scholarly journals Small Subcutaneous Soft Tissue Tumors (<5 cm) Can Be Sarcomas and Contrast-Enhanced Ultrasound (CEUS) Is Useful to Identify Potentially Malignant Masses

2020 ◽  
Vol 17 (23) ◽  
pp. 8868
Author(s):  
Armanda De Marchi ◽  
Simona Pozza ◽  
Lorena Charrier ◽  
Filadelfo Cannone ◽  
Franco Cavallo ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Malignant Tumors ◽  
Univariate Analysis ◽  
Soft Tissue Tumors ◽  
Deep Fascia ◽  
Contrast Enhanced Ultrasound ◽  
Predictive Values ◽  
Contrast Enhanced ◽  
Potentially Malignant ◽  
Sensitivity Specificity

Subcutaneous masses smaller than 5 cm can be malignant, in contrast with the international guidelines. Ultrasound (US) and magnetic resonance imaging (MRI) are useful to distinguish a potentially malignant mass from the numerous benign soft tissue (ST) lesions. Contrast-enhanced ultrasound (CEUS) was applied in ST tumors, without distinguishing the subcutaneous from the deep lesions. We evaluated CEUS and MRI accuracy in comparison to histology in differentiating malignant from nonmalignant superficial ST masses, 50% smaller than 5 cm. Sensitivity, specificity, and positive and negative predictive values (PPV, NPV) with their 95% confidence intervals (CI) were calculated. Of malignant cases, 44.4% measured ≤5 cm. At univariate analysis, no statistically significant differences emerged between benign and malignant tumors in relation with clinical characteristics, except for relationship with the deep fascia (p = 0.048). MRI accuracy: sensitivity 52.8% (CI 37.0, 68.0), specificity 74.1% (CI 55.3, 86.8), PPV 73.1% (CI 53.9, 86.3), and NPV 54.1% (CI 38.4, 69.0). CEUS accuracy: sensitivity 75% (CI 58.9, 86.3), specificity 37% (CI 21.5, 55.8), PPV 61.4% (CI 46.6, 74.3), and NPV 52.6% (CI 31.7, 72.7). CEUS showed a sensitivity higher than MRI, whereas PPV and NPV were comparable. Also, masses measuring less than 5 cm can be malignant and referral criteria for centralization could be revised.

scholarly journals MRI-based radiomics to predict lipomatous soft tissue tumors malignancy: a pilot study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Benjamin Leporq ◽  
Amine Bouhamama ◽  
Frank Pilleul ◽  
Fabrice Lame ◽  
Catherine Bihane ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Predictive Value ◽  
Malignant Tumors ◽  
External Validation ◽  
Soft Tissue Tumors ◽  
Support Vector ◽  
Mr Images ◽  
Gadolinium Contrast ◽  
Contrast Enhanced ◽  
Lipomatous Tumors

Abstract Objectives To develop and validate a MRI-based radiomic method to predict malignancies in lipomatous soft tissue tumors. Methods This retrospective study searched in the database of our pathology department, data from patients with lipomatous soft tissue tumors, with histology and gadolinium-contrast enhanced T1w MR images, obtained from 56 centers with non-uniform protocols. For each tumor, 87 radiomic features were extracted by two independent observers to evaluate the inter-observer reproducibility. A reduction of learning base dimension was performed from reproducibility and relevancy criteria. A model was subsequently prototyped using a linear support vector machine to predict malignant lesions. Results Eighty-one subjects with lipomatous soft tissue tumors including 40 lipomas and 41 atypical lipomatous tumors or well-differentiated liposarcomas with fat-suppressed T1w contrast enhanced MR images available were retrospectively enrolled. Based on a Pearson’s correlation coefficient threshold at 0.8, 55 out of 87 (63.2%) radiomic features were considered reproducible. Further introduction of relevancy finally selected 35 radiomic features to be integrated in the model. To predict malignant tumors, model diagnostic performances were as follow: AUROC = 0.96; sensitivity = 100%; specificity = 90%; positive predictive value = 90.9%; negative predictive value = 100% and overall accuracy = 95.0%. Conclusion This work demonstrates that radiomics allows to predict malignancy in soft tissue lipomatous tumors with routinely used MR acquisition in clinical oncology. These encouraging results need to be further confirmed in an external validation population.

scholarly journals Evaluation of characteristics of thyroid nodules on contrast-enhanced ultrasonography: a retrospective analysis of 252 cases

2020 ◽  
Vol 22 (2) ◽  
pp. 164
Author(s):  
Wen Luo ◽  
Xiao Yang ◽  
Jiani Yuan ◽  
Lina Pang ◽  
Peidi Zhang ◽  
...  
Keyword(s):  
Retrospective Review ◽  
Thyroid Nodules ◽  
Contrast Enhanced Ultrasound ◽  
Diagnostic Specificity ◽  
Benign Lesions ◽  
Predictive Values ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Benign Nodules ◽  
Sensitivity Specificity

Aim: This study investigated the enhancement patterns observed on contrast-enhanced ultrasound (CEUS) images for differentiating thyroid nodules.Material and methods: A retrospective review was conducted of CEUS cine loops of 252 nodules by two independent readers. Seven categories of enhancement patterns were identified: concentric hypoenhancement; heterogeneous hypoenhancement; hypoenhancement with sharp margin; homogeneous hyper/isoenhancement; hyper/isoenhancement with ring-like vascularity; island-like enhancement; and no perfusion. Associations between these patterns and the confirmed pathological/cytological outcomes (178 malignant, 74 benign) were analyzed and the sensitivity, specificity and positive predictive values (PPVs) determined. The agreement of the readers’ assessments was evaluated by Kappa value.Results: For malignant nodules, the predominant 3 patterns were: concentric hypoenhancement, heterogeneous hypoenhancement and homogeneous hyper/isoenhancement. For each of these, the diagnostic specificity was above 87% and the PPV more than 85%. Combining these patterns for malignancy the rates of sensitivity, specificity and PPV for reader 1 (reader 2) were 96.1% (98.9%), 71.6% (71.6%), and 89.1% (89.3%), respectively. For benign nodules, the predominant 4 patterns were: hypoenhancement with sharp margin; hyper/isoenhancement with ring-like vascularity; island-like enhancement; and no perfusion. The specificity for each was above 98% and the PPV more than 70%. Combining these patterns for benignity, the rates of sensitivity, specificity and PPV for reader 1 (reader 2) were 71.6% (71.6%), 96.1% (98.9%) and 88.3% (96.3%), respectively. The inter-reviewers agreement for classifying enhancement patterns was excellent (κ = 0.84, 95% CI: 0.79-0.89).Conclusions: Enhancement patterns of thyroid nodules on CEUS investigation, enable differentiation between malignant and benign lesions with good diagnostic sensitivity, specificity and PPV.

scholarly journals The Orthopedic-Vascular Multidisciplinary Approach Improves Patient Safety in Surgery for Musculoskeletal Tumors: A Large-Volume Center Experience

2021 ◽  
Vol 11 (6) ◽  
pp. 462
Author(s):  
Andrea Angelini ◽  
Michele Piazza ◽  
Elisa Pagliarini ◽  
Giulia Trovarelli ◽  
Andrea Spertino ◽  
...  
Keyword(s):  
Patient Safety ◽  
Soft Tissue ◽  
Malignant Tumors ◽  
Univariate Analysis ◽  
Soft Tissue Tumors ◽  
Oncologic Outcomes ◽  
Interventional Treatment ◽  
Major Complications ◽  
Vascular Structures

Objective: Wide-margin resection is mandatory for malignant bone and soft tissue tumors. However, this increases the complexity of resections, especially when vessels are involved. Patients in this high-risk clinical setting could be surgically treated using the multidisciplinary orthopedic-vascular approach. This study was carried out in this healthcare organization to evaluate patient safety in term of oncologic outcomes and reduction of the complication rate. Materials and Methods: We retrospectively reviewed 74 patients (37 males, 37 females; mean age 46 years, range 9–88) who underwent surgical excision for bone/soft tissue malignant tumors closely attached to vascular structures from October 2015 to February 2019. Vascular surgery consisted of isolation of at least one vessel (64 patients), bypass reconstruction (9 patients), and end-to-end anastomosis (1 patient). Mean follow-up was 27 months. Patients’ demographics, tumor characteristics, adjuvant treatments, type of orthopedic and vascular procedures, and oncologic and functional outcomes and complications were recorded. Results: Overall survival was 85% at 3 years follow-up. In total, 22 patients experienced at least one major complication requiring further surgery and 13 patients experienced at least one minor complication, whereas 17 reported deviations from the normal postoperative course without the need for pharmacological or interventional treatment. Major complications were higher in pelvic resections compared to limb-salvage procedures (p = 0.0564) and when surgical time was more than 4 h (p = 0.0364 at univariate analysis, whereas the most important multivariate independent predictors for major complications were pelvic resection (p = 0.0196) and preoperative radiotherapy (p = 0.0426). Conclusions: A multidisciplinary ortho-vascular approach for resection of malignant bone and soft tissue tumors tightly attached to important vascular structures should be considered a good clinical practice for patient safety.

Diagnostic performance of intravascular perfusion based contrast-enhanced ultrasound LI-RADS in the evaluation of hepatocellular carcinoma

2021 ◽  
pp. 1-9
Author(s):  
Dongsheng Zuo ◽  
Kefeng Yang ◽  
Size Wu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diagnostic Performance ◽  
Focal Liver Lesions ◽  
Liver Imaging ◽  
Diagnostic Efficiency ◽  
Liver Lesions ◽  
Contrast Enhanced Ultrasound ◽  
Predictive Values ◽  
Contrast Enhanced ◽  
Sensitivity Specificity

BACKGROUND: The contrast-enhanced ultrasound (CEUS) liver imaging reporting and data system (LI-RADS) is a relative new algorithm for hepatocellular carcinoma (HCC) assessment. OBJECTIVE: To validate the diagnostic efficiency of the intravascular perfusion based CEUS LI-RADS for HCC. METHODS: Archives of 873 patients with focal liver lesions (FLLs) undergoing CEUS were reviewed, and target images were read by two sonologists independently according to the CEUS LI-RADS. The diagnostic performance was calculated and compared. RESULTS: Assessment with reference to CEUS LI-RADS, 87 of 218 FLLs (39.9%) were categorized as LR-5, 131 of 218 FLLs (60.1%) were categorized as non-LR-5, 19 of 99 HCCs were categorized as non-LR-5, and 7 of 119 non-HCCs were categorized as LR-5. The sensitivity, specificity, AUROC, positive and negative predictive values of CEUS LI-RADS for diagnosing HCC were 80.81%(95%CI: 71.7%–88.0%), 94.1%(95%CI: 88.3%–97.6%), 0.87 (95%CI: 0.82–0.92), 91.9%(95%CI: 84.1%–96.7%), and 85.5%(95%CI: 78.3%–91.0%), respectively. CONCLUSIONS: The diagnostic efficiency of the intravascular perfusion based CEUS LI-RADS for the evaluation of HCCs is very good.

scholarly journals Hand tumors: A review of 186 patients at a single institute

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199399
Author(s):  
Taketsugu Fujibuchi ◽  
Hiroshi Imai ◽  
Joji Miyawaki ◽  
Teruki Kidani ◽  
Hiroshi Kiyomatsu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Clinical Features ◽  
Malignant Tumors ◽  
Proximal Phalanx ◽  
Delayed Diagnosis ◽  
Ring Finger ◽  
Soft Tissue Tumors ◽  
Body Parts ◽  
Maximal Diameter ◽  
Benign Soft Tissue Tumors

Purpose: The spectrum of diagnoses and clinical features of hand tumors differ from those of tumors in other body parts. However, only a few reports have comprehensively referenced the diagnosis and clinical features of hand tumors. This study aimed to elucidate the diagnostic distribution and the clinical features of hand tumors undergone surgery in our institute. Patients and methods: A total of 235 lesions in 186 patients diagnosed with hand tumors between 1978 and 2020 were reviewed. Age at surgery, gender, chief complaint, tumor location, and pathological diagnosis were analyzed. Results: There were 121 benign bone tumors, 98 benign soft tissue tumors, and 16 malignant tumors. Chondroma and tenosynovial giant cell tumor were common benign bone and soft tissue tumors at the proximal phalanx of the ring finger and the palm, respectively. Meanwhile, chondrosarcoma and synovial sarcoma were common malignant tumors at the dorsal part of the hand. Local pain and painless mass were the chief complaints in patients with benign bone and soft tissue tumors, respectively. Most patients with malignant tumors were referred after unplanned resection. When patients were classified into two categories by tumor size according to maximal diameter, tumors larger than 19 mm had a significantly higher risk of malignant ( p = 0.031) despite being smaller than other tumors in different body parts. Conclusion: When a tumor malignancy is suspected, the patient should be referred to a specialist to avoid unplanned resection or delayed diagnosis due to misdiagnosis. Knowing the distribution and clinical features should help in diagnosing hand tumors.

scholarly journals Evaluation of Cystic and Solid Renal Lesions with Contrast-Enhanced Ultrasound: A Retrospective Study

2021 ◽  
Vol 07 (01) ◽  
pp. E25-E34
Author(s):  
Arash Najafi ◽  
Michael Wildt ◽  
Nicolin Hainc ◽  
Joachim Hohmann
Keyword(s):  
Final Diagnosis ◽  
Cystic Lesions ◽  
Likelihood Ratios ◽  
Renal Lesions ◽  
Contrast Enhanced ◽  
Potentially Malignant ◽  
Sensitivity Specificity ◽  
Solid Lesions ◽  
Conclusive Diagnosis

Abstract Purpose Renal lesions are frequent random findings on CT, MRI, and conventional ultrasound. Since they are usually found accidentally, the respective examinations have not been performed optimally to provide a conclusive diagnosis, making additional multiphase contrast-enhanced examinations necessary. The aim of the study is to correlate CEUS findings with the final diagnosis and to determine whether it is a suitable method for the conclusive characterization of undetermined renal lesions. Materials and Methods All CEUS examinations of focal renal lesions performed at our institute between 2007 and 2014 were retrospectively examined. 437 patients with a total of 491 lesions and 543 examinations were included. 54 patients had bilateral lesions. One patient had three lesions in one kidney. Histology was available in 49 cases and follow-ups in 124 cases. The sensitivity, specificity, positive and negative predictive value as well as positive and negative likelihood ratios were calculated. Results There were 54 malignant and 437 benign lesions. The sensitivity and specificity were 0.981/0.954 overall, 1.000/0.956 for cystic lesions, 0.977/0.906 for solid lesions, and 0.971/0.071 for the histologically confirmed lesions. Bosniak classification was consistent in 289 of 301 lesions (96%). Only 12 lesions (3.9%) were falsely assessed as malignant. Conclusion CEUS is an appropriate method for the clarification of undetermined renal lesions. The characterization of cystic lesions according to Bosniak is adequately possible, especially for potentially malignant lesions (types III and IV).

scholarly journals Detectability on Plain CT is an Effective Discriminator between Carcinoma and Benign Disorder for a Polyp >10 mm in the Gallbladder

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 388
Author(s):  
Tatsunori Satoh ◽  
Masataka Kikuyama ◽  
Keiko Sasaki ◽  
Hirotoshi Ishiwatari ◽  
Shinya Kawaguchi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Multivariate Analysis ◽  
Odds Ratio ◽  
Patient Characteristics ◽  
Polyp Size ◽  
Predictive Values ◽  
Lesion Detectability ◽  
Contrast Enhanced ◽  
Cell Densities ◽  
Sensitivity Specificity

An appropriate diagnosis is required to avoid unnecessary surgery for gallbladder cholesterol polyps (GChPs) and to appropriately treat pedunculated gallbladder carcinomas (GCs). Generally, polyps >10 mm are regarded as surgical candidates. We retrospectively evaluated plain and contrast-enhanced (CE) computed tomography (CT) findings and histopathological features of 11 early GCs and 10 GChPs sized 10–30 mm to differentiate between GC and GChP >10 mm and determine their histopathological background. Patient characteristics, including polyp size, did not significantly differ between groups. All GCs and GChPs were detected on CE-CT; GCs were detected more often than GChPs on plain CT (73% vs 9%; p < 0.01). Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for GCs were 73%, 90%, 89%, 75%, and 81%, respectively. On multivariate analysis, lesion detectability on plain CT was independently associated with GCs (odds ratio, 27.1; p = 0.044). Histopathologically, GChPs consisted of adipose tissue. Although larger vessel areas in GCs than in GChPs was not significant (52,737 μm2 vs 31,906 μm2; p = 0.51), cell densities were significantly greater in GCs (0.015/μm2 vs 0.0080/μm2; p < 0.01). Among GPs larger than 10 mm, plain CT could contribute to differentiating GCs from GChPs.

scholarly journals Multiparametric ultrasound diagnosis of metastatic and lymphoproliferative changes in lymph nodes in primary-multiple malignant tumors, including breast cancer and lymphoma

2019 ◽  
Vol 8 (4) ◽  
pp. 37-44 ◽  
Author(s):  
E. V. Kovaleva ◽  
T. Yu. Danzanova ◽  
G. T. Sinyukova ◽  
P. I. Lepedatu ◽  
E. A. Gudilina ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Differential Diagnosis ◽  
Lymph Nodes ◽  
Shear Wave ◽  
Malignant Tumors ◽  
Shear Wave Elastography ◽  
Doppler Imaging ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Multiparametric Ultrasound

In this article, based on two clinical examples, the possibilities of multiparametric ultrasound in the differential diagnosis of metastatic and lymphoproliferative changes in lymph nodes in primary-multiple malignant tumors, including breast cancer and lym - phoma, are evaluated. Multiparameteric ultrasound includes B-mode, color and energy Doppler imaging, strain elastography, shear wave elastography and contrast-enhanced ultrasound (CEUS). Standardization and reproducibility of these ultrasound techniques will allow to objectify the study, obtaining specific indicators of shear wave velocity in the zones of interest and specific signs of contrast enhancement, which can be used as impor tant differential diagnostic tool in oncology.

scholarly journals Histopathological study of soft tissue tumours in a tertiary health centre in southern part of Assam

2021 ◽  
Vol 9 (11) ◽  
pp. 3391
Author(s):  
Khadija S. Tapadar ◽  
Manoj K. Deka ◽  
R. N. Chaubey ◽  
Shah A. Sheikh ◽  
Gargi R. Choudhury ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Malignant Tumors ◽  
Soft Tissue Tumors ◽  
The Body ◽  
World Health ◽  
Vascular Tumors ◽  
Benign Tumors ◽  
Peripheral Nerve Sheath Tumors ◽  
Pleomorphic Sarcoma ◽  
Younger Age

Background: Soft tissue tumors are defined as mesenchymal proliferations which occur in the extraskeletal non-epithelial tissues of the body, excluding the viscera, coverings of brain and   lymphoreticular system. The objective of this study was to study the histopathological features of soft tissue tumors and to study the occurrence of soft tissue tumors in relation to age, sex and anatomical site.Methods: This study comprised of 89 cases studied over a period of two years. All soft tissue tumors, their gross features, microscopic findings were analysed in detail. Soft tissue tumors were divided into benign and malignant categories and further sub typing were done according to World Health Organization (WHO) classification. The distribution of soft tissue tumors according to the age, sex and site of occurrence was studied.Results: Out of 89 cases of soft tissue tumors, 76 cases were benign, 4 cases belonged to intermediate category and 9 cases were malignant. Adipocytic tumors formed the largest group constituting 39 cases. Vascular tumors were the second commonest (26 cases) followed by peripheral nerve sheath tumors (11 cases). The benign tumors were seen in younger age as compared to malignant tumors. Malignant soft tissue tumors was seen to be more common in male than female and pleomorphic sarcoma and liposarcoma was commonest (3 cases each).Conclusions: Benign tumors were more common than malignant. The most common benign tumors were lipoma followed by hemangioma and schwannoma. The most common malignant tumor was pleomorphic sarcoma. The benign tumors were seen in younger age as compared to malignant tumors.

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