased from 79.7% to 94.8% (p = 0.26), specificity from 82.4% to 95.3% (p = 0.013) and accuracy from 81.3 to 95.1% (p = 0.004), in comparison with using of only one feature of contrast enhancement intensity in the differential diagnosis of malignant and benign lesions. Conclusion: Thus, using contrast enhancement pattern allows to increase the efficiency of CESM in breast cancer detection.

scholarly journals DIFFERENTIAL DIAGNOSTICS OF BREAST PATHOLOGY USING CONTRAST ENHANCEMENT PATTERNS IN CONTRAST-ENHANCED SPECTRAL MAMMOGRAPHY

2020 ◽  
Vol 66 (3) ◽  
pp. 252-261
Author(s):  
Roksana Ulyanova ◽  
A. Chernaya ◽  
Petr Krivorotko ◽  
Sergey Novikov ◽  
Sergey Kanaev ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Contrast Enhancement ◽  
World Literature ◽  
Differential Diagnostics ◽  
Diagnostic Feature ◽  
Benign Lesions ◽  
Intravenous Contrast ◽  
Dynamic Contrast Enhancement ◽  
Contrast Enhanced ◽  
Detailed Assessment

Dual-energy contrast-enhanced spectral mammography (CESM) is a new promising method for visualizing pathological changes in breast, which combines digital mammography and a functional assessment of vascularization using intravenous contrast ehnancement. According to accumulated experience CESM is well tolerated by patients and is similar to magnetic resonance imaging with dynamic contrast enhancement (MRI with DCE), but at the same time, CESM is more affordable and can be performed in patients with contraindications for MRI. However, few studies have been conducted to evaluate the role of CESM. In the world literature, interpretation of contrast images is based only on the degree of accumulation of the contrast agent, but we propose a more detailed assessment of the structure of the hypervascular lesions by highlighting the contrast enhancement patterns. Objective: to determine the diagnostic effectiveness of CESM using the contrast enhancement patterns in malignant and benign lesions. Materials and methods. 239 women with suspicious for breast cancer lesions were examined from August 2018 to December 2019. The mean age of the women was 51 years. 322 lesions were revealed, 149 (46.3%) were malignant, 173 (53.7%) were benign. All lesions were histologically confirmed. As a result of the analysis of our data, 9 types of contrast enhancement patterns were distinguished: reticulate, granular, annular, diffuse-spherical, lacunar, cloud-like, heterogeneous-annular, point, cotton-like. Results. Using an additional diagnostic feature - contrast enhancement patterns in lesions, increased the sensitivity of CESM from 91.3% to 98.0% (p=0.26), specificity from 80.3% to 93, 6% (p=0.013), accuracy from 85.4 to 95.7% (p=0.004) in comparison with using of only one feature of contrast enhancement intensity in the differential diagnosis of malignant and benign lesions. Conclusion: thus, this approach of interpreting subtraction images allows to increase the efficiency of CESM in diagnosis of breast cancer.

Differential Diagnosis of Spine Tumors: My Favorite Mistake

2019 ◽  
Vol 23 (01) ◽  
pp. 026-035 ◽  
Author(s):  
Domenico Albano ◽  
Carmelo Messina ◽  
Salvatore Gitto ◽  
Olympia Papakonstantinou ◽  
Luca Sconfienza
Keyword(s):  
Differential Diagnosis ◽  
Pulse Sequences ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Imaging Features ◽  
Correct Interpretation ◽  
Benign Lesions ◽  
Contrast Enhanced ◽  
Robust Reliability

AbstractImaging has a pivotal role in the detection and characterization of spine bone tumors (SBTs), especially using magnetic resonance (MR) imaging and computed tomography (CT). Although MR performed with conventional pulse sequences has a robust reliability in the assessment of SBTs, some imaging features of benign lesions and malignancies overlap, making the differential diagnosis challenging. Several imaging tools are now available to perform a correct interpretation of images of SBTs including diffusion-weighted imaging, dynamic contrast-enhanced MR, Dixon sequences, and dual-energy CT. Nevertheless, strengths and weaknesses of imaging modalities should be kept in mind, and it is crucial to be aware of the pitfalls that can be encountered in daily clinical practice when dealing with these lesions. This review provides an overview on the main challenges encountered when dealing with SBTs, providing some tricks of the trade to avoid possible diagnostic traps.

scholarly journals Value of Contrast-Enhanced Ultrasound in Differential Diagnosis of Focal Liver Lesions

2017 ◽  
pp. 36-52
Author(s):  
E. I. Peniaeva ◽  
J. R. Kamalov ◽  
A. N. Sencha ◽  
U. N. Patrunov ◽  
E. A. Sencha
Keyword(s):  
Differential Diagnosis ◽  
Contrast Enhancement ◽  
Complex Analysis ◽  
Final Diagnosis ◽  
Arterial Phase ◽  
Focal Liver Lesions ◽  
Diagnostic Feature ◽  
Liver Lesions ◽  
Contrast Enhanced ◽  
Venous Phase

Purpose:to evaluate the diagnostic value of contrastenhanced ultrasound (CEUS) with SonoVue in differential diagnosis of focal liver lesions (FLL) in a multidisciplinary clinic in Russian Federation.Materials and methods. Bolus intravenous administration of 1.2 ml of SonoVue (Bracco Swiss CA, Switzerland) followed with 5ml saline flush was used for liver CEUS. We utilized the scanners Mindray DC-8 (Mindrаy, China), Logiq S8 (GE, USA), Philips Epiq 7 (Philips, Holland), SonoScape S9 (SonoScape, China), Hitachi Ascendus (Hitachi, Japan) with 3.0–5.0 MHz convex probes in specialized “contrast” mode with low mechanic index (MI 0.08–0.1). The study conferred 73 patients in the age between 18 and 84 years (mean age 49 years) with FLL. CEUS was performed in 22 patients with previously verified diagnosis, while the rest of patients underwent CEUS before the final diagnosis. Contrast-enhanced liver CT was performed in all patients. In 49 (67.12%) of 73 cases, a pathology was performed after a targeted core-needle biopsy or autopsy. Qualitative features of US contrast enhancement of FLL were evaluated.Results. Qualitative aspects of CEUS for differentiation of FLL were defined. The principal sign for diagnosis between benign and malignant masses with CEUS was hypoenhancement of malignant lesions in comparison to surrounding normal parenchyma in portal and late venous phase (p ≤ 0.01). Alternatively, hyper- or isoenhancement throughout late venous phase was characteristic for benign FLL. Diffuse heterogeneous contrast enhancement was indicative of malignant FLL, and homogeneous – for benign. Additional diagnostic feature (p ≤ 0.05) was the type of contrast enhancement in the arterial phase. Heterogeneous diffuse contrast enhancement was observed in malignant FLL, while homogeneous – in benign FLL. Peripheral nodular contrast enhancement with centripetal filling was characteristic for liver hemangioma, centrifugal filling with “spoke-wheel” vascular pattern – for FNH, and peripheral rim-like hyperenhancement with rapid achievement of hypoenhancement at the beginning of the portal phase – for liver metastasis.Conclusion.Complex analysis of qualitative characteristics of CEUS with SonoVue is a promising option for differential diagnosis of FLL (sensitivity 92.85%, specificity 91.3%, diagnostic accuracy 92.15%) and can be utilized in daily practice.

Application of Contrast-Enhanced Ultrasound in the Differential Diagnosis of Different Molecular Subtypes of Breast Cancer

2020 ◽  
Vol 42 (6) ◽  
pp. 261-270
Author(s):  
Xingyu Liang ◽  
Ziyao Li ◽  
Lei Zhang ◽  
Dongmo Wang ◽  
Jiawei Tian
Keyword(s):  
Breast Cancer ◽  
Contrast Enhancement ◽  
Triple Negative ◽  
Breast Lesions ◽  
Luminal Epithelium ◽  
Enhancement Pattern ◽  
Over Expression ◽  
Contrast Enhanced ◽  
Her 2 ◽  
Triple Negative Subtype

To explore the value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of molecular subtypes of breast cancer. Sixty-two cases of breast cancer were divided into luminal epithelium A or B subtype (luminal A/B), Her-2 over-expression subtype and triple negative subtype (TN). CEUS and routine ultrasonography were performed for all patients before surgery. (1) The luminal epithelium subtype contrast enhancement pattern was more likely to present with radial edge (76.92%, p < 0.05) and low perfusion (69.23%, p < 0.05). The maximum intensity (IMAX) was lower in the luminal epithelium subtype ( p < 0.05). (2) The Her-2 over-expression subtype contrast enhancement pattern was more likely to present with centripetal enhancement (93.75%, p < 0.05) and perfusion defect (75.0%, p < 0.05), and the time to peak (TTP) was shorter (80.0%, p < 0.05). (3) The contrast enhancement pattern of the triple negative subtype was shown to have a clear boundary. Compared to the other two subtypes, the triple negative subtype did not have significantly different perfusion parameters ( p > 0.05). (4) Our study showed that the areas under the ROC curve for radial edge, low perfusion and IMAX for the luminal epithelium subtype breast lesions were 76.5%, 75.6%, and 82.1%, respectively. Additionally, the areas under the ROC curve for centripetal enhancement, perfusion defect and TTP for the Her-2 over-expression subtype breast lesions were 68.6%, 92.4%, and 97.8%, respectively. The sensitivity, specificity, and diagnostic accuracy of clear boundaries in detecting triple negative subtype breast lesions were 90.5%, 80.0%, and 91.9%, respectively.

Diagnostic performance of contrast-enhanced dual-energy spectral mammography (CESM): a retrospective study involving 644 breast lesions

2019 ◽  
Vol 124 (10) ◽  
pp. 1006-1017 ◽  
Author(s):  
María del Mar Travieso-Aja ◽  
Daniel Maldonado-Saluzzi ◽  
Pedro Naranjo-Santana ◽  
Claudia Fernández-Ruiz ◽  
Wilsa Severino-Rondón ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Diagnostic Performance ◽  
Dual Energy ◽  
Breast Lesions ◽  
Contrast Enhanced

scholarly journals Contrast-Enhanced Ultrasound in the Differential Diagnosis of Primary Thyroid Lymphoma and Nodular Hashimoto’s Thyroiditis in a Background of Heterogeneous Parenchyma

2021 ◽  
Vol 10 ◽  
Author(s):  
Lulu Yang ◽  
Haina Zhao ◽  
Yushuang He ◽  
Xianglan Zhu ◽  
Can Yue ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Hashimoto’S Thyroiditis ◽  
Diagnostic Performance ◽  
Roc Curves ◽  
Hashimoto's Thyroiditis ◽  
Imaging Features ◽  
Contrast Enhanced Ultrasound ◽  
Thyroid Lymphoma ◽  
Contrast Enhanced ◽  
Primary Thyroid Lymphoma

ObjectiveTo investigate the diagnostic performance of contrast-enhanced ultrasound (CEUS) in the differentiation of primary thyroid lymphoma (PTL) and nodular Hashimoto’s thyroiditis (NHT) in patients with background of heterogeneous diffuse Hashimoto’s thyroiditis (HT).MethodsSixty HT patients with 64 thyroid nodules (31 PTL and 33 NHT) who had undergone CEUS examination were included in this study. With histopathological results as the reference, we evaluated the imaging features of each nodule on both conventional ultrasonography (US) and CEUS. Quantitative CEUS parameters including peak intensity (PI), time to peak (TTP), and area under the time–intensity curve (AUC) were gathered in the nodule and background parenchyma. The ratio indexes of theses parameters were calculated by the ratio of the lesion and the corresponding thyroid parenchyma. Logistic regression and receiver operating characteristic (ROC) curves analyses of valuable US indicators were further preformed to evaluate the diagnostic capability of CEUS in discrimination of PTL and NHT.ResultsAmong all the observed US imaging features and CEUS parameters, 10 indicators showed significant differences between PTL and NHT (all P &lt; 0.05). All the significant indicators were ranked according to the odds ratios (ORs). Eight of them were CEUS associated including imaging features of enhancement pattern, degree, homogeneity, and quantification parameters of PI, AUC, ratios of PI, AUC, and TTP, while indicators on conventional US, including vascularity and size ranked the last two with ORs less than 3. The five single CEUS parameters showed good diagnostic performance in diagnosis of PTL with areas under ROC curves of 0.72–0.83 and accuracies of 70.3–75.0%. The combination of CEUS imaging features and the ratios of PI, AUC, and TTP demonstrated excellent diagnostic efficiency and achieved area under ROC curve of 0.92, which was significantly higher than any of the five single parameters (all P &lt; 0.05), with a sensitivity of 83.9%, specificity of 87.9%, and accuracy of 85.9%.ConclusionsCEUS is an efficient diagnostic tool in the differential diagnosis of PTL and NHT for patients with diffuse HT. Conjoint analysis of CEUS imaging features and quantification parameters could improve the diagnostic values.

Diagnostic Accuracy of Mammography and Contrast-Enhanced MR Imaging in 238 Histologically Verified Breast Lesions

1997 ◽  
Vol 38 (4) ◽  
pp. 489-496 ◽  
Author(s):  
B. Boné ◽  
Z. Péntek ◽  
L. Perbeck ◽  
B. Veress
Keyword(s):  
Mr Imaging ◽  
Breast Surgery ◽  
Histopathological Examination ◽  
High Sensitivity ◽  
Histopathological Diagnosis ◽  
Breast Lesions ◽  
Benign Lesions ◽  
Post Contrast ◽  
X Ray ◽  
Contrast Enhanced

Purpose: To determine the sensitivity and specificity of X-ray mammography and of MR imaging in 238 consecutively operated breasts, and to correlate the findings to histopathological diagnosis. Material and Methods: Over 15 months, 220 patients scheduled for breast surgery were examined consecutively, before surgery, by means of both mammography and MR imaging. of the 220 patients, 18 underwent bilateral breast surgery. The entire breast was examined by means of T1-weighted transversal images using a 3D fast low-angle shot (FLASH) sequence. One pre— and 2 post-contrast scans were performed. Each breast was examined by means of mammography and 3 views were applied as routine. All palpable and mammographically suspect lesions were examined on additional images as microfocus magnification or spot compression. The two methods were evaluated independently of each other. Results: In total, 145 malignant and 93 benign lesions were found at histopathological examination. The sensitivity of mammography was 89% and MR imaging 92%. The specificity was 72% in both methods. When the results of the 2 methods were combined, a sensitivity of 99% and a specificity of 55% was achieved. Conclusion: Mammography and MR imaging seemed to complement each other to produce a high sensitivity. Unfortunately it is impossible at present to supplement mammography with MR imaging in each patient as a routine owing to the current technical and financial limitations.

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