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Mou Y, Han X, Li J, Yu P, Wang C, Song Z, Wang X, Zhang M, Zhang H, Mao N, Song X. Development and Validation of a Computed Tomography-Based Radiomics Nomogram for the Preoperative Prediction of Central Lymph Node Metastasis in Papillary Thyroid Microcarcinoma. Acad Radiol 2024; 31:1805-1817. [PMID: 38071100 DOI: 10.1016/j.acra.2023.11.030] [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] [Received: 10/11/2023] [Revised: 11/16/2023] [Accepted: 11/19/2023] [Indexed: 05/12/2024]
Abstract
RATIONALE AND OBJECTIVES This study aims to develop and validate a computed tomography (CT)-based radiomics nomogram for pre-operatively predicting central lymph node metastasis (CLNM) in patients with papillary thyroid microcarcinoma (PTMC) and explore the underlying biological basis by using RNA sequencing data. METHODS This study trained 452 PTMC patients across two hospitals from January 2012 to December 2020. The sets were randomly divided into the training (n = 339), internal test (n = 86), external test (n = 27) sets. Radiomics features were extracted from primary lesion's pre-operative CT images for each patient. After screening for features, five algorithms such as K-nearest neighbor, logistics regression, linear-support vector machine (SVM), Gaussian SVM, and polynomial SVM were used to establish the radiomics models. The performance of these five algorithms was evaluated and compared directly to radiologist's interpretation (CT-reported lymph node status). The radiomics signature score (Rad-score) was generated using a linear combination of the selected features. By combining the clinical risk factors and Rad score, a radiomics nomogram was established and compared with Rad-score and clinical model. The performance of the nomogram was evaluated based on the receiver operating characteristic (ROC) curve, calibration curve, and the decision curve analysis (DCA). The potential biological basis of nomogram was revealed by performing genetic analysis based on the RNA sequencing data. RESULTS A total of 25 radiomic features were ultimately selected to train the machine learning models, and the five machine learning models outperformed the radiologists' interpretation by achieving area under the ROC curves (AUCs) ranging from 0.606 to 0.730 in the internal test set. By incorporating the Rad score and clinical risk factors (sex, age, tumor-diameter, and CT-reported lymph node status), this nomogram achieved AUCs of 0.800 and 0.803 in the internal and external test set, which were higher than that of the Rad-score and clinical model, respectively. Calibration curves and DCA also showed that the nomogram had good performance. As for the biological basis exploration, in patients predicted by nomogram to be PTC patients with CLMN, 109 genes were dysregulated, and some of them were associated with pathways and biological processes such as tumor angiogenesis. CONCLUSION This radiomics nomogram successfully identified CLNM on pretreatment imaging across multiple institutions, exceeding the diagnostic ability of radiologists and had the potential to be integrated into clinical decision making as a non-invasive pre-operative tool.
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Affiliation(s)
- Yakui Mou
- Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai 264000, China (Y.M., X.H., J.L., P.Y., C.W., Z.S., X.W., M.Z., X.S.); Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases; Yantai 264000, China (Y.M., P.Y., C.W., Z.S., X.W., M.Z., X.S.); Yantai Key Laboratory of Otorhinolaryngologic Diseases, Yantai 264000, China (Y.M., P.Y., C.W., Z.S., X.W., M.Z., X.S.)
| | - Xiao Han
- Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai 264000, China (Y.M., X.H., J.L., P.Y., C.W., Z.S., X.W., M.Z., X.S.); Department of Otolaryngology-Head and Neck Surgery, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing 210019, China (X.H.)
| | - Jingjing Li
- Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai 264000, China (Y.M., X.H., J.L., P.Y., C.W., Z.S., X.W., M.Z., X.S.); Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China (J.L.)
| | - Pengyi Yu
- Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai 264000, China (Y.M., X.H., J.L., P.Y., C.W., Z.S., X.W., M.Z., X.S.); Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases; Yantai 264000, China (Y.M., P.Y., C.W., Z.S., X.W., M.Z., X.S.); Yantai Key Laboratory of Otorhinolaryngologic Diseases, Yantai 264000, China (Y.M., P.Y., C.W., Z.S., X.W., M.Z., X.S.)
| | - Cai Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai 264000, China (Y.M., X.H., J.L., P.Y., C.W., Z.S., X.W., M.Z., X.S.); Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases; Yantai 264000, China (Y.M., P.Y., C.W., Z.S., X.W., M.Z., X.S.); Yantai Key Laboratory of Otorhinolaryngologic Diseases, Yantai 264000, China (Y.M., P.Y., C.W., Z.S., X.W., M.Z., X.S.)
| | - Zheying Song
- Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai 264000, China (Y.M., X.H., J.L., P.Y., C.W., Z.S., X.W., M.Z., X.S.); Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases; Yantai 264000, China (Y.M., P.Y., C.W., Z.S., X.W., M.Z., X.S.); Yantai Key Laboratory of Otorhinolaryngologic Diseases, Yantai 264000, China (Y.M., P.Y., C.W., Z.S., X.W., M.Z., X.S.); School of Clinical Medicine, Weifang Medical University, Weifang 261042, China (Z.S., X.W.)
| | - Xiaojie Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai 264000, China (Y.M., X.H., J.L., P.Y., C.W., Z.S., X.W., M.Z., X.S.); Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases; Yantai 264000, China (Y.M., P.Y., C.W., Z.S., X.W., M.Z., X.S.); Yantai Key Laboratory of Otorhinolaryngologic Diseases, Yantai 264000, China (Y.M., P.Y., C.W., Z.S., X.W., M.Z., X.S.); School of Clinical Medicine, Weifang Medical University, Weifang 261042, China (Z.S., X.W.)
| | - Mingjun Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai 264000, China (Y.M., X.H., J.L., P.Y., C.W., Z.S., X.W., M.Z., X.S.); Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases; Yantai 264000, China (Y.M., P.Y., C.W., Z.S., X.W., M.Z., X.S.); Yantai Key Laboratory of Otorhinolaryngologic Diseases, Yantai 264000, China (Y.M., P.Y., C.W., Z.S., X.W., M.Z., X.S.)
| | - Haicheng Zhang
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai 264000, China (H.Z., N.M.)
| | - Ning Mao
- Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai 264000, China (H.Z., N.M.)
| | - Xicheng Song
- Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai 264000, China (Y.M., X.H., J.L., P.Y., C.W., Z.S., X.W., M.Z., X.S.); Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases; Yantai 264000, China (Y.M., P.Y., C.W., Z.S., X.W., M.Z., X.S.); Yantai Key Laboratory of Otorhinolaryngologic Diseases, Yantai 264000, China (Y.M., P.Y., C.W., Z.S., X.W., M.Z., X.S.).
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Mehdikhani B, Benam M, Moradkhani A, Roostaee A, Bahman SS, Barmayoon P, Dezyani G, Safarpour Lima Z. Evaluation of diagnostic value of Doppler ultrasound in the diagnosis of malignant breast masses. Eur J Transl Myol 2024; 34:12372. [PMID: 38536011 PMCID: PMC11264213 DOI: 10.4081/ejtm.2024.12372] [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: 02/09/2024] [Accepted: 02/25/2024] [Indexed: 04/19/2024] Open
Abstract
Breast cancer is the leading cause of cancer mortality in women, and it is on the rise in Iran. Therefore, an early-stage diagnosis of breast cancer is of critical importance. Because ultrasound is one of the available, inexpensive, and minimally invasive techniques for distinguishing malignant from benign masses, a comparison of conventional ultrasound, color Doppler, and spectral Doppler findings can be useful. The purpose of this study was to determine the diagnostic value of sonographic indices, specifically Doppler parameters, in identifying the nature of breast masses. This is a cross-sectional study, with diagnostic value analysis. Before undergoing a biopsy, 80 patients with breast masses underwent B-mode and Doppler breast ultrasound. The ultrasound findings were then compared to pathologic results to determine which groups were malignant or benign. The resulting data were analyzed using statistical tests and diagnostic values with SPSS 22 software. B-mode grey-scale ultrasound indices such as mass shape, mass margin, mass orientation, and posterior features, as well as Doppler indices such as vascularity, RI (Resistive Index), PI (Pulsatility Index), and PSV (Peak Systolic Velocity), were found to be statistically significant with pathological findings. Color Doppler revealed vascularity in 65% of benign and 84% of malignant masses. The diagnostic value results revealed that mass shape, mass margin, mass orientation, and posterior features all play a significant role in predicting lesion malignancy, with a sensitivity of 92%, 58%, 64%, 56%, and specificity of 59%, 66%, 82%, and 84%, respectively. The RI, PI, and PSV indices were significantly higher in malignant masses, and all of them had remarkable diagnostic values in predicting malignancy, with a (Area Under The Curve) AUC of 0.863, 0.882, 0.702, a sensitivity of 84% and 84%, 68%, and a specificity of 83%, 86%, and 62%, respectively, at the optimal cut-off points (0.65, 1.32, 12.40) obtained from the Receiver Operating Characteristics (ROC) curves.
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Affiliation(s)
- Bahareh Mehdikhani
- Department of Radiology, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran.
| | - Milad Benam
- Department of Radiology, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran.
| | | | - Ayda Roostaee
- Department of Radiology, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran.
| | - Seyedeh Sabahat Bahman
- Department of Radiology, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran.
| | - Pooyan Barmayoon
- Department of Radiology, Firoozgar Clinical Research Development Center (FCRDC), Iran University of Medical Sciences, Tehran.
| | - Ghazaleh Dezyani
- Department of Radiology, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran.
| | - Zeinab Safarpour Lima
- Department of Radiology, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran.
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The Benefit of Superb Microvascular Imaging and Shear Wave Elastography in Differentiating Metastatic Axillary Lymphadenopathy from Lymphadenitis. Clin Breast Cancer 2022; 22:515-520. [DOI: 10.1016/j.clbc.2022.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/11/2022] [Accepted: 03/09/2022] [Indexed: 11/20/2022]
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Lin J, Lin W, Xu L, Lin T. Diagnostic value of various vascular features of breast cancer by age. Clin Hemorheol Microcirc 2022; 80:317-325. [PMID: 34719486 DOI: 10.3233/ch-211258] [Citation(s) in RCA: 2] [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 Tumor angiogenesis plays a critical role in the growth and metastasis of breast cancer. Evaluating the added value of vascular features to Breast Imaging Reporting and Data System (BI-RADS) in differentiating malignant masses from benign ones is essential. Micro-flow Imaging (MFI) is a promising noninvasive diagnostic method for the microvessels in breast tumors, but its precise value is still uncertain. OBJECTIVES Understanding whether malignant tumor vascular characteristics by MFI are associated with breast cancer and whether the diagnostic efficiency varies by age. MATERIALS AND METHODS B-mode ultrasound and MFI were performed for 153 solid breast lesions. The vessels images by MFI were reviewed and assessed by two investigators, respectively. Then the diagnostic efficacy of different vascular features combined with BI-RADS was evaluated in different age groups. RESULTS The mean size of lesions is 19.4 (range 18-78) mm. There were 94 breast masses in benign, while 59 breast masses in malignant by pathology. III Adler classification, penetrating vessels, and complex flow pattern showed a positive association with a high risk of malignant breast lesions (p < 0.05). BI-RADS combined with vessel characteristics show better improvement of diagnostic performance of breast lesions in the elderly group than in the young group. CONCLUSIONS Vascular features by MFI contribute to malignant breast masses' diagnosis, and the association might be modified by age.
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Affiliation(s)
- Jia Lin
- Department of Ultrasound, First Affiliated Hospital, Shantou Unviersity Medical College, Shantou, Guangdong, China
| | - Wenqiang Lin
- Department of Ultrasound, First Affiliated Hospital, Shantou Unviersity Medical College, Shantou, Guangdong, China
| | - Liang Xu
- Shantou University Medical College, Shantou, Guangdong, China
| | - Teng Lin
- Department of Ultrasound, First Affiliated Hospital, Shantou Unviersity Medical College, Shantou, Guangdong, China
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Ranjkesh M, Hajibonabi F, Seifar F, Tarzamni MK, Moradi B, Khamnian Z. Diagnostic Value of Elastography, Strain Ratio, and Elasticity to B-Mode Ratio and Color Doppler Ultrasonography in Breast Lesions. Int J Gen Med 2020; 13:215-224. [PMID: 32547163 PMCID: PMC7259450 DOI: 10.2147/ijgm.s247980] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 05/11/2020] [Indexed: 12/05/2022] Open
Abstract
Purpose The aim of this study was to investigate the sensitivity, specificity, and diagnostic accuracy of sonoelastography (SE), strain ratio (SR), elasticity to B-mode (E/B) ratio, and color Doppler ultrasonography (US) in suspected breast lesions. Materials and Methods This prospective study was conducted on women referred to Alzahra university hospital of Tabriz for annual screening of breast cancer between May 2017 and December 2018. B-mode US, SE, and color Doppler imaging were conducted in females with suspected mammography reports. The lesions in B-mode were classified according to the Breast Imaging Reporting and Data System (B-RADS). The results of SE imaging were graded based on five-grade SE score. SR and E/B ratio of each lesion were also analyzed in SE images. Color Doppler findings were categorized from 0 (no visible vessel) to 2 (> two vessels) based on the vascularity of the tumor. Pathology results were used as the gold standard to measure the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and diagnostic accuracy of each modality. Results One-hundred and ten breast lesions of 104 women aged 42.05±10.33 years were included in the study. Seventy-seven of the lesions were benign and 3 were malignant. Sensitivity and specificity of 97.0% and 77.9% for B-mode US, 93.9% and 87.0% for SE score, 81.8% and 66.2% for color Doppler US, 72.7% and 77.6% for E/B ratio (cutoff: 1.05), and 77.3% and 79.6% for SR (cutoff: 1.90) were obtained, respectively. Addition of SE score to B-mode US increased the sensitivity to 93.9%, specificity to 93.5%, and AUC from 0.95 to 0.97. Cumulative color Doppler US with B-mode US did not enhance the diagnostic accuracy of B-mode US. Conclusion SE was more effective than color Doppler US for distinguishing malignant from benign breast lesion. Among the three different SE features, five-grade SE score was superior to E/B ratio and SR.
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Affiliation(s)
- Mahnaz Ranjkesh
- Medical Radiation Sciences Research Group, Tabriz University of Medical Sciences, Tabriz, Iran.,Radiology Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farid Hajibonabi
- Radiology Department, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.,Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Seifar
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Kazem Tarzamni
- Medical Radiation Sciences Research Group, Tabriz University of Medical Sciences, Tabriz, Iran.,Radiology Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behzad Moradi
- Medical Radiation Sciences Research Group, Tabriz University of Medical Sciences, Tabriz, Iran.,Radiology Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zhila Khamnian
- Social Determinant of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Ustabaşıoğlu FE, Korkmaz S, İlgen U, Solak S, Kula O, Turan S, Emmüngil H. Quantitative Assessment of Salivary Gland Parenchymal Vascularization Using Power Doppler Ultrasound and Superb Microvascular Imaging: A Potential Tool in the Diagnosis of Sjögren’s Syndrome. Balkan Med J 2020; 37:203-207. [PMID: 32270946 PMCID: PMC7285670 DOI: 10.4274/balkanmedj.galenos.2020.2019.11.91] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background: Primary Sjögren’s syndrome is a chronic inflammatory autoimmune disease. Minor salivary gland biopsy is the gold standard for the diagnosis of primary Sjögren’s syndrome. Superb microvascular imaging, power Doppler ultrasound, and color Doppler of the salivary glands represent non-invasive, non-irradiating modality for evaluating the vascularity of the salivary glands in the diagnosis and follow-up of primary Sjögren’s syndrome. Aims: To evaluate the efficacy of superb microvascular imaging and vascularity index in salivary glands for the sonographic diagnosis of primary Sjögren’s syndrome. Study Design: Prospective case-control study. Methods: Twenty participants with primary Sjögren’s syndrome and 20 healthy subjects were included in the study. Both parotid glands and submandibular glands were evaluated by superb microvascular imaging, power Doppler ultrasound, and color Doppler. The diagnostic accuracy of superb microvascular imaging was compared using these techniques. Results: In the patient group, the vascularity index values of superb microvascular imaging in parotid glands and submandibular glands were 3.5±1.66, 5.06±1.94, respectively. While the same values were 1.0±0.98 and 2.44±1.34 in the control group (p≤0.001). In the patient group, the vascularity index values of power Doppler ultrasound in parotid glands and submandibular glands were 1.3±1.20 and 2.59±1.82, respectively. While the same values were 0.3±0.32 and 0.85±0.68 in the control group (p≤0.001). The superb microvascular imaging vascularity index cut-off value for the diagnosis of primary Sjögren’s syndrome in parotid glands that maximizes the accuracy was 1.85 (area under the curve: 0.906; 95% confidence interval: 0.844, 0.968), and its sensitivity and specificity were 87.5% and 72.5%, respectively. While the superb microvascular imaging vascularity index cut-off value for the diagnosis of primary Sjögren’s syndrome in submandibular gland that maximizes the accuracy was 3.35 (area under the curve: 0.873; 95% confidence interval: 0.800, 0.946), its sensitivity and specificity were 82.5% and 70%, respectively. Conclusion: Superb microvascular imaging with high reproducibility of the vascularity index has a higher sensitivity and specificity than the power Doppler ultrasound in the diagnosis of primary Sjögren’s syndrome. It can be a noninvasive technique in the diagnosis of primary Sjögren’s syndrome when used with clinical, laboratory and other imaging methods.
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Affiliation(s)
| | - Selçuk Korkmaz
- Department of Biostatistics and Medical Informatics, Trakya University School of Medicine, Edirne, Turkey
| | - Ufuk İlgen
- Department of Rheumatology, Trakya University School of Medicine, Edirne, Turkey
| | - Serdar Solak
- Department of Radiology, Trakya University School of Medicine, Edirne, Turkey
| | - Osman Kula
- Department of Radiology, Trakya University School of Medicine, Edirne, Turkey
| | - Sezin Turan
- Department of Rheumatology, Trakya University School of Medicine, Edirne, Turkey
| | - Hakan Emmüngil
- Department of Rheumatology, Trakya University School of Medicine, Edirne, Turkey
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Enshaei A, Mohammadi A, Moosavi Toomatari SB, Yekta Z, Moosavi Toomatari SE, Ghasemi-Rad M, Shamspour SZ, Sarabi ZK, Sepehrvand N. Diagnostic value of a power Doppler ultrasound-based malignancy index for differentiating malignant and benign solid breast lesions. Indian J Cancer 2020; 57:44-48. [PMID: 31929234 DOI: 10.4103/ijc.ijc_424_18] [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: 11/04/2022]
Abstract
Background Power Doppler ultrasound (PDUS) can provide useful information regarding the vascularity of breast lesions. The aim of this study was to investigate the diagnostic performance of a new PDUS-driven malignancy index in differentiating between malignant and benign causes of solid breast lesions. Materials and Methods Patients with solid breast lesions were enrolled consecutively and evaluated first by PDUS and subsequently by histopathologic assessment after undergoing surgical biopsy. A custom-made software was used to extract data from images for calculating malignancy index formula. Results A total of 87 patients with solid breast lesions were enrolled. Histopathologic evaluation identified 49 patients as benign and 38 patients as malignant. Malignancy index was significantly higher in the malignant group as compared to benign tumors (6.31 vs 0.30,P < 0.001). Area under the receiver operating characteristics (ROC) curve (AUC) was 0.98 (95% confidence interval (CI) 0.95-1.00). According to the ROC curve analysis, the cut-off point of 1.23 for malignancy index had a sensitivity and specificity of 94.7% (95% CI 82.2-99.3) and 94.0% (95% CI 83.1-98.7), respectively. Conclusion Comparing with the histopathologic evaluation as the gold standard for diagnosing breast lesions, PDUS-driven malignancy index was shown to have a high discriminative performance in identifying malignant lesions with high sensitivity, specificity, and diagnostic accuracy. The noninvasive nature of PDUS is an important advantage that could prevent unnecessary biopsies.
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Affiliation(s)
- Ali Enshaei
- Department of Surgery, Urmia University of Medical Sciences, Urmia, Iran
| | - Afshin Mohammadi
- Department of Radiology, Urmia University of Medical Sciences, Urmia, Iran
| | | | - Zahra Yekta
- Department of Community Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | | | | | | | - Zahra Karimi Sarabi
- Department of Anesthesiology, Urmia University of Medical Sciences, Urmia, Iran
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Raza W, Mohy-U-Din HA, Malik SS, Manzoor I, Nadeem B. Reliability of Sonoelastography in Ductal Carcinoma. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:21-25. [PMID: 30309749 DOI: 10.1016/j.ultrasmedbio.2018.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 08/25/2018] [Accepted: 08/29/2018] [Indexed: 06/08/2023]
Abstract
The objective of the study was to evaluate the reliability of sonoelastography in ductal carcinoma in patients in primary and secondary health care settings. Google Scholar, PubMed, Medline, Medscape, Wikipedia and NCBI were searched in January 2018 for all original research and review articles to identify relevant studies. Two reviewers selected the articles independently for based on the title and abstract. The selection criteria were sonoelastography accuracy for diagnosing ductal carcinoma as index text, B-mode sonography, and micropure imaging; surgery and histologic findings were used as reference text; and benign and malignant breast abnormalities and ductal carcinoma were used as target conditions. Two reviewers extracted the data on selected study characteristics, and the results were used to construct the tables and figures. Fifteen studies on ductal carcinoma were found. The overall sensitivity of sonoelastography in diagnosing ductal carcinoma was 85.7%, and the specificity, 79.8%. On the basis of the literature review, it was concluded that sonoelastography has high sensitivity and specificity in diagnosing ductal carcinoma.
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Jung HK, Park AY, Ko KH, Koh J. Comparison of the Diagnostic Performance of Power Doppler Ultrasound and a New Microvascular Doppler Ultrasound Technique (AngioPLUS) for Differentiating Benign and Malignant Breast Masses. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018. [PMID: 29528130 DOI: 10.1002/jum.14602] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
This study was performed to compare the diagnostic performance of power Doppler ultrasound (US) and a new microvascular Doppler US technique (AngioPLUS; SuperSonic Imagine, Aix-en-Provence, France) for differentiating benign and malignant breast masses. Power Doppler US and AngioPLUS findings were available in 124 breast masses with confirmed pathologic results (benign, 80 [64.5%]; malignant, 44 [35.5%]). The diagnostic performance of each tool was calculated to distinguish benign from malignant masses using a receiver operating characteristic curve analysis and compared. The area under the curve showed that AngioPLUS was superior to power Doppler US in differentiating benign from malignant breast masses, but the difference was not statistically significant.
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Affiliation(s)
- Hae Kyoung Jung
- Department of Radiology, CHA Bundang Medical Center, CHA University, Seoul, Korea
| | - Ah Young Park
- Department of Radiology, CHA Bundang Medical Center, CHA University, Seoul, Korea
| | - Kyung Hee Ko
- Department of Radiology, CHA Bundang Medical Center, CHA University, Seoul, Korea
| | - Jieun Koh
- Department of Radiology, CHA Bundang Medical Center, CHA University, Seoul, Korea
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Caliskan E, Ozturk M, Bayramoglu Z, Comert RG, Adaletli I. Evaluation of parotid glands in healthy children and adolescents using shear wave elastography and superb microvascular imaging. Radiol Med 2018; 123:710-718. [PMID: 29713928 DOI: 10.1007/s11547-018-0897-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 04/20/2018] [Indexed: 01/31/2023]
Abstract
OBJECTIVES We aim to determine parotid gland elasticity values from healthy children and adolescents using shear wave elastography (SWE). We also define the degree of vascularity using superb microvascular imaging (SMI), power Doppler (PD), and color Doppler (CD) and compare SMI with CD and PD. MATERIALS AND METHODS A total of 100 cases, comprising 50 girls and 50 boys, with ages ranging from 3 to 17 years were included in this prospective study. SWE, SMI, PD, and CD measurements were taken from both parotid glands, and the relationships with sex, age, and body mass index (BMI) were determined. The SMI was compared with the PD and CD. RESULTS The median elasticity values measured with SWE were 8.37 ± 2.09 kPa and 1.68 ± 0.26 m/s on the right and 8.33 ± 2.04 kPa and 1.69 ± 0.26 m/s on the left. There were significant positive correlations present for those aged below and above 10 years and for BMI with elasticity values. The median vascular spot numbers measured using SMI, PD, and CD were 5 ± 1.70, 3.5 ± 1.45, and 2 ± 1.1 on the right and 4 ± 1.7, 4 ± 1.43, and 2 ± 1.05 on the left, respectively. The median values obtained with SMI were significantly higher than the median values obtained with both PD and CD. CONCLUSION This study determined the reference SWE, SMI, PD, and CD values for normal parotid glands in healthy children and adolescents. Elasticity values were affected by age and BMI. There was no correlation between vascularity values and age, sex, or BMI. SMI provided more detailed information about vascularity compared with the other methods.
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Affiliation(s)
- Emine Caliskan
- Department of Pediatric Radiology, Istanbul Faculty of Medicine, Turgut Ozal Street, Fatih, 34063, Istanbul, Turkey.
| | - Mehmet Ozturk
- Department of Radiology, Faculty of Medicine, Selcuk University, Alaeddin Keykubat Yerleşkesi, kademi Mah. Yeni Istanbul Street. No:369, Konya, Turkey
| | - Zuhal Bayramoglu
- Department of Pediatric Radiology, Istanbul Faculty of Medicine, Turgut Ozal Street, Fatih, 34063, Istanbul, Turkey
| | - Rana Gunoz Comert
- Department of Radiology, Istanbul Faculty of Medicine, Turgut Ozal Street, Fatih, Istanbul, Turkey
| | - Ibrahim Adaletli
- Department of Pediatric Radiology, Istanbul Faculty of Medicine, Turgut Ozal Street, Fatih, 34063, Istanbul, Turkey
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Ibrahim R, Rahmat K, Fadzli F, Rozalli FI, Westerhout CJ, Alli K, Vijayananthan A, Moosa F. Evaluation of solid breast lesions with power Doppler: value of penetrating vessels as a predictor of malignancy. Singapore Med J 2016; 57:634-640. [PMID: 27872938 PMCID: PMC5331140 DOI: 10.11622/smedj.2016001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION This study aimed to evaluate the vascular pattern of solid breast lesions using power Doppler ultrasonography (PDUS) and assess whether the presence of intratumoural penetrating vessels can predict breast cancer malignancy. METHODS Greyscale ultrasonography (US) and PDUS were prospectively performed on 91 women in Malaysia with histopathologically proven breast lesions. The diagnostic accuracy of greyscale US, PDUS, and both greyscale US and PDUS was calculated and compared. RESULTS The 91 women had 102 breast lesions (55 benign, 47 malignant). Of the 47 malignant lesions, 36 demonstrated intratumoural penetrating vessels. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of greyscale US findings in diagnosing malignancy were 100.0%, 71.4%, 74.1% and 100.0%, respectively. The presence of calcification in the breast lesion and the margin, shape and posterior acoustic features of the lesion were significant parameters in predicting malignancy (p < 0.01). The sensitivity, specificity, PPV and NPV of the presence of intratumoural penetrating vessels in predicting malignancy were 76.5%, 80.0%, 76.5% and 80.0%, respectively. When both greyscale US and PDUS were used, there was a significant correlation in predicting malignancy (p < 0.05). The specificity and PPV values of the combined greyscale US and PDUS method (89.0% and 85.7%, respectively) were higher than those of greyscale US or PDUS alone. CONCLUSION Flow patterns revealed by PDUS can be useful for differentiating benign and malignant breast lesions. The visualisation of penetrating vessels in solid breast lesions can be used to complement greyscale US findings in predicting malignancy.
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Affiliation(s)
- Rositaa Ibrahim
- Department of Biomedical Imaging, University Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kartini Rahmat
- Department of Biomedical Imaging, University Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Farhana Fadzli
- Department of Biomedical Imaging, University Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Faizatul Izza Rozalli
- Department of Biomedical Imaging, University Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Caroline Judy Westerhout
- Department of Biomedical Imaging, University Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kasumawati Alli
- Department of Biomedical Imaging, University Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Anushya Vijayananthan
- Department of Biomedical Imaging, University Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Fatimah Moosa
- Department of Biomedical Imaging, University Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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13
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Lee JH, Shin HJ, Yoon JH, Kim EK, Moon HJ, Lee HS, Kwon HJ, Kwak JY. Predicting lymph node metastasis in patients with papillary thyroid carcinoma by vascular index on power Doppler ultrasound. Head Neck 2016; 39:334-340. [PMID: 27704649 DOI: 10.1002/hed.24592] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND For patients with papillary thyroid carcinoma (PTC), lymph node metastasis is associated with an increased recurrence rate. The purpose of this study was to investigate whether the vascular endothelial growth factor (VEGF), microvessel density (MVD), and vascular index (VI) can predict lymph node metastasis in patients with PTC. METHODS From January 2011 to October 2011, 202 patients with PTCs underwent preoperative staging ultrasound evaluation. To evaluate vascularity, we measured the VI, VEGF expression, and MVD. RESULTS The VI was significantly correlated with MVD (p = .009). On multivariate analysis, young age showed a significant correlation with lymph node metastasis (p < .001; p < .001; p < .001). However, the other clinicopathologic features, VEGF, MVD, and VI failed to show any significant correlations with lymph node metastasis. CONCLUSION Although the VI showed significant correlation with MVD, it was not significantly correlated to lymph node metastasis. © 2016 Wiley Periodicals, Inc. Head Neck 39: 334-340, 2017.
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Affiliation(s)
- Ji Hye Lee
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Korea
| | - Hyun Joo Shin
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Korea
| | - Jung Hyun Yoon
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Korea
| | - Eun-Kyung Kim
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Korea
| | - Hee Jung Moon
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Korea
| | - Hye Sun Lee
- Biostastistics Collaboration Unit, Medical Research Center, Yonsei University, College of Medicine, Seoul, Korea
| | - Hyeong Ju Kwon
- Department of Pathology, Yonsei University, College of Medicine, Seoul, Korea.,Department of Pathology, Yonsei University, Wonju College of Medicine, Wonju, Korea
| | - Jin Young Kwak
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Korea
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Yongfeng Z, Ping Z, Wengang L, Yang S, Shuangming T. Application of a Novel Microvascular Imaging Technique in Breast Lesion Evaluation. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:2097-2105. [PMID: 27321174 DOI: 10.1016/j.ultrasmedbio.2016.05.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 04/01/2016] [Accepted: 05/09/2016] [Indexed: 06/06/2023]
Abstract
Conventional power Doppler imaging (PDI) and the novel Superb Microvascular Imaging (SMI) technique were applied to observe the distribution of microvessels in 135 breast lesions, using semi-quantitative grading, penetrating vessel evaluation and flow distribution pattern to evaluate diagnostic efficacy. Compared with PDI, SMI detected more flow signals and details of microvessels. Further, when a centrally distributed branching or diffusing mode was used as a criterion for diagnosing malignancy, SMI improved diagnosis of breast masses. Sensitivity, specificity, positive predictive value and negative predictive value of SMI-assessed flow distribution were 85.4%, 92.6%, 83.3% and 93.5%, respectively, compared with 70.7%, 92.6%, 80.5% and 87.9% for PDI. We also found that flow distribution pattern analysis is superior to semi-quantitative grading and the penetrating vessel method in differentiating malignant breast lesions. Our work here further supports SMI as a novel and promising technique in visualizing microvasculature in breast lesions that may be of paramount use in initial diagnosis as well as follow-up assessment in various treatment regimes.
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Affiliation(s)
- Zhao Yongfeng
- Department of Ultrasound, Third Xiangya Hospital of Central South University, Hunan, China
| | - Zhou Ping
- Department of Ultrasound, Third Xiangya Hospital of Central South University, Hunan, China.
| | - Liu Wengang
- Department of Ultrasound, Third Xiangya Hospital of Central South University, Hunan, China
| | - Shao Yang
- Department of Ultrasound, Third Xiangya Hospital of Central South University, Hunan, China
| | - Tian Shuangming
- Department of Ultrasound, Third Xiangya Hospital of Central South University, Hunan, China
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15
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Zhan J, Diao XH, Jin JM, Chen L, Chen Y. Superb Microvascular Imaging-A new vascular detecting ultrasonographic technique for avascular breast masses: A preliminary study. Eur J Radiol 2016; 85:915-21. [PMID: 27130051 DOI: 10.1016/j.ejrad.2015.12.011] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 11/15/2015] [Accepted: 12/14/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Superb Microvascular Imaging (SMI) is a new vascular imaging technique detecting a slower velocity that color Doppler flow image (CDFI) cannot. The aim of this study is to evaluate the clinical value of SMI for detecting penetrating vessels (PVs) in avascular breast lesions. METHODS Seventy-nine patients with 82 breast lesions were examined by conventional ultrasound and diagnosed as Breast Imaging Reporting and Data System (BI-RADS) level 3 or 4. CDFI detected no PVs; subsequently, Power Doppler (PD), Advanced Dynamic Flow (ADF), and SMI were performed to detect any PVs in the breast lesions. RESULTS Compared with PD or ADF, SMI revealed significantly (P<0.01) higher median numbers of PVs in breast lesions. The area under the receiver operating characteristic curve was 0.914 before the corrected classification versus 0.947 after the corrected classification (P<0.05). CONCLUSIONS SMI was helpful in the differential diagnosis of benign versus malignant in avascular breast lesions, especially those in BI-RADS category 4.
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Affiliation(s)
- Jia Zhan
- Department of Ultrasound Huadong Hospital, Fudan University, Shanghai, PR China.
| | - Xue-Hong Diao
- Department of Ultrasound Huadong Hospital, Fudan University, Shanghai, PR China.
| | - Jia-Mei Jin
- Department of Ultrasound Huadong Hospital, Fudan University, Shanghai, PR China.
| | - Lin Chen
- Department of Ultrasound Huadong Hospital, Fudan University, Shanghai, PR China.
| | - Yue Chen
- Department of Ultrasound Huadong Hospital, Fudan University, Shanghai, PR China.
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16
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Liu D, Huang Y, Tian D, Yin J, Deng LJ. Value of sonographic bidirectional arterial flow combined with elastography for diagnosis of breast imaging reporting and data system category 4 breast masses. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2015; 34:759-766. [PMID: 25911707 DOI: 10.7863/ultra.35.5.759] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate the role of bidirectional arterial flow combined with ultrasound elastography for differentiation of American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) category 4 masses. METHODS A total of 116 BI-RADS category 4 breast masses were evaluated with color Doppler sonography, spectral analysis, and elastography. The sensitivity, specificity, accuracy, positive and negative predictive values, and receiver operator characteristic curve were used to estimate the diagnostic performance for each modality and the combination method. RESULTS The combination method had the best sensitivity (81.1%) but less specificity (94.9%) and the best accuracy (90.5%). The discriminating power of the combined method (area under the curve [AUC], 0.880; 95% confidence interval [CI], 80.0%-96.0%) was significantly higher than that of bidirectional arterial flow (AUC, 0.818; 95% CI, 72.0%-91.6%; P< .01) and elastography (AUC, 0.765; 95% CI, 65.9%-87.0%; P< .01). CONCLUSIONS Bidirectional arterial flow evaluation, when combined with elastography, could potentially improve diagnostic accuracy for BI-RADS category 4 breast masses.
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Affiliation(s)
- Da Liu
- Departments of Orthopedic Surgery (D.L.) and Ultrasound (Y.H., D.T., J.Y., L.D.), Shengjing Hospital of China Medical University, Shenyang, China
| | - Ying Huang
- Departments of Orthopedic Surgery (D.L.) and Ultrasound (Y.H., D.T., J.Y., L.D.), Shengjing Hospital of China Medical University, Shenyang, China
| | - Dan Tian
- Departments of Orthopedic Surgery (D.L.) and Ultrasound (Y.H., D.T., J.Y., L.D.), Shengjing Hospital of China Medical University, Shenyang, China
| | - Jing Yin
- Departments of Orthopedic Surgery (D.L.) and Ultrasound (Y.H., D.T., J.Y., L.D.), Shengjing Hospital of China Medical University, Shenyang, China
| | - Li-Jun Deng
- Departments of Orthopedic Surgery (D.L.) and Ultrasound (Y.H., D.T., J.Y., L.D.), Shengjing Hospital of China Medical University, Shenyang, China
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17
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Shin HJ, Kim EK, Moon HJ, Yoon JH, Han KH, Kwak JY. Can increased tumoral vascularity be a quantitative predicting factor of lymph node metastasis in papillary thyroid microcarcinoma? Endocrine 2014; 47:273-82. [PMID: 24366642 DOI: 10.1007/s12020-013-0131-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 11/21/2013] [Indexed: 12/15/2022]
Abstract
The aim of the present study was to evaluate the clinical implications of the vascular index (VI) as a predicting factor for central and lateral lymph node metastasis (LNM) in patients with papillary thyroid microcarcinoma (PTMC). From January 2011 to October 2011, 588 patients (495 females, 93 males) who were diagnosed with PTMC were included. Clinicopathologic characteristics of patients and ultrasound (US) features of the lesions including VI were evaluated retrospectively. The VI was measured with QLAB 7.0 quantification software using preoperative Doppler US images. Univariate and multivariate analysis were used to assess predictive factors of LNM. From 588 patients, 140 patients (23.8 %) had central LNM and 26 patients (4.4 %) had lateral LNM on pathologic results. The presence of lateral LNM [odds ratio (OR) 5.46; 95 % confidence interval (CI) = 2.19-13.64], bilaterality (OR 2.16; 95 % CI 1.17-4.01), and increased tumor size (OR 1.15; 95 % CI 1.04-1.28) were significant independent factors for predicting central LNM. The presence of central LNM (OR 5.58; 95 % CI 2.22-14.04), upper third location of malignancy (OR 2.50; 95 % CI 1.01-6.21), and tumor size (OR 1.34; 95 % CI 1.03-1.73) were significant independent factors for predicting lateral LNM. However, the VI was not a significant predicting factor for both central and lateral LNM. Therefore, the VI of PTMC may not be useful for predicting central and lateral LNM in patients with PTMC.
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Affiliation(s)
- Hyun Joo Shin
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemoon-gu, Seoul, 120-752, South Korea
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18
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Chen M, Wang WP, Jia WR, Tang L, Wang Y, Zhan WW, Fei XC. Three-dimensional contrast-enhanced sonography in the assessment of breast tumor angiogenesis: correlation with microvessel density and vascular endothelial growth factor expression. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2014; 33:835-846. [PMID: 24764339 DOI: 10.7863/ultra.33.5.835] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES The purpose of this study was to differentiate perfusion and vascular characteristics between benign and malignant breast lesions by 3-dimensional contrast-enhanced sonography and evaluate their correlation with microvessel density and vascular endothelial growth factor (VEGF) expression for further clinical exploration. METHODS Three-dimensional contrast-enhanced sonography was performed in 183 patients with breast lesions, and sonographic characteristics were carefully observed for further analysis. The mean microvessel density and VEGF expression were measured by immunohistochemical analysis. RESULTS Pathologic results showed 35 benign and 148 malignant cases. Malignancy and benignity differed significantly in peripheral vessel characteristics (number, distribution, course, degree of dilatation, and penetrating vessels), rim perfusion and coarseness degree, intratumoral perfusion type, and intratumoral vessel dilatation (P< .05) but not the presence of peripheral and intratumoral vessels and intratumoral perfusion (P > .05). The specificity of penetrating vessels was 88.6% for diagnosing malignancy. The sensitivity, specificity, and accuracy of rim perfusion coarseness were 90.2%, 70.4%, and 85.3% respectively. The sensitivity of the intratumoral perfusion type was 77.8%, whereas the specificity of intratumoral vessel dilatation was 88.9%. Microvessel density and VEGF expression were significantly correlated with perfusion and vascular characteristics (P < .05), except the presence of peripheral vessels, rim perfusion, and intratumoral perfusion (P> .05). The presence of intratumoral vessels was related to VEGF (P< .05) but not microvessel density (P > .05). CONCLUSIONS Three-dimensional contrast-enhanced sonographic characteristics were statistically different between benign and malignant breast lesions. Some of them also correlated significantly with microvessel density and VEGF expression and therefore have potential for objective evaluation of tumor angiogenesis.
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Affiliation(s)
- Man Chen
- Department of Diagnostic Ultrasound, Zhong Shan Hospital, Fudan University School of Medicine, 180 Fen Lin Rd, 200032 Shanghai, China.
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Li J, Xing P, Feng L, Dong H, Jin F, Wu Y, Zheng X. The value of substratified combined imaging assessment with mammography and ultrasonography for Chinese women with palpable breast masses. Breast Cancer Res Treat 2014; 144:391-6. [PMID: 24519388 DOI: 10.1007/s10549-014-2863-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Accepted: 01/27/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Jiguang Li
- Breast Division, The First Affiliated Hospital of China Medical University, China Medical University Cancer Institute, Shenyang, 110001, People's Republic of China,
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Nawawi O, Ying Goh K, Rahmat K. A rare case of primary infiltrating neuroendocrine carcinoma of the breast. IRANIAN JOURNAL OF RADIOLOGY 2012; 9:212-6. [PMID: 23408015 PMCID: PMC3569554 DOI: 10.5812/iranjradiol.8517] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Revised: 06/18/2012] [Accepted: 06/28/2012] [Indexed: 11/16/2022]
Abstract
Primary neuroendocrine carcinoma of the breast is a very rare malignant tumor. There are not many cases reported in the English literature since it was first documented in 1983. Reports on the imaging features, in particular the ultrasonographic features of this rare tumor are scarce. Herein, we report a case of aggressive primary infiltrating neuroendocrine carcinoma of the breast, masquerading as an inflammatory breast condition in a 22-year-old young lady, perhaps the youngest case ever reported in the English literature. We discuss the imaging features and highlight the Doppler ultrasonographic findings of this rare breast carcinoma. This is the first documentation on Doppler ultrasonographic findings of primary neuroendocrine carcinoma of the breast in the literature.
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Affiliation(s)
- Ouzreiah Nawawi
- Department of Biomedical Imaging, University of Malaya Medical Center, Kuala Lumpur, Malaysia
- Corresponding author: Ouzreiah Nawawi, Department of Biomedical Imaging, University Malaya Medical Center, 59100, Kuala Lumpur, Malaysia. Tel.: +60-379492069, Fax: +60-379494603, E-mail:
| | - Keat Ying Goh
- Department of Biomedical Imaging, University of Malaya Medical Center, Kuala Lumpur, Malaysia
| | - Kartini Rahmat
- University Malaya Research Imaging Center (UMRIC), Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
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Shen ZY, Hu B, Wu MF. Correlation between Blood Flow Signal of Color Flow Imaging and Nottingham Prognostic Index in Patients with Breast Carcinoma. ACTA ACUST UNITED AC 2012; 7:126-130. [PMID: 22740799 DOI: 10.1159/000337766] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND: The purpose of this study was to investigate the relationship between blood supply detected by Doppler ultrasound and the Nottingham Prognostic Index (NPI) in breast cancer patients. PATIENTS AND METHODS: 137 patients with breast carcinoma, who had undergone color Doppler flow imaging (CDFI) and surgery, were involved in this retrospective study. CDFI was divided into 4 levels: absent (grade 0), minimal (grade 1), moderate (grade 2), and marked (grade 3). NPI was calculated as: NPI = 0.2 × tumor size (cm) + grade (I-III) + lymph node score (1-3). All patients were followed until the final observation (July 2010), or until the time of death. The survival state of the patients was divided into 3 categories: healthy survival, metastasis, and death. RESULTS: Blood signal grades were positively correlated with NPI (Spearman r = 0.55926, p < 0.0001) and survival state (χ(2) = 9.0248, p < 0.01). Patients with abundant blood flow signal (grade 2-3) had a significantly shorter overall survival than did those with limited blood flow signal (grade 0-1) (χ(2) = 5.0384, p = 0.0248). CONCLUSION: Flow signal measured by Doppler ultrasound may be useful as a prognostic indicator for patients with breast carcinoma.
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Affiliation(s)
- Zhi-Yong Shen
- Department of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, Jiangsu Nantong, China
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Choi JJ, Kang BJ, Kim SH, Lee JH, Jeong SH, Yim HW, Song BJ, Jung SS. Role of sonographic elastography in the differential diagnosis of axillary lymph nodes in breast cancer. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2011; 30:429-436. [PMID: 21460142 DOI: 10.7863/jum.2011.30.4.429] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVES The purpose of this study was to evaluate the diagnostic utility of sonographic elastography in differentiating reactive and metastatic axillary lymph nodes in breast cancer. METHODS A total of 64 lymph nodes (reactive, n = 33; metastatic, n = 31) from 62 patients with breast cancer were examined by both B-mode sonography and elastography from April to July 2009. Two experienced radiologists retrospectively assessed B-mode sonograms by the sum of scores for 4 criteria: short diameter, shape, hilum, and cortical thickening. Elastographic images were given scores of 1 to 4 according to the percentage of high-elasticity areas in the lymph nodes. We compared the diagnostic performance of B-mode sonography, elastography, and combined examinations. We also calculated the strain ratio of the lymph node and subcutaneous fat tissue. RESULTS The elasticity score for malignant lymph nodes (mean, 3.1) was higher than the score for benign lymph nodes (mean, 2.2; P < .0001). With a cutoff between elasticity scores of 2 and 3, elastography showed 80.7% sensitivity, 66.7% specificity, and 73.4% accuracy. With a cutoff between B-mode sonographic scores of 1 and 2, B-mode sonography showed 74.2% sensitivity and 78.8% specificity. Combined B-mode and elastographic sonography showed higher sensitivity (87.1%) than B-mode sonography alone. With a strain ratio cutoff point of 2.3, sensitivity was 82.8%, and specificity was 56.3%. CONCLUSIONS Sonographic elastography may increase the sensitivity of B-mode sonography in the detection of metastatic axillary lymph nodes.
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Affiliation(s)
- Jae Jeong Choi
- Department of Radiology, Seoul St Mary's Hospital, Seoul, Korea
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Ginat DT, Destounis SV, Barr RG, Castaneda B, Strang JG, Rubens DJ. US elastography of breast and prostate lesions. Radiographics 2010; 29:2007-16. [PMID: 19926759 DOI: 10.1148/rg.297095058] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Elastography is a technique that maps relative tissue stiffness. Ultrasonographic (US) elastography (sonoelastography) is a novel modality that is the subject of active research for clinical applications, primarily breast and prostate lesion imaging. Breast and prostate tumors generally have biomechanical properties different from those of normal tissues: Tumors are usually stiffer. This phenomenon is responsible for tissue contrast on elastograms. For the prostate gland and breast, the main image acquisition techniques are vibration sonoelastography and compression sonoelastography. The sonoelastographic appearances of several common breast lesions, including fibroadenomas, simple and complex cysts, ductal carcinomas, malignant lymph nodes, and hematomas, are reviewed. In addition, the US elastographic appearances of the normal prostate gland, prostate carcinomas, and benign prostate hyperplasia are illustrated. Potential pitfalls in the interpretation of elastograms, including false-positive and false-negative images, are illustrated. These imaging findings are derived from ongoing research because sonoelastography is not yet accepted for routine clinical use.
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Affiliation(s)
- Daniel T Ginat
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY 14642-8648, USA.
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