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Hu Y, Li A, Wu MJ, Ma Q, Mao CL, Peng XJ, Ye XH, Liu BJ, Xu HX. Added value of contrast-enhanced ultrasound to conventional ultrasound for characterization of indeterminate soft-tissue tumors. Br J Radiol 2023; 96:20220404. [PMID: 36400064 PMCID: PMC10997008 DOI: 10.1259/bjr.20220404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/05/2022] [Accepted: 11/10/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To assess the added value of contrast-enhanced ultrasound (CEUS) to conventional ultrasound in differentiating benign soft-tissue tumors from malignant ones. METHODS 197 soft-tissue tumors underwent ultrasound examination with confirmed histopathology were retrospectively evaluated. The radiologists classified all the tumors as benign, malignant, or indeterminate according to ultrasound features. The indeterminate tumors underwent CEUS were reviewed afterwards for malignancy identification by using individual and combined CEUS features. RESULTS Ultrasound analysis classified 62 soft-tissue tumors as benign, 111 tumors as indeterminate and 24 tumors as malignant. There 104 indeterminate tumors were subject to CEUS. Three CEUS features including enlargement of enhancement area, infiltrative enhancement boundary, and intratumoral arrival time difference were significantly associated with the tumor nature in both univariable and multivariable analysis for the indeterminate tumors (all p < 0.05). When at least one out of the three discriminant CEUS features were present, the best sensitivity of 100% for malignancy identification was obtained with the specificity of 66.7% and the AUC of 0.833. When at least two of the three discriminant CEUS features were present, the best area under the receiver operating characteristic curve (AUC) of 0.924 for malignancy identification was obtained. The combination of at least two discriminant CEUS features showed much better diagnostic performance than the optimal combination of ultrasound features in terms of AUC (0.924 vs 0.608, p < 0.0001), sensitivity (94.0% vs 42.0%, p < 0.0001), and specificity (90.7% vs 79.6%, p = 0.210) for the indeterminate tumors. CONCLUSION The combination CEUS features of enlargement of enhancement area, infiltrative enhancement boundary and intratumoral arrival time difference are valuable to improve the discriminating performance for indeterminate soft-tissue tumors on conventional ultrasound. ADVANCES IN KNOWLEDGE The combination of peritumoral and arrival-time CEUS features can improve the discriminating performance for indeterminate soft-tissue tumors on conventional ultrasound.
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Affiliation(s)
- Yu Hu
- Department of Medical Ultrasound, The First Affiliated
Hospital of Nanjing Medical University, Nanjing,
China
| | - Ao Li
- Department of Medical Ultrasound, The First Affiliated
Hospital of Nanjing Medical University, Nanjing,
China
| | - Meng-Jie Wu
- Department of Medical Ultrasound, The First Affiliated
Hospital of Nanjing Medical University, Nanjing,
China
| | - Qian Ma
- Department of Medical Ultrasound, The First Affiliated
Hospital of Nanjing Medical University, Nanjing,
China
| | - Cui-Lian Mao
- Department of Medical Ultrasound, The First Affiliated
Hospital of Nanjing Medical University, Nanjing,
China
| | - Xiao-Jing Peng
- Department of Medical Ultrasound, The First Affiliated
Hospital of Nanjing Medical University, Nanjing,
China
| | - Xin-Hua Ye
- Department of Medical Ultrasound, The First Affiliated
Hospital of Nanjing Medical University, Nanjing,
China
| | - Bo-Ji Liu
- Department of Medical Ultrasound, The First Affiliated
Hospital of Nanjing Medical University, Nanjing,
China
| | - Hui-Xiong Xu
- Department of Medical Ultrasound, The First Affiliated
Hospital of Nanjing Medical University, Nanjing,
China
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García Cañamaque L, Field CA, Furtado FS, Plaza DE Las Heras I, Husseini JS, Balza R, Jarraya M, Catalano OA, Mitjavila Casanovas M. Contribution of positron emission tomography/magnetic resonance imaging in musculoskeletal malignancies. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF... 2022; 66:3-14. [PMID: 34881853 DOI: 10.23736/s1824-4785.21.03432-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Positron emission tomography/computed tomography (PET/CT) is a promising hybrid imaging technique for evaluating musculoskeletal malignancies. Both technologies, independently are useful for evaluating this type of tumors. PET/MR has great potential combining metabolic and functional imaging PET with soft tissue contrast and multiparametric sequences of MR. In this paper we review the existing literature and discuss the different protocols, new available radiotracers to conclude with the scarce evidence available the most useful/probable indications of the PET MR for the for musculoskeletal malignancies.
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Affiliation(s)
- Lina García Cañamaque
- Department of Nuclear Medicine, Madrid Sanchinarro University Hospital, Madrid, Spain -
| | - Caroline A Field
- Department of Nuclear Medicine, Madrid Sanchinarro University Hospital, Madrid, Spain
| | - Felipe S Furtado
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Jad S Husseini
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Rene Balza
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Mohamed Jarraya
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Onofrio A Catalano
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
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Husseini JS, Balza R, Evangelista L, Cañamaque LG, Catalano OA. PET/MR for evaluation of musculoskeletal malignancies. Clin Transl Imaging 2021. [DOI: 10.1007/s40336-021-00470-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kogan F, Broski SM, Yoon D, Gold GE. Applications of PET-MRI in musculoskeletal disease. J Magn Reson Imaging 2019; 48:27-47. [PMID: 29969193 DOI: 10.1002/jmri.26183] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 04/19/2018] [Indexed: 12/26/2022] Open
Abstract
New integrated PET-MRI systems potentially provide a complete imaging modality for diagnosis and evaluation of musculoskeletal disease. MRI is able to provide excellent high-resolution morphologic information with multiple contrast mechanisms that has made it the imaging modality of choice in evaluation of many musculoskeletal disorders. PET offers incomparable abilities to provide quantitative information about molecular and physiologic changes that often precede structural and biochemical changes. In combination, hybrid PET-MRI can enhance imaging of musculoskeletal disorders through early detection of disease as well as improved diagnostic sensitivity and specificity. The purpose of this article is to review emerging applications of PET-MRI in musculoskeletal disease. Both clinical applications of malignant musculoskeletal disease as well as new opportunities to incorporate the molecular capabilities of nuclear imaging into studies of nononcologic musculoskeletal disease are discussed. Lastly, we discuss some of the technical considerations and challenges of PET-MRI as they specifically relate to musculoskeletal disease. LEVEL OF EVIDENCE 5 TECHNICAL EFFICACY: Stage 3 J. Magn. Reson. Imaging 2018;48:27-47.
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Affiliation(s)
- Feliks Kogan
- Department of Radiology, Stanford University, Stanford, California, USA
| | | | - Daehyun Yoon
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Garry E Gold
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Bioengineering, Stanford University, Stanford, California, USA.,Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA
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Bluemel C, Fendler WP, Lopci E, Rubello D, Herrmann K. Positron emission tomography in pediatric and adult sarcoma. Clin Transl Imaging 2015. [DOI: 10.1007/s40336-015-0109-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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6
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Teixeira SR, Martinez-Rios C, Hu L, Bangert BA. Clinical applications of pediatric positron emission tomography-magnetic resonance imaging. Semin Roentgenol 2014; 49:353-66. [PMID: 25498232 DOI: 10.1053/j.ro.2014.10.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Sara R Teixeira
- Department of Radiology, University Hospitals Case Medical Center, Cleveland, OH; Division of Radiology, Ribeirao Preto Medical School, University of Sao Paulo, São Paulo, Brazil
| | - Claudia Martinez-Rios
- Department of Radiology, University Hospitals Case Medical Center, Cleveland, OH; Case Western Reserve University, Cleveland, OH
| | | | - Barbara A Bangert
- Department of Radiology, University Hospitals Case Medical Center, Cleveland, OH; Case Western Reserve University, Cleveland, OH.
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Nordstrom R, Cherry S, Azhdarinia A, Sevick-Muraca E, VanBrocklin H. Photons across medicine: relating optical and nuclear imaging. BIOMEDICAL OPTICS EXPRESS 2013; 4:2751-2762. [PMID: 24409377 PMCID: PMC3862159 DOI: 10.1364/boe.4.002751] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 10/22/2013] [Accepted: 10/22/2013] [Indexed: 06/03/2023]
Abstract
The Optics in the Life Sciences conference sponsored by the Optical Society of America was held in Waikoloa Beach, HI on April 14 - 18, 2013. Papers were presented in the areas of Bio-Optics: Design & Application, Novel Techniques in Microscopy, Optical Molecular Probes, Imaging & Drug Delivery, and Optical Trapping Applications. A focal point of the meeting was a special symposium entitled "Photons Across Medicine", organized by Adam Wax, Duke University, highlighting activities of joint interest between the Optical Society of America (OSA) and the Society for Nuclear Medicine and Molecular Imaging (SNMMI). This paper is a synopsis of the presentations made at this joint symposium. Central to the special symposium presentations was the fact that the optical and nuclear imaging communities share common interests and challenges. These are highlighted in this article. Also discussed was the fact that the nuclear technologies in imaging have found their way into general clinical utility, a feat that has yet to be achieved by optical methods. Because of the common ground shared by the two technologies, coordination between the two societies should be planned.
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Affiliation(s)
| | - Simon Cherry
- Department of Biomedical Engineering, University of California at Davis, Davis, CA, 95616 USA
| | - Ali Azhdarinia
- University of Texas Health and Science Center, Houston, TX, 77030 USA
| | - Eva Sevick-Muraca
- University of Texas Health and Science Center, Houston, TX, 77030 USA
| | - Henry VanBrocklin
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, CA, 94143 USA
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Buchbender C, Heusner TA, Lauenstein TC, Bockisch A, Antoch G. Oncologic PET/MRI, Part 2: Bone Tumors, Soft-Tissue Tumors, Melanoma, and Lymphoma. J Nucl Med 2012; 53:1244-52. [DOI: 10.2967/jnumed.112.109306] [Citation(s) in RCA: 127] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Reliability of Margin Assessment after Surgery for Extremity Soft Tissue Sarcoma: The SSG Experience. Sarcoma 2012; 2012:290698. [PMID: 22761544 PMCID: PMC3385668 DOI: 10.1155/2012/290698] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Revised: 04/23/2012] [Accepted: 04/28/2012] [Indexed: 11/24/2022] Open
Abstract
Surgery remains the mainstay of soft tissue sarcoma (STS) treatment and has been the primary treatment for the majority of patients in Scandinavia during the last 30 years although the use of adjuvant radiotherapy has increased. Patient and treatment characteristics have been recorded in the Scandinavian Sarcoma Group (SSG) Register since 1987. When the effect of new radiotherapy guidelines from 1998 was evaluated, the reliability of surgical margin assessments among different Scandinavian institutions was investigated.
Margins were reevaluated by a panel of sarcoma surgeons, studying pathology and surgical reports from 117 patients, randomly selected among 470 recorded patients treated between 1998–2003. In 80% of cases, the panel agreed with the original classification. Disagreement was most frequent when addressing the distinction between marginal and wide margins. Considered the element of judgment inherent in all margin assessment, we find this reliability acceptable for using the Register for studies of local control of STS.
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Müller J, Schrader M, Schrader A, Höpfner M, Zengerling F. Stellenwert der Positronenemissionstomographie bei urologischen Tumoren. Urologe A 2012; 51:331-40. [DOI: 10.1007/s00120-012-2834-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
Rhabdomyosarcoma (RMS) is a malignant childhood tumor of mesenchymal origin that currently has a greater than 70% overall 5-year survival. Multimodality treatment is determined by risk stratification according to pretreatment stage, postoperative group, histology, and site of the primary tumor. Pretreatment staging is dependent on primary tumor site, size, regional lymph node status, and presence of metastases. Unique to RMS is the concept of postoperative clinical grouping that assesses the completeness of disease resection and takes into account lymph node evaluation. At all tumor sites, the clinical grouping, and therefore completeness of resection, is an independent predictor of outcome. Overall, the prognosis for RMS is dependent on primary tumor site, patient age, completeness of resection, extent of disease, including the presence and number of metastatic sites and histology and biology of the tumor cells. Therefore, the surgeon plays a vital role in RMS by contributing to risk stratification for treatment, local control of the primary tumor, and outcome. The current state-of-the-art treatment is determined by treatment protocols developed by the Soft Tissue Sarcoma Committee of the children's Oncology Group.
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Affiliation(s)
- Roshni Dasgupta
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
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