A Pilot Study on Diagnostic Performance of Contrast-Enhanced Ultrasonography for Detection of Early Cervical Cancer

Pálsdóttir, Kolbrún; Epstein, Elisabeth

doi:10.1016/j.ultrasmedbio.2018.04.018

Cited by 15 publications

(10 citation statements)

References 166 publications

(200 reference statements)

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“…In this evaluation, more emphasis is put on the subjective qualitative assessment of contrast enhancement over the wash-in and wash-out phases, location of contrast uptake in the tumors and vessel pattern, which were the basis of our classifications in the present study 38 . Also, in a recently published study on cervical cancer, it was found that a focal filling pattern was strongly associated with a remaining tumor after conization 11 . Semiquantitative DCE-US parameters from the TIC have shown promising results in monitoring the treatment effect of antiangiogenetic drugs and in differentiating benign cervical tissue from cervical cancer 11,39 .…”

Section: Discussionmentioning

confidence: 91%

“…Also, in a recently published study on cervical cancer, it was found that a focal filling pattern was strongly associated with a remaining tumor after conization 11 . Semiquantitative DCE-US parameters from the TIC have shown promising results in monitoring the treatment effect of antiangiogenetic drugs and in differentiating benign cervical tissue from cervical cancer 11,39 . In our study on the DCE-US assessment of endometrial cancer, we conclude that qualitative parameters, i.e.…”

Section: Discussionmentioning

confidence: 91%

“…Picking a representative ROI is a known challenge that can introduce substantial variability 25 . In a pilot study using DCE-US in cervical cancer staging, three out of four patients had necrosis in areas of hypoenhancement 11 . In our study, only time-to-peak was predictive of FIGO Stage ≥ IB for both ROIs.…”

Section: Discussionmentioning

confidence: 98%

“…In healthy women, contrast enhancement is normally lower in the endometrium than in the myometrium but, in cancerous endometrium, contrast enhancement is often higher than in the myometrium, which is indicative of higher capillary blood flow, with earlier arrival time, shorter time-to-peak, higher peak intensity and steeper wash-in slope 6,7 . Some studies have shown that these TIC measures can distinguish benign from malignant endometrial lesions [8][9][10] , and can also be used in the assessment of cervical cancer 11 .…”

Section: Introductionmentioning

confidence: 99%

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Dynamic contrast‐enhanced ultrasound improves diagnostic performance in endometrial cancer staging

Green

Epstein

2020

Ultrasound in Obstet & Gyne

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Objectives To compare the sensitivity and specificity of conventional two‐dimensional transvaginal ultrasound/power Doppler (2D‐TVU/PD) alone and 2D‐TVU/PD combined with dynamic contrast‐enhanced ultrasound (DCE‐US) in diagnosing deep myometrial invasion (MI) and cervical stromal involvement (CSI) in women with endometrial cancer (EC), and to assess the association of DCE‐US semiquantitative and qualitative variables with International Federation of Gynecology and Obstetrics (FIGO) Stage ≥ IB and ‘high‐risk’ cancer. Methods This was a prospective study of 101 consecutive women with biopsy‐confirmed EC, undergoing expert ultrasound examination at Karolinska University Hospital, a tertiary referral center. All consenting women underwent DCE‐US using a 1.5–2.5‐mL intravenous bolus of SonoVue contrast agent, as well as conventional 2D‐TVU/PD examination. DCE‐US videoclips were analyzed with regard to filling (global or focal), wash‐in (prior, simultaneous or after) and wash‐out (global or focal) patterns of the contrast agent in the tumor compared with the surrounding tissue, as well as semiquantitative DCE‐US parameters (wash‐in slope, time‐to‐peak, peak intensity and area under the time–intensity curve (TIC)) obtained from a TIC. The study cohort was compared with a control cohort of women with EC examined at our center according to the International Endometrial Tumor Analysis protocol using 2D‐TVU/PD only, matched at a ratio of 3:1 for FIGO stage and grade. The sensitivity and specificity of 2D‐TVU/PD alone in the control cohort and in combination with DCE‐US in the study cohort in the diagnosis of deep MI, CSI and high‐risk cancer (defined as FIGO Stage ≥ IB and/or Grade 3 endometrioid and/or non‐endometrioid histology) were compared, using pathological evaluation after hysterectomy as the ‘gold standard’. Results After exclusions, 93 women were included in the study cohort and were matched to 279 women in the control cohort. The prevalence of FIGO Stage IA, Grade 1–2 EC was 52% in both cohorts. The sensitivity of 2D‐TVU/PD with DCE‐US in the study cohort was higher than that of 2D‐TVU/PD alone in the control cohort in diagnosing both deep MI (0.74 vs 0.62; P = 0.036) and CSI (0.75 vs 0.51; P < 0.001), whereas the specificity was not significantly different (0.87 vs 0.85 and 0.96 vs 0.95, respectively). Compared with 2D‐TVU/PD alone, the specificity of 2D‐TVU/PD with DCE‐US was higher in detecting high‐risk cancer (0.94 vs 0.85; P = 0.024) but the sensitivity did not differ (0.73 vs 0.71). High‐risk cancer and FIGO Stage ≥ IB were characterized by a ‘focal’ filling pattern, with a ‘prior’ wash‐in pattern and a ‘focal’ wash‐out pattern on subjective assessment of DCE‐US videoclips. All semiquantitative DCE‐US parameters were significantly predictive of FIGO Stage ≥ IB but not of high‐risk cancer, despite a clear trend. Conclusions Compared with 2D‐TVU/PD alone, combining 2D‐TVU/PD with DCE‐US can significantly improve the detection of deep MI and CSI in women with EC, without increasing the false‐positive...

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Dynamic contrast‐enhanced ultrasound improves diagnostic performance in endometrial cancer staging

Green

Epstein

2020

Ultrasound in Obstet & Gyne

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“…By drawing a time-intensity curve (TIC), CEUS extracts and analyses CEUS-related parameters to provide key information for the diagnostic stage and efficacy assessment of tumors. However, its application value in the evaluation of gynecological diseases remains to be proven ( 17 ), and there are few studies on the application of CEUS in cervical cancer ( 18 – 20 ).…”

Section: Introductionmentioning

confidence: 99%

Contrast-enhanced ultrasound combined with elastic imaging for predicting the efficacy of concurrent chemoradiotherapy in cervical cancer: a feasibility study

Ma,

Zhao,

Chen

2024

Front. Oncol.

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ObjectiveContrast-enhanced ultrasound (CEUS) and elastography are of great value in the diagnosis of cervical cancer (CC). However, there is limited research on the role of contrast-enhanced ultrasound combined with elastography in predicting concurrent chemoradiotherapy and disease progression for cervical cancer. The purpose of this study was to evaluate the feasibility of contrast-enhanced ultrasound combined with elastography and tumor prognosis.MethodsMRI was performed on 98 patients with cervical cancer before and after treatment. Before, during, and 1 week after the treatment, contrast-enhanced ultrasound and elastography were conducted, and the alterations of ultrasound-related parameters at each time point of the treatment were compared. The correlation between contrast-enhanced ultrasound combined with elastic imaging and oncological outcome was assessed.ResultsThere was no notable difference in overall clinical data between the complete remission (CR) group and the partial remission (PR) group (P>0.05). Before treatment, there were no statistically significant differences in elasticity score, time to peak (TTP), and peak intensity (PI) between the CR group and the PR group. However, there were no statistical differences in elastic strain ratio (SR) and area under the curve (AUC) before and after treatment between the CR group and the PR group, and there were also no statistical differences in the elastic strain ratio (SR) and area under the curve (AUC) of contrast-enhanced ultrasound parameters between the CR group and the PR group before and during treatment. There was a statistically significant difference after treatment (P<0.05).At present, the follow-up of patients is about 1 year, 7 patients were excluded due to loss to follow-up, and 91 patients were included in the follow-up study. Through the review of the cases and combined with MRI (version RECIST1.1) and serology and other related examinations, if the patient has a new lesion or the lesion is larger than before, the tumor marker Squamous cell carcinoma antigen (SCC-Ag) is significantly increased twice in a row, and the patient is divided into progressive disease (PD). Those who did not see significant changes were divided into stable disease (SD) group. The relationship between clinical characteristics, ultrasound parameters and disease progression in 91 patients was compared. There was no significant difference in age and clinical stage between the two groups (P>0.05), but there was a significant difference in the elevation of tumor marker squamous cell carcinoma antigen (SCC-Ag) between the two groups (P<0.05).With the growth of tumors, TTP decreased, elasticity score and PI increased, and the difference was statistically significant (P<0.05). The AUC of SCC-Ag was 0.655, the sensitivity was 85.3%, and the specificity was 45.6%.The AUC, sensitivity and specificity of ultrasound parameters combined with SCC-Ag predicted disease progression was 0.959, 91.2% and 94.8%.ConclusionsUsing contrast-enhanced ultrasound and elastography to predict the efficacy and disease progression of concurrent chemoradiotherapy is feasible. In addition, the combination of SCC-Ag with contrast-enhanced ultrasound and elastography can further enhance the efficiency of predicting disease progression.

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Comparison of contrast-enhanced ultrasonography and magnetic resonance imaging in the evaluation of tumor size and local invasion of surgically treated cervical cancer

Huang

et al. 2022

Abdom Radiol

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A Pilot Study on Diagnostic Performance of Contrast-Enhanced Ultrasonography for Detection of Early Cervical Cancer

Cited by 15 publications

References 166 publications

Dynamic contrast‐enhanced ultrasound improves diagnostic performance in endometrial cancer staging

Dynamic contrast‐enhanced ultrasound improves diagnostic performance in endometrial cancer staging

Contrast-enhanced ultrasound combined with elastic imaging for predicting the efficacy of concurrent chemoradiotherapy in cervical cancer: a feasibility study

Comparison of contrast-enhanced ultrasonography and magnetic resonance imaging in the evaluation of tumor size and local invasion of surgically treated cervical cancer

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