Correlation Between Contrast-enhanced Ultrasound Characteristics (Qualitative and Quantitative) and Pathological Prognostic Factors in Breast Cancer

Vraka, Irène; Panourgias, Evangelia; Sifakis, Emmanouil G.; Κουρέας, Ανδρέας; Galanis, Petros; Dellaportas, Dionysios; Γουλιάμος, Αθανάσιος; Antoniou, Aristides

doi:10.21873/invivo.11333

Cited by 25 publications

(17 citation statements)

References 49 publications

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“…Controversial cases were reanalyzed and discussed until a unified conclusion was achieved. Characteristics of the lymph nodes shown in the CEUS image include (1) lesion's enhancement order: due to the different directions of contrast agent, enhancement order of lymph nodes includes centrifugal perfusion and centripetal perfusion; (2) internal lesion's homogeneity: according to whether the contrast agent filled the defect area within the lesion at the time of peak, internal lesion's homogeneity was divided into homogeneous enhancement and inhomogeneous enhancement; (3) lesion's enhancement degree: compared with adjacent tissues around the lymph node region at peak enhancement, the degree of nodal enhancement could be divided into hyperenhancement, hypoenhancement, and no enhancement; (4) presence of perfusion defects: whether there is a filling defect area after the injection of contrast agent (15).…”

Section: Ceus Examinationmentioning

confidence: 99%

The Value of CEUS in Distinguishing Cancerous Lymph Nodes From the Primary Lymphoma of the Head and Neck

et al. 2020

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The purpose of this study was to assess the ability of contrast-enhanced ultrasonography (CEUS) in the differential diagnosis of cancerous lymph nodes. Methods: Contrast-enhanced ultrasonography was performed in the cervical nodules of included patients, and the diagnoses were confirmed by pathological examination. Contrast-enhanced ultrasonography images and parameters of head and neck lymphomas were compared with those of cancerous lymph nodes. Besides, receiver operating characteristic curve was operated to access the diagnostic value of CEUS. Results: Finally, a total of 63 head and neck lymphomas and 80 cervical cancerous lymph nodes were enrolled in this study. Results showed that the CEUS images of lymphoma were mainly characterized by homogeneous enhancement (71.43%), and approximately half of them were centripetal perfusion (58.73%), whereas most CEUS images of cancerous lymph nodes were inhomogeneous enhancement (82.50%) and centripetal perfusion (92.50%). Quantitative analysis of CEUS parameters indicated that PI (derived peak intensity) and AUC (area under the curve) of lymphomas were both lower than those of cancerous lymph nodes (PI: 8.78 vs. 10.51, AUC: 652.62 vs. 784.09, respectively) (P < 0.05). Receiver operating characteristic analysis showed that the sensitivity of CEUS parameters in the differential diagnosis was significant (80.00%), although the specificity was not high (47.62%). When parameters were combined with the image features, the accuracy of diagnosis was greatly improved (from 0.655 to 0.899). Conclusion: Contrast-enhanced ultrasonography could be a promising tool for the differential diagnosis of head and neck lymphomas and cancerous lymph nodes.

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Section: Ceus Examinationmentioning

confidence: 99%

The Value of CEUS in Distinguishing Cancerous Lymph Nodes From the Primary Lymphoma of the Head and Neck

et al. 2020

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“…Compared to that of the surrounding thyroid tissue, the peak intensity of the nodule was classified into ( 1 ): hypo-enhancement ( 2 ), iso-enhancement ( 3 ), hyper-enhancement. According to the preceding studies ( 27 , 28 ), the presence of tumor-adjacent hyper-enhancement area(s) was indicative of high invasiveness of tumors. This feature was defined as the hyper-enhancement area(s) abutting on tumor.…”

Section: Methodsmentioning

confidence: 90%

Ultrasound and Contrast-Enhanced Ultrasound Characteristics Associated With cN1 and Microscopic pN1 in Papillary Thyroid Carcinoma

et al. 2022

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ObjectivesLymph node metastases (LNMs) could be stratified into clinical N1 (cN1) and microscopic pN1 (pathological N1), which bear different biological behavior and prognosis. Our study aimed to investigate the associations between LNMs and primary tumor’s US (ultrasound) and CEUS (contrast-enhanced ultrasound) characteristics based on the stratification of LNMs into cN1 and microscopic pN1 in papillary thyroid carcinoma (PTC).MethodsFrom August 2019 to May 2020, 444 consecutive PTC patients who underwent preoperative neck US and CEUS evaluation were included. According to regional lymph node status, the patients were classified into cN1 group versus cN0 (clinical N0) group and microscopic pN1 group versus pN0 (pathological N0) group. For multiple PTCs, the largest one was selected for the evaluation of US, CEUS and clinical features. Univariate and multivariate analyses were performed to determine independent predictors of cN1 and microscopic pN1.Results85 cN1 versus 359 cN0 patients and 117 microscopic pN1 versus 242 pN0 patients were analyzed. Multivariate logistic regression analysis showed that <55-years-old (OR: 2.56 (1.08–6.04), male [OR: 2.18 (1.22–3.91)], large size [OR: 2.59 (1.71–3.92)], calcification [OR: 3.88 (1.58–9.51)], and hyper-enhancement [OR: 2.78 (1.22–6.30)] were independent risk factors of cN1, while <55-years-old [OR: 1.91 (1.04–3.51)], large size [OR: 1.56 (1.003–2.42)], multifocality [OR: 1.67 (1.04–2.66)] were independent risk factors of microscopic pN1.ConclusionsFor patients with PTC, young age, male, large size, calcification, and hyper-enhancement were independent predictors of cN1, while young age, large size and multifocality were independent predictors of microscopic pN1.

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“…According to the literature 2,3,8,10,12 and our clinical experience, indicators from B‐mode US and CEUS were defined as follows: (1) shape—regular (round or oval) or irregular; (2) orientation—parallel or not parallel; (3) margin—circumscribed or not circumscribed (indistinct, angular, microlobulated, or spiculated); (4) echo pattern—hypoechoic, isoechoic, hyperechoic, complex cystic and solid, or heterogeneous; (5) microcalcifications—present or absent; (6) posterior features—no posterior acoustic features, enhancement, shadowing, or a combined pattern; (7) vascularity—absent, internal vascularity, or vessels in the rim; (8) enhancement direction—centrifugal enhancement (enhancement originating from the center of the lesion and developing centrifugally), diffused enhancement, or centripetal enhancement (enhancement originating from the periphery of the lesion and developing centripetally); (9) enhancement intensity—hyperenhancement, hypoenhancement, or isoenhancement; (10) enhancement mode—homogeneous enhancement or heterogeneous enhancement; (11) enhancement scope—enlarged or not enlarged (compared with corresponding values measured by B‐mode US when both the length and width measured by CEUS were enlarged, or either was enlarged by ≥3 mm); (12) enhancement boundary—well defined (>50% of the lesion circumference clearly visible) or poorly defined (<50% of lesion circumference clearly visible); (13) enhancement shape—regular or irregular; (14) perfusion defect—absence or presence of a blood perfusion defect; (15) perforator vessels—absence or presence of penetrating vessels; and (16) enhancement time—rapidly, equally, or slowly (compared with surrounding normal breast tissue).…”

Section: Methodsmentioning

confidence: 99%

“…6 Using the characteristics of the blood flow distribution and microcirculation perfusion to improve the diagnostic accuracy of BI-RADS category 3 to 5 breast lesions is an important recent research topic. 5,[7][8][9][10] Qualitative and quantitative indicators have been studied for the application of CEUS in breast disease for decades, and their importance has been proven. [11][12][13] Studies show differences between benign and malignant breast lesions in CEUS characteristics.…”

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confidence: 99%

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Modified Model for Diagnosing Breast Imaging Reporting and Data System Category 3 to 5 Breast Lesions

Zhou

Jin

et al. 2020

J of Ultrasound Medicine

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Objectives-The aim of this study was to explore a modified model to simplify the diagnostic process for American College of Radiology Breast Imaging Reporting and Data System category 3 to 5 breast lesions and evaluate the model's diagnostic efficacy. Methods-A retrospective review was conducted of breast lesions examined by B-mode ultrasound (US) and contrast-enhanced ultrasound (CEUS) and diagnosed by histopathologic examination from October 2016 to August 2019. The US characteristics of a combined model (US + CEUS model) with relatively high diagnostic value were selected by a lasso regression analysis to establish a modified model. Two nomograms were developed. The results were internally validated by bootstrap resampling. Results-Overall, 206 breast lesions in 198 patients, 136 benign and 70 malignant, were included. Ultrasound characteristics included in the modified model were shape, margin, microcalcification, enhanced intensity, enhanced scope, and enhanced time. For the US + CEUS model and modified model, sensitivities were 94.3% and 93.3%; specificities were 85.9% and 81.4%; accuracies were 89.3% and 88.7% and areas under the curve were 0.957 and 0.944, respectively. No statistically significant differences were seen in the diagnostic efficacies of the models (P = .097). Bootstrap-corrected sensitivities, specificities. and accuracies of the models were consistent with these results. Bootstrap-corrected areas under the curve for the US + CEUS model and the modified model were 0.955 and 0.940, respectively. Conclusions-The modified model with fewer indicators conveniently and effectively diagnosed the malignancy of Breast Imaging Reporting and Data System category 3 to 5 breast lesions without reducing diagnostic efficacy.

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Correlation Between Contrast-enhanced Ultrasound Characteristics (Qualitative and Quantitative) and Pathological Prognostic Factors in Breast Cancer

Abstract: CEUS has the potential to provide a prevision of pathological prognostic factors in malignant breast lesions, helping in the better early patient management.

Cited by 25 publications

References 49 publications

The Value of CEUS in Distinguishing Cancerous Lymph Nodes From the Primary Lymphoma of the Head and Neck

The Value of CEUS in Distinguishing Cancerous Lymph Nodes From the Primary Lymphoma of the Head and Neck

Ultrasound and Contrast-Enhanced Ultrasound Characteristics Associated With cN1 and Microscopic pN1 in Papillary Thyroid Carcinoma

Modified Model for Diagnosing Breast Imaging Reporting and Data System Category 3 to 5 Breast Lesions

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