Single-center study: dynamic contrast-enhanced ultrasound in the diagnostic assessment of carotid body tumors

Abstract

Background: Carotid body tumors (CBTs) depict the most common paraganglioma of the head and neck that can metastasize in up to 15% of cases. They develop either sporadically or hereditarily and may produce catecholamines ("functioning CBTs") resulting in associated symptoms like headache, palpitations or flush.Non-functioning CBTs usually present as slowly and often tender growing mass which may affect adjacent cranial nerves. CBTs can be visualized by ultrasound, CT, MRI or angiography. Pre-surgical interventional embolization, surgical resection and radiation therapy are therapeutical options. The aim of this retrospective single-center study is to assess the safe and real-time evaluation of CBTs by contrast-enhanced ultrasound (CEUS).Methods: Ten patients with CBT were included in this study on whom CEUS was performed between 2007-2018 (mean age: 62 years). In 6/10 patients, results were confirmed by MRI, 4/12 patients underwent subsequent angiography. CEUS was performed and interpreted by a single consultant radiologist with experience since 2000 (EFSUMB level 3). VueBox ® software was used for standardized perfusion quantification.Results: CEUS allowed to detect all CBTs and visualize intratumoral microcirculation. Perfusion quantification was performed in 6/10 cases. CBTs showed significantly reduced peak-enhancement (PE), reduced wash-in perfusion index (WiPI) and significantly elevated time to peak (TTP) compared to common carotid arteries (CCA).Conclusions: CEUS is a useful and safe tool for identifying CBTs and evaluating intratumoral microperfusion at high spatial and temporal resolutions in real-time. In addition to conventional ultrasound, CT, MRI and digital substraction angiography (DSA), CEUS may be implemented in the future diagnostic work-up and follow-up of CBT patients.

The quantitative evaluation of contrast-enhanced ultrasound in the differentiation of small renal cell carcinoma subtypes and angiomyolipoma

“…Furthermore, CEUS has a high sensitivity for avoiding false-negative cases, which saves resources without compromising effectiveness and leaves more CT or MRI availabilities for other patients in need. Thus, CEUS is more cost-effective than MRI or CT (10)(11)(12).…”

Anwendung der Kontrastmittelsonografie im Kopf-Hals-Bereich: Update

“…Versuche, den CEUS zur Therapiekontrolle zu nutzen, gibt es auch bei den Paragangliomen der Karotisbifurkation. Mittels CEUS kann die Mikroperfusion innerhalb des Tumors dargestellt [44] und der Therapieerfolg einer Embolisation beurteilt werden [45]. Systematische Studien zu diesem Thema stehen jedoch aus.…”

Subtype prediction of intrahepatic cholangiocarcinoma using dynamic contrast-enhanced ultrasound

“…Therefore, a more objective and stable evaluation method of CEUS is needed. CEUS quantitative analysis software such as VueBox® can quantitatively analyze the data based on CEUS cines, which provides intuitive, quantitative, and visual parameters for the diagnosis, differential diagnosis between benign and malignant lesions, and follow-up after treatment of many lesions [18][19][20][21][22][23][24]. We hypothesized that dynamic contrast-enhanced ultrasound (DCE-US) has potential clinical value in the differentiation of the ICC subtypes.…”