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Zhang N, Sun L, Chen X, Song H, Wang W, Sun H. Meta-analysis of contrast-enhanced ultrasound in differential diagnosis of breast adenosis and breast cancer. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024. [PMID: 39206962 DOI: 10.1002/jcu.23803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Accepted: 08/18/2024] [Indexed: 09/04/2024]
Abstract
This systematic review and meta-analysis study aimed to determine the total capacity of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of breast lesions and breast cancer. For collecting papers, four groups of keywords were searched in five databases. The required information was extracted from the selected papers. In addition to the descriptive findings, a meta-analysis was also conducted. Thirty-three of thirty-six studies (91.67%) on the differential diagnosis of various degrees and types of breast lesions showed that CEUS has proper performance. The pooled values related to the sensitivity and specificity of CEUS were computed by 88.00 and 76.17.
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Affiliation(s)
- Na Zhang
- Department of Electrodiagnosis, Jilin Province FAW General Hospital, Changchun, China
| | - Limin Sun
- Department of Electrodiagnosis, Jilin Province FAW General Hospital, Changchun, China
| | - Xing Chen
- Department of Cardiology, Jilin Province FAW General Hospital, Changchun, China
| | - Hanxing Song
- Department of Electrodiagnosis, Jilin Province FAW General Hospital, Changchun, China
| | - Wenyu Wang
- Thoracic Surgery Department, Jilin Province FAW General Hospital, Changchun, China
| | - Hui Sun
- Department of Electrodiagnosis, Jilin Province FAW General Hospital, Changchun, China
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Sun J, Shen X, Zhang N, Zhang Q, Xing K, Liu Y. Combination of conventional ultrasound with quantitative and qualitative analyses of CEUS for the differentiation of benign and malignant breast solid lesions: A modified breast cancer model. Asian J Surg 2024:S1015-9584(24)01844-X. [PMID: 39214812 DOI: 10.1016/j.asjsur.2024.08.104] [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: 05/27/2024] [Revised: 08/05/2024] [Accepted: 08/15/2024] [Indexed: 09/04/2024] Open
Abstract
OBJECTIVE Breast cancer has become one of the main diseases threatening women's health and lives. Ultrasound (US) is the first diagnostic option for several patients because of its non-radiation, convenient, and low-cost features. Conventional US combined with contrast-enhanced US (CEUS) has improved diagnostic accuracy, while due to the presence of numerous parameters, no international consensus on diagnostic criteria could be attained. Therefore, it is necessary to develop a reliable diagnostic model with the involvement of a few parameters while increasing the diagnostic accuracy. METHODS Data from 265 patients, including conventional US, CEUS, and postoperative pathological results, were collected. 21 parameters from the conventional US and both qualitative and quantitative aspects of CEUS were analyzed through univariate and multivariate logistic regression analyses. Specific parameters with independent influential factors were identified. A nomogram was subsequently developed to visually represent the contribution and linear weighting of each parameter. The effectiveness of the new model was assessed through calibration curves and the Hosmer-Lemeshow goodness-of-fit test. RESULTS Six independent influential factors for breast malignant tumors were identified, including homogeneous echo, lesion vascularity, enhancement mode, enhancement shape, nourishing vessels, and slope. The area under the curve (AUC) values in the training and test datasets were 0.933 and 0.860, respectively. The modified model exhibited satisfactory diagnostic accuracy and operability. CONCLUSION The modified model, despite incorporating fewer parameters, maintained diagnostic accuracy. It is exhibited as a convenient, effective, and easily deployable model for diagnosing malignant breast nodules.
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Affiliation(s)
- Jingjing Sun
- Department of Ultrasound, Handan Central Hospital, Handan, China.
| | - Xianghui Shen
- Department of Ultrasound, Handan Central Hospital, Handan, China
| | - Ning Zhang
- Department of Ultrasound, Handan Central Hospital, Handan, China
| | - Qiang Zhang
- Department of Ultrasound, Handan Central Hospital, Handan, China
| | - Kai Xing
- Department of Ultrasound, Handan Central Hospital, Handan, China
| | - Yanchao Liu
- Department of Ultrasound, Handan Central Hospital, Handan, China
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Yu MQ, Zhang LL, Jiang LP, Zhou AY. The value of contrast-enhanced ultrasound in the diagnosis of BI-RADS-US 4a lesions less than 2 cm in diameter. Clin Hemorheol Microcirc 2022; 83:195-205. [PMID: 35599475 DOI: 10.3233/ch-221460] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND: Breast cancer is the most common malignant tumor in women. Early diagnosis of benign and malignant breast tumors is of great significance. OBJECTIVE: To retrospectively analyze the value of contrast-enhanced ultrasonography (CEUS) in the diagnosis of Breast Imaging-Reporting and Data System (BI-RADS) 4a breast lesions less than 2 cm in diameter. METHODS: CEUS was performed for 143 breast masses less than 2 cm in diameter that were diagnosed as BI-RADS 4a by ultrasound and reclassified. Considering pathological diagnosis as the gold standard, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of reclassified lesions after CEUS for the diagnosis of benign and malignant masses were analyzed. RESULTS: BI-RADS 4a breast masses with a diameter less than 2 cm (n = 143) were confirmed by pathology; 103 and 40 were classified as benign and malignant, respectively. The sensitivity, specificity, PPV, and NPV of CEUS for the diagnosis were 90%, 86%, 72%, and 95%, respectively. The area under the receiver operating characteristic (ROC) curve of CEUS for the diagnosis of benign and malignant tumors after CEUS was 0.904. CONCLUSION: CEUS can help to improve the diagnostic accuracy of BI-RADS 4a masses with a diameter less than 2 cm.
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Affiliation(s)
- Mei-qin Yu
- Department of Ultrasound Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Li-li Zhang
- Department of Ultrasound Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Li-ping Jiang
- Department of Ultrasound Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Ai-yun Zhou
- Department of Ultrasound Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Lu J, Zhou P, Jin C, Xu L, Zhu X, Lian Q, Gong X. Diagnostic Value of Contrast-Enhanced Ultrasonography With SonoVue in the Differentiation of Benign and Malignant Breast Lesions: A Meta-Analysis. Technol Cancer Res Treat 2020; 19:1533033820971583. [PMID: 33308040 PMCID: PMC7739090 DOI: 10.1177/1533033820971583] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE A meta-analysis was conducted to evaluate the diagnostic performance of contrast-enhanced ultrasonography using the contrast agent SonoVue to differentiate benign from malignant breast lesions. METHOD A comprehensive search of the literature was performed using the Embase, PubMed, and Web of Science databases to retrieve studies published before February 2020. Data were extracted, and pooled sensitivity, specificity, and diagnostic odds ratios were calculated with meta-analysis software. Heterogeneity was evaluated via the Q test and I2 statistic. Meta-regression and subgroup analyses were applied to evaluate potential sources of heterogeneity. Publication bias was assessed using the Deeks' funnel plot asymmetry test. A summary receiver operating characteristic curve (SROC) was constructed. RESULTS A total of 27 studies including 5378 breast lesions subjected to CEUS examination with SonoVue were included in the meta-analysis. The pooled sensitivity and specificity values were 0.90 (95% confidence interval [CI], 0.88-0.91; inconsistency index [I2] = 75.7%) and 0.83 (95% CI, 0.82-0.85; I2 = 91.0%), respectively. The pooled diagnostic odds ratio was 48.35% (95% CI, 31.22-74.89; I2 = 77.6%). The area under the summary receiver operating characteristic curve (AUC) was 0.9354. Meta-regression analysis revealed the region of patient residence and dose of contrast agent as potential sources of heterogeneity (P < .01). Subgroup analysis showed a higher area under the summary receiver operating characteristic curve for European and higher contrast agent dose subgroups (P < .05). CONCLUSION Contrast-enhanced ultrasonography with SonoVue displays high sensitivity, specificity, and accuracy when differentiating benign from malignant breast lesions. Despite its current limitations, this technique presents a promising tool for diagnosing breast lesions in clinical practice.
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Affiliation(s)
- Jianghao Lu
- Department of Ultrasound, First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Peng Zhou
- Department of Ultrasound, First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Chunchun Jin
- Department of Ultrasound, First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Lifeng Xu
- Department of Ultrasound, First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Xiaomin Zhu
- Department of Ultrasound, First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Qingshu Lian
- Department of Ultrasound, First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
| | - Xuehao Gong
- Department of Ultrasound, First Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
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Park AY, Seo BK. Up-to-date Doppler techniques for breast tumor vascularity: superb microvascular imaging and contrast-enhanced ultrasound. Ultrasonography 2017; 37:98-106. [PMID: 29025210 PMCID: PMC5885476 DOI: 10.14366/usg.17043] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/09/2017] [Accepted: 08/19/2017] [Indexed: 12/21/2022] Open
Abstract
Ultrasonographic Doppler techniques have improved greatly over the years, allowing more sophisticated evaluation of breast tumor vascularity. Superb microvascular imaging (SMI) and contrast-enhanced ultrasound (CEUS) with second-generation contrast agents are two representative up-to-date techniques. SMI is a sensitive Doppler technique that adopts an intelligent filter system to separate low-flow signals from artifacts. With the development of second-generation contrast agents, CEUS has also emerged as a useful Doppler technique for evaluating tumor microcirculation. Both techniques can improve the diagnostic performance of gray-scale ultrasonography by providing vascular information useful not only for the morphologic assessment of microvessels, but also for the quantitative analysis of perfusion. In this review, we explain the imaging principles and previous research underlying these two vascular techniques, and describe our clinical experiences.
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Affiliation(s)
- Ah Young Park
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.,Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Bo Kyoung Seo
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
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Ma X, Liu R, Zhu C, Zhang J, Ling W. Diagnostic Value of Contrast-Enhanced Sonography for Differentiation of Breast Lesions: A Meta-analysis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:2095-2102. [PMID: 27503752 DOI: 10.7863/ultra.15.10005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 12/30/2015] [Indexed: 06/06/2023]
Abstract
OBJECTIVES The purpose of this study was to systematically review and evaluate the diagnostic accuracy of contrast-enhanced sonography in the differential diagnosis of benign and malignant breast lesions. METHODS The scientific literature databases PubMed and Embase were comprehensively searched for relevant studies before January 2015. Data were pooled to yield the summary sensitivity, specificity, and diagnostic odds ratio using meta-analysis software. RESULTS A total of 29 studies with 2296 lesions were included in the analysis. The pooled sensitivity and specificity were 0.88 (95% confidence interval [CI], 0.86-0.90; inconsistency index [I(2)] = 77.9%) and 0.80 (95% CI, 0.78-0.83; I(2) = 84.0%), respectively. The pooled diagnostic odds ratio was 30.35 (95% CI, 15.75-58.48; I(2)= 82.1%), and the area under the summary receiver operating characteristic curve was 0.9115 (SE, 0.0243). CONCLUSIONS The comprehensive results suggest that contrast-enhanced sonography could be a potentially effective method for differential diagnosis of benign and malignant breast lesions.
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Affiliation(s)
- Xuelei Ma
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China, Department of Oncology, West China Hospital, Sichuan University, Chengdu, China, Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Rongjun Liu
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Chenjing Zhu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China, Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Jing Zhang
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Wenwu Ling
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, China
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Park AY, Seo BK, Cha SH, Yeom SK, Lee SW, Chung HH. An Innovative Ultrasound Technique for Evaluation of Tumor Vascularity in Breast Cancers: Superb Micro-Vascular Imaging. J Breast Cancer 2016; 19:210-3. [PMID: 27382399 PMCID: PMC4929264 DOI: 10.4048/jbc.2016.19.2.210] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 01/26/2016] [Indexed: 01/08/2023] Open
Abstract
Tumor vascularity is an important indicator for differential diagnosis, tumor growth, and prognosis. Superb micro-vascular imaging (SMI) is an innovative ultrasound technique for vascular examination that uses a multidimensional filter to eliminate clutter and preserve extremely low-velocity flows. Theoretically, SMI could depict more vessels and more detailed vascular morphology, due to the increased sensitivity of slow blood flow. Here, we report the early experience of using SMI in 21 breast cancer patients. We evaluated tumor vascular features in breast cancer and compared SMI and conventional color or power Doppler imaging. SMI was superior to color or power Doppler imaging in detecting tumor vessels, the details of vessel morphology, and both peripheral and central vascular distribution. In conclusion, SMI is a promising ultrasound technique for evaluating microvascular information of breast cancers.
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Affiliation(s)
- Ah Young Park
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Bo Kyoung Seo
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Sang Hoon Cha
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Suk Keu Yeom
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Seung Wha Lee
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Hwan Hoon Chung
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
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Qiao JJ, Yu J, Yu Z, Li N, Song C, Li M. Contrast-enhanced ultrasonography in differential diagnosis of benign and malignant ovarian tumors. PLoS One 2015; 10:e0118872. [PMID: 25764442 PMCID: PMC4357383 DOI: 10.1371/journal.pone.0118872] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 01/24/2015] [Indexed: 01/16/2023] Open
Abstract
Objective To evaluate the accuracy of contrast-enhanced ultrasonography (CEUS) in differential diagnosis of benign and malignant ovarian tumors. Methods The scientific literature databases PubMed, Cochrane Library and CNKI were comprehensively searched for studies relevant to the use of CEUS technique for differential diagnosis of benign and malignant ovarian cancer. Pooled summary statistics for specificity (Spe), sensitivity (Sen), positive and negative likelihood ratios (LR+/LR−), and diagnostic odds ratio (DOR) and their 95%CIs were calculated. Software for statistical analysis included STATA version 12.0 (Stata Corp, College Station, TX, USA) and Meta-Disc version 1.4 (Universidad Complutense, Madrid, Spain). Results Following a stringent selection process, seven high quality clinical trials were found suitable for inclusion in the present meta-analysis. The 7 studies contained a combined total of 375 ovarian cancer patients (198 malignant and 177 benign). Statistical analysis revealed that CEUS was associated with the following performance measures in differential diagnosis of ovarian tumors: pooled Sen was 0.96 (95%CI = 0.92∼0.98); the summary Spe was 0.91 (95%CI = 0.86∼0.94); the pooled LR+ was 10.63 (95%CI = 6.59∼17.17); the pooled LR− was 0.04 (95%CI = 0.02∼0.09); and the pooled DOR was 241.04 (95% CI = 92.61∼627.37). The area under the SROC curve was 0.98 (95% CI = 0.20∼1.00). Lastly, publication bias was not detected (t = −0.52, P = 0.626) in the meta-analysis. Conclusions Our results revealed the high clinical value of CEUS in differential diagnosis of benign and malignant ovarian tumors. Further, CEUS may also prove to be useful in differential diagnosis at early stages of this disease.
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Affiliation(s)
- Jing-Jing Qiao
- The Second Department of Oncology, the Second Affiliated Hospital of Dalian Medical University, Dalian 116027, P.R. China
| | - Jing Yu
- The Second Department of Oncology, the Second Affiliated Hospital of Dalian Medical University, Dalian 116027, P.R. China
| | - Zhe Yu
- The Second Department of Oncology, the Second Affiliated Hospital of Dalian Medical University, Dalian 116027, P.R. China
| | - Na Li
- The Second Department of Oncology, the Second Affiliated Hospital of Dalian Medical University, Dalian 116027, P.R. China
| | - Chen Song
- The Second Department of Oncology, the Second Affiliated Hospital of Dalian Medical University, Dalian 116027, P.R. China
| | - Man Li
- The Second Department of Oncology, the Second Affiliated Hospital of Dalian Medical University, Dalian 116027, P.R. China
- * E-mail:
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Kiessling F, Fokong S, Bzyl J, Lederle W, Palmowski M, Lammers T. Recent advances in molecular, multimodal and theranostic ultrasound imaging. Adv Drug Deliv Rev 2014; 72:15-27. [PMID: 24316070 DOI: 10.1016/j.addr.2013.11.013] [Citation(s) in RCA: 142] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 11/14/2013] [Accepted: 11/25/2013] [Indexed: 12/12/2022]
Abstract
Ultrasound (US) imaging is an exquisite tool for the non-invasive and real-time diagnosis of many different diseases. In this context, US contrast agents can improve lesion delineation, characterization and therapy response evaluation. US contrast agents are usually micrometer-sized gas bubbles, stabilized with soft or hard shells. By conjugating antibodies to the microbubble (MB) surface, and by incorporating diagnostic agents, drugs or nucleic acids into or onto the MB shell, molecular, multimodal and theranostic MBs can be generated. We here summarize recent advances in molecular, multimodal and theranostic US imaging, and introduce concepts how such advanced MB can be generated, applied and imaged. Examples are given for their use to image and treat oncological, cardiovascular and neurological diseases. Furthermore, we discuss for which therapeutic entities incorporation into (or conjugation to) MB is meaningful, and how US-mediated MB destruction can increase their extravasation, penetration, internalization and efficacy.
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Zhang JX, Cai LS, Chen L, Dai JL, Song GH. CEUS helps to rerate small breast tumors of BI-RADS category 3 and category 4. BIOMED RESEARCH INTERNATIONAL 2014; 2014:572532. [PMID: 24967380 PMCID: PMC4055582 DOI: 10.1155/2014/572532] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 04/29/2014] [Accepted: 05/01/2014] [Indexed: 11/17/2022]
Abstract
PURPOSE The primary aim of this study was to explore if classification, whether using the BI-RADS categories based on CEUS or conventional ultrasound, was conducive to the identification of benign and malignant category 3 or 4 small breast lesions. MATERIAL AND METHODS We evaluated 30 malignant and 77 benign small breast lesions using CEUS. The range of enhancement, type of enhancement strength, intensity of enhancement, and enhancement patterns were independent factors included to assess the BI-RADS categories. RESULTS Of the nonenhanced breast lesions, 97.8% (44/45) were malignant, while, of the hyperplasic nodules, 96.8% (30/31) showed no enhancement in our study. Category changes of the lesions were made according to the features determined using CEUS. The results showed that these features could improve diagnostic sensitivity (from 70.0 to 80.0, 80.0, 90.0, and 90.0%), reduce the negative likelihood ratio (from 0.33 to 0.22, 0.25, 0.11, and 0.12), and improve the NPV (from 88.8 to 92.2, 91.2, 96.2, and 95.5%). However, this was not conducive to improve diagnostic specificity or the PPV. CONCLUSION The vast majority of nonenhanced small breast lesions were malignant and most of the hyperplasic nodules showed no contrast enhancement. As a reference, CEUS was helpful in identifying BI-RADS category 3 or 4 small breast lesions.
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Affiliation(s)
- Jian-xing Zhang
- Departments of Ultrasound, Second Affiliated Hospital, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510120, China
| | - Li-shan Cai
- Departments of Ultrasound, First Affiliated Hospital, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510405, China
| | - Ling Chen
- Departments of Ultrasound, Second Affiliated Hospital, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510120, China
| | - Jiu-long Dai
- Departments of Ultrasound, Second Affiliated Hospital, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510120, China
| | - Guang-hui Song
- Departments of Ultrasound, Second Affiliated Hospital, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510120, China
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Yuan Z, Quan J, Yunxiao Z, Jian C, Zhu H, Liping G. Diagnostic value of contrast-enhanced ultrasound parametric imaging in breast tumors. J Breast Cancer 2013; 16:208-13. [PMID: 23843855 PMCID: PMC3706868 DOI: 10.4048/jbc.2013.16.2.208] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 03/06/2013] [Indexed: 12/26/2022] Open
Abstract
PURPOSE This study aimed to evaluate the diagnostic value of SonoLiver software for parametric imaging in breast tumors. METHODS Contrast-enhanced ultrasound (CEUS) was performed in 216 breast lesions (113 malignant, 103 benign). The CEUS parameters were compared between benign and malignant lesions. The rise time, the time to peak, the mean transit time and dynamic vessel pattern (DVP) were analyzed using SonoLiver software. RESULTS Quantitative analysis showed that the rise time was 16.52±4.15 seconds in the benign group vs. 13.86±3.36 seconds in the malignant group (p=0.007), and the time to peak was 19.86±4.87 seconds in the benign group vs. 16.52±4.85 seconds in the malignant group (p=0.009). The mean transit time was 80.55±18.65 seconds in the benign group vs. 65.16±20.28 seconds in the malignant group (p=0.006). The difference between the distribution of DVP in benign and malignant tumors was statistically significant. One hundred one malignant tumors (89.4%) performed an irregular red/yellow fill in the region of interest (ROI) and 85 benign tumors (82.5%) performed a single blue/green fill in the ROI. The sensitivity, specificity, and accuracy of parametric imaging in breast tumors were 84.1%, 85.4%, 84.7%, respectively. CONCLUSION The CEUS parametric imaging can distinguish differences between malignant and benign breast tumors as well as provide diagnostic information on breast lesions.
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Affiliation(s)
- Zhang Yuan
- Department of Ultrasound, Pudong New Area People's Hospital, Shanghai, China
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Hollow silica and silica-boron nano/microparticles for contrast-enhanced ultrasound to detect small tumors. Biomaterials 2012; 33:5124-9. [PMID: 22498299 DOI: 10.1016/j.biomaterials.2012.03.066] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Accepted: 03/18/2012] [Indexed: 12/15/2022]
Abstract
Diagnosing tumors at an early stage when they are easily curable and may not require systemic chemotherapy remains a challenge to clinicians. In order to improve early cancer detection, gas filled hollow boron-doped silica particles have been developed, which can be used for ultrasound-guided breast conservation therapy. The particles are synthesized using a polystyrene template and subsequently calcinated to create hollow, rigid nanoporous microspheres. The microshells are filled with perfluoropentane vapor. Studies were performed in phantoms to optimize particle concentration, injection dose, and the ultrasound settings such as pulse frequency and mechanical index. In vitro studies have shown that these particles can be continuously imaged by US up to 48 min and their signal lifetime persisted for 5 days. These particles could potentially be given by intravenous injection and, in conjunction with contrast-enhanced ultrasound, be utilized as a screening tool to detect smaller breast cancers before they are detectible by traditional mammography.
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