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Zuo D, Qian JJ, Dong Y, Wang WP, Tian XF, Qiu YJ, Dietrich CF. Incidentally Detected Liver Metastases during Pancreas Contrast-enhanced Ultrasound. BIO INTEGRATION 2021; 2:135-142. [DOI: 10.15212/bioi-2021-0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023] Open
Abstract
Abstract Purpose: The purpose of current study was to investigate the value of the late-phase enhancement features of pancreas contrast-enhanced ultrasound (CEUS) in the detection of liver metastases in patients with pancreatic ductal adenocarcinomas (PDAC).Methods:
From October 2020 to March 2021, 86 patients were prospectively enrolled. The gold standard of liver metastatic and PDAC lesions were based on histopathologically diagnoses and multiple imaging modalities results. B-mode ultrasound (BMUS) was performed to detect suspected liver metastases
before CEUS. During the late phase of pancreas CEUS, the entire liver was scanned again to detect hypoenhanced liver metastases. Liver metastases were confirmed by biopsy and histopathological results. The number and size of liver metastases detected by BMUS and during CEUS late phase were
recorded and compared.Results: Suspected liver metastases were detected in 14 patients by BMUS (n = 23). During the late phase of CEUS, hypoenhanced liver metastases were detected in 23 patients (n = 87). When compared with BMUS, whole-liver scan during the late phase of CEUS detected
more isoechoic, small, or superficially located lesions. Compared with BMUS, the specificity, sensitivity, positive predictive value, and negative predictive value of CEUS in diagnosing of liver metastases in PDAC patients were significantly improved (96.72% vs. 100%, 48% vs. 92%, 85.71% vs.
100%, and 83.10% vs. 96.83%, respectively) (P < 0.05).Conclusion: The late phase whole liver scan during CEUS of pancreas helps to detect more liver metastases, which is important for further clinical decision-making.
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Affiliation(s)
- Dan Zuo
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Ji-Jiang Qian
- Department of Ultrasound, Shaoxing Yuecheng People’s Hospital, Zhejiang 200032, China
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Wen-Ping Wang
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Xiao-Fan Tian
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Yi-Jie Qiu
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Christoph Frank Dietrich
- Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
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Bitterer F, Hornung M, Platz Batista da Silva N, Schlitt HJ, Stroszczynski C, Wege AK, Jung EM. In vivo detection of breast cancer liver metastases in humanized tumour mice using tumour specific contrast agent BR55®. Clin Hemorheol Microcirc 2021; 76:559-572. [PMID: 32924994 DOI: 10.3233/ch-200898] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To investigate the diagnostic accuracy of high-resolution ultrasound (HRU) for the detection of hepatic metastases of breast cancer in a humanized tumour mouse (HTM) using clinical standard technology. In addition, the efficiency of standard contrast-enhanced ultrasound (CEUS) [microbubbles of sulphur hexafluoride] and CEUS using a novel VEGFR2-targeted contrast agent [BR55®] was examined. METHODS A total of 14 HTM were sonographically examined twice. In addition to a human immune system, the animals developed hepatic tumour lesions after intrahepatic injection of BT-474 breast cancer cells. Digital cine loops from the arterial phase (15-35 sec), the portal venous phase (35-90 sec) and the late phase (3-15 min) of the entire liver were analysed. Data were correlated to histopathology. RESULTS After 9 months, half of the mice (7/14) revealed the development of hepatic breast cancer metastases. The detection limit was 1 mm tumour diameter. In particular, the use of targeted contrast media reduced the needed tumour diameter and helped to precisely classify tumour tissue. In 93% (13/14), the findings of ultrasound could be approved by histological examination by the pathologist. CONCLUSIONS This study in HTM demonstrated the high feasibility of tumour specific contrast media and standard HRU contrast agents to detect early liver metastases.
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Affiliation(s)
- Florian Bitterer
- Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Matthias Hornung
- Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | | | - Hans J Schlitt
- Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | | | - Anja K Wege
- Department of Gynecology and Obstetrics, University Medical Center Regensburg, Regensburg, Germany
| | - Ernst-Michael Jung
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
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3
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Wege AK, Kirchhammer N, Kazandjian LV, Prassl S, Brandt M, Piendl G, Ortmann O, Fischer S, Brockhoff G. A novel rabbit derived anti-HER2 antibody with pronounced therapeutic effectiveness on HER2-positive breast cancer cells in vitro and in humanized tumor mice (HTM). J Transl Med 2020; 18:316. [PMID: 32799890 PMCID: PMC7429704 DOI: 10.1186/s12967-020-02484-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 08/08/2020] [Indexed: 01/05/2023] Open
Abstract
Background Antibody based cancer therapies have achieved convincing success rates combining enhanced tumor specificity and reduced side effects in patients. Trastuzumab that targets the human epidermal growth factor related receptor 2 (HER2) is one of the greatest success stories in this field. For decades, trastuzumab based treatment regimens are significantly improving the prognosis of HER2-positive breast cancer patients both in the metastatic and the (neo-) adjuvant setting. Nevertheless, ≥ 50% of trastuzumab treated patients experience de-novo or acquired resistance. Therefore, an enhanced anti-HER2 targeting with improved treatment efficiency is still aspired. Methods Here, we determined cellular and molecular mechanisms involved in the treatment of HER2-positive BC cells with a new rabbit derived HER2 specific chimeric monoclonal antibody called “B100″. We evaluated the B100 treatment efficiency of HER2-positive BC cells with different sensitivity to trastuzumab both in vitro and in the presence of a human immune system in humanized tumor mice. Results B100 not only efficiently blocks cell proliferation but more importantly induces apoptotic tumor cell death. Detailed in vitro analyses of B100 in comparison to trastuzumab (and pertuzumab) revealed equivalent HER2 internalization and recycling capacity, similar Fc receptor signaling, but different HER2 epitope recognition with high binding and treatment efficiency. In trastuzumab resistant SK-BR-3 based humanized tumor mice the B100 treatment eliminated the primary tumor but even more importantly eradicated metastasized tumor cells in lung, liver, brain, and bone marrow. Conclusion Overall, B100 demonstrated an enhanced anti-tumor activity both in vitro and in an enhanced preclinical HTM in vivo model compared to trastuzumab or pertuzumab. Thus, the use of B100 is a promising option to complement and to enhance established treatment regimens for HER2-positive (breast) cancer and to overcome trastuzumab resistance. Extended preclinical analyses using appropriate models and clinical investigations are warranted.
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Affiliation(s)
- Anja Kathrin Wege
- Clinic of Gynecology and Obstetrics, University Medical Center Regensburg, Regensburg, Germany.
| | - Nicole Kirchhammer
- Clinic of Gynecology and Obstetrics, University Medical Center Regensburg, Regensburg, Germany.,Department of Biomedicine, University of Basel, Basel, Switzerland
| | | | | | | | - Gerhard Piendl
- Clinic of Gynecology and Obstetrics, University Medical Center Regensburg, Regensburg, Germany
| | - Olaf Ortmann
- Clinic of Gynecology and Obstetrics, University Medical Center Regensburg, Regensburg, Germany
| | | | - Gero Brockhoff
- Clinic of Gynecology and Obstetrics, University Medical Center Regensburg, Regensburg, Germany
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Pohlman RM, Varghese T. Physiological Motion Reduction Using Lagrangian Tracking for Electrode Displacement Elastography. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:766-781. [PMID: 31806499 PMCID: PMC7241290 DOI: 10.1016/j.ultrasmedbio.2019.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/19/2019] [Accepted: 11/04/2019] [Indexed: 05/03/2023]
Abstract
Minimally invasive treatments such as microwave ablation (MWA) have been growing in popularity for extending liver cancer survival rates in patients, when surgery is not an option. As a non-ionizing, real-time alternative to contrast-enhanced computed tomography, electrode displacement elastography (EDE) has shown promise as an imaging modality for MWA. Despite imaging efficacy, motion artifacts caused by physiological motion result in unintended speckle pattern variance, thereby inhibiting consistent and accurate ablated region visualization. To combat these unavoidable motion artifacts, a Lagrangian deformation tracking (LDT) approach based on freehand EDE was developed to track tissue movement and better define tissue properties. For validating LDT efficacy, a spherical inclusion phantom as well as seven in vivo data sets were processed, and strain tensor images were compared with identical time sampled images estimated using a traditional Eulerian approach. In vivo results revealed greater consistency among visualized LDT strain tensor images, with segmented ablated regions exhibiting standard deviation reductions of up to 98% when compared with Eulerian strain tensor images. Additionally, Lagrangian strain tensor images provided Dice coefficient improvements up to 25%, and success rates improved from approximately 50% to nearly 100% for ablated region visualization.
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Affiliation(s)
- Robert M Pohlman
- Department of Electrical and Computer Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA; Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
| | - Tomy Varghese
- Department of Electrical and Computer Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA; Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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5
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Bach A, Hameister C, Slowinski T, Jung EM, Thomas A, Fischer T. Can acoustic structural quantification be used to characterize the ultrasound echotexture of the peripheral zone of breast lesions? Clin Hemorheol Microcirc 2019; 72:189-200. [PMID: 30714952 PMCID: PMC6700716 DOI: 10.3233/ch-180484] [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] [Indexed: 12/07/2022]
Abstract
BACKGROUND: Besides mammography, breast ultrasound is the most important imaging modality for women with suspected breast cancer. New software tools bear high potential for improved detectability and specification of malignant breast lesions. OBJECTIVE: To compare the halo depicted around malignant breast lesions by ultrasound using Acoustic Structure Quantification (ASQ) of raw image data with the echogenic rim seen in B-mode ultrasound. METHODS: This retrospective study included 37 women for whom conventional B-mode ultrasound of the breast and ASQ were available as well as histopathology findings for comparison. Software tools were used to measure the halo area or echogenic rim and tumor area and calculate halo-to-lesion ratios for the two ultrasound modes. Six inexperienced readers characterized the breast lesions based on this information. Specificity, sensitivity, positive predictive value (PPV), and negative predictive value (NPV) were determined. ANOVA, the Wilcoxon test, and ROC curve analysis were performed. RESULTS: There was a linear relationship between ASQ-based and B-mode-based halo-to-lesion ratios; however, a systematic error was also noted. ASQ-derived ratios tended to be higher for breast lesions with lymphangioinvasion (p = 0.051, n.s.) and higher N-stages (p > 0.925, n.s.), while there was no correlation with other markers. Because of the significantly greater conspicuity of peritumoral halos in the ASQ mode, inexperienced readers achieved greater sensitivity (78% vs. 74%) and specificity (75% vs. 71%) and higher NPVs (75% vs. 71%) and PPVs (78% vs. 74%) compared with B-mode images. Greater halo conspicuity affected the identification of malignant lesions with both modes; ASQ was found to be particularly well suited (FBimage (1,100) = 19.253, p < 0.001; FASQ (1,100) = 52.338, p < 0.001). The inexperienced readers were significantly more confident about their diagnosis using the ASQ maps (z = –3.023, p = 0.003). CONCLUSIONS: We conclude that the halo in ASQ and the echogenic rim in B-mode ultrasound are attributable to different morphologic correlates. ASQ improves diagnostic accuracy and confidence of inexperienced examiners because of improved halo visibility.
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Affiliation(s)
- Annika Bach
- Department of Radiology, University Berlin, Charité, Berlin, Germany
| | | | - Torsten Slowinski
- Department of Nephrology, University Berlin, Charité, Berlin, Germany
| | - Ernst Michael Jung
- Department of Radiology and Interdisciplinary Ultrasound Centre, Universitary Hospital, Regensburg, Germany
| | - Anke Thomas
- Department of Obstetrics and Gynecology and Ultrasound Research Laboratory, University Berlin, Charité, Berlin, Germany
| | - Thomas Fischer
- Department of Radiology and Interdisciplinary Ultrasound Centre and Ultrasound Research Laboratory, University Berlin, Charité, Berlin, Germany
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6
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Pandit H, Tinney JP, Li Y, Cui G, Li S, Keller BB, Martin RCG. Utilizing Contrast-Enhanced Ultrasound Imaging for Evaluating Fatty Liver Disease Progression in Pre-clinical Mouse Models. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:549-557. [PMID: 30527843 DOI: 10.1016/j.ultrasmedbio.2018.10.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/16/2018] [Accepted: 10/19/2018] [Indexed: 06/09/2023]
Abstract
We developed a protocol to investigate and optimize the application of contrast-enhanced ultrasound (CEUS) to non-invasive diagnosis of progressing fatty liver disease in mouse models. Eighteen 4-wk-old male C57 L/J mice were randomly assigned to one of the three groups and placed on a control diet, high-fat diet or non-alcoholic steatohepatitis diet for the next 10 wk. After 14 wk, B-mode imaging and CEUS imaging using a VisualSonics Vevo2100 system were performed. CEUS imaging and data analysis using three different parameters-peak enhancement, wash-in rate and wash-in perfusion index-revealed a significant decrease in representative blood flow in the high-fat diet group versus controls and a further significant decrease in the non-alcoholic steatohepatitis group (p < 0.001; n = 6/group). In conclusion, compared with B-mode imaging, non-targeted CEUS imaging was more sensitive in diagnosing early-stage fatty infiltration-mediated vascularity changes in liver parenchyma and provided a more accurate steatohepatitis diagnosis in mouse models.
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Affiliation(s)
- Harshul Pandit
- Division of Surgical Oncology, Hiram C. Polk, Jr., MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA; Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Joseph P Tinney
- Kosair Charities Pediatric Health Research Program, Cardiovascular Innovation Institute, University of Louisville, Louisville, Kentucky, USA; Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Yan Li
- Division of Surgical Oncology, Hiram C. Polk, Jr., MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Guozhen Cui
- Division of Surgical Oncology, Hiram C. Polk, Jr., MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Suping Li
- Division of Surgical Oncology, Hiram C. Polk, Jr., MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Bradley B Keller
- Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky, USA; Kosair Charities Pediatric Health Research Program, Cardiovascular Innovation Institute, University of Louisville, Louisville, Kentucky, USA; Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Robert C G Martin
- Division of Surgical Oncology, Hiram C. Polk, Jr., MD Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA; Department of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky, USA.
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7
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Regulation of Programmed Death Ligand 1 (PD-L1) Expression in Breast Cancer Cell Lines In Vitro and in Immunodeficient and Humanized Tumor Mice. Int J Mol Sci 2018; 19:ijms19020563. [PMID: 29438316 PMCID: PMC5855785 DOI: 10.3390/ijms19020563] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 02/02/2018] [Accepted: 02/06/2018] [Indexed: 12/31/2022] Open
Abstract
Programmed death ligand 1 (PD-L1) expression is an efficient strategy of tumor cells to escape immunological eradiation. However, only little is known about the factors that affect the cellular expression levels. Here we assessed the PD-L1 expression on different breast cancer cell lines under standard in vitro culture conditions and as a function of Epirubicin or Paclitaxel treatment. Moreover, we evaluated the expression in immunodeficient tumor mice as well as in humanized tumor mice (i.e., in the presence of a human immune system). We found highest PD-L1 levels in JIMT-1 and MDA-MB-231 cells. Epirubicin treatment caused a decrease and Paclitaxel treatment an increased PD-L1 expression in MDA-MB-231 cells. In addition, we identified nuclear PD-L1 in MDA-MB-231 cells. All in vivo transplanted breast cancer cell lines downregulated PD-L1 expression compared to their in vitro counterpart. Neither the gene copy number nor the presence of human immune system in humanized tumor mice had an effect on the PD-L1 content. We demonstrate that the degree of PD-L1 expression amongst breast cancer cell lines varies considerably. In addition, cytotoxic treatments and other extrinsic parameters differentially affect the expression. Hence, further investigations including in vivo evaluations are necessary to understand PD-L1 regulation for advanced breast cancer stratification.
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Wendl C, Janke M, Jung W, Stroszczysnski C, Jung E. Contrast-enhanced ultrasound with perfusion analysis for the identification of malignant and benign tumours of the thyroid gland. Clin Hemorheol Microcirc 2016; 63:113-21. [DOI: 10.3233/ch-151966] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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9
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Chiorean L, Caraiani C, Radziņa M, Jedrzejczyk M, Schreiber-Dietrich D, Dietrich CF. Vascular phases in imaging and their role in focal liver lesions assessment. Clin Hemorheol Microcirc 2016; 62:299-326. [PMID: 26444602 DOI: 10.3233/ch-151971] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Liliana Chiorean
- Med. Klinik 2, Caritas Krankenhaus Bad Mergentheim, Bad Mergentheim, Germany
- Département d’Imagerie Médicale, Clinique des Cévennes Annonay, France
| | - Cosmin Caraiani
- Department of Radiology and Computed Tomography, “Octavian Fodor” Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania; “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Maija Radziņa
- Diagnostic Radiology Institute, Paula Stradins Clinical University Hospital, Riga, Latvia
| | - Maciej Jedrzejczyk
- Department of Diagnostic Imaging, Institute of Mother and Child, Warsaw, Poland
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Secil M, Mungan U, Yorukoglu K. Suture granuloma after orchiectomy: sonography, doppler and elastography features. Int Braz J Urol 2016; 41:813-6. [PMID: 26401877 PMCID: PMC4757013 DOI: 10.1590/s1677-5538.ibju.2013.0207] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 04/03/2015] [Indexed: 11/22/2022] Open
Abstract
Suture granuloma is a mass forming benign lesion that develops at the site of surgery as a foreign body reaction to non-absorbable suture material. We present a case of suture granuloma that developed at the inguinal region after orchiectomy, and define the sonography, color Doppler sonography and real-time ultrasound elastography findings in correlation with the histopathological findings.
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Affiliation(s)
- Mustafa Secil
- Dokuz Eylul University Faculty of Medicine - Radiology, Inciralti, Izmir, Turkey
| | - Ugur Mungan
- Dokuz Eylul University Faculty of Medicine - Urology, Inciralti, Izmir, Turkey
| | - Kutsal Yorukoglu
- Dokuz Eylul University Faculty of Medicine - Pathology, Inciralti, Izmir, Turkey
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11
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Jung EM, Platz Batista da Silva N, Jung W, Farkas S, Stroszczynski C, Rennert J. Is Strain Elastography (IO-SE) Sufficient for Characterization of Liver Lesions before Surgical Resection--Or Is Contrast Enhanced Ultrasound (CEUS) Necessary? PLoS One 2015; 10:e0123737. [PMID: 26114286 PMCID: PMC4482620 DOI: 10.1371/journal.pone.0123737] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 12/19/2014] [Indexed: 12/21/2022] Open
Abstract
Aim To evaluate the diagnostic accuracy of IO-SE in comparison to IO-CEUS for the differentiation between malignant and benign liver lesions. Material and Methods In a retrospective diagnostic study IO-CEUS and SE examinations of 49 liver lesions were evaluated and compared to histopathological examinations. Ultrasound was performed using a multifrequency linear probe (6–9 MHz). The loops of CEUS were evaluated up to 5 min. The qualitative characterization of IO-SE was based on a color coding system (blue = hard, red = soft). Stiffness of all lesions was quantified by a specific scaling of 0–6 (0 = low, 6 = high) using 7 ROIs (2 central, 5 peripheral). Results All malignant lesions displayed a characteristic portal venous washout and could be diagnosed correctly by IO-CEUS. 3/5 benign lesions could not be characterized properly either by IO-CEUS or IO-SE prior to resection. Thus for IO-CEUS sensitivity, specificity, positive and negative predictive value and accuracy were 100%, 40%, 94%, 100% and 94%. Lesion sizes were between 8 and 59 mm in diameter. Regarding the IO-SE, malignant lesions showed a marked variability. In qualitative analysis, 31 of the malignant lesions were blue colored denoting overall induration. Thirteen malignant lesions showed an inhomogenous color pattern with partial indurations. Two of the benign lesions also displayed overall induration. The other benign lesions showed an inhomogenous color mapping. Calculated sensitivity of the SE was 70.5%, specificity 60%, PPV 94%, NPV 18.75%, and accuracy 69%. Conclusion IO-CEUS is useful for localization and characterization of liver lesions prior to surgical resection whereas IO-SE provided correct characterization only for a limited number of lesions.
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Affiliation(s)
- Ernst Michael Jung
- University Hospital Regensburg, Department of Radiology, Regensburg, Germany
| | | | - Wolfgang Jung
- Saarland University, Department of Materials Research, Saarbrücken, Germany
| | - Stefan Farkas
- University Hospital Regensburg, Department of Surgery, Regensburg, Germany
| | | | - Janine Rennert
- University Hospital Regensburg, Department of Radiology, Regensburg, Germany
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12
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Ren WP, Yu MH, Xu P. Contrast-enhanced ultrasonography vs contrast-enhanced computed tomography for assessing blood supply of liver metastases. Shijie Huaren Xiaohua Zazhi 2015; 23:1328-1332. [DOI: 10.11569/wcjd.v23.i8.1328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To compare the value of contrast-enhanced ultrasonography (CEUS) vs contrast-enhanced computed tomography (CECT) in assessing the blood supply of liver metastases (LM).
METHODS: Fifty-five patients with LM (70 nodules) who underwent both CEUS and CECT were included. The degree of enhancement in arterial phase, the appearance of vasa vasorum and the classification of the blood supply around the nodule were compared between CEUS and CECT.
RESULTS: The degree of enhancement in arterial phase was more significant for CEUS than for CECT (1: 59% vs 5%; 0: 41% vs 62%; -1: 0% vs 33%) (P < 0.05). The appearance of vasa vasorum around the nodule was significantly more frequent for CEUS than for CECT (54% vs 34%, χ2 = 5.674, P = 0.017). The rate of abundant blood supply was 70% for CEUS, significantly higher than that for CECT (30%; χ2 = 19.330, P = 0.000).
CONCLUSION: CEUS is better than CECT in evaluation of blood supply of LM.
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13
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Dudea M, Clichici S, Olteanu DE, Nagy A, Cucoş M, Dudea S. Usefulness of real-time elastography strain ratio in the assessment of bile duct ligation-induced liver injury and the hepatoprotective effect of chitosan: an experimental animal study. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:114-123. [PMID: 25438858 DOI: 10.1016/j.ultrasmedbio.2014.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 07/30/2014] [Accepted: 08/03/2014] [Indexed: 06/04/2023]
Abstract
The purpose of the study described here was to evaluate the usefulness of the elastographic strain ratio in the assessment of liver changes in an experimental animal setting and the hepatoprotective effects of chitosan. Ultrasonography and Strain Ratio calculation were performed before and after bile duct ligation (BDL) in three groups of Wistar albino rats (n = 10 animals per group): (i) rats subjected to bile duct ligation only; (ii) rats subjected to bile duct ligation and administered chitosan for 14 d; (iii) rats subjected to bile duct ligation and administered chitosan for 7 d. The results were compared with the laboratory data and pathologic findings. Strain ratios revealed an increase in liver stiffness after bile duct ligation (p < 0.05), except in the group with chitosan administered for 7 d, and agreed with laboratory and pathology data. In conclusion, strain ratio can be used as an experimental research instrument in the assessment of liver response to injury. To the best of our knowledge, this is the first study reporting on the usefulness of the sonoelastographic liver-to-kidney strain ratio in assessing the effects of experimentally induced liver lesions.
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Affiliation(s)
- Marina Dudea
- Physiology Department, University of Medicine and Pharmacy "Iuliu Haţieganu", Cluj-Napoca, Romania
| | - Simona Clichici
- Physiology Department, University of Medicine and Pharmacy "Iuliu Haţieganu", Cluj-Napoca, Romania.
| | - Diana Elena Olteanu
- Physiology Department, University of Medicine and Pharmacy "Iuliu Haţieganu", Cluj-Napoca, Romania
| | - Andras Nagy
- Pathology Department, Universitatea deŞtiinţe Agricole şi Medicină Veterinară (USAMV), Cluj-Napoca, Romania
| | - Maria Cucoş
- Physiology Department, University of Medicine and Pharmacy "Iuliu Haţieganu", Cluj-Napoca, Romania
| | - Sorin Dudea
- Radiology Department, University of Medicine and Pharmacy "Iuliu Haţieganu", Cluj-Napoca, Romania
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Wege AK, Schmidt M, Ueberham E, Ponnath M, Ortmann O, Brockhoff G, Lehmann J. Co-transplantation of human hematopoietic stem cells and human breast cancer cells in NSG mice: a novel approach to generate tumor cell specific human antibodies. MAbs 2014; 6:968-77. [PMID: 24870377 PMCID: PMC4171030 DOI: 10.4161/mabs.29111] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 04/23/2014] [Accepted: 05/05/2014] [Indexed: 12/18/2022] Open
Abstract
Humanized tumor mice (HTM) were generated by the co-transplantation of human hematopoietic stem cells and human breast cancer cells overexpressing HER2 into neonatal NOD-scid IL2Rγ(null) (NSG) mice. These mice are characterized by the development of a human immune system in combination with human breast cancer growth. Due to concurrent transplantation into newborn mice, transfer of MHC-mismatched tumor cells resulted in solid coexistence and immune cell activation (CD4(+) T cells, natural killer cells, and myeloid cells), but without evidence for rejection. Histological staining of the spleen of HTM revealed co-localization of human antigen-presenting cells together with human T and B cells allowing MHC-dependent interaction, and thereby the generation of T cell-dependent antibody production. Here, we investigated the capability of these mice to generate human tumor-specific antibodies and correlated immunoglobulin titers with tumor outgrowth. We found detectable IgM and also IgG amounts in the serum of HTM, which apparently controlled tumor development when IgG serum concentrations were above 10 µg/ml. Western blot analyses revealed that the tumor-specific antibodies generated in HTM did not recognize HER2/neu antigens, but different, possibly relevant antigens for breast cancer therapy. In conclusion, HTM offer a novel approach to generate complete human monoclonal antibodies that do not require further genetic manipulation (e. g., humanization) for a potential application in humans. In addition, efficacy and safety of the generated antibodies can be tested in the same mouse model under human-like conditions. This might be of particular interest for cancer subtypes with no currently available antibody therapy.
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Affiliation(s)
- Anja K Wege
- Department of Gynecology and Obstetrics; University Medical Center Regensburg; Regensburg, Germany
| | - Marcus Schmidt
- Department of Obstetrics and Gynecology; University Hospital; Mainz, Germany
| | - Elke Ueberham
- Department of Cell Engineering/GLP; Fraunhofer Institute for Cell Therapy and Immunology; Leipzig, Germany
| | - Marvin Ponnath
- Department of Gynecology and Obstetrics; University Medical Center Regensburg; Regensburg, Germany
| | - Olaf Ortmann
- Department of Gynecology and Obstetrics; University Medical Center Regensburg; Regensburg, Germany
| | - Gero Brockhoff
- Department of Gynecology and Obstetrics; University Medical Center Regensburg; Regensburg, Germany
| | - Jörg Lehmann
- Department of Cell Engineering/GLP; Fraunhofer Institute for Cell Therapy and Immunology; Leipzig, Germany
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15
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Jiang J, Shang X, Zhang H, Ma W, Xu Y, Zhou Q, Gao Y, Yu S, Qi Y. Correlation between maximum intensity and microvessel density for differentiation of malignant from benign thyroid nodules on contrast-enhanced sonography. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2014; 33:1257-1263. [PMID: 24958412 DOI: 10.7863/ultra.33.7.1257] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES The purpose of this study was to retrospectively evaluate contrast-enhanced sonography for differentiation of benign and malignant thyroid nodules by analyzing the correlation between maximum intensity and microvessel density. METHODS From February 2010 to May 2012, 122 patients (85 female and 37 male; mean age ± SD, 45 ± 9.1 years) with thyroid nodules (62 papillary thyroid carcinomas, 30 nodular goiters, and 30 adenomas) that underwent routine thyroid sonography and were diagnosed by surgery were included in this study. Contrast-enhanced sonography was performed, and enhancement patterns were classified into 3 groups: high, equal, and low enhancement. As a time-intensity curve parameter, the correlation of maximum intensity with CD31 and CD34 microvessel density counts was analyzed. RESULTS On contrast-enhanced sonography, most patients with papillary thyroid carcinomas showed a heterogeneous low enhancement pattern, whereas most patients with nodular goiters showed an equal enhancement pattern, and patients with adenomas showed a high enhancement pattern. The detection of papillary thyroid carcinomas with low enhancement had sensitivity of 96.8%, specificity of 95.0%, and accuracy of 95.9%. Compared with the papillary thyroid group, the mean microvessel density counts were significantly higher in the nodular goiter and adenoma groups (P< .05). We also found that the maximum intensity was significantly associated with CD31 and CD34 counts (CD31, r = 0.963; P < .01; CD34, r = 0.968; P < .01). CONCLUSIONS Maximum intensity has a significant relationship with microvessel density. Contrast-enhanced sonography is a practical and convenient means for differentiating benign from malignant thyroid nodules.
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Affiliation(s)
- Jue Jiang
- Department of Ultrasound, Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, China
| | - Xu Shang
- Department of Ultrasound, Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, China
| | - Hongli Zhang
- Department of Ultrasound, Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, China
| | - Wenqi Ma
- Department of Ultrasound, Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, China
| | - Yongbo Xu
- Department of Ultrasound, Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, China
| | - Qi Zhou
- Department of Ultrasound, Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, China.
| | - Ya Gao
- Department of Ultrasound, Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, China
| | - Shanshan Yu
- Department of Ultrasound, Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, China
| | - Yanhua Qi
- Department of Ultrasound, Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, China
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