Kinetics of a US Contrast Agent in Benign and Malignant Adnexal Tumors

Ordén, Maija-Riitta; Jurvelin, Jukka S.; Kirkinen, Pertti

doi:10.1148/radiol.2262011450

Cited by 99 publications

(74 citation statements)

References 29 publications

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“…In the first study, enhancement ratio, uptake time, and wash-out parameters were excellent for discriminating benign from malignant ovarian tumors in women. 6 In the second study, the wash-out time and AUC were shown to be more accurate than Doppler sonography for discrimination of ovarian cancer from benign tumors. 7 Characterization of ovarian lesions may be improved with new imaging modalities such as PIH sonography.…”

Section: D a Bmentioning

confidence: 91%

“…4,5 A few studies have evaluated the use of contrastenhanced TVS in the differentiation of benign and malignant ovarian tumors by showing more prominent enhancement of malignant lesions. [6][7][8][9][10] However, some of these studies were performed with Doppler imaging to assess tumor enhancement after contrast agent administration. 7,8 This method has low contrast and resolution, substantial background noise, and considerable operator dependence.…”

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confidence: 99%

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Diagnostic Parameters to Differentiate Benign From Malignant Ovarian Masses With Contrast-Enhanced Transvaginal Sonography

Fleischer

Lyshchik

Jones

et al. 2009

Journal of Ultrasound in Medicine

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Objective. The aim of this study was to evaluate diagnostic parameters to differentiate between benign versus malignant ovarian masses using contrast-enhanced transvaginal sonography (TVS). Methods. Thirty-three consecutive patients with 36 morphologically abnormal ovarian masses (solid or cystic with papillary excrescences, focally thickened walls, or irregular solid areas) smaller than 10 cm received a microbubble contrast agent intravenously while undergoing pulse inversion harmonic TVS. The following parameters were assessed: presence of contrast enhancement, time to peak enhancement, peak contrast enhancement, half wash-out time, and area under the enhancement curve (AUC). Tumor histologic analysis was used to distinguish benign from malignant ovarian tumors. Results. Twenty-six benign masses and 10 malignancies were studied. Of all examined criteria, an AUC of greater than 787 seconds -1 was the most accurate diagnostic criterion for ovarian cancer, with 100.0% sensitivity and 96.2% specificity. Additionally, peak contrast enhancement of greater than 17.2 dB (90.0% sensitivity and 98.3% specificity) and half wash-out time of greater than 41.0 seconds (100.0% sensitivity and 92.3% specificity) proved to be useful. Conclusions. Our data suggest that the AUC, peak enhancement, and half wash-out time had the greatest diagnostic accuracy for contrast-enhanced TVS in differentiation between benign and malignant ovarian masses. Key words: ovarian cancer; contrast-enhanced transvaginal sonography; pulse inversion harmonic imaging. Obstetrics and Gynecology (A.C.F., H.W.J., M.A.C., R.F.A.) Received April 21, 2009, from the Departments of Radiology (A.C.F., A.L., R.F.A., P.K.W.) and

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Section: D a Bmentioning

confidence: 91%

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confidence: 99%

Diagnostic Parameters to Differentiate Benign From Malignant Ovarian Masses With Contrast-Enhanced Transvaginal Sonography

Fleischer

Lyshchik

Jones

et al. 2009

Journal of Ultrasound in Medicine

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“…Harmonics and pulse inversion technology have improved signal-to-noise ratios and structural conspicuity while the introduction of IV contrast agents (akin to those used with CT and MRI) has helped to more accurately detect, characterize and quantify aberrant vascularity and blood flow. [82][83][84] The contrast enhancement of ultrasound helps to visualize tumor neovascularization in developing microscopic (not macroscopic) tumors by delineating the aberrant leaky vascular channels associated with early malignancy. The incompetent extracellular matrix of neovascularization allows extravasation of RBCs (5-7 microns) and contrast agents (1-10 microns in diameter), which can then be detected by ultrasound.…”

Section: Epigenetic Aberrations As Biomarkers In Eocmentioning

confidence: 99%

Biomarkers for ovarian cancer detection and therapy

Dutta

Wang²,

Phalen³

et al. 2010

Cancer Biology & Therapy

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“…However, magnetic resonance imaging (MRI) is superior in the characterization of adnexal masses (4) and should be used to further characterize indeterminate adnexal mass identified by US (5). Previous imaging studies have reported accuracies in the characterization of malignancy of adnexal masses ranging from 60 to 95% for US (4,6,7) and from 83 to 94% for MRI (3, 4, 7Á13); the lower figure of 83% is from a relatively early pioneer study using older equipment (3).…”

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confidence: 99%

Magnetic resonance evaluation of adnexal masses

2008

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Background: Accurate evaluation of adnexal masses allows correct surgical procedure, avoiding unnecessary surgery. Purpose: To evaluate the accuracy of magnetic resonance imaging (MRI) in the diagnosis of malignancy of adnexal lesions. Material and Methods: We retrospectively reviewed the pelvic MRI scans of 161 patients with 199 surgically confirmed adnexal masses, between November 1998 and June 2005. The criteria for adnexal malignancy were contrast-enhanced solid lesions, contrast-enhanced solid components in mixed lesions (except those with low-signal-intensity solid components on T2-weighted imaging [T2WI]), contrast-enhanced papillary projections in cystic lesions (except those with low-signal-intensity papillary projections on T2WI), or septal thickness ≥3 mm. Ascites, peritoneal metastasis, and pelvic adenopathy were also regarded as criteria for malignancy. Results: On MRI evaluation, 97 adnexal lesions were malignant and 102 were non-malignant. Thirty-two percent of patients with ascites had benign lesions. Histopathologic evaluation of the adnexal lesions showed that 83 were malignant (true positives), 100 were non-malignant (true negatives), and seven were uncertain malignant potential tumors; two were false negative and seven were false positive. The MRI sensitivity and specificity for malignancy were 98% and 93%, respectively. MRI reached an accuracy of 95%, with a positive predictive value of 0.92 and a negative predictive value of 0.98 for malignant adnexal lesions. The kappa coefficient was 0.906, indicating almost perfect agreement between MRI and histological results. Conclusion: MRI is an accurate method for evaluating the malignancy of adnexal lesions.

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Kinetics of a US Contrast Agent in Benign and Malignant Adnexal Tumors

Abstract: After microbubble contrast agent injection, malignant and benign adnexal lesions behave differently in degree, onset, and duration of Doppler US enhancement.

Cited by 99 publications

References 29 publications

Diagnostic Parameters to Differentiate Benign From Malignant Ovarian Masses With Contrast-Enhanced Transvaginal Sonography

Diagnostic Parameters to Differentiate Benign From Malignant Ovarian Masses With Contrast-Enhanced Transvaginal Sonography

Biomarkers for ovarian cancer detection and therapy

Magnetic resonance evaluation of adnexal masses

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