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Huang H, Zheng Y, Chang M, Song J, Xia L, Wu C, Jia W, Ren H, Feng W, Chen Y. Ultrasound-Based Micro-/Nanosystems for Biomedical Applications. Chem Rev 2024; 124:8307-8472. [PMID: 38924776 DOI: 10.1021/acs.chemrev.4c00009] [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: 06/28/2024]
Abstract
Due to the intrinsic non-invasive nature, cost-effectiveness, high safety, and real-time capabilities, besides diagnostic imaging, ultrasound as a typical mechanical wave has been extensively developed as a physical tool for versatile biomedical applications. Especially, the prosperity of nanotechnology and nanomedicine invigorates the landscape of ultrasound-based medicine. The unprecedented surge in research enthusiasm and dedicated efforts have led to a mass of multifunctional micro-/nanosystems being applied in ultrasound biomedicine, facilitating precise diagnosis, effective treatment, and personalized theranostics. The effective deployment of versatile ultrasound-based micro-/nanosystems in biomedical applications is rooted in a profound understanding of the relationship among composition, structure, property, bioactivity, application, and performance. In this comprehensive review, we elaborate on the general principles regarding the design, synthesis, functionalization, and optimization of ultrasound-based micro-/nanosystems for abundant biomedical applications. In particular, recent advancements in ultrasound-based micro-/nanosystems for diagnostic imaging are meticulously summarized. Furthermore, we systematically elucidate state-of-the-art studies concerning recent progress in ultrasound-based micro-/nanosystems for therapeutic applications targeting various pathological abnormalities including cancer, bacterial infection, brain diseases, cardiovascular diseases, and metabolic diseases. Finally, we conclude and provide an outlook on this research field with an in-depth discussion of the challenges faced and future developments for further extensive clinical translation and application.
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Affiliation(s)
- Hui Huang
- School of Environmental and Chemical Engineering, Shanghai University, Shanghai 200444, P. R. China
- Materdicine Lab, School of Life Sciences, Shanghai University, Shanghai 200444, P. R. China
| | - Yi Zheng
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, P. R. China
| | - Meiqi Chang
- Laboratory Center, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, P. R. China
| | - Jun Song
- Materdicine Lab, School of Life Sciences, Shanghai University, Shanghai 200444, P. R. China
| | - Lili Xia
- Materdicine Lab, School of Life Sciences, Shanghai University, Shanghai 200444, P. R. China
| | - Chenyao Wu
- Materdicine Lab, School of Life Sciences, Shanghai University, Shanghai 200444, P. R. China
| | - Wencong Jia
- Materdicine Lab, School of Life Sciences, Shanghai University, Shanghai 200444, P. R. China
| | - Hongze Ren
- Materdicine Lab, School of Life Sciences, Shanghai University, Shanghai 200444, P. R. China
| | - Wei Feng
- School of Environmental and Chemical Engineering, Shanghai University, Shanghai 200444, P. R. China
- Materdicine Lab, School of Life Sciences, Shanghai University, Shanghai 200444, P. R. China
| | - Yu Chen
- School of Environmental and Chemical Engineering, Shanghai University, Shanghai 200444, P. R. China
- Materdicine Lab, School of Life Sciences, Shanghai University, Shanghai 200444, P. R. China
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Li JK, Jin ZY, Xu YJ, Fu NQ, Jiang Y, Li SY, Niu RL, Liu G, Wang ZL. Contrast-enhanced ultrasound to predict malignant upgrading of atypical ductal hyperplasia. Breast Cancer Res 2024; 26:27. [PMID: 38347651 PMCID: PMC10863177 DOI: 10.1186/s13058-024-01772-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/17/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND A malignancy might be found at surgery in cases of atypical ductal hyperplasia (ADH) diagnosed via US-guided core needle biopsy (CNB). The objective of this study was to investigate the diagnostic performance of contrast-enhanced ultrasound (CEUS) in predicting ADH diagnosed by US-guided CNB that was upgraded to malignancy after surgery. METHODS In this retrospective study, 110 CNB-diagnosed ADH lesions in 109 consecutive women who underwent US, CEUS, and surgery between June 2018 and June 2023 were included. CEUS was incorporated into US BI-RADS and yielded a CEUS-adjusted BI-RADS. The diagnostic performance of US BI-RADS and CEUS-adjusted BI-RADS for ADH were analyzed and compared. RESULTS The mean age of the 109 women was 49.7 years ± 11.6 (SD). The upgrade rate of ADH at CNB was 48.2% (53 of 110). The sensitivity, specificity, positive predictive value, and negative predictive value of CEUS for identification of malignant upgrading were 96.2%, 66.7%,72.9%, and 95.0%, respectively, based on BI-RADS category 4B threshold. The two false-negative cases were low-grade ductal carcinoma in situ. Compared with the US, CEUS-adjusted BI-RADS had better specificity for lesions smaller than 2 cm (76.7% vs. 96.7%, P = 0.031). After CEUS, 16 (10 malignant and 6 nonmalignant) of the 45 original US BI-RADS category 4A lesions were up-classified to BI-RADS 4B, and 3 (1 malignant and 2 nonmalignant) of the 41 original US BI-RADS category 4B lesions were down-classified to BI-RADS 4A. CONCLUSIONS CEUS is helpful in predicting malignant upgrading of ADH, especially for lesions smaller than 2 cm and those classified as BI-RADS 4A and 4B on ultrasound.
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Affiliation(s)
- Jun Kang Li
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
- Department of Ultrasound, Chinese PLA 63820 Hospital, Mianyang, Sichuan, China
| | - Zhi Ying Jin
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Yong Jie Xu
- Department of Ultrasound Diagnosis, Strategic Support Force Medical Center of Chinese PLA, Beijing, China
| | - Nai Qin Fu
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Ying Jiang
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Shi Yu Li
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Rui Lan Niu
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Gang Liu
- Department of Radiology, The First Medical Center, Chinese PLA General Hospital, Beijing, China.
| | - Zhi Li Wang
- Department of Ultrasound, The First Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
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Lang M, Liang P, Shen H, Li H, Yang N, Chen B, Chen Y, Ding H, Yang W, Ji X, Zhou P, Cui L, Wang J, Xu W, Ye X, Liu Z, Yang Y, Wei T, Wang H, Yan Y, Wu C, Wu Y, Shi J, Wang Y, Fang X, Li R, Yu J. Head-to-head comparison of perfluorobutane contrast-enhanced US and multiparametric MRI for breast cancer: a prospective, multicenter study. Breast Cancer Res 2023; 25:61. [PMID: 37254149 DOI: 10.1186/s13058-023-01650-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/22/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Multiparametric magnetic resonance imaging (MP-MRI) has high sensitivity for diagnosing breast cancers but cannot always be used as a routine diagnostic tool. The present study aimed to evaluate whether the diagnostic performance of perfluorobutane (PFB) contrast-enhanced ultrasound (CEUS) is similar to that of MP-MRI in breast cancer and whether combining the two methods would enhance diagnostic efficiency. PATIENTS AND METHODS This was a head-to-head, prospective, multicenter study. Patients with breast lesions diagnosed by US as Breast Imaging Reporting and Data System (BI-RADS) categories 3, 4, and 5 underwent both PFB-CEUS and MP-MRI scans. On-site operators and three reviewers categorized the BI-RADS of all lesions on two images. Logistic-bootstrap 1000-sample analysis and cross-validation were used to construct PFB-CEUS, MP-MRI, and hybrid (PFB-CEUS + MP-MRI) models to distinguish breast lesions. RESULTS In total, 179 women with 186 breast lesions were evaluated from 17 centers in China. The area under the receiver operating characteristic curve (AUC) for the PFB-CEUS model to diagnose breast cancer (0.89; 95% confidence interval [CI] 0.74, 0.97) was similar to that of the MP-MRI model (0.89; 95% CI 0.73, 0.97) (P = 0.85). The AUC of the hybrid model (0.92, 95% CI 0.77, 0.98) did not show a statistical advantage over the PFB-CEUS and MP-MRI models (P = 0.29 and 0.40, respectively). However, 90.3% false-positive and 66.7% false-negative results of PFB-CEUS radiologists and 90.5% false-positive and 42.8% false-negative results of MP-MRI radiologists could be corrected by the hybrid model. Three dynamic nomograms of PFB-CEUS, MP-MRI and hybrid models to diagnose breast cancer are freely available online. CONCLUSIONS PFB-CEUS can be used in the differential diagnosis of breast cancer with comparable performance to MP-MRI and with less time consumption. Using PFB-CEUS and MP-MRI as joint diagnostics could further strengthen the diagnostic ability. Trial registration Clinicaltrials.gov; NCT04657328. Registered 26 September 2020. IRB number 2020-300 was approved in Chinese PLA General Hospital. Every patient signed a written informed consent form in each center.
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Affiliation(s)
- Manlin Lang
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical School, Beijing, 100039, China
| | - Ping Liang
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China
| | - Huiming Shen
- Department of Ultrasound, Zhongda Hospital Southeast University, Nanjing, 210009, China
| | - Hang Li
- Department of Breast Surgery, Affiliated Hospital of Putian University, Putian, 351100, China
| | - Ning Yang
- Department of Ultrasound, Xingcheng People's Hospital, Xingcheng, 125100, China
| | - Bo Chen
- Department of Ultrasound Medicine, Lu'an People's Hospital of Anhui Province, Liuan, 237000, China
| | - Yixu Chen
- Department of Ultrasound, The Fifth People's Hospital of Chengdu, Chengdu, 611130, China
| | - Hong Ding
- Department of Ultrasound, Huashan Hospital, Shanghai, 200040, China
| | - Weiping Yang
- Department of Ultrasound, Guangxi Medical University Cancer Hospital, Nanning, 530021, China
| | - Xiaohui Ji
- Department of Ultrasound, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050011, China
| | - Ping Zhou
- Department of Ultrasound, The Third Xiangya Hospital, Changsha, 410000, China
| | - Ligang Cui
- Department of Ultrasound, Peking University Third Hospital, Beijing, 100191, China
| | - Jiandong Wang
- General Surgery, Chinese PLA General Hospital, Beijing, 100853, China
| | - Wentong Xu
- General Surgery, Chinese PLA General Hospital, Beijing, 100853, China
| | - Xiuqin Ye
- Department of Ultrasound, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical College of Jinan University, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital, Shenzhen, 518020, China
| | - Zhixing Liu
- Department of Ultrasound Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Yu Yang
- Department of Ultrasound, Beijing Friendship Hospital, Beijing, 100050, China
| | - Tianci Wei
- Department of Ultrasound, The 2nd Affiliated Hospital of Harbin, Harbin, 150001, China
| | - Hui Wang
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, 130033, China
| | - Yuanyuan Yan
- Department of Ultrasound, Zhengzhou Central Hospital, Zhengzhou, 450000, China
| | - Changjun Wu
- Department of Ultrasonography, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China
| | - Yiyun Wu
- Department of Ultrasound, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China
| | - Jingwen Shi
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Yaxi Wang
- Department of Ultrasound, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, China
| | - Xiuxia Fang
- Department of Ultrasound, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010050, China
| | - Ran Li
- Department of Ultrasound, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453100, China
| | - Jie Yu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China.
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Dai YQ, Liang P, Wang J, Luo YC, Yu XL, Han ZY, Liu FY, Li X, Tan SL, Wang Z, Wu C, Li JM, Yu J. Microwave ablation without subsequent lumpectomy versus breast-conserving surgery for early breast cancer: a propensity score matching study. Int J Hyperthermia 2023; 40:2186325. [PMID: 36944374 DOI: 10.1080/02656736.2023.2186325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
PURPOSE To compare the efficacy of ultrasound-guided percutaneous microwave ablation (MWA) without subsequent lumpectomy and breast-conserving surgery (BCS) in patients with early breast cancer (BC). MATERIALS AND METHODS This retrospective cohort study enrolled 106 patients with early BC (T0/1/2 N0/1 M0) treated by MWA (n = 21) or BCS (n = 85) from October 2014 to December 2020. Propensity score matching (PSM) was performed to balance the baseline characteristics between MWA and BCS groups. The tumor progression, overall survival (OS), disease-specific survival (DSS), complications, and cosmetic results were compared. RESULTS After PSM, there were 21 patients with balanced baseline characteristics in each group. After a median follow-up of 43 months (range, 15-89 months), there was no significant difference in tumor progression (10% vs 2%, p = 0.18), OS (96% vs 99%, p = 0.36), DSS (100% vs 99%, p > 0.99), and complications (0% vs 19%, p = 0.58). The operation time of MWA was shorter (60 min vs 101 min, p < 0.001) than that of BCS. For the management of metastatic lymph nodes, five (5/21, 24%) patients with six metastatic nodes underwent ablation in the MWA group and three patients (3/21, 14%) with six metastatic nodes underwent axillary lymph node dissection in the BCS group. All the patients in the MWA group reported excellent cosmetic results, but 29% of BCS patients expressed dissatisfaction with breast asymmetry (10%) and scar formation (19%) (p < 0.001). CONCLUSION This pilot study indicated that in selected early BC patients, microwave ablation without subsequent lumpectomy had comparable tumor control effect with breast-conserving surgery and better cosmetic results at an intermediate follow-up.HighlightsMWA without subsequent lumpectomy has a comparable interim survival effect and better cosmetic results as BCS in the treatment of selected early breast cancer.MWA has the potential to be a viable and promising therapeutic option for breast cancer patients reluctant or intolerant to surgery with the advantage of minimal invasion.
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Affiliation(s)
- Yu-Qing Dai
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jiandong Wang
- Department of Breast Surgery, Chinese PLA Medical College, Beijing, China
| | - Yan-Chun Luo
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiao-Ling Yu
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhi-Yu Han
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Fang-Yi Liu
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xin Li
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shui-Lian Tan
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhen Wang
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Chong Wu
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jian-Ming Li
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jie Yu
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
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Xu J, Li J. A model for the early identification of sentinel lymph node metastasis in patients with breast cancer based on contrast‑enhanced ultrasound and clinical features. Oncol Lett 2022; 24:378. [PMID: 36238843 PMCID: PMC9494614 DOI: 10.3892/ol.2022.13498] [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: 02/14/2022] [Accepted: 08/25/2022] [Indexed: 11/06/2022] Open
Abstract
The present study was designed to establish a model for the early identification of sentinel lymph node (SLN) metastasis in patients with breast cancer (BC). The SLN metastasis predictive model was established with a retrospective training set of 365 patients with BC and was re-evaluated using a prospective validation set of 402 patients with BC. The multivariable analysis indicated that the tumor diameter [odds ratio (OR), 1.189; 95% confidence interval (CI), 1.124-1.257; P<0.001], menopause (OR, 1.011; 95% CI, 0.603-1.436; P<0.001), estrogen receptor (ER) expression (OR, 3.199; 95% CI, 1.077-6.567; P=0.043) and contrast-enhanced ultrasonography (CEUS) type (OR, 10.563; 95% CI, 6.890-28.372; P<0.001) were independent predictors of SLN status in patients with BC. The SLN metastasis predictive model was as follows: (0.173 × tumor diameter)-(4.490 × menopause) + (2.322 × ER) + (5.445 × CEUS type)-1.9521. In the training set, the model was highly sensitive (83.6%) and specific (94.3%) for the early identification of SLN metastasis. Similarly, in the validation set, the model was highly sensitive (70.4%) and specific (89.5%) for the early identification of SLN metastasis in patients with BC. Overall, in the present study, a model was successfully established to predict SLN metastasis in patients with BC that includes tumor diameter, menopausal status, ER expression and CEUS detection.
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Affiliation(s)
- Juan Xu
- Department of Interventional Ultrasound, Cangzhou Central Hospital, Cangzhou, Hebei 061000, P.R. China
| | - Junzhi Li
- Department of Interventional Ultrasound, Cangzhou Central Hospital, Cangzhou, Hebei 061000, P.R. China
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Guo W, Li F, Jia C, Wang T, Zhang X, Yao G, Shi X, Bai M. The clinical value of conventional ultrasound combined with contrast-enhanced ultrasound in the evaluation of BI-RADS 4 lesions detected by magnetic resonance imaging. Br J Radiol 2022; 95:20220025. [PMID: 35604699 PMCID: PMC10162066 DOI: 10.1259/bjr.20220025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 05/04/2022] [Accepted: 05/08/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To determine the value of conventional ultrasound combined with contrast-enhanced ultrasound (CEUS) in Breast Imaging Reporting and Data System (BI-RADS) Category 4 lesions as detected by MRI. METHODS A total of 176 breast lesions from 171 patients were detected by MRI and categorised as BI-RADS 4. All patients also underwent ultrasound and CEUS scans. The combination of ultrasound-BI-RADS and CEUS 5-point scoring system created the Rerated BI-RADS (referred to as CEUS-BI-RADS). The diagnostic performances of ultrasound and CEUS-BI-RADS were then compared. A χ2 test was used to compare the CEUS features of mass-like and non-mass-like enhancement types of MRI-BI-RADS 4 lesions. RESULTS There were 167 (167/176) breast lesions detected by ultrasound, with a detection rate of 94.89%, while all were subsequently detected by "second-look" ultrasound combined with CEUS, with a detection rate of 100%. The areas under the receiver operating characteristic curves for ultrasound and CEUS-BI-RADS were 0.810 and 0.940, respectively. The diagnostic efficiency of CEUS-BI-RADS was significantly higher than that of ultrasound alone (z = 3.264, p = 0.001). For both mass-like and non-mass-like enhancement types of MRI-BI-RADS 4 lesions, CEUS-BI-RADS demonstrated satisfactory sensitivity and accuracy. Moreover, 29 (29/176) category 4 lesions were downgraded to 3 by CEUS-BI-RADS. CONCLUSION Ultrasound combined with CEUS can allow reclassification, reduce biopsy rates, and facilitate pre-surgical localisation for biopsy or surgery for MRI-BI-RADS 4 lesions. ADVANCES IN KNOWLEDGE For MRI-BI-RADS Category 4 lesions with a wide range of malignancies, ultrasound combined with CEUS is a promising diagnostic approach with high clinical utility.
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Affiliation(s)
- Wenjuan Guo
- 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
| | - Chao Jia
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tong Wang
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuemei Zhang
- Department of Pathology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Gehong Yao
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiudong Shi
- Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Bai
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Liu W, Zong M, Gong HY, Ling LJ, Ye XH, Wang S, Li CY. Comparison of Diagnostic Efficacy Between Contrast-Enhanced Ultrasound and DCE-MRI for Mass- and Non-Mass-Like Enhancement Types in Breast Lesions. Cancer Manag Res 2020; 12:13567-13578. [PMID: 33408526 PMCID: PMC7781362 DOI: 10.2147/cmar.s283656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/16/2020] [Indexed: 01/19/2023] Open
Abstract
Background Contrast-enhanced ultrasound (CEUS) can provide angiogenesis information about breast lesions; however, its diagnostic performance in comparison with that of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has not been systematically investigated. This study aimed to evaluate the diagnostic efficacy of CEUS and DCE-MRI in mass-like and non-mass-like enhancement types of breast lesions. Material and Methods A retrospective study was conducted on 252 patients with breast lesions who underwent CEUS and DCE-MRI before surgery between January 2016 and February 2020. Histopathological results were used as reference standards. All patients were classified into mass-like and non-mass-like enhancement lesion groups. The mass-like lesion group was further divided into three categories according to different sizes (group 1: <10 mm, group 2: 10-20 mm, and group 3: >20 mm). Sensitivity, specificity, positive predictive value, negative predictive value, and receiver operating characteristic curve were analyzed to assess the diagnostic performance of these two modalities. Results For mass-like breast lesions, DCE-MRI (Az=0.981) manifested better diagnostic performance than CEUS (Az=0.940) in medium-sized (10-20 mm) tumors (Z=2.018, P=0.043), but both had similar diagnostic performance in smaller (<10 mm) and larger (>20 mm) tumors (P=0.717, P=0.394). For non-mass-like enhancement lesions, CEUS and DCE-MRI showed no significant difference (Z=1.590, P=0.119) and revealed good diagnostic performance (Az=0.859, Az=0.947) in differentiating the two groups. Conclusion For mass-like breast lesions, DCE-MRI showed better diagnostic performance than CEUS in differentiating benign and malignant tumors of medium-sizes (10-20mm) but not of smaller (<10mm) and larger (>20 mm) sizes. For non-mass-like lesions, both modalities showed similar diagnostic performance.
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Affiliation(s)
- Wei Liu
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People's Republic of China
| | - Min Zong
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People's Republic of China
| | - Hai-Yan Gong
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People's Republic of China
| | - Li-Jun Ling
- Department of Breast Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People's Republic of China
| | - Xin-Hua Ye
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People's Republic of China
| | - Shui Wang
- Department of Breast Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People's Republic of China
| | - Cui-Ying Li
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People's Republic of China
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