Wan-Ru Jia1, Wei-Min Chai2, Lei Tang3, Yi Wang4, Xiao-Chun Fei5, Bao-San Han6, Man Chen7. 1. Department of Diagnostic Ultrasound, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, No. 197 Rui Jin 2nd Road, Shanghai 200025, China. Electronic address: jiawanru@126.com. 2. Department of Radiology, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, No. 197 Rui Jin 2nd Road, Shanghai 200025, China. Electronic address: chai_weimin@yahoo.com.cn. 3. Department of Diagnostic Ultrasound, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, No. 197 Rui Jin 2nd Road, Shanghai 200025, China. Electronic address: jessietang1003@163.com. 4. Department of Diagnostic Ultrasound, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, No. 197 Rui Jin 2nd Road, Shanghai 200025, China. Electronic address: xiatian.0602@163.com. 5. Department of Pathology, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, No. 197 Rui Jin 2nd Road, Shanghai 200025, China. Electronic address: xcf0222@163.com. 6. Department of Comprehensive Breast Health Center, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, No. 197 Rui Jin 2nd Road, Shanghai 200025, China. Electronic address: hanbaosan@126.com. 7. Department of Diagnostic Ultrasound, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, No. 197 Rui Jin 2nd Road, Shanghai 200025, China. Electronic address: lucyjia1370@126.com.
Abstract
OBJECTIVE: To explore the clinical value of three-dimensional contrast enhanced ultrasound (3D-CEUS) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) score systems in evaluating breast tumor angiogenesis by comparing their diagnostic efficacy and correlation with biological factors. METHODS: 3D-CEUS was performed in 183 patients with breast tumors by Esaote Mylab90 with SonoVue (Bracco, Italy), DCE-MRI was performed on a dedicated breast magnetic resonance imaging (DBMRI) system (Aurora Dedicated Breast MRI Systems, USA) with a dedicated breast coil. 3D-CEUS and DCE-MRI score systems were created based on tumor perfusion and vascular characteristics. Microvessel density (MVD), vascular endothelial growth factor (VEGF) and matrix metalloproteinases (MMP-2, MMP-9) expression were measured by immunohistochemistry. RESULTS: Pathological results showed 35 benign and 148 malignant breast tumors. MVD (P=0.000, r=0.76), VEGF (P=0.000, r=0.55), MMP-2 (P=0.000, r=0.39) and MMP-9 (P=0.000, r=0.41) expression were all significantly different between benignity and malignancy. Regarding 3D-CEUS 4 points as cutoff value, the sensitivity, specificity and accuracy were 85.1%, 94.3% and 86.9%, respectively, and correlated well with MVD (P=0.000, r=0.50), VEGF (P=0.000, r=0.50), MMP-2 (P=0.000, r=0.50) and MMP-9 (P=0.000, r=0.66). Taking DCE-MRI 5 points as cutoff value, the sensitivity, specificity and accuracy were 86.5%, 94.3% and 88.0%, respectively and also correlated well with MVD (P=0.000, r=0.52), VEGF (P=0.000, r=0.44), MMP-2 (P=0.000, r=0.42) and MMP-9 (P=0.000, r=0.35). CONCLUSIONS: 3D-CEUS score system displays inspiring diagnostic performance and good agreement with DCE-MRI scoring. Moreover, both score systems correlate well with MVD, VEGF, MMP-2 and MMP-9 expression, and thus have great potentials in tumor angiogenesis evaluation.
OBJECTIVE: To explore the clinical value of three-dimensional contrast enhanced ultrasound (3D-CEUS) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) score systems in evaluating breast tumor angiogenesis by comparing their diagnostic efficacy and correlation with biological factors. METHODS: 3D-CEUS was performed in 183 patients with breast tumors by Esaote Mylab90 with SonoVue (Bracco, Italy), DCE-MRI was performed on a dedicated breast magnetic resonance imaging (DBMRI) system (Aurora Dedicated Breast MRI Systems, USA) with a dedicated breast coil. 3D-CEUS and DCE-MRI score systems were created based on tumor perfusion and vascular characteristics. Microvessel density (MVD), vascular endothelial growth factor (VEGF) and matrix metalloproteinases (MMP-2, MMP-9) expression were measured by immunohistochemistry. RESULTS: Pathological results showed 35 benign and 148 malignant breast tumors. MVD (P=0.000, r=0.76), VEGF (P=0.000, r=0.55), MMP-2 (P=0.000, r=0.39) and MMP-9 (P=0.000, r=0.41) expression were all significantly different between benignity and malignancy. Regarding 3D-CEUS 4 points as cutoff value, the sensitivity, specificity and accuracy were 85.1%, 94.3% and 86.9%, respectively, and correlated well with MVD (P=0.000, r=0.50), VEGF (P=0.000, r=0.50), MMP-2 (P=0.000, r=0.50) and MMP-9 (P=0.000, r=0.66). Taking DCE-MRI 5 points as cutoff value, the sensitivity, specificity and accuracy were 86.5%, 94.3% and 88.0%, respectively and also correlated well with MVD (P=0.000, r=0.52), VEGF (P=0.000, r=0.44), MMP-2 (P=0.000, r=0.42) and MMP-9 (P=0.000, r=0.35). CONCLUSIONS: 3D-CEUS score system displays inspiring diagnostic performance and good agreement with DCE-MRI scoring. Moreover, both score systems correlate well with MVD, VEGF, MMP-2 and MMP-9 expression, and thus have great potentials in tumor angiogenesis evaluation.
Authors: Anush Sridharan; John R Eisenbrey; Priscilla Machado; Haydee Ojeda-Fournier; Annina Wilkes; Alexander Sevrukov; Robert F Mattrey; Kirk Wallace; Carl L Chalek; Kai E Thomenius; Flemming Forsberg Journal: IEEE Trans Ultrason Ferroelectr Freq Control Date: 2015-03 Impact factor: 2.725