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.

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 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 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.

scholarly journals Effect of the dynamic curve type from the perifocal infiltration zone obtained by magnetic resonance imaging on prognosis in pelvic pathologies in women

2020 ◽  
Vol 16 (1) ◽  
pp. 71-77
Author(s):  
T. A. Bergen ◽  
V. A. Fokin ◽  
G. E. Trufanov ◽  
A. V. Smagina ◽  
I. A. Soynov
Keyword(s):  
Magnetic Resonance Imaging ◽  
Differential Diagnosis ◽  
Magnetic Resonance ◽  
Contrast Enhancement ◽  
Prognostic Significance ◽  
Resonance Imaging ◽  
Intravenous Contrast ◽  
Dynamic Contrast Enhancement ◽  
Pelvic Mri ◽  
Prognostic Accuracy

The aim of the study is to evaluate the role and prognostic significance of magnetic resonance imaging (MRI) perfusion methods in prognosis of disease course and outcome based on evaluation of the perifocal infiltration zone in pelvic disorders in women.Materials and methods. Retrospective analysis of pelvic MRI data obtained using MRI system with induced magnetic field of 1.5 T was performed. The study included 530 protocols of pelvic scans in women. Two equal groups (n = 265) of patients with oncological and nononcological pathologies of pelvic organs were formed; after application of propensity score matching, each group contained 165 patients. All examination protocols included dynamic contrast enhancement. The obtained data were statistically analyzed using the Stata 13 software.Results. In the study, types of dynamic curves obtained using dynamic contrast enhancement from the perifocal infiltration zone were analyzed. There was no data showing a correlation between the type of dynamic curve from the zone of perifocal changes and disease prognosis or possibility of differential diagnosis.Conclusions. Evaluation of the perifocal infiltration zone per MRI results with intravenous contrast does not affect prognostic accuracy of the method (p >0.05); contrast can be used only for differential diagnosis or evaluation of local advancement of the process.

Contrast-enhanced MR imaging as a prognostic indicator of breast cancer

1998 ◽  
Vol 39 (3) ◽  
pp. 279-284 ◽  
Author(s):  
B. Boné ◽  
P. Aspelin ◽  
L. Bronge ◽  
B. Veress
Keyword(s):  
Breast Cancer ◽  
Mr Imaging ◽  
Contrast Enhancement ◽  
Tumor Angiogenesis ◽  
Histological Grade ◽  
Biological Behavior ◽  
Lymph Node Status ◽  
Breast Cancers ◽  
Contrast Enhanced ◽  
Proliferating Activity

Background: Using contrast-enhanced MR imaging in the diagnosis of breast cancer may provide additional information not only on tumor extension but also on the biological behavior of tumors. Thus certain characteristics such as tumor angiogenesis and the proliferating activity of the tumor, which have been shown to correlate significantly with prognosis, are both potentially amenable to analysis by MR imaging Material and Methods: We compared contrast enhancement in 50 malignant breast tumors at MR imaging to several prognostic factors, such as tumor size, lymph-node status, histological grade of malignancy, tumor angiogenesis, and proliferating activity as shown by the mitotic count and PCNA immunoreactivity Results: There was significant correlation between contrast enhancement at MR imaging of breast cancer and both tumor angiogenesis and proliferative cellular activity as shown by PCNA immunoreactivity. Furthermore, there was a correlation between contrast enhancement and tumor malignancy grade as well as tumor invasiveness Conclusion: These observations suggest that contrast enhancement at MR imaging may be influenced by factors that have prognostic value. If this assumption is correct, contrast-enhanced MR imaging may become a valuable prognostic tool in the pre-operative evaluation of breast cancers

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.

Multiparametric MRI With Dynamic Contrast Enhancement, Diffusion-Weighted Imaging, and 31-Phosphorus Spectroscopy at 7 T for Characterization of Breast Cancer

2015 ◽  
Vol 50 (11) ◽  
pp. 766-771 ◽  
Author(s):  
Alexander M.Th. Schmitz ◽  
Wouter B. Veldhuis ◽  
Marian B.E. Menke-Pluijmers ◽  
Wybe J.M. van der Kemp ◽  
Tijl A. van der Velden ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Contrast Enhancement ◽  
Diffusion Weighted Imaging ◽  
Multiparametric Mri ◽  
Dynamic Contrast Enhancement ◽  
Diffusion Weighted
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