Feature analysis of ultrasound elastography image for quantitative assessment of cutaneous carcinoma.

BACKGROUND: To evaluate the feasibility of using quantitative texture features computed from high frequency ultrasound and ultrasound elastography (USE) images in the discrimination of benign from malignant skin lesions. METHODS: A commercial ultrasound system with a 14 MHz transducer was used to visualize skin lesions requiring biopsy on clinical evaluation. Patients were enrolled over a 6-month period and imaged prospectively by operators blind to the histopathologic diagnosis. Anatomic ultrasound and USE imaging of the skin lesions was performed using a 2-4 mm gel standoff pad before biopsy and histopathologic evaluation. The ElastoAnalysis software developed for the texture analysis of USE images was provided by Hitachi. The software computes thirteen texture features within a region of interest (ROI), which have demonstrated promise in diagnostic characterization of liver fibrosis staging and in quantitative elastography of breast cancer. This approach has not yet been studied in the quantitative assessment of skin cancer. Results were retrospectively compared to the histopathologic diagnosis and a diagnostic criteria with the goal of maximizing sensitivity was evaluated for each textural feature. RESULTS: Of the 37 lesions included, among 30 patients who participated, 12 lesions were malignant and 25 were benign. Eleven out of thirteen textural metrics computed by the software were useful in differentiating benign from malignant lesions with 100% sensitivity and specificities ranging from 28% to 85%. CONCLUSIONS: This feasibility study demonstrated that feature analysis of USE may be useful in quantitatively differentiating cancerous from benign primary solitary skin lesions prior to biopsy.

Prognostic Predictors of Visual Outcome in Open Globe Injury: Emphasis on Facial CT Findings.

BACKGROUND AND PURPOSE: The present prognostic models for open globe injuries have a limited ability to predict visual outcome before a comprehensive ophthalmologic examination or operation because they depend on the data derived from the ophthalmologic examination and intraoperative findings. The purpose of our study was to determine the specific CT and preoperative clinical data that can predict the prognosis of open globe injury. MATERIALS AND METHODS: We analyzed the relationship of 29 variables derived from clinical and CT data from 97 globe injuries with visual acuity at 1 month. A prediction model was derived from 49 globe injuries by regression analysis, followed by receiver operating characteristic curve analysis of the best CT predictor. RESULTS: Four variables with significance on a regression model were the following: posterior segment hemorrhage (ß = -0.93, P < .0001), presenting visual acuity (ß = 0.28, P = .042), orbital emphysema (ß = 0.46, P = .0018), and complex facial fracture (ß = -0.43, P = .009). Receiver operating characteristic analysis of the posterior segment hemorrhage predicted profound vision loss (light perception or no light perception) with an area under the curve of 0.97. The receiver operating characteristic table indicated that grade III posterior segment hemorrhage has a strong positive predictive value of 100% for profound vision loss. On the other hand, the absence of posterior segment hemorrhage has a strong positive predictive value of 93% for mild-to-severe vision loss (visual acuity better than light perception). CONCLUSIONS: Radiologists, with the help of CT and preoperative clinical data, can predict visual acuity after open globe injury.

Role of FDG PET/CT in investigating the mechanisms underlying atherosclerotic plaque formation and evolution.

This review article is focused on the role of FDG-PET/CT in visualizing atherosclerosis and on the relevance of inflammatory cells such as macrophages and T-lymphocytes in the formation of the atherosclerotic plaque. The vulnerability of the inflammatory plaque and the risk derived from the provocation of cardio- and cerebrovascular incidents independently from the presence of stenotic vessels are discussed as well as the evolution toward calcified plaque. The important role of FDG-PET/CT in early diagnosis of inflammatory plaque is discussed in both animal studies and in clinical setting. The possibility of curing inflammatory plaques, type of drugs, and the possibility of monitoring the anti-inflammatory treatment by FDG-PET/CT are also discussed.