Contrast-enhanced ultrasound (CEUS) for the evaluation of gallbladder diseases in comparison to cross-sectional imaging modalities and histopathological results

Background Renal pseudotumors appear as benign cortical hypertrophies and are typically assessed by contrast-enhanced computed tomography or magnetic resonance imaging to rule out malignancy. Purpose To investigate whether contrast-enhanced ultrasound (CEUS) can rule out renal neoplasm and thus potentially reduce cross-sectional imaging and further follow-up in these patients. Material and Methods Thirty-two patients with presumption of developmental renal pseudotumor on CEUS between June 2011 and July 2019 were retrospectively analyzed. All patients were examined with a standardized renal US protocol including B-mode, color-coded duplex sonography (CCDS), and CEUS by an experienced radiologist (EFSUMB level 3). Images were retrospectively interpreted in consensus by two highly experienced radiologists. Histopathological reports, cross-sectional imaging findings, and clinical course (treatment response, long-term imaging follow-up) were defined as standard of reference. Results CEUS correctly identified 8/9 neoplastic lesions and missed one oncocytoma within the 32 included patients. Irregular vessel structure (88.9% vs. 13.0%, P = 0.007) and hyperenhancement (66.6% vs. 17.4%, P = 0.031) on CEUS were more common in neoplasm compared to developmental pseudotumors reaching statistical significance. Compared with the standard of reference, CEUS had 89% sensitivity (95% confidence interval [CI] 57–98), 96% specificity (95% CI 80–99), a positive predictive value of 89% (95% CI 57–98), and a negative predictive value of 96% (95% CI 79–99) for ruling out renal malignancy in developmental pseudotumors. Conclusion CEUS is a safe and fast method to rule out neoplasm in the diagnostic work-up of renal pseudotumors. In conjunction with B-mode and CCDS, CEUS has the potential to reduce further (invasive) diagnostic procedures.

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Using Contrast-Enhanced Ultrasound in Addition to Cross-Sectional Imaging for Indeterminate Renal Cysts May Lead to Overclassification in Bosniak III Category: A Case-Control Study

European Surgical Research ◽

10.1159/000517405 ◽

2021 ◽

pp. 1-6

Author(s):

François Audenet ◽

Jordan Sapetti ◽

Christophe Delavaud ◽

Virginie Verkarre ◽

Jean-Michel Correas ◽

...

Keyword(s):

Lower Risk ◽

Renal Cyst ◽

Renal Cysts ◽

Contrast Enhanced Ultrasound ◽

Pathological Findings ◽

Cross Sectional ◽

Contrast Enhanced ◽

Risk Of Malignancy ◽

Cross Sectional Imaging ◽

Sectional Imaging

Introduction: Indeterminate renal cysts may require several imaging modalities before clinical decision. The aim of this study was to investigate the effect of the imaging modality used to characterize indeterminate renal cysts on the pathological findings after surgical resection. Methods: From our institutional database, we identified all patients surgically treated for Bosniak III renal masses between January 2008 and January 2018. All complex renal cysts were characterized with a combination of computed tomography (CT) and/or magnetic resonance imaging (MRI), and/or contrast-enhanced ultrasound (CEUS) and discussed during a multidisciplinary tumor board. Potential association between clinical/radiological characteristics and the pathological findings were investigated, using univariate and multivariate analyses. Results: Of the 52 renal cystic lesions surgically removed, with a preoperative diagnosis of Bosniak III renal cyst, 19 (37%) were malignant and 33 (63%) were benign. The proportion of malignant lesions decreased from 47% when the renal cyst was characterized with cross-sectional imaging (CT and/or MRI) to 17% when the diagnosis required CEUS in addition to cross-sectional imaging. In multivariate analysis, prior history of renal cell carcinoma was associated with a higher risk of malignancy (p = 0.016) and diagnosis made with CEUS was associated with a lower risk of malignancy (p = 0.040). Conclusion: We found that using CEUS in addition to cross-sectional imaging to characterize indeterminate renal cysts tends to redefine Bosniak III as lesions with a lower risk of malignancy and can lead to overclassification.

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Value of contrast-enhanced ultrasound (CEUS) in Focal Liver Lesions (FLL) with inconclusive findings on cross-sectional imaging

Clinical Hemorheology and Microcirculation ◽

10.3233/ch-190718 ◽

2020 ◽

Vol 74 (3) ◽

pp. 327-339 ◽

Cited By ~ 1

Author(s):

Timo Alexander Auer ◽

Thomas Fischer ◽

Stephan Rodrigo Marticorena Garcia ◽

Tobias Penzkofer ◽

Ernst-Michael Jung ◽

...

Keyword(s):

Focal Liver Lesions ◽

Liver Lesions ◽

Contrast Enhanced Ultrasound ◽

Cross Sectional ◽

Contrast Enhanced ◽

Cross Sectional Imaging ◽

Sectional Imaging

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Ultrasound of the pediatric chest

British Journal of Radiology ◽

10.1259/bjr.20190058 ◽

2019 ◽

Vol 92 (1100) ◽

pp. 20190058 ◽

Cited By ~ 2

Author(s):

Priscilla Joshi ◽

Aishvarya Vasishta ◽

Mayank Gupta

Keyword(s):

Pleural Effusion ◽

Imaging Modalities ◽

Lung Ultrasonography ◽

Cross Sectional ◽

Clinical Exam ◽

Alara Principle ◽

Pediatric Chest ◽

Cross Sectional Imaging ◽

Sectional Imaging ◽

Cystic Masses

Cross-sectional imaging modalities like MRI and CT provide images of the chest which are easily understood by clinicians. However, these modalities may not always be available and are expensive. Lung ultrasonography (US) has therefore become an important tool in the hands of clinicians as an extension of the clinical exam, which has been underutilized by the radiologists. Reinforcement of the ALARA principle along with the dictum of “Image gently” have resulted in increased use of modalities which do not require radiation. Hence, ultrasound, which was earlier being used mainly to confirm the presence of pleural effusion as well as evaluate it and differentiate solid from cystic masses, is now being used to evaluate the lung as well. This review highlights the utility of ultrasound of the paediatric chest. It also describes the normal and abnormal appearances of the paediatric lung on ultrasound as well as the advantages and limitations of this modality.

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Localisation and staging of gastrin producing tumours using cross-sectional imaging modalities

Wiener klinische Wochenschrift ◽

10.1007/s00508-007-0886-0 ◽

2007 ◽

Vol 119 (19-20) ◽

pp. 588-592 ◽

Cited By ~ 14

Author(s):

Klaus Jochen Klose ◽

Johannes T. Heverhagen

Keyword(s):

Imaging Modalities ◽

Cross Sectional ◽

Cross Sectional Imaging ◽

Sectional Imaging

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Primary ovarian carcinoid: value of octreotide scintigraphy for diagnosis and correlation with other cross-sectional imaging modalities and pathology

Journal of Ultrasound in Medicine ◽

10.7863/jum.1997.16.7.505 ◽

1997 ◽

Vol 16 (7) ◽

pp. 505-508

Author(s):

V Trapanotto ◽

U M Hamper ◽

A Gordon ◽

A S Krasner ◽

A C Civelek

Keyword(s):

Imaging Modalities ◽

Cross Sectional ◽

Octreotide Scintigraphy ◽

Cross Sectional Imaging ◽

Sectional Imaging

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Point-of-care contrast enhanced lung ultrasound and COVID-19

Ultrasound ◽

10.1177/1742271x211047945 ◽

2021 ◽

pp. 1742271X2110479

Author(s):

Alice Tee ◽

Gibran Timothy Yusuf ◽

Adrian Wong ◽

Deepak Rao ◽

Sa Tran ◽

...

Keyword(s):

Inflammatory Markers ◽

Lung Ultrasound ◽

Point Of Care ◽

Contrast Enhanced Ultrasound ◽

Cross Sectional ◽

Patient Demographics ◽

Pulmonary Angiogram ◽

Contrast Enhanced ◽

Cross Sectional Imaging ◽

Ct Pulmonary Angiogram

Objectives Bedside lung ultrasound has been indispensable during the coronavirus disease 2019 (COVID-19) pandemic, allowing us to rapidly assess critically unwell patients. We demonstrate the unique application of contrast-enhanced ultrasound with the aim of further understanding this disease. Methods Patient demographics were recorded alongside recent cross-sectional imaging and inflammatory markers. Ultrasound was conducted by experienced operators in a portable setting. Conventional six-point lung ultrasound method was used to evaluate B-lines, small (subpleural) consolidation and the pleura. Areas of small consolidation were targeted after intravenous administration of ultrasound contrast. Results The areas of small consolidations, a potential sign of pneumonia on B-mode lung ultrasound, usually enhance on contrast-enhanced ultrasound. Our study revealed these areas to be avascular, indicating an underlying thrombotic/infarction process. Findings were present in 100% of the patients we examined. We have also shown that the degree of infarction correlates with CT severity (r = 0.4) and inflammatory markers, and that these areas improve as patients recover. Conclusions We confirmed the theory of immune thrombus by identifying the presence of microthrombi in the lungs of 100% of our patients, despite 79% having had a recent negative CT pulmonary angiogram study. contrast-enhanced ultrasound can be utilised to add confidence to an uncertain COVID-19 diagnosis and for prognosticating and monitoring progress in confirmed COVID-19 patients. Contrast-enhanced ultrasound is clearly very different to CT, the gold standard, and while there are specific pathologies that can only be detected on CT, contrast-enhanced ultrasound has many advantages, most notability the ability to pick up microthrombi at the periphery of the lungs.

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Evaluation of genitourinary fistulas in pelvic malignancies with etiopathologic correlation: role of cross sectional imaging in detection and management

British Journal of Radiology ◽

10.1259/bjr.20200049 ◽

2020 ◽

Vol 93 (1111) ◽

pp. 20200049 ◽

Cited By ~ 1

Author(s):

Anitha Mandava ◽

Veeraiah Koppula ◽

Gaurav Sharma ◽

Meghana Kandati ◽

K.V.V.N. Raju ◽

...

Keyword(s):

Imaging Findings ◽

Cross Sectional ◽

Pelvic Malignancies ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Cross Sectional Imaging ◽

Sectional Imaging ◽

Ct And Mri

Objective: Genitourinary fistulas in pelvic malignancies are abnormal communications occurring due to either locally advanced tumours invading the surrounding organs or post-therapeutic complications of malignancies. In this article we review and describe the role of cross-sectional imaging findings in the management of genitourinary fistulas in pelvic malignancies. Methods: A retrospective study, for the period January 2012 to December 2018, was undertaken in patients with pelvic malignancies having genitourinary fistulas. The cross-sectional (CT and MRI) imaging findings in various types of fistulas were reviewed and correlated with the primary malignancy and the underlying etiopathology. Results: Genitourinary fistulas were observed in 71 patients (6 males, 65 females). 11 types of fistulas were identified in carcinomas of cervix, rectum, ovary, urinary bladder, sigmoid colon, vault, endometrium and prostate. The commonest were rectovaginal and vesicovaginal fistulas. 13 patients had multiple fistulas. The sensitivity, specificity, positive and negative predictive values of CT and MRI are 98%, 100%, 66%, 98% and 95%, 25%, 88% and 50% respectively. Contrast-enhanced CT with oral and rectal contrast is more sensitive and specific than MRI in the evaluation of genitourinary fistulas. Conclusion: Imaging findings significantly influence the management and outcome of genitourinary fistulas in pelvic malignancies. Contrast-enhanced CT is the imaging modality of choice in the evaluation of pelvic fistulas associated with malignancies and MRI is complimentary to it. Advances in knowledge: To our knowledge, this study is the first of its kind wherein the mean duration of occurrence of fistulas in pelvic malignancies is correlated with the underlying etiopathology.

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