Abstract
Objectives
There is currently no widely available, minimally invasive first-level examination that allows physicians to identify soft-tissue lesions that are likely to be malignant. The aim of this pilot study was to explore the potential suitability of dynamic contrast-enhanced ultrasound (DCE-US) for this purpose.
Materials and methods
23 patients were referred to the Veneto Oncological Institute for work-up of superficial soft-tissue lesions. Fourteen lesions were examined with CEUS and enhancement kinetics was analyzed. Subsequently, all lesions were surgically removed and subjected to histological analysis.
Results
The 14 lesions included in the study were histologically classified as malignant (n = 7) or benign (n = 7, including 3 schwannomas). A statistically significant difference between benign and malignant lesions was found in terms of mean times to peak enhancement intensity (p = 0.03) but not mean filling times (FT). When schwannomas were analyzed as a separate group, their mean FT was found to be significantly different from that of the other benign lesions (p = 0.001) and from that of the group comprising other benign lesions as well as malignant lesions (p < 0.005).
Conclusions
CEUS with analysis of contrast-enhancement kinetics is a relatively low-cost, minimally invasive imaging technique, which appears to be a potentially effective first-level method for identifying suspicious soft-tissue masses.
Riassunto
Obiettivi
Allo stato dell’arte manca un esame di primo livello, facilmente disponibile e minimamente invasivo che permetta di individuare le lesioni sospette di malignità dei tessuti molli. Scopo di questo studio pilota è fornire primissime indicazioni di valore esplorativo sulle capacità dell’ecografia con mezzo di contrasto (CEUS) di identificare le lesioni sospette sulla base della cinetica contrastografica.
Materiali e metodi
23 pazienti con lesioni dei tessuti molli superficiali inviati dall’Istituto Oncologico Veneto sono stati sottoposti a CEUS e studio della cinetica ecocontrastografica; tutte le lesioni sono state sottoposte ad escissione chirurgica ed analisi istologica.
Risultati
Su 14 lesioni incluse nello studio (7 maligne, 3 schwannomi, 4 benigne), la differenza del time-to-peak medio tra quelle maligne e benigne, diversamente dal Filling-Time (FT), è risultata statisticamente significativa (p = 0.03).
Considerando gli schwannomi come gruppo a parte, si registrano differenze statisticamente significative per i valori di FT tra gli schwannomi e le altre lesioni benigne (p = 0.001) e tra le lesioni benigne e quelle maligne (p < 0.005).
Conclusioni
L’analisi della cinetica ecocontrastografica sembra poter permettere di riconoscere le lesioni sospette già con un’indagine di primo livello, relativamente poco invasiva ed economica.
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Stramare, R., Gazzola, M., Coran, A. et al. Contrast-enhanced ultrasound findings in soft-tissue lesions: preliminary results. J Ultrasound 16, 21–27 (2013). https://doi.org/10.1007/s40477-013-0005-1
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DOI: https://doi.org/10.1007/s40477-013-0005-1