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Value of CEUS combined with feeding artery ablation in the microwave ablation of large solid benign thyroid nodules. Eur Radiol 2023; 33:2407-2414. [PMID: 36472698 DOI: 10.1007/s00330-022-09313-1] [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: 08/29/2022] [Revised: 11/07/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To investigate the value of contrast-enhanced ultrasound (CEUS) combined with feeding artery ablation in the microwave ablation (MWA) of large solid benign thyroid nodules (LSBTNs) with a diameter ≥ 4 cm. METHODS We retrospectively analyzed 122 patients with LSBTN ≥ 4 cm in diameter treated with MWA. During evaluations before and after MWA, 53 patients who underwent conventional ultrasound examination were classified as the routine group, and 69 patients who underwent CEUS combined with feeding artery ablation were classified as the union group. The differences in ablation energy required per milliliter (AERPM), complication rate, regrowth rate, and volume reduction rate (VRR) were compared between the two groups. RESULTS The AERPM of the union group was significantly less than that of the routine group (956.3 ± 38.5 J/mL vs. 1025.9 ± 121.5 J/mL, p < 0.001). The complication rate of the routine group was significantly higher than that of the union group (13.2% vs. 2.9%, p = 0.031). The regrowth rate of the routine group (22.6%, 12/53) was significantly higher than that of the union group (7.2%, 5/69) (p = 0.015). At the 1st, 3rd, 6th, 12th, 18th, and 24th month after ablation, the mean VRRs of the routine group were significantly less than those of the union group, with p values of < 0.001, < 0.001, 0.002, 0.007, 0.013, and < 0.001, respectively. CONCLUSIONS The application of CEUS combined with feeding artery ablation in the MWA of LSBTNs is helpful to reduce the regrowth rate, improve the ablation efficiency, and reduce bleeding. KEY POINTS • CEUS combined with feeding artery ablation in MWA of LSBTNs is helpful to reduce regrowth rate. • CEUS combined with feeding artery ablation can help improve ablation efficiency than conventional ultrasound in LSBTNs. • CEUS combined with feeding artery ablation helps reduce the incidence of bleeding during MWA.
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Bin Y, Meng Z, Huang LL, Hu XY, Song JM, Xie YT, Kang M, Wang RS. Prognostic value of the cervical lymph node necrosis ratio in nasopharyngeal carcinoma. Radiother Oncol 2022; 177:185-190. [PMID: 36375560 DOI: 10.1016/j.radonc.2022.11.007] [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: 06/15/2022] [Revised: 10/01/2022] [Accepted: 11/05/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE Whether cervical lymph node necrosis (CNN) is an independent adverse prognostic factor in nasopharyngeal carcinoma (NPC) has not been determined. In this study, the CNN ratio was graded quantitatively to explore the prognostic value in NPC. PARTICIPANTS AND METHODS We retrospectively reviewed a total of 648 pathologically confirmed as NPC. We outlined metastatic lymph nodes and necrotic area of lymph nodes slice by slice on the magneticresonanceimages (MRI) cross section, and calculated the corresponding CNN ratio. RESULTS The median CNN ratio (17.37 %) was taken as the cut-off point, 256 (39.51 %) patients were divided into CNN1 group (<17.37 %, n = 128) and CNN2 group (≥17.37 %, n = 128), 392 (60.49 %) patients without lymph nodes necrosis were CNN0. Among the CNN0, CNN1 and CNN2 groups, five-year overall survival (OS) was 82.4 %, 76.6 % and 71.1 %, locoregional recurrence-free survival (LRRFS) was 91.3 %, 91.1 % and 90.5 %, distant metastasis-free survival (DMFS) was 83.7 %, 78.5 % and 68.7 %, progression-free survival (PFS) was 78.3 %, 71.7 % and 61.6 % respectively. By multivariate analysis, CNN was an independent prognostic factor for OS (P = 0.003), DMFS (P = 0.019) and PFS (P = 0.007). More than 3 cycles of chemotherapy significantly increased OS (P = 0.024) and DMFS (P = 0.015) in the CNN1 group. CONCLUSIONS This study indicated that CNN is one of the factors with the negative prognosis of NPC. The CNN ratio might be used as one of the reference factors in the formulation of individualized treatment plan.
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Affiliation(s)
- Ying Bin
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, Guangxi, China
| | - Zhen Meng
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, Guangxi, China; Department of Oncology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, 530021, Guangxi, China
| | - Lu-Lu Huang
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, Guangxi, China
| | - Xue-Ying Hu
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, Guangxi, China; Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, 530021, Guangxi, China
| | - Jun-Mei Song
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, Guangxi, China
| | - Yi-Ting Xie
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, Guangxi, China; Department of Radiation Oncology, the Second Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China
| | - Min Kang
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, Guangxi, China; Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, 530021, Guangxi, China
| | - Ren-Sheng Wang
- Department of Radiation Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China; Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University), Ministry of Education, Nanning, 530021, Guangxi, China; Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, 530021, Guangxi, China.
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Corvino A, Catalano F, Cipolletta Campanile A, Cocco G, Delli Pizzi A, Corvino F, Varelli C, Catalano O. Interventional Ultrasound in Dermatology: A Pictorial Overview Focusing on Cutaneous Melanoma Patients. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:3137-3144. [PMID: 35920315 PMCID: PMC9805223 DOI: 10.1002/jum.16073] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/04/2022] [Accepted: 07/10/2022] [Indexed: 05/26/2023]
Abstract
Cutaneous melanoma incidence is increasing worldwide, representing an aggressive tumor when evolving to the metastatic phase. High-resolution ultrasound (US) is playing a growing role in the assessment of newly diagnosed melanoma cases, in the locoregional staging prior to the sentinel lymph-node biopsy procedure, and in the melanoma patient follow-up. Additionally, US may guide a number of percutaneous procedures in the melanoma patients, encompassing diagnostic and therapeutic modalities. These include fine needle cytology, core biopsy, placement of presurgical guidewires, aspiration of lymphoceles and seromas, and electrochemotherapy.
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Affiliation(s)
- Antonio Corvino
- Motor Science and Wellness DepartmentUniversity of Naples “Parthenope”NaplesItaly
| | | | | | - Giulio Cocco
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Science of AgingUniversity “G. D'Annunzio”ChietiItaly
| | - Andrea Delli Pizzi
- Department of Innovative Technologies in Medicine and DentistryUniversity “G. d'Annunzio”ChietiItaly
| | - Fabio Corvino
- Vascular and Interventional Radiology DepartmentCardarelli HospitalNaplesItaly
| | - Carlo Varelli
- Radiology UnitVarelli Diagnostic InstituteNaplesItaly
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Zhang Y, Yu T, Su D, Tang W, Yang G. Value of Contrast-Enhanced Ultrasound in the Ultrasound Classification of Cervical Tuberculous Lymphadenitis. Front Med (Lausanne) 2022; 9:898688. [PMID: 35774999 PMCID: PMC9237207 DOI: 10.3389/fmed.2022.898688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/25/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose The purpose of this study was to investigate the clinical value of contrast-enhanced ultrasound (CEUS) in the ultrasound (US) classification of cervical tuberculous lymphadenitis (CTL). Materials and Methods This retrospective study included 70 patients diagnosed with CTL. All patients underwent both conventional US and CEUS. Both methods were compared to determine their agreement with pathological CTL results. Results The results of conventional US classification were as follows: 18 patients (25.7%) were type I, 25 patients (35.7%) type II, 21 patients (30.0%) type III, and 6 patients (8.6%) type IV, respectively. The results of CEUS classification were as follows: 9 patients (12.9%) were type I, 33 patients (47.1%) type II, 22 patients (31.4%) type III, and 6 patients (8.6%) type IV. Conventional US classification and pathological results showed moderate agreement in terms of US classification results for CTL (Kappa = 0.693); the accuracy of conventional US classification was 78.6% (55/70), and the accuracy of types II and III were 71.0% (22/31) and 82.6% (19/23), respectively. CEUS classification and pathological results showed strong agreement (Kappa = 0.871); the accuracy of CEUS classification was 91.4% (64/70), and the accuracy of types II and III were 93.6% (29/31) and 87.0% (20/23), respectively. Conclusion In combined with conventional US, CEUS could provide more information on blood flow enhancement patterns and identify the area of lymph node necrosis in CTL. This could contribute to a more accurate US classification of CTL.
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Zhang W, Chu J, Yang G, Ni T. Correlation between physical characteristics of biopsy specimen and disease of cervical lymph node after contrast-enhanced ultrasound. BMC Surg 2022; 22:223. [PMID: 35690851 PMCID: PMC9188253 DOI: 10.1186/s12893-022-01671-3] [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: 01/29/2022] [Accepted: 04/25/2022] [Indexed: 12/03/2022] Open
Abstract
Background To investigate the correlation between physical characteristics and disease of cervical lymph node biopsy specimens after contrast-enhanced ultrasound. Methods All patients were biopsied after CEUS, 235 patients were divided into three groups A, B and C according to the physical characteristics of specimens: 92 patients in group A were complete tissue specimens; 113 patients in group B were discontinuous tissue specimens. There were 30 patients in group C, including a small number of tissue and floc, purulent and bloody specimens. Pathological examination, pathogen culture examination and Gene X-Pert MIB examination were completed for all patients in the three groups, and statistical analysis was conducted on the integrity and traits of the specimens. Results Group A included 92 intact tissue specimens, 21 with reactive hyperplasia, 17 with lymphoma, 12 with metastatic carcinoma, 13 with lymphadenopathy, 15 with necrotizing lymphadenitis, and rare lymphadenopathy. In group B, 113 patients were treated with intermittent tissue specimens, including infected lymph nodes, lymphoma in 1 case, metastatic carcinoma in 3 cases and sarcoidosis in 1 case. There were 30 patients in group C, including a small amount of tissue and floc, purulent and bloody specimens, all of which were infected lymph nodes. The χ2 value of malignant and benign lymph nodes was 42.401, p = 0.000. Conclusion The physical characteristics of cervical lymph node biopsy specimens after CEUS are correlated with the disease, which has guiding significance for postoperative specimen selection.
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Affiliation(s)
- Wenzhi Zhang
- Department of Ultrasound, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine (Red Cross Hospital of Hangzhou, Integrated Chinese and Western Medicine Hospital of Zhejiang Province), 310003, Hangzhou, China
| | - Jie Chu
- Department of Ultrasound, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine (Red Cross Hospital of Hangzhou, Integrated Chinese and Western Medicine Hospital of Zhejiang Province), 310003, Hangzhou, China
| | - Gaoyi Yang
- Department of Ultrasound, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine (Red Cross Hospital of Hangzhou, Integrated Chinese and Western Medicine Hospital of Zhejiang Province), 310003, Hangzhou, China.
| | - Tu Ni
- Department of Ultrasound, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine (Red Cross Hospital of Hangzhou, Integrated Chinese and Western Medicine Hospital of Zhejiang Province), 310003, Hangzhou, China
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Zhang X, Wang L, Feng N, Ni T, Tang W. Reassessing the Value of Contrast-Enhanced Ultrasonography in Differential Diagnosis of Cervical Tuberculous Lymphadenitis and Lymph Node Metastasis of Papillary Thyroid Carcinoma. Front Oncol 2021; 11:694449. [PMID: 34722243 PMCID: PMC8551861 DOI: 10.3389/fonc.2021.694449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/24/2021] [Indexed: 12/31/2022] Open
Abstract
Aim We aimed to evaluate the ability of contrast-enhanced ultrasonography (CEUS) to perform differential diagnosis of cervical tuberculous lymphadenitis and lymph node metastasis from papillary thyroid cancer (PTC). Methods We analyzed 102 enlarged cervical lymph nodes as diagnosed by conventional ultrasound (US) and CEUS. The US and CEUS enhancement pattern and the time intensity curve (TIC) of the metastatic lymph nodes or tuberculous lymph nodes were compared following standard pathological protocols. The TIC included peak time (TTP), peak intensity (PI), and area under the gamma curve (AUC). Results Pathological results demonstrated that 48 out of the 102 enlarged lymph nodes were lymph node metastasis from PTC, while 54 were tuberculous lymphadenitis. There was statistically significant differences in hyperechoic islands, pulse-like enhancement, and asynchronous enhancement between tuberculous lymphadenitis and lymph node metastasis (P < 0.05), but their diagnostic sensitivity and specificity were unsatisfactory. In addition, our data did not show statistically significant difference in enhancement direction, enlarged range on CEUS, and perfusion defect (P > 0.05). Similarly, quantitative parameters such as PI, TTP, and AUC did not yield significant differences between the groups. Conclusion Taken together, the present results demonstrate that CEUS can provide valuable information on lymph node blood flow, which can be used to identify tuberculous lymphadenitis and lymph node metastasis of PTC.
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Affiliation(s)
- Xu Zhang
- Department of Ultrasound, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lingling Wang
- Department of Ultrasound, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Na Feng
- Department of Ultrasound, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Tu Ni
- Department of Ultrasound, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wei Tang
- Department of Ultrasound, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Huang S, Zhao Y, Jiang X, Lin N, Zhang M, Wang H, Zheng A, Ma X. Clinical Utility of Contrast-enhanced Ultrasound for the Diagnosis of Lymphadenopathy. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:869-879. [PMID: 33487474 DOI: 10.1016/j.ultrasmedbio.2020.12.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 02/05/2023]
Abstract
This meta-analysis aimed to evaluate the diagnostic accuracy of contrast-enhanced ultrasonography (CEUS) in identifying lymphazdenopathy. PubMed, Web of Science, Embase and the Cochrane Library were searched for relevant articles through September 2020. A total of 16 articles, which included 1787 participants, were analyzed. The summary sensitivity, specificity, positive likelihood ratio (LR), negative LR and diagnostic odds ratio of CEUS for diagnosing lymphadenopathy were 0.88 (0.86-0.90), 0.90 (0.88-0.92), 6.04 (3.67-9.95), 0.15 (0.10-0.21) and 47.38 (23.45-95.66), respectively. The summary receiver operating characteristic (SROC) area under the curve (AUC) was 0.9405. After omitting outliers identified in a bivariate box plot and forest plot, heterogeneity was decreased, and the pooled sensitivity and specificity were 0.87 (0.84-0.90) and 0.87 (0.84-0.90), respectively. Furthermore, the SROC AUC was 0.9327. In conclusion, CEUS has the potential to be a valuable tool for characterizing lymphadenopathy and could provide clinical decision support.
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Affiliation(s)
- Siyang Huang
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Tumor Targeted and Immune Therapy, Clinical Research Center for Breast, State Key Laboratory of Biotherapy, West China Hospital, Sichuan, Chengdu, China
| | - Yunuo Zhao
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Xian Jiang
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Tumor Targeted and Immune Therapy, Clinical Research Center for Breast, State Key Laboratory of Biotherapy, West China Hospital, Sichuan, Chengdu, China
| | - Nan Lin
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Mingxuan Zhang
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Hang Wang
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Aiping Zheng
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Xuelei Ma
- Department of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
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Piskunowicz M, Back SJ, Darge K, Humphries PD, Jüngert J, Ključevšek D, Lorenz N, Mentzel HJ, Squires JH, Huang DY. Contrast-enhanced ultrasound of the small organs in children. Pediatr Radiol 2021; 51:2324-2339. [PMID: 33830288 PMCID: PMC8566395 DOI: 10.1007/s00247-021-05006-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/17/2020] [Accepted: 02/08/2021] [Indexed: 11/28/2022]
Abstract
In pediatric and adult populations, intravenous contrast-enhanced ultrasound (CEUS) remains off-label for imaging of organs other than the liver and heart. This limited scope inhibits potential benefits of the new modality from a more widespread utilization. Yet, CEUS is potentially useful for imaging small organs such as the thyroid gland, lymph nodes, testes, ovaries and uterus, with all having locations and vasculature favorable for this type of examination. In the adult population, the utility of CEUS has been demonstrated in a growing number of studies for the evaluation of these small organs. The aim of this article is to present a review of pediatric CEUS of the thyroid gland, lymph nodes, testes, ovaries and uterus as well as to draw from the adult literature indications for possible applications in children.
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Affiliation(s)
- Maciej Piskunowicz
- Department of Radiology, Medical University of Gdansk, M. Sklodowskiej-Curie 3a Street, 80-210, Gdansk, Poland.
| | - Susan J. Back
- grid.25879.310000 0004 1936 8972Department of Radiology, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Kassa Darge
- grid.25879.310000 0004 1936 8972Department of Radiology, Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Paul D. Humphries
- grid.424537.30000 0004 5902 9895Department of Radiology, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Jörg Jüngert
- grid.5330.50000 0001 2107 3311Department of Pediatrics, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Damjana Ključevšek
- grid.29524.380000 0004 0571 7705Department of Radiology, University Children’s Hospital Ljubljana, Ljubljana, Slovenia
| | - Norbert Lorenz
- grid.4488.00000 0001 2111 7257Children’s Hospital, Dresden Municipal Hospital, Teaching-Hospital of Technical University Dresden, Dresden, Germany
| | - Hans-Joachim Mentzel
- grid.275559.90000 0000 8517 6224Section of Pediatric Radiology, Institute of Diagnostic and Interventional Radiology, University Hospital, Jena, Germany
| | - Judy H. Squires
- grid.239553.b0000 0000 9753 0008Department of Radiology, University of Pittsburgh Medical Center, Children’s Hospital of Pittsburgh, Pittsburgh, PA USA
| | - Dean Y. Huang
- grid.46699.340000 0004 0391 9020Department of Radiology, King’s College Hospital, Denmark Hill, London, UK
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