1
|
Mu WN, Li JH, Liu Y, Wen Y, Liu X. Clinical application of ultrasound-guided Core Needle Biopsy Histology and Fine Needle Aspiration Cytology in Cervical Lymph Nodes. Pak J Med Sci 2023; 39:752-756. [PMID: 37250537 PMCID: PMC10214824 DOI: 10.12669/pjms.39.3.6630] [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: 05/16/2022] [Revised: 07/15/2022] [Accepted: 01/29/2023] [Indexed: 11/02/2023] Open
Abstract
Objectives To investigate the difference of application of core needle biopsy histology and fine needle aspiration cytology in cervical lymphadenopathy. Methods A retrospective analysis was made on 80 patients with cervical lymphadenopathy admitted to Baoding No.1 Central Hospital from to October 2018 to February 2020, and they were randomly divided into two groups: core needle group and fine needle group. Patients in the core needle group were given core needle biopsy histology, while those in the fine needle group were given fine needle aspiration cytology, and the puncture results and surgical complications were compared between the two groups. Results The accuracy rates of the core needle group and the fine needle group in the diagnosis of malignant cervical lymph nodes were 95.83% and 72.22% respectively, with a statistically significant difference (χ²=4.683, p=0.030). The sensitivity, specificity, positive predictive value and negative predictive value of the core needle group were 100.00%, 93.75%, 95.83% and 100.00% respectively, while those of the fine needle group were 86.67%, 90.00%, 86.67% and 90.00% respectively, with no statistically significant differences between the two groups (p>0.05). The complication rate in the core needle group was 22.50%, which was higher than the 5.00% in the fine needle group (χ²=5.165, p=0.023). Conclusions No significant difference was observed between core needle biopsy histology and fine needle aspiration cytology in diagnosing cervical lymphadenopathy, but the former has a high complication rate.
Collapse
Affiliation(s)
- Wei-na Mu
- Wei-na Mu, Department of Ultrasound, Baoding No.1 Central Hospital, Baoding 071000, Hebei, China
| | - Jian-heng Li
- Jian-heng Li, Hebei University, Baoding 071000, Hebei, China
| | - Ying Liu
- Ying Liu Department of Ultrasound, Baoding Baoshihua Oriental Hospital, Baoding 071051, Hebei, China
| | - Ying Wen
- Ying Wen Department of Ultrasound, The 82 Group Army Hospital of the People’s Liberation Army of China, Baoding 071000, Hebei, China
| | - Xin Liu
- Xin Liu, Department of Ultrasound, Baoding No.1 Central Hospital, Baoding 071000, Hebei, China
| |
Collapse
|
2
|
Ultrasound procedure for the diagnosis of mass lesions in the oral region. Oral Radiol 2023; 39:93-100. [PMID: 35332418 DOI: 10.1007/s11282-022-00605-2] [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: 11/14/2021] [Accepted: 03/03/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES To examine the diagnostic usefulness and procedures of ultrasonography (US) for mass lesions in the soft tissue of the oral region. METHODS This study involved patients with mass lesions (tumorous lesions and cysts) who had undergone US and histopathological examinations from January 2017 to December 2019. The following points were evaluated by two observers using an evaluation scale: vascularity, echo intensity level, boundary, margin shape, distribution of internal echoes, and capsule. The usefulness of each point for differential diagnosis of tumorous lesions and cysts was statistically analyzed. RESULTS Forty-five mass lesions in the soft tissue of the oral region (33 tumorous lesions and 12 cysts) were analyzed. There were significant differences in four evaluation points between the tumorous lesions and cysts: vascularity, echo intensity level, boundary, and margin shape. Cysts were almost completely excluded diagnostically, especially when vascularity was observed. There were also significant differences in two evaluation points between nonvascular tumorous lesions and cysts: echo intensity level and boundary. CONCLUSIONS In US examination for mass lesions in the oral region, it was possible to diagnose tumorous lesions and exclude cysts when vascularity was observed. When vascularity was not observed, however, tumorous lesions and cysts could be identified using two evaluation points: echo intensity level and boundary.
Collapse
|
3
|
Dai Y, Wang Z, Yan E, Li J, Ge H, Xiao N, Cheng J, Diao P. Development of a novel signature derived from single cell RNA-sequencing for preoperative prediction of lymph node metastasis in head and neck squamous cell carcinoma. Head Neck 2022; 44:2171-2180. [PMID: 35726502 DOI: 10.1002/hed.27126] [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: 03/17/2022] [Revised: 05/11/2022] [Accepted: 06/07/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Lymph node metastasis (LNM) is considered as an adverse prognostic indicator for cancer patients. Preoperative knowledge of LNM is valuable for pretreatment decision making. Here, we sought to develop and validate an LNM signature for preoperative prediction of LNM in patients with head and neck squamous cell carcinoma (HNSCC). METHODS By studying single cell RNA-sequencing data (scRNA-seq), differentially expressed mRNA were selected and analyzed through univariate logistic regression and least absolute shrinkage and selection operator (LASSO) to identify an LNM signature. Multivariate logistic regression was utilized to establish an LNM nomogram incorporating LNM signature and T-classification. RESULTS The LNM signature was significantly associated with lymph node status and prognosis. The LNM signature and LNM nomogram displayed a robust predictive effect. CONCLUSION Our study reveals that LNM signature is a powerful biomarker for preoperative prediction of LNM in patients with HNSCC, which may be effective to realize individualized outcome prediction.
Collapse
Affiliation(s)
- Yibin Dai
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, China
| | - Ziyu Wang
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Jiangsu, China
| | - Enshi Yan
- Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Jiangsu, China
| | - Jin Li
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, China.,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Jiangsu, China
| | - Han Ge
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, China.,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Jiangsu, China
| | - Na Xiao
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, China.,Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Jiangsu, China
| | - Jie Cheng
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, China.,Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Jiangsu, China
| | - Pengfei Diao
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, China.,Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Jiangsu, China
| |
Collapse
|
4
|
Ding A, Zuo J, Lv H, Zhou L, Ding S, Yu Q, Xiong P. Imaging identification of primary mammary analogue secretory carcinoma and acinic cell carcinoma in major salivary glands. Oral Dis 2021; 28:1861-1870. [PMID: 34773340 DOI: 10.1111/odi.14080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 10/12/2021] [Accepted: 10/29/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The present study aimed to characterize and differentiate the ultrasonography (US) and computed tomography (CT) features of mammary analogue secretory carcinoma (MASC) and acinic cell carcinoma (AciCC). METHODS AND PATIENTS A total of 83 patients with clinically proven MASC and AciCC were analyzed. The following characteristics were assessed on US, CT, and magnetic resonance imaging: lesion size, shape, margin, echogenicity, echotexture, cystic components, posterior echo, vascularity, density, degree of enhancement, enhancement pattern, signal intensity (SI) on T1- and T2-weighted images (WI), hemorrhages, and lymph node enlargement. RESULTS Similarities were observed between the imaging performance of MASC and AciCC. Differences between the two characteristics of shape on US and cystic components on CT were statistically significant. The proportion of MASC to regular shape on US (p = 0.006) and cystic components on CT (p = 0.027) was significantly higher than that of AciCC. Regular shape on US had the highest sensitivity in the identification of MASC and AciCC, while regular shape on US + cystic component on CT had the highest specificity. CONCLUSIONS The shape on US and cystic components on CT are key characteristics for distinguishing MASC and AciCC.
Collapse
Affiliation(s)
- AngAng Ding
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Jiaxin Zuo
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Huan Lv
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Lu Zhou
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Shiwen Ding
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Qian Yu
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Ping Xiong
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| |
Collapse
|
5
|
Zhi X, Chen J, Xie F, Sun J, Herth FJF. Diagnostic value of endobronchial ultrasound image features: A specialized review. Endosc Ultrasound 2021; 10:3-18. [PMID: 32719201 PMCID: PMC7980684 DOI: 10.4103/eus.eus_43_20] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) technology is important in the diagnosis of intrathoracic benign and malignant lymph nodes (LNs). With the development of EBUS imaging technology, its role in noninvasive diagnosis, as a supplement to pathology diagnosis, has been given increasing attention in recent years. Many studies have explored qualitative and quantitative methods for the three EBUS modes, as well as a variety of multimodal analysis methods, to find the optimal method for the noninvasive diagnosis using EBUS for LNs. Here, we review and comment on the research methods and predictive diagnostic value, discuss the existing problems, and look ahead to the future application of EBUS imaging.
Collapse
Affiliation(s)
- Xinxin Zhi
- Department of Respiratory Endoscopy, Shanghai Jiao Tong University, Shanghai; Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai; Shanghai Engineering Research Center of Respiratory Endoscopy, Shanghai, China
| | - Junxiang Chen
- Department of Respiratory Endoscopy, Shanghai Jiao Tong University, Shanghai; Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai; Shanghai Engineering Research Center of Respiratory Endoscopy, Shanghai, China
| | - Fangfang Xie
- Department of Respiratory Endoscopy, Shanghai Jiao Tong University, Shanghai; Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai; Shanghai Engineering Research Center of Respiratory Endoscopy, Shanghai, China
| | - Jiayuan Sun
- Department of Respiratory Endoscopy, Shanghai Jiao Tong University, Shanghai; Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai; Shanghai Engineering Research Center of Respiratory Endoscopy, Shanghai, China
| | - Felix J F Herth
- Department of Pneumology and Critical Care Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
6
|
Zhi X, Wang L, Chen J, Zheng X, Li Y, Sun J. Scoring model of convex probe endobronchial ultrasound multimodal imaging in differentiating benign and malignant lung lesions. J Thorac Dis 2020; 12:7645-7655. [PMID: 33447457 PMCID: PMC7797845 DOI: 10.21037/jtd-2020-abpd-005] [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] [Indexed: 12/26/2022]
Abstract
Background Convex probe endobronchial ultrasound images can reflect the morphology, blood flow status and stiffness of the lesions. Endobronchial ultrasound multimodal imaging has great value for the diagnosis of intrathoracic lymph nodes. This study aimed to analyze the application of endobronchial ultrasound multimodal imaging on lung lesions. Methods Patients undergoing endobronchial ultrasound-guided transbronchial needle aspiration in Shanghai Chest Hospital from July 2018 to December 2019 were retrospectively enrolled. Nine grayscale features (long and short axes, margin, shape, lobulation sign, echogenicity, necrosis, liquefaction, calcification, and air-bronchogram), blood flow volume and elastography five-score method were analyzed to explore the best diagnostic method. The gold standard for diagnosing lesions depends on the histological and cytopathological findings of endobronchial ultrasound-guided transbronchial needle aspiration, transthoracic biopsy, resected sample of lesions, microbiological examination or clinical follow-up of at least 6 months. Results Endobronchial ultrasound multimodal imaging of 97 malignant lung lesions and 19 benign lung lesions from 116 patients were analyzed. There were statistically significant differences in distinct margin, presence of lobulation sign, presence of necrosis, and elastography grading score 4–5 between malignant and benign lung lesions, among which presence of lobulation sign and elastography grading score 4–5 were independent predictors. A diagnostic scoring model was then constructed based on the above four features, and when two or more features were present, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy for malignant lung lesions prediction were 92.78%, 57.89%, 91.84%, 61.11% and 87.07%, respectively. Conclusions The combination of endobronchial ultrasound grayscale and elastography has potential value for malignant and benign lung lesions differentiation. The diagnostic scoring model established in this study needs further validation to guide the malignant and benign diagnosis of lung lesions.
Collapse
Affiliation(s)
- Xinxin Zhi
- Department of Respiratory Endoscopy, Shanghai Jiao Tong University, Shanghai, China.,Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Engineering Research Center of Respiratory Endoscopy, Shanghai, China
| | - Lei Wang
- Department of Ultrasound, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Junxiang Chen
- Department of Respiratory Endoscopy, Shanghai Jiao Tong University, Shanghai, China.,Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Engineering Research Center of Respiratory Endoscopy, Shanghai, China
| | - Xiaoxuan Zheng
- Department of Respiratory Endoscopy, Shanghai Jiao Tong University, Shanghai, China.,Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Engineering Research Center of Respiratory Endoscopy, Shanghai, China
| | - Ying Li
- Department of Respiratory Endoscopy, Shanghai Jiao Tong University, Shanghai, China.,Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Engineering Research Center of Respiratory Endoscopy, Shanghai, China
| | - Jiayuan Sun
- Department of Respiratory Endoscopy, Shanghai Jiao Tong University, Shanghai, China.,Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Engineering Research Center of Respiratory Endoscopy, Shanghai, China
| |
Collapse
|
7
|
The influence of cervical lymph node number of neck dissection on the prognosis of the early oral cancer patients. J Dent Sci 2020; 15:519-525. [PMID: 33505625 PMCID: PMC7816029 DOI: 10.1016/j.jds.2020.06.002] [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: 05/03/2020] [Revised: 06/01/2020] [Indexed: 11/23/2022] Open
Abstract
Background/purpose The status of neck lymph nodes (LNs) plays an important role in survival of oral cavity cancer. Early stage oral cancer patients are still at a risk for locoregional metastasis. We aimed to determine the number of LNs that needs to be retrieved for adequate diagnosis and treatment of the neck tumor. Materials and methods We conducted a retrospective study of 126 oral cavity cancer patients who underwent wide excision and 3 types of neck dissection at MacKay Memorial Hospital, Taiwan. Data from the operative and pathology reports were collected and analyzed. The significant difference was defined as p < 0.05 by SPSS 21.0 and Prizm 5 software. Results There was a significant difference between the total retrieved LNs and tumor differentiation and nerve invasion on multivariate analysis. Receiveroperating characteristic (ROC) curve showed significant difference in the total number of neck LNs between the survival and expired groups. The cut-off point was 36.5 nodes. However, there was no difference in survival between supraomohyoid and modified radical neck dissection. Conclusion Retrieval of adequate LNs can improve oral cancer survival rates. If total number of neck nodes examined is <37 with poor differentiation and/or nerve invasion, early oral cancer patients with neck dissection have a lower survival rate and are candidates for adjuvant therapy.
Collapse
|
8
|
Nishio N, Fujimoto Y, Hiramatsu M, Maruo T, Tsuzuki H, Mukoyama N, Yokoi S, Wada A, Kaneko Furukawa M, Furukawa M, Sone M. Diagnosis of cervical lymph node metastases in head and neck cancer with ultrasonic measurement of lymph node volume. Auris Nasus Larynx 2019; 46:889-895. [PMID: 30857763 DOI: 10.1016/j.anl.2019.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 01/16/2019] [Accepted: 02/05/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The purpose of this study was to evaluate the usefulness of ultrasound (US) volume measurement of the cervical lymph nodes for diagnosing nodal metastasis in patients with head and neck cancer using a node-by-node comparison. METHODS Thirty-four consecutive patients with head and neck cancer from one tertiary university hospital were prospectively enrolled from 2012 to 2017. Patients with histologically proven squamous cell primary tumors in the head and neck region scheduled to undergo a therapeutic neck dissection were eligible. For each patient, 1-4 target lymph nodes were selected from the planned neck dissection levels. Lymph nodes with thickness >20 mm or in a cluster were excluded. Node-by-node comparisons between the pre-operative US assessment, the post-operative actual measurements and histopathological results were performed for all target lymph nodes. Quantitative measurements, such as three diameters, ratios of the three diameters and volume were analyzed in this study. Lymph node volume was calculated using the ellipsoid formula. RESULTS Patients comprised 28 men and 6 women with a mean age of 60.0 years (range, 29-80 years) at the time of surgery. In total, 67 target lymph nodes were analyzed in this study and the thickness ranged from 3.9 to 20.0 mm (mean 8.0 mm). There was a strong correlation between the US volume and post-operative actual volume (ρ = 0.87, p < 0.01). The US volume measured 2156 ± 2156 mm3 for the tumor positive nodes, which was significantly greater than the US volume of 512 ± 315 mm3 for tumor negative nodes (p < 0.01). Significant differences between tumor positive and tumor negative nodes were found in five variables (volume, thickness, major axis, minor axis and ratio of minor axis to thickness) for total lymph nodes. To identify predictors of lymph node metastasis, ROC curves of the US variables of target lymph nodes were compared, of which 4 variables were considered acceptable for predicting the lymph node metastasis: volume (AUC 0.86), thickness (AUC 0.86), major axis (AUC 0.79), and minor axis (AUC 0.79) for total lymph nodes. The optimal cut-off level for US volume in total lymph nodes was found to be 1242 mm3, whereby a 62% sensitivity and 98% specificity was reached (likelihood ratio: 25.2). CONCLUSION Pre-operative ultrasonic volume measurement of the cervical lymph nodes was useful for early detection of cervical nodal metastasis in head and neck cancer.
Collapse
Affiliation(s)
- Naoki Nishio
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Otolaryngology, Stanford University, Stanford, CA, USA.
| | - Yasushi Fujimoto
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mariko Hiramatsu
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takashi Maruo
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hidenori Tsuzuki
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuaki Mukoyama
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sayaka Yokoi
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akihisa Wada
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Masaki Furukawa
- Department of Otorhinolaryngology, Hiro-Yama Clinic, Tokyo, Japan
| | - Michihiko Sone
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| |
Collapse
|
9
|
La Manna S, Lee E, Ouzounova M, Di Natale C, Novellino E, Merlino A, Korkaya H, Marasco D. Mimetics of suppressor of cytokine signaling 3: Novel potential therapeutics in triple breast cancer. Int J Cancer 2018; 143:2177-2186. [DOI: 10.1002/ijc.31594] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 04/20/2018] [Accepted: 05/02/2018] [Indexed: 01/09/2023]
Affiliation(s)
- Sara La Manna
- Department of Pharmacy; University of Naples “Federico II”; Naples Italy
| | - Eunmi Lee
- Department of Biochemistry and Molecular Biology, Georgia Cancer Center, Augusta University, Augusta; Georgia
| | - Maria Ouzounova
- Department of Biochemistry and Molecular Biology, Georgia Cancer Center, Augusta University, Augusta; Georgia
| | - Concetta Di Natale
- Department of Pharmacy; University of Naples “Federico II”; Naples Italy
| | - Ettore Novellino
- Department of Pharmacy; University of Naples “Federico II”; Naples Italy
| | - Antonello Merlino
- Department of Chemical Sciences; University of Naples “Federico II”; Naples Italy
| | - Hasan Korkaya
- Department of Biochemistry and Molecular Biology, Georgia Cancer Center, Augusta University, Augusta; Georgia
| | - Daniela Marasco
- Department of Pharmacy; University of Naples “Federico II”; Naples Italy
| |
Collapse
|
10
|
Ying M, Cheng SCH, Ahuja AT. Diagnostic Accuracy of Computer-Aided Assessment of Intranodal Vascularity in Distinguishing Different Causes of Cervical Lymphadenopathy. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:2010-2016. [PMID: 27131839 DOI: 10.1016/j.ultrasmedbio.2016.03.014] [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: 11/09/2015] [Revised: 03/10/2016] [Accepted: 03/20/2016] [Indexed: 06/05/2023]
Abstract
Ultrasound is useful in assessing cervical lymphadenopathy. Advancement of computer science technology allows accurate and reliable assessment of medical images. The aim of the study described here was to evaluate the diagnostic accuracy of computer-aided assessment of the intranodal vascularity index (VI) in differentiating the various common causes of cervical lymphadenopathy. Power Doppler sonograms of 347 patients (155 with metastasis, 23 with lymphoma, 44 with tuberculous lymphadenitis, 125 reactive) with palpable cervical lymph nodes were reviewed. Ultrasound images of cervical nodes were evaluated, and the intranodal VI was quantified using a customized computer program. The diagnostic accuracy of using the intranodal VI to distinguish different disease groups was evaluated and compared. Metastatic and lymphomatous lymph nodes tend to be more vascular than tuberculous and reactive lymph nodes. The intranodal VI had the highest diagnostic accuracy in distinguishing metastatic and tuberculous nodes with a sensitivity of 80%, specificity of 73%, positive predictive value of 91%, negative predictive value of 51% and overall accuracy of 68% when a cutoff VI of 22% was used. Computer-aided assessment provides an objective and quantitative way to evaluate intranodal vascularity. The intranodal VI is a useful parameter in distinguishing certain causes of cervical lymphadenopathy and is particularly useful in differentiating metastatic and tuberculous lymph nodes. However, it has limited value in distinguishing lymphomatous nodes from metastatic and reactive nodes.
Collapse
Affiliation(s)
- Michael Ying
- Department of Health Technology and Informatics, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Sammy C H Cheng
- Department of Health Technology and Informatics, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Anil T Ahuja
- Department of Imaging and Interventional Radiology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China.
| |
Collapse
|
11
|
Baladi MG, Tucunduva Neto RRCM, Cortes ARG, Aoki EM, Arita ES, Freitas CF. Ultrasound analysis of mental artery flow in elderly patients: a case-control study. Dentomaxillofac Radiol 2015. [PMID: 26205777 DOI: 10.1259/dmfr.20150097] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Mental artery flow decreases with age and may have an aetiological role in alveolar ridge atrophy. The aim of this study was to identify factors associated with alterations of mental artery flow, assessed by ultrasonography. METHODS This case-control study was conducted on elderly patients (aged above 60 years) at the beginning of dental treatment. Intraoral B-mode Doppler ultrasonography was used to assess mental artery flow. The cases were defined as patients with a weak/absent ultrasound signal, whereas the controls presented a strong ultrasound signal. Demographics and radiographic findings (low bone mineral density on dual-energy X-ray absorptiometry and mandibular cortical index on panoramic radiographs) were analysed as risk factors for weak/absent ultrasound signal and were calculated as adjusted odds ratios (AORs) with 95% confidence intervals (CIs) using conditional logistic regression. In addition, the Student's t-test was used to compare the mean alveolar bone height of the analysed groups. A p-value <0.05 was considered statistically significant. RESULTS A total of 30 ultrasound examinations (12 cases and 18 controls) were analysed. A weak/absent mental artery pulse strength was significantly associated with edentulism (AOR = 3.67; 95% CI = 0.86-15.63; p = 0.046). In addition, there was a significant difference in alveolar bone height between edentulous cases and controls (p = 0.036). CONCLUSIONS Within the limitations of this study, the present results indicate that edentulism is associated with diminished mental artery flow, which, in turn, affects alveolar bone height.
Collapse
Affiliation(s)
- Marina G Baladi
- 1 Oral Radiology Division, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Arthur R G Cortes
- 2 Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA.,3 Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Eduardo M Aoki
- 1 Oral Radiology Division, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Emiko S Arita
- 1 Oral Radiology Division, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Claudio F Freitas
- 1 Oral Radiology Division, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| |
Collapse
|
12
|
Osanai H, Kuroiwa H, Uchida K, Kagami H, Yamada K, Taguchi A. Sonographic appearances of cervical lymph nodes in healthy young Japanese adults: Association with age, sex, and body mass index. JOURNAL OF CLINICAL ULTRASOUND : JCU 2015; 43:295-301. [PMID: 25156086 DOI: 10.1002/jcu.22231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 06/11/2014] [Accepted: 07/30/2014] [Indexed: 06/03/2023]
Abstract
PURPOSE We investigated whether there was any association between age, sex, and body mass index (BMI) and nodal morphology and vascular pattern in healthy young Japanese adults. METHODS Three neck regions in 100 healthy subjects, 19-40 years old, were examined by gray-scale and color Doppler sonography. Vascular pattern was classified into three groups: avascular, hilar, or scattered. A linear mixed-effect model was used to identify associations of age, sex, or BMI with the short-axis diameter and the short-to-long axis diameter ratio (S/L). A cumulative link mixed model was used to identify any association between age, sex, BMI, and vascular pattern. RESULTS In the upper cervical region, a decrease in the short-axis diameter was statistically significantly associated with aging (p = 0.04), and an increase in the short-axis diameter was significantly associated with greater BMI (p < 0.001). An increase in short-axis diameter was significantly associated with female sex (p = 0.02) and higher BMI (p = 0.002) in the submandibular region, whereas it was associated with higher BMI (p = 0.001) in the submental region. A greater S/L was significantly associated with higher BMI and female sex in all regions. The scattered vascular pattern tended to be associated with lower BMI (p = 0.051) in the upper cervical region, but it was significantly associated with higher BMI (p = 0.01) in the submental region. CONCLUSIONS Nodal morphology and vascular pattern may be associated with age, sex, and BMI.
Collapse
Affiliation(s)
- Hizuru Osanai
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, Shiojiri, 399-0781, Japan
| | | | | | | | | | | |
Collapse
|
13
|
Burusapat C, Jarungroongruangchai W, Charoenpitakchai M. Prognostic factors of cervical node status in head and neck squamous cell carcinoma. World J Surg Oncol 2015; 13:51. [PMID: 25889704 PMCID: PMC4336753 DOI: 10.1186/s12957-015-0460-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 01/10/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cervical nodal status is one of prognostic factors in head and neck squamous cell carcinoma (HNSCC). The objective of this study was to identify prognostic factors of cervical node status including site and size of primary tumors, presence of lymphovascular invasion, and size of cervical node for appropriate further treatment in HNSCC. METHODS A 5-year retrospective review of patients with HNSCC in Phramongkutklao Hospital from 2009 to 2013 was conducted. Histopathologic data on primary tumors and cervical nodes were reviewed. Cervical nodes were divided into five groups: 1-3, 4-6, 7-9, 10-30, and >30 mm. Numbers of positive and negative nodes were compared in different sizes and sites and the presence of extracapsular extension. RESULTS In all, 165 patients and 1,472 nodes were reviewed. The mean age was 52.6 years and 77.58% were male. The most frequent primary site was oral tongue (50.91%). In sum, 52.72% showed lymphovascular invasion. Thirty-five patients (81.40%) in therapeutic neck dissections and 18 patients (69.23%) in prophylactic neck dissections showed nodal metastasis. The mean size of metastatic nodes was 3.89 mm (range, 2-45 mm) and 3.53 mm (range, 2-23 mm), respectively. Significant associations were found between the size of cervical nodes and the site of primary tumor of the oral tongue, lip, base of the tongue, and floor of the mouth (p < 0.05). Metastatic lymph nodes showed extracapsular extension 69.55%. No significance was found between extracapsular extension and clinical staging, size of primary tumor, pathologic differentiation, and size of cervical nodes. Sizes of cervical lymph node of squamous cell carcinoma (SCC) of the oral tongue and lip were statistically significant with the size of tumor and tumor grading (p < 0.05). CONCLUSIONS A statistical significance was found between the size of cervical nodes and the site of primary tumor of the oral tongue and lip. Herein, we recommended performing neck dissection in all cases of SCC of the base of the tongue, floor of the mouth, buccal mucosa, and retromolar trigone.
Collapse
Affiliation(s)
- Chairat Burusapat
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Phramongkutklao Hospital and College of Medicine, 315 Ratchawithi Road, Thung Phayathai, Ratchathewi, Bangkok, 10400, Thailand.
| | - Weerawut Jarungroongruangchai
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Phramongkutklao Hospital and College of Medicine, 315 Ratchawithi Road, Thung Phayathai, Ratchathewi, Bangkok, 10400, Thailand.
| | | |
Collapse
|
14
|
Ogura I, Kaneda T, Sasaki Y, Sekiya K, Tokunaga S. Characteristic power Doppler sonographic images of tumorous and non-tumorous buccal space lesions. Dentomaxillofac Radiol 2013; 42:20120460. [PMID: 23520393 DOI: 10.1259/dmfr.20120460] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the characteristic power Doppler sonographic images of buccal space tumorous and non-tumorous lesions. METHODS 48 patients with buccal space lesions were evaluated with greyscale sonography followed by power Doppler sonography with a 12 MHz linear transducer. On greyscale sonography, buccal space lesions were assessed for the boundary (clear or unclear), echogenicity (hypoechoic or isoechoic) and internal architecture (homogeneous or heterogeneous). Power Doppler sonography was performed to evaluate the vascular signals within the buccal space lesions. RESULTS 48 lesions were found in the 48 patients; of these 48 lesions, 28 were tumourous and 20 were non-tumourous. In the 28 tumours, 15 cases showed clear boundaries, 15 cases were hypoechoic relative to adjacent tissues and 22 cases presented with a heterogeneous appearance on greyscale sonography. The internal vascularity of 19 tumours was shown using power Doppler sonography. In the 20 non-tumorous lesions, 11 cases showed clear boundaries, 17 cases were hypoechoic relative to adjacent tissues and 13 cases presented with a homogeneous appearance on greyscale sonography. 18 non-tumorous lesions showed no internal vascularity using power Doppler sonography. Logistic multivariate regression analysis between the tumour group and the non-tumorous lesions group demonstrated that the internal architecture (odds ratio = 8.270, p = 0.029) and vascular signals (odds ratio = 17.533, p = 0.003) were significant variables. CONCLUSIONS Power Doppler sonography is a useful technique for the differential diagnosis of tumorous and non-tumorous buccal space lesions.
Collapse
Affiliation(s)
- I Ogura
- Department of Radiology, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan.
| | | | | | | | | |
Collapse
|
15
|
Li L, Mori S, Kodama M, Sakamoto M, Takahashi S, Kodama T. Enhanced sonographic imaging to diagnose lymph node metastasis: importance of blood vessel volume and density. Cancer Res 2013; 73:2082-92. [PMID: 23333937 DOI: 10.1158/0008-5472.can-12-4200] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Lymph node size is an important variable in ultrasound diagnosis of lymph node metastasis. However, the size criterion often leads to oversight of tumor-positive lymph nodes within the range of "normal" size, such that more accurate diagnostic criteria for lymph node metastasis are required. In this study, we show how diagnosis of lymph node metastasis can be improved by evaluating changes in blood vessel volume and density using a novel contrast-enhanced high-frequency ultrasound (CE-HFUS) system with Sonazoid. An MRL/MpJ-lpr/lpr (MRL/lpr) mouse model of lymph node metastasis was used in which lymph nodes are similar in size to humans. Metastasis via lymphatic vessels to proper axillary lymph nodes (proper ALN) was induced by injection of tumor cells into the subiliac lymph nodes. Within 21 days of injection, significant increases in blood vessel volume and density, but no increases in the size of the proper ALNs, were observed. The increase in blood vessel density was confirmed with immunohistochemical analysis and was positively related to tumor cell proliferation as measured using bioluminescence imaging. Together, our results showed that alterations in blood vessel volume and density precede alterations in lymph node size in the early stages of lymph node metastasis. Detection of these changes by ultrasonography may offer new criteria for early diagnosis of lymph node metastasis.
Collapse
Affiliation(s)
- Li Li
- Department of Biomedical Engineering, Graduate School of Biomedical Engineering, Tohoku University, Sendai, Miyagi, Japan
| | | | | | | | | | | |
Collapse
|