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Zhu Y, Li Y, Tang Y, Zhang J, Jia S, Jiang Z, Luo X, Ishikawa M, Kato T. Comparing qSMI and qCEUS for assessing vascularization in uterine cervical cancer: operable versus non-operable group. Front Oncol 2024; 14:1380725. [PMID: 39188687 PMCID: PMC11345174 DOI: 10.3389/fonc.2024.1380725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 07/26/2024] [Indexed: 08/28/2024] Open
Abstract
Objective The present study aimed to compare the effectiveness and reliability of quantified superb microvascular imaging (qSMI) and quantified contrast-enhanced ultrasonography (qCEUS) in assessing vascularization in both operable and non-operable uterine cervical cancer. Methods A case-control study included 64 patients with pathology-proven and untreated cervical cancer, who underwent transvaginal ultrasonography combined with qSMI and qCEUS between January 2022 and June 2023. SMI results were quantified as the vascular index (VI), which were compared to 12 quantitative parameters of CEUS calculated with time-intensity curves (TIC). Results According to FIGO staging and different treatment regimens, 64 patients with cervical cancer were divided into operable group (IA ~ IIA, n = 19) and non-operable group (IIB ~ IV, n = 45). In comparison to the operable group, the non-operable group showed significantly higher values in VI, peak intensity (PI), area under the curve (AUC), wash-in area (iAUC), wash-out area (oAUC), wash-in rate (WiR), mean intensity (Mean Int), and standard deviation (STD) (all P < 0.05). VI demonstrated strong correlations with CEUS parameters, notably PI (r = 0.854, P < 0.001) and AUC (r = 0.635, P < 0.001). Furthermore, VI showed a better predictive performance for treatment-group assignment than qCEUS parameters, with an 80.7% accuracy, 64.4% sensitivity and 89.5% specificity. Conclusion Both qSMI and qCEUS exhibit significant and comparable utility in detecting microvascular hyperplasia and predicting treatment-group assignments in cervical cancer. Furthermore, qSMI may offer added convenience in implementation.
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Affiliation(s)
- Yi Zhu
- Department of Ultrasound, Sichuan Cancer Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Yanjie Li
- Department of Ultrasound, Sichuan Cancer Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
- Graduate School, Chengdu Medical College, Chengdu, China
| | - Yixin Tang
- Department of Ultrasound, Suining Central Hospital, Suining, China
| | - Jie Zhang
- Department of Gynecological Oncology, Sichuan Cancer Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Shijun Jia
- Department of Pathology, Sichuan Cancer Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Zhuolin Jiang
- Department of Ultrasound, Sichuan Cancer Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
- Graduate School, Chengdu Medical College, Chengdu, China
| | - Xinyi Luo
- Department of Ultrasound, Sichuan Cancer Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
- Graduate School, Chengdu Medical College, Chengdu, China
| | - Mitsuya Ishikawa
- Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan
| | - Tomoyasu Kato
- Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan
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Ma Y, Zhao X, Chen X. Contrast-enhanced ultrasound combined with elastic imaging for predicting the efficacy of concurrent chemoradiotherapy in cervical cancer: a feasibility study. Front Oncol 2024; 14:1301900. [PMID: 38634056 PMCID: PMC11021703 DOI: 10.3389/fonc.2024.1301900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
Objective Contrast-enhanced ultrasound (CEUS) and elastography are of great value in the diagnosis of cervical cancer (CC). However, there is limited research on the role of contrast-enhanced ultrasound combined with elastography in predicting concurrent chemoradiotherapy and disease progression for cervical cancer. The purpose of this study was to evaluate the feasibility of contrast-enhanced ultrasound combined with elastography and tumor prognosis. Methods MRI was performed on 98 patients with cervical cancer before and after treatment. Before, during, and 1 week after the treatment, contrast-enhanced ultrasound and elastography were conducted, and the alterations of ultrasound-related parameters at each time point of the treatment were compared. The correlation between contrast-enhanced ultrasound combined with elastic imaging and oncological outcome was assessed. Results There was no notable difference in overall clinical data between the complete remission (CR) group and the partial remission (PR) group (P>0.05). Before treatment, there were no statistically significant differences in elasticity score, time to peak (TTP), and peak intensity (PI) between the CR group and the PR group. However, there were no statistical differences in elastic strain ratio (SR) and area under the curve (AUC) before and after treatment between the CR group and the PR group, and there were also no statistical differences in the elastic strain ratio (SR) and area under the curve (AUC) of contrast-enhanced ultrasound parameters between the CR group and the PR group before and during treatment. There was a statistically significant difference after treatment (P<0.05).At present, the follow-up of patients is about 1 year, 7 patients were excluded due to loss to follow-up, and 91 patients were included in the follow-up study. Through the review of the cases and combined with MRI (version RECIST1.1) and serology and other related examinations, if the patient has a new lesion or the lesion is larger than before, the tumor marker Squamous cell carcinoma antigen (SCC-Ag) is significantly increased twice in a row, and the patient is divided into progressive disease (PD). Those who did not see significant changes were divided into stable disease (SD) group. The relationship between clinical characteristics, ultrasound parameters and disease progression in 91 patients was compared. There was no significant difference in age and clinical stage between the two groups (P>0.05), but there was a significant difference in the elevation of tumor marker squamous cell carcinoma antigen (SCC-Ag) between the two groups (P<0.05).With the growth of tumors, TTP decreased, elasticity score and PI increased, and the difference was statistically significant (P<0.05). The AUC of SCC-Ag was 0.655, the sensitivity was 85.3%, and the specificity was 45.6%.The AUC, sensitivity and specificity of ultrasound parameters combined with SCC-Ag predicted disease progression was 0.959, 91.2% and 94.8%. Conclusions Using contrast-enhanced ultrasound and elastography to predict the efficacy and disease progression of concurrent chemoradiotherapy is feasible. In addition, the combination of SCC-Ag with contrast-enhanced ultrasound and elastography can further enhance the efficiency of predicting disease progression.
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Affiliation(s)
- Yujuan Ma
- Tianshui Maternity and Child Healthcare Hospital, Tianshui, China
| | - Xuebo Zhao
- Graduate School of Qinghai University, Xining, China
- Department of Ultrasound Medicine, Qinghai Provincial People’s Hospital, Xining, China
| | - Xianxia Chen
- Department of Ultrasound Medicine, Qinghai Provincial People’s Hospital, Xining, China
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Yang L, Duan D, Xiong Y, Liu T, Zhao L, Lai F, Gu D, Zhou L. Preoperative multimodal ultrasonic imaging in a case of Peutz-Jeghers syndrome complicated by atypical lobular endocervical glandular hyperplasia: a case report and literature review. Hered Cancer Clin Pract 2024; 22:3. [PMID: 38419118 PMCID: PMC10900695 DOI: 10.1186/s13053-024-00275-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 02/13/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Peutz-Jeghers syndrome (PJS), an autosomal dominant multiple cancerous disorder, is clinically characterized by mucocutaneous macules and multiple gastrointestinal hamartomatous polyps. Gastric-type endocervical adenocarcinoma (G-EAC), a special subtype of cervical adenocarcinoma with non-specific symptoms and signs, is known to occur in approximately 11% of female patients with PJS. CASE PRESENTATION Here, we report a case of PJS in a 24-year-old female with multiple mucocutaneous black macules who complained of vaginal discharge and menorrhagia. Moreover, we first described the multimodal ultrasonographical manifestations of PJS-correlated G-EAC. The three-dimensional reconstructed view of G-EAC on 3D realisticVue exhibited a distinctive "cosmos pattern" resembling features on magnetic resonance imaging, and the contrast-enhanced ultrasound displayed a "quick-up and slow-down" pattern of the solid components inside the mixed cervical echoes. We reported the multimodal ultrasonographical characteristics of a case of PJS-related G-EAC, as well as reviewed PJS-related literature and medical imaging features and clinical characteristics of G-EAC to provide insight into the feasibility and potential of utilizing multimodal ultrasonography for the diagnosis of G-EAC. CONCLUSIONS Multimodal ultrasound can visualize morphological features, solid components inside, and blood supplies of the G-EAC lesion and distinguish the G-EAC lesion from normal adjacent tissues. This facilitates preoperative diagnosis and staging of PJS-related G-EAC, thereby aiding subsequent health and reproductive management for patients with PJS.
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Affiliation(s)
- Liwen Yang
- Department of Ultrasonography, School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology, No. 1617, Riyue Avenue, Chengdu, Sichuan, 610091, China
| | - Duan Duan
- Department of Gynecology, School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology, Chengdu, China
| | - Ying Xiong
- Department of Gynecology, School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology, Chengdu, China
| | - Tianjiao Liu
- Department of Gynecology, School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology, Chengdu, China
| | - Lijun Zhao
- Department of Ultrasonography, School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology, No. 1617, Riyue Avenue, Chengdu, Sichuan, 610091, China
| | - Fan Lai
- Department of Obstetrics, School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology, Chengdu, China
| | - Dingxian Gu
- Department of Gynecology, School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology, Chengdu, China
| | - Liuying Zhou
- Department of Ultrasonography, School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology, No. 1617, Riyue Avenue, Chengdu, Sichuan, 610091, China.
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Olinger K, Liu X, Khoshpouri P, Khoshpouri P, Scoutt LM, Khurana A, Chaubal RN, Moshiri M. Added Value of Contrast-enhanced US for Evaluation of Female Pelvic Disease. Radiographics 2024; 44:e230092. [PMID: 38175802 DOI: 10.1148/rg.230092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
Since the first application of contrast-enhanced US (CEUS) in the late 1960s, the use of US contrast agents has grown tremendously, and this examination has proved to be a valuable adjunct to diagnostic US for detection and characterization of disease. Also, CEUS has emerged as an excellent option for evaluation of indeterminate lesions that require additional imaging, given its excellent safety profile, including that in patients with end-stage renal disease or allergies to contrast material who are unable to undergo contrast-enhanced CT or MRI. US traditionally has been considered the imaging modality of choice for evaluation of the female pelvis, followed by MRI and rarely fluoroscopy, CT, PET, or angiography. CEUS has the potential to add significant value in imaging gynecologic disease, and indications for its use in the female pelvis are expected to continue evolving. It can aid in evaluation of nonvascular structures, such as assessment of tubal patency, uterine cavity morphology, and pelvic fistulas. CEUS can help characterize poorly vascularized gynecologic tumors or tissues with slow flow by using qualitative and quantitative parameters and aid in image-guided interventions or biopsies by facilitating visualization of lesions that are difficult to see with other imaging modalities. The authors provide an overview of current applications of US contrast agents in the female pelvis and discuss associated factors such as technique, interpretation, and image optimization. They also discuss the limitations of CEUS and describe its utility in the evaluation of female pelvic disease by using an organ system case-based approach. © RSNA, 2024 Test Your Knowledge questions for this article are available in the supplemental material.
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Affiliation(s)
- Kristen Olinger
- From the Department of Radiology, University of North Carolina at Chapel Hill, 2021 Old Clinic Bldg, Chapel Hill, NC 27599 (K.O.); Department of Radiology, University of Toronto, Toronto, Ontario, Canada (X.L.); Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada (Parisa Khoshpouri); Department of Radiology, University of Washington, Seattle, WA (Pegah Khoshpouri); Department of Radiology, Yale University, New Haven, CT (L.M.S.); Department of Radiology, University of Kentucky, Lexington, KY (A.K.); Department of Radiology, Jaslok Hospital, Mumbai, India (R.N.C.); and Department of Radiology, Vanderbilt University Medical Center, Nashville, TN (M.M.)
| | - Xiaoyang Liu
- From the Department of Radiology, University of North Carolina at Chapel Hill, 2021 Old Clinic Bldg, Chapel Hill, NC 27599 (K.O.); Department of Radiology, University of Toronto, Toronto, Ontario, Canada (X.L.); Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada (Parisa Khoshpouri); Department of Radiology, University of Washington, Seattle, WA (Pegah Khoshpouri); Department of Radiology, Yale University, New Haven, CT (L.M.S.); Department of Radiology, University of Kentucky, Lexington, KY (A.K.); Department of Radiology, Jaslok Hospital, Mumbai, India (R.N.C.); and Department of Radiology, Vanderbilt University Medical Center, Nashville, TN (M.M.)
| | - Parisa Khoshpouri
- From the Department of Radiology, University of North Carolina at Chapel Hill, 2021 Old Clinic Bldg, Chapel Hill, NC 27599 (K.O.); Department of Radiology, University of Toronto, Toronto, Ontario, Canada (X.L.); Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada (Parisa Khoshpouri); Department of Radiology, University of Washington, Seattle, WA (Pegah Khoshpouri); Department of Radiology, Yale University, New Haven, CT (L.M.S.); Department of Radiology, University of Kentucky, Lexington, KY (A.K.); Department of Radiology, Jaslok Hospital, Mumbai, India (R.N.C.); and Department of Radiology, Vanderbilt University Medical Center, Nashville, TN (M.M.)
| | - Pegah Khoshpouri
- From the Department of Radiology, University of North Carolina at Chapel Hill, 2021 Old Clinic Bldg, Chapel Hill, NC 27599 (K.O.); Department of Radiology, University of Toronto, Toronto, Ontario, Canada (X.L.); Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada (Parisa Khoshpouri); Department of Radiology, University of Washington, Seattle, WA (Pegah Khoshpouri); Department of Radiology, Yale University, New Haven, CT (L.M.S.); Department of Radiology, University of Kentucky, Lexington, KY (A.K.); Department of Radiology, Jaslok Hospital, Mumbai, India (R.N.C.); and Department of Radiology, Vanderbilt University Medical Center, Nashville, TN (M.M.)
| | - Leslie M Scoutt
- From the Department of Radiology, University of North Carolina at Chapel Hill, 2021 Old Clinic Bldg, Chapel Hill, NC 27599 (K.O.); Department of Radiology, University of Toronto, Toronto, Ontario, Canada (X.L.); Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada (Parisa Khoshpouri); Department of Radiology, University of Washington, Seattle, WA (Pegah Khoshpouri); Department of Radiology, Yale University, New Haven, CT (L.M.S.); Department of Radiology, University of Kentucky, Lexington, KY (A.K.); Department of Radiology, Jaslok Hospital, Mumbai, India (R.N.C.); and Department of Radiology, Vanderbilt University Medical Center, Nashville, TN (M.M.)
| | - Aman Khurana
- From the Department of Radiology, University of North Carolina at Chapel Hill, 2021 Old Clinic Bldg, Chapel Hill, NC 27599 (K.O.); Department of Radiology, University of Toronto, Toronto, Ontario, Canada (X.L.); Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada (Parisa Khoshpouri); Department of Radiology, University of Washington, Seattle, WA (Pegah Khoshpouri); Department of Radiology, Yale University, New Haven, CT (L.M.S.); Department of Radiology, University of Kentucky, Lexington, KY (A.K.); Department of Radiology, Jaslok Hospital, Mumbai, India (R.N.C.); and Department of Radiology, Vanderbilt University Medical Center, Nashville, TN (M.M.)
| | - Rajas N Chaubal
- From the Department of Radiology, University of North Carolina at Chapel Hill, 2021 Old Clinic Bldg, Chapel Hill, NC 27599 (K.O.); Department of Radiology, University of Toronto, Toronto, Ontario, Canada (X.L.); Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada (Parisa Khoshpouri); Department of Radiology, University of Washington, Seattle, WA (Pegah Khoshpouri); Department of Radiology, Yale University, New Haven, CT (L.M.S.); Department of Radiology, University of Kentucky, Lexington, KY (A.K.); Department of Radiology, Jaslok Hospital, Mumbai, India (R.N.C.); and Department of Radiology, Vanderbilt University Medical Center, Nashville, TN (M.M.)
| | - Mariam Moshiri
- From the Department of Radiology, University of North Carolina at Chapel Hill, 2021 Old Clinic Bldg, Chapel Hill, NC 27599 (K.O.); Department of Radiology, University of Toronto, Toronto, Ontario, Canada (X.L.); Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada (Parisa Khoshpouri); Department of Radiology, University of Washington, Seattle, WA (Pegah Khoshpouri); Department of Radiology, Yale University, New Haven, CT (L.M.S.); Department of Radiology, University of Kentucky, Lexington, KY (A.K.); Department of Radiology, Jaslok Hospital, Mumbai, India (R.N.C.); and Department of Radiology, Vanderbilt University Medical Center, Nashville, TN (M.M.)
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Zhong J, Huang L, Su M, Wu M, Lin X, Shui X, Jiang Y, Zhang X. Ultrasound Microvessel Visualization in Cervical Cancer: Association Between Novel Ultrasound Techniques and Histologic Microvessel Densities. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:2537-2547. [PMID: 37730477 DOI: 10.1016/j.ultrasmedbio.2023.08.017] [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: 02/07/2023] [Revised: 07/27/2023] [Accepted: 08/23/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE The aim of the work described here was to evaluate the feasibility of superb microvascular imaging (SMI) and vascular endothelial growth factor receptor 2 (VEGFR2)-targeted microbubble (MBVEGFR2)-based ultrasound molecular imaging (USMI) for visualizing microvessels in cervical cancer. METHODS Hela cells were used to establish subcutaneous cervical cancer models. SMI and MBVEGFR2-based USMI were performed, and the results were compared with intratumoral microvessel density (MVD) in four groups based on tumor diameter (<3 mm, 3-5 mm, 5-7 mm and ≥7 mm). The vascularization index (VI, %) was evaluated for SMI, and the normalized intensity difference (NID) for USMI. RESULTS Tumors with diameters ranging from 3 to 5 mm had the highest VI (39.07 ± 1.58) in SMI, and VI significantly decreased with increasing tumor size (all p values <0.001). The strongest signal intensity was observed in very early tumors (d < 3 mm: 43.80 ± 3.58%) after MBVEGFR2 administration; the NID gradually decreased with increasing diameter of tumors (all p values = 0.007). However, no significant differences were observed in NID after administration of non-targeted (control) microbubbles (MBCon) (all p values = 0.125). MBVEGFR2-based USMI had the strongest correlation with MVD in displaying microvessels of cervical cancer compared with SMI and MBCon (R2 = 0.78 vs. R2 = 0.40 and R2 = 0.38). CONCLUSION These findings validate the superiority and accuracy of MBVEGFR2-based USMI for microvessel imaging and monitoring of angiogenesis in cervical cancer compared with SMI and MBCon. Nonetheless, SMI remains an alternative to microvessel imaging when ultrasonic contrast agent use is contraindicated.
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Affiliation(s)
- Junlin Zhong
- Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Licong Huang
- Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Manting Su
- Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Manli Wu
- Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xin Lin
- Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xing Shui
- Department of Cardiovascular Medicine, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Ye Jiang
- Department of Pathology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xinling Zhang
- Department of Ultrasound, Laboratory of Novel Optoacoustic (Ultrasonic) Imaging, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
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Zhang J, Xiang JD, Jia C, Du LF, Li F. Contrast-Enhanced Ultrasonography for Transabdominal and Transrectal Ultrasound in Staging Cervical Cancer: A Reliability Study. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:2283-2290. [PMID: 37495499 DOI: 10.1016/j.ultrasmedbio.2023.06.018] [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: 11/02/2022] [Revised: 06/06/2023] [Accepted: 06/26/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE This retrospective study aimed to evaluate the consistency of transrectal contrast-enhanced ultrasonography (TR-CEUS) with post-operative pathology and the value of contrast-enhanced ultrasonography (CEUS) in staging surgically treated cervical cancer when combined with conventional ultrasonography (US). METHODS From October 2020 to March 2023, hospitalized patients with stage IB and II cervical cancer confirmed by total hysterectomy were consecutively enrolled. The standard images of US and CEUS by transabdominal (TA-US/CEUS) and transrectal (TR-US/CEUS) approaches and magnetic resonance imaging (MRI) were acquired, on which the size and stage of the tumors were evaluated, and the consistency of results with the pathological specimen was analyzed. RESULTS Thirty-nine patients with cervical cancer were finally enrolled in this study. The results showed that CEUS significantly improved the reliability of TA-US in evaluating tumor diameter; the intraclass correlation coefficient (ICC) was from 0.672 to 0.735. TR-US indicated good reliability with or without the addition of CEUS (ICC = 0.796 and 0.780). In terms of tumor staging, CEUS improved the consistency of transabdominal (weighted κ values from 0.689 to 0.731) and transrectal staging of tumors (κ from 0.758 to 0.785), and the staging of TR-US combined with TR-CEUS had the highest consistency with post-operative results, similar to MRI (κ, respectively 0.785 and 0.789). CEUS can reflect the heterogeneity of the tumor. Heterogeneous enhancement and perfusion defects were more common in >2 cm cervical cancer (50%, 20/40 and 52.5%, 21/40), respectively, and perfusion defects were more common in moderately to poorly differentiated tumors (66.67%, 20/30). CONCLUSION For stage IB and IIA cervical cancer, CEUS can aid in assessing the International Federation for Gynecology and Obstetrics staging of tumors alongside TA-US and TR-US. The combination of TR-US and TR-CEUS has shown good consistency with pathology in the staging of cervical cancer, comparable to that of MRI.
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Affiliation(s)
- Juan Zhang
- Department of Gynaecology and Obstetrics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiang-Dong Xiang
- Department of Gynaecology and Obstetrics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chao Jia
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lian-Fang Du
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fan Li
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Zhu Y, Tang Y, Jiang Z, Zhang J, Jia S, Li Y, Luo X, Kato T, Zhang G. Potential diagnostic value of quantitative superb microvascular imaging in premalignant and malignant cervical lesions. Front Oncol 2023; 13:1250842. [PMID: 37692857 PMCID: PMC10492516 DOI: 10.3389/fonc.2023.1250842] [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: 06/30/2023] [Accepted: 08/07/2023] [Indexed: 09/12/2023] Open
Abstract
Objective The purpose of this study was to assess the diagnostic efficacy of the vascular index (VI) on superb microvascular imaging (SMI) in distinguishing normal uterine cervical epithelium, high-grade cervical intraepithelial neoplasia (CIN), and cervical cancer. Methods The retrospective study included women with pathology-confirmed CIN or cervical cancer, who underwent transvaginal ultrasound and SMI between April 2021 and October 2022. The SIM manifestations of normal cervix and cervical lesions were reviewed. SIM were measured and converted into vascular index (VI) which compared between cervical lesions and control groups. We have retrospectively compared ultrasound features of cervical lesions and characteristics of patients. Measurement reliability was evaluated by intra class correlation coefficient (ICC). Results A total of 235 consecutive females were enrolled, comprising 38 with high-grade CIN, 96 with cervical cancer, and 101 with a normal uterine cervix. The microvascular architecture exhibited significant variations between premalignant and malignant cervical lesions. Branch-like patterns were predominantly observed in high-grade CIN, while crab claw-like and fireball-like patterns were more commonly associated with cervical cancer. The median VI of cervical cancer (34.7 ± 10.3) was significantly higher than that of high-grade CIN (17.6 ± 4.2) (P < 0.001). Moreover, the VI values of cervical cancer differed significantly among different FIGO stages and pathological types (P < 0.001 and P = 0.003, respectively). The VI demonstrated superior diagnostic performance for cervical lesions compared to vascular patterns (AUC = 0.974 and 0.969, respectively). Using a cut-off value of 25.5, the VI yielded a sensitivity of 82.3% and a specificity of 99.3% for cervical lesion detection. Conclusions The SMI parameter (VI) exhibited a significantly higher value in cervical cancer compared to high-grade CIN, with a high level of agreement among observers. These findings suggest that quantitative SMI holds promise as an imaging technique for the detection and characterization of cervical lesions.
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Affiliation(s)
- Yi Zhu
- Outpatient Department (Ultrasound), Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China (UESTC), Chengdu, China
- Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan
| | - Yixin Tang
- Department of Ultrasound, Suining Central Hospital, Suining, China
| | - Zhuolin Jiang
- Outpatient Department (Ultrasound), Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China (UESTC), Chengdu, China
- Graduate School, Chengdu Medical College, Chengdu, China
| | - Jie Zhang
- Department Gynecological Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China (UESTC), Chengdu, China
| | - Shijun Jia
- Department Pathology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China (UESTC), Chengdu, China
| | - Yanjie Li
- Outpatient Department (Ultrasound), Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China (UESTC), Chengdu, China
- Graduate School, Chengdu Medical College, Chengdu, China
| | - Xinyi Luo
- Outpatient Department (Ultrasound), Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China (UESTC), Chengdu, China
- Graduate School, Chengdu Medical College, Chengdu, China
| | - Tomoyasu Kato
- Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan
| | - Guonan Zhang
- Department Gynecological Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China (UESTC), Chengdu, China
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Sun C, Wang Q, Hou L, Zhang R, Chen Y, Niu L. A contrast-enhanced ultrasound-based nomogram for the prediction of therapeutic efficiency of anti-PD-1 plus anti-VEGF agents in advanced hepatocellular carcinoma patients. Front Immunol 2023; 14:1229560. [PMID: 37575236 PMCID: PMC10413126 DOI: 10.3389/fimmu.2023.1229560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
Background There is no study focusing on noninvasive predictors for the efficacy of sintilimab (anti-PD-1) plus IBI305 (a bevacizumab biosimilar) treatment in advanced hepatocellular carcinoma (HCC). Method A total of 33 patients with advanced HCC were prospectively enrolled and received sintilimab plus IBI305 treatment from November 2018 to October 2019. Baseline characteristics including clinical data, laboratory data, and tumor features based on pretreatment CT/MR were collected. Meanwhile, pretreatment contrast-enhanced ultrasound (CEUS) for target tumor was performed and quantitative parameters were derived from time-intensity curves (TICs). A nomogram was developed based on the variables identified by the univariable and multivariable logistic regression analysis. The discrimination, calibration, and clinical utility of the nomogram were evaluated. Results Tumor embolus and grad ratio were significant variables related to the efficacy of sintilimab plus IBI305 strategy. The nomogram based on these two variables achieved an excellent predictive performance with an area under curve (AUC) of 0.909 (95% CI, 0.813-1). A bootstrapping for 500 repetitions was performed to validate this model and the AUC of the bootstrap model was 0.91 (95% CI, 0.8-0.98). The calibration curve and decision curve analysis (DCA) showed that the nomogram had a good consistency and clinical utility. Conclusions This study has established and validated a nomogram by incorporating the quantitative parameters of pretreatment CEUS and baseline clinical characteristics to predict the anti-PD-1 plus anti-VEGF treatment efficacy in advanced HCC patients.
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Affiliation(s)
- Chao Sun
- Department of Ultrasound, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qian Wang
- Department of Ultrasound, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lu Hou
- Department of Radiotherapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rui Zhang
- Department of Ultrasound, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Chen
- Department of Ultrasound, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lijuan Niu
- Department of Ultrasound, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Zhong J, Su M, Jiang Y, Huang L, Chen Y, Huang Z, Zhang X. VEGFR2 targeted microbubble-based ultrasound molecular imaging improving the diagnostic sensitivity of microinvasive cervical cancer. J Nanobiotechnology 2023; 21:220. [PMID: 37438780 DOI: 10.1186/s12951-023-01984-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 07/05/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND The current diagnostic methods of microinvasive cervical cancer lesions are imaging diagnosis and pathological evaluation. Pathological evaluation is invasive and imaging approaches are of extremely low diagnostic performance. There is a paucity of effective and noninvasive imaging approaches for these extremely early cervical cancer during clinical practice. In recent years, ultrasound molecular imaging (USMI) with vascular endothelial growth factor receptor type 2 (VEGFR2) targeted microbubble (MBVEGFR2) has been reported to improve the early diagnosis rates of breast cancer (including ductal carcinoma in situ), pancreatic cancer and hepatic micrometastases. Herein, we aimed to assess the feasibility of MBVEGFR2-based USMI in extremely early cervical cancer detection to provide an accurate imaging modality for microinvasive cervical cancer (International Federation of Gynecology and Obstetrics (FIGO) Stage IA1 and IA2). RESULTS We found MBVEGFR2-based USMI could successfully distinguish extremely early lesions in diameter < 3 mm from surrounding normal tissues (all P < 0.05), and the sensitivity gradually decreased along with increasing tumor diameter. Moreover, normalized intensity difference (NID) values showed a good linear correlation with microvessel density (MVD) (R2 = 0.75). In addition, all tumors could not be identified from surrounding muscles in subtracted ultrasound images when mice were administered MBCon. CONCLUSIONS Overall, MBVEGFR2-based USMI has huge potential for clinical application for the early detection of microinvasive cervical cancer (FIGO Stage IA1 and IA2), providing the foothold for future studies on the imaging screening of this patient population.
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Affiliation(s)
- Junlin Zhong
- Department of Ultrasound, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong, China
| | - Manting Su
- Department of Ultrasound, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong, China
| | - Ye Jiang
- Department of Pathology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong, China
| | - Licong Huang
- Department of Ultrasound, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong, China
| | - Ying Chen
- Department of Ultrasound, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong, China
| | - Zhuoshan Huang
- Department of Cardiovascular Medicine, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong, China
| | - Xinling Zhang
- Department of Ultrasound, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong, China.
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Comparison of contrast-enhanced ultrasonography and magnetic resonance imaging in the evaluation of tumor size and local invasion of surgically treated cervical cancer. ABDOMINAL RADIOLOGY (NEW YORK) 2022; 47:2928-2936. [PMID: 35670876 DOI: 10.1007/s00261-022-03558-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/13/2022] [Accepted: 05/13/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVES This retrospective study aimed to compare the performance of contrast-enhanced ultrasound (CEUS) and magnetic resonance imaging (MRI) in staging surgically treated early-stage cervical cancer. METHODS Patients with surgically treated cervical carcinoma confirmed by post-operative pathological findings were included between December 2016 and December 2018. All included patients underwent both CEUS and MRI examinations before the surgery. Post-operative pathology was used as the gold standard. The κ values were calculated to assess the agreements of CEUS and MRI in staging cervical carcinoma in comparison with post-operative pathology. RESULTS Complete data were available for 39 patients. CEUS showed great inter-observer reproducibility in tumor measurement [Intra-class Correlation Coefficient (ICC) 0.831] and moderate inter-observer reproducibility in the evaluation of vaginal infiltration and parametrial invasion (Cohen's κ 0.692 and 0.624). Tumor size was comparable as measured by CEUS and MRI (ICC 0.769). Both CEUS and MRI presented good concordance with post-operative pathology in staging cervical cancer (weighted κ 0.732 and 0.761). CONCLUSION CEUS was comparable to MRI in staging surgically treated cervical cancer and might be considered in the pre-treatment work-up for cervical cancer.
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11
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Dong Rui T, Dong Y, Song Qing L, Tong R, Wang Fei F, Yu T, Luo Y. Volume computed tomography perfusion as a predictive marker for treatment response to concurrent chemoradiotherapy in cervical cancer: a prospective study. Acta Radiol 2021; 62:281-288. [PMID: 32551871 DOI: 10.1177/0284185120919261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Computed tomography perfusion (CTP) can provide information on blood perfusion as a reliable marker of tumor response to therapy. PURPOSE To assess the role of volume CTP (vCTP) parameters in predicting treatment response to concurrent chemoradiotherapy (CCRT) for cervical cancer. MATERIAL AND METHODS Thirty-three patients with cervical cancer underwent vCTP. Three CTP parameters of cervical cancer-including arterial flow (AF), blood volume (BV), and permeability surface (PS)-were measured in two different ways: the region of interest incorporating the "local hot" with the highest enhancement and "cold spot" with the lowest enhancement; and "whole-tumor" measurements. The patients were divided into non-residual and residual tumor groups according to the short-term response to treatment. The clinical and perfusion parameters were compared between the two groups. RESULTS There was no significant difference in age, body mass index, FIGO stage, pathological grade, or pretreatment tumor size between the two groups (P > 0.05). The non-residual tumor group had higher pretreatment AF in high-perfusion and low-perfusion subregions than the residual tumor group (P <0.05), but the AF in whole-tumor regions was not different between the two groups (P > 0.05). There were no differences in BV and PS between the two groups (P > 0.05). The diagnostic potency of AF in the low-perfusion subregion was higher than that in the high-perfusion subregion. CONCLUSION vCTP parameters are valuable for the prediction of short-term effects. The AF in the low-perfusion subregion was a more effective index for predicting treatment response to CCRT of cervical cancer.
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Affiliation(s)
- Tong Dong Rui
- Department of Radiology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital & Institute, Shenyang, Liaoning, PR China
| | - Yue Dong
- Department of Radiology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital & Institute, Shenyang, Liaoning, PR China
| | - Ling Song Qing
- Department of Radiology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital & Institute, Shenyang, Liaoning, PR China
| | - Rui Tong
- Department of Radiology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital & Institute, Shenyang, Liaoning, PR China
| | - Fei Wang Fei
- Department of Radiology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital & Institute, Shenyang, Liaoning, PR China
| | - Tao Yu
- Department of Radiology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital & Institute, Shenyang, Liaoning, PR China
| | - YaHong Luo
- Department of Radiology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital & Institute, Shenyang, Liaoning, PR China
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Yue D, Tong DR, Fei Fei W, Miao ZX, Ting PH, Tao Y, Ya Hong L. Imaging Features of the Whole Uterus Volume CT Perfusion and Influence Factors of Blood Supply: A Primary Study in Patients with Cervical Squamous Carcinoma. Acad Radiol 2019; 26:e216-e223. [PMID: 30201435 DOI: 10.1016/j.acra.2018.07.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 07/30/2018] [Accepted: 07/30/2018] [Indexed: 11/28/2022]
Abstract
RATIONALE AND OBJECTIVES To explore the imaging features of whole uterus volume CT perfusion (vCTP) and the influence factors of blood supply in cervical squamous carcinoma (CSC). MATERIALS AND METHODS vCTP was performed on a 640-slice computed tomography system in 43 patients with CSC diagnosed by biopsy, and 24 cases of them underwent magnetic resonance imaging. The size of the tumor was measured on vCTP and magnetic resonance (MR) images. Perfusion parameters, including arterial blood flow (AF), blood volume, and permeability surface (PS), were measured by two radiologists, using interclass correlation coefficient to evaluate the interobserver reliability. The difference of tumor size and perfusion data was analyzed by paired t test and rank sum test. The correlation of perfusion parameters with some factors was analyzed by Pearson or Spearman correlation analysis. RESULTS Tumor sizes were not significantly different between vCTP and MR images. The interclass correlation coefficient of each parameter was 0.818-0.945. The AF value of CSC was significantly higher than normal uterine body, and the blood volume and PS values of CSC were not statistically different compared with those of normal uterine body. There was no significant difference in AF value of CSC among different FIGO stages and pathological grades. The AF and PS values of CSC were negatively correlated with the age of the patients. CONCLUSION The vCTP could accurately shows the size of the CSC with use of MR as the reference standard, and its perfusion parameters have good measurement stability; the CSC was hypervascular, but this trend was less pronounced in older women.
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Affiliation(s)
- Dong Yue
- Department of Radiology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital &Institute, 44# Xiao He Yan Road, Shenyang, Liaoning 110042, China
| | - Dong Rui Tong
- Department of Radiology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital &Institute, 44# Xiao He Yan Road, Shenyang, Liaoning 110042, China
| | - Wang Fei Fei
- Department of Radiology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital &Institute, 44# Xiao He Yan Road, Shenyang, Liaoning 110042, China
| | - Zhang Xiao Miao
- Department of Radiology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital &Institute, 44# Xiao He Yan Road, Shenyang, Liaoning 110042, China
| | - Pang Hui Ting
- Department of Radiology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital &Institute, 44# Xiao He Yan Road, Shenyang, Liaoning 110042, China
| | - Yu Tao
- Department of Radiology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital &Institute, 44# Xiao He Yan Road, Shenyang, Liaoning 110042, China
| | - Luo Ya Hong
- Department of Radiology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital &Institute, 44# Xiao He Yan Road, Shenyang, Liaoning 110042, China.
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Wang J, Huang J, Ma Q, Liu G. Association between quantitative parameters of CEUS and Sall4/Wnt/β-catenin signaling in patients with hepatocellular carcinoma. Cancer Manag Res 2019; 11:3339-3347. [PMID: 31114369 PMCID: PMC6489647 DOI: 10.2147/cmar.s199968] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 02/25/2019] [Indexed: 02/06/2023] Open
Abstract
Objectives: In this study, we aim to investigate the correlations of quantitative parameters of contrast-enhanced ultrasonography (CEUS) and Spalt-Like Transcription Factor 4 (Sall4)/Wnt/β-catenin signaling pathway with clinicopathological features and prognosis of patients with hepatocellular carcinoma (HCC). Methods: The CEUS was performed to detect the liver function and the prognosis of patients. The expression of Sall4, WNT3a and β-catenin was evaluated using immunohistochemical staining. Sall4, WNT3a and β-catenin mRNA expression was measured by SYBR green qPCR assay. Results: We found that the mRNA and protein expression of Sall4, WNT3a and β-catenin in the HCC tissues were significantly upregulated compared with the adjacent normal tissues. Upregulation of these proteins was associated with tumor differentiation, TNM stage, tumor size, vascular invasion and liver cirrhosis of HCC patients. In addition, we found that decreased time to peak and washout time and increased peak intensity and area under the curve of CEUS in the HCC were also correlated with TNM stage, tumor size and vascular invasion. Moreover, Sall4, WNT3a and β-catenin protein were significantly associated with the TTP, PI, AUC, and WOT. Conclusion: This study suggests that quantitative parameters of CEUS and Sall4/Wnt/β-catenin signaling may be helpful for early diagnosis and prognosis prediction of HCC patients.
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Affiliation(s)
- Jianjun Wang
- Department of Ultrasonography, General Hospital of Ningxia Medical University, Ningxia, People's Republic of China
| | | | - Qianfeng Ma
- Department of Ultrasonography, General Hospital of Ningxia Medical University, Ningxia, People's Republic of China
| | - Guanghui Liu
- Human Anatomy and Histoembryology, School of Physical Education, Wuhan Business University, Wuhan, People's Republic of China
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Niu X, Jiang W, Zhang X, Ding Z, Xue H, Wang Z, Zhao C. Comparison of Contrast-Enhanced Ultrasound and Positron Emission Tomography/Computed Tomography (PET/CT) in Lymphoma. Med Sci Monit 2018; 24:5558-5565. [PMID: 30095086 PMCID: PMC6098669 DOI: 10.12659/msm.908849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background This study aimed to assess the value of contrast-enhanced ultrasound (CEUS) in the diagnosis and prognosis of lymphoma based on PET-CT. Material/Methods Our study included 88 superficial lymph nodes and 63 patients who underwent ultrasound-guided biopsy or surgery for pathology from October 2015 to March 2017. All lymph nodes were assessed by CEUS and PET-CT. CEUS and PET-CT parameters were recorded, including arrive time (AT), time to peak (TTP), base intensity (BI), peak intensity (PI), ascending slope (AS), descending slope (DS), area under the TIC curve (AUC), maximum standardized uptake value (SUVmax), and mean standardized uptake value (SUVmean). Pearson’s correlation was used to assess the associations of CEUS and PET-CT parameters. Results Of the 88 lymph nodes examined,12 were Hodgkin’s lymphoma (HL) and76 were non-Hodgkin’s lymphoma (NHL). The variations of CEUS dose parameters (ΔI, AUC, and AS) were positively correlated with PET-CT results (SUVmax and TLG). Correlation coefficients were 0.609, 0.518, 0.456, 0.630, 0.593, and 0. 532, respectively. The remaining time values (AT, TP, and ΔT) were negatively associated with PET-CT results. Correlation coefficients were −0.239, −0.272, −0.284and −0.377, −0.391, and −0.320, respectively. Conclusions Quantitative CEUS data were correlated with PET-CT values, with potential use in the diagnosis of lymphoma.
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Affiliation(s)
- Xiaoyan Niu
- Department of Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China (mainland)
| | - Wenbin Jiang
- Department of Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China (mainland)
| | - Xiaojuan Zhang
- Department of Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China (mainland)
| | - Zhaoyan Ding
- Department of Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China (mainland)
| | - Hongwei Xue
- Department of Lymphoma, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China (mainland)
| | - Zhenguang Wang
- Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China (mainland)
| | - Cheng Zhao
- Department of Ultrasound, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China (mainland)
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Pálsdóttir K, Epstein E. A Pilot Study on Diagnostic Performance of Contrast-Enhanced Ultrasonography for Detection of Early Cervical Cancer. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:1664-1671. [PMID: 29859688 DOI: 10.1016/j.ultrasmedbio.2018.04.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 04/06/2018] [Accepted: 04/23/2018] [Indexed: 06/08/2023]
Abstract
In this cohort study of 49 women with all stages of cervical cancer and 21 healthy controls, we compared contrast-enhanced ultrasonography (CEUS) filling pattern and semi-quantitative parameters in the two groups. Participants were examined with conventional grayscale and power Doppler ultrasound (US) followed by CEUS, using a 2.5 mL bolus of intravenous contrast agent. CEUS video clips were analyzed with regard to contrast distribution (focal or global) and semi-quantitative parameters. Focal contrast distribution was found in 3% (1/32) of the women with no tumor versus 89% (34/38) of women with histologically detectable tumor. A semi-quantitative analysis showed that the amount of contrast over a period of the whole tumor (area under the curve [AUC[ 0.92, 95% confidence interval [CI] 0.87-1.0), and the maximal intensity area (AUC 0.94, 95% CI 0.84-1.0) could accurately distinguish tumors from healthy tissue. In conclusion, the CEUS parameters differ significantly between tumors and healthy cervical tissue.
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Affiliation(s)
- Kolbrún Pálsdóttir
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
| | - Elisabeth Epstein
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden
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Zheng W, Chen K, Peng C, Yin SH, Pan YY, Liu M, Lin SY, Pei XQ. Contrast-enhanced ultrasonography vs MRI for evaluation of local invasion by cervical cancer. Br J Radiol 2018; 91:20170858. [PMID: 30028181 DOI: 10.1259/bjr.20170858] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE: The purpose of this study is to compare contrast-enhanced ultrasound (CEUS) to MRI for evaluating local invasion of cervical cancer. METHODS: A total of 108 patients with cervical cancer were included in this study. All the enrolled patients were Stage IIA2-IVB according to the International Federation of Obstetrics and Gynecology and treated with volumetric modulated arc therapy. Tumour size in different dimensions was compared between MRI and CEUS. The correlation coefficients (r) between MRI and CEUS for diagnosing local invasion, parametrial extension, and invasion to vagina, uterine corpus and adjacent organs were assessed. RESULTS: Measurements by MRI and CEUS were strongly correlated in the three dimensions: left-right r = 0.84, craniocaudal r = 0.86 and anteroposterior r = 0.88. Vaginal and parametrial invasion were detected by both MRI and CEUS with moderate concordance, and invasion of uterine corpus, bladder and rectum with good concordance. CONCLUSION: CEUS is comparable to MRI for measuring tumour size, with good concordance for evaluating invasion of cervical cancer. ADVANCES IN KNOWLEDGE: CEUS is a less expensive non-invasive modality for assessment of tumour size and invasion of cervical cancer.
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Affiliation(s)
- Wei Zheng
- 1 Department of Ultrasound, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine , Guangzhou , China
| | - Kai Chen
- 2 Department of Radiotherapy, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine , Guangzhou , China
| | - Chuan Peng
- 1 Department of Ultrasound, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine , Guangzhou , China
| | - Shao-Han Yin
- 3 Department of Radiology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine , Guangzhou , China
| | - Yong-Ying Pan
- 4 Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University , Guangzhou , China
| | - Min Liu
- 1 Department of Ultrasound, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine , Guangzhou , China
| | - Shi-Yang Lin
- 1 Department of Ultrasound, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine , Guangzhou , China
| | - Xiao-Qing Pei
- 1 Department of Ultrasound, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine , Guangzhou , China
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Barillari G, Monini P, Sgadari C, Ensoli B. The Impact of Human Papilloma Viruses, Matrix Metallo-Proteinases and HIV Protease Inhibitors on the Onset and Progression of Uterine Cervix Epithelial Tumors: A Review of Preclinical and Clinical Studies. Int J Mol Sci 2018; 19:E1418. [PMID: 29747434 PMCID: PMC5983696 DOI: 10.3390/ijms19051418] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 05/03/2018] [Accepted: 05/04/2018] [Indexed: 12/15/2022] Open
Abstract
Infection of uterine cervix epithelial cells by the Human Papilloma Viruses (HPV) is associated with the development of dysplastic/hyperplastic lesions, termed cervical intraepithelial neoplasia (CIN). CIN lesions may regress, persist or progress to invasive cervical carcinoma (CC), a leading cause of death worldwide. CIN is particularly frequent and aggressive in women infected by both HPV and the Human Immunodeficiency Virus (HIV), as compared to the general female population. In these individuals, however, therapeutic regimens employing HIV protease inhibitors (HIV-PI) have reduced CIN incidence and/or clinical progression, shedding light on the mechanism(s) of its development. This article reviews published work concerning: (i) the role of HPV proteins (including HPV-E5, E6 and E7) and of matrix-metalloproteinases (MMPs) in CIN evolution into invasive CC; and (ii) the effect of HIV-PI on events leading to CIN progression such as basement membrane and extracellular matrix invasion by HPV-positive CIN cells and the formation of new blood vessels. Results from the reviewed literature indicate that CIN clinical progression can be monitored by evaluating the expression of MMPs and HPV proteins and they suggest the use of HIV-PI or their derivatives for the block of CIN evolution into CC in both HIV-infected and uninfected women.
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Affiliation(s)
- Giovanni Barillari
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 1 via Montpellier, 00133 Rome, Italy.
| | - Paolo Monini
- National HIV/AIDS Research Center, Istituto Superiore di Sanità, 299 viale Regina Elena, 00161 Rome, Italy.
| | - Cecilia Sgadari
- National HIV/AIDS Research Center, Istituto Superiore di Sanità, 299 viale Regina Elena, 00161 Rome, Italy.
| | - Barbara Ensoli
- National HIV/AIDS Research Center, Istituto Superiore di Sanità, 299 viale Regina Elena, 00161 Rome, Italy.
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Xuan ZD, Zhou L, Wang Y, Zheng X. Prognostic value of the combination of serum levels of vascular endothelial growth factor, C-reactive protein and contrast-enhanced ultrasound in patients with primary liver cancer who underwent transcatheter arterial chemoembolization. Expert Rev Anticancer Ther 2017; 17:1169-1178. [PMID: 29048943 DOI: 10.1080/14737140.2017.1395284] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Zhi-Dong Xuan
- The 3rd Department of Ultrasound, Cangzhou Central Hospital, Cangzhou, P.R. China
| | - Li Zhou
- The 3rd Department of Ultrasound, Cangzhou Central Hospital, Cangzhou, P.R. China
| | - Yu Wang
- The 3rd Department of Ultrasound, Cangzhou Central Hospital, Cangzhou, P.R. China
| | - Xue Zheng
- The 3rd Department of Ultrasound, Cangzhou Central Hospital, Cangzhou, P.R. China
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Lee SH, Yun SJ, Kim DH, Jo HH, Park YS. Severity of nonalcoholic fatty liver disease on sonography and risk of coronary heart disease. JOURNAL OF CLINICAL ULTRASOUND : JCU 2017; 45:391-399. [PMID: 28369989 DOI: 10.1002/jcu.22472] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 12/28/2016] [Accepted: 02/04/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE To evaluate the relationship between nonalcoholic fatty liver disease (NAFLD) on sonography (US) and the risk of coronary heart disease (CHD) as well as the predictive value of US-diagnosed NAFLD to determine intermediate/high CHD risk compared with as well as in combination on with NAFLD fibrosis score (NFS). METHODS This retrospective study included 1,276 patients examined between November 2015 and August 2016. NAFLD was categorized as absent, mild, moderate, or severe based on liver-to-kidney echogenicity, visibility of intrahepatic vessel walls, and the diaphragm. The Framingham risk score (FRS) and NFS were used to predict CHD risk and hepatic fibrosis severity. Spearman correlation test, multivariate-adjusted logistic regression analysis, and receiver operating characteristic curves were used for statistical evaluation. RESULTS FRS increased as NAFLD severity increased, and US-determined NAFLD severity and FRS were highly positively correlated (r = 0.683, p < 0.001). The odds ratios for intermediate/high CHD risk increased with increasing NAFLD severity. The predictive performance of US-determined NAFLD severity for determining intermediate/high CHD risk in NAFLD patients was 0.738. There was no significant difference between US-determined NAFLD severity and NFS in terms of identifying intermediate/high CHD risk (p = 0.88). However, the combination of US-determined NAFLD severity and NFS significantly improved the ability to distinguish intermediate/high CHD risk compared with that of US-determined NAFLD severity or NFS alone (p < 0.001 for both). CONCLUSIONS US-determined NAFLD severity was well correlated with FRS and associated with the prevalence of intermediate/high CHD risk. The combination of US-determined NAFLD severity and NFS may be useful for predicting CHD risk. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:391-399, 2017.
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Affiliation(s)
- Sun Hwa Lee
- Department of Emergency Medicine, Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Seoul, Nowon-gu, 139-707, Republic of Korea
| | - Seong Jong Yun
- Department of Radiology, Aerospace Medical Center, Republic of Korea Air Force, Box 335-21, 635 Danjae-ro, Namil-myeon, Cheongwon-gun, Chungcheongbuk-do, 363-849, Republic of Korea
| | - Dong Hyeon Kim
- Department of Radiology, Aerospace Medical Center, Republic of Korea Air Force, Box 335-21, 635 Danjae-ro, Namil-myeon, Cheongwon-gun, Chungcheongbuk-do, 363-849, Republic of Korea
| | - Hyeon Hwan Jo
- Department of Radiology, Aerospace Medical Center, Republic of Korea Air Force, Box 335-21, 635 Danjae-ro, Namil-myeon, Cheongwon-gun, Chungcheongbuk-do, 363-849, Republic of Korea
| | - Yong Sung Park
- Department of Radiology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 149 Sangil-dong, Gangdong-gu, Seoul, 134-727, Republic of Korea
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Can quantitative contrast-enhanced ultrasonography predict cervical tumor response to neoadjuvant chemotherapy? Eur J Radiol 2016; 85:2111-2118. [DOI: 10.1016/j.ejrad.2016.09.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 09/22/2016] [Accepted: 09/24/2016] [Indexed: 11/22/2022]
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