Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 121
Filtrar
Mais filtros

Base de dados
País/Região como assunto
Tipo de documento
Intervalo de ano de publicação
1.
BMC Cancer ; 24(1): 910, 2024 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-39075447

RESUMO

PURPOSE: A practical noninvasive method is needed to identify lymph node (LN) status in breast cancer patients diagnosed with a suspicious axillary lymph node (ALN) at ultrasound but a negative clinical physical examination. To predict ALN metastasis effectively and noninvasively, we developed an artificial intelligence-assisted ultrasound system and validated it in a retrospective study. METHODS: A total of 266 patients treated with sentinel LN biopsy and ALN dissection at Peking Union Medical College & Hospital(PUMCH) between the year 2017 and 2019 were assigned to training, validation and test sets (8:1:1). A deep learning model architecture named DeepLabV3 + was used together with ResNet-101 as the backbone network to create an ultrasound image segmentation diagnosis model. Subsequently, the segmented images are classified by a Convolutional Neural Network to predict ALN metastasis. RESULTS: The area under the receiver operating characteristic curve of the model for identifying metastasis was 0.799 (95% CI: 0.514-1.000), with good end-to-end classification accuracy of 0.889 (95% CI: 0.741-1.000). Moreover, the specificity and positive predictive value of this model was 100%, providing high accuracy for clinical diagnosis. CONCLUSION: This model can be a direct and reliable tool for the evaluation of individual LN status. Our study focuses on predicting ALN metastasis by radiomic analysis, which can be used to guide further treatment planning in breast cancer.


Assuntos
Inteligência Artificial , Axila , Neoplasias da Mama , Linfonodos , Metástase Linfática , Humanos , Feminino , Neoplasias da Mama/patologia , Neoplasias da Mama/diagnóstico por imagem , Metástase Linfática/diagnóstico por imagem , Metástase Linfática/patologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Axila/diagnóstico por imagem , Adulto , Linfonodos/patologia , Linfonodos/diagnóstico por imagem , Ultrassonografia/métodos , Idoso , Aprendizado Profundo , Biópsia de Linfonodo Sentinela/métodos , Curva ROC , Redes Neurais de Computação , Valor Preditivo dos Testes
2.
Endocr Pract ; 30(3): 239-245, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38122932

RESUMO

OBJECTIVE: To investigate the usefulness of ultrasound (US) for the localization of ectopic hyperparathyroidism and compare it with 99mTc-sestamibi (99mTc-MIBI), 4-dimensional computed tomography (4D-CT), and 11C-choline positron emission tomography/ computed tomography (PET/CT). METHODS: Of the 527 patients with surgically confirmed primary hyperparathyroidism, 79 patients with ectopic hyperparathyroidism were enrolled. The diagnostic performance of US, 99mTc-MIBI, US + MIBI, 4D-CT, and 11C-choline PET/CT was calculated, and the factors affecting the sensitivity of US and 99mTc-MIBI were analyzed. RESULTS: Eighty-three ectopic parathyroid lesions were found in 79 patients. The sensitivity was 75.9%, 81.7%, 95.1%, 83.3%, and 100% for US, 99mTc-MIBI, US + MIBI, 4D-CT, and 11C-choline PET/CT, respectively. The difference in sensitivity among these different modalities did not achieve statistical significance (P > .05). The US sensitivity was significantly higher for ectopic lesions in the neck region than for those in the anterior mediastinum/chest wall (85.9% vs. 42.1%, P < .001). The 99mTc-MIBI and 4D-CT sensitivity was not significantly different between these two groups (84.1% vs. 94.6%, P = .193 and 81.3% vs. 85.7%, P = 1). The 11C-choline PET/CT sensitivity was 100% in both groups. CONCLUSIONS: US is a valuable tool for the localization of ectopic hyperparathyroidism, especially for ectopic lesions in the neck region.


Assuntos
Hiperparatireoidismo Primário , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Tomografia Computadorizada Quadridimensional/métodos , Hiperparatireoidismo Primário/diagnóstico por imagem , Colina , Tecnécio Tc 99m Sestamibi , Glândulas Paratireoides/diagnóstico por imagem , Compostos Radiofarmacêuticos
3.
BMC Med Imaging ; 24(1): 46, 2024 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-38365645

RESUMO

PURPOSE: To study the value of ultrasound in the diagnosis of juxtaglomerular cell tumor (JGCT). METHODS: From January 2005 to July 2020, fifteen patients diagnosed as JGCT by surgical pathology in Peking Union Medical College Hospital were collected. All patients underwent preoperative ultrasound examination. The clinical, laboratory, ultrasound, computed tomography (CT), surgical, and pathological features of the patients were analyzed retrospectively. RESULTS: The 15 patients were 5 males and 10 females with a median age of 29 years (10∼72 years). 14 of them had hypertension and one had normal blood pressure. The tumors were all solitary, with a median diameter of 1.5 cm (0.9-5.9 cm). Among the fifteen patients, eleven were correctly detected by preoperative ultrasound, and four were missed. There was a significant difference in tumor size (2.64 ± 1.48 cm vs. 1.23 ± 0.21 cm) and whether the tumor protruded outward (9/11 vs. 0/4) between the ultrasound-detected group and the ultrasound-missed group (p = 0.010, p = 0.011). Of the 11 tumors detected by ultrasound, four were extremely hypoechoic, two were hypoechoic, three were isoechoic, and two were hyperechoic. Color Doppler showed no blood flow in five tumors with the size range from 0.9 to 2.0 cm, and mild blood flow in six tumors with the size range from 2.8 to 5.9 cm. CONCLUSIONS: JGCT is rare, and has characteristic clinical manifestations. Diagnosis should be suspected in case of secondary hypertension, particularly in young women, if no renal vascular cause was found. Ultrasound, combined with clinical manifestations, was helpful for the diagnosis.


Assuntos
Adenoma , Hipertensão , Neoplasias Renais , Masculino , Humanos , Feminino , Adulto , Estudos Retrospectivos , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/patologia , Ultrassonografia , Hipertensão/diagnóstico por imagem
4.
J Transl Med ; 21(1): 798, 2023 11 09.
Artigo em Inglês | MEDLINE | ID: mdl-37946210

RESUMO

BACKGROUND: The 70-gene signature (70-GS, MammaPrint) test has been recommended by the main guidelines to evaluate prognosis and chemotherapy benefit of hormonal receptor positive human epidermal receptor 2 negative (HR + /Her2-) early breast cancer (BC). However, this expensive assay is not always accessible and affordable worldwide. Based on our previous study, we established nomogram models to predict the binary and quartile categorized risk of 70-GS. METHODS: We retrospectively analyzed a consecutive cohort of 150 female patients with HR + /Her2- BC and eligible 70-GS test. Comparison of 40 parameters including the patients' medical history risk factors, imaging features and clinicopathological characteristics was performed between patients with high risk (N = 62) and low risk (N = 88) of 70-GS test, whereas risk calculations from established models including Clinical Treatment Score Post-5 years (CTS5), Immunohistochemistry 3 (IHC3) and Nottingham Prognostic Index (NPI) were also compared between high vs low binary risk of 70-GS and among ultra-high (N = 12), high (N = 50), low (N = 65) and ultra-low (N = 23) quartile categorized risk of 70-GS. The data of 150 patients were randomly split by 4:1 ratio with training set of 120 patients and testing set 30 patients. Univariate analyses and multivariate logistic regression were performed to establish the two nomogram models to predict the the binary and quartile categorized risk of 70-GS. RESULTS: Compared to 70-GS low-risk patients, the high-risk patients had significantly less cardiovascular co-morbidity (p = 0.034), more grade 3 BC (p = 0.006), lower progesterone receptor (PR) positive percentage (p = 0.007), more Ki67 high BC (≥ 20%, p < 0.001) and no significant differences in all the imaging parameters of ultrasound and mammogram. The IHC3 risk and the NPI calculated score significantly correlated with both the binary and quartile categorized 70-GS risk classifications (both p < 0.001). The area under curve (AUC) of receiver-operating curve (ROC) of nomogram for binary risk prediction were 0.826 (C-index 0.903, 0.799-1.000) for training and 0.737 (C-index 0.785, 0.700-0.870) for validation dataset respectively. The AUC of ROC of nomogram for quartile risk prediction was 0.870 (C-index 0.854, 0.746-0.962) for training and 0.592 (C-index 0.769, 0.703-0.835) for testing set. The prediction accuracy of the nomogram for quartile categorized risk groups were 55.0% (likelihood ratio tests, p < 0.001) and 53.3% (p = 0.04) for training and validation, which more than double the baseline probability of 25%. CONCLUSIONS: To our knowledge, we are the first to establish easy-to-use nomograms to predict the individualized binary (high vs low) and the quartile categorized (ultra-high, high, low and ultra-low) risk classification of 70-GS test with fair performance, which might provide information for treatment choice for those who have no access to the 70-GS testing.


Assuntos
Neoplasias da Mama , Nomogramas , Humanos , Feminino , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/genética , Neoplasias da Mama/tratamento farmacológico , Estudos Retrospectivos , População do Leste Asiático , Fatores de Risco
5.
Eur Radiol ; 33(3): 1593-1602, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36152038

RESUMO

OBJECTIVES: To evaluate the preoperative diagnostic value of contrast-enhanced lymphatic ultrasound (CEUS) for the sentinel lymph node (SLN) status in early breast cancer. MATERIALS AND METHODS: We prospectively recruited 102 consecutive patients with clinically node-negative early breast cancer from July 2021 to October 2021. All patients underwent conventional US and percutaneous CEUS examinations. The CEUS of SLNs were classified into four enhancement patterns: homogeneous (I), featured inhomogeneous (II), focal defect (III), and no enhancement (IV). The diagnostic performance of conventional US and CEUS for SLN metastasis was assessed by receiver operating characteristic (ROC) curves and decision curves. RESULTS: A total of 78 women were enrolled in this study, including 55, 18, and 5 patients with negative axilla, 1-2, and ≥ 3 metastastic SLNs pathologically, respectively. The identification rate of SLNs by CEUS was 100%. Patterns I and II can select 91.7% (44/48) of patients with disease-free axilla, while patterns III and IV had higher percentages of metastasis (65.2%, p < 0.001 and 57.1%, p < 0.002, respectively). For the SLN metastatic burden, 100% (48/48) of patients with pattern I/II had ≤ 2 metastatic SLNs. Compared with conventional US, the CEUS enhancement patterns showed significant improvement in diagnosing metastatic SLNs (0.813 vs 0.601, p < 0.001). CEUS had greater clinical benefits and correctly reclassified 48% of metastatic SLNs (p < 0.001) without sacrificing the classification accuracy of negative SLNs (p = 0.25), and could improve prediction accuracy by 0.42 (p < 0.001). CONCLUSIONS: CEUS demonstrated better diagnostic performance and greater clinical benefits than conventional US for the preoperative diagnosis of SLNs, showing its potential to select candidates for precluding axillary surgery in early breast cancer. KEY POINTS: • The homogeneous and featured inhomogeneous enhancement of SLNs are highly suggestive of negative LNs, while focal defect (p < 0.001) and no enhancement (p < 0.002) patterns had higher percentages of metastasis. • The proportion of SLNs with highly suspicious signs on conventional US increases as the type of enhancement pattern increases (no suspicious signs in pattern I/II, 34.8% in pattern III, and 85.7% in pattern IV). • Compared with conventional US, CEUS improved the area under the receiver operating characteristic curve (0.813 vs. 0.601, p < 0.001) and had greater clinical benefits (IDI = 0.42, p < 0.001) for the diagnosis of axillary metastasis.


Assuntos
Neoplasias da Mama , Linfadenopatia , Linfonodo Sentinela , Humanos , Feminino , Linfonodo Sentinela/diagnóstico por imagem , Linfonodo Sentinela/patologia , Neoplasias da Mama/patologia , Biópsia de Linfonodo Sentinela , Meios de Contraste/farmacologia , Metástase Linfática/diagnóstico por imagem , Metástase Linfática/patologia , Ultrassonografia , Linfadenopatia/patologia , Axila/patologia , Linfonodos/diagnóstico por imagem , Linfonodos/patologia
6.
Skin Res Technol ; 29(1): e13260, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36704877

RESUMO

BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory disease. Monoclonal antibody dupilumab was approved to treat moderate-to-severe AD in recent years. An objective assessment of treatment response by skin imaging modality is adjuvant for clinical evaluations. This study aimed to explore the value of dermoscopy and high-frequency ultrasound (HFUS) imaging characteristics in treatment evaluation for moderate-to-severe AD patients treated with dupilumab. METHODS: Moderate-to-severe AD patients refractory to conventional therapy were enrolled in the study. All patients went through at least a 16-week standardized treatment of dupilumab. Clinical scores (eczema area scoring index [EASI], SCOARD, numerical rating scale of pruritus, dermatology life quality index), dermoscopy, and HFUS examinations were conducted at 0, 2, 4, 8, 12, and 16 weeks of treatment. Erythema, scales, erosion, and pigmentation under dermoscopy were scored, and subepidermal low-echogenic band (SLEB) thickness under HFUS was measured as quantitative indexes. Descriptive analysis and mixed effect linear regression models were used for statistical analysis. RESULTS: Sixteen patients were enrolled in the study and their average age was 45.63 ± 18.18 years. All clinical scores decreased with significant difference after 16-week treatment compared with baseline. All patients achieved EASI 50 (EASI score decreased by 50% or more), and 9/16 patients reached EASI 75 after 16-week treatment. Dermoscopy evaluation of erythema, scales and erosion scores were decreased, and the sign of pigmentation score was increased after treatment. For HFUS, the mean SLEB value was 0.51 ± 0.29 mm and decreased to 0.27 ± 0.15 mm after 16-week treatment (p < 0.01). SLEB value decreased linearly with treatment time and correlated with clinical scores. However, SLEB values of two patients were 0.57 and 0.68 mm at week 16, respectively, which were higher than the average, and one of the patients showed EASI 75. CONCLUSION: Dermoscopy and HFUS were able to reveal deeper inflammation response than clinical scores in AD and can be an effective method to evaluate and monitor clinical improvement during dupilumab treatment for AD patients. The preliminary value of imaging methods for predicting the treatment endpoint of dupilumab remains to be verified.


Assuntos
Anticorpos Monoclonais Humanizados , Dermatite Atópica , Adulto , Humanos , Pessoa de Meia-Idade , Dermatite Atópica/diagnóstico por imagem , Dermatite Atópica/tratamento farmacológico , Dermoscopia , Método Duplo-Cego , Índice de Gravidade de Doença , Resultado do Tratamento
7.
Pediatr Radiol ; 53(11): 2253-2259, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37438472

RESUMO

BACKGROUND: Parathyroidectomy is the only curative treatment for primary hyperparathyroidism (PHPT). Ultrasound (US) and technetium-99 m sestamibi (99mTc-MIBI) scintigraphy are recommended as the first-line localization imaging modalities for PHPT in adults, but the value of preoperative imaging in pediatric patients has not been reported. OBJECTIVE: To evaluate the added value of 99mTc-MIBI scintigraphy in pediatric PHPT patients with positive ultrasound results. MATERIALS AND METHODS: Pediatric patients (≤18 years old) who were diagnosed with PHPT and underwent surgical treatment in Peking Union Medical College Hospital between January 2003 and January 2021 were included in this study. Demographic and clinical characteristics, preoperative localization US, 99mTc-MIBI scintigraphy and pathology results were collected. Preoperative localization results were evaluated by comparison with surgical and pathological findings. RESULTS: There were 32 pediatric PHPT patients with median age of 14.7 ± 2.5 years who all proved to have single-gland disease without ectopic lesions. The median lesion size was 2.85 cm (range 1.0-5.8 cm). All patients underwent US and 99mTc-MIBI scintigraphy. Neck US demonstrated 100% sensitivity. Of 32 patients with a positive US, 99mTc-MIBI scintigraphy was concordant in 30 (93.8%). In 2 patients (6.3%), US reported suspected multigland disease, which was correctly diagnosed by 99mTc-MIBI scintigraphy as single lesions. CONCLUSION: In pediatric PHPT patients, US achieved high sensitivity for preoperative localization. 99mTc-MIBI scintigraphy for pediatric patients with positive US results would not increase the sensitivity. Implementation of 99mTc-MIBI scintigraphy could increase the specificity in pediatric patients with multigland disease suspected by US.


Assuntos
Hiperparatireoidismo Primário , Tecnécio Tc 99m Sestamibi , Adulto , Humanos , Criança , Adolescente , Hiperparatireoidismo Primário/diagnóstico por imagem , Hiperparatireoidismo Primário/cirurgia , Cintilografia , Ultrassonografia/métodos , Sensibilidade e Especificidade , Compostos Radiofarmacêuticos
8.
Breast Cancer Res Treat ; 196(2): 409-422, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36166112

RESUMO

PURPOSE: Screen-detected unilateral non-palpable breast cancer (NPBC) shows favorable prognosis, whereas bilateral breast cancer (BBC), especially synchronous BBC (SBBC) manifests worse survival than unilateral breast cancer (BC). It remains unclear whether screen-detected bilateral NPBC has compromised survival and requires intensified treatment or favorable prognosis and needs de-escalating therapy. METHODS: From 2003 to 2017, 1,075 consecutive NPBC patients were retrospectively reviewed. There were 988 patients with unilateral NPBC (UniNPBC), and 87 patients with ipsilateral NPBC + any contralateral BC [(N + AnyContra) PBC], including 32 patients with bilateral NPBC (BiNPBC) and 55 patients with ipsilateral NPBC + contralateral palpable cancer [(N + Contra) PBC]. Median follow-up time was 91 (48-227) months. Clinicopathological characteristics were compared between UniNPBC and BBC, whereas relapse-free survival (RFS) and overall survival (OS) among BBC subgroups. RFS and OS factors of BBC were identified. RESULTS: Compared to UniNPBC, patients with screen-detected bilateral BC had more invasive (85.1%, 74.8%), ER negative (26.4%, 17.1%), PR negative (36.8%, 23.5%), triple-negative (21.6%, 8.5%) BC as well as less breast conserving surgery (17.2%, 32.4%), radiotherapy (13.8%, 32.0%) and endocrine therapy (71.3%, 83.9%). 10 year RFS and OS rates of (N + AnyContra) PBC (72.8%, 81.5%), (N + Contra) PBC (60.6%, 73.9%), and synchronous (N + Contra) PBC (58.1%, 70.1%) were significantly compromised compared to UniNPBC (91.0%, 97.2%). RFS factors of BBC included pN3 (p = 0.048), lymphovascular invasion (p = 0.008) and existence of contralateral palpable interval BC (p = 0.008), while the OS relevant factor was pN3 (p = 0.018). CONCLUSION: Screen-detected bilateral NPBC including SynBiNPBC and MetaBiNPBC showed good prognosis as UniNPBC so that the therapy of BiNPBC could be de-escalated and optimized according to UniNPBC. Contrarily, screen-detected ipsilateral NPBC with contralateral palpable BC [(N + Contra) PBC] manifested unfavorable survival worse than UniNPBC and synchronous (N + Contra) PBC had the worst survival among all subgroups, implying that these were actually bilateral interval BC and required intensified treatment.


Assuntos
Neoplasias da Mama , Humanos , Feminino , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/terapia , Estadiamento de Neoplasias , Estudos Retrospectivos , Recidiva Local de Neoplasia/patologia , Prognóstico , Hospitais , China
9.
J Surg Res ; 271: 59-66, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34839110

RESUMO

BACKGROUND: To investigate retrospectively an association between the number of metastatic sentinel lymph nodes (SLNs) per total number of SLNs per patient (i.e., the SLN positive rate, or SLN-PR) and non-SLN metastasis in breast cancer. METHODS: A large population (n = 2250) underwent SLN dissection from January 1, 2014 to January 1, 2020; 627 (27.87%) had at least one positive SLN (SLN+). Among these, 283 underwent axillary lymph node (ALN) dissection, and formed the test group. Four external validation groups comprised 43 patients treated in 2019. SLN mappings were examined using methylene blue and indocyanine green. Lymph node ultrasound, SLN-PR, and pathological characteristics were compared between patients with and without non-SLN metastasis. An SLN-PR cutoff value was calculated using receiver operating characteristic (ROC) curves. Associations between clinicopathological variables and SLN-PR with non-SLN metastasis were analyzed by multivariate logistic regression model. RESULTS: The median age was 47 years (IQR: 42-56 y). The median number of resected SLNs was 4. Patients with positive non-SLNs (126/283, 44.52%) had a median of 2 positive node. SLN-PR > 0.333 was a risk factor for non-SLN positivity (area under the ROC curve, 0.726); and carried significantly higher risk of non-SLN metastasis (P < 0.001). This was validated in the external group. CONCLUSIONS: SLN-PR > 0.333 was associated with greater risk of non-SLN metastasis. This provides a reference to non-SLN metastasis in patients with SLN metastasis, an indication for ALN dissection and choice of adjuvant treatment.


Assuntos
Neoplasias da Mama , Linfonodo Sentinela , Axila/patologia , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Feminino , Humanos , Excisão de Linfonodo , Linfonodos/patologia , Linfonodos/cirurgia , Metástase Linfática/patologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Linfonodo Sentinela/patologia , Linfonodo Sentinela/cirurgia , Biópsia de Linfonodo Sentinela
10.
Skin Res Technol ; 28(6): 780-785, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35969183

RESUMO

BACKGROUND: Vulvar lichen sclerosus (VLS) is a chronic inflammatory disease initially involving anogenital areas. Noninvasive assessment is essential for precise management in VLS. We aim to analyze high-frequency ultrasound (HFUS) features and correlate HFUS with histopathological changes. MATERIALS AND METHODS: Forty patients with histopathologically confirmed VLS lesions were retrospectively identified from August 2020 to September 2021. The clinical manifestations, dermoscopic images as well as both 20 and 50 MHz HFUS images were assessed. HFUS assessment included epidermal morphology, hypoechoic dermal band thickness, and hypoechoic dermal band internal echo. We compared HFUS images with histopathology, and Pearson's correlation coefficient was used to assess the relationship between hypoechoic dermal band thickness and histopathological depth. RESULTS: Hypoechoic dermal band was present in 100% (40/40) VLS lesions. There was a significant linear positive correlation between the histopathological depth and corresponding hypoechoic dermal band thickness, with a Pearson correlation coefficient of 0.685 (p < 0.001). Besides, 95% (38/40) lesions revealed smooth epidermis, and the internal echo of hypoechoic dermal band was assessed as homogeneous in 60% (24/40) and inhomogeneous in 40% (16/40) lesions. CONCLUSION: HFUS characteristics, as well as measurable hypoechoic dermal band thickness, may provide valuable information in the precise diagnosis and the treatment monitoring of VLS.


Assuntos
Líquen Escleroso e Atrófico , Líquen Escleroso Vulvar , Humanos , Feminino , Líquen Escleroso Vulvar/diagnóstico por imagem , Estudos Retrospectivos , Ultrassonografia/métodos , Epiderme/diagnóstico por imagem , Epiderme/patologia , Líquen Escleroso e Atrófico/diagnóstico por imagem , Líquen Escleroso e Atrófico/patologia
11.
Skin Res Technol ; 28(6): 833-839, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36281955

RESUMO

BACKGROUND: Acne treatment may fail or cause undesirable side effects due to inaccurate evaluation. High-frequency ultrasound (HFUS) can monitor systemic treatment in patients with moderate-to-severe acne vulgaris. MATERIALS AND METHODS: In this prospective study, consecutive patients with moderate-to-severe acne vulgaris were recruited. Patients were graded by a comprehensive clinical assessment before and after therapy. Simultaneous HFUS grading was independently evaluated according to the sonographic scoring system for acne (SSSA). Clinical and HFUS grades were compared through kappa analysis. RESULTS: A total of 70 patients were enrolled. At baseline, 36 (51.4%) and 34 (48.6%) patients were graded as moderate and severe, respectively, through clinical assessment. However, 27 patients (38.6%) scored SSSA-Grade II and 43 (61.4%) scored SSSA-Grade III in the HFUS grading. Sixty-one patients (87.1%) were in the consistent category as per clinical assessment and HFUS grades, with Kappa1  = 0.745, whereas higher HFUS grades were observed in nine patients. By the end of the observation, 65 of all patients (92.9%) showed significant improvement and 5 (7.1%) showed no apparent improvement after the treatment. According to the clinical assessment, 14, 52, and 4 patients were graded as mild, moderate, and severe, respectively. On the other hand, 11, 51, and 8 patients had SSSA-Grade I, II, and III, respectively. Of all patients, 63 (90.0%) had consistent evaluation results, with Kappa2  = 0.762, whereas the remaining seven patients had an HFUS grade higher than the clinical. CONCLUSION: HFUS is a useful tool for dermatologists to monitor the treatment of moderate and severe acne vulgaris.


Assuntos
Acne Vulgar , Humanos , Estudos Prospectivos , Resultado do Tratamento , Acne Vulgar/tratamento farmacológico , Administração Cutânea
12.
Skin Res Technol ; 28(2): 265-273, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34865255

RESUMO

BACKGROUND: Melanocytic nevi (MN) can be classified into three subtypes according to the depth of the nests of nevus cells which is important for management. High-frequency ultrasound (HF-US) can clearly reveal the lesion size, contour, depth, and internal structures. However, the HF-US studies of MN according to subtypes are limited. We aimed to describe the HF-US features of MN and explore its value in accurate classification. MATERIALS AND METHODS: This retrospective study was conducted from January 2018 to November 2019. Eighty-five patients with MN were included and examined by 50 and 20 MHz HF-US. The HF-US features were recorded including morphological flatness, depth, shape, boundary, internal echogenicity, hyperechoic spots, lateral acoustic shadow, posterior echoic patterns, mushroom signs, and straw-hat signs. Each image was evaluated by two physicians independently, and the consistency was tested. RESULTS: Eleven lesions could not be detected by HF-US. The rest 74 lesions underwent ultrasonic analysis. MN appeared as strip-shaped or oval, hypoechoic areas localized in the epidermis and dermis under ultrasonography. A strong consistency between HF-US and dermoscopy of determining the lesion depth was achieved (κ = 0.935, p < 0.001). The hyperechoic spots were found in 57.6% intradermal nevi. The mushroom signs were seen in 34.8% intradermal nevi, and the straw-hat signs were seen in all the compound nevi. CONCLUSION: MN can be correctly classified using HF-US, and it had a strong correlation with dermoscopic and clinical classification. HF-US could further reveal the internal morphological features of MN, which may support more precise classification and management.


Assuntos
Melanoma , Nevo Pigmentado , Neoplasias Cutâneas , Dermoscopia/métodos , Humanos , Melanoma/patologia , Nevo Pigmentado/patologia , Estudos Retrospectivos , Neoplasias Cutâneas/patologia , Ultrassonografia
13.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 44(3): 478-483, 2022 Jun.
Artigo em Zh | MEDLINE | ID: mdl-35791947

RESUMO

The breast cancer diagnosed in the women at or above age 70 is defined as breast cancer in the elderly.As the population keeps aging,breast cancer in the elderly presents increasing incidence and high mortality.Early detection,early diagnosis,and early treatment might improve the prognosis of these patients. Comprehensively evaluating the functional age of elderly patients is essential for the individualized treatment. Medical imaging plays a key role in the screening,early diagnosis,therapy selection,evaluation of neoadjuvant therapy efficacy,and postoperative follow-up.We reviewed the current literature and focused on the role of medical imaging in the diagnosis and treatment recommendations for breast cancer in the elderly.


Assuntos
Neoplasias da Mama , Idoso , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/cirurgia , Feminino , Humanos , Mamografia , Programas de Rastreamento , Terapia Neoadjuvante , Prognóstico
14.
J Cell Mol Med ; 25(18): 8973-8984, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34409723

RESUMO

NF-κB, a critical cytokine of inflammatory bowel diseases (IBD), is a viable marker to reflect the inflammatory activity of the intestine. We aimed to develop NF-κB-targeted microbubbles (MBs) and perform molecular contrast-enhanced ultrasound (CEUS) to quantify NF-κB expressions on the intestinal wall in IBD mice in vivo. In this study, NF-κB-targeted MBs were fabricated by connecting biotin-loaded NF-κB antibodies and avidin-loaded MBs. NF-κB-targeted MBs presented as transparent and round bubbles with an average diameter of 1.03/µm±0.01. The specific binding of targeted MBs and inflammatory cells was validated by in vitro experiments, including flow cytometry, Western blot and immunofluorescence, which revealed the specific binding of targeted MBs and inflammatory cells. Subsequently, NF-κB-targeted CEUS imaging was performed on mice with chemical-induced colitis, and the peak intensity (PI) and time-to-peak (TTP) were quantified. Pathological and immunohistochemical (IHC) examinations were further implemented. For the target CEUS group, fast enhancement followed by slow subsiding was observed. The PI of target CEUS of the IBD mice was significantly higher than that of non-target CEUS of the IBD mice, healthy controls and target CEUS of the treated IBD mice (34835%[13379-73492%] VS 437%[236-901%], 130%[79-231%], 528%[274-779%], p<0.0001), in accordance with the IHC results of NF-κB expressions. The TTP of target CEUS of the treated mice was significantly higher than that of untreated mice (35.7s [18.1-49.5s] VS 8.3s [4.2-12.5s], p<0.0001). Therefore, we suggested that NF-κB-targeted CEUS could accurately detect and quantify NF-κB expressions on the intestinal walls of IBD, enabling the evaluation of intestinal inflammation.


Assuntos
Doenças Inflamatórias Intestinais , Intestinos/diagnóstico por imagem , Microbolhas , NF-kappa B/metabolismo , Animais , Feminino , Doenças Inflamatórias Intestinais/diagnóstico por imagem , Doenças Inflamatórias Intestinais/metabolismo , Intestinos/patologia , Camundongos , Camundongos Endogâmicos C57BL , Células NIH 3T3 , Células RAW 264.7
15.
Eur Radiol ; 31(2): 928-937, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32845388

RESUMO

OBJECTIVES: To establish a prediction model for evaluating the axillary lymph node (ALN) status of patients with T1/T2 invasive breast cancer based on radiomics analysis of US images of primary breast lesions. METHODS: Between August 2016 and November 2018, a total of 343 patients with histologically proven malignant breast tumors were included in this study and randomly assigned to the training and validation groups at a ratio of 7:3. ALN tumor burden was defined as low (< 3 metastatic ALNs) or high (≥ 3 metastatic ALNs). Radiomics features were obtained using the PyRadiomics package, and the radiomics score was established by least absolute shrinkage and selection operator regression. A nomogram combining the breast cancer US radiomics score with patient age and lesion size was generated based on the multivariate logistic regression results. RESULTS: In the training and validation cohorts, 29.1% (69/237) and 32.08% (34/106) of patients were pathologically diagnosed with more than 2 metastatic ALNs, respectively. The radiomics score consisted of 16 US features, and patient age and lesion diameter identified by US were included to construct the model. The AUC of the model was 0.846 (95% CI, 0.790-0.902) for the training cohort and 0.733 (95% CI, 0.613-0.852) for the validation cohort. The calibration curves showed good agreement between the predictions and observations. CONCLUSIONS: Our novel nomogram demonstrates high accuracy in predicting ALN tumor burden in breast cancer patients. We also suggest further development of PyRadiomics to improve US radiomics. KEY POINTS: • A nomogram based on US was developed to predict ALN tumor burden (low, < 3 metastatic ALNs; high, ≥ 3 metastatic ALNs). • The nomogram could assist clinicians in evaluating treatment strategies for T1/T2 invasive breast cancer.


Assuntos
Neoplasias da Mama , Nomogramas , Neoplasias da Mama/diagnóstico por imagem , Humanos , Linfonodos/diagnóstico por imagem , Metástase Linfática , Estudos Retrospectivos , Carga Tumoral
16.
Skin Res Technol ; 27(3): 453-460, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33112015

RESUMO

BACKGROUND: The clinical manifestations of early mycosis fungoides (eMF) are non-specific and similar to inflammatory skin diseases. High-frequency ultrasonography (HF-US) can show small structure of skin lesions and is helpful to provide information objectively. MATERIALS AND METHODS: A case-control study was designed in 62 patients with multiple erythemas and scales, including 18 eMF and 44 age-matched patients with eczema (EC) or psoriasis vulgaris (PsV). The most significant lesions were collected by 50 MHz HF-US. The assessment of ultrasound included epidermal morphology and thickness, infiltration depth, subepidermal low echogenic band (SLEB) boundary and thickness, internal echo, and number of linear acoustic shadows (LAS) behind the epidermis. The ultrasonic characteristics of eMF, EC, and PsV lesions were analyzed. RESULTS: Epidermal thickness (P < .001, sensitivity 88.9%, specificity 75.0%) and SLEB thickness (P = 0.006, sensitivity 55.6%, specificity 90.9%) were useful for differential diagnosis of eMF and PsV/EC. When eMF was diagnosed by epidermal thickness < 0.2375 mm, the AUC was 0.845, which had the highest diagnostic efficacy among all ultrasound signs. In addition, compared with eMF and EC, the LAS number of PsV lesions was the highest and statistically significant. CONCLUSION: The results showed that HF-US could provide some extra information in identification of eMF, EC, and PsV and has potential clinical value.


Assuntos
Micose Fungoide , Neoplasias Cutâneas , Estudos de Casos e Controles , Diagnóstico Diferencial , Humanos , Micose Fungoide/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico por imagem , Ultrassonografia
17.
Skin Res Technol ; 27(5): 766-773, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33638227

RESUMO

BACKGROUND: Basal cell carcinoma (BCC) is the most common cutaneous malignancy. Occasionally, it may have an appearance similar to that of some benign pigmented skin lesions. Therefore, additional information is needed to differentiate these lesions. MATERIALS AND METHODS: A diagnostic accuracy study was performed from February 2018 to April 2019. All lesions underwent ultrasound examination with 50 and 20 MHz probes. The high-frequency ultrasound (HFUS) images were evaluated independently by 2 experienced doctors for the presence of predefined features, including the depth, shape, margin, anechoic area, hyperechoic spots, epidermal interrupted echo, mushroom sign, flat-bottom sign, and superficial hyperechoic focus (SHEF). RESULTS: A total of 54 BCCs, 51 melanocytic nevi and 55 seborrheic keratoses (SK), were included. BCCs often involved the subcutaneous tissue (11/54, 20.4%; P < .001) and had an irregular shape (26/54, 48.1%; P < .001) and ill-defined borders (26/54, 48.1%; P < .001), while most benign pigmented lesions had a regular shape (101/106, 95.3%; P < .001) and well-defined borders (95/106, 89.6%; P < .001). BCCs occasionally showed anechoic areas (10/54, 18.5%; P < .001) and epidermal interrupted echo (18/54, 33.3%; P < .001). Moreover, hyperechoic spots could be found in BCCs (43/54, 79.6%), nevi (27/51, 52.9%), and SK (30, 54.5%) (P = .001), with mean number of 7.3, 5.5, and 8.0, respectively. The mushroom signs were all present in melanocytic nevi (18/51, 35.3%), while the flat-bottom sign (43/55, 78.2%; P < .001) and SHEF (40/55, 72.7%; P < .001) presented mainly in SKs. CONCLUSIONS: Based on the typical features, HFUS could improve the accuracy of BCC identification and should be considered when dermatologists are unsure about the lesion type.


Assuntos
Carcinoma Basocelular , Ceratose Seborreica , Nevo Pigmentado , Neoplasias Cutâneas , Carcinoma Basocelular/diagnóstico por imagem , Humanos , Ceratose Seborreica/diagnóstico por imagem , Nevo Pigmentado/diagnóstico por imagem , Neoplasias Cutâneas/diagnóstico por imagem , Ultrassonografia
18.
J Ultrasound Med ; 39(10): 1927-1937, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32319698

RESUMO

OBJECTIVES: This study was aimed to assess the ultrasound (US) characteristics of mycosis fungoides (MF)/Sézary syndrome (SS) and explore the value of high-frequency US in accuracy staging for classic mycosis fungoides (cMF). METHODS: A prospective study was designed. Twenty-six patients with histopathologically confirmed MF or SS were enrolled to undergo HF-US examinations. Both 50- and 20-MHz US images of the most prominent lesion of each patient were collected by a cutaneous diagnostic US system, and the US characteristics in different stages were analyzed by 2 physicians independently. The Fisher exact test was used for the statistical analysis. RESULTS: A total of 26 patients underwent this study, including 23 with cMF, 2 with folliculotropic mycosis fungoides (FMF), and 1 with SS. Among cMF, 16 patients with patches or plaques (the early-stage group) showed a subepidermal low-echogenic band, and only 3 lesions in the plaque stage partially extended to the superficial dermis. Seven patients with tumors (the advanced-stage group) showed lesions that infiltrated to the deep dermis or subcutaneous tissue. The infiltration depth (P < .001), clarity of the boundary (P = .002), and homogeneity of internal echoes (P = .001) were significantly different between the early and advanced stages. Additionally, the 2 FMF lesions and 1 SS lesion had characteristic manifestations, showing a well-defined subepidermal low-echogenic band with patchy hypoechoic regions around the hair follicles in the dermis. CONCLUSIONS: High-frequency US can be used to accurately detect the infiltration depth and morphologic features of MF/SS lesions and provide important information for tumor staging of cMF. Additionally, the characteristic US features in FMF and SS might be helpful for diagnosis.


Assuntos
Micose Fungoide , Síndrome de Sézary , Neoplasias Cutâneas , Humanos , Micose Fungoide/diagnóstico por imagem , Micose Fungoide/patologia , Estadiamento de Neoplasias , Prognóstico , Estudos Prospectivos , Síndrome de Sézary/diagnóstico por imagem , Síndrome de Sézary/patologia , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/patologia
20.
BMC Cancer ; 19(1): 939, 2019 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-31604469

RESUMO

BACKGROUND: This preliminary study aimed to examine the feasibility of sentinel lymph node biopsy (SLNB) using contrast-enhanced ultrasound (CEUS) vs. indocyanine green fluorescence (ICG), combined with blue dye in patients with breast cancer. METHODS: This was a retrospective study of consecutive female patients with invasive stage I-III (based on pre-operative physical examination and imaging) primary breast cancer at the Peking Union Medical College Hospital between 01/2013 and 01/2015 who underwent preoperative SLNB by ICG + blue dye or CEUS + blue dye. The numbers of detected SLNs, detection rates, and recurrence-free survival (RFS) rates were compared between the two groups. RESULTS: A total of 443 patients were included. The detection rates of SLNs in the CEUS + blue dye and ICG + blue dye groups were 98.4 and 98.1%, respectively (P = 0.814). The average numbers of SLNs detected per patient showed no significant difference between the two groups (3.06 ± 1.33 and 3.12 ± 1.31 in the CEUS + blue dye and ICG + blue dye groups, respectively; P = 0.659). After a median follow-up of 46 months, five patients in the CEUS + blue dye group and 15 in the ICG + blue dye group had recurrence. RFS rates showed no significant difference (P = 0.55). CONCLUSION: This preliminary study suggests that CEUS + blue dye and ICG + blue dye are both feasible for SLN detection in breast cancer.


Assuntos
Neoplasias da Mama/patologia , Corantes , Verde de Indocianina , Metástase Linfática/diagnóstico por imagem , Azul de Metileno , Imagem Óptica/métodos , Biópsia de Linfonodo Sentinela/métodos , Ultrassonografia Mamária/métodos , Adulto , Idoso , Axila , Intervalo Livre de Doença , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Imagem Óptica/efeitos adversos , Estudos Retrospectivos , Linfonodo Sentinela/patologia , Ultrassonografia Mamária/efeitos adversos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA