1
|
Izzetti R, Nisi M. Imaging the Micron: New Directions in Diagnosis with Ultra-High-Frequency Ultrasound. Diagnostics (Basel) 2024; 14:735. [PMID: 38611648 PMCID: PMC11012073 DOI: 10.3390/diagnostics14070735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
In recent decades, advancements in medical imaging technologies have revolutionized diagnostic and therapeutic approaches, enhancing the precision and efficacy of healthcare interventions [...].
Collapse
Affiliation(s)
- Rossana Izzetti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy;
| | | |
Collapse
|
2
|
Li D, Yang F, Zhao Y, Wang Q, Ren W, Sun L, Shan D, Qin C. High-Frequency Ultrasound Imaging to Distinguish High-Risk and Low-Risk Dermatofibromas. Diagnostics (Basel) 2023; 13:3305. [PMID: 37958200 PMCID: PMC10650765 DOI: 10.3390/diagnostics13213305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/19/2023] [Accepted: 10/21/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Dermatofibroma has various pathological classifications, some of which pose a risk of recurrence and metastasis. Distinguishing these high-risk dermatofibromas based on appearance alone can be challenging. Therefore, high-frequency ultrasound may provide additional internal information on these lesions, helping to identify high-risk and low-risk dermatofibroma early. METHODS In this retrospective study, 50 lesions were analyzed to explore the correlation between clinical and high-frequency ultrasound features and dermatofibroma risk level. Based on their pathological features, the lesions were divided into high-risk (n = 17) and low-risk (n = 33) groups. Subsequently, an identification model based on significant high-frequency ultrasound features was developed. RESULTS Significant differences were observed in the thickness, shape, internal echogenicity, stratum basal, and Doppler vascular patterns between the high-risk and low-risk groups. The median lesion thickness for the high-risk dermatofibroma group was 4.1 mm (IQR: 3.2-6.1 mm), while it was 3.1 mm (IQR: 1.3-4.2 mm) for the low-risk dermatofibroma group. In the high-risk dermatofibroma group, irregular morphology was predominant (70.6%, 12/17), the most common being dermis-to-subcutaneous soft tissue penetration (64.7%, 11/17), and heterogenous internal echogenicity was observed in the majority of cases (76.5%, 13/17). On the other hand, regular morphology was more prevalent in the low-risk dermatofibroma group (78.8%, 26/33), primarily limited to the dermis layer (78.8%, 26/33), with homogeneous internal echogenicity also being prevalent in the majority of cases (81.8%, 27/33). Regarding the Doppler vascularity pattern, 69.7% (23/33) of low-risk dermatofibromas had no blood flow, while 64.7% (11/17) of high-risk dermatofibromas had blood flow. CONCLUSION High-frequency ultrasound is crucial in distinguishing high-risk and low-risk dermatofibromas, making it invaluable for clinical management.
Collapse
Affiliation(s)
- Danhua Li
- Department of Medical Ultrasound, Jinshan Hospital, Fudan University, Shanghai 201508, China; (D.L.); (Y.Z.)
| | - Feiyue Yang
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tongji University, Shanghai 200072, China; (F.Y.); (Q.W.); (W.R.); (L.S.)
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China
| | - Yang Zhao
- Department of Medical Ultrasound, Jinshan Hospital, Fudan University, Shanghai 201508, China; (D.L.); (Y.Z.)
| | - Qiao Wang
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tongji University, Shanghai 200072, China; (F.Y.); (Q.W.); (W.R.); (L.S.)
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai 200443, China
| | - Weiwei Ren
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tongji University, Shanghai 200072, China; (F.Y.); (Q.W.); (W.R.); (L.S.)
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China
- Department of Medical Ultrasound, Shanghai Skin Disease Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai 200443, China
| | - Liping Sun
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tongji University, Shanghai 200072, China; (F.Y.); (Q.W.); (W.R.); (L.S.)
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China
| | - Dandan Shan
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Tongji University, Shanghai 200072, China; (F.Y.); (Q.W.); (W.R.); (L.S.)
- Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Shanghai 200072, China
| | - Chuan Qin
- Department of Medical Ultrasound, Jinshan Hospital, Fudan University, Shanghai 201508, China; (D.L.); (Y.Z.)
- Department of Ultrasound, Karamay Central Hospital, Karamay 834000, China
| |
Collapse
|
3
|
Nisi M, Gennai S, Graziani F, Izzetti R. The Reliability of Ultrasonographic Assessment of Depth of Invasion: A Systematic Review with Meta-Analysis. Diagnostics (Basel) 2023; 13:2833. [PMID: 37685371 PMCID: PMC10486678 DOI: 10.3390/diagnostics13172833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Depth of invasion (DOI) has been recognized to be a strong prognosticator for oral squamous cell carcinoma (OSCC). Several diagnostic techniques can be employed for DOI assessment, however intraoral ultrasonography has been increasingly applied for the intraoral evaluation of OSCCs. The aim of the present study is to review the evidence on the application of intraoral ultrasonography to the assessment of DOI in patients affected by OSCC. A systematic electronic and manual literature search was performed, and data from eligible studies were reviewed, selected, and extracted. The studies had to report the correlation between DOI estimated with ultrasonography versus histopathology. A meta-analysis was conducted on the quantitative data available. Sixteen articles were included in the review following the screening of the initial 228 studies retrieved from the literature. The meta-analysis showed a significant correlation between ultrasonographic and histopathologic measurements (p < 0.01). The studies were all at low/moderate risk of bias. Ultrasonography appears a valuable tool for DOI assessment.
Collapse
Affiliation(s)
| | | | | | - Rossana Izzetti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56123 Pisa, Italy
| |
Collapse
|
4
|
Arbune M, Padurariu-Covit MD, Niculet E, Chiscop I, Arbune AA, Tatu AL. Ulceration and a White Lesion of the Tongue in a Male HIV Positive Patient: A Journey on the Avenue of Differential Diagnoses in Search of a Solution. Life (Basel) 2023; 13:life13040901. [PMID: 37109430 PMCID: PMC10147043 DOI: 10.3390/life13040901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/21/2023] [Accepted: 03/24/2023] [Indexed: 03/31/2023] Open
Abstract
Oral lesions are early indicator of immunosuppression, leading to HIV new diagnoses. The type of oral lesions can reveal opportunistic diseases that are correlated with the severity of immune depletion. Highly active antiretroviral therapy decreases the incidence of opportunistic oral infections, whereas a large variety of lesions are frequently experienced in people with HIV. Overlapping pathogenic mechanisms and multiple contributing etiologies are related to unusual, atypical oral lesions that are challenging in the clinical practice. We present a rare case of eosinophilic granuloma of the tongue in an older male HIV patient with severe immunosuppression due to the failure of antiretroviral treatment. Differential diagnoses considered squamous carcinoma, lymphoma, viral, fungal or bacterial infections and autoimmune disorders, as well as the influence of HIV immune disfunctions or the influence of cannabidiol use. The histopathologic and immunohistochemistry examination clarified the inflammatory reactive benign substrate of the lesion, although future survey of the oral lesions is essential.
Collapse
Affiliation(s)
- Manuela Arbune
- Clinical Medical Department, Medicine and Pharmacy Faculty, “Dunarea de Jos” University of Galati, 800008 Galati, Romania; (M.A.); (A.-L.T.)
- Infectious Diseases Clinic Department I, Infectious Diseases Clinic Hospital “Sf. Cuv. Parascheva”, 800179 Galati, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research (MIC-DIR), “Dunarea de Jos” University, 800010 Galati, Romania;
| | - Monica-Daniela Padurariu-Covit
- The School for Doctoral Studies in Biomedical Sciences, “Dunarea de Jos” University of Galați, 800008 Galati, Romania
- Hematology Department, Emergency County Hospital “Sf. Apostol Andrei”, 800578 Galati, Romania
- Correspondence: (M.-D.P.-C.); (E.N.)
| | - Elena Niculet
- Multidisciplinary Integrated Center of Dermatological Interface Research (MIC-DIR), “Dunarea de Jos” University, 800010 Galati, Romania;
- The School for Doctoral Studies in Biomedical Sciences, “Dunarea de Jos” University of Galați, 800008 Galati, Romania
- Pathology Department, Emergency County Hospital “Sf. Apostol Andrei”, 800578 Galati, Romania
- Correspondence: (M.-D.P.-C.); (E.N.)
| | - Iulia Chiscop
- Oral and Maxillofacial Surgery Department, Emergency County Hospital “Sf. Apostol Andrei”, 800578 Galati, Romania;
- Clinical Surgery Department, Medicine and Pharmacy Faculty, “Dunarea de Jos” University of Galati, 800008 Galati, Romania
| | - Anca-Adriana Arbune
- Multidisciplinary Integrated Center of Dermatological Interface Research (MIC-DIR), “Dunarea de Jos” University, 800010 Galati, Romania;
- Neurology Department, Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Alin-Laurențiu Tatu
- Clinical Medical Department, Medicine and Pharmacy Faculty, “Dunarea de Jos” University of Galati, 800008 Galati, Romania; (M.A.); (A.-L.T.)
- Multidisciplinary Integrated Center of Dermatological Interface Research (MIC-DIR), “Dunarea de Jos” University, 800010 Galati, Romania;
- Dermato-Venerology Clinic Department, Infectious Diseases Clinic Hospital “Sf. Cuv. Parascheva”, 800179 Galati, Romania
| |
Collapse
|
5
|
Janowska A, Oranges T, Granieri G, Romanelli M, Fidanzi C, Iannone M, Dini V. Non-invasive imaging techniques in presurgical margin assessment of basal cell carcinoma: Current evidence. Skin Res Technol 2023; 29:e13271. [PMID: 36823508 PMCID: PMC10155792 DOI: 10.1111/srt.13271] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/19/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND The diagnosis of basal cell carcinoma (BCC) is based on clinical and dermoscopical features. In uncertain cases, innovative imaging techniques, such as reflectance confocal microscopy (RCM) and optical coherence tomography (OCT), have been used. The main limitation of these techniques is the inability to study deep margins. HFUS (high-frequency ultrasound) and the most recent UHFUS (ultra-high-frequency ultrasound) have been used in various applications in dermatology, but they are not yet routinely used in the diagnosis of BCC. A key point in clinical practice is to find an imaging technique that can help to reduce post-surgical recurrences with a careful presurgical assessment of the lesional margins. This technique should show high sensitivity, specificity, reproducibility and simplicity of execution. This concept is very important for the optimal management of patients who are often elderly and have many comorbidities. The aim of the paper is to analyse the characteristics of current imaging techniques and the studies in the literature on this topic. MATERIALS AND METHODS The authors independently searched the MEDLINE, PubMed, Embase, Scopus, ScienceDirect and Cochrane Library databases for studies looking for non-invasive imaging techniques for the presurgical margin assessment of BCC. RESULTS Preoperative study of the BCC subtype can help to obtain a complete excision with free margins. Different non-invasive imaging techniques have been studied for in vivo evaluation of tumour margins, comparing the histologic evaluation with a radical surgery. The possibility to study the lateral and deep margins would allow a reduction of recurrences and sparing of healthy tissue. CONCLUSION HFUS and UHFUS represent the most promising, non-invasive techniques for the pre-operative study of BCC facilitating the characterization of vascularization, deep lateral margins and high-risk subtypes, although they are limited by insufficient literature unlike RCM and OCT.
Collapse
Affiliation(s)
| | - Teresa Oranges
- Department of DermatologyAzienda Ospedaliero‐Universitaria Ospedale Pediatrico MeyerFlorenceItaly
| | | | | | | | | | | |
Collapse
|
6
|
Serrano C, Lazo M, Serrano A, Toledo-Pastrana T, Barros-Tornay R, Acha B. Clinically Inspired Skin Lesion Classification through the Detection of Dermoscopic Criteria for Basal Cell Carcinoma. J Imaging 2022; 8:197. [PMID: 35877641 PMCID: PMC9319034 DOI: 10.3390/jimaging8070197] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/05/2022] [Accepted: 07/08/2022] [Indexed: 12/10/2022] Open
Abstract
Background and Objective. Skin cancer is the most common cancer worldwide. One of the most common non-melanoma tumors is basal cell carcinoma (BCC), which accounts for 75% of all skin cancers. There are many benign lesions that can be confused with these types of cancers, leading to unnecessary biopsies. In this paper, a new method to identify the different BCC dermoscopic patterns present in a skin lesion is presented. In addition, this information is applied to classify skin lesions into BCC and non-BCC. Methods. The proposed method combines the information provided by the original dermoscopic image, introduced in a convolutional neural network (CNN), with deep and handcrafted features extracted from color and texture analysis of the image. This color analysis is performed by transforming the image into a uniform color space and into a color appearance model. To demonstrate the validity of the method, a comparison between the classification obtained employing exclusively a CNN with the original image as input and the classification with additional color and texture features is presented. Furthermore, an exhaustive comparison of classification employing different color and texture measures derived from different color spaces is presented. Results. Results show that the classifier with additional color and texture features outperforms a CNN whose input is only the original image. Another important achievement is that a new color cooccurrence matrix, proposed in this paper, improves the results obtained with other texture measures. Finally, sensitivity of 0.99, specificity of 0.94 and accuracy of 0.97 are achieved when lesions are classified into BCC or non-BCC. Conclusions. To the best of our knowledge, this is the first time that a methodology to detect all the possible patterns that can be present in a BCC lesion is proposed. This detection leads to a clinically explainable classification into BCC and non-BCC lesions. In this sense, the classification of the proposed tool is based on the detection of the dermoscopic features that dermatologists employ for their diagnosis.
Collapse
Affiliation(s)
- Carmen Serrano
- Dpto. Teoría de la Señal y Comunicaciones, Universidad de Sevilla, Camino de los Descubrimientos s/n, 41092 Seville, Spain; (M.L.); (B.A.)
| | - Manuel Lazo
- Dpto. Teoría de la Señal y Comunicaciones, Universidad de Sevilla, Camino de los Descubrimientos s/n, 41092 Seville, Spain; (M.L.); (B.A.)
| | - Amalia Serrano
- Hospital Universitario Virgen Macarena, Calle Dr. Fedriani, 3, 41009 Seville, Spain;
| | - Tomás Toledo-Pastrana
- Hospitales Quironsalud Infanta Luisa y Sagrado Corazón, Calle San Jacinto, 87, 41010 Seville, Spain;
| | | | - Begoña Acha
- Dpto. Teoría de la Señal y Comunicaciones, Universidad de Sevilla, Camino de los Descubrimientos s/n, 41092 Seville, Spain; (M.L.); (B.A.)
| |
Collapse
|
7
|
Fogante M, Carboni N, Argalia G. Clinical application of ultra-high frequency ultrasound: Discovering a new imaging frontier. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:817-825. [PMID: 35730639 DOI: 10.1002/jcu.23255] [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: 05/16/2022] [Revised: 06/02/2022] [Accepted: 06/05/2022] [Indexed: 06/15/2023]
Abstract
The ultra-high frequency ultrasound (UHFUS) is characterized by the use of probes between 30 and 100 MHz. This technology has recently been introduced in clinical practice and represents an opportunity for the diagnosis of numerous pathologies. The high spatial resolution of UHFUS, up to 30 μ in pixel size, allows to study the pathological modifications and to guide microsurgery treatments in anatomical body structures not evaluable by conventional HFUS. The aim of this work is to provide a review of the literature on the current clinical applications of UHFUS and to discuss its added role in different clinical settings.
Collapse
Affiliation(s)
- Marco Fogante
- Department of Radiological Sciences, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Ancona, Italy
| | - Nicola Carboni
- Department of Radiological Sciences, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Ancona, Italy
| | - Giulio Argalia
- Department of Radiological Sciences, Azienda Ospedaliero-Universitaria "Ospedali Riuniti", Ancona, Italy
| |
Collapse
|
8
|
Izzetti R, Fulvio G, Nisi M, Gennai S, Graziani F. Reliability of OMERACT Scoring System in Ultra-High Frequency Ultrasonography of Minor Salivary Glands: Inter-Rater Agreement Study. J Imaging 2022; 8:jimaging8040111. [PMID: 35448238 PMCID: PMC9026431 DOI: 10.3390/jimaging8040111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/03/2022] [Accepted: 04/12/2022] [Indexed: 12/10/2022] Open
Abstract
Minor salivary gland ultra-high frequency ultrasonography (UHFUS) has recently been introduced for the evaluation of patients with suspected primary Sjögren’s Syndrome (pSS). At present, ultrasonographic assessment of major salivary glands is performed using the Outcome Measures in Rheumatology (OMERACT) scoring system. Previous reports have explored the possibility of applying the OMERACT scoring system to minor salivary glands UHFUS, with promising results. The aim of this study was to test the inter-reader concordance in the assignment of the OMERACT score to minor salivary gland UHFUS. The study was conducted on 170 minor salivary glands UHFUS scans of patients with suspected pSS. Three independent readers performed UHFUS image evaluation. Intraclass correlation coefficient (ICC) was employed to assess inter-reader reliability. Bland and Altman analysis was employed to test the agreement with a gold standard examiner. ICC values > 0.9 were found for scores 0 and 1, while score 2 and score 3 presented ICCs of 0.873 and 0.785, respectively. The measurements performed by the three examiners were in agreement with the gold standard examiner. According to these results, UHFUS interpretation showed good inter-observer reliability, suggesting that OMERACT score can be effectively used for the evaluation of glandular alterations, even for minor salivary glands.
Collapse
Affiliation(s)
- Rossana Izzetti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (M.N.); (S.G.); (F.G.)
- Unit of Dentistry and Oral Surgery, University Hospital of Pisa, 56126 Pisa, Italy
- Correspondence:
| | - Giovanni Fulvio
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy;
- Unit of Rheumatology, University Hospital of Pisa, 56126 Pisa, Italy
| | - Marco Nisi
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (M.N.); (S.G.); (F.G.)
- Unit of Dentistry and Oral Surgery, University Hospital of Pisa, 56126 Pisa, Italy
| | - Stefano Gennai
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (M.N.); (S.G.); (F.G.)
- Unit of Dentistry and Oral Surgery, University Hospital of Pisa, 56126 Pisa, Italy
| | - Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (M.N.); (S.G.); (F.G.)
- Unit of Dentistry and Oral Surgery, University Hospital of Pisa, 56126 Pisa, Italy
| |
Collapse
|
9
|
Faita F, Oranges T, Di Lascio N, Ciompi F, Vitali S, Aringhieri G, Janowska A, Romanelli M, Dini V. Ultra-high-frequency ultrasound and machine learning approaches for the differential diagnosis of melanocytic lesions. Exp Dermatol 2022; 31:94-98. [PMID: 33738861 DOI: 10.1111/exd.14330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 03/14/2021] [Accepted: 03/15/2021] [Indexed: 12/12/2022]
Abstract
Malignant melanoma (MM) is one of the most dangerous skin cancers. The aim of this study was to present a potential new method for the differential diagnosis of MM from melanocytic naevi (MN). We examined 20 MM and 19 MN with a new ultra-high-frequency ultrasound (UHFUS) equipped with a 70 MHz linear probe. Ultrasonographic images were processed for calculating 8 morphological parameters (area, perimeter, circularity, area ratio, standard deviation of normalized radial range, roughness index, overlap ratio and normalized residual mean square value) and 122 texture parameters. Colour Doppler images were used to evaluate the vascularization. Features reduction was implemented by means of principal component analysis (PCA), and 23 classification algorithms were tested on the reduced features using histological response as ground-truth. Best results were obtained using only the first component of the PCA and the weighted k-nearest neighbour classifier; this combination led to an accuracy of 76.9%, area under the ROC curve of 83%, sensitivity of 84% and specificity of 70%. The histological analysis still remains the gold-standard, but the UHFUS images processing using a machine learning approach could represent a new non-invasive approach.
Collapse
Affiliation(s)
- Francesco Faita
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Teresa Oranges
- Department of Dermatology, University of Pisa, Pisa, Italy
- Dermatology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Nicole Di Lascio
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Francesco Ciompi
- Computational Pathology Group, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Saverio Vitali
- Diagnostic and Interventional Radiology, University of Pisa, Pisa, Italy
| | - Giacomo Aringhieri
- Diagnostic and Interventional Radiology, University of Pisa, Pisa, Italy
| | - Agata Janowska
- Department of Dermatology, University of Pisa, Pisa, Italy
| | | | - Valentina Dini
- Department of Dermatology, University of Pisa, Pisa, Italy
| |
Collapse
|
10
|
Venkatasamy A, Guerin E, Blanchet A, Orvain C, Devignot V, Jung M, Jung AC, Chenard MP, Romain B, Gaiddon C, Mellitzer G. Ultrasound and Transcriptomics Identify a Differential Impact of Cisplatin and Histone Deacetylation on Tumor Structure and Microenvironment in a Patient-Derived In Vivo Model of Gastric Cancer. Pharmaceutics 2021; 13:1485. [PMID: 34575561 PMCID: PMC8467189 DOI: 10.3390/pharmaceutics13091485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/09/2021] [Accepted: 09/13/2021] [Indexed: 01/06/2023] Open
Abstract
The reasons behind the poor efficacy of transition metal-based chemotherapies (e.g., cisplatin) or targeted therapies (e.g., histone deacetylase inhibitors, HDACi) on gastric cancer (GC) remain elusive and recent studies suggested that the tumor microenvironment could contribute to the resistance. Hence, our objective was to gain information on the impact of cisplatin and the pan-HDACi SAHA (suberanilohydroxamic acid) on the tumor substructure and microenvironment of GC, by establishing patient-derived xenografts of GC and a combination of ultrasound, immunohistochemistry, and transcriptomics to analyze. The tumors responded partially to SAHA and cisplatin. An ultrasound gave more accurate tumor measures than a caliper. Importantly, an ultrasound allowed a noninvasive real-time access to the tumor substructure, showing differences between cisplatin and SAHA. These differences were confirmed by immunohistochemistry and transcriptomic analyses of the tumor microenvironment, identifying specific cell type signatures and transcription factor activation. For instance, cisplatin induced an "epithelial cell like" signature while SAHA favored a "mesenchymal cell like" one. Altogether, an ultrasound allowed a precise follow-up of the tumor progression while enabling a noninvasive real-time access to the tumor substructure. Combined with transcriptomics, our results underline the different intra-tumoral structural changes caused by both drugs that impact differently on the tumor microenvironment.
Collapse
Affiliation(s)
- Aina Venkatasamy
- Streinth Lab (Stress Response and Innovative Therapies), Strasbourg University, Inserm UMR_S 1113 IRFAC (Interface Recherche Fondamental et Appliquée à la Cancérologie), 67200 Strasbourg, France; (A.V.); (E.G.); (A.B.); (C.O.); (V.D.); (A.C.J.); (B.R.)
- IHU-Strasbourg (Institut Hospitalo-Universitaire), 67091 Strasbourg, France
| | - Eric Guerin
- Streinth Lab (Stress Response and Innovative Therapies), Strasbourg University, Inserm UMR_S 1113 IRFAC (Interface Recherche Fondamental et Appliquée à la Cancérologie), 67200 Strasbourg, France; (A.V.); (E.G.); (A.B.); (C.O.); (V.D.); (A.C.J.); (B.R.)
| | - Anais Blanchet
- Streinth Lab (Stress Response and Innovative Therapies), Strasbourg University, Inserm UMR_S 1113 IRFAC (Interface Recherche Fondamental et Appliquée à la Cancérologie), 67200 Strasbourg, France; (A.V.); (E.G.); (A.B.); (C.O.); (V.D.); (A.C.J.); (B.R.)
| | - Christophe Orvain
- Streinth Lab (Stress Response and Innovative Therapies), Strasbourg University, Inserm UMR_S 1113 IRFAC (Interface Recherche Fondamental et Appliquée à la Cancérologie), 67200 Strasbourg, France; (A.V.); (E.G.); (A.B.); (C.O.); (V.D.); (A.C.J.); (B.R.)
| | - Véronique Devignot
- Streinth Lab (Stress Response and Innovative Therapies), Strasbourg University, Inserm UMR_S 1113 IRFAC (Interface Recherche Fondamental et Appliquée à la Cancérologie), 67200 Strasbourg, France; (A.V.); (E.G.); (A.B.); (C.O.); (V.D.); (A.C.J.); (B.R.)
| | | | - Alain C. Jung
- Streinth Lab (Stress Response and Innovative Therapies), Strasbourg University, Inserm UMR_S 1113 IRFAC (Interface Recherche Fondamental et Appliquée à la Cancérologie), 67200 Strasbourg, France; (A.V.); (E.G.); (A.B.); (C.O.); (V.D.); (A.C.J.); (B.R.)
- Laboratoire de Biologie Tumorale, ICANS, 67200 Strasbourg, France
| | - Marie-Pierre Chenard
- Pathology Department, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France;
| | - Benoit Romain
- Streinth Lab (Stress Response and Innovative Therapies), Strasbourg University, Inserm UMR_S 1113 IRFAC (Interface Recherche Fondamental et Appliquée à la Cancérologie), 67200 Strasbourg, France; (A.V.); (E.G.); (A.B.); (C.O.); (V.D.); (A.C.J.); (B.R.)
- Digestive Surgery Department, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
| | - Christian Gaiddon
- Streinth Lab (Stress Response and Innovative Therapies), Strasbourg University, Inserm UMR_S 1113 IRFAC (Interface Recherche Fondamental et Appliquée à la Cancérologie), 67200 Strasbourg, France; (A.V.); (E.G.); (A.B.); (C.O.); (V.D.); (A.C.J.); (B.R.)
| | - Georg Mellitzer
- Streinth Lab (Stress Response and Innovative Therapies), Strasbourg University, Inserm UMR_S 1113 IRFAC (Interface Recherche Fondamental et Appliquée à la Cancérologie), 67200 Strasbourg, France; (A.V.); (E.G.); (A.B.); (C.O.); (V.D.); (A.C.J.); (B.R.)
| |
Collapse
|
11
|
Evaluation of Depth of Invasion in Oral Squamous Cell Carcinoma with Ultra-High Frequency Ultrasound: A Preliminary Study. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11167647] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Intraoral ultrasonography has been widely employed for the preoperative assessment of tumor margins due to its capability to evaluate depth of invasion (DOI) and tumor thickness (TT). Recently, a novel ultrasonographic technique, ultra-high frequency ultrasound (UHFUS) has been increasingly applied to the study of oral lesions. This study evaluates the potential application of intraoral UHFUS to assess DOI and TT parameters of oral squamous cell carcinoma (OSCC) lesions. Patients clinically suspected of OSCC lesions were enrolled and underwent an intraoral UHFUS examination preoperatively. The parameters of TT, DOI, echogenicity, and vascularization were assessed. The parameters of TT and DOI as evaluated by means of UHFUS were compared to histology, which was set as the benchmark. Ten patients in total were enrolled. UHFUS-based DOI and TT measurements were found to positively correlate with histology (p < 0.05), although UHFUS provided a slight overestimation of DOI. No differences were found in terms of echogenicity or vascularization depending on the site of the lesion. According to these preliminary results, UHFUS could support the preoperative assessment of TT and DOI, potentially enhancing the clinical evaluation of OSCC.
Collapse
|
12
|
Izzetti R, Nisi M, Aringhieri G, Vitali S, Oranges T, Romanelli M, Caramella D, Graziani F, Gabriele M. Ultra-high frequency ultrasound in the differential diagnosis of oral pemphigus and pemphigoid: An explorative study. Skin Res Technol 2021; 27:682-691. [PMID: 33405267 DOI: 10.1111/srt.13000] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/05/2020] [Accepted: 12/05/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Intraoral ultra-high frequency ultrasound (UHFUS) is an emerging technique in oral medicine, due to its possibility to provide submillimeter resolution imaging of superficial mucosal structures. In this study, the potential role of UHFUS in the diagnosis of oral pemphigus vulgaris (PV) and mucous membrane pemphigoid (MMP) is assessed. MATERIALS AND METHODS Consecutive patients with suspected oral PV or MMP were enrolled. All patients underwent clinical examination, laboratory tests, intraoral UHFUS scan, and biopsy. Histology and direct immunofluorescence were set as benchmark for diagnosis confirmation. The sensitivity and specificity of UHFUS compared to histology were assessed. Mann-Whitney test was performed to evaluate the presence of differences in the echogenicity of PV and MMP. P-value was set at P < 0.05. RESULTS Twenty-five patients were included. Thirteen patients were diagnosed with PV, and twelve with MMP. The UHFUS features of PV and MMP lesions were described. Image analysis showed statistically significant differences between the echogenicity of PV and MMP lesions (P < 0.05). Good concordance between UHFUS and histology was found. UHFUS showed 75% sensitivity in the diagnosis of PV and 66.7% in the diagnosis of MMP. CONCLUSIONS UHFUS appears a valuable tool in the diagnosis of PV and MMP. Although histology and immunofluorescence remain the gold standard, UHFUS role in the diagnostic algorithm of PV and MMP seems promising as a chair-side tool consistently enhancing clinical evaluation of oral bullous lesions.
Collapse
Affiliation(s)
- Rossana Izzetti
- Unit of Dentistry and Oral Surgery, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Marco Nisi
- Unit of Dentistry and Oral Surgery, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Giacomo Aringhieri
- Diagnostic and Interventional Radiology, Department of Translational Research and of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Saverio Vitali
- Diagnostic and Interventional Radiology, Department of Translational Research and of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Teresa Oranges
- Unit of Dermatology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marco Romanelli
- Unit of Dermatology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Davide Caramella
- Diagnostic and Interventional Radiology, Department of Translational Research and of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Filippo Graziani
- Unit of Dentistry and Oral Surgery, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Mario Gabriele
- Unit of Dentistry and Oral Surgery, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| |
Collapse
|
13
|
Izzetti R, Oranges T, Janowska A, Gabriele M, Graziani F, Romanelli M. The Application of Ultra-High-Frequency Ultrasound in Dermatology and Wound Management. INT J LOW EXTR WOUND 2020; 19:334-340. [DOI: 10.1177/1534734620972815] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The management of lower extremity wounds is frequently performed by means of clinical examination, representing a challenge for the clinician due to the various conditions that can potentially enter differential diagnosis. Several diagnostic techniques are available in the dermatologist’s arsenal as a support to diagnosis confirmation, including dermoscopy and ultrasonography. Recently, a novel ultrasonographic technique involving the use of ultra-high ultrasound frequencies has entered the scene, and appears a promising tool in the diagnostic workup of skin ulcerative lesions. The focus of this review is to discuss the potential role of ultra-high-frequency ultrasonography in the diagnostic workup of wounds in the light of the current applications of the technique.
Collapse
|
14
|
Izzetti R, Vitali S, Aringhieri G, Nisi M, Oranges T, Dini V, Ferro F, Baldini C, Romanelli M, Caramella D, Gabriele M. Ultra-High Frequency Ultrasound, A Promising Diagnostic Technique: Review of the Literature and Single-Center Experience. Can Assoc Radiol J 2020; 72:418-431. [PMID: 32721173 DOI: 10.1177/0846537120940684] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Ultra-high frequency ultrasonography (UHFUS) is a recently introduced diagnostic technique which finds several applications in diverse clinical fields. The range of frequencies between 30 and 100 MHz allows for high spatial resolution imaging of superficial structures, making this technique suitable for the imaging of skin, blood vessels, musculoskeletal anatomy, oral mucosa, and small parts. However, the current clinical applications of UHFUS have never been analyzed in a consistent multidisciplinary manner. The aim of this study is to revise and discuss the current applications of UHFUS in different aspects of research and clinical practice, as well as to provide some examples of the current work-in-progress carried out in our center. MATERIALS AND METHODS A literature search was performed in order to retrieve articles reporting the applications of UHFUS both in research and in clinical settings. Inclusion criteria were the use of frequencies above 30 MHz and study design conducted in vivo on human subjects. RESULTS In total 66 articles were retrieved. The majority of the articles focused on dermatological and vascular applications, although musculoskeletal and intraoral applications are emerging fields of use. We also describe our experience in the use of UHFUS as a valuable diagnostic support in the fields of dermatology, rheumatology, oral medicine, and musculoskeletal anatomy. CONCLUSION Ultra-high frequency ultrasonography application involves an increasing number of medical fields. The high spatial resolution and the superb image quality achievable allow to foresee a wider use of this novel technique, which has the potential to bring innovation in diagnostic imaging.
Collapse
Affiliation(s)
- Rossana Izzetti
- Unit of Dentistry and Oral Surgery, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, 9310University of Pisa, Pisa, Italy
| | - Saverio Vitali
- Diagnostic and Interventional Radiology, Department of Translational Research and of New Technologies in Medicine and Surgery, 9310University of Pisa, Pisa, Italy
| | - Giacomo Aringhieri
- Diagnostic and Interventional Radiology, Department of Translational Research and of New Technologies in Medicine and Surgery, 9310University of Pisa, Pisa, Italy
| | - Marco Nisi
- Unit of Dentistry and Oral Surgery, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, 9310University of Pisa, Pisa, Italy
| | - Teresa Oranges
- Unit of Dermatology, Department of Clinical and Experimental Medicine, 9310University of Pisa, Pisa, Italy
| | - Valentina Dini
- Unit of Dermatology, Department of Clinical and Experimental Medicine, 9310University of Pisa, Pisa, Italy
| | - Francesco Ferro
- Unit of Rheumatology, Department of Clinical and Experimental Medicine, 9310University of Pisa, Pisa, Italy
| | - Chiara Baldini
- Unit of Rheumatology, Department of Clinical and Experimental Medicine, 9310University of Pisa, Pisa, Italy
| | - Marco Romanelli
- Unit of Dermatology, Department of Clinical and Experimental Medicine, 9310University of Pisa, Pisa, Italy
| | - Davide Caramella
- Diagnostic and Interventional Radiology, Department of Translational Research and of New Technologies in Medicine and Surgery, 9310University of Pisa, Pisa, Italy
| | - Mario Gabriele
- Unit of Dentistry and Oral Surgery, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, 9310University of Pisa, Pisa, Italy
| |
Collapse
|