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Pertea M, Grosu OM, Filip A, Moraru DC, Luca S, Fotea MC, Lunca S, Olinici D, Poroch V, Carp C, Veliceasa B. Rare Benign Tumors and Tumor-like Lesions of the Hand without Skin Damage-Clinical, Imagistic and Histopathological Diagnosis, Retrospective Study. Diagnostics (Basel) 2023; 13:diagnostics13061204. [PMID: 36980511 PMCID: PMC10046979 DOI: 10.3390/diagnostics13061204] [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: 02/19/2023] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND The broad spectrum of diagnoses and clinical features of hand tumors and the absence of pathognomonic signs often lead to an inaccurate or delayed diagnosis. However, only a few reports have comprehensively referenced the diagnosis and clinical features of hand tumors. This study intends to highlight the clinical, imaging and histological characteristics of uncommon hand tumors or tumor-like lesions. METHODS In this retrospective study, we report a series of 80 patients diagnosed with rare hand tumors and tumor-like lesions without skin damage. Age, gender, tumor location, imaging examinations and clinical and laboratory findings were analyzed. The histopathological exam established the final diagnosis. Surgery was indicated and performed in all cases. RESULTS This study included: neurofibroma, glomus tumor, lipoma, schwannoma, epidermal inclusion cyst and idiopathic tenosynovitis with "rice bodies." We have described the clinical, imagistic and histopathological particularities of these tumors. Surgical management included the complete removal of tumors, with no recurrence recorded within two years and overall high patient satisfaction. The most common findings were lipomas and the rarest neurofibromas. CONCLUSIONS To optimize the care of hand tumors and reduce diagnostic and treatment errors, knowledge of hand tumor types and their clinical and laboratory characteristics is necessary for every surgeon.
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Affiliation(s)
- Mihaela Pertea
- Department Plastic Surgery and Reconstructive, Faculty of Medicine,"Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- Department of Plastic Surgery and Reconstructive Microsurgery, "Sf. Spiridon" Emergency County Hospital, 700111 Iasi, Romania
| | - Oxana Madalina Grosu
- Department Plastic Surgery and Reconstructive, Faculty of Medicine,"Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- Department of Plastic Surgery and Reconstructive Microsurgery, "Sf. Spiridon" Emergency County Hospital, 700111 Iasi, Romania
| | - Alexandru Filip
- Department Plastic Surgery and Reconstructive, Faculty of Medicine,"Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- Department of Orthopaedics and Traumatology, "Sf. Spiridon" Emergency County Hospital, 700111 Iasi, Romania
| | - Dan Cristian Moraru
- Department Plastic Surgery and Reconstructive, Faculty of Medicine,"Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- Department of Plastic Surgery and Reconstructive Microsurgery, "Sf. Spiridon" Emergency County Hospital, 700111 Iasi, Romania
| | - Stefana Luca
- Department Plastic Surgery and Reconstructive, Faculty of Medicine,"Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- Department of Plastic Surgery and Reconstructive Microsurgery, "Sf. Spiridon" Emergency County Hospital, 700111 Iasi, Romania
| | - Madalina-Cristina Fotea
- Department of Plastic Surgery and Reconstructive Microsurgery, "Sf. Spiridon" Emergency County Hospital, 700111 Iasi, Romania
| | - Sorinel Lunca
- Department Plastic Surgery and Reconstructive, Faculty of Medicine,"Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- Second Surgical Clinic, Regional Institute of Oncology, 700483 Iasi, Romania
| | - Doinita Olinici
- Department Plastic Surgery and Reconstructive, Faculty of Medicine,"Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- Department of Dermatology, "Sf. Spiridon" Emergency County Hospital, 700111 Iasi, Romania
| | - Vladimir Poroch
- Department Plastic Surgery and Reconstructive, Faculty of Medicine,"Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- Department of Palliative Care, Regional Institute of Oncology, 700483 Iasi, Romania
| | - Claudiu Carp
- Department Plastic Surgery and Reconstructive, Faculty of Medicine,"Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- Department of Orthopaedics and Traumatology, "Sf. Spiridon" Emergency County Hospital, 700111 Iasi, Romania
| | - Bogdan Veliceasa
- Department Plastic Surgery and Reconstructive, Faculty of Medicine,"Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania
- Department of Orthopaedics and Traumatology, "Sf. Spiridon" Emergency County Hospital, 700111 Iasi, Romania
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Chang MY, Kie JH, Chae J, Lee JK. Partial excision of schwannomatosis with fascicular invasion occurring in the ulnar nerve above the elbow: A 1-year follow-up study. ANN CHIR PLAST ESTH 2023:S0294-1260(23)00004-3. [PMID: 36801116 DOI: 10.1016/j.anplas.2023.01.004] [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: 12/04/2022] [Revised: 01/01/2023] [Accepted: 01/19/2023] [Indexed: 02/18/2023]
Abstract
Although not as common as solitary lesions, multiple schwannomas do occur, even in single nerve lesions. We report a rare case of a 47-year-old female patient who presented with multiple schwannomas with inter-fascicular invasion in the ulnar nerve above the cubital tunnel. Preoperative MRI revealed a 10-cm multilobulated tubular mass along the ulnar nerve above the elbow joint. During excision under 4.5° loupe magnification, we separated three ovoid yellow-colored neurogenic tumors of different sizes, but there were still remaining lesions as it was difficult to completely separate lesions from the ulnar nerve due to the risk of iatrogenic nerve ulnar nerve injury. The operative wound was closed. Postoperative biopsy confirmed the diagnosis of the three schwannomas. During the follow-up, the patient recovered without neurological symptom or limitations in range of motion, and there were no neurological abnormalities. At 1year after surgery, small lesions remained in the most proximal part. However, the patient had no clinical symptoms and was satisfied with the surgical results. Although a long-term follow-up is necessary for this patient, we were able to obtain good clinical and radiological results.
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Affiliation(s)
- M-Y Chang
- Department of Radiology, National Health Insurance Service Ilsan Hospital, Ilsandong-gu, Goyang-si, Gyeonggi-do, South Korea
| | - J H Kie
- Department of Pathology, National Health Insurance Service Ilsan Hospital, Ilsandong-gu, Goyang-si, Gyeonggi-do, South Korea
| | - J Chae
- Department of Orthopaedic Surgery, Yonsei university college of medicine, Seoul, Republic of Korea; Department of Orthopaedic Surgery, National Health Insurance Service Ilsan Hospital, Ilsandong-gu, Goyang-si, Gyeonggi-do, South Korea
| | - J-K Lee
- Department of Orthopaedic Surgery, National Health Insurance Service Ilsan Hospital, Ilsandong-gu, Goyang-si, Gyeonggi-do, South Korea.
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Karna MB, Kinanta PBS, Aprilya D. Recurrent schwannoma of digital nerve on both hands: A very rare case report. Int J Surg Case Rep 2023; 103:107915. [PMID: 36764077 PMCID: PMC9929521 DOI: 10.1016/j.ijscr.2023.107915] [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: 12/20/2022] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Schwannoma is the most common benign tumor of peripheral nerves and usually occurs solitary with a very low risk of recurrence. Schwannoma of the hand, particularly involving the digital nerve, is sporadic and most commonly leads to a misdiagnosis due to its rarity. Histopathology remains the gold standard diagnostic, however, with a thorough physical examination and radiologic imaging, this benign tumor can be managed well with the preservation of nerve function. CASE PRESENTATION We reported a rare case of digital nerve schwannomas on the bilateral hands of a 52-year-old white male with one recurrent mass on the right hand despite a previously complete debulking of the mass. CLINICAL DISCUSSION Intraoperatively, we removed lobulated whitish-yellow masses and left the nerve origin of the tumor intact (common palmar digital nerve and ulnar-side digital nerve). The histopathology supported the diagnosis of schwannoma. At the one-year follow-up, there is no recurrence and the patient remains asymptomatic. CONCLUSION Determining differential diagnosis by both clinical and preoperative imaging is essential, especially in the case of recurrence and multiple tumorous lesions. Malignancy or malignant degeneration should still be kept in mind. Complete removal is needed to prevent recurrence followed by a long-term follow-up.
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Affiliation(s)
- Made Bramantya Karna
- Department of Orthopaedic and Traumatology, Prof Ngoerah General Hospital/Faculty of Medicine, University of Udayana, Denpasar, Indonesia.
| | - Putu Bihan Surya Kinanta
- Department of Orthopaedic and Traumatology, Prof Ngoerah General Hospital/Faculty of Medicine, University of Udayana, Denpasar, Indonesia
| | - Dina Aprilya
- Department of Orthopaedic and Traumatology, Fatmawati General Hospital, Jakarta, Indonesia
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Li X, Fu J, Zhou H, Dong Y, Alhaskawi A, Wang Z, Lai J, Yao C, Ezzi SHA, Kota VG, Abdulla MHAH, Guan M, Lou X, Lu H. The effects of melatonin in the treatment of acute brachial plexus compression injury in rats. Front Neurol 2023; 14:1111101. [PMID: 36937512 PMCID: PMC10015383 DOI: 10.3389/fneur.2023.1111101] [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: 11/29/2022] [Accepted: 01/30/2023] [Indexed: 03/05/2023] Open
Abstract
Introduction Brachial plexus injury (BPI) is one of the most destructive peripheral nerve injuries and there is still a lack of effective treatment. Methods This study was conducted to evaluate the effects of melatonin in the treatment of acute brachial plexus compression injury in rats using histopathological, histomorphometric, immunohistochemical and electrophysiological methods. Forty-eight adult male Sprague Dawley rats were randomly allocated into three groups: sham, melatonin and vehicle groups. The brachial plexus compression injury model was performed by a vascular clamp. Melatonin group received intraperitoneal injection of melatonin at doses of 10 mg/kg for 21 days after crush injury. The conduction velocity and amplitude of compound muscle action potential (CAMP) in the regenerated nerve, and nerve histomorphometry, as well as levels of myelin protein zero (P0) protein of the crush region were assessed. Results Compared with the vehicle group, the melatonin group which reported significant increased CMAP conduction velocity and amplitude also showed thicker myelin sheath and lower levels of P0 protein. Discussion Our results suggest that melatonin effectively promotes nerve regeneration and improves the function of damaged nerves. Melatonin treatment is a promising strategy for the treatment of acute brachial plexus compression injury.
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Affiliation(s)
- Xigong Li
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jing Fu
- Department of Stomatology, Affiliated Hangzhou Xixi Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Haiying Zhou
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yanzhao Dong
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Ahmad Alhaskawi
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Zewei Wang
- Department of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jingtian Lai
- Department of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Chengjun Yao
- Department of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Sohaib Hasan Abdullah Ezzi
- Department of Orthopaedics of the 3rd Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Vishnu Goutham Kota
- Department of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | | | - Ming Guan
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xianfeng Lou
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Hui Lu
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Alibaba-Zhejiang University Joint Research Center of Future Digital Healthcare, Zhejiang University, Hangzhou, Zhejiang, China
- *Correspondence: Hui Lu
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Schwannoma of the Upper Limb: Retrospective Study of a Rare Tumor with Uncommon Locations. Diagnostics (Basel) 2022; 12:diagnostics12061319. [PMID: 35741129 PMCID: PMC9222006 DOI: 10.3390/diagnostics12061319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/21/2022] [Accepted: 05/22/2022] [Indexed: 12/04/2022] Open
Abstract
Background: Although schwannoma (neurilemmoma) is the most common tumor of the peripheral nerve, its low incidence, slow growth and vague symptoms often lead to misdiagnosis or delayed diagnosis. The aim of the study is to present a series with a large number of schwannomas in the upper limbs, some with very rare occurrence. Methods: We report 17 patients with a mean age of 58.5 years and upper limb schwannomas, located on the median, ulnar and radial nerves, but also on the posterior interosseous nerve and digital collateral nerves. The diagnosis was made by clinical examination and imaging tests, and in no case was a preoperative biopsy performed. Surgical treatment was established based on symptoms or aesthetic concerns. In all cases, a diagnosis of schwannoma was confirmed through histopathological and immunohistochemical examinations. Results: For all patients, a complete tumor enucleation was performed under a surgical microscope. No recurrence was recorded at 2 years after surgery. Patient satisfaction was good, with complete socio-professional integration in all cases. Conclusions: Although more frequently present on the main nerve trunks, schwannoma may be present on the collateral digital nerves in rare cases. A correct technique with complete tumor excision offers excellent postoperative outcomes and avoids recurrences.
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Terzić Z, Radonjić D, Paunović M, Ljaljević A, Bojić M. Large solitary encapsulated neurofibroma of upper arm: A case report. SANAMED 2022. [DOI: 10.5937/sanamed17-36810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction: Neurofibromas are benign tumors of neuronal origin, occurring most commonly in young adults, with no gender predilection. The connection of neurofibroma with disorders on a general level as von Recklinghausen's disease makes its diagnosis critical. Case report: A 32-old female patient was administered to the Clinic of Plastic surgery, Clinical Center of Montenegro in Podgorica, with a 10-year history of painless, subcutaneous tumor of the right upper arm that grew in size over the last ten years. The patient reported progressive pain and tingling in her right forearm and right hand for the last 12 months. An MRI showed a non-homogenous tumor of the middle third portion of the triceps muscle, in close contact with the humerus but without infiltrating it. The tumor was removed, with a definitive histopathological result of a solitary benign neurofibroma. Conclusions: This example of successful treatment of solitary neurofibroma may serve to increase the awareness of surgeons and radiologists in small countries regarding benign peripheral nerve sheath tumors. The patient is under observation for two years with no signs of relapse and no other features indicative of neurofibromatosis type 1.
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Kühn JP, Wagner M, Bozzato A, Linxweiler M. Multiple schwannomas of the facial nerve mimicking cervical lymphoma: a case report. J Med Case Rep 2021; 15:436. [PMID: 34412684 PMCID: PMC8377860 DOI: 10.1186/s13256-021-03006-x] [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: 12/22/2020] [Accepted: 07/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In this report, we describe the first case in literature of a patient with multiple schwannomas of the marginal mandibular branch of the facial nerve. CASE PRESENTATION A Caucasian patient presented with a sudden onset of left lower facial nerve palsy House-Brackmann score III for 1 month. Computed tomography imaging was performed to exclude a cerebral event and revealed multiple tumors within the left parotid gland. Duplex ultrasound and magnetic resonance imaging scans delineated multiple, hypoechoic tumors, round in shape and well defined without a hilar structure along the left mandible. For histological verification, a left-side partial parotidectomy and extirpation of an intraparotideal node was performed with use of a nerve-integrity monitor. Histomorphological analysis of the resected tissue revealed a benign schwannoma. Facial nerve function remained unchanged since the operation. The size of the nonresected tumors is currently monitored regularly by ultrasonography. Fibromatosis has been excluded. CONCLUSIONS If multiple tumors occur in the parotid gland and the angle of the jaw, schwannomas need to be considered as a differential diagnosis. To plan the right diagnostic surgical intervention and prevent nerve damage, a thorough ultrasound examination is essential in preoperative diagnostic work-up for any suspicious lesion of the parotid gland and jaw region.
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Affiliation(s)
- Jan Philipp Kühn
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Kirrbergerstr. 100, building 6, 66421, Homburg, Germany.
| | - Mathias Wagner
- Department of General and Surgical Pathology, Saarland University Medical Center, 66421, Homburg, Germany
| | - Alessandro Bozzato
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Kirrbergerstr. 100, building 6, 66421, Homburg, Germany
| | - Maximilian Linxweiler
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Medical Center, Kirrbergerstr. 100, building 6, 66421, Homburg, Germany
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Abstract
Objective This study was performed to analyze the clinical, radiographic, and pathological features of hand angioleiomyoma causing nerve compression and assess the outcomes of surgical excision. Methods This case series included three men and one woman (mean age, 53.3 years; range, 49–56 years). The patients’ chief complaint was numbness of the fingers. The patients’ medical histories were reviewed, and the diagnosis of angioleiomyoma with nerve compression was confirmed by means of imaging examination and pathological analysis. Results Three tumors occurred in the palm and one in the finger, and the average maximum tumor diameter was 1.8 cm (range, 0.8–2.6 cm). Preoperative magnetic resonance imaging demonstrated well-defined masses with isointense signals on T1 sequences, hyperintense signals on T2 sequences, and strong heterogeneous enhancement after injection of contrast material. All tumors were located near nerves, leading to nerve compression. The diagnosis of angioleiomyoma was confirmed by postoperative pathology. Finger sensation recovered and no recurrence was found during an average follow-up of 37 months (range, 25–59 months). Conclusions Angioleiomyoma should be considered among the differential diagnoses of hand tumors and timely resection should be performed, particularly if the mass is causing numbness and/or pain with positive Tinel’s sign and/or tenderness.
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Affiliation(s)
- Qianjun Jin
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province 310003, P.R. China
| | - Hui Lu
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province 310003, P.R. China
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Abstract
Neurofibroma is a rare nerve sheath tumor of neuroectodermal origin, especially the huge and isolated neurofibroma located in the inguinal region. To our knowledge, no such case has previously been reported. We report a case of 34-year-old male patient with a 4-year history of progressive enlargement of the medial root mass in his left thigh with sitting and standing disorders along with pain. The tumor was completely removed by operation, and pathological diagnosis showed neurofibroma. There was no obvious neurologic defect after surgery, and no recurrence tendency was found in the follow-up of 2 years. For a large solitary mass with slow growth and no malignant clinical manifestations for a long time, clinicians cannot rule out the hypothetical diagnosis of neurofibroma, even though its growth site is very rare, such as this case of a huge tumor located in the groin. For neurogenic tumors, early operation should be performed, and the prognosis of patients after tumor resection is excellent.
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Affiliation(s)
- Haiying Zhou
- Department of Orthopedics, The First Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang Province, P. R. China
| | - Hui Lu
- Department of Orthopedics, The First Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang Province, P. R. China
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Zhou HY, Jiang S, Ma FX, Lu H. Peripheral nerve tumors of the hand: Clinical features, diagnosis, and treatment. World J Clin Cases 2020; 8:5086-5098. [PMID: 33269245 PMCID: PMC7674743 DOI: 10.12998/wjcc.v8.i21.5086] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/15/2020] [Accepted: 09/25/2020] [Indexed: 02/05/2023] Open
Abstract
The majority of the tumors arising from the peripheral nerves of the hand are relatively benign. However, a tumor diagnosed as malignant peripheral nerve sheath tumor (MPNST) has destructive consequences. Clinical signs and symptoms are usually caused by direct and indirect effects of the tumor, such as nerve invasion or compression and infiltration of surrounding tissues. Definitive diagnosis is made by tumor biopsy. Complete surgical removal with maximum reservation of residual neurologic function is the most appropriate intervention for most symptomatic benign peripheral nerve tumors (PNTs) of the hand; however, MPNSTs require surgical resection with a sufficiently wide margin or even amputation to improve prognosis. In this article, we review the clinical presentation and radiographic features, summarize the evidence for an accurate diagnosis, and discuss the available treatment options for PNTs of the hand.
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Affiliation(s)
- Hai-Ying Zhou
- Department of Orthopedics, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Shuai Jiang
- Department of Orthopedics, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Fei-Xia Ma
- Department of Breast Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang Province, China
| | - Hui Lu
- Department of Orthopedics, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
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Hu X, Liu Z, Zhou H, Fang J, Lu H. Deep HT: A deep neural network for diagnose on MR images of tumors of the hand. PLoS One 2020; 15:e0237606. [PMID: 32797089 PMCID: PMC7428075 DOI: 10.1371/journal.pone.0237606] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/29/2020] [Indexed: 12/13/2022] Open
Abstract
Background There are many types of hand tumors, and it is often difficult for imaging diagnosticians to make a correct diagnosis, which can easily lead to misdiagnosis and delay in treatment. Thus in this paper, we propose a deep neural network for diagnose on MR Images of tumors of the hand in order to better define preoperative diagnosis and standardize surgical treatment. Methods We collected MRI figures of 221 patients with hand tumors from one medical center from 2016 to 2019, invited medical experts to annotate the images to form the annotation data set. Then the original image is preprocessed to get the image data set. The data set is randomly divided into ten parts, nine for training and one for test. Next, the data set is input into the neural network system for testing. Finally, average the results of ten experiments as an estimate of the accuracy of the algorithm. Results This research uses 221 images as dataset and the system shows an average confidence level of 71.6% in segmentation of hand tumors. The segmented tumor regions are validated through ground truth analysis and manual analysis by a radiologist. Conclusions With the recent advances in convolutional neural networks, vast improvements have been made for image segmentation, mainly based on the skip-connection-linked encoder decoder deep architectures. Therefore, in this paper, we propose an automatic segmentation method based on DeepLab v3+ and achieved a good diagnostic accuracy rate.
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Affiliation(s)
- Xianliang Hu
- School of Mathematical Sciences, Zhejiang Univeristy, Hangzhou, Zhejiang Province, P. R. China
| | - Zongyu Liu
- School of Mathematical Sciences, Zhejiang Univeristy, Hangzhou, Zhejiang Province, P. R. China
| | - Haiying Zhou
- Department of Orthopedics, The First Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang Province, P. R. China
| | - Jianyong Fang
- Suzhou Warrior Pioneer Software Co., Ltd., Suzhou, Jiangsu Province, P. R. China
| | - Hui Lu
- Department of Orthopedics, The First Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang Province, P. R. China
- * E-mail:
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