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Leng X, Japaer R, Zhang H, Yeerlan M, Ma F, Ding J. Relationship of shear wave elastography anisotropy with tumor stem cells and epithelial-mesenchymal transition in breast cancer. BMC Med Imaging 2021; 21:171. [PMID: 34789199 PMCID: PMC8600915 DOI: 10.1186/s12880-021-00707-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 11/03/2021] [Indexed: 12/15/2022] Open
Abstract
Background This study is to examine the feasibility of shear wave elastography (SWE) anisotropy in assessing the prognosis of breast cancer. Methods We enrolled 119 breast cancer patients from January 2017 to October 2019. SWE was performed before operation. Emax (maximum elasticity value), Emean (average elasticity value), Esd (standard deviation of the lesion elasticity value), Eratio (elasticity value of adipose tissue), anisotropy coefficient and difference were recorded. After operation, we collected clinical pathological data, and performed immunohistochemistry and real-time PCR tests on CD44, CD24, E-cadherin, β-catenin, vimentin and N-cadherin. Finally, we analyzed the correlation among parameters of SWE, anisotropy and clinicopathology, and markers of CSCs (cancer stem cells) and EMT (epithelial-mesenchymal transition). Results Emax, Emean and Esd of the cross section were higher than those of the longitudinal section. Breast cancer with a higher elastic modulus was often accompanied by a hyperechoic halo, which was manifested as mixed echo and post-echo attenuation, and was accompanied by a higher BI-RADS (breast imaging reporting and data system) classification. When breast cancer had hyperechoic halo and weakened posterior echo, SWE of the lesion showed more obvious anisotropy. In addition, larger diameter of the longitudinal section indicated higher stiffness of the cross section. Correlation analysis showed that E-cadherin was negatively correlated with SWE in longitudinal section. CD44, N-cadherin, β-catenin were positively correlated with SWE in longitudinal and cross sections. Vimentin and CD24 had no correlation with SWE parameters. Conclusion SWE of breast cancer is anisotropic. The cross-sectional SWE is better than the longitudinal SWE, Emax is better than Emean, the anisotropy of SWE is better than SWE, and the anisotropy factor is better than the anisotropy difference.
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Affiliation(s)
- Xiaoling Leng
- Department of Ultrasound, Affiliated Tumor Hospital of Xinjiang Medical University, No. 789 Suzhou East Road, Xinshi District, Urumqi, 830011, People's Republic of China
| | - Rexida Japaer
- Department of Ultrasound, Affiliated Tumor Hospital of Xinjiang Medical University, No. 789 Suzhou East Road, Xinshi District, Urumqi, 830011, People's Republic of China
| | - Haijian Zhang
- Department of Ultrasound, Affiliated Tumor Hospital of Xinjiang Medical University, No. 789 Suzhou East Road, Xinshi District, Urumqi, 830011, People's Republic of China
| | - Mila Yeerlan
- Department of Ultrasound, Affiliated Tumor Hospital of Xinjiang Medical University, No. 789 Suzhou East Road, Xinshi District, Urumqi, 830011, People's Republic of China
| | - Fucheng Ma
- Department of Ultrasound, Affiliated Tumor Hospital of Xinjiang Medical University, No. 789 Suzhou East Road, Xinshi District, Urumqi, 830011, People's Republic of China.
| | - Jianbing Ding
- Department of Ultrasound, Affiliated Tumor Hospital of Xinjiang Medical University, No. 789 Suzhou East Road, Xinshi District, Urumqi, 830011, People's Republic of China. .,School of Basic Medicine, Xinjiang Medical University, No. 567 Shangde North Road, Urumqi, 830017, Xinjiang, People's Republic of China.
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A Cross-Machine Comparison of Shear-Wave Speed Measurements Using 2D Shear-Wave Elastography in the Normal Female Breast. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11209391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Quantitative measures of radiation-induced breast stiffness are required to support clinical studies of novel breast radiotherapy regimens and exploration of personalised therapy, however, variation between shear-wave elastography (SWE) machines may limit the usefulness of shear-wave speed (cs) for this purpose. Mean cs measured in four healthy volunteers’ breasts and a phantom using 2D-SWE machines Acuson S2000 (Siemens Medical Solutions) and Aixplorer (Supersonic Imagine) were compared. Shear-wave speed was measured in the skin region, subcutaneous adipose tissue and parenchyma. cs estimates were on average 2.3% greater when using the Aixplorer compared to S2000 in vitro. In vivo, cs estimates were on average 43.7%, 36.3% and 49.9% significantly greater (p << 0.01) when using the Aixplorer compared to S2000, for skin region, subcutaneous adipose tissue and parenchyma, respectively. In conclusion, despite relatively small differences between machines observed in vitro, large differences in absolute measures of shear wave speed measured were observed in vivo, which may prevent pooling of cross-machine data in clinical studies of the breast.
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Chen YL, Gao Y, Chang C, Wang F, Zeng W, Chen JJ. Ultrasound shear wave elastography of breast lesions: correlation of anisotropy with clinical and histopathological findings. Cancer Imaging 2018; 18:11. [PMID: 29622044 PMCID: PMC5887177 DOI: 10.1186/s40644-018-0144-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 03/27/2018] [Indexed: 11/10/2022] Open
Abstract
Background Ultrasound shear-wave elastography (SWE) may increase specificity of breast lesion assessment with ultrasound, but elasticity measurements may change with transducer orientation, defined as anisotropy. In this study, we aimed to observe the anisotropy of SWE of breast lesions, and its correlation with clinical and histopathological findings. Methods This retrospective study was approved by institutional review board. From June 2014 to June 2015, a total of 276 women (mean age, 48.75 ± 12.12 years) with 276 breast lesions (174 malignant, 102 benign) were enrolled for conventional ultrasound and SWE before surgical excision. Elasticity modulus in the longest diameter and orthogonal diameter were recorded, including maximum elasticity (Emax), mean elasticity (Emean), standard deviation (Esd) and ratio between mean elasticity of lesion and normal fatty tissue (Eratio). Anisotropy coefficients including anisotropic difference (AD) and anisotropy factors (AF) were calculated, and correlations with malignancy, tumor size, palpability, movability, lesion location and histopathology were analyzed. Results The average Emax, Emean, Esd and Eratio of the longest diameter were significantly higher than orthogonal diameter (P < 0.05). AUCs of ADs and AFs were inferior to quantitative parameters (P < 0.001), with AUCs of AFs superior to ADs (P < 0.001). ADs showed no significant correlation with malignancy, palpability, movability, distance from nipple and skin, and histopathological patterns. ADmean was significantly higher in inner half than outer half of the breast (P = 0.034). Higher AFs were significantly correlated with larger lesion size (P = 0.042), palpability (P < 0.05), shorter distance from nipple and skin (P < 0.05) and higher suspicion for malignancy (P < 0.001). AFs were significantly higher in IDC than DCIS (P < 0.05), higher in Grade II/III than Grade I IDC (P < 0.001), and correlated with ER/PR(+) (P < 0.05). Conclusions AF of SWE was an indicator for malignancy and more aggressive breast cancer.
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Affiliation(s)
- Ya-Ling Chen
- Department of Ultrasound, Fudan University Shanghai Cancer Center, No. 270 Dong-An Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, No. 270 Dong-An Road, Shanghai, 200032, China
| | - Yi Gao
- Department of Ultrasound, Fudan University Shanghai Cancer Center, No. 270 Dong-An Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, No. 270 Dong-An Road, Shanghai, 200032, China
| | - Cai Chang
- Department of Ultrasound, Fudan University Shanghai Cancer Center, No. 270 Dong-An Road, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, No. 270 Dong-An Road, Shanghai, 200032, China.
| | - Fen Wang
- Department of Ultrasound, Fudan University Shanghai Cancer Center, No. 270 Dong-An Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, No. 270 Dong-An Road, Shanghai, 200032, China
| | - Wei Zeng
- Department of Ultrasound, Fudan University Shanghai Cancer Center, No. 270 Dong-An Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, No. 270 Dong-An Road, Shanghai, 200032, China
| | - Jia-Jian Chen
- Department of Breast Surgery, Fudan University Shanghai Cancer Center, No. 270 Dong-An Road, Shanghai, 200032, China
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Zhang M, Rubin JM. A Response to Skerl et al. (2016). Acad Radiol 2017; 24:1050. [PMID: 28341413 DOI: 10.1016/j.acra.2017.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 02/08/2017] [Indexed: 11/24/2022]
Affiliation(s)
- Man Zhang
- Department of Radiology, University of Michigan Health System, 1500 E Medical Center Dr, Ann Arbor, MI 48109
| | - Jonathan M Rubin
- Department of Radiology, University of Michigan Health System, 1500 E Medical Center Dr, Ann Arbor, MI 48109
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Engelmann G, Quader J, Teufel U, Schenk JP. Limitations and opportunities of non-invasive liver stiffness measurement in children. World J Hepatol 2017; 9:409-417. [PMID: 28357028 PMCID: PMC5355763 DOI: 10.4254/wjh.v9.i8.409] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 11/29/2016] [Accepted: 01/14/2017] [Indexed: 02/06/2023] Open
Abstract
Changes in liver structure are an important issue in chronic hepatopathies. Until the end of the 20th century, these changes could only be determined by histological analyses of a liver specimen obtained via biopsy. The well-known limitations of this technique (i.e., pain, bleeding and the need for sedation) have precluded its routine use in follow-up of patients with liver diseases. However, the introduction of non-invasive technologies, such as ultrasound and magnetic resonance imaging, for measurement of liver stiffness as an indirect marker of fibroses has changed this situation. Today, several non-invasive tools are available to physicians to estimate the degree of liver fibrosis by analysing liver stiffness. This review describes the currently available tools for liver stiffness determination that are applicable to follow-up of liver fibrosis/cirrhosis with established clinical use in children, and discusses their features in comparison to the “historical” tools.
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