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Comparison between Histological Features and Strain Elastographic Characteristics in Canine Mammary Carcinomas. Vet Sci 2021; 9:vetsci9010009. [PMID: 35051093 PMCID: PMC8779832 DOI: 10.3390/vetsci9010009] [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: 11/15/2021] [Revised: 12/21/2021] [Accepted: 12/24/2021] [Indexed: 12/13/2022] Open
Abstract
Elastography is a sonographic technique that provides a noninvasive evaluation of the stiffness of a lesion. The objective of this work was to evaluate the accuracy of strain elastography, the most accessible modality in clinical practice, to discriminate between different histological types of malignant mammary neoplasms in the canine species, which can provide complementary information in real time to the diagnosis and thus help in the choice of surgical technique. A total of 34 females with 56 mammary carcinomas were selected and classified into three histological groups according to their aggressiveness. The histological and elastographic characteristics of these malignant tumors were analyzed and compared to evaluate the diagnostic accuracy of strain elastography. Visual score presented a sensitivity of 88.0%, specificity of 58.1%, and accuracy of 71.43% in distinguishing the most aggressive group of carcinomas. The strain ratio had a sensitivity of 84.0%, specificity of 61.1%, and accuracy of 69.64%. On the other hand, intratumoral strain ratio obtained a sensitivity of 71.40% and specificity of 61.90% when intratumoral fibrosis was taken as reference, with an accuracy of 66.07%. Similarly, peritumoral strain ratio was also positively related to fibrosis in the periphery of lesions (p ≤ 0.001), with a sensitivity of 93.80%, specificity of 77.50% and an accuracy of 92.87%. In conclusion, accuracy of this elastographic modality can be a useful method to differentiate more aggressive histological types. Therefore, it represents an additional diagnostic technique useful in the daily clinic thanks to the short time required for the examination, which allows real-time visualization and immediate interpretation of the results.
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2
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Shao J, Shi G, Qi Z, Zheng J, Chen S. Advancements in the Application of Ultrasound Elastography in the Cervix. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:2048-2063. [PMID: 34049726 DOI: 10.1016/j.ultrasmedbio.2021.04.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 04/01/2021] [Accepted: 04/10/2021] [Indexed: 06/12/2023]
Abstract
Ultrasound elastography is a modern imaging technique that has developed rapidly in recent years. It enables objective measurement of tissue stiffness, a physical property intuitive to the human sense of touch. This novel technology has become a hotspot and plays a major role in scientific research and academic practice. Presently, ultrasound elastography has been used in the identification of benign and malignant tumors in superficial organs, such as breast and thyroid, providing clinically accurate diagnosis and treatment. The method has also been widely used for the liver, kidney, prostate, lymph nodes, blood vessels, skin and muscle system. In the application of cervical lesions, ultrasound elastography can distinguish normal cervix from abnormal cervix and differentiate benign from malignant lesions. It can significantly improve the diagnostic specificity for cervical cancer and is also useful for assessing infiltration depth and stage of cervical cancer, as well as predicting chemoradiotherapy treatment response. For cervical evaluation during pregnancy, ultrasound elastography is useful for assessing cervical softening and predicting premature delivery and outcome of induced labor. This article reviews the principles of ultrasound elastography as well as the current status and limitations in its application for cervical lesions and the cervix during pregnancy.
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Affiliation(s)
- Juntao Shao
- Department of Ultrasound, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, China.
| | - Guilian Shi
- School of Biomedical Engineering, Hubei University of Science and Technology, Xianning, Hubei Province, China
| | - Zhengqin Qi
- Department of Ultrasound, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, China
| | - Jingjing Zheng
- Department of Ultrasound, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, China
| | - Shigao Chen
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
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Zhou B, Shao J, Kisby CK, Zhang X. Ultrasound vibro-elastography for assessing mechanical properties of porcine reproductive tissues in an ex vivo model. Clin Biomech (Bristol, Avon) 2020; 78:105093. [PMID: 32619871 DOI: 10.1016/j.clinbiomech.2020.105093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 06/09/2020] [Accepted: 06/12/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The aim of this study was to use ultrasound vibro-elastography (UVE) for measuring surface wave speed and assessing mechanical properties of ex vivo porcine reproductive tissues, including the uterus, bladder, cornua and cervix. METHODS In UVE, a 0.1-s harmonic vibration at low frequency was generated on the tissue surface with a handheld shaker. A linear-array ultrasound probe was used to measure the resulting surface wave propagation. Surface wave speeds of tissues were measured in the frequency range of 100-300 Hz. Mechanical properties of the tissue were calculated based on wave speed dispersion with frequency. FINDINGS The obtained results showed that the surface wave speeds of porcine bladder, cervix, cornua and uterus increased with frequency. There were no statistically significant differences in the wave speeds or mechanical properties among the porcine bladder, cervix, cornua and uterus. INTERPRETATION Experimental data obtained in this study may be used as a reference to study in vivo surface wave speed or mechanical properties for porcine or human reproductive tissues.
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Affiliation(s)
- Boran Zhou
- Department of Radiology, Mayo Clinic, USA
| | - Juntao Shao
- Department of Radiology, Mayo Clinic, USA; Department of Ultrasound, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei Province, China
| | - Cassandra K Kisby
- Division of Urogynecology, Department of Obstetrics & Gynecology, Mayo Clinic, USA
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Chen Y, Jiang J, Shi J, Chang W, Shi J, Chen M, Zhang Q. Dual-mode ultrasound radiomics and intrinsic imaging phenotypes for diagnosis of lymph node lesions. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:742. [PMID: 32647667 PMCID: PMC7333147 DOI: 10.21037/atm-19-4630] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background The ultrasonic diagnosis of lymph node lesions is usually based on a small number of subjective visual features from a single ultrasonic modality, which limits diagnostic accuracy. Therefore, our study aimed to propose a computerized method for using dual-mode ultrasound radiomics and the intrinsic imaging phenotypes for accurately differentiating benign, lymphomatous, and metastatic lymph nodes. Methods A total of 543 lymph nodes from 538 patients were examined with both B-mode ultrasonography and elastography. The data set was randomly divided into a training set of 407 nodes and a validation set of 136 nodes. First, we extracted 430 radiomic features from dual-mode images. Then, we combined the least absolute shrinkage and selection operator with the analysis of variance to select several typical features. We retrieved the intrinsic imaging phenotypes by using a hierarchical clustering of all radiomics features, and we integrated the phenotypes with the selected features for the classification of benign, lymphomatous, and metastatic nodes. Results The areas under the receiver operating characteristic curves (AUCs) on the validation set were 0.960 for benign vs. lymphomatous, 0.716 for benign vs. metastatic, 0.933 for lymphomatous vs. metastatic, and 0.856 for benign vs. malignant. Conclusions The radiomics features and intrinsic imaging phenotypes derived from the dual-mode ultrasound can capture the distinctions between benign, lymphomatous, and metastatic nodes and are valuable in node differentiation.
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Affiliation(s)
- Ying Chen
- Shanghai Institute for Advanced Communication and Data Science, Shanghai University, Shanghai, China.,The SMART (Smart Medicine and AI-based Radiology Technology) Lab, Institute of Biomedical Engineering, Shanghai University, Shanghai, China.,School of Communication and Information Engineering, Shanghai University, Shanghai, China
| | - Jianwei Jiang
- Department of Ultrasound Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Shi
- Shanghai Institute for Advanced Communication and Data Science, Shanghai University, Shanghai, China.,The SMART (Smart Medicine and AI-based Radiology Technology) Lab, Institute of Biomedical Engineering, Shanghai University, Shanghai, China.,School of Communication and Information Engineering, Shanghai University, Shanghai, China
| | - Wanying Chang
- Department of Ultrasound Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Shi
- Shanghai Institute for Advanced Communication and Data Science, Shanghai University, Shanghai, China.,School of Communication and Information Engineering, Shanghai University, Shanghai, China
| | - Man Chen
- Department of Ultrasound Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi Zhang
- Shanghai Institute for Advanced Communication and Data Science, Shanghai University, Shanghai, China.,The SMART (Smart Medicine and AI-based Radiology Technology) Lab, Institute of Biomedical Engineering, Shanghai University, Shanghai, China.,School of Communication and Information Engineering, Shanghai University, Shanghai, China.,Hangzhou YITU Healthcare Technology, Hangzhou, China
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5
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Zengel P, Notter F, Clevert DA. VTIQ and VTQ in combination with B-mode and color Doppler ultrasound improve classification of salivary gland tumors, especially for inexperienced physicians. Clin Hemorheol Microcirc 2019; 70:457-466. [DOI: 10.3233/ch-189312] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Affiliation(s)
- Pamela Zengel
- Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Florian Notter
- Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Dirk A. Clevert
- Department of Radiology, Ludwig-Maximilians-Universität München, Munich, Germany
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Zengel P, Notter F, Clevert DA. Does acoustic radiation force elastography improve the diagnostic capability of ultrasound in the preoperative characterization of masses of the parotid gland? Dentomaxillofac Radiol 2018; 47:20180068. [PMID: 29745753 DOI: 10.1259/dmfr.20180068] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES: Ultrasound is the method of choice for preoperative evaluation of tumours of the parotid glands. However, existing methods do not allow for clear differentiation between the most common benign tumours and malignant tumours. The aim of our study was to evaluate if acoustic radiation force, Virtual Touch Quantification (VTQ) elastography helps to improve the preoperative evaluation of parotid masses. METHODS: We investigated the parenchyma of 102 parotid glands, 14 lymph nodes of healthy volunteers and 51 tumours of the parotid gland via ultrasound, colour Doppler ultrasound and VTQ. The results were matched with histopathology and analyzed. RESULTS: The perfusion in pleomorphic adenoma, the most frequent benign tumour of the parotid gland, was significantly lower in comparison to malignant tumours. All tumours showed statistically significant higher perfusion in comparison to the parenchyma or the lymph nodes of the gland. Shear wave velocity of the user-defined region of interest was statistically significant more frequently an overflow value higher than 8.5 m/s in total tumours in comparison to parenchyma or lymph nodes. The different tumour types presented no significant difference in the shear wave velocity. CONCLUSIONS: VTQ in combination with classical ultrasound examination provides additional data useful in distinguishing between benign and malignant tumours and thus shows promise for integration into preexisting ultrasound protocols. However, despite the improvement, clear differentiation of tumours is still not possible and further investigation is recommended.
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Affiliation(s)
- Pamela Zengel
- 1 Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-Universität München , Munich , Germany
| | - Florian Notter
- 1 Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-Universität München , Munich , Germany
| | - Dirk A Clevert
- 2 Institute of Radiology, Ludwig-Maximilians-Universität München , Munich , Germany
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Farrokh A, Schaefer F, Degenhardt F, Maass N. Comparison of Two Different Ultrasound Devices Using Strain Elastography Technology in the Diagnosis of Breast Lesions Related to the Histologic Results. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:978-985. [PMID: 29477744 DOI: 10.1016/j.ultrasmedbio.2018.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 01/08/2018] [Accepted: 01/18/2018] [Indexed: 06/08/2023]
Abstract
This study was conducted to provide evidence that elastograms of two different devices and different manufacturers using the same technical approach provide the same diagnoses. A total of 110 breast lesions were prospectively analysed by two experts in ultrasound, using the strain elastography function from two different manufacturers (Hitachi HI-RTE, Hitachi Medical Systems, Wiesbaden, Germany; and Siemens eSie Touch, Siemens Medical Systems, Erlangen, Germany). Results were compared with the histopathologic results. Applying the Bowker test of symmetry, no statistically significant difference between the two elastography functions of these two devices was found (p = 0.120). The Cohen's kappa of k = 0.591 showed moderate strength of agreement between the two elastograms. The two examiners yielded moderate strength of agreement analysing the elastograms (Hitachi HI-RTE, k = 0.478; Siemens eSie Touch, k = 0.441). In conclusion, evidence is provided that elastograms of the same lesion generated by two different ultrasound devices equipped with a strain elastography function do not significantly differ.
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Affiliation(s)
- André Farrokh
- University Hospital Schleswig-Holstein, Campus Kiel, Department of Gynecology and Obstetrics, Kiel, Germany.
| | - Fritz Schaefer
- University Hospital Schleswig-Holstein, Campus Kiel, Department of Breast Imaging and Interventions, Kiel, Germany
| | - Friedrich Degenhardt
- Hannover Medical School, Department of Gynecology and Obstetrics, Hannover, Germany
| | - Nicolai Maass
- University Hospital Schleswig-Holstein, Campus Kiel, Department of Gynecology and Obstetrics, Kiel, Germany
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8
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B-mode ultrasound examination of canine mammary gland neoplastic lesions of small size (diameter < 2 cm). Vet Res Commun 2018. [PMID: 29541992 DOI: 10.1007/s11259-018-9716-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Ultrasonography is a valuable tool for the evaluation of neoplastic lesions in the dog and there is a growing interest in the use of this technique for the stadiation of canine mammary tumours. An accurate assessment of small sized nodules facilitates the stadiation of the mammary lesions and helps the clinician in the choice of the most indicated surgical therapy. The aim of this study was to identify those ultrasound criteria that may be useful in discriminating between benign and malignant lesions of small size (diameter smaller than 2 cm). Sixty-two nodules, < 2 cm in larger diameter, belonging to thirty-five bitches presented between January 2012 and February 2014 were evaluated. Tumours were observed by conventional ultrasound and assessed for: shape (regular-irregular), limit (defined-ill-defined), margins (regular-irregular), echogenicity (hypoechoic-isoechoic-hyperecoic), echotexture (homogeneus-heterogeneus), presence of hyperecoic halo, distal acoustic enhancement or shadowing and surrounding tissue alterations. Among the alterations in surrounding tissues, the disruption of the glandular tissue and the increase in echogenicity of the peritumoral tissues were assessed. Thereafter, bitches were subjected to mastectomy and nodules were evaluated histologically. None of the ultasound criteria considered in the current study showed a statistically significant relation with malignancy, except for the presence of alterations in the tissue surrounding the nodules. According to our results, this characteristic may indicate malignancy, however its subjectivity may affect the applicability in clinical practice. In conclusions, conventional ultrasound in bitches had a limited ability in discriminating benign and malignant mammary gland neoplastic lesions of small size (diameter < 2 cm).
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Cheng R, Li J, Ji L, Liu H, Zhu L. Comparison of the diagnostic efficacy between ultrasound elastography and magnetic resonance imaging for breast masses. Exp Ther Med 2017; 15:2519-2524. [PMID: 29456656 DOI: 10.3892/etm.2017.5674] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 03/03/2017] [Indexed: 11/06/2022] Open
Abstract
The present study compared the efficacy of ultrasound elastography (UE), magnetic resonance imaging (MRI) and the combination of the two methods (UE+MRI) in the differential diagnosis of benign and malignant breast tumors. In total, 86 patients with breast masses were recruited and evaluated by UE, MRI and UE+MRI. Strain ratios of UE were calculated for the breast mass and adjacent normal tissues. In addition, the receiver operating characteristic (ROC) curve was obtained, while the sensitivity and specificity were calculated to determine the optimal cut-off point for the differential diagnosis. The area under the ROC curve (AUC) was also calculated to evaluate the diagnostic performance of these methods. The results indicated that the diagnostic accuracy of UE+MRI was significantly higher compared with the UE or MRI methods in the differential diagnosis of invasive ductal, invasive lobular, intraductal papillary, medullary and mucinous carcinomas (all P<0.05). The optimal cut-off points of ROC curve of the Strain Ratio in the diagnosis of breast lesions were 2.81, 3.76 and 3.42 for UE, MRI and UE+MRI, respectively. Furthermore, the AUC values were 86.7, 79.2 and 91.4%, while the diagnostic accuracy rates were 82.5, 75.5 and 95.3%, for UE, MRI and UE+MRI, respectively. Accuracy rate differences between UE and MRI or between UE and UE+MRI were statistically significant (P<0.05), whereas no significant difference existed between MRI and UE+MRI (P>0.05). Finally, the diagnostic consistency of the UE+MRI method with the pathological diagnosis was higher compared with UE or MRI alone. In conclusion, the combination of UE and MRI is superior to the use of UE or MRI alone in the differential diagnosis of benign and malignant breast masses.
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Affiliation(s)
- Rong Cheng
- Department of Ultrasound, Nuclear Industry 215 Hospital of Shanxi Province, Xianyang, Shanxi 712000, P.R. China
| | - Jing Li
- Department of Ultrasound, Nuclear Industry 215 Hospital of Shanxi Province, Xianyang, Shanxi 712000, P.R. China
| | - Li Ji
- Department of Ultrasound, Nuclear Industry 215 Hospital of Shanxi Province, Xianyang, Shanxi 712000, P.R. China
| | - Huining Liu
- Department of Ultrasound, Nuclear Industry 215 Hospital of Shanxi Province, Xianyang, Shanxi 712000, P.R. China
| | - Limin Zhu
- Department of Ultrasound, Nuclear Industry 215 Hospital of Shanxi Province, Xianyang, Shanxi 712000, P.R. China
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Zengel P, Notter F, Reichel CA, Clevert DA. Does Virtual Touch IQ elastography help to improve the preoperative diagnosis of parotid tumors: A prospective trial. Clin Hemorheol Microcirc 2017; 67:425-434. [PMID: 28885210 DOI: 10.3233/ch-179223] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
BACKGROUND It is difficult to assess tumors of the parotid gland preoperatively. However, it is essential for the surgeon to know which kind of tumor is present. Ultrasound is the method of choice, but there is still no reliable differential diagnostic tool for determining whether a tumor is malignant or benign. OBJECTIVE The aim of our study was to examine the value of Virtual Touch imaging quantification (VTIQ) elastograpy in distinguishing between malignant and benign tumors as well as in identifying the most common benign tumor types. METHODS The parenchyma of 100 parotid glands and 12 lymph nodes of healthy volunteers and 50 tumors of the parotid gland were analyzed via ultrasound, color Doppler ultrasound, and VTIQ, and the results were then compared with histopathology. RESULTS In comparison with benign tumors, in malignant tumors the tumor border was diffuse, the perfusion higher, and the VTIQ quality much lower. Share wave velocity of the user-defined region of interest was more frequently higher than 6.8 m/s in malignant tumors in comparison to benign tumors. CONCLUSIONS VTIQ in combination with ultrasound examination provides additional information for distinguishing between benign and malignant tumors and shows promise for integration into preexisting ultrasound protocols.
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Affiliation(s)
- Pamela Zengel
- Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Florian Notter
- Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Christoph A Reichel
- Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Dirk A Clevert
- Institute of Radiology, Ludwig-Maximilians-Universität München, Munich, Germany
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Depciuch J, Kaznowska E, Golowski S, Koziorowska A, Zawlik I, Cholewa M, Szmuc K, Cebulski J. Monitoring breast cancer treatment using a Fourier transform infrared spectroscopy-based computational model. J Pharm Biomed Anal 2017; 143:261-268. [DOI: 10.1016/j.jpba.2017.04.039] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 04/19/2017] [Accepted: 04/23/2017] [Indexed: 11/25/2022]
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12
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Verification of the effectiveness of the Fourier transform infrared spectroscopy computational model for colorectal cancer. J Pharm Biomed Anal 2017; 145:611-615. [PMID: 28793272 DOI: 10.1016/j.jpba.2017.07.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2017] [Revised: 07/21/2017] [Accepted: 07/23/2017] [Indexed: 11/21/2022]
Abstract
Colorectal cancer is one of the most common cancers. Its formation is influenced by genetic and environmental factors. Despite the continuous development of diagnostic tools and cancer therapies, there are no methods that allow a real-time estimation of treatment efficiency. This method can be a vibrational spectroscopy. The resulting infrared spectrum (FTIR) of the tissue gives us information about the chemical composition and the content of the individual components. We have noticed that tumor tissues, healthy and after chemotherapy tissues, have different vibrational spectra. It was also shown that spectra acquired from normal (benign) tissues were similar to those derived from tissues post-chemotherapy. The similarity was greater, when the effectiveness of chemotherapy, confirmed by medical documentation, was better. Therefore, we decided to use the physical model proposed in our earlier paper to verify its correctness and to show whether a particular type of chemotherapy was effective or not. Comparison of the results obtained from the physical model with patients data have been found as close to the physical condition.
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Wang M, Yang Z, Liu C, Yan J, Zhang W, Sun J, Cui G. Differential Diagnosis of Breast Category 3 and 4 Nodules Through BI-RADS Classification in Conjunction with Shear Wave Elastography. ULTRASOUND IN MEDICINE & BIOLOGY 2017; 43:601-606. [PMID: 27988221 DOI: 10.1016/j.ultrasmedbio.2016.10.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 10/04/2016] [Accepted: 10/13/2016] [Indexed: 06/06/2023]
Abstract
Ultrasound (US) has become one of the important imaging methods for differentiating benign from malignant breast lesions. In 2013, the American College of Radiology published the fifth edition of the Breast Imaging-Reporting and Data System (BI-RADS). BI-RADS is a guide with recommendations for the standardization of breast imaging (US, mammography and magnetic resonance imaging) reports and for the auditing of centers employing such methods. Its objective is to standardize the nomenclature used in the reports. However, current US examinations are neither adequately sensitive nor sufficiently specific enough. The average Young's modulus was measured through shear wave elastography (SWE) to evaluate the diagnostic value of the BI-RADS classification in conjunction with SWE in differentiating BI-RADS 3 and 4 nodules. A total of 100 consecutive women with 126 breast lesions, including 65 benign and 61 malignant lesions, were included. The average Young's modulus of breast nodules and peri-nodule tissue (Emean1 and Emean2) was also determined through SWE. A receiver operating characteristic curve was drawn on the basis of pathologic results. The highest cut-off values were C1 and C2. At Emean1 > C1 or Emean2 > C2, BI-RADS 3 was increased to 4a and BI-RADS 4a was increased to 4b. At Emean1 ≤ C1 and Emean2 ≤ C2, BI-RADS 4b was decreased to 4a. Other BI-RADS classifications remained unchanged. BI-RADS 3 and 4a were considered benign. BI-RADS 4b and 4c were malignant. The area under the curve, sensitivity and specificity of the BI-RADS classification in conjunction with SWE were 0.952, 93.4% and 95.4%, respectively. The area under the curve, sensitivity and specificity of the original BI-RADS classification were 0.883, 82.0% and 87.7%, respectively. Differences were statistically significant (p = 0.028, Z-test). The diagnostic sensitivity and specificity were increased effectively. As a new method, BI-RADS classification in conjunction with SWE that combines the average Young's modulus yields a high value in terms of the differential diagnosis of breast nodules.
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Affiliation(s)
- Min Wang
- Department of Ultrasound, Affiliated Hospital of Binzhou Medical College, Binzhou, China
| | - Zhi Yang
- Department of Ultrasound, Affiliated Hospital of Binzhou Medical College, Binzhou, China
| | - Can Liu
- Department of Ultrasound, Affiliated Hospital of Binzhou Medical College, Binzhou, China
| | - Junhong Yan
- Department of Ultrasound, Affiliated Hospital of Binzhou Medical College, Binzhou, China
| | - Wenxiao Zhang
- Department of Ultrasound, Affiliated Hospital of Binzhou Medical College, Binzhou, China
| | - Jian Sun
- Department of Ultrasound, Affiliated Hospital of Binzhou Medical College, Binzhou, China
| | - Guanghe Cui
- Department of Ultrasound, Affiliated Hospital of Binzhou Medical College, Binzhou, China.
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Schröder C, Lock G, Schmidt C, Löning T, Dieckmann KP. Real-Time Elastography and Contrast-Enhanced Ultrasonography in the Evaluation of Testicular Masses: A Comparative Prospective Study. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:1807-1815. [PMID: 27181687 DOI: 10.1016/j.ultrasmedbio.2016.03.026] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 03/19/2016] [Accepted: 03/22/2016] [Indexed: 06/05/2023]
Abstract
This study investigates the usefulness of contrast-enhanced ultrasound (CEUS) and real-time elastography (RTE) for the characterization of testicular masses by comparing pre-operative ultrasound findings with post-operative histology. Sixty-seven patients with 68 sonographically detected testicular masses underwent B-mode, color-coded Doppler sonography (CCDS), CEUS and RTE according to defined criteria. For RTE, elasticity score (ES), difference of elasticity score (D-ES), strain ratio (SR) and size quotient (Qsize) were evaluated. Histopathologically, 54/68 testicular lesions were neoplastic (47 malignant, 7 benign). Descriptive statistics revealed the following results (neoplastic vs. non-neoplastic) for sensitivity, specificity, positive predictive value, negative predictive value and accuracy, respectively: B-mode, 100%, 43%, 87%, 100%, 88%; CCDS 81%, 86%, 96%, 55%, 82%; CEUS 93%, 85%, 96%, 73%, 91%; ES 98%, 25%, 85%, 75%, 85%; D-ES 98%, 50%, 90%, 83%, 89%; SR 90%, 45%, 86%, 56%, 81%; and Qsize 57%, 83%, 94%, 28%, 61%. B-mode with CCDS remains the standard for assessing testicular masses. In characterization of testicular lesions, CEUS clearly outperformed all other modalities. Our study does not support the routine use of RTE in testicular ultrasonography because of its low specificity.
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Affiliation(s)
- Claudia Schröder
- Department of Internal Medicine, Albertinen-Krankenhaus, Hamburg, Germany
| | - Guntram Lock
- Department of Internal Medicine, Albertinen-Krankenhaus, Hamburg, Germany.
| | - Christa Schmidt
- Department of Internal Medicine, Albertinen-Krankenhaus, Hamburg, Germany
| | - Thomas Löning
- Institute of Pathology, Albertinen-Krankenhaus, Hamburg, Germany
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15
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Zhou J, Yang Z, Zhan W, Zhang J, Hu N, Dong Y, Wang Y. Breast Lesions Evaluated by Color-Coded Acoustic Radiation Force Impulse (ARFI) Imaging. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:1464-1472. [PMID: 27131841 DOI: 10.1016/j.ultrasmedbio.2016.02.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 02/17/2016] [Accepted: 02/19/2016] [Indexed: 06/05/2023]
Abstract
The goal of our study was to investigate the value of color-coded Virtual Touch tissue imaging (VTI) using acoustic radiation force impulse (ARFI) technology in the characterization of breast lesions and to compare it with conventional ultrasound (US). Conventional US and color-coded VTI were performed in 196 solid breast lesions in 196 consecutive women (age range 17-91 y; mean 48.17 ± 14.46 y). A four-point scale VTI score was assigned for each lesion according to the color pattern both in the lesion and in the surrounding breast tissue. The mean VTI score was significantly higher for malignant lesions (3.80 ± 0.66, range 1-4) than for benign ones (2.02 ± 1.20, range 1-4) (p < 0.001), and the optimal cut-off value was between score 3 and score 4. The area under the receiver operating characteristic (ROC) curve for combined conventional US and VTI (0.945) was significantly higher than that for conventional US (0.902) and for VTI (0.871) (p = 0.0021 and p < 0.001, respectively). It was concluded that color-coded VTI with the proposed four-point scale score system combined with conventional US might have the potential to aid in the characterization of benign and malignant breast lesions.
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Affiliation(s)
- JianQiao Zhou
- Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - ZhiFang Yang
- Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - WeiWei Zhan
- Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
| | - JingWen Zhang
- Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Na Hu
- Department of Ultrasound, Cancer Hospital, Fudan University, Shanghai, China
| | - YiJie Dong
- Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - YingYing Wang
- Department of Ultrasound, Ningbo fourth People's Hospital, Xiangshan, China
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Depciuch J, Kaznowska E, Zawlik I, Wojnarowska R, Cholewa M, Heraud P, Cebulski J. Application of Raman Spectroscopy and Infrared Spectroscopy in the Identification of Breast Cancer. APPLIED SPECTROSCOPY 2016; 70:251-263. [PMID: 26903561 DOI: 10.1177/0003702815620127] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Raman spectroscopy and infrared (IR) spectroscopy are both techniques that allow for the investigation of vibrating chemical particles. These techniques provide information not only about chemical particles through the identification of functional groups and spectral analysis of so-called "fingerprints", these methods allow for the qualitative and quantitative analyses of chemical substances in the sample. Both of these spectral techniques are frequently being used in biology and medicine in diagnosing illnesses and monitoring methods of therapy. The type of breast cancer found in woman is often a malignant tumor, causing 1.38 million new cases of breast cancer and 458 000 deaths in the world in 2013. The most important risk factors for breast cancer development are: sex, age, family history, specific benign breast conditions in the breast, ionizing radiation, and lifestyle. The main purpose of breast cancer screening tests is to establish early diagnostics and to apply proper treatment. Diagnoses of breast cancer are based on: (1) physical techniques (e.g., ultrasonography, mammography, elastography, magnetic resonance, positron emission tomography [PET]); (2) histopathological techniques; (3) biological techniques; and (4) optical techniques (e.g., photo acoustic imaging, fluorescence tomography). However, none of these techniques provides unique or especially revealing answers. The aim of our study is comparative spectroscopic measurements on patients with the following: normal non-cancerous breast tissue; breast cancer tissues before chemotherapy; breast cancer tissues after chemotherapy; and normal breast tissues received around the cancerous breast region. Spectra collected from breast cancer patients shows changes in amounts of carotenoids and fats. We also observed changes in carbohydrate and protein levels (e.g., lack of amino acids, changes in the concentration of amino acids, structural changes) in comparison with normal breast tissues. This fact verifies that Raman spectroscopy and IR spectroscopy are very useful diagnostic tools that will shed new light in understanding the etiology of breast cancer.
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Affiliation(s)
- Joanna Depciuch
- Center for Innovation and Transfer of Natural Sciences and Engineering Knowledge, University of Rzeszow, Rzeszow, Poland Department of Biology - Agriculture, University of Rzeszow, Rzeszow, Poland
| | - Ewa Kaznowska
- Center for Innovative Research in Medical and Natural Sciences, University of Rzeszow, Rzeszow, Poland
| | - Izabela Zawlik
- Center for Innovative Research in Medical and Natural Sciences, University of Rzeszow, Rzeszow, Poland Department of Medical Genetics, Institute of Nursing and Health Sciences, Faculty of Medicine, University of Rzeszow, Rzeszow, Poland
| | - Renata Wojnarowska
- Center of Microelectronic and Nanotechnology, University of Rzeszow, Rzeszow, Poland
| | - Marian Cholewa
- Center for Innovation and Transfer of Natural Sciences and Engineering Knowledge, University of Rzeszow, Rzeszow, Poland
| | - Philip Heraud
- Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Józef Cebulski
- Center for Innovation and Transfer of Natural Sciences and Engineering Knowledge, University of Rzeszow, Rzeszow, Poland
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Abstract
The detection of intraductal breast papillomas can be difficult; however, it is very important for diagnosis and treatment. Although intraductal papillomas are usually benign growths, a small percentage may be malignant. No imaging modality can distinguish between benign and malignant papillomas; that is done only with a biopsy. The symptoms vary greatly, ranging from asymptomatic to nipple discharge to a palpable mass. Multiple modalities, including mammography and ductography, have been used to identify papillomas, while magnetic resonance imaging is used to further evaluate known papillomas. Sonography has been proven crucial in identifying these masses, thereby providing information for proper treatment including ultrasound-guided biopsies. The uses of various sonographic techniques, such as color Doppler, harmonic imaging, ballottement, use of stand-off pads, echo palpation, and elastography, have improved the detection of these masses.
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Liu XJ, Zhu Y, Liu PF, Xu YL. Elastography for Breast Cancer Diagnosis: a Useful Tool for Small and BI-RADS 4 Lesions. Asian Pac J Cancer Prev 2015; 15:10739-43. [DOI: 10.7314/apjcp.2014.15.24.10739] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Zhou J, Zhan W, Dong Y, Yang Z, Zhou C. Stiffness of the surrounding tissue of breast lesions evaluated by ultrasound elastography. Eur Radiol 2014; 24:1659-67. [PMID: 24706104 DOI: 10.1007/s00330-014-3152-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Revised: 01/24/2014] [Accepted: 03/12/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate the stiffness of the surrounding tissue of breast lesions using the strain ratio assessment method by ultrasound (US) elastography. METHODS This was an institutional ethics committee approved prospective study. A total of 127 breast lesions in 118 women (mean age 48.23 ± 14.32, range 20-90) were examined with conventional and elastographic US. The strain ratio assessment method was utilized to semi-quantitatively evaluate the stiffness of the breast lesions and the surrounding tissue. RESULTS Fifty-five lesions were malignant and 72 were benign. The strain ratio of the surrounding tissue was significantly higher in malignant cases (1.49 ± 0.67) than in benign ones (1.17 ± 0.44) (P = 0.001), and yielded an Az value of 0.669 in the diagnosis of breast lesions. There was a significant high positive correlation between the strain ratio of the lesion and the strain ratio of the surrounding tissue in the malignant group (r = 0.740, P < 0.001), and a significant moderate positive correlation in the benign group (r = 0.595, P < 0.001). CONCLUSION The stiffness of the surrounding tissue of malignant breast lesions was higher than that of benign lesions. The strain ratio of the surrounding tissue and the lesions was significantly correlated, and has potential for breast lesion diagnosis. KEY POINTS • Stiffness of the surrounding tissue of malignant breast lesions was increased. • Stiffness of the surrounding tissue correlated with stiffness of breast lesions. • Stiffness of the surrounding tissue has potential use in diagnosis of breast lesions.
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Affiliation(s)
- JianQiao Zhou
- Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200025, China
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JSUM ultrasound elastography practice guidelines: breast. J Med Ultrason (2001) 2013; 40:359-91. [DOI: 10.1007/s10396-013-0457-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Accepted: 05/07/2013] [Indexed: 12/14/2022]
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Sonoelastography of parotid gland tumours: initial experience and identification of characteristic patterns. Eur Radiol 2012; 22:947-56. [DOI: 10.1007/s00330-011-2344-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 10/28/2011] [Accepted: 11/07/2011] [Indexed: 12/19/2022]
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Coley BD. The future of pediatric US. Pediatr Radiol 2011; 41 Suppl 1:S220-7. [PMID: 21523605 DOI: 10.1007/s00247-011-1991-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Revised: 01/04/2011] [Accepted: 01/13/2011] [Indexed: 10/18/2022]
Abstract
Despite advances in other modalities, US remains an essential technology in pediatric imaging. Improvements in technology provide increasingly detailed anatomical images, and new techniques show promise in providing novel anatomical as well as physiological and structural information. Other specialties are recognizing the value of US to their patients and are increasingly performing their own examinations. Economic and social factors are also influencing the development and use of US. This review will evaluate many of these issues and demonstrate that the future of pediatric US is bright and that pediatric radiologists can and should continue to be leaders in its use and development.
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Affiliation(s)
- Brian D Coley
- Department of Radiology, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
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Kwon HJ, Kang MJ, Cho JH, Oh JY, Nam KJ, Han SY, Lee SW. Acoustic radiation force impulse elastography for hepatocellular carcinoma-associated radiofrequency ablation. World J Gastroenterol 2011; 17:1874-8. [PMID: 21528062 PMCID: PMC3080723 DOI: 10.3748/wjg.v17.i14.1874] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 02/22/2011] [Accepted: 03/01/2011] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the potential usefulness of acoustic radiation force impulse (ARFI) images for evaluation of hepatocellular carcinomas (HCC)-associated radiofrequency ablation.
METHODS: From January 2010 to June 2010, a total of 38 patients with HCC including recurred HCCs after RFA underwent ARFI elastography. The brightness of tumor was checked and the shear wave velocity was measured for the quantification of stiffness. According to the brightness, the tumors were classified as brighter, same color and darker compared with adjacent parenchyma. Using the same methods, 8 patients with recurred HCCs after RFA state were evaluated about the brightness compared with adjacent RFA ablation area.
RESULTS: In the 38 patients with HCCs, 20 (52.6%) were brighter than surrounding cirrhotic parenchyma. Another 13 (34.2%) were darker. The others (5 cases, 13.2%) were seen as the same color as the adjacent liver parenchyma. Post-RFA lesions were darker than previous tumor and surrounding parenchyma in all 38 cases. However, recurred HCCs were brighter than the treated site in all 8 cases.
CONCLUSION: Using ARFI technique is helpful for differential diagnosis in order to detect recurred HCCs more easily in patients with confusing status.
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