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Intra- and Inter-Observer Variability of Quantitative Parameters Used in Contrast-Enhanced Ultrasound of Kidneys of Healthy Cats. Animals (Basel) 2022; 12:ani12243557. [PMID: 36552476 PMCID: PMC9774712 DOI: 10.3390/ani12243557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/05/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Contrast-enhanced ultrasound (CEUS) is a non-invasive imaging technique which allows qualitative and quantitative assessment of tissue perfusion. Although CEUS offers numerous advantages, a major challenge remains the variability in tissue perfusion quantification. This study aimed to assess intra- and inter-observer variability for quantification of renal perfusion. Two observers with different levels of expertise performed a quantitative analysis of 36 renal CEUS studies, twice. The CEUS data were collected from 12 healthy cats at 3 different time points with a 7-day interval. The inter- and intra-observer agreement was assessed by the intraclass correlation coefficient. Within and between observers, a good agreement was demonstrated for intensity-related parameters in the cortex, medulla, and interlobular artery. For some parameters, ICCinter was considerably lower than ICCintra, mostly when the ROI encompassed the entire kidney or medulla. With the exception of time to peak (TTP) and mean transit time (mTTI), time-related and slope-related parameters showed poor agreement among observers. In conclusion, it may be advised against having the quantitative assessment of renal perfusion performed by different observers, especially if their experience levels differ. The cortical mTTI seemed to be the most appropriate parameter as it showed a favorable inter-observer agreement and inter-period agreement.
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Liu H, Cao H, Chen L, Fang L, Liu Y, Zhan J, Diao X, Chen Y. The quantitative evaluation of contrast-enhanced ultrasound in the differentiation of small renal cell carcinoma subtypes and angiomyolipoma. Quant Imaging Med Surg 2022; 12:106-118. [PMID: 34993064 DOI: 10.21037/qims-21-248] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/22/2021] [Indexed: 12/24/2022]
Abstract
Background Contrast-enhanced ultrasound (CEUS) has been widely used for renal lesion diagnosis and differential diagnosis. However, qualitative analysis of CEUS is subject to examinations with low reproducibility. This study aims to investigate the diagnostic value of CEUS quantitative parameters in differentiating small renal cell carcinoma (RCC) subtypes and angiomyolipoma (AML). Methods A retrospective analysis was performed on 97 cases of a small renal mass undergoing a CEUS before a radical or partial nephrectomy procedure. A region of interest (ROI) was placed in the tumor's maximum enhanced region (ROImax) as much as possible, and adjacent renal cortex (ROIrefer) was selected from normal renal tissue around a mass of the same depth. The time-intensity curve (TIC) was used to analyze the ROImax and the ROIrefer of the tumors quantitatively. Then the parameters of the ROImax and the ROIrefer, including the differences between the parameters of the ROImax and the ROIrefer, were analyzed statistically. Results In RCC and clear cell renal cell carcinoma (ccRCC), the peak intensity (PI), slope (SL), area under the curve (AUC), area under the wash-in curve (AWI), area under the wash-out curve (AWO), time to peak intensity (TTP) and the mean transit time (MTT) were statistically significant between ROImax and ROIrefer (all P=0.000). The △PI (△PI = PImax - PIrefer), △SL (△SL = SLmax - SLrefer), △AUC (△AUC = AUCmax - AUCrefer), △AWI (△AWI = AWImax - AWIrefer) and △AWO (△AWO = AWOmax - AWOrefer) of RCC were significantly higher than in AML (P=0.007, 0.000, 0.003, 0.048, 0.009, respectively), while the TTP (△TTP = TTPmax - TTPrefer) and △MTT (△MTT = MTTmax - MTTrefer) of RCC were significantly lower (both P=0.000). In comparison with papillary renal cell carcinoma (pRCC) and chromophobe renal cell carcinoma (chRCC), the △PI, △SL, △AUC and △AWO of ccRCC were all larger (all P<0.05). The sensitivity, specificity, and AUC of the combination of parameter difference for differentiating RCC from AML were 100%, 81.2%, and 0.965, respectively, and for differentiating ccRCC from pRCC and chRCC, 85.71%, 85.92% and 0.911, respectively. Conclusions CEUS quantitative parameters have value in differentiating small RCC from AML and distinguishing ccRCC from pRCC and chRCC.
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Affiliation(s)
- Hui Liu
- Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, China
| | - Hongli Cao
- Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, China
| | - Lin Chen
- Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, China
| | - Liang Fang
- Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, China
| | - Yingchun Liu
- Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, China
| | - Jia Zhan
- Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, China
| | - Xuehong Diao
- Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, China
| | - Yue Chen
- Department of Ultrasound, Huadong Hospital, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai, China
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Kunz P, Kiesl S, Groß S, Kauczor HU, Schmidmaier G, Fischer C. Intra-observer and Device-Dependent Inter-observer Reliability of Contrast-Enhanced Ultrasound for Muscle Perfusion Quantification. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:275-285. [PMID: 31733932 DOI: 10.1016/j.ultrasmedbio.2019.10.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 10/06/2019] [Accepted: 10/11/2019] [Indexed: 06/10/2023]
Abstract
Muscle perfusion quantification by contrast-enhanced ultrasound (CEUS) may facilitate treatment decisions in musculoskeletal disorders. Translation into clinical routine relies on high intra-observer and inter-observer reliability and transferability between ultrasound devices to enable validation and multicenter studies. This study evaluates these aspects for deltoid muscle perfusion quantification, including possible multicenter study setups. One hundred sixty-six CEUS quantifications were conducted on 42 shoulders. Intra-observer reliability revealed a high intra-class correlation coefficient (ICC, r = 0.91) and low coefficient of variation (CV, 10.28%). Inter-observer reliability revealed an ICC of .84 and a CV of 17.1%, but these values decreased when different ultrasound devices were used (ICC = .60, CV = 18.6%). Re-evaluating subgroups with high sectional plane concordance significantly increased reliability (intra-observer: ICC = .97, CV = 5.49%, inter-observer/same device: ICC = .98, CV = 5.83%, varying devices: ICC = .78, CV = 9.8%). CEUS perfusion quantification of the deltoid seems applicable for multicenter studies, yet pooling different ultrasound devices remains critical. Sectional plane concordance appears to be crucial for reliability and transferability of CEUS muscle perfusion quantifications.
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Affiliation(s)
- Pierre Kunz
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Ultrasound Centre, HTRG, Heidelberg University Hospital, Heidelberg, Germany; Clinic for Shoulder and Elbow Surgery, Catholic Hospital Mainz, Mainz, Germany.
| | - Sophia Kiesl
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Ultrasound Centre, HTRG, Heidelberg University Hospital, Heidelberg, Germany
| | - Sascha Groß
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Ultrasound Centre, HTRG, Heidelberg University Hospital, Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Gerhard Schmidmaier
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Ultrasound Centre, HTRG, Heidelberg University Hospital, Heidelberg, Germany
| | - Christian Fischer
- Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Ultrasound Centre, HTRG, Heidelberg University Hospital, Heidelberg, Germany
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Nisa K, Lim SY, Shinohara M, Nagata N, Sasaoka K, Dermlim A, Leela-Arporn R, Morita T, Yokoyama N, Osuga T, Sasaki N, Morishita K, Nakamura K, Ohta H, Takiguchi M. Repeatability and reproducibility of quantitative contrast-enhanced ultrasonography for assessing duodenal perfusion in healthy dogs. J Vet Med Sci 2017; 79:1585-1590. [PMID: 28781327 PMCID: PMC5627333 DOI: 10.1292/jvms.17-0174] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Contrast-enhanced ultrasonography (CEUS) with microbubbles as a contrast agent allows the visualization and quantification of tissue perfusion. The assessment of canine intestinal perfusion by quantitative CEUS may provide
valuable information for diagnosing and monitoring chronic intestinal disorders. This study aimed to assess the repeatability (intraday variability) and reproducibility (interday variability) of quantitative duodenal CEUS in
healthy dogs. Six healthy beagles underwent CEUS three times within one day (4-hr intervals) and on two different days (1-week interval). All dogs were sedated with a combination of butorphanol (0.2 mg/kg) and midazolam (0.1
mg/kg) prior to CEUS. The contrast agent (Sonazoid®) was administered using the intravenous bolus method (0.01 ml/kg) for imaging of the duodenum. Time-intensity curves (TIC) were created by drawing
multiple regions of interest (ROIs) in the duodenal mucosa, and perfusion parameters, including the time-to-peak (TTP), peak intensity (PI), area under the curve (AUC), and wash-in and wash-out rates (WiR and WoR, respectively),
were generated. Intraday and interday coefficients of variation (CVs) for TTP, PI, AUC, WiR and WoR were <25% (range, 2.27–23.41%), which indicated that CEUS was feasible for assessing duodenal perfusion in healthy sedated
dogs. A further study of CEUS in dogs with chronic intestinal disorders is necessary to evaluate its clinical applicability.
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Affiliation(s)
- Khoirun Nisa
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Sue Yee Lim
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Masayoshi Shinohara
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Noriyuki Nagata
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Kazuyoshi Sasaoka
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Angkhana Dermlim
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Rommaneeya Leela-Arporn
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Tomoya Morita
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Nozomu Yokoyama
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Tatsuyuki Osuga
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Noboru Sasaki
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Keitaro Morishita
- Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Kensuke Nakamura
- Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Hiroshi Ohta
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Mitsuyoshi Takiguchi
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
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Chouhan MD, Mookerjee RP, Bainbridge A, Walker-Samuel S, Davies N, Halligan S, Lythgoe MF, Taylor SA. Use of Caval Subtraction 2D Phase-Contrast MR Imaging to Measure Total Liver and Hepatic Arterial Blood Flow: Preclinical Validation and Initial Clinical Translation. Radiology 2016; 280:916-23. [PMID: 27171018 PMCID: PMC5015842 DOI: 10.1148/radiol.2016151832] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Caval subtraction phase-contrast MR imaging is technically feasible and may offer a
reproducible and clinically viable method for measuring total liver blood flow and
hepatic arterial flow. Purpose To validate caval subtraction two-dimensional (2D) phase-contrast magnetic
resonance (MR) imaging measurements of total liver blood flow (TLBF) and hepatic
arterial fraction in an animal model and evaluate consistency and reproducibility
in humans. Materials and Methods Approval from the institutional ethical committee for animal care and research
ethics was obtained. Fifteen Sprague-Dawley rats underwent 2D phase-contrast MR
imaging of the portal vein (PV) and infrahepatic and suprahepatic inferior vena
cava (IVC). TLBF and hepatic arterial flow were estimated by subtracting
infrahepatic from suprahepatic IVC flow and PV flow from estimated TLBF,
respectively. Direct PV transit-time ultrasonography (US) and fluorescent
microsphere measurements of hepatic arterial fraction were the standards of
reference. Thereafter, consistency of caval subtraction phase-contrast MR
imaging–derived TLBF and hepatic arterial flow was assessed in 13
volunteers (mean age, 28.3 years ± 1.4) against directly measured
phase-contrast MR imaging PV and proper hepatic arterial inflow; reproducibility
was measured after 7 days. Bland-Altman analysis of agreement and coefficient of
variation comparisons were undertaken. Results There was good agreement between PV flow measured with phase-contrast MR imaging
and that measured with transit-time US (mean difference, −3.5 mL/min/100 g;
95% limits of agreement [LOA], ±61.3 mL/min/100 g). Hepatic arterial fraction
obtained with caval subtraction agreed well with those with fluorescent
microspheres (mean difference, 4.2%; 95% LOA, ±20.5%). Good consistency was
demonstrated between TLBF in humans measured with caval subtraction and direct
inflow phase-contrast MR imaging (mean difference, −1.3 mL/min/100 g; 95%
LOA, ±23.1 mL/min/100 g). TLBF reproducibility at 7 days was similar between
the two methods (95% LOA, ±31.6 mL/min/100 g vs ±29.6 mL/min/100 g). Conclusion Caval subtraction phase-contrast MR imaging is a simple and clinically viable
method for measuring TLBF and hepatic arterial flow. Online supplemental
material is available for this article.
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Affiliation(s)
- Manil D Chouhan
- From the University College London Centre for Medical Imaging (M.D.C., S.H., S.A.T.), Institute for Liver and Digestive Health (R.P.M., N.D.), and Centre for Advanced Biomedical Imaging (S.W.S., M.F.L.), Division of Medicine, University College London, 250 Euston Rd, 3rd Floor East, London NW1 2PG, England; and Department of Medical Physics, University College London Hospitals NHS Trust, London, England (A.B.)
| | - Rajeshwar P Mookerjee
- From the University College London Centre for Medical Imaging (M.D.C., S.H., S.A.T.), Institute for Liver and Digestive Health (R.P.M., N.D.), and Centre for Advanced Biomedical Imaging (S.W.S., M.F.L.), Division of Medicine, University College London, 250 Euston Rd, 3rd Floor East, London NW1 2PG, England; and Department of Medical Physics, University College London Hospitals NHS Trust, London, England (A.B.)
| | - Alan Bainbridge
- From the University College London Centre for Medical Imaging (M.D.C., S.H., S.A.T.), Institute for Liver and Digestive Health (R.P.M., N.D.), and Centre for Advanced Biomedical Imaging (S.W.S., M.F.L.), Division of Medicine, University College London, 250 Euston Rd, 3rd Floor East, London NW1 2PG, England; and Department of Medical Physics, University College London Hospitals NHS Trust, London, England (A.B.)
| | - Simon Walker-Samuel
- From the University College London Centre for Medical Imaging (M.D.C., S.H., S.A.T.), Institute for Liver and Digestive Health (R.P.M., N.D.), and Centre for Advanced Biomedical Imaging (S.W.S., M.F.L.), Division of Medicine, University College London, 250 Euston Rd, 3rd Floor East, London NW1 2PG, England; and Department of Medical Physics, University College London Hospitals NHS Trust, London, England (A.B.)
| | - Nathan Davies
- From the University College London Centre for Medical Imaging (M.D.C., S.H., S.A.T.), Institute for Liver and Digestive Health (R.P.M., N.D.), and Centre for Advanced Biomedical Imaging (S.W.S., M.F.L.), Division of Medicine, University College London, 250 Euston Rd, 3rd Floor East, London NW1 2PG, England; and Department of Medical Physics, University College London Hospitals NHS Trust, London, England (A.B.)
| | - Steve Halligan
- From the University College London Centre for Medical Imaging (M.D.C., S.H., S.A.T.), Institute for Liver and Digestive Health (R.P.M., N.D.), and Centre for Advanced Biomedical Imaging (S.W.S., M.F.L.), Division of Medicine, University College London, 250 Euston Rd, 3rd Floor East, London NW1 2PG, England; and Department of Medical Physics, University College London Hospitals NHS Trust, London, England (A.B.)
| | - Mark F Lythgoe
- From the University College London Centre for Medical Imaging (M.D.C., S.H., S.A.T.), Institute for Liver and Digestive Health (R.P.M., N.D.), and Centre for Advanced Biomedical Imaging (S.W.S., M.F.L.), Division of Medicine, University College London, 250 Euston Rd, 3rd Floor East, London NW1 2PG, England; and Department of Medical Physics, University College London Hospitals NHS Trust, London, England (A.B.)
| | - Stuart A Taylor
- From the University College London Centre for Medical Imaging (M.D.C., S.H., S.A.T.), Institute for Liver and Digestive Health (R.P.M., N.D.), and Centre for Advanced Biomedical Imaging (S.W.S., M.F.L.), Division of Medicine, University College London, 250 Euston Rd, 3rd Floor East, London NW1 2PG, England; and Department of Medical Physics, University College London Hospitals NHS Trust, London, England (A.B.)
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Quantitative evaluation of contrast-enhanced ultrasound for differentiation of renal cell carcinoma subtypes and angiomyolipoma. Eur J Radiol 2016; 85:795-802. [PMID: 26971426 DOI: 10.1016/j.ejrad.2016.01.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 01/05/2016] [Accepted: 01/16/2016] [Indexed: 12/18/2022]
Abstract
PURPOSE To investigate the value of quantitative parameters of contrast-enhanced ultrasound (CEUS) in the differentiation of subtypes of renal cell carcinoma (RCC) and angiomyolipoma (AML). METHODS The quantitative characteristics of 341 RCCs and 88 AMLs were analyzed with quantitative software (SonoLiver). Quantitative analysis was conducted in the whole tumor (ROItumor) and the maximum enhanced area of the tumor (ROImax), acquiring the parameters of maximum intensity (IMAX), rise time (RT), time to peak (TTP), mean transit time (mTT), and area under the curve (AUC), were derived and analyzed. The difference values between ROImax and normal renal cortex (ΔPar.s, including ΔIMAX, ΔRT, ΔTTP, ΔmTT, ΔAUC) were compared among renal histotypes. RESULTS All time-related parameters (including RT, TTP and mTT) of ROImax were shorter than the corresponding parameters of ROItumor in RCC subtypes (all p<0.05), but made no statistical difference in AMLs (all p>0.05). There were significant differences of all ΔPar.s among RCC subtypes and AML (all p<0.01). ΔIMAX and ΔAUC showed the trend that ccRCC>AML>pRCC=chRCC. ΔTTP showed AML=pRCC=chRCC>ccRCC, ΔRT and ΔmTT showed AML>pRCC=chRCC=ccRCC. ΔmTT could distinguish RCC from AML with the area under the ROC curve (AUC) of 0.86. The AUC of ΔIMAX and ΔAUC was 0.89 and 0.92 vs 0.85 and 0.85 for discriminating between pRCC (or chRCC) and AML vs ccRCC and AML. CONCLUSIONS Quantitative analysis of CEUS is a useful modality in AML and RCC subtypes' differentiation, by using ΔmTT, ΔIMAX and ΔAUC.
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Christofides D, Leen E, Averkiou M. Automatic respiratory gating for contrast ultrasound evaluation of liver lesions. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2014; 61:25-32. [PMID: 24402893 DOI: 10.1109/tuffc.2014.6689773] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Dynamic contrast-enhanced ultrasound (DCEUS) has been used in radiology for many years for lesion detection and characterization. In recent years, more emphasis has been placed on tumor perfusion quantification with DCEUS. To ensure accuracy in both quantitative and qualitative evaluation of liver tumors with DCEUS, sources of noise in clinical data must be identified and, if possible, removed. One of the major sources of such noise is respiratory motion. A new automatic respiratory gating (ARG) algorithm is presented and evaluated with clinical data. The results of the evaluation demonstrate the potential of the ARG algorithm for clinical use as a fast and easy-to-implement method for removing respiratory motion from DCEUS loops.
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Eisenbrey JR, Wilson CC, Ro RJ, Fox TB, Liu JB, Chiou SY, Forsberg F. Correlation of ultrasound contrast agent derived blood flow parameters with immunohistochemical angiogenesis markers in murine xenograft tumor models. ULTRASONICS 2013; 53:1384-91. [PMID: 23659876 PMCID: PMC3696523 DOI: 10.1016/j.ultras.2013.04.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 04/04/2013] [Accepted: 04/04/2013] [Indexed: 05/08/2023]
Abstract
PURPOSE In this study we used temporal analysis of ultrasound contrast agent (UCA) estimate blood flow dynamics and demonstrate their improved correlation to angiogenesis markers relative to previously reported, non-temporal fractional vascularity estimates. MATERIALS AND METHODS Breast tumor (NMU) or glioma (C6) cells were implanted in either the abdomen or thigh of 144 rats. After 6, 8 or 10 days, rats received a bolus UCA injection of Optison (GE Healthcare, Princeton, NJ; 0.4 ml/kg) during power Doppler imaging (PDI), harmonic imaging (HI), and microflow imaging (MFI) using an Aplio ultrasound scanner with 7.5 MHz linear array (Toshiba America Medical Systems, Tustin, CA). Time-intensity curves of contrast wash-in were constructed on a pixel-by-pixel basis and averaged to calculate maximum intensity, time to peak, perfusion, and time integrated intensity (TII). Tumors were then stained for four immunohistochemical markers (bFGF, CD31, COX-2, and VEGF). Correlations between temporal parameters and the angiogenesis markers were investigated for each imaging mode. Effects of tumor model and implant location on these correlations were also investigated. RESULTS Significant correlation over the entire dataset was only observed between TII and VEGF for all three imaging modes (R=-0.35, -0.54, -0.32 for PDI, HI and MFI, respectively; p<0.0001). Tumor type and location affected these correlations, with the strongest correlation of TII to VEGF found to be with implanted C6 cells (R=-0.43, -0.54, -0.52 for PDI, HI and MFI, respectively; p<0.0002). CONCLUSIONS While UCA-derived temporal blood flow parameters were found to correlate strongly with VEGF expression, these correlations were also found to be influenced by both tumor type and implant location.
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Affiliation(s)
- John R. Eisenbrey
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107
| | - Christian C. Wilson
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107
- College of Physicians and Surgeons, Columbia University, New York, NY 10032
| | - Raymond J. Ro
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107
- School of Biomedical Engineering, Sciences and Health Systems, Drexel University, Philadelphia, PA19104
| | - Traci B Fox
- Department of Radiological Sciences, Jefferson School of Health Professions, Thomas Jefferson University, Philadelphia, PA19107
| | - Ji-Bin Liu
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107
| | - See-Ying Chiou
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107
| | - Flemming Forsberg
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107
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