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Chen K, Wu S. The utility of quantifying the orientation of breast masses in ultrasound imaging. Sci Rep 2024; 14:4578. [PMID: 38403659 PMCID: PMC10894861 DOI: 10.1038/s41598-024-55298-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 02/22/2024] [Indexed: 02/27/2024] Open
Abstract
The aim of this study was to quantify the orientation of breast masses and determine whether it can enhance the utility of a not parallel orientation in predicting breast mass malignancy. A total of 15,746 subjects who underwent breast ultrasound examinations were initially enrolled in the study. Further evaluation was performed on subjects with solid breast masses (≤ 5 cm) intended for surgical resection and/or biopsy. The orientation angle, defined as the acute angle between the align of the maximal longitudinal diameter of the breast mass and the surface of the breast skin, was measured. Receiver operating characteristic (ROC) curve analysis was conducted, and various performance measures including sensitivity, specificity, positive and negative predictive values, accuracy, odds ratio, and the area under the ROC curve (AUC) were calculated. Multivariate analysis was performed to determine if the orientation angle was an independent predictor of breast malignancy. Decision curve analysis (DCA) was also conducted to assess the net benefit of adopting the orientation angle for predicting breast mass malignancy. The final analysis included 83 subjects with breast cancer and 135 subjects with benign masses. The intra-group correlation coefficient for the measurement of the orientation angle of breast masses was 0.986 (P = 0.001), indicating high reproducibility. The orientation angles of malignant and benign breast masses were 36.51 ± 14.90 (range: 10.7-88.6) degrees and 15.28 ± 8.40 (range: 0.0-58.7) degrees, respectively, and there was a significant difference between them (P < 0.001). The cutoff value for the orientation angle was determined to be 22.9°. The sensitivity, specificity, positive and negative predictive values, accuracy, odds ratio, and AUC for the prediction of breast malignancy using the orientation angle were 88.0%, 87.4%, 81.1%, 92.2%, 87.6%, 50.67%, and 0.925%, respectively. Multivariate analysis revealed that the orientation angle (> 22.9°), not circumscribed margin, and calcifications of the breast mass were independent factors predicting breast malignancy. The net benefit of adopting the orientation angle for predicting breast malignancy was 0.303. Based on these findings, it can be concluded that quantifying the orientation angle of breast masses is useful in predicting breast malignancy, as it demonstrates high sensitivity, specificity, AUC, and standardized net benefit. It optimizes the utility of the not parallel orientation in assessing breast mass malignancy.
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Affiliation(s)
- Kailiang Chen
- Department of Ultrasound, The First Affiliated Hospital of Hainan Medical University, No.31, Longhua Road, Haikou, 570102, China
| | - Size Wu
- Department of Ultrasound, The First Affiliated Hospital of Hainan Medical University, No.31, Longhua Road, Haikou, 570102, China.
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Wu Z, Liao M, Li H, Huang S, Liang X, Chen B, Zhang G, Yang Y, Xu X. Multimodal ultrasonic manifestations of secretory carcinoma of the breast. Clin Hemorheol Microcirc 2024; 87:367-373. [PMID: 38393895 DOI: 10.3233/ch-242095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Secretory carcinoma of the breast (SCB) is a rare and specific type of breast cancer. Owing to its rarity, the number of SCB reports available is limited, with most of them focusing on clinical and pathological characteristics but no reports on its multimodal ultrasound (US) features. Thus, we present a rare case of SCB, retrospectively analyzing manifestations of US and contrast-enhanced US, as well as its pathological basis, aiming to enhance the understanding of US image features of SCB and provide more valuable information for clinical diagnosis. Moreover, the treatment strategy adopted for this patient may serve as a template for future management of SCB.
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Affiliation(s)
- Zehong Wu
- Department of Ultrasonography, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Manli Liao
- Department of Ultrasonography, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Huajuan Li
- Department of Ultrasonography, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Shengchao Huang
- Department of Breast Surgery, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Xin Liang
- Department of Ultrasonography, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Bohan Chen
- Department of Pathological Diagnosis and Research Center, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Guoli Zhang
- Department of Ultrasonography, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Yuping Yang
- Department of Ultrasonography, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Xiaohong Xu
- Department of Ultrasonography, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
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Zeng YH, Yang YP, Liu LJ, Xie J, Dai HX, Zhou HL, Huang X, Huang RL, Liu EQ, Deng YJ, Li HJ, Wu JJ, Zhang GL, Liao ML, Xu XH. The discriminatory diagnostic value of multimodal ultrasound combined with blood cell analysis for granulomatous lobular mastitis and invasive ductal carcinoma of the breast. Clin Hemorheol Microcirc 2024; 86:481-493. [PMID: 38007642 DOI: 10.3233/ch-231999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
OBJECTIVE To explore the discriminatory diagnostic value of multimodal ultrasound(US) combined with blood cell analysis (BCA) for Granulomatous Lobular Mastitis (GLM) and Invasive Ductal Carcinoma (IDC) of the breast. METHODS A total of 157 breast disease patients were collected and divided into two groups based on postoperative pathological results: the GLM group (57 cases with 57 lesions) and the IDC group (100 cases with 100 lesions). Differences in multimodal ultrasound features and the presence of BCA were compared between the two groups. The receiver operating characteristic (ROC) curve was used to calculate the optimal cutoff values, sensitivity, specificity, 95% confidence interval (CI), and the area under the curve (AUC) for patient age, lesion size, lesion resistive index (RI), and white blood cell (WBC) count in BCA. Sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and AUC were calculated for different diagnostic methods. RESULTS There were statistically significant differences (P < 0.05) observed between GLM and IDC patients in terms of age, breast pain, the factors in Conventional US (lesion size, RI, nipple delineation, solitary/multiple lesions, margin, liquefaction area, growth direction, microcalcifications, posterior echogenicity and abnormal axillary lymph nodes), the factors in CEUS (contrast agent enhancement intensity, enhancement pattern, enhancement range, and crab-like enhancement) and the factors in BCA (white blood cells, neutrophils, lymphocytes and monocytes). ROC curve analysis results showed that the optimal cutoff values for distinguishing GLM from IDC were 40.5 years for age, 7.15 cm for lesion size, 0.655 for lesion RI, and 10.525*109/L for white blood cells. The diagnostic accuracy of conventional US combined with CEUS (US-CEUS) was the highest (97.45%). The diagnostic performance AUCs for US-CEUS, CEUS, and US were 0.965, 0.921 and 0.832, respectively. CONCLUSION Multifactorial analysis of multimodal ultrasound features and BCA had high clinical application value in the differential diagnosis of GLM and IDC.
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Affiliation(s)
- Yan-Hao Zeng
- Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Yu-Ping Yang
- Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Li-Juan Liu
- Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Jun Xie
- Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Hai-Xia Dai
- Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Hong-Lian Zhou
- Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Xing Huang
- Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Rong-Li Huang
- Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Er-Qiu Liu
- Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Yi-Jing Deng
- Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Hua-Juan Li
- Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Jia-Jian Wu
- Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Guo-Li Zhang
- Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Man-Li Liao
- Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Xiao-Hong Xu
- Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
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Chaloupka M, Pyrgidis N, Ebner B, Pfitzinger PL, Volz Y, Berg E, Enzinger B, Atzler M, Ivanova T, Pfitzinger PL, Stief CG, Apfelbeck M, Clevert DA. mpMRI-targeted biopsy of the prostate in men ≥ 75 years. 7-year report from a high-volume referral center. Clin Hemorheol Microcirc 2024; 86:63-70. [PMID: 37718788 DOI: 10.3233/ch-238101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
OBJECTIVE Multiparametric magnetic resonance imaging (mpMRI) -Ultrasound- fusion guided biopsy of the prostate (FBx) is the new gold standard for the detection of prostate cancer. Hallmark studies showing superior detection rates of FBx over randomized biopsies routinely excluded patients≥75 years and information on outcome of FBx on this patient cohort is sparse. As a large referral center, we have performed FBx on a substantial number of patients this age. By evaluating outcome of FBx of patients over the age of 75 years we wanted to close the gap of knowledge on this patient cohort. MATERIALS AND METHODS Between 2015 -2022, 1577 patients underwent FBx at our department and were considered for analysis. Clinical and histopathological parameters were recorded. Clinical data comprised age at FBx, serum level of Prostate-specific antigen (PSA), prostate volume, PSA-density, history of previous biopsies of the prostate, result of the digital rectal examination (DRE) and assessment of the indexlesion of mpMRI according to the Prostate Imaging and Reporting Data System (PI-RADS). Univariate analysis and multivariable logistic regression was used to identify age barrier of 75 years as a potential risk factor of detection of clinically significant prostate cancer by FBx. RESULTS 379/1577 patients (24%) were≥75 years and 1198/1577 (76%) patients were < 75 years, respectively. Preoperative PSA was significantly higher in patients≥75 years compared to patients < 75 years (9.54 vs. 7.8, p < 0.001). Patients≥75 years presented significantly more often with mpMRI target lesions classified as PI-RADS 5 compared to patients < 75 years (45% vs. 29%, p < 0.001). Detection rate of clinically significant prostate cancer was significantly higher in patients≥75 years compared to patients < 75 years (63% vs. 43%, p < 0.001). Aggressive prostate cancer grade ISUP 5 was significantly more often detected in patients≥75 years compared to patients < 75 years (13% vs. 8%, p = 0.03). On multivariable logistic regression model adjusted for PSA and PI-RADS score, age barrier of 75 years was identified as a significant risk factor for the detection of clinically significant prostate cancer by FBx (OR: 1.77, 95% CI: 1.36 -2.31, p < 0.001). CONCLUSION After evaluation of a large patient cohort, we show that age≥75 years represents a significant risk factor for the detection of clinically significant prostate cancer. Further studies on mid- and long term outcome are necessary to draw conclusions for clinical decision making in this patient cohort.
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Affiliation(s)
- Michael Chaloupka
- Department of Urology, LMU Klinikum, Ludwigs-Maximilians University Munich, Munich, Germany
| | - Nikolaos Pyrgidis
- Department of Urology, LMU Klinikum, Ludwigs-Maximilians University Munich, Munich, Germany
| | - Benedikt Ebner
- Department of Urology, LMU Klinikum, Ludwigs-Maximilians University Munich, Munich, Germany
| | - Paulo L Pfitzinger
- Department of Urology, LMU Klinikum, Ludwigs-Maximilians University Munich, Munich, Germany
| | - Yannic Volz
- Department of Urology, LMU Klinikum, Ludwigs-Maximilians University Munich, Munich, Germany
| | - Elena Berg
- Department of Urology, LMU Klinikum, Ludwigs-Maximilians University Munich, Munich, Germany
| | - Benazir Enzinger
- Department of Urology, LMU Klinikum, Ludwigs-Maximilians University Munich, Munich, Germany
| | - Michael Atzler
- Department of Urology, LMU Klinikum, Ludwigs-Maximilians University Munich, Munich, Germany
| | - Troya Ivanova
- Department of Urology, LMU Klinikum, Ludwigs-Maximilians University Munich, Munich, Germany
| | - Paulo L Pfitzinger
- Department of Urology, LMU Klinikum, Ludwigs-Maximilians University Munich, Munich, Germany
| | - Christian G Stief
- Department of Urology, LMU Klinikum, Ludwigs-Maximilians University Munich, Munich, Germany
| | - Maria Apfelbeck
- Department of Urology, LMU Klinikum, Ludwigs-Maximilians University Munich, Munich, Germany
| | - Dirk-André Clevert
- Department of Radiology, Interdisciplinary Ultrasound-Center, LMU Klinikum, Ludwigs-Maximilians University Munich, Munich, Germany
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Heine N, Brebant V, Seitz S, Eigenberger A, Prantl L, Tessmann V. Lightweight implants in breast reconstruction. Clin Hemorheol Microcirc 2023:CH239101. [PMID: 36970892 DOI: 10.3233/ch-239101] [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: 06/18/2023]
Abstract
OBJECTIVE Since the first use of silicone implants by Cronin in 1962, there have been several attempts to introduce alternative filling materials for breast implants on the market. A promising new development are lightweight implants, whose filler material is one third lighter than conventional silicone gel. While these implants have been used primarily for aesthetic augmentation, a benefit could be expected particularly in post-mastectomy reconstruction. MATERIALS AND METHODS Since 2019, 92 operations using lightweight implants have been performed at our clinic, 61 of them for breast reconstruction after mastectomy. These have been compared to 92 breast reconstructions using conventional silicone implants. RESULTS The average volume of the lightweight implants was 30% higher than of the conventional implants (452 ml resp. 347 ml), whereas the implant weight was comparable in both groups (317 g resp. 347 g). Grade 3-4 capsular fibrosis was seen in 6 cases in both groups; revision was required 9 times (lightweight implants) and 7 times (conventional silicone implants) during the follow-up period. DISCUSSION To our knowledge, this is the first study to investigate the use of lightweight implants in breast reconstruction. With exception of the filler material, the implants used in the two groups were comparable in shape and surface. The inserted lightweight implants had a greater volume but nearly the same weight as the conventional implants and were used in patients with a higher body mass index. Thus, lightweight implants were preferred in patients whose reconstruction required a larger implant volume. CONCLUSION Lightweight implants are a new alternative for breast reconstruction especially in case that larger implant volume is demanded. The increased complication rate has to be verified in further studies.
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Affiliation(s)
- N Heine
- University Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Regensburg and Caritas Hospital St. Josef, Regensburg, Germany
| | - V Brebant
- University Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Regensburg and Caritas Hospital St. Josef, Regensburg, Germany
| | - S Seitz
- Department of Obstetrics and Gynecology, Caritas Hospital St. Josef, University of Regensburg, Regensburg, Germany
| | - A Eigenberger
- University Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Regensburg and Caritas Hospital St. Josef, Regensburg, Germany
- Medical Device Lab, Regensburg Center of Biomedical Engineering (RCBE), Faculty of Mechanical Engineering, Ostbayerische Technische Hochschule Regensburg, Regensburg, Germany
| | - L Prantl
- University Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Regensburg and Caritas Hospital St. Josef, Regensburg, Germany
| | - V Tessmann
- University Center for Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Regensburg and Caritas Hospital St. Josef, Regensburg, Germany
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Bai X, Wang Y, Song R, Li S, Song Y, Wang H, Tong X, Wei W, Ruan L, Zhao Q. Ultrasound and clinicopathological characteristics of breast cancer for predicting axillary lymph node metastasis. Clin Hemorheol Microcirc 2023; 85:147-162. [PMID: 37694357 PMCID: PMC10657709 DOI: 10.3233/ch-231777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
OBJECTIVES The goal of this study was to assess the clinicopathological and ultrasound (US) features of breast cancer for predicting the risk of axillary lymph node metastasis. METHODS Patients with breast cancer were included in this retrospective, monocentric, observational study. Their preoperative ultrasound features, clinical data, laboratory results and postoperative pathologic results and immunophenotyping were collected. The association of these factors of breast cancer with axillary lymph node metastasis was evaluated by univariate and multivariate analysis. RESULTS In this study, 471 patients diagnosed with breast cancer at the First Affiliated Hospital of Xi'an Jiaotong University between July 2016 and September 2019 were collected, with a total of 471 nodules, of which 231(49.0%) had axillary lymph node metastasis, and 240(51.0%) did not. The parameters of hyperechoic halo, posterior acoustic decrease, microcalcification, carcinogenic embryonic antigen (CEA), cancer antigen-153 (CA153), CK5/6 (+), Ki67 (≥40%), AR (+) and histological grade (grade II and grade III) were significantly and independently associated with axillary lymph node metastasis (p < 0.05 for all). CONCLUSIONS The combination of ultrasound features, tumor markers, pathology, and immunohistochemistry can predict axillary lymph node metastasis in breast cancer patients.
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Affiliation(s)
- Xiaofang Bai
- The Department of Ultrasound Medicine, The First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Yunyue Wang
- The Department of Ultrasound Medicine, The First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Ruxi Song
- The Department of Ultrasound Medicine, The First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Shangan Li
- The Department of Ultrasound Medicine, The First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Yan Song
- The Department of Ultrasound Medicine, The First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Huan Wang
- The Department of Pain Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xiaoning Tong
- Department of Clinical Laboratory, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Wei Wei
- The Department of Ultrasound Medicine, The First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Litao Ruan
- The Department of Ultrasound Medicine, The First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
| | - Qiaoling Zhao
- The Department of Ultrasound Medicine, The First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, China
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