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Characterisation of Collagen Re-Modelling in Localised Prostate Cancer Using Second-Generation Harmonic Imaging and Transrectal Ultrasound Shear Wave Elastography. Cancers (Basel) 2021; 13:cancers13215553. [PMID: 34771715 PMCID: PMC8582793 DOI: 10.3390/cancers13215553] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/20/2021] [Accepted: 11/03/2021] [Indexed: 12/19/2022] Open
Abstract
Prostate cancer has a poor prognosis and high mortality rate due to metastases. Extracellular matrix (ECM) re-modelling and stroma composition have been linked to cancer progression, including key components of cell migration, tumour metastasis, and tissue modulus. Moreover, collagens are one of the most significant components of the extracellular matrix and have been ascribed to many aspects of neoplastic transformation. This study characterises collagen re-modelling around localised prostate cancer using the second harmonic generation of collagen (SHG), genotyping and ultrasound shear wave elastography (USWE) measured modulus in men with clinically localised prostate cancer. Tempo-sequence assay for gene expression of COL1A1 and COL3A1 was used to confirm the expression of collagen. Second-harmonic generation imaging and genotyping of ECM around prostate cancer showed changes in content, orientation, and type of collagen according to Gleason grades (cancer aggressivity), and this correlated with the tissue modulus measured by USWE in kilopascals. Furthermore, there were clear differences between collagen orientation and type around normal and cancer tissues.
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Ranjkesh M, Hajibonabi F, Seifar F, Tarzamni MK, Moradi B, Khamnian Z. Diagnostic Value of Elastography, Strain Ratio, and Elasticity to B-Mode Ratio and Color Doppler Ultrasonography in Breast Lesions. Int J Gen Med 2020; 13:215-224. [PMID: 32547163 PMCID: PMC7259450 DOI: 10.2147/ijgm.s247980] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 05/11/2020] [Indexed: 12/05/2022] Open
Abstract
Purpose The aim of this study was to investigate the sensitivity, specificity, and diagnostic accuracy of sonoelastography (SE), strain ratio (SR), elasticity to B-mode (E/B) ratio, and color Doppler ultrasonography (US) in suspected breast lesions. Materials and Methods This prospective study was conducted on women referred to Alzahra university hospital of Tabriz for annual screening of breast cancer between May 2017 and December 2018. B-mode US, SE, and color Doppler imaging were conducted in females with suspected mammography reports. The lesions in B-mode were classified according to the Breast Imaging Reporting and Data System (B-RADS). The results of SE imaging were graded based on five-grade SE score. SR and E/B ratio of each lesion were also analyzed in SE images. Color Doppler findings were categorized from 0 (no visible vessel) to 2 (> two vessels) based on the vascularity of the tumor. Pathology results were used as the gold standard to measure the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and diagnostic accuracy of each modality. Results One-hundred and ten breast lesions of 104 women aged 42.05±10.33 years were included in the study. Seventy-seven of the lesions were benign and 3 were malignant. Sensitivity and specificity of 97.0% and 77.9% for B-mode US, 93.9% and 87.0% for SE score, 81.8% and 66.2% for color Doppler US, 72.7% and 77.6% for E/B ratio (cutoff: 1.05), and 77.3% and 79.6% for SR (cutoff: 1.90) were obtained, respectively. Addition of SE score to B-mode US increased the sensitivity to 93.9%, specificity to 93.5%, and AUC from 0.95 to 0.97. Cumulative color Doppler US with B-mode US did not enhance the diagnostic accuracy of B-mode US. Conclusion SE was more effective than color Doppler US for distinguishing malignant from benign breast lesion. Among the three different SE features, five-grade SE score was superior to E/B ratio and SR.
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Affiliation(s)
- Mahnaz Ranjkesh
- Medical Radiation Sciences Research Group, Tabriz University of Medical Sciences, Tabriz, Iran.,Radiology Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farid Hajibonabi
- Radiology Department, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.,Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Seifar
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Kazem Tarzamni
- Medical Radiation Sciences Research Group, Tabriz University of Medical Sciences, Tabriz, Iran.,Radiology Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behzad Moradi
- Medical Radiation Sciences Research Group, Tabriz University of Medical Sciences, Tabriz, Iran.,Radiology Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zhila Khamnian
- Social Determinant of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Zhao Q, Wang XL, Sun JW, Jiang ZP, Tao L, Zhou XL. Comparison of strain and acoustic radiation force impulse elastography of breast lesions by qualitative evaluation. Clin Hemorheol Microcirc 2018; 70:39-50. [PMID: 29660916 DOI: 10.3233/ch-170364] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Qing Zhao
- In-Patient Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Nan Gang, Harbin, Heilongjiang, China
| | - Xiao-Lei Wang
- In-Patient Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Nan Gang, Harbin, Heilongjiang, China
| | - Jia-Wei Sun
- In-Patient Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Nan Gang, Harbin, Heilongjiang, China
| | - Zhao-Peng Jiang
- In-Patient Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Nan Gang, Harbin, Heilongjiang, China
| | - Lin Tao
- In-Patient Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Nan Gang, Harbin, Heilongjiang, China
| | - Xian-Li Zhou
- In-Patient Ultrasound Department, Second Affiliated Hospital of Harbin Medical University, Nan Gang, Harbin, Heilongjiang, China
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Wang JW, Guo ZX, Lin QG, Zheng W, Zhuang SL, Lin SY, Li AH, Pei XQ. Ultrasound elastography as an imaging biomarker for detection of early tumor response to chemotherapy in a murine breast cancer model: a feasibility study. Br J Radiol 2018; 91:20170698. [PMID: 29400545 DOI: 10.1259/bjr.20170698] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE This study investigated the feasibility of using strain elastography (SE) and real time shear wave elastography (RT-SWE) to evaluate early tumor response to cytotoxic chemotherapy in a murine xenograft breast cancer tumor model. METHODS MCF-7 breast cancer-bearing nude mice were treated with either cisplatin 2 mg kg-1 plus paclitaxel 10 mg kg-1 (treatment group) or sterile saline (control group) once daily for 5 days. The tumor elasticity was measured by SE or RT-SWE before and after therapy. Tumor cell density was assessed by hematoxylin and eosin staining, and the ratio of collagen fibers in the tumor was evaluated by Van Gieson staining. The correlation between tumor elasticity, as determined by SE and SWE, as well as the pathological tumor responses were analyzed. RESULTS Chemotherapy significantly attenuated tumor growth compared to the control treatment (p < 0.05). Chemotherapy also significantly increased tumor stiffness (p < 0.05) and significantly decreased (p < 0.05) tumor cell density compared with the control. Moreover, chemotherapy significantly increased the ratio of collagen fibers (p < 0.05). Tumor stiffness was positively correlated with the ratio of collagen fibers but negatively correlated with tumor cell density. CONCLUSION The study suggests that ultrasound elastography by SE and SWE is a feasible tool for assessing early responses of breast cancer to chemotherapy in our murine xenograft model. Advances in knowledge: This study showed that the tumor elasticity determined by ultrasound elastography could be a feasible imaging biomarker for assessing very early therapeutic responses to chemotherapy.
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Affiliation(s)
- Jian-Wei Wang
- 1 Department of Ultrasound, Collaborative Innovation Center of Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center , Guangzhou , PR China
| | - Zhi-Xing Guo
- 1 Department of Ultrasound, Collaborative Innovation Center of Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center , Guangzhou , PR China
| | - Qing-Guang Lin
- 1 Department of Ultrasound, Collaborative Innovation Center of Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center , Guangzhou , PR China
| | - Wei Zheng
- 1 Department of Ultrasound, Collaborative Innovation Center of Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center , Guangzhou , PR China
| | - Shu-Lian Zhuang
- 2 Department of Ultrasound, Guangdong Provincial Traditional Chinese Medicine Hospital, the second affiliated hospital of Guangzhou University of traditional Chinese medicine , Guangzhou , PR China
| | - Shi-Yang Lin
- 1 Department of Ultrasound, Collaborative Innovation Center of Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center , Guangzhou , PR China
| | - An-Hua Li
- 1 Department of Ultrasound, Collaborative Innovation Center of Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center , Guangzhou , PR China
| | - Xiao-Qing Pei
- 1 Department of Ultrasound, Collaborative Innovation Center of Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center , Guangzhou , PR China
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Skerl K, Cochran S, Evans A. First step to facilitate long-term and multi-centre studies of shear wave elastography in solid breast lesions using a computer-assisted algorithm. Int J Comput Assist Radiol Surg 2017; 12:1533-1542. [PMID: 28478519 PMCID: PMC5569155 DOI: 10.1007/s11548-017-1596-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 04/24/2017] [Indexed: 12/24/2022]
Abstract
Purpose Shear wave elastography (SWE) visualises the elasticity of tissue. As malignant tissue is generally stiffer than benign tissue, SWE is helpful to diagnose solid breast lesions. Until now, quantitative measurements of elasticity parameters have been possible only, while the images were still saved on the ultrasound imaging device. This work aims to overcome this issue and introduces an algorithm allowing fast offline evaluation of SWE images. Methods The algorithm was applied to a commercial phantom comprising three lesions of various elasticities and 207 in vivo solid breast lesions. All images were saved in DICOM, JPG and QDE (quantitative data export; for research only) format and evaluated according to our clinical routine using a computer-aided diagnosis algorithm. The results were compared to the manual evaluation (experienced radiologist and trained engineer) regarding their numerical discrepancies and their diagnostic performance using ROC and ICC analysis. Results ICCs of the elasticity parameters in all formats were nearly perfect (0.861–0.990). AUC for all formats was nearly identical for \documentclass[12pt]{minimal}
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\begin{document}$${E}_{\mathrm{mean}}$$\end{document}Emean (0.863–0.888). The diagnostic performance of SD using DICOM or JPG estimations was lower than the manual or QDE estimation (AUC 0.673 vs. 0.844). Conclusions The algorithm introduced in this study is suitable for the estimation of the elasticity parameters offline from the ultrasound system to include images taken at different times and sites. This facilitates the performance of long-term and multi-centre studies.
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Affiliation(s)
- Katrin Skerl
- Medical Research Institute, Ninewells Hospital and Medical School, Mailbox 4, Dundee, DD1 9SY, Scotland, UK. .,Image Science for Interventional Techniques, University of Auvergne, 28, Place Henri Dunant, BP 38, 63001, Clermont-Ferrand Cedex, France.
| | - Sandy Cochran
- School of Engineering, University of Glasgow, Glasgow, G12 8QQ, Scotland, UK
| | - Andrew Evans
- Medical Research Institute, Ninewells Hospital and Medical School, Mailbox 4, Dundee, DD1 9SY, Scotland, UK
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Wang Y, Yao B, Li H, Zhang Y, Gao H, Gao Y, Peng R, Tang J. Assessment of Tumor Stiffness With Shear Wave Elastography in a Human Prostate Cancer Xenograft Implantation Model. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:955-963. [PMID: 28258646 DOI: 10.7863/ultra.16.03066] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 08/08/2016] [Indexed: 05/19/2023]
Abstract
OBJECTIVES To investigate the stiffness of human prostate cancer in a xenograft implantation model using shear wave elastography and compare the pathologic features of tumors with varying elasticity. METHODS Human prostate cancer DU-145 cells were injected into 24 nude male mice. The mice were divided into 3 groups according to the time of transplantation (6, 8, and 10 weeks). The volume, elasticity, and Young modulus of tumors were recorded by 2-dimensional sonography and shear wave elastography. The tumors were collected for pathologic analyses: hematoxylin-eosin staining, Ponceau S, and aniline staining were used to stain collagen and elastic fibers, and picric acid-sirius red staining was used to indicate type I and III collagen. The area ratios of collagen I/III were calculated. The correlation between the Young modulus of the tumor and area ratio of collagen I/III were evaluated. Immunohistochemistry of vimentin and α-smooth muscle actin was performed. RESULTS Nineteen tumors in 3 groups were collected. The volume and mean Young modulus increased with the time of transplantation. There were more collagen fibers in the stiff tumors, and there were significant differences in the area ratios of collagen I/III between groups 1 (mean ± SD, 0.50 ± 0.17) and 3 (1.97 ± 0.56; P < .01). The Young modulus of the tumors showed a very significant correlation with the area ratios of collagen I/III (r = 0.968; P < .05). The expression level of α-smooth muscle actin protein was higher in group 3 than in the other groups, but differences in vimentin expression were barely seen. CONCLUSIONS Shear wave elastography is a novel useful technology for showing the elasticity of human prostate cancer xenograft implantation tumors. Collagen fibers, especially collagen type I, play a crucial role in the elasticity in the human prostate cancer xenograft implantation model.
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Affiliation(s)
- Yiru Wang
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Binwei Yao
- Department of Experimental Pathology, Beijing Institute of Radiation Medicine, Beijing, China
| | - Hongfei Li
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Yan Zhang
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Hanjing Gao
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Yabin Gao
- Department of Experimental Pathology, Beijing Institute of Radiation Medicine, Beijing, China
| | - Ruiyun Peng
- Department of Experimental Pathology, Beijing Institute of Radiation Medicine, Beijing, China
| | - Jie Tang
- Department of Ultrasound, Chinese PLA General Hospital, Beijing, China
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