Superb Microvascular Imaging Improves Detection of Vascularity in Indeterminate Renal Masses

Leong, Joon Yau; Wessner, Corinne E.; Kramer, Michael R.; Forsberg, Flemming; Halpern, Ethan J.; Lyshchik, Andrej; Torkzaban, Mehnoosh; Morris, Andrew; Byrne, Kelly; VanMeter, Maris; Trabulsi, Edouard J.; Lallas, Costas D.; Eisenbrey, John R.

doi:10.1002/jum.15299

Cited by 13 publications

(15 citation statements)

References 19 publications

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“…This algorithm separates low-velocity flow signals from clutter artifacts and provides high sensitivity for the visualization of low-velocity flow with high resolution [ 16 ]. Investigators have reported that SMI can detect more flow signals within tumors than conventional color Doppler or PDUS and thereby complement conventional Doppler scans in the examination of tumorous lesions [ 17 , 18 , 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

The Value of Microvascular Imaging for Triaging Indeterminate Cervical Lymph Nodes in Patients with Papillary Thyroid Carcinoma

Lee

Yoon

et al. 2020

Cancers

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Assessment of lymph node (LN) status in patients with papillary thyroid carcinoma (PTC) is often troublesome because of cervical LNs with indeterminate US (ultrasound) features. We aimed to explore whether Superb Microvascular Imaging (SMI) could be helpful for distinguishing metastasis from indeterminate LNs when combined with power Doppler US (PDUS). From 353 consecutive patients with PTC, LNs characterized as indeterminate by PDUS were evaluated by SMI to distinguish them from metastasis. Indeterminate LNs were reclassified according to the SMI, the malignancy risk of each category was assessed, and the diagnostic performance of suspicious findings on SMI was calculated. The incidence of US-indeterminate LNs was 26.9%. Eighty PDUS-indeterminate LNs (39 proven as benign, 41 proven as malignant) were reclassified into probably benign (n = 26), indeterminate (n = 20), and suspicious (n = 34) categories according to SMI, with malignancy risks of 19.2%, 20.0%, and 94.1%, respectively. After combining SMI with PDUS, 80.8% (21/26) of probably benign LNs and 94.1% (32/34) of suspicious LNs could be correctly diagnosed as benign and metastatic, respectively. The diagnostic sensitivity, specificity, and accuracy of categorizing LNs as suspicious based on SMI were 78.1%, 94.9%, and 86.3%, respectively. In conclusion, the combination of SMI with PDUS was helpful for the accurate stratification of indeterminate LNs based on US in patients with PTC.

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Section: Introductionmentioning

confidence: 99%

The Value of Microvascular Imaging for Triaging Indeterminate Cervical Lymph Nodes in Patients with Papillary Thyroid Carcinoma

Lee

Yoon

et al. 2020

Cancers

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“…However, as it is still unknown whether mSMI could effectively distinguish renal malignant tumor and benign renal mass in HD patients as well as nondialysis patients, accumulation of data will be needed to address this point. It has been reported that mSMI had the 63% sensitivity to detect indeterminate renal masses compared with other modalities such as color Doppler imaging or power Doppler imaging in nondialysis patients 6 . In addition, it will need further investigation with a large number of subjects about the sensitivity and specificity of mSMI of ultrasonography for detection of early stage RCCs in HD patients.…”

Section: Discussionmentioning

confidence: 98%

“…It has been reported that mSMI had the 63% sensitivity to detect indeterminate renal masses compared with other modalities such as color Doppler imaging or power Doppler imaging in nondialysis patients. 6 In addition, it will need further investigation with a large number of subjects about the sensitivity and specificity of mSMI of ultrasonography for detection of early stage RCCs in HD patients.…”

Section: Discussionmentioning

confidence: 99%

Renal cell carcinoma sharply captured by imaging technology at an early stage in a hemodialysis patient: Usefulness of noninvasive monochrome superb microvascular imaging

Ohsawa¹,

Kadoya

Obata

et al. 2021

Hemodialysis International

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It has been drawing much attention that type 2 diabetes mellitus is closely associated with increased incidence of numerous cancers and their poor prognosis. Consequently, malignancy has been recently recognized as one of diabetic complications in addition to various conventional complications. Furthermore, it is well known that the prevalence of renal cell carcinoma (RCC) is drastically increased in hemodialysis (HD) patients. Therefore, screening of RCCs in HD patients is a very important and urgent issue as there are no highly sensitive tumor markers for RCCs. Monochrome superb microvascular imaging (mSMI) is a relatively new Doppler ultrasound technique and is useful especially when evaluating very slow blood flow state, because this allows for imaging microvessels with low velocity in the absence of a contrast agent. Thus, mSMI might be also useful when contrast enhancement is not obvious on CT and/or contrast‐enhanced ultrasonography using perflubutane or contrast agents are contraindicated. Moreover, it has been reported that mSMI could effectively detect vascularity of renal malignant tumor than benign renal mass in nondialysis patients. We propose that mSMI of ultrasonography could become one of the very useful methods for detecting RCCs at an early stage with high sensitivity in HD patients.

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“…Leong et al recently imaged 41 patients harboring 50 renal masses with Superb Micro-Vascular Imaging (SMI). They found that SMI had a higher diagnostic accuracy than standard color Doppler imaging and power Doppler imaging for the detection of vascularity within solid renal masses [47]. They concluded that SMI might have potential in the detection of microvascularity within indeterminate solid renal masses.…”

Section: Micro-doppler Techniquesmentioning

confidence: 99%

Expanding the Role of Ultrasound for the Characterization of Renal Masses

Roussel

Campi

Bertolo

et al. 2022

JCM

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The incidental detection of renal masses has been steadily rising. As a significant proportion of renal masses that are surgically treated are benign or indolent in nature, there is a clear need for better presurgical characterization of renal masses to minimize unnecessary harm. Ultrasound is a widely available and relatively inexpensive real-time imaging technique, and novel ultrasound-based applications can potentially aid in the non-invasive characterization of renal masses. Evidence acquisition: We performed a narrative review on novel ultrasound-based techniques that can aid in the non-invasive characterization of renal masses. Evidence synthesis: Contrast-enhanced ultrasound (CEUS) adds significant diagnostic value, particularly for cystic renal masses, by improving the characterization of fine septations and small nodules, with a sensitivity and specificity comparable to magnetic resonance imaging (MRI). Additionally, the performance of CEUS for the classification of benign versus malignant renal masses is comparable to that of computed tomography (CT) and MRI, although the imaging features of different tumor subtypes overlap significantly. Ultrasound molecular imaging with targeted contrast agents is being investigated in preclinical research as an addition to CEUS. Elastography for the assessment of tissue stiffness and micro-Doppler imaging for the improved detection of intratumoral blood flow without the need for contrast are both being investigated for the characterization of renal masses, though few studies have been conducted and validation is lacking. Conclusions: Several novel ultrasound-based techniques have been investigated for the non-invasive characterization of renal masses. CEUS has several advantages over traditional grayscale ultrasound, including the improved characterization of cystic renal masses and the potential to differentiate benign from malignant renal masses to some extent. Ultrasound molecular imaging offers promise for serial disease monitoring and the longitudinal assessment of treatment response, though this remains in the preclinical stages of development. While elastography and emerging micro-Doppler techniques have shown some encouraging applications, they are currently not ready for widespread clinical use.

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Superb Microvascular Imaging Improves Detection of Vascularity in Indeterminate Renal Masses

Cited by 13 publications

References 19 publications

The Value of Microvascular Imaging for Triaging Indeterminate Cervical Lymph Nodes in Patients with Papillary Thyroid Carcinoma

The Value of Microvascular Imaging for Triaging Indeterminate Cervical Lymph Nodes in Patients with Papillary Thyroid Carcinoma

Renal cell carcinoma sharply captured by imaging technology at an early stage in a hemodialysis patient: Usefulness of noninvasive monochrome superb microvascular imaging

Expanding the Role of Ultrasound for the Characterization of Renal Masses

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