Real-time contrast-enhanced specific ultrasound in staging and follow-up of splenic lymphomas

Abstract

From January 2003 to April 2005 we studied 25 lymphoma patients (10 with HD, 4 with low-grade NHL, 6 with high-grade NHL and 5 with chronic lymphatic leukaemia; 14 men, 11 women, age range 28-79 years). After a baseline US study we rapidly injected 4.8 mL of the second-generation microbubble contrast agent SonoVue (Bracco, Italy). Contrast enhanced studies were carried out with the contrast-specific software named Contrast Tuned Imaging (Esaote, Italy) using a continuous, harmonic acquisition and a low acoustic pressure. The CS-US findings were correlated with results of standard tools, including CT, MRI, US follow up. CS-US revealed correctly 47 out of the 52 lesions identified by CT scan, in the absence of false positive findings (sensitivity = 90%; Specificity = 100%, in comparison to CT scan). Complete concordance in evaluating the lesion extension of the CS-US in respect to CT was 88%, while underestimate occurred in 9% and overestimate in 3% of cases. On the contrary, basic sonography defined correctly the dimensional alteration in 52% of the cases, underestimated in 35% and overestimated in 13%, thus showing significantly lower accuracy (chi-square = 30.0, p < 0.001). In our experience, CS-US was superior to conventional sonography even from a qualitative point of view.

The EFSUMB Guidelines and Recommendations on the Clinical Practice of Contrast Enhanced Ultrasound (CEUS): Update 2011 on non-hepatic applications

“…CEUS may aid in detecting focal lesions in the spleen [79]. Lesions that are not seen on baseline US can be revealed by CEUS, which has been found to be 90 % sensitive and 100 % specific compared to CT with respect to lesion detection in lymphoma patients [93]. In a retrospective study on splenic metastases, CEUS increased the detection rate by 38 % [94].…”

Use of Contrast‐enhanced Ultrasound for Characterization of Focal Splenic Lesions

“…[6][7][8] Recently, abdominal extrahepatic application has been proposed. 9,10 Initial studies suggest that contrastenhanced ultrasound is of diagnostic value in patients with splenic and perisplenic lesions, [11][12][13][14][15][16] but little information is available on the perfusion pattern of focal splenic nodules. Benign neoplasia is uncommon in humans and malignancy is extremely rare.…”

Romanian National Guidelines on Contrast Enhanced Ultrasound in clinical practice

“…CEUS is useful for the detection of malignant FSLs in oncologic patients, when CECT and/or CEMRI and/or PET are contraindicated or inconclusive. Studies showed 90% sensitivity and 100% specificity as compared to CECT with respect to lesion detection in lymphoma patients [86] and increased the detection rate of metastases by 38% as compared to splenic conventional US [75]. In monitoring response to chemotherapy, the positive results are seen earlier on CEUS compared to PET-CT [70].…”