Contrast‐enhanced ultrasound is helpful for differentiating benign from malignant parietal pleural lesions

Abstract

Introduction: To describe the value of contrast-enhanced ultrasound (CEUS) for the differentiation of malignant from benign parietal pleural lesions (PPLs).Materials and Methods: From November 2005 to June 2019, 63 patients with histologically/cytologically confirmed PPLs were investigated by CEUS. On CEUS, the extent of enhancement (EE; marked or reduced/absent) and the homogeneity of enhancement (HE; homogeneous or inhomogeneous) were analyzed retrospectively.Results: In total, 24/63 lesions were benign, and 39/63 lesions were malignant. On CEUS, 11/24 benign and 36/39 malignant lesions showed a marked enhancement.A marked enhancement was significantly more frequently associated with malignancy compared with benign lesions (p < 0.001). In five cases, due to the absence of enhancement, it was not possible to determine the HE. In the remaining cases, 9/20 benign and 19/38 malignant lesions showed an inhomogeneous enhancement (p = 0.79). Conclusion:On CEUS, marked enhancement was significantly more frequently associated with malignant compared with benign lesions. However, some benign lesions, such as chronic inflammatory processes, may also show a marked enhancement.Therefore, the interpretation of perfusion patterns in these lesions must always take into account the clinical background of the patient.

Utility of high-frequency B-mode and contrast-enhanced ultrasound for the differential diagnosis of benign and malignant pleural diseases: a prospective study

“…In addition, we also found that the PI and the area under the TIC of malignant pleural disease were significantly higher than those of benign pleural disease. Compared with previous studies (17,22), our result further confirmed that marked enhancement was significantly more frequently associated with malignant compared with benign pleural disease, from the perspective of precise quantitative analysis. Furthermore, although the malignant pleural disease evidenced several enhancement modes, the benign pleural disease seldom exhibited centripetal enhancement, which may thus be rather specific for pleural disease (Figures 3,4).…”

“…However, US has not been widely used to diagnose pleural diseases. Although only 50 cases were included in this study, this study still included most types of diseases that can led to pleural thickening (see Table 1 ), and the sample size of our study was basically similar to previous studies about pleural US ( 13 , 17 ). We performed a prospective analysis and found that both high-frequency B-mode US and CEUS were able to clearly distinguish between benign and malignant thickened pleurae.…”

“…The efficacy of CEUS in terms of pleural disease diagnosis remains unproven. Although previous studies reported that marked enhancement was significantly more frequently associated with malignant compared with benign lesions, the enhancement pattern and TIC of the pleurae were not investigated in the retrospective study ( 17 , 22 ). In the present prospective study, we found that the enhancement mode and quantitative data from the TIC usefully aided the differential diagnosis of benign and malignant pleural diseases.…”

“…Qureshi et al reported that pleural thickening >1 cm and diaphragmatic thickening >7 mm were highly suggestive of malignant pleural disease ( 13 ). However, a recent study showed that the selection of 15 mm as a cut-off value yielded a sensitivity of 78.6%, a specificity of 74.1%, and an AUC of 0.714 in diagnosing malignant pleural disease ( 17 ). We also found that malignant pleurae were significantly thicker than benign pleurae.…”

Diagnostic Performance of Point Shear Wave Elastography (pSWE) Using Acoustic Radiation Force Impulse (ARFI) Technology in Mesenteric Masses: A Feasibility Study

“…In addition, magnetic resonance imaging (MRI), positron emission tomography–computed tomography (PET-CT), and B-mode ultrasound (US) are used for evaluating MMs [ 2 , 3 , 9 , 10 ]. As a new trend in US imaging, contrast-enhanced ultrasound (CEUS) is used to assess perfusion patterns of various pathologies, including MMs [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. Another new trend in US imaging is US elastography, which is a non-invasive tool for assessing tissue stiffness, with guidelines available for hepatic and non-hepatic applications [ 21 , 22 , 23 , 24 , 25 , 26 ].…”