Assessment of optic nerve and optic tract alterations in patients with orbital space-occupying lesions using probabilistic diffusion tractography.

AIM: To investigate the diffusion changes in both the optic nerve and optic tract in orbital space-occupying lesion patients with decreased visual acuity, and its clinical significance using probabilistic diffusion tractography (PDT). METHODS: Twenty patients with orbital space-occupying lesions and 25 age- and gender-matched healthy persons were included. All patients and controls underwent routine orbital magnetic resonance imaging and diffusion tensor imaging (DTI), using a 3.0T magnetic resonance scanner (Trio Tim Siemens). After the image data were preprocessed, each DTI parameters of the optic nerve and optic tract was obtained by PDT, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD). The asymmetry index (AI) of each parameter was calculated. Compared the parameters of the affected side optic nerve and ipsilateral optic tract with the contralateral side by paired sample t-test; compared AI of parameters of optic nerve and optic tract between the patient group and the control group by independent sample t-test. Patients were divided into three subgroups according to the low vision grade standard of WHO, compared the FA and AI of FA between the three subgroups by single factor variance analysis. RESULTS: The affected side optic nerve presented significantly decreased FA, increased MD, AD, and RD values compared to the unaffected side (P<0.05). The AI of FA, MD, AD, and RD of optic nerve in the patients was significantly higher than that of the controls (P<0.05). The comparison results of the optic tract showed that there was no significant difference between the patient group and control group in terms of the bilateral optic tracts in patients (P>0.05). The AIs of the FA value of the optic nerve in the eyesight <0.1 subgroup was significantly higher than that in the other groups (P<0.05). CONCLUSION: FA, MD, AD, and RD of the affected side optic nerve of the orbital space-occupying lesions have significantly changed, the FA value is the most sensitive. The PDT could be a useful tool to provide valid quantitative markers of optic nerve injuries and evaluate the severity of orbital diseases, which other examinations cannot be acquired.

Application of shear wave elastography in fine needle aspiration biopsy for thyroid nodule.

Ultrasound guided fine needle aspiration biopsy (FNAB) is the first-line procedure in diagnosing thyroid nodules. However, emerging studies have reported its unsatisfactory cell sample for cytology evaluation. In this case report, shear wave elastography (SWE) guided FNAB on a thyroid nodule is presented. Biopsies were performed on both hard and soft areas of the same nodule on the SWE image. Cytological results demonstrated the sufficient diagnostic components and typical nuclear features of papillary carcinoma found on the specimen from the hard area. This case study indicates SWE is a useful complementary tool to conventional B-mode ultrasound in guiding thyroid nodule FNAB.

Diagnostic potential of strain ratio measurement and a 5 point scoring method for detection of breast cancer: Chinese experience.

AIM: To evaluate the differential diagnostic potential of lesion stiffness assessed by the sonoelastographic strain index ratio (SR) and elastographic color scoring system (UE) for breast lesions. MATERIALS AND METHODS: Three hundred and forty two breast masses (158 benign and 184 malignant) from 325 consecutive patients (mean age 44.2 years; range 16-81)who had been scheduled for a sonographically guided core biopsy were examined with grey scale sonography,doppler sonography and sonoelastography. Each lesion was classified with ACR's BI-RADS assessment category (2, 3 and 4A=Benign and; 4B, 4C, 5=Malignant) and the 5-point scoring system proposed by Itoh et al, with scoring 1-3=benign and 4-5=malignant. Strain and area ratios of each lesion were calculated within the same machine. Histological diagnosis was used as the reference standard. The area under the curve (AUC) and cut-off point were obtained by receiver operating curve and the cross table Fischer Test was carried out for assessing diagnostic value. Sensitivity, specificity, PPV, NPV, accuracy and false-discovery rates were compared. RESULTS: The mean strain ratios for benign and malignant lesions were 1.87 and 7.9 respectively. (P<0.0001). When a cutoff point of 3.54 was used, SR had a sensitivity of 94.6%, a specificity 94.3%, a PPV of 95.1%, an NPV of 93.7% and an accuracy of 94.4%. The AUC values were 0.90 for the 5 point scoring system (UE) and 0.96 for the strain index ratio. The overall diagnostic performance was SR method was better (P<0.05). CONCLUSIONS: Strain ratio measurement could be another effective predictor in elastography imaging besides 5 the point scoring system for differential diagnosis of breast lesions.

Breast elastography: a hospital-based preliminary study in China.

The performance of ultrasound elastography in the characterization of 170 breast lesions with histologic correlation was evaluated in 150 consecutive patients who were diagnosed as having benign or malignant masses on B mode sonography. Each lesion was classified with ACR's BI-RADS lexicon (benign=2 and 3, malignant 4 and 5) using Ueno elastography classification scores (benign=1-3, malignant=4-5). Of the 170 lesions, 70 were histologically malignant, and 100 were benign. Ultrasound elastography was superior in detecting breast cancer, since the accuracy (95.8%), sensitivity (98.6%), specificity (96.0%), and positive predictive values (94.5%) were higher than those of B mode sonography (90.6%, 91.4%, 90.0% and 86.5% respectively). The sensitivity (98.57%) and false discovery rate (1.1%), when both modalities were jointly used (sonography and /UE) was better then those of sonography and UE singly. However, the specificity (90%) was found similar to sonography. In conclusion, ultrasound elastography is superior to B mode sonography in assessing the nature of breast lesions.