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- Saracco, A, et al.
(författare)
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Contrast-enhanced ultrasound (CEUS) in assessing early response among patients with invasive breast cancer undergoing neoadjuvant chemotherapy
- 2017
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Ingår i: Acta radiologica (Stockholm, Sweden : 1987). - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 58:4, s. 394-402
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Tidskriftsartikel (refereegranskat)abstract
- One of the big challenges in onco-radiology is to find a reliable imaging method that may predict early response during the first cycles of any neoadjuvant chemotherapy. Purpose To evaluate the use of real-time harmonic contrast-enhanced ultrasound (CEUS) in predicting early response in breast cancer tumors under neoadjuvant chemotherapy (NAC) treatment. Material and Methods Nineteen consecutive patients with invasive breast cancer were evaluated with a bolus dose of 2.4 mL contrast agent using CEUS, before and after two cycles of epirubicin and docetaxel. The lognormal function was used for quantitative analysis of kinetic data to evaluate early response. Results There was statistically significant difference in time-to-peak ( tp) between responders and non-responders (two sample t-test, P = 0.027) where tp was significantly longer at the week 5 than at the baseline scan among responders when compared to non-responders. Conclusion In-flow of intravascular contrast agent in tumors is significantly slower in responders at real-time harmonic CEUS, and might be effectively used for the evaluation of early response to chemotherapy in invasive breast cancer. However, further investigations in a larger and more heterogeneous population should be performed to corroborate the reliability of the method.
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- Saracco, A, et al.
(författare)
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Contrast-enhanced ultrasound using real-time contrast harmonic imaging in invasive breast cancer: comparison of enhancement dynamics with three different doses of contrast agent
- 2015
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Ingår i: Acta radiologica (Stockholm, Sweden : 1987). - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 56:1, s. 34-41
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Tidskriftsartikel (refereegranskat)abstract
- In the last few years new potential applications have been developed for contrast-enhanced ultrasound (CEUS) and the management of breast diseases, but there is still some debate concerning the optimal dose to evaluate breast lesions, especially as a diagnostic tool. Purpose To compare different CEUS doses of injected contrast agent in order to establish an optimal dose for the diagnosis of invasive breast cancer. Material and Methods In Group A we compared the bolus dose of 1.2 mL vs. 2.4 mL and in Group B we compared the bolus dose of 2.4 mL vs. 4.8 mL (26 and 25 invasive carcinomas, respectively). CEUS was performed in real-time contrast harmonic imaging (CHI) using a L9-3 MHz probe. All examinations were recorded in a contrast side/side imaging mode loop for 120 s. Wash-in and wash-out patterns of the contrast agent were analyzed with advanced US quantification software and kinetic curves were used for statistical analysis. Results In Group B (2.4 mL vs. 4.8 mL), more and stronger correlation was found among kinetic parameters (area under the curve, P < 0.00001; lognormal model parameters, μ, P = 0.0007 and σ, P < 0.0001; mean transit time, P < 0.0001; model-based wash-out ratios, W21m, P = 0.0002; W50m, P = 0.0001; time-to-peak, P = 0.005) as compared to Group A (1.2 mL vs. 2.4 mL). Conclusion The optimal way to evaluate kinetic features of invasive breast tumors using real-time CEUS is with an injection of contrast agent of either 2.4 mL or 4.8 mL.
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- Saracco, A, et al.
(författare)
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Differentiation between benign and malignant breast tumors using kinetic features of real-time harmonic contrast-enhanced ultrasound
- 2012
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Ingår i: Acta radiologica (Stockholm, Sweden : 1987). - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 53:4, s. 382-388
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Tidskriftsartikel (refereegranskat)abstract
- Contrast-enhanced ultrasound (CEUS) has gained interest because of its ability to gather vascular information in diverse organs. There is still a subject of debate concerning its value in breast lesions, especially as a differential diagnostic tool. Purpose To investigate whether kinetic parameters of CEUS can differentiate between malignant and benign breast lesions. Material and Methods We evaluated 75 malignant and 21 benign lesions in the breast or axilla. Contrast harmonic imaging (CHI) US was performed after the injection of a bolus dose of 2.4 mL of Sono Vue® (Bracco, Milano, Italy). The following parameters were calculated for kinetic analysis: initial slope, time to peak enhancement, wash-out ratios W21 and W50 (relative decrease in signal intensity from the peak enhancement to 21 s and 50 s, respectively). Results A significant difference was found between the benign and malignant lesions in time-to-peak ( P value <0.05) and wash-out ratios W21 ( P value <0.001) and W50 ( P value <0.001). The mean time-to-peak was 9.3 s for malignant and 14.6 s for benign lesions. The mean signal drop from peak to signal intensity measured at 50 s was 85% for malignant and 66% for benign lesions. There was no difference in absolute values of peak signal intensity and initial slope. The most significant difference between standardized benign and malignant wash-out curves was found at 21 s but statistical significance was reached in the range of 14–50 s. Conclusion Real-time CEUS can evolve into a new non-invasive option for differentiate malignant from benign breast lesions.
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- Szabo, BK, et al.
(författare)
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Adjunctive diagnostic value of targeted electrical impedance imaging to conventional methods in the evaluation of breast lesions
- 2005
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Ingår i: Acta radiologica (Stockholm, Sweden : 1987). - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 46:8, s. 782-790
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To determine the diagnostic accuracy of targeted electrical impedance imaging in characterizing breast lesions, and to evaluate whether lesion size, depth and histopathology affect the diagnosis. Material and Methods: A total of 137 women with 145 lesions (79 malignant and 66 benign) found by palpation or mammography were prospectively enrolled in this study. The patients were examined by means of clinical breast examination, mammography, ultrasonography, and electrical impedance imaging with TransScan TS2000. A level of suspicion (LOS) post-processing algorithm (v2.67) was used for TS2000 lesion assessment. Imaging findings were correlated with cytologic ( n = 54) and histologic diagnoses ( n = 91). Patients with benign lesions were followed up for a mean of 36 months. Results: TS2000 showed a high sensitivity (86%) which did not differ significantly from that of mammography (87%) and ultrasonography (US) (75%). The specificity of TS2000 (49%) was significantly lower compared to mammography (97%, P<0.0001) and US (100%, P<0.0001). The additive use of TS2000 to mammography and US yielded no significant increase in sensitivity (97%), but the decrease in specificity was significant (46%, P<0.0001). Diagnostic effectiveness of TS2000 (Az = 0.68), as measured by the area under the ROC curve, was significantly lower than for mammography (Az = 0.93, P<0.0001) and for US (Az = 0.91, P<0.0001). When using TS2000 in addition to mammography and US (Az = 0.86), a significant impairment was found ( P = 0.0003). Conclusion: The role of targeted electrical impedance imaging as an adjunct to mammography and ultrasonography in the diagnosis of breast lesions is not justified by the result of this study.
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- Szabo, BK, et al.
(författare)
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Dynamic MR imaging as a predictor of prognosis in breast cancer
- 2006
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Ingår i: SPECTROSCOPY-AN INTERNATIONAL JOURNAL. - : Hindawi Limited. - 0712-4813. ; 20:1, s. 19-28
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Forskningsöversikt (övrigt vetenskapligt/konstnärligt)abstract
- Contrast-enhanced MR imaging (CE-MRI) has become a widely accepted complementary method for diagnosing breast cancer. It has been suggested for evaluating patients with breast implants, patients at risk of tumour multifocality or recurrence, search for occult primary cancer in presence of axillary metastasis and monitoring the effect of preoperative chemotherapy. The clinical usefulness of MR imaging in patients with increased genetic risk of breast cancer is still under investigation. There is scientific evidence to support the hypothesis that CE-MRI may carry the prognostic significance of angiogenesis, and one of the future indications of this method can be the prognostic evaluation of breast cancer patients by the functional mapping of the angiogenic activity of tumours. On the basis of the promising results of recent reports, further large-scale studies are needed to evaluate the impact of MR parameters on long term overall survival of patients with breast cancer.
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