ABSTRACT
Objective:To investigate the value of qualitative characteristics of contrast-enhanced ultrasound (CEUS) and VueBox quantitative parameters in the evaluation of pathological molecular typing of breast cancer.Methods:A retrospective analysis was performed on 133 patients with pathologically confirmed breast cancer who underwent CEUS examination in the People′s Hospital of Guangxi Zhuang Autonomous Region from January 2020 to July 2022. The patients were divided into Luminal A type, Luminal B type, human epidermal growth factor receptor-2(HER-2) type and triple negative type according to the results of immunohistochemistry. The differences of qualitative characteristics and quantitative parameters of CEUS in different molecular subtypes of breast cancer were analyzed. The ROC curve was used to evaluate the diagnostic efficacy of CEUS in the differentiation of molecular subtypes of breast cancer.Results:There were significant differences in enhancement intensity, post-enhancement boundary, filling defect and peripheral radial convergence among different molecular subtypes of breast cancer(all P<0.05), while there was no significant difference in enhancement uniformity ( P>0.05). Peak enhancement (PE), wash-in and wash-out areas under the curve (WiWoAUC), and wash-in ratio (WiR) of HER-2 type and triple-negative type breast cancer were higher than Luminal A type and Luminal B type (all P<0.05). ROC curve analysis showed that PE and radial convergence had reasonable diagnostic efficiency in Luminal A type, and the areas under the curve were 0.849 and 0.780, sensitivity was 0.711 and 0.889, specificity was 0.909 and 0.671, accuracy was 0.842 and 0.744, respectively. The areas under the curve of PE in diagnosing Luminal B type was 0.852, the sensitivity, specificity, and accuracy were 0.825, 0.763 and 0.782, respectively. The area under the curve of WiWoAUC and filling defect in diagnosing HER-2 type were 0.912 and 0.898, the sensitivity was 0.903 and 0.903, the specificity was 0.853 and 0.892, and the accuracy was 0.865 and 0.895, respectively. The area under the curve of clear boundary after enhancement in diagnosing triple negative type was 0.919, and the sensitivity, specificity and accuracy were 0.941, 0.897 and 0.902, respectively. Conclusions:There are differences in the qualitative characteristics and quantitative parameters of contrast-enhanced ultrasound in different molecular types of breast cancer. CEUS is suggested as a noninvasive modality for preoperative prediction of molecular subtypes of breast cancer.
ABSTRACT
Objective:To evaluate the value of VueBox ? contrast-enhanced ultrasound (CEUS) quantitative analysis combined with ACR TI-RADS classification in the diagnosis of benign and malignant solid thyroid nodules. Methods:A total of 201 patients with thyroid solid nodules (201 nodules) who underwent surgery or puncture biopsy in the People′s Hospital of Guangxi Zhuang Autonomous Region were enrolled from October 2020 to February 2022. The preoperative conventional ultrasound and contrast-enhanced ultrasound images were retrospectively analyzed. According to the pathological results, they were divided into the malignant group and benign group. The differences of the quantitative parameters of CEUS between the two groups were analyzed, including peak enhancement (PE), wash-in and wash-out area under the curve (WiWoAUC), wash-in perfusion index (WiPI). ΔPE, ΔWiWoAUC, ΔWiPI were obtained by calculating the parameter difference between the surrounding normal glands and nodules. ROC curve was used to analyze the value of different quantitative parameters in the differential diagnosis of benign and malignant solid thyroid nodules. The CEUS quantitative parameters with best diagnostic performance was selected and combined with ACR TI-RADS classification system to evaluate the diagnostic efficiency of the single diagnostic approaches and the combined approach.Results:The quantitative parameters of PE, WiWoAUC, WiPI, ΔPE, ΔWiWoAUC, ΔWiPI were significantly different between benign group and malignant group (all P<0.001). ΔPE had the highest diagnostic value among all the quantitative parameters (the area under the ROC curve was 0.802), and the cut-off value was 0.21.ΔPE combined with ACR TI-RADS classification showed the best efficiency in diagnosis of benign and malignant thyroid nodules, with an area under the curve of 0.898, and the sensitivity, specificity, positive predictive value and negative predictive value of 73.39%, 93.48%, 93.02% and 74.78%, respectively. Conclusions:Quantitative parameters of CEUS by using VueBox ? software is valuable for the differential diagnosis of benign and malignant solid thyroid nodules, and its combination with ACR TI-RADS classification can improve the diagnosis accuracy.