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Chen SH, Xiang XZ, Che PF, Hu B, Shui DY, Zhao Y, Wang L. Superb Microvascular Imaging for the Differentiation of Benign and Malignant Breast Lesions: A System Review and Meta-Analysis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:1385-1399. [PMID: 36579829 DOI: 10.1002/jum.16159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 12/04/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To evaluate the diagnostic performance of SMI in the diagnosis of benign and malignant breast lesions. METHODS A systematic search of PubMed, EMBASE, Cochrane, OVID, SCI, and SCOPUS was performed to find relevant studies which applied SMI to differentiate benign and malignant breast lesions. All the studies were published before October 10, 2022. Only studies published in English were collected. Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was applied to assess the quality of the included studies. Summary receiver operating characteristic (SROC) modeling was also performed to the diagnostic performance of SMI in the diagnosis of benign and malignant breast lesions. Subgroup analyses and meta-regression were performed to find out the heterogeneity. RESULTS Twenty studies which include a total of 2873 lesions (1748 benign and 1125 malignant) in 2740 patients were evaluated in this meta-analysis. The summary sensitivity and specificity were 0.82 (95% confidence interval [CI]: 0.76-0.86), 0.70 (95% CI: 0.64-0.76) for SMI vascular degree, 0.77 (95% CI: 0.67-0.84), 0.79 (95% CI: 0.75-0.83) for SMI vascular distribution, 0.78 (95% CI: 0.70-0.84), 0.75 (95% CI: 0.69-0.80) for SMI vascular morphology, 0.81 (95% CI: 0.72-0.87), 0.80 (95% CI: 0.75-0.85) SMI penetration vessel. For SMI overall vascular features, the summary sensitivity and summary specificity were 0.74 (95% CI: 0.61-0.84) and 0.80 (95% CI: 0.76-0.84). The result of subgroup analysis and meta-analysis showed malignant rate and country might be the cause of heterogeneity of diagnostic accuracy of vascular grade and morphology. CONCLUSION SMI vascular features have high sensitivity and specificity in the differentiation of benign and malignant lesions. Future international multicenter studies in various regions with large sample size are required to confirm these findings.
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Affiliation(s)
- Si-Han Chen
- Department of Ultrasonic Imaging, Affiliated Renhe Hospital, China Three Gorges University, Yichang, Hubei, China
| | - Xiao-Zhen Xiang
- Department of Ultrasonic Imaging, Affiliated Renhe Hospital, China Three Gorges University, Yichang, Hubei, China
| | - Peng-Fei Che
- Department of Ultrasonic Imaging, Affiliated Renhe Hospital, China Three Gorges University, Yichang, Hubei, China
| | - Bing Hu
- Department of Ultrasonic Imaging, Affiliated Renhe Hospital, China Three Gorges University, Yichang, Hubei, China
| | - Dian-Ya Shui
- Department of Ultrasonic Imaging, Yichang Second People's Hospital, Yichang, Hubei, China
| | - Yun Zhao
- Medical School of China, Three Gorges University, Yichang, Hubei, China
| | - Li Wang
- Department of Ultrasonic Imaging, Affiliated Renhe Hospital, China Three Gorges University, Yichang, Hubei, China
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Bozkurt YE, Gumus BH, Ozbay M, Duzgun F, Taneli F, Kurutep S. The Relationship of Testicular Sonoelastography with Gonadotropin Hormone Levels and Sperm Parameters. Niger J Clin Pract 2023; 26:586-590. [PMID: 37357474 DOI: 10.4103/njcp.njcp_390_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Background: Elastography is a non-invasive medical imaging technique that helps determine the stiffness of organs and other structures in our body. In this study, we investigated the effectiveness of elastography in the diagnosis of infertility. Aim In this study, we aimed to examine the relationship between testicular elastography and hormonal parameters and sperm parameters. Patients and Methods The study included 136 patients, 272 testicles were examined, and the mean age of the study participants was 30.1 years. Testicular tissue stiffness was measured by scrotal ultrasonographic shear wave elastography. Gonadotropin and testosterone hormones were measured from blood samples. Spermiogram parameters were studied manually. Results The control group included 66 patients, and the varicocele group consisted of 70 patients. Testicular stiffness degrees of the control group were measured as 4.29 kPa for the right testis and 4.23 kPa for the left testis. The varicocele group was divided into grades 1, 2, and 3 according to physical examination. In group 1 (grade 1), the right testis was 4.07 ± 1.24 kPa and the left testis was 3.77 ± 0.98 kPa. In group 2 (grade 2), the right testis was 4.31 ± 1.40 kPa and the left testis was 3.98 ± 0.93 kPa. In group 3 (grade 3), the right testis was 4.73 ± 1.50 kPa and the left testis was 3.99 ± 1.68 kPa. Hormone and sperm parameters were not statistically significant when comparing the control and varicocele groups. There was no statistical significance between the testicular tissue stiffness degrees of the control and varicocele groups. Hormone and spermiogram findings were also similar in groups. Conclusion It is known that varicocele leads to histological tissue changes in the testes. These changes result in tissue softness and loss while affecting sperm parameters and testosterone levels in a negative way. Before varicocele surgery, there is a need for new imaging methods with more sensitivity that can detect tissue changes in the testes.
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Affiliation(s)
- Yunus Erol Bozkurt
- Department of Urology, Manisa Merkez Efendi State Hospital, Manisa, Turkey
| | - Bilal H Gumus
- Department of Urology, Manisa Merkez Efendi State Hospital, Manisa, Turkey
| | - Mehmet Ozbay
- Department of Urology, Manisa Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Fatih Duzgun
- Department of Radiology, Manisa Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Fatma Taneli
- Department of Biochemistry, Manisa Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Semra Kurutep
- Department of Microbiology, Manisa Celal Bayar University Faculty of Medicine, Manisa, Turkey
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Lian KM, Lin T. Virtual touch tissue imaging for differential diagnosis in ACR TI-RADS category 3-4 thyroid nodules: Conservative and aggressive methods. Clin Hemorheol Microcirc 2023; 85:123-134. [PMID: 37718784 DOI: 10.3233/ch-231694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
PURPOSE Many Thyroid Imaging Reporting and Data System (TI-RADS) category 3-4 nodules are benign. Our study aimed to add virtual touch tissue imaging (VTI) to TI-RADS using two methods, namely conservative and aggressive, and to explore which method had better diagnostic performance and which method avoided more unnecessary biopsies. METHODS From January 2016 to December 2021, we included 121 thyroid nodules classified as TI-RADS category 3-4 in 115 consecutive patients in this retrospective study. This study used the reference standard for pathological diagnosis by surgical resection or biopsy. The diagnostic performance of the different methods was evaluated and compared by receiver operating characteristic (ROC) and area under the ROC curve (AUC). RESULTS In this study, the aggressive approach had the best diagnostic performance among TI-RADS alone, the conservative approach, and the aggressive approach (AUC: 0.863 versus 0.598, P = 0.0007; 0.863 versus 0.755, P = 0.0067). When we used an aggressive approach, 75.44% (43/57) of the 57 false-positive nodes diagnosed by TI-RADS were appropriately downgraded from TI-RADS category 4 to category 3, avoiding unnecessary biopsies. CONCLUSION VTI improves the diagnostic performance of TI-RADS. The aggressive approach of combining the TI-RADS with VTI would help reduce unnecessary biopsies.
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Affiliation(s)
- Kai-Mei Lian
- Department of Ultrasound, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Teng Lin
- Department of Ultrasound, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
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Zhu YC, Zhang Y, Shan J, Deng SH, Shi XR, Jiang Q. Added Value of Superb Microvascular Imaging and Virtual Touch Imaging Quantification in Assisting Thyroid Cancer Classification. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:3364-3371. [PMID: 34489133 DOI: 10.1016/j.ultrasmedbio.2021.07.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/17/2021] [Accepted: 07/23/2021] [Indexed: 06/13/2023]
Abstract
This prospective study determined the value added by superb microvascular imaging (SMI) and Virtual Touch imaging quantification (VTIQ) to conventional ultrasonography in classifying malignant and benign thyroid nodules. One hundred eighty-three thyroid nodules (TNs) in 120 patients (112 benign and 71 malignant TNs) were evaluated. SMI revealed noticeable variance between benign and malignant TNs (p < 0.001). Malignant nodules tended to have rich vascularity (grade 3: 38/71, 53.5%) compared with benign nodules (grade 3: 33/112, 29.5%). There is a statistically significant difference between malignant and benign TNs with respect to shear-wave speed (SWS) values (all p values <0.001). The SWS mean, maximum and ratio of malignant nodules were 3.97 ± 1.34, 4.79 ± 1.70 and 1.25 ± 0.39, respectively. The SWS mean, maximum and ratio of benign nodules were 2.65 ± 0.42, 2.97 ± 0.46 and 1.15 ± 0.35, respectively. With respect to area under the curve values, the combined use of SMI or VTIQ improved the diagnostic performance of classifying malignant and benign TNs compared with that of ultrasonography alone. The combination of three modalities achieved the greatest area under the curve values (0.9811, 95% confidence interval: 0.95529-1.000), followed by US + VTIQ (0.9747, 0.94543-1.000), US + SMI (0.9032, 0.85345-0.95391) and ultrasonography (0.8291, 0.76417-0.89403).
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Affiliation(s)
- Yi-Cheng Zhu
- Department of Ultrasonography, Pudong New Area People's Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Yuan Zhang
- Department of Ultrasonography, Pudong New Area People's Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Jun Shan
- Department of Ultrasonography, Pudong New Area People's Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Shu-Hao Deng
- Department of Ultrasonography, Pudong New Area People's Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Xiu-Rong Shi
- Department of Ultrasonography, Pudong New Area People's Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China.
| | - Quan Jiang
- Department of Ultrasonography, Pudong New Area People's Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
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Li L, Lv G, Shen H, Liao L, Zhong R, Zheng C, Yang S. Applications of Mechanical Arm in the Virtual Touch Tissue Imaging Quantification and the Differential Diagnosis of Breast Tumors. Ultrasound Q 2021; 38:25-30. [PMID: 35239628 DOI: 10.1097/ruq.0000000000000577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT To assess the diagnostic performance of quantitative parameters for virtual touch tissue imaging quantification by the mechanical arm probe, 128 women with 152 breast lesions (90 benign and 62 malignant) were included and maximum elasticity (Vmax), median elasticity (Vmean), maximum elasticity minus minimum (Vmax-min), and minimum elasticity (Vmin) were measured. Intercorrelation coefficients and Bland-Altman plots were used to compare the repeatability and consistency of handheld probe and mechanical arm measurements. Receiver operating characteristic curve was used to evaluate the diagnostic efficiency. The results showed that intercorrelation coefficients were 0.694 to 0.951 by the mechanical arm and 95% limits of agreement were wider than handheld probe. Using 4.36 m/s as cutoff value for Vmax by the mechanical arm, we achieved sensitivity (88.7%) and specificity (90.0%). We concluded that the mechanical arm can reduce the influence of different scanning pressures on the elastic modulus of breast tissue.
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Affiliation(s)
- Ling Li
- Department of Ultrasound, Zhangzhou Hospital affiliated to Fujian Medical University, Zhangzhou
| | - Guorong Lv
- Department of Clinical Medicine, Quanzhou Medical College, Quanzhou
| | - Haolin Shen
- Department of Ultrasound, Zhangzhou Hospital affiliated to Fujian Medical University, Zhangzhou
| | - Liping Liao
- Department of Ultrasound, Zhangzhou Hospital affiliated to Fujian Medical University, Zhangzhou
| | - Rong Zhong
- Department of Ultrasound, Zhangzhou Hospital affiliated to Fujian Medical University, Zhangzhou
| | - Chunnuan Zheng
- Department of Pathology, Zhangzhou Hospital affiliated to Fujian Medical University, Zhangzhou, Fujian, China
| | - Shuping Yang
- Department of Ultrasound, Zhangzhou Hospital affiliated to Fujian Medical University, Zhangzhou
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Muršić M, Sjekavica I, Šimunović M, Ježek D. THE ROLE OF ULTRASOUND ELASTOGRAPHY IN THE DIAGNOSIS OF PATHOLOGIC CONDITIONS OF TESTICLES AND SCROTUM. Acta Clin Croat 2021; 60:41-49. [PMID: 34588720 PMCID: PMC8305351 DOI: 10.20471/acc.2021.60.01.06] [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] [Received: 06/01/2020] [Accepted: 12/06/2020] [Indexed: 11/24/2022] Open
Abstract
Several years ago, elastography emerged as a potentially very useful ultrasound technique that is currently used in diagnostic workup of the breast, liver and some other organ systems, whereas for other ones it is still mainly in the phase of research. The aim of the study was to compare elasticity index (EI) of testicles using strain elastography in healthy subjects and those with pathologic changes of testicles/scrotum. A total of 117 patients were included in the study. Measurements were performed on a Logiq E9 ultrasound system using strain elastography. In healthy subjects, the mean EI value was 1.34±0.35 for right testis and 1.49±0.47 for left testis. Increased mean EI values were found in the following six conditions: patients with varicocele, infertile patients, solitary testis after orchidectomy of the other testicle because of tumor, patients with testicular tumors, patients after orchidopexy of undescended testicle, and patients with congenitally smaller testicle. There is a paucity of literature data on the use of elastography in testes, as well as on normal elastography values in testicular tissue. Strain elastography was demonstrated to be a valuable method to acquire additional information in patients with pathologic changes in testicles/scrotum. These data provide reference values for further research in a larger sample of subjects.
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Affiliation(s)
| | - Ivica Sjekavica
- 1Department of Diagnostic and Interventional Radiology, Zagreb University Hospital Centre, Zagreb, Croatia; 2University of Zagreb, School of Medicine, Zagreb, Croatia; 3Department of Transfusion Medicine and Transplantation Biology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Marko Šimunović
- 1Department of Diagnostic and Interventional Radiology, Zagreb University Hospital Centre, Zagreb, Croatia; 2University of Zagreb, School of Medicine, Zagreb, Croatia; 3Department of Transfusion Medicine and Transplantation Biology, Zagreb University Hospital Centre, Zagreb, Croatia
| | - Davor Ježek
- 1Department of Diagnostic and Interventional Radiology, Zagreb University Hospital Centre, Zagreb, Croatia; 2University of Zagreb, School of Medicine, Zagreb, Croatia; 3Department of Transfusion Medicine and Transplantation Biology, Zagreb University Hospital Centre, Zagreb, Croatia
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Abstract
BACKGROUND Elasticity assessment of breast lesions can also be used as an associated criterion in the B‑mode ultrasound (US) assessment for differentiation between benign or malignant lesions. OBJECTIVES The goal was to identify techniques available to measure US elasticity, assess the use of B‑mode BI-RADS® classification combined with elastography, and identify which artefacts influence the US elasticity result. MATERIALS AND METHODS Based on different studies and meta-analyses, clinical application in daily routine of the presented US elastography techniques will be investigated concerning the statistical performance of semi-quantitative and quantitative cut-off values to differentiate benign from malignant lesions. RESULTS Supported by meta-analyses, all presented US elastography techniques improve the specificity by decreasing the B‑mode sensitivity. In the literature the semi-quantitative and quantitative cut-off values often vary considerably. The interobserver variability of strain elastography shows a fair agreement and the interobserver variability of shear wave elastography a substantial agreement. CONCLUSIONS Considering the limitations and artefacts of each technique, US elastography is able to enhance the true positive and true negative results. In the case of a higher B‑mode BI-RADS® classification (4b, 4c, 5) or in a high-risk situation to develop breast cancer, a large core needle biopsy should be performed despite lesion softness in elastography.
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Affiliation(s)
- Christian Weismann
- Universitätsinstitut für Radiologie der PMU, Mammadiagnostik u. Mammaintervention, Uniklinikum Salzburg, Landeskrankenhaus, Müllner Hauptstraße 48, 5020, Salzburg, Österreich.
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Lian KM, Lin T. The value of color-map virtual touch tissue imaging (CMV) in the differential diagnosis of benign and malignant breast lesions. Clin Hemorheol Microcirc 2021; 78:49-56. [PMID: 33523047 DOI: 10.3233/ch-201088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Researchers have evaluated the virtual touch tissue imaging (VTI) value in the diagnosis of breast lesions, mostly based on gray-scale. PURPOSE This study aimed to evaluate the value of color-map virtual touch tissue imaging (CMV) in the diagnosis of breast lesions. METHODS We retrospectively analyzed the VTI images of 55 breast lesions in 49 female patients who underwent an examination of breast lesions in our hospital from January 2019 to December 2019. The pathological results were taken as the gold standard. The receiver operating characteristic (ROC) curve of CMV was analyzed, and its diagnostic performance was evaluated. Weighted Kappa (k) statistics were used to assess the inter-observer agreement for CMV. RESULTS A total of 55 breast lesions were included, including 19 malignant lesions and 36 benign lesions. Multivariate analysis showed that patients with higher CMV scores (P = 0.014, odds ratio [OR] = 13.667, 95% confidence interval = 1.702-109.773) were independent predictors of breast cancer. The sensitivity, specificity, and the area under curve (AUC) of CMV were 94.47%, 72.22%, and 0.912. The CMV's inter-observer agreement was almost perfect among radiologists with different work experience (k = 0.854, standard error = 0.049, 95% CI = 0.758-0.950). CONCLUSIOS CMV has high accuracy and repeatability in the diagnosis of malignant breast lesions.
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Affiliation(s)
- Kai-Mei Lian
- Department of Ultrasound, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Teng Lin
- Department of Ultrasound, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
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Li J, Chen M, Cao CL, Zhou LQ, Li SG, Ge ZK, Zhang WH, Xu JW, Cui XW, Dietrich CF. Diagnostic Performance of Acoustic Radiation Force Impulse Elastography for the Differentiation of Benign and Malignant Superficial Lymph Nodes: A Meta-analysis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:213-222. [PMID: 31343772 DOI: 10.1002/jum.15096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 06/18/2019] [Accepted: 06/24/2019] [Indexed: 06/10/2023]
Abstract
To estimate the diagnostic performance of acoustic radiation force impulse elastography in distinguishing between benign and malignant superficial lymph nodes, relevant articles published before October 31, 2018, in China and other countries were used. Conclusively, a total of 18 articles were analyzed. Sixteen studies used Virtual Touch tissue quantification (Siemens Healthineers, Erlangen, Germany), and 4 studies used Virtual Touch tissue imaging (Siemens Healthineers). After a meta-analysis, it was found that acoustic radiation force impulse elastography is an efficient method for detecting superficial lymph nodes. In addition, if the cutoff value for the shear wave velocity were less than 2.85 m/s, the summary sensitivity would increase, and the heterogeneity would be reduced.
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Affiliation(s)
- Jun Li
- Department of Medical Ultrasound, First Affiliated Hospital of Medical College, Shihezi University, Shihezi, China
| | - Ming Chen
- Department of Medical Ultrasound, First Affiliated Hospital of Medical College, Shihezi University, Shihezi, China
| | - Chun-Li Cao
- Department of Medical Ultrasound, First Affiliated Hospital of Medical College, Shihezi University, Shihezi, China
| | - Li-Qiang Zhou
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shu-Gang Li
- Department of Public Health, Medical College, Shihezi University, Shihezi, China
| | - Zong-Kai Ge
- Department of Internal Medicine, Occupational Disease Prevention and Treatment Center, China Pingmei Shenma Group, Pingdingshan, China
| | - Wei-Hong Zhang
- Department of Medical Ultrasound, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jian-Wei Xu
- Department of Medical Ultrasound, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin-Wu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Christoph F Dietrich
- Medical Clinic 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany
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The Japanese Breast Cancer Society Clinical Practice Guidelines for Breast Cancer Screening and Diagnosis, 2018 Edition. Breast Cancer 2019; 27:17-24. [PMID: 31734900 PMCID: PMC8134289 DOI: 10.1007/s12282-019-01025-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 11/09/2019] [Indexed: 12/14/2022]
Abstract
This article updates readers as to what is new in the Japanese Breast Cancer Society Clinical Practice Guidelines for Breast Cancer Screening and Diagnosis, 2018 Edition. Breast cancer screening issues are covered, including matters of breast density and possible supplemental modalities, along with appropriate pre-operative/follow-up diagnostic breast imaging tests. Up-to-date clinical practice guidelines for breast cancer screening and diagnosis should help to provide patients and clinicians with not only evidence-based breast imaging options, but also accurate and balanced information about the benefits and harms of intervention, which ultimately enables shared decision making about imaging test plans.
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Dong F, Wu H, Zhang L, Tian H, Liang W, Ye X, Liu Y, Xu J. Diagnostic Performance of Multimodal Sound Touch Elastography for Differentiating Benign and Malignant Breast Masses. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:2181-2190. [PMID: 30593673 DOI: 10.1002/jum.14915] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 11/04/2018] [Accepted: 11/15/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Evaluating the value of screening breast masses by separate or combined use of multimodal Sound Touch Elastography. METHODS Women with 159 masses (mean size, 14.86 ± 6.57 mm; range, 5.30-30.00 mm) were enrolled in the study. The pathology results were adopted as diagnostic standards. The abilities of Young's modulus (E), shear modulus (G), and shear wave (C) to differentiate malignant and benign breast masses based on receiver operating characteristic curves were evaluated, and the optimal cutoff values were obtained. Sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were calculated. Then, the values were combined to perform an overall analysis of Sound Touch Elastography using evidence-based medicine, construct forest plots, and calculate areas under the summary receiver operating characteristic curves, pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic scores. RESULTS A total of 159 masses with a mean size of 14.86 ± 6.57 mm (range, 5.30-30.00 mm) were included. For the various parameters, the diagnostic values were as follows: Gmax > Emax > Cmax > Csd > Esd > Gsd > Emean > Gmean > Cmean . There were no significant differences in Emin , Gmin , or Cmin . When the 9 parameters were combined, the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic scores and areas under the summary receiver operating characteristic curves were 84% (95% confidence interval [CI], 79%-88%), 82% (95% CI, 80%-84%), 4.75 (95% CI, 4.15-5.43), 0.20 (95% CI, 0.15-0.25), 3.19 (95% CI, 2.84-3.54) and 90.2% (95% CI, 87%-92%), respectively. CONCLUSIONS Sound Touch Elastography can be recognized as a new ultrasound-based diagnostic method for differentiation between benign and malignant breast masses.
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Affiliation(s)
- Fajin Dong
- Department of Ultrasound, Second Clinical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China
| | - Huaiyu Wu
- Department of Ultrasound, Second Clinical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China
| | - Lei Zhang
- Department of Ultrasound, Second Clinical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China
| | - Hongtian Tian
- Department of Ultrasound, Second Clinical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China
| | - Weiyu Liang
- Department of Ultrasound, Second Clinical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China
| | - Xiuyin Ye
- Department of Ultrasound, Second Clinical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China
| | - Yan Liu
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Health, and The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Qilu Hospital of Shandong University, Jinan, China
| | - Jinfeng Xu
- Department of Ultrasound, Second Clinical College of Jinan University, Shenzhen People's Hospital, Shenzhen, China
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You QQ, Xu M, Yao MH, Xu G, Liu H, Pu H, Xiang LH, Wu R. Diagnostic value of acoustic radiation force impulse for BI-RADS category 4 breast lesions of different sizes. Clin Hemorheol Microcirc 2018; 70:143-154. [PMID: 29710678 DOI: 10.3233/ch-170299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Qi-Qin You
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
- Department of Medical Ultrasound, Qingpu Brance of Zhongshan Hospital, Fudan University School of Medicine, Shanghai, China
| | - Ming Xu
- Department of Medical Ultrasound, Huai’an First People’s Hospital, Nanjing Medical University School of Medicine, Huai’an, Jiangsu, China
| | - Ming-Hua Yao
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
| | - Guang Xu
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
| | - Hui Liu
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
| | - Huan Pu
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
| | - Li-Hua Xiang
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
| | - Rong Wu
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
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Acoustic Radiation Force Based Ultrasound Elasticity Imaging for Biomedical Applications. SENSORS 2018; 18:s18072252. [PMID: 30002352 PMCID: PMC6069000 DOI: 10.3390/s18072252] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 07/03/2018] [Accepted: 07/11/2018] [Indexed: 01/02/2023]
Abstract
Pathological changes in biological tissue are related to the changes in mechanical properties of biological tissue. Conventional medical screening tools such as ultrasound, magnetic resonance imaging or computed tomography have failed to produce the elastic properties of biological tissues directly. Ultrasound elasticity imaging (UEI) has been proposed as a promising imaging tool to map the elastic parameters of soft tissues for the clinical diagnosis of various diseases include prostate, liver, breast, and thyroid gland. Existing UEI-based approaches can be classified into three groups: internal physiologic excitation, external excitation, and acoustic radiation force (ARF) excitation methods. Among these methods, ARF has become one of the most popular techniques for the clinical diagnosis and treatment of disease. This paper provides comprehensive information on the recently developed ARF-based UEI techniques and instruments for biomedical applications. The mechanical properties of soft tissue, ARF and displacement estimation methods, working principle and implementation instruments for each ARF-based UEI method are discussed.
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Ren WW, Li XL, Wang D, Liu BJ, Zhao CK, Xu HX. Evaluation of shear wave elastography for differential diagnosis of breast lesions: A new qualitative analysis versus conventional quantitative analysis. Clin Hemorheol Microcirc 2018; 69:425-436. [PMID: 29660908 DOI: 10.3233/ch-170334] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Wei-Wei Ren
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
| | - Xiao-Long Li
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
| | - Dan Wang
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
| | - Bo-Ji Liu
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
| | - Chong-Ke Zhao
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
| | - Hui-Xiong Xu
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University School of Medicine, Shanghai, China
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Aslan H, Pourbagher A. Breast Involvement by Hematologic Malignancies: Ultrasound and Elastography Findings with Clinical Outcomes. J Clin Imaging Sci 2017; 7:42. [PMID: 29296470 PMCID: PMC5747218 DOI: 10.4103/jcis.jcis_65_17] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 10/22/2017] [Indexed: 12/22/2022] Open
Abstract
Objective: Hematological malignancies very rarely involve the breast. The aim of this study is to retrospectively evaluate B-mode ultrasound (US) and elastography (ES) findings of breast involvement by hematologic malignancies with clinical outcomes. Materials and Methods: All core-needle biopsy results that were performed at our tertiary breast center from January 2013 to September 2016 were searched. Our search revealed 9 patients with breast involvement either by leukemia or lymphoma. All patients were examined using B-mode US and ES. US and ES findings were analyzed with the consensus of two radiologists, and clinical outcomes were noted. Results: The mean age of the study population was 41.6 years (range, 20–83 years). Two patients showed diffuse hypoechoic parenchymal infiltration. The elasticity assessments of these lesions were soft and intermediate. The remaining 7 patients had mass lesions. The elasticity assessment of these masses according to Breast Imaging Reporting and Data System US was as follows: Soft (n = 1), intermediate (n = 4), high (n = 2). Conclusions: It is important to consider that hematologic malignancies may appear as soft or intermediate lesions on ES. Patients’ history and clinical background should help us to consider breast involvement. In addition, the clinical outcomes may not be related with elasticity assessments.
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Affiliation(s)
- Hulya Aslan
- Department of Radiology, Faculty of Medicine, Baskent University, Adana Dr. Turgut Noyan Teaching and Medical Research Center, Dadaloglu Mh, Adana, Turkey
| | - Aysin Pourbagher
- Department of Radiology, Faculty of Medicine, Baskent University, Adana Dr. Turgut Noyan Teaching and Medical Research Center, Dadaloglu Mh, Adana, Turkey
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Ultrasonography methods for predicting malignancy in canine mammary tumors. PLoS One 2017; 12:e0178143. [PMID: 28542533 PMCID: PMC5439728 DOI: 10.1371/journal.pone.0178143] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 05/08/2017] [Indexed: 12/15/2022] Open
Abstract
The aim of this study was to evaluate and compare the efficacy of B-mode, Doppler, contrast-enhanced ultrasonography (CEUS), and Acoustic Radiation Force Impulse (ARFI) elastography in predicting malignancy in canine mammary masses. This was a prospective cohort study from 2014 to 2016, which included 153 bitches with one or more mammary masses. A total of 300 masses were evaluated by ultrasonography (B-mode, Doppler, CEUS, and ARFI) and subsequently classified as benign or malignant by histopathology. Each ultrasound parameters studied were compared between benign and malignant masses by Chi-square or Student tests and differences were considered significant when P < 0.01. For the variables that proved significant differences were estimated the cut-off point, sensitivity, specificity, accuracy, and area under curve (AUC) by receiver-operating characteristic curve (ROC) analysis in a logistic regression model using histopathological classification as reference, to assess and compare diagnostic performance of each technique. Out of 300 mammary masses evaluated 246 were classified as malignant and 54 as benign. B-mode measurements showed sensitivity 67.9%, and specificity 67.6% as malignancy predictors on canine mammary masses; Doppler indexes systolic (>21.2 m/s) and diastolic velocity (>4.8 m/s) sensitivity 79.2% and specificity 70.8%; CEUS wash-out time (<80.5 s) sensitivity 80.2% and specificity 16.7%; and ARFI elastography shear velocity (SWV > 2.57 m/s) sensitivity 94.7% and specificity 97.2% In conclusion B-mode and Doppler ultrasound evaluations may assist in malignancy prediction of canine mammary masses with moderate sensitivity and specificity, already the SWV was an great accurate predictor. Therefore, ARFI elastography exam inclusion in veterinary clinic oncology and research is highly recommended, since it allows fast, non-invasive, and complication-free malignancy prediction of canine mammary masses.
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Yao MH, Wu R, Xu G, Zhao LX, Liu H, Pu H, Fang Y. A novel two-dimensional quantitative shear wave elastography to make differential diagnosis of breast lesions: Comprehensive evaluation and influencing factors. Clin Hemorheol Microcirc 2017; 64:223-233. [PMID: 27814283 DOI: 10.3233/ch-16188] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Virtual touch imaging quantification (VTIQ), a form of shear wave elastography, may help in the diagnosis of breast lesions. OBJECTIVE We aimed to evaluate the diagnostic performance of combined VTIQ and conventional ultrasound (US), and assess the factors influencing VTIQ measurement. METHODS From September 2014 to December 2014, 162 patients with breast lesions were examined by US and VTIQ to assess shear wave speed (SWS) and morphological characteristics (lesion shape, orientation, margin and echo pattern). The sensitivity, specificity and accuracy of VTIQ, US and VTIQ+US for the diagnosis of breast lesions was evaluated in comparison to pathological results. Factors influencing deviations in SWS measurements were assessed by logistic regression. RESULTS The SWS cut-off between malignant and benign lesions was 3.73 m/s. The sensitivity, specificity and accuracy were: 98.07%, 55.96%, and 69.57% for US; 76.92%, 78.89% and 78.26% for VTIQ; and 98.07%, 84.40% and 88.82% for US+VTIQ. The two factors that influenced the SWS results were the lesion margin (odds ratio [OR], 16.363; 95% confidence interval [CI], 3.220-29.020) and vascularity (OR, 6.712; 95% CI, 1.358-9.072). CONCLUSIONS The lesion margin and vascularity could affect the measurement of SWS as well as the experience of examiner. However, VTIQ is still a reliable method that provides valuable information in the differential diagnosis of breast lesions, and may reduce unnecessary biopsies.
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Carlson NS. Current Resources for Evidence-Based Practice, January/February 2017. J Obstet Gynecol Neonatal Nurs 2016; 46:91-99. [PMID: 27840207 DOI: 10.1016/j.jogn.2016.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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