Dokumentenart: | Artikel | ||||
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Titel eines Journals oder einer Zeitschrift: | Clinical Hemorheology and Microcirculation | ||||
Verlag: | IOS PRESS | ||||
Ort der Veröffentlichung: | AMSTERDAM | ||||
Band: | 64 | ||||
Nummer des Zeitschriftenheftes oder des Kapitels: | 4 | ||||
Seitenbereich: | S. 735-745 | ||||
Datum: | 2017 | ||||
Institutionen: | Medizin > Lehrstuhl für Chirurgie Medizin > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medizin > Lehrstuhl für Röntgendiagnostik | ||||
Identifikationsnummer: |
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Stichwörter / Keywords: | TIME TISSUE ELASTOGRAPHY; DEGUM MULTICENTER; LESIONS; CEUS; MICROVASCULARIZATION; RECOMMENDATIONS; GUIDELINES; DIAGNOSIS; ABLATION; Ultrasound; elastography; surgery; CEUS; strain elastography | ||||
Dewey-Dezimal-Klassifikation: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
Status: | Veröffentlicht | ||||
Begutachtet: | Ja, diese Version wurde begutachtet | ||||
An der Universität Regensburg entstanden: | Ja | ||||
Dokumenten-ID: | 42007 |
Zusammenfassung
OBJECTIVE: To evaluate the efficacy of strain elastography (SE) using semi-quantitative measurement methods compared to constrast enhanced ultrasound during liver tumor surgery (Io-CEUS) for dignity assessment of focal liver lesions (FLL). MATERIAL AND METHODS: Prospective data acquisition and retrospective analysis of US data of 100 patients (116 lesions) who underwent liver tumor surgery ...
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Zusammenfassung
OBJECTIVE: To evaluate the efficacy of strain elastography (SE) using semi-quantitative measurement methods compared to constrast enhanced ultrasound during liver tumor surgery (Io-CEUS) for dignity assessment of focal liver lesions (FLL). MATERIAL AND METHODS: Prospective data acquisition and retrospective analysis of US data of 100 patients (116 lesions) who underwent liver tumor surgery between 10/2010 and 03/2016. Retrospective reading of SE color patterns was performed establishing groups depending on dominant color (> 50% blue = stiff, inhomogenous, > 50% yellow/red/ green = soft tissue). Semi-quantitative analysis was performed by Q-analysis based on a scale from 0 (soft) to 6 (stiff). 2 ROIs were placed centrally, 5 ROIs in the lesion's surrounding tissue. Io-CEUS was performed by bolus injection of 5-10 ml sulphurhexaflourid microbubbles evaluating wash-in-and -out-kinetics in arterial, portal venous and late phase. Histopathology after surgical resection served as goldstandard. RESULTS: 100 patients (m: 65, f: 35, mean age 60.5 years) with 116 liver lesions were included. Lesion's size ranged from 0.5 to 8.4 cm (mean 2.42 cm SD +/- 1.44 cm). Postoperative histology showed 105 malignant and 11 benign lesions. Semiquantitative analysis showed central indurations of > 2.5 in 76/105 cases suggesting malignancy. 7 benign lesions displayed no central indurations correctly characterized benign by SE. ROC-analysis and Youden index showed a sensitivity of 72.4% and specificity of 63.6% assuming a cut-off of 2.5. Io-CEUS correctly characterized 103/ 105 as malignant. Sensitivity was 98%, specificity 72.7%. CONCLUSION: Strain elastography is a valuable tool for non-invasive characterization of FLLs. Semi-quantitative intratumoral stiffness values of > 2.5 suggested malignancy. However, sensitivity of Io-CEUS in detecting malignant lesions was higher compared to SE. In conclusion SE should be considered for routine use during intraoperative US in addition to Io-CEUS for optimization of curative liver surgery.
Metadaten zuletzt geändert: 12 Feb 2021 10:07