Optimization of Region of Interest Drawing for Quantitative Analysis

Abstract

reast cancer is the most common type of cancer in women worldwide, with nearly 1.7 million new cases diagnosed in 2012, and is the second most common type of cancer overall. It represents about 12% of all new cancer cases and 25% of all cancers in women. 1 Sonography is an important modality that is frequently used in all aspects of breast imaging, including breast cancer screening, evaluation of palpable abnormalities, further characterization of lesions detected mammographically, and determining the method of percutaneous biopsy. 2 Advances in ultrasound technology include harmonic imaging, compound imaging, power Doppler imaging, faster frame rates, and higher-resolution transducers. Recently, elastography and three-dimensional sonography have also been used to evaluate breast lesions. 3 Norio Nakata, MD, Tomoyuki Ohta, MD, Makiko Nishioka, MD, Hiroshi Takeyama, MD, Yasuo Toriumi, MD, Kumiko Kato, MD, Hiroko Nogi, MD, Makiko Kamio, MD, Kunihiko Fukuda, MD Received October 16, 2014, ORIGINAL RESEARCHObjectives-This study was performed to evaluate the diagnostic utility of quantitative analysis of benign and malignant breast lesions using contrast-enhanced sonography.Methods-Contrast-enhanced sonography using the perflubutane-based contrast agent Sonazoid (Daiichi Sankyo, Tokyo, Japan) was performed in 94 pathologically proven palpable breast mass lesions, which could be depicted with B-mode sonography.Quantitative analyses using the time-intensity curve on contrast-enhanced sonography were performed in 5 region of interest (ROI) types (manually traced ROI and circular ROIs of 5, 10, 15, and 20 mm in diameter). The peak signal intensity, initial slope, time to peak, positive enhancement integral, and wash-out ratio were investigated in each ROI.Results-There were significant differences between benign and malignant lesions in the time to peak (P < .05), initial slope (P < .001), and positive enhancement integral (P < .05) for the manual ROI. Significant differences were found between benign and malignant lesions in the time to peak (P < .05) for the 5-mm ROI; the time to peak (P < .05) and initial slope (P < .05) for the 10-mm ROI; absolute values of the peak signal intensity (P < .05), time to peak (P < .01), and initial slope (P < .005) for the 15-mm ROI; and the time to peak (P < .05) and initial slope (P < .05) for the 20-mm ROI. There were no statistically significant differences in any wash-out ratio values for the 5 ROI types.Conclusions-Kinetic analysis using contrast-enhanced sonography is useful for differentiation between benign and malignant breast lesions.

Diagnostic Performance of Contrast-Enhanced Ultrasound in Renal Cancer: A Meta-Analysis

“…Contrast-enhanced ultrasound is a new detection method developed in ultrasound contrast agent and contrast imaging technology. It can observe blood perfusion in tumor in real time, continuously and dynamically, which further improves the accuracy of clinical diagnosis (5)(6)(7). CEUS can effectively display the low blood perfusion state and ischemic necrosis of tumor lesions with a diameter of less than 1 cm, thereby providing more information for the diagnosis of renal cancer, and at the same time eliminates the disadvantages of enhanced CT and MRI examinations (8,9).…”

Value of Contrast‐Enhanced Ultrasound in the Diagnosis of Renal Cancer and in Comparison With Contrast‐Enhanced Computed Tomography: A Meta‐analysis

“…Vascularization of suspicious focal lesions could be dynamically evaluated at both the microcirculation and microcirculation levels during US imaging. As a safe, nonradioactive, and real‐time imaging tool, CEUS is widely applied in clinics to differentiate between benign and malignant focal lesions in various organs, including the liver, breast, and kidney . In recent years, emerging studies have assessed the diagnostic performance of CEUS for renal cancer and in comparison with other commonly used imaging technologies such as CECT and MRI.…”

Contrast-enhanced ultrasonography for early prediction of response of neoadjuvant chemotherapy in breast cancer

“…Δpeak2 and ΔRBF2, obtained from ROI 2 after the first cycle, were significantly higher in responders than non-responders (p<0.05). Some studies ( 11 , 12 , 29 ) have explained that different regions within the same malignant lesion can have different characteristics because of tumor heterogeneity. We know that large and rich nourishing vessels in the tumors provide nutrients, whereas tumor angiogenesis as well as new tumor tissue formation are often at the edge of the lesion to infiltrate surrounding normal tissues.…”