The purpose of this study was to assess the role of US in the detection of intraductal spread of breast cancer in comparison with mammography (MMG) and MRI. In 46 patients with breast cancer, US features of the intraductal component were classified as ductal type or distorted type. Histopathologically, 29 of 46 (63%) cases had intraductal components, and the sensitivity, specificity, and accuracy rates in detection of intraductal spread were 89, 76, and 85%, respectively. Each US pattern demonstrated good correspondence to the histologic components, and the distorted type correlated well with comedo-type carcinoma. Mammography was performed in all cases, and the sensitivity, specificity, and accuracy rates in detection of intraductal spread were 55, 100, and 72%, respectively. In comedo type, MMG could diagnose the extent of intraductal spread more accurately compared with US examination. Magnetic resonance imaging comparison was available in 25 cases. Magnetic resonance imaging depicted intraductal extension as an enhanced area during the early phase of a contrast enhancement study with a sensitivity of 93%. Ultrasound and MRI were closely related in terms of morphologic characteristics: the ductal type of US image correlated well with linear enhancement on MRI, whereas the distorted type correlated with regional or segmental enhancement. Current US examination is useful in depicting the intraductal spread of breast cancer; however, US has a tendency to underestimate intraductal component of comedo type compared with MMG and MRI.
Forty-seven patients with thyroid nodules (13 papillary carcinomas, 14 adenomas, and 20 adenomatous goiters) underwent color Doppler sonography with a 7.5 MHz transducer. Perinodular or intranodular color flow signals were depicted in 10 of 13 papillary carcinomas, in 10 of 14 follicular adenomas, and in 14 of 20 adenomatous goiters. No correlation existed between the presence of color signals and pathology, whereas the detection rate of color signals had a dependence on the size of the lesions. No specific flow pattern for malignancy could be found. Color Doppler sonography would not improve the ability to differentiate benign from malignant nodules significantly.
The nodule detection performance on the LCD monitors with a spatial resolution higher than a matrix size of 1,024x1,280 was found to be equivalent to that on the high-resolution CRT monitor.
Blood flow in several types of tumors (two hepatomas, two hemangiomas, two renal cell carcinomas, one hydatidiform mole, and five invasive moles) was assessed with real-time two-dimensional color Doppler echography (ultrasound). In one of the hepatomas and all five of the invasive moles (but not in the hydatidiform mole or in either of the hemangiomas), the intratumoral flow was demonstrated with color Doppler echography, correlating well with the angiographic or dynamic computed tomographic findings. In the invasive moles, rapid blood flow was seen within the hypoechoic zone of the tumor. On follow-up study of four of the invasive moles, disappearance of the hypoechoic area due to blood flow was observed when chemotherapy was successful. Trophoblastic disease is considered to be the best application for color Doppler echography because it provides accurate evaluation of residual tumor after chemotherapy.
Differentiation between metastasis-free pancreatic cancer and mass-forming pancreatitis is difficult by FDG-PET/CT due to considerable overlapping between the SUVmax values of the two diseases, although the differential diagnosis may be possible either at the higher range of SUVmax (> 7.7 at 1 hour or > 9.98 at 2 hours) for pancreatic cancer or at the lower range of SUVmax (<3.37 at 1 hour or <3.53 at 2 hours) for mass-forming pancreatitis.
Our results show that elasticity imaging provides relatively reliable predictions for malignancy, especially in BI-RADS category 4 masses, compared with MR DWI.
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