Real-Time Sonoelastography of Major Salivary Gland Tumors

Dumitriu, Dana; Dudea, Sorin M; Botar-Jid, Carolina; Băciuţ, Mihaela; Băciuț, Grigore

doi:10.2214/ajr.11.6529

Cited by 53 publications

(59 citation statements)

References 27 publications

(35 reference statements)

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“…6 One radiologist who was blinded to the pathologic findings or final diagnoses reviewed the static images, except for those of the 23 patients who were previously diagnosed as AML with CT. The strain ratio was measured by comparing the tumour (B) to the renal cortex for all renal lesions.…”

Section: Discussionmentioning

confidence: 99%

“…Elastography in terms of the application of pressure to the probe has a relatively greater operator dependency, and strain values may change with different degrees of manual compression, as well as with the composition and structure of tissues. 19,20 Furthermore, various factors, such as lesion size, depth, and density can affect the performance of elastography, and it can be difficult to achieve optimal image quality for every case.…”

Section: -12mentioning

confidence: 99%

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Strain elastography in the characterization of renal cell carcinoma and angiomyolipoma

Keskin

Güven

Keskin³

et al. 2015

CUAJ

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E67 ORIGINAL RESEARCHCite as: Can Urol Assoc J 2015;9(1-2):e67-71. http://dx.doi.org/10.5489/cuaj.2349 Published online February 9, 2015. AbstractIntroduction: We evaluate the diagnostic performance of strain elastography to differentiate renal cell carcinoma (RCC) from angiomyolipoma (AML). Methods: Strain elastography was performed in 65 patients (mean age 55.5 years; range: 32-81) who had renal lesions (24 AMLs and 41 RCCs) prospectively. Lesions were classified according to lesion size and histological subtypes. The strain ratios of the RCCs and AMLs were evaluated by a radiologist. The area under the curve and the cut-off point were used to assess diagnostic performance. Sensitivity, specificity, and positive and negative predictive values were obtained. Results: In assessing the mean strain ratio, we divided the groups in 3 according to size: (1) <20-mm lesions; (2) 20-to 40-mm lesions; and (3) >40-mm lesions; the respective mean strain ratios were: 1.5 ± 0.5 (range: 0.06-5.92), 2.8 ± 0.4 (range: 0.17-9.92), 2.7 ± 0.3 (range: 0.08-6.15). When RCCs and AMLs were compared, there was a statistically significant difference in the strain ratio among the 3 groups divided per lesion size (p < 0.01). For the strain ratio, the mean ± standard deviation was 1.1 ± 0.1 for AMLs and 3.4 ± 0.3 for RCCs (p < 0.01). When lesion subtypes were compared, there was a statistically significant difference in the strain ratio between the AML and clear cell RCC (p < 0.01). Conclusions: For assessing renal lesions, strain elastography and strain ratio values may be useful in differentiating RCCs from AMLs. IntroductionUltrasound (US) elastography is a new radiological modality. In conventional B-mode imaging, tissue hardness in real time is represented in colour. Because most malignant tumours are harder than benign tissues, benign and malignant tissues were differentiated significantly by this technique. In the literature, a good correlation between strain elastography and histologic analysis was reported, with high sensitivity and specificity for differentiation between benign and malignant masses in breast tissue. 1 We hypothesized that evaluation of tissue elasticity might be useful for renal mass characterization. Tan and colleagues found significant differences between strain ratios for angiomyolipomas (AMLs) and renal cell carcinomas (RCCs) (p < 0.01).2 The aim of our study, therefore, was to prospectively determine the diagnostic efficiency of sonoelastography for differentiating RCCs from AMLs. Methods Study populationThere were 65 patients in our study population (28 men and 37 women) who underwent US, including elastography of a renal mass, at our institution between March 2012 and February 2013. The mean age of patients was 55.5 ± 12.3 (range: 32-81). The study population had various renal masses, including 41 RCCs and 24 AMLs. The RCCs were diagnosed by resection. The histopathological examination was performed by our pathologists. Histological subtype was clear cell carcinoma in 26 patients, papillary cell carcinoma ...

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Section: Discussionmentioning

confidence: 99%

Section: -12mentioning

confidence: 99%

Strain elastography in the characterization of renal cell carcinoma and angiomyolipoma

Keskin

Güven

Keskin³

et al. 2015

CUAJ

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“…Because many diseases correlate with changes in the mechanical properties of tissues, this technique has been successfully applied in detecting and assessing various pathologies of thyroid gland, breast, lymph nodes, major salivary gland, prostate, kidney, and liver [1][2][3][11][12][13][14][15][16][17]. However, to our knowledge, no study has been reported previously in the medical literature using real time sonoelastography to assess gallbladder polyps.…”

Section: Discussionmentioning

confidence: 99%

“…Second, most of the gallbladder polyps were accepted as benign by sonographic follow-up without histopathological diagnosis. Third, elastography itself has certain limitations, including relatively high operator dependency, factors affecting the performance of elastography, such as size, depth, and density of the lesion, strain values containing variables with different degrees of compression and solid components affected by the lack of strain of the fluid portion [2,3,14,22]. Finally, description of the elasticity pattern is a subjective method.…”

Section: Discussionmentioning

confidence: 99%

The use of real-time elastography in the assessment of gallbladder polyps: preliminary observations

Teber¹,

Tan²,

Dönmez³

et al. 2014

Med Ultrason

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Aims: Gallbladder polyps often have a benign nature. Current guidelines suggest surgical removal of polyps greater than 10 mm. However, the accuracy of the size criteria is limited because neoplasia can be found in gallbladder polyps less than 10 mm. The aim of this study was to evaluate the feasibility of real time elastography for gallbladder polyps and to demonstrate the elasticity properties of the polyps. Material and method: Fifty-three polypoid lesions of the gallbladder were prospectively examined with real-time elastography. Of these patients, 52 had a diagnosis of benign gallbladder polyps and one patient was accepted as a gallbladder carcinoma due to its clinical and radiological findings. B-mode and real-time elastographic images were simultaneously presented as a two-panel image, and the elastogram was displayed in a color scale that ranged from red (greatest strain, softest component), to green (average strain, intermediate component), to blue (no strain, hardest component). Results: The mean size for benign gallbladder polyps was 7.2 ± 3 mm (range, 5-21 mm). All benign gallbladder polyps on consecutive real-time elastographic images appeared as having a high-strain elastographic pattern. Only one patient who was accepted with gallbladder carcinoma had a gallbladder polyp with low elasticity properties. Conclusions: Our study showed that real time elastography of gallbladder polyps is feasible. This novel approach may be useful for the characterization of polypoid lesions of the gallbladder.

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“…1-3 However, elasticity imaging (both by qualitative and quantitative elastographic methods) is not definitive in distinguishing benign from malignant lesions in the salivary glands. [4][5][6][7][8][9] In particular, the appearance of pleomorphic adenomas Deniz Cebi Olgun, MD, Fatih Kantarci, MD, Umit Taskin, MD, Fahrettin Kilic, MD, Mehmet Faruk Oktay, Serdar Altinay, MD, Nuray Kepil, MD, Ibrahim Adaletli, MD, Mehmet Ada, MD, Ismail Mihmanli, MD Received July 2, 2013, Objectives-The purpose of this study was to evaluate whether the relative proportions of stromal to cellular components of pleomorphic adenomas have an effect on the shear elastic modulus determined by shear wave elastography (SWE).Methods-This study was approved by the Ethics Committee of our institution and performed between September 2011 and December 2012. Thirty-five patients who underwent surgery for a parotid mass were included in the study.…”

mentioning

confidence: 99%

Relative Proportions of Stromal to Cellular Components of Pleomorphic Adenomas

Olgun

Kantarcı

Taşkın

et al. 2014

J of Ultrasound Medicine

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Determination With Shear Wave Elastography easurement of tissue stiffness by sonography is a relatively new and expanding field of research. The principle theory in elastography is that malignant tumors are stiffer than benign ones. Preliminary evidence suggests that elastographic techniques may have a discriminatory value for detecting malignancies in the breast and thyroid gland. 1-3 However, elasticity imaging (both by qualitative and quantitative elastographic methods) is not definitive in distinguishing benign from malignant lesions in the salivary glands. [4][5][6][7][8][9] In particular, the appearance of pleomorphic adenomas Deniz Cebi Olgun, MD, Fatih Kantarci, MD, Umit Taskin, MD, Fahrettin Kilic, MD, Mehmet Faruk Oktay, Serdar Altinay, MD, Nuray Kepil, MD, Ibrahim Adaletli, MD, Mehmet Ada, MD, Ismail Mihmanli, MD Received July 2, 2013, Objectives-The purpose of this study was to evaluate whether the relative proportions of stromal to cellular components of pleomorphic adenomas have an effect on the shear elastic modulus determined by shear wave elastography (SWE).Methods-This study was approved by the Ethics Committee of our institution and performed between September 2011 and December 2012. Thirty-five patients who underwent surgery for a parotid mass were included in the study. The maximum shear elastic modulus of the mass was measured by SWE. Pleomorphic adenomas were histopathologically subdivided into stroma-poor, intermediate-stroma, and stroma-rich tumors based on the relative proportion of stromal to cellular components.Results-The maximum shear elastic modulus values of the pleomorphic adenomas ranged from 12.6 to 291.9 kPa (mean ± SD, 120.9 ± 92.8 kPa). The Friedman test revealed a statistically significant relationship between the stromal amount and maximum shear elastic modulus (P < .001). Stroma-poor adenomas (mean, 32.3 ± 27.7 kPa; range, 12.6-81.1 kPa) were softer on SWE than stroma-rich adenomas (mean, 174.1 ± 48.4 kPa; range, 92.7-217.2 kPa; P = .009). No such significant difference was detected between stroma-poor and intermediate-stroma tumors (mean, 146.3 ± 106.1 kPa; range, 19.1-291.9 kPa; P = .062) or between intermediate-stroma and stroma-rich tumors (P = .465).Conclusions-Shear wave elastography depicts pleomorphic adenomas with a variable appearance, which is due to the relative proportions of stromal to cellular contents in the tumors.

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Real-Time Sonoelastography of Major Salivary Gland Tumors

Cited by 53 publications

References 27 publications

Strain elastography in the characterization of renal cell carcinoma and angiomyolipoma

Strain elastography in the characterization of renal cell carcinoma and angiomyolipoma

The use of real-time elastography in the assessment of gallbladder polyps: preliminary observations

Relative Proportions of Stromal to Cellular Components of Pleomorphic Adenomas

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