scholarly journals Differential Diagnosis of Benign and Malignant Level Tumors in Children by Quantitative MRI with Intracellular Contrast Agent

2021 ◽  
Vol 4 (3) ◽  
pp. 56-63
Author(s):  
E. A. Petrash ◽  
M. A. Shorikov ◽  
E. V. Mikhaylova ◽  
A. L. Nikulina
Keyword(s):  
Differential Diagnosis ◽  
Contrast Agent ◽  
Malignant Tumors ◽  
Liver Parenchyma ◽  
Quantitative Mri ◽  
Benign Tumors ◽  
Focal Liver Lesions ◽  
Before And After ◽  
Body Coil ◽  
Student’S T

Purpose: Тo determine the possibilities of quantitative assessment of mpMRI with EOB-DTPA in the differential diagnosis of benign and malignant tumors in children.Material and methods: 30 patients (male — 17, female — 13) with 83 tumors underwent MRI. Age ranged from 5 months to 20 years. All children underwent MRI on 3T or 1.5T MR-scanners using body coil. Fat saturated T1WI were performed before and after hepatotropic MR-contrast agent (gadoxetic acid) injection in arterial, portal, venous and delayed phases (1, 5, 20, 40 min). Tumors were divided into 2 groups: benign (52) and malignant (31). In this work we use only pre- and postcontrast T1WI. Diagnosis was confirmed histologically (all malignant and a part of benign FLL) and long-term MRI follow-up studies (for benign). To eliminate influence of external factors we used coefficients for each MR-program, the signal was normalized to intact liver parenchyma, spleen, abdominal aorta and v. cava inferior, also normalization to native series has been performed. Coefficients were compared for malignant and benign tumors using Student’s t-test, significantly different parameters were further used to build mathematical model by constructing a logistic regression with step-by-step selection of the most informative values.Results: Regression model is presented by formula. The model is informative and statistically significant (p < 0.001). If A>0.5 tumors has a malignant nature if А ≤ 0.5–benign. Model sensitivity and specificity are 0.862 and 0.925, respectively.Conclusion: Our model could be an excellent assistance in differentiation of benign and malignant focal liver lesions and reduces diagnostic path, effects the proper patients management. 

scholarly journals A novel decision tree model based on chromosome imbalances in cell-free DNA and CA-125 in the differential diagnosis of ovarian cancer

2021 ◽  
pp. 172460082199235
Author(s):  
Weina Zhang ◽  
Yu-min Zhang ◽  
Yuan Gao ◽  
Shengmiao Zhang ◽  
Weixin Chu ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Differential Diagnosis ◽  
Decision Tree ◽  
Copy Number ◽  
Malignant Tumors ◽  
Copy Number Variations ◽  
Ca 125 ◽  
Benign Tumors ◽  
Cell Free Dna ◽  
Free Dna

Objective: CA-125 is widely used as biomarker of ovarian cancer. However, CA-125 suffers low accuracy. We developed a hybrid analytical model, the Ovarian Cancer Decision Tree (OCDT), employing a two-layer decision tree, which considers genetic alteration information from cell-free DNA along with CA-125 value to distinguish malignant tumors from benign tumors. Methods: We consider major copy number alterations at whole chromosome and chromosome-arm level as the main feature of our detection model. Fifty-eight patients diagnosed with malignant tumors, 66 with borderline tumors, and 10 with benign tumors were enrolled. Results: Genetic analysis revealed significant arm-level imbalances in most malignant tumors, especially in high-grade serous cancers in which 12 chromosome arms with significant aneuploidy ( P<0.01) were identified, including 7 arms with significant gains and 5 with significant losses. The area under receiver operating characteristic curve (AUC) was 0.8985 for copy number variations analysis, compared to 0.8751 of CA125. The OCDT was generated with a cancerous score (CScore) threshold of 5.18 for the first level, and a CA-125 value of 103.1 for the second level. Our most optimized OCDT model achieved an AUC of 0.975. Conclusions: The results suggested that genetic variations extracted from cfDNA can be combined with CA-125, and together improved the differential diagnosis of malignant from benign ovarian tumors. The model would aid in the pre-operative assessment of women with adnexal masses. Future clinical trials need to be conducted to further evaluate the value of CScore in clinical settings and search for the optimal threshold for malignancy detection.

Preparation of Magnetic Resonance Nano Contrast Agent and Its Adoption in Diagnosis of Breast Cancer

2021 ◽  
Vol 13 (9) ◽  
pp. 1611-1621
Author(s):  
Rong Guo ◽  
Binbin Ma ◽  
Jiaqiu Nie
Keyword(s):  
Breast Cancer ◽  
Differential Diagnosis ◽  
Magnetic Resonance ◽  
Contrast Agent ◽  
Malignant Tumors ◽  
Nipple Discharge ◽  
Mri Contrast Agent ◽  
Cytotoxicity Test ◽  
Mri Contrast ◽  
Magnetic Resonance Imaging Mri

This study aimed to explore the value of preoperative mammography in the differential diagnosis of benign and malignant tumors of nipple discharge. A biocompatible T1 contrast agent KMnF3 nanoparticle was first developed in the research, and then RGD-coupled KMnF3 nanoparticles were further synthesized as a highly sensitive tumor-targeted magnetic resonance imaging (MRI) contrast agent. While the nanoparticle was characterized physically, cytotoxicity test and MRI test in breast cancer mice were performed, and the excised tumors were subjected to immunostaining and tumor electron microscope section processing. At the same time, 60 patients with nipple discharge were screened to participate in the research, and the prepared MRI nano contrast agent was used for the differential diagnosis of breast benign/malignant tumors of nipple discharge. In the experiment, the synthetic nanoparticles were tested by Fourier transformed infrared (FTIR), which proved that the designed RGDtu/KMnF3 nanoparticles were successfully synthesized. The quantitative analysis of the synthesized nanoparticles showed that the relaxation efficiency reached 23.12 mM−1s−1, and there was no obvious toxicity. After staining, the microscope showed that the tumor was proliferating. After intravenous injection of low-dose RGDtu/KMnF3 contrast agent, nanoparticles were found in the tumor tissue. It was found that the synthesized nanoparticles enhanced the contrast of tumors with a volume of less than 50 mm3 by observing tumor slices. The imaging of the patient’s breast showed that the X-ray classification of galactography based on this contrast agent was statistically significant in distinguishing benign/malignant lesions of nipple discharge (X2 = 58.700, P < 0.01).

Ensuring the most effective strategy for cancer treatment of patients with brain tumors.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e14000-e14000
Author(s):  
Elena A. Sheiko ◽  
Elena M. Frantsiyants ◽  
Eduard E. Rostorguev ◽  
Irina V. Kaplieva ◽  
Valeria A. Bandovkina ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Brain Tumors ◽  
Blood Plasma ◽  
Histological Analysis ◽  
Malignant Tumors ◽  
Kinetic Method ◽  
Benign Tumors ◽  
Tumor Removal ◽  
Plastic Tube ◽  
Malignant Brain Tumors

e14000 Background: The purpose of the study was to analyze changes in the total activity of trypsin-like proteinases (TLPs) in the blood plasma in patients with brain tumors for the preoperative differential diagnosis of benign, primary and secondary malignant brain tumors. Methods: TLPs were measured in 164 patients with brain tumors. The blood had been collected from the patients in a standard plastic tube with 3.8% sodium citrate (9:1) 3 days prior to the surgery. Citrate blood was centrifuged; citrated plasma was obtained and used to determine the total TLP activity by the unified kinetic method. Results were compared with the data in donors. Results: TLP activity in 37 (22.6%) of 164 patients was within the normal range (258–402 IU/mL, on the average 333.0±27.1 IU/mL). Benign brain tumors (meningioma) were diagnosed in all 37 patients after the tumor removal and histological analysis. In 74 (45.1%) of 164 patients, TLP activity was within 1158–1626 IU/mL (on the average 1331.0±102.4 IU/mL, p < 0.05), i.e. 3.8-5.3 times higher than the norm in donors (malignancy coefficient on average 4.4±0.3 times). Primary malignant brain tumors (glioblastoma) were diagnosed in all 74 patients after the tumor removal and histological analysis. In 53 (32.3%) of 164 patients, TLP activity was within 1794–2868 IU/mL (on the average 2227.0±174.1 IU/mL, p < 0.05), i.e. 5.9-9.4 times higher than the norm in donors (malignancy coefficient on average 7.3±0.5 times). Secondary malignant brain tumors (metastases) were diagnosed in all 53 patients after the tumor removal and histological analysis. Conclusions: The specificity of the proposed method for the differential diagnosis of brain tumors was very high: for benign tumors - 97.2%, for primary malignant tumors - 98.6% and for secondary malignant tumors - 98.1%. So, TLP activity indices in the blood plasma are an informative auxiliary laboratory test that will help in clarifying and/or confirming the differential diagnosis of brain tumors.

Diagnostic approach using the expression profiling of the P53 tumor suppressor gene and its related proteins in ovarian epithelial tumors

2005 ◽  
Vol 15 (3) ◽  
pp. 453-461 ◽  
Author(s):  
H. Lee ◽  
G. Park ◽  
J. H. Jung ◽  
W. S. Ahn ◽  
J. M. Lee ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Malignant Tumors ◽  
Cyclin E ◽  
Receiver Operating Curve ◽  
Benign Tumors ◽  
Cutoff Value ◽  
Borderline Tumors ◽  
Expression Levels ◽  
Epithelial Tumors ◽  
Ovarian Epithelial Tumors

The initial aim of this study was to examine the expression profiles of P53 and its upstream genes, downstream genes, and cell cycle regulators to determine whether these markers are useful for making a differential diagnosis among the benign, borderline, and malignant ovarian epithelial tumors. Between borderline and malignant tumors, the increased expression levels of P53, Bax, Cyclin E, and cyclin-dependent kinase-2 as well as the decreased expression levels of growth arrest and DNA damage (GADD45) and murine double minute-2 (MDM2) were significantly associated with malignancy (P < 0.01, each). Using the receiver operating curve (ROC), the most reliable cutoff value of the added-up staining scores of those markers was 4.5 with 79% sensitivity and 89% specificity for malignancy. Between benign and borderline tumors, the P21 and Bax expression levels were significantly higher in borderline tumors, whereas the Bcl-2 expression level was much higher in benign tumors (P < 0.01, each). Using the ROC, the cutoff value of the added-up staining scores used to discriminate between the two groups was 2.5 with 70% sensitivity and 74% specificity for borderline tumors. Thus, for the differential diagnosis between borderline and malignant tumors, the cutoff value 4.5 of the cumulative staining scores can be used. However, the cutoff value 2.5 for discrimination between benign and borderline tumors may not be useful because of its relatively low sensitivity and specificity. In addition, the P53, GADD45, Cyclin E, and MDM2 expression levels in malignant ovarian tumors might be useful for determining the histologic grade and type.

scholarly journals Color Doppler sonography with contrast in the differentiation of ovarian tumors

2003 ◽  
Vol 58 (4) ◽  
pp. 185-192 ◽  
Author(s):  
Eduardo Cardoso Blanco ◽  
Ayrton Roberto Pastore ◽  
Angela Maggio da Fonseca ◽  
Filomena Marino Carvalho ◽  
Jesus Paula Carvalho ◽  
...  
Keyword(s):  
Doppler Sonography ◽  
Malignant Tumors ◽  
Color Doppler ◽  
Resistance Index ◽  
Ovarian Tumors ◽  
Benign Tumors ◽  
Positive Finding ◽  
Vascular Flow ◽  
Before And After ◽  
Benign Ovarian Tumors

The objective of this study was to differentiate benign ovarian tumors from malignant ones before surgery using color and pulsed Doppler sonography, and to compare results obtained before and after use of contrast medium, thereby verifying whether contrast results in an improvement in the diagnostic sensitivity. METHODS: Sixty two women (mean age 49.9 years) with ovarian tumors were studied, 45 with benign and 17 with malignant tumors. All women underwent a transvaginal color Doppler ultrasonographic exam. A study of the arterial vascular flow was made in all tumor areas, as well as an impedance evaluation of arterial vascular flow using the resistance index. RESULT: Localization of the vessels in the tumor revealed a greater proportion of malignant tumors with detectable internal vascular flows (64%) than benign tumors with such flows (22%). There was a considerable overlap of these findings. The use of contrast identified a greater number of vessels with confirmation in the totality of tumors, but did not improve the Doppler capacity in tumoral differentiation. Malignant tumors presented lower values of resistance index than the benign ones, whether or not contrast was used. The cutoff value for resistance index that better maximized the Doppler sensitivity and specificity was 0.55. Through this value, an increase of the sensitivity after contrast use was obtained, varying from 47% to 82%, while specificity remained statistically unchanged. CONCLUSION: Although the injection of a microbubble agent improved the sensitivity of the method detecting vascularization of tumors, a positive finding for vascularization by this method was not clinically useful in the differentiation of benign and malignant ovarian tumors.

scholarly journals CONTRAST-ENCHANCED ULTRASOUND IN THE DIFFERENTIAL DIAGNOSIS OF FOCAL NODULAR HYPERPLASIA AND HEPATIC ADENOMA

2019 ◽  
Vol 26 (2) ◽  
pp. 50-63 ◽  
Author(s):  
Alexey N. Katrich ◽  
Nikolai S. Ryabinin ◽  
Sergey V. Polshikov ◽  
Nikita A. Katrich
Keyword(s):  
Differential Diagnosis ◽  
Contrast Agent ◽  
Focal Nodular Hyperplasia ◽  
Ultrasound Contrast Agent ◽  
Hepatocellular Adenoma ◽  
Morphological Data ◽  
Arterial Phase ◽  
Benign Tumors ◽  
Focal Lesions ◽  
Nodular Hyperplasia

Aim. To increase the effectiveness of the differential diagnosis of benign focal lesions of the liver using contrast-enhanced ultrasound (CEUS).Materials and methods. A retrospective analysis of the examination results of 37 patients with morphologically confi rmed liver benign tumors was carried out. According to the morphological data, the patients were divided into two groups: 22 patients with focal nodular hyperplasia (FNH) and 15 patients with hepatocellular adenoma (HCA). All the patients underwent multiparametric ultrasound examination using CEUS.Results. According to the obtained data, despite the nearly equal intensity of fi lling FNH and HCA with a contrast agent (96% and 80%, accordingly), FNH is characterized by an earlier contrasting (WASH IN) pattern in the arterial phase (AF), with the ‘onset of contrasting in the focus’ parameter being signifi cantly different from HCA (p<0.05). Specifi c signs of FNH included the following: the spoke-wheel pattern and an increased intensity of ultrasound contrast agent (USCA) accumulation — 96% of cases; ‘center-to-edge’ fi lling — 86% of cases. WASH-OUT is not a typical sign of FNA. A complete (100% of cases) and intensive (80% of cases) centripetal (80% of cases) fi lling is characteristic of HCA. No specifi c types of vascular pattern were observed. In 6 (40%) patients, WASH-OUT and ‘relative hyperechoic’ were detected in the portal phase.Conclusion. CEUS is established to be an effective method of the differential diagnosis of FNH and HCA. 

scholarly journals Aim: To investigate the value of ElastPQ measurement for differential diagnosis of benign and malignant focal liver lesions (FLLs) by using histologic results as a reference standard. Material and methods: A total of 154 patients were included. ElastPQ measurement was performed for each lesion in which the shear wave speed (SWS) was measured. The difference in SWS and SWS ratio of FLL to surrounding liver were evaluated, and the cut off value was investigated. Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic performance. Histology as a gold standard was obtained by surgery in all patients. Results: A total of 154 lesions including 129 (83.7 %) malignant FLLs and 25 (16.3 %) benign ones were analysed. The SWS of malignant and benign FLLs was significantly different, 2.77±0.68 m/s and 1.57±0.55 m/s (p<0.05). The SWS ratio of each FLL to surrounding liver parenchyma was 2.23±0.49 for malignant and 1.14±0.36 for benign FLLs (p<0.05). The cut off value for differential diagnosis was 2.06 m/s for SWS and 1.67 for SWS ratio. Conclusions: ElastPQ measurement provides reliable quantitative stiffness information of FLLs and may be helpful in the differential diagnosis between malignant and benign FLLs.

2017 ◽  
Vol 19 (3) ◽  
pp. 259 ◽  
Author(s):  
Yi Dong ◽  
Wen-Ping Wang ◽  
Yadan Xu ◽  
Jiaying Cao ◽  
Feng Mao ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Gold Standard ◽  
Diagnostic Performance ◽  
Wave Speed ◽  
Operating Characteristic ◽  
Liver Parenchyma ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Shear Wave Speed ◽  
The Difference

Aim: To investigate the value of ElastPQ measurement for differential diagnosis of benign and malignant focal liver lesions (FLLs) by using histologic results as a reference standard.Material and methods: A total of 154 patients were included. ElastPQ measurement was performed for each lesion in which the shear wave speed (SWS) was measured. The difference in SWS and SWS ratio of FLL to surrounding liver were evaluated, and the cut off value was investigated. Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic performance. Histology as a gold standard was obtained by surgery in all patients.Results: A total of 154 lesions including 129 (83.7 %) malignant FLLs and 25 (16.3 %) benign ones were analysed. The SWS of malignant and benign FLLs was significantly different, 2.77±0.68 m/s and 1.57±0.55 m/s (p<0.05). The SWS ratio of each FLL to surrounding liver parenchyma was 2.23±0.49 for malignant and 1.14±0.36 for benign FLLs (p<0.05). The cut off value for differential diagnosis was 2.06 m/s for SWS and 1.67 for SWS ratio.Conclusions: ElastPQ measurement provides reliable quantitative stiffness information of FLLs and may be helpful in the differential diagnosis between malignant and benign FLLs.

Shear Wave Dispersion Imaging for the Characterization of Focal Liver Lesions – A Pilot study

2021 ◽  
Author(s):  
Daniel Jesper ◽  
Steffen Fiedler ◽  
Daniel Klett ◽  
Maximilian J Waldner ◽  
Barbara Schellhaas ◽  
...  
Keyword(s):  
Shear Wave ◽  
Wave Dispersion ◽  
Liver Parenchyma ◽  
Benign Tumors ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Shear Wave Speed ◽  
Lower Shear ◽  
Malignant Lesions

Abstract Purpose Shear wave dispersion imaging is a novel ultrasound-based technique, which analyzes the speed of different shear wave components depending on their frequency. The dispersion of shear wave speed correlates with the viscosity of the liver parenchyma. The aim of this prospective study was to evaluate the use of shear wave dispersion imaging in focal liver lesions in the non-cirrhotic liver. Methods Patients with unclear focal liver lesions in B-mode ultrasound were prospectively assigned to shear wave dispersion imaging (m/s/kHz). Measurements were conducted within the lesion and in the liver parenchyma of the right liver lobe using an intercostal window. Histology and contrast-enhanced ultrasound served as the reference for the characterization of the lesions. Results Out of 46 patients included in this study, 24 had liver metastases and 22 had benign liver lesions. Benign lesions consisted mostly of hemangiomas (n=12) and focal nodular hyperplasia (n=8). Malignant lesions showed significantly lower shear wave dispersion (13.0±2.45 m/s/kHz) compared to benign tumors (15.2±2.74 m/s/kHz, p<0.01). In further subgroup analysis, the difference was significant for hemangiomas (15.32±2.42 m/s/kHz, p=0.04) but not for FNHs (14.98±3.36 m/s/kHz, p=0.38). The dispersion of reference liver parenchyma did not differ significantly between the groups (p=0.54). Conclusion The quantification of viscosity by shear wave dispersion is a new parameter for the characterization of focal liver lesions with higher dispersion values in hemangiomas and lower dispersion values in metastases. However, it cannot differentiate reliably between benign and malignant lesions.

scholarly journals The emerging role of the molecular marker p27 in the differential diagnosis of adrenocortical tumors

2013 ◽  
Vol 2 (3) ◽  
pp. 137-145 ◽  
Author(s):  
Sofia S Pereira ◽  
Tiago Morais ◽  
Madalena M Costa ◽  
Mariana P Monteiro ◽  
Duarte Pignatelli
Keyword(s):  
Differential Diagnosis ◽  
Cyclin D1 ◽  
Adrenal Glands ◽  
Malignant Tumors ◽  
Molecular Profile ◽  
Benign Tumors ◽  
Ki 67 ◽  
Adrenocortical Tumors ◽  
Percentage Area

Malignant adrenocortical tumors (ACTs) are rare and highly aggressive; conversely, benign tumors are common and frequently found incidentally (the so-called incidentalomas). Currently, the use of molecular markers in the diagnosis of ACTs is still controversial. The aim of this study was to analyze the molecular profile of different ACTs with the purpose of identifying markers useful for differentiating between these tumors. The ACTs that were studied (n=31) included nonfunctioning adenomas (ACAn)/incidentalomas (n=13), functioning adenomas with Cushing's syndrome (ACAc) (n=7), and carcinomas (n=11); normal adrenal glands (n=12) were used as controls. For each sample, the percentage area stained for the markers StAR, IGF2, IGF1R, p53, MDM2, p21, p27, cyclin D1, Ki-67, β-catenin, and E-cadherin was quantified using a morphometric computerized tool. IGF2, p27, cyclin D1, and Ki-67 were the markers for which the percentage of stained area was significantly higher in carcinoma samples than in adenoma samples. Ki-67 and p27 were the markers that exhibited the highest discriminative power for differential diagnosis between carcinomas and all type of adenomas, while IGF2 and StAR were only found to be useful for differentiating between carcinomas and ACAn and between carcinomas and ACAc respectively. The usefulness of Ki-67 has been recognized before in the differential diagnosis of malignant tumors. The additional use of p27 as an elective marker to distinguish benign ACTs from malignant ACTs should be considered.

scholarly journals Newborn With Enlarged Erythematous Mass on Back: Case Report and Review of Medical Literature

2018 ◽  
Vol 5 ◽  
pp. 2333794X1880355
Author(s):  
Myo-Sabai Aye ◽  
Maheshwar Mahaseth ◽  
Arlene Rozzelle ◽  
Indira Bhagat ◽  
Prashant Agarwal
Keyword(s):  
Differential Diagnosis ◽  
Medical Literature ◽  
Malignant Tumors ◽  
Subcutaneous Fat ◽  
Skin Condition ◽  
Benign Tumors ◽  
Fat Necrosis ◽  
Subcutaneous Fat Necrosis ◽  
Skin Nodules ◽  
Sclerema Neonatorum

Newborn skin nodules are usually benign and self-resolving skin condition. Differential diagnosis of such lesions include cysts, hemangioma, abscess, cellulitis, sclerema neonatorum, subcutaneous fat necrosis, neurofibromatosis, benign tumors, or malignant tumors such as rhabdomyosarcoma, infantile fibrosarcoma, or neuroblastoma. We report a case of congenital subcutaneous fat necrosis in a 7-day-old baby presenting with multiple erythematous mass on back.

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