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Objective@#To investigate the value of tumor perfusion parameter measured by using double contrast-enhanced ultrasound (DCEUS) QontraXt three-dimensional pseudocolor quantitative analysis to the therapeutic effect evaluation of preoperative neoadjuvant chemotherapy (NAC) in advanced gastric cancer (AGC) patients.@*Methods@#Eighty-nine AGC patients underwent 3 cycles of preoperative NAC (XELOX) followed by complete resection of lesion. The DCEUS QontraXt three-dimensional pseudocolor was performed one or two weeks before the NAC and operation were applied, respectively. The peak enhancement (PE), time to peak (TP), sharpness of the bolus (β) and area under the enhancement curve (AUC) of primary gastric tumor were measured by QontraXt three-dimensional pseudocolor quantitative analysis. These DCEUS parameters between respond and non-respond groups before and after NAC therapy were compared. The prediction accuracy of DCEUS to the therapeutic effect evaluation of preoperative NAC was determined by the receive operating characteristic (ROC) curves.@*Results@#Among 89 AGC patients, 52 patients responded to NAC therapy, while 37 patients resisted to NAC therapy. Twelve cases in respond group and 26 cases in non-respond group were mucinous carcinoma. Forty cases in respond group and 11 cases in non-respond group were non-mucinous carcinoma (P<0.05). In responder group, the PE and TP before NAC were (53.7±9.3)% and (14 521±2 667) ms, and (32.2±5.5)% and (17 235±1 898) ms after NAC. The ratio of changes of PE (ΔPE) and TP (ΔTP) were 0.43±0.17 and 0.36±0.14, respectively. In non-respond group, the PE and TP before NAC were (54.4±7.2)% and (13 869±3 247) ms, and (45.3±6.1)% and (15 127±1 423) ms after NAC therapy. The ratio of ΔPE and ΔTP were 0.24±0.20 and 0.22±0.12. The PE and TP after NAC, the ratio of ΔPE and ΔTP were significant different among these two groups (all of P<0.05). The ROC curves showed that the ratio of ΔPE in assessing the respond of gastric cancer patients to NAC was superior compared to other parameters (AUC=0.784, P=0.004). The optimal cut-off value of the ratio of ΔPE was 24% and its sensitivity and specificity to the therapeutic effect evaluation of NAC in gastric cancer were 82.7% and 64.9%.@*Conclusion@#DCEUS QontraXt three-dimensional pseudocolor quantitative analysis might be a novel, noninvasive and reliable method to evaluate the therapeutic effect of preoperative NAC in AGC patients.
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Objective@#To assess value of contrast enhanced ultrasound (CEUS) in TN staging of pancreatic cancer and compared with contrast enhanced computed tomography(CECT).@*Methods@#Seventy-eight cases with pancreatic cancer confirmed by pathology were enrolled in this study. All patients were examined using CEUS and CECT and staged according to the 8th guideline of pancreas tumors of AJCC. The diagnostic accuracies of CEUS in TN staging of pancreas tumors were compared with CECT.@*Results@#The diagnostic accuracies of CEUS in T staging and N staging of pancreatic cancer were 80.8%, and 78.2%, respectively. For CECT, the diagnostic accuracies in T staging and N staging were 88.5%, and 88.5%, respectively. There was no significant difference in the diagnostic accuracies between CEUS and CECT in T staging(χ2=1.56, P=0.21). The diagnostic accuracy of CEUS in N staging was significantly lower than that of CECT(χ2=3.86, P=0.04).@*Conclusions@#The diagnostic accuracy of CEUS in T staging of pancreatic cancer is similar to that of CECT, while in its N staging is lower than that of CECT.
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Objective To assess the characterization and usefulness of contrast enhanced ultrasound (CEUS) to diagnose focal lesions of pancreas in comparison to contrast enhanced computed tomography (CECT).Methods 177 cases of focal solid lesions of the pancreas confirmed by pathology were collected.The enhanced patterns and diagnostic capability of CEUS were analyzed,and these results were compared with those of CECT.Results The diagnostic accuracies of ultrasound,CEUS and CECT were 61.6％ (109/177),89.3％ (158/177),and 92.1％ (163/177),respectively.There was no significant difference between the diagnostic accuracies of CEUS and CECT (P =0.071).The sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV),and accurate rate for CEUS were 90.9％,63.6％,73.8％,86.2％,82.5％ (the areas under the curve,AUC =0.820),and 89.8％,69.3％,76.7％,85.9％,84.7％ for CECT (AUC =0.847),respectively,when the hypo-enhanced was regarded as the cut value.No significant difference was found between these results from CEUS and CECT (P =0.071).Conclusions The diagnostic ability of CEUS in focal lesions of the pancreas is similar to that of CECT.
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Objective To compare the accuracy of double contrast-enhanced ultrasound (DCEUS) and multi-detector row CT (MDCT) in determining the gross classification in patients with gastric carcinoma (GC) preoperatively.Methods 239 patients with GC proved by endoscopic biopsy were included.DCEUS (intravenous microbubbles combined with oral contrast-enhanced ultrasound) and MDCT were performed preoperatively.The diagnostic accuracy of DCEUS and MDCT in determining gross classification was calculated and compared.Results The overall accuracy of DCEUS in determining the gross appearance of GC was higher than that of MDCT (85％ vs.80％,P ＜ 0.05);there was no significant difference in accuracy between DCEUS and MDCT for Borrmann Ⅰ and Ⅳ classification of AGC (x2 =1.175,P =0.323 for type Ⅰ;x2 =2.171,P =0.141 for type Ⅳ);the accuracy of DCEUS for EGC,Borrmann Ⅱ and Ⅲ classification of GC was higher than that of MDCT (x2 =16.307,P =0.000 for EGC;x2 =39.950,P =0.000 for type Ⅱ;x2 =35.770,P =0.000 for type Ⅲ).Conclusion DCEUS is valuable in determining gross typing of gastric adenocarcinoma preoperatively.
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Objective To discuss the value of double contrast-enhanced ultrasound(DCEUS) as a method to predict the pathologic grade of regression to preoperative neoadjuvant chemotherapy(NAC) in advanced gastric cancer(AGC) patients,the contrast parameters of gastric carcinoma were measured and its correlation with pathologic response degree was analyzed.Methods Fifty seven patients with endoscopic biopsy-proven AGC were considered for a complete resection of the lesion and had a DCEUS prior to and following XELOX pre-operative NAC therapy for 3 cycles.The arrival time (AT),time-to-peak (TTP), baseline intensity(BI) and peak intensity(PI) of the primary gastric tumor were measured.The enhanced intensity(EI)was defined as PI minus BI.The percentage of change of DCEUS parameters before and after NAC therapy and its correlation with phathologic grades of regression was calculated.Patients were divided into responder and nonreponder group according to different pathologic response grade.The differences of DCEUS parameters between two groups were compared.The diagnostic accuracy of DCEUS in prediction of benefit from preoperative NAC was represented by means of receive operating characteristic(ROC)curves. Results After NAC,the PI and EI values of local gastric cancer were significantly lower than before NAC. There were significant differences in PI and EI after NAC between the responder and nonresponder groups. Among the DCEUS parameters showed significant correlation with pathologic grade of regression,the correlation factor was highest in percentage of EI reduction of primary gastric tumor(ρ= -0.501 ,P =0.007).When the optimal cutoff value of EI reduction rate of gastric tumor determined was 27%,a sensitivity of 81 .8% and specificity of 66.7% were achieved.Conclusions DCEUS might be a novel, noninvasive,liable and potential method to select the benefit responder from the preoperative NAC in AGC patient.
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Objective To evaluate the diagnostic value of virtual touch tissue quantification (VTQ) for nonpalpable breast masses.Methods Two hundred and one nonpalpable breast masses in 176 women who had been scheduled for a sonographically guided core biopsy or operation were examined with the B-mode sonography and VTQ.The pathologic diagnosis was used as the golden standard.The diagnostic performances of the two methods were evaluated with receiver operating characteristic curve(ROC).Results The mean shear wave velocity (SWV) measurement values were (6.17 ± 1.95)m/s in malignant masses and (3.39± 1.82)m/s in benign masses(P ＜0.01),respectively.The area under the ROC curve was 0.789 for the VTQ and 0.840 for the BI-RADS-US,respectively.No statistically difference was found between them.The area under the ROC curve of the combination of the two methods was 0.934,the diagnostic performance of the combination was better than that of BLRADS-US(P ＜0.01)and VTQ alone (P ＜0.01).Conclusions VTQ is a good method for diagnosing nonpalpable breast lesions.The combination of BI-RADS-US and VTQ has better diagnostic perform ance for differentiation of nonpalpable breast lesions,which has important value in clinical application.
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Objective To evaluate the diagnostic and prognostic value of BRAF V600E mutation screening of ultrasound-guided fine-needle aspiration (FNA)specimens in patients with thyroid nodule. Methods The BRAF V600E mutation status were assessed in FNA specimens of 104 patients with thyroid nodules before operations.The BRAF mutation status,clinical,and pathology records of the patients were reviewed and the associations between these characteristics and papillary thyroid cancer (PTC ) were analyzed.Results Seventy-one PTC and 14 benign thyroid nodules were included in this study.BRAF V600E mutations were found in 57/71 (80%)PTC.All benign thyroid nodules had no BRAF V600E mutation.The sensitivity,specificity,positive predictive value and negative predictive value of BRAF V600E mutations in differentiation between PTC and benign thyroid nodules were 80%,100%,100% and 50%(P < 0.001 ).In 44 patients with PTC who underwent surgery,the central compartment lymph node metastases and extrathyroidal invasion were not significantly different between BRAF-positive and BRAF-negative PTC (P = 0.283 and 0.307 ).Conclusions BRAF V600E mutation may be a potential tool to facilitate ultrasound in diagnosis of PTC.In patients with PTC,the presence of the BRAFV600E mutation was not significantly associated with prognostic factors.