Abstract
Background: Despite the usefulness of elastography in assessing the stiffness/elasticity of tissues, and its proven diagnostic accuracy in thyroid, breast, and prostate cancers, among others, it is not yet applied in transthoracic ultrasound (TUS) scans to investigate lung nodules. Purpose: To investigate the potential clinical utility of TUS elastography in diagnosing lung cancer proven by fine-needle aspiration biopsy (FNAB). Material and Methods: TUS elastography was performed in 95 consecutive patients (71 men, 24 women; age, 62.84 ± 7.37 years) with lesions suspected of involving the chest wall or the pleura detected on chest X-ray or computed tomography (CT). Patients with pleural effusions were not enrolled, but were further evaluated by pleural fluid cytology. Patients were excluded from the study if a diagnosis had already been made based on sputum cytology and/or broncho-scopic histology (making TUS biopsy unnecessary) or if their lung lesions could not be visualized under standard US. Under FNAB, 34 consolidations were ascribed to pneumonia and 65 to cancer. Under TUS, tissue stiffness, detected using a convex multifrequency 2-8-mHz probe and a MyLab ™Twice - ElaXto, was scored from 1 (greatest elasticity) to 5 (no elasticity). Subpleural solid masses (2-5 cm) were initially detected by TUS and subsequently assessed by FNAB. Results: Histological diagnoses were: small cell lung cancer (4/61), adenocarcinoma (29/61), squamous cell carcinoma (SCC) (12/61), large cell lung carcinoma (12/61), and lymphomas (4/61). Patients' age and mass sizes (3.06 ± 0.88 cm) were not significantly associated with any histological type. A significant lower elasticity of SCC (4.67 ±0.492) was observed versus other types of lung cancer (P <0.005), and versus pneumonia (2.35 ± 0.48). Conclusion: Since only squamous cell lung carcinoma displays the feature of significantly reduced elasticity, and since no clear-cut diagnostic key is yet available, the clinical usefulness of TUS elastography is currently limited with a view to characterizing tumors. Nevertheless, it does enable good non-invasive imaging of lung nodules, providing information on their stiffness, and can improve the accuracy and yield of FNAB.
| Original language | English |
|---|---|
| Pages (from-to) | 798-805 |
| Number of pages | 8 |
| Journal | Acta Radiologica |
| Volume | 56 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - Jan 1 2015 |
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Keywords
- FNAB
- Lung cancer
- Pleural
- Ultrasound elastography
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Radiological and Ultrasound Technology
- Medicine(all)
Cite this
Lung transthoracic ultrasound elastography imaging and guided biopsies of subpleural cancer : A preliminary report. / Sperandeo, Marco; Trovato, Francesca M.; Dimitri, Lucia; Catalano, Daniela; Simeone, Anna; Martines, Giuseppe Fabio; Piscitelli, Angela Pamela; Trovato, Guglielmo M.
In: Acta Radiologica, Vol. 56, No. 7, 01.01.2015, p. 798-805.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Lung transthoracic ultrasound elastography imaging and guided biopsies of subpleural cancer
T2 - A preliminary report
AU - Sperandeo, Marco
AU - Trovato, Francesca M.
AU - Dimitri, Lucia
AU - Catalano, Daniela
AU - Simeone, Anna
AU - Martines, Giuseppe Fabio
AU - Piscitelli, Angela Pamela
AU - Trovato, Guglielmo M.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Background: Despite the usefulness of elastography in assessing the stiffness/elasticity of tissues, and its proven diagnostic accuracy in thyroid, breast, and prostate cancers, among others, it is not yet applied in transthoracic ultrasound (TUS) scans to investigate lung nodules. Purpose: To investigate the potential clinical utility of TUS elastography in diagnosing lung cancer proven by fine-needle aspiration biopsy (FNAB). Material and Methods: TUS elastography was performed in 95 consecutive patients (71 men, 24 women; age, 62.84 ± 7.37 years) with lesions suspected of involving the chest wall or the pleura detected on chest X-ray or computed tomography (CT). Patients with pleural effusions were not enrolled, but were further evaluated by pleural fluid cytology. Patients were excluded from the study if a diagnosis had already been made based on sputum cytology and/or broncho-scopic histology (making TUS biopsy unnecessary) or if their lung lesions could not be visualized under standard US. Under FNAB, 34 consolidations were ascribed to pneumonia and 65 to cancer. Under TUS, tissue stiffness, detected using a convex multifrequency 2-8-mHz probe and a MyLab ™Twice - ElaXto, was scored from 1 (greatest elasticity) to 5 (no elasticity). Subpleural solid masses (2-5 cm) were initially detected by TUS and subsequently assessed by FNAB. Results: Histological diagnoses were: small cell lung cancer (4/61), adenocarcinoma (29/61), squamous cell carcinoma (SCC) (12/61), large cell lung carcinoma (12/61), and lymphomas (4/61). Patients' age and mass sizes (3.06 ± 0.88 cm) were not significantly associated with any histological type. A significant lower elasticity of SCC (4.67 ±0.492) was observed versus other types of lung cancer (P <0.005), and versus pneumonia (2.35 ± 0.48). Conclusion: Since only squamous cell lung carcinoma displays the feature of significantly reduced elasticity, and since no clear-cut diagnostic key is yet available, the clinical usefulness of TUS elastography is currently limited with a view to characterizing tumors. Nevertheless, it does enable good non-invasive imaging of lung nodules, providing information on their stiffness, and can improve the accuracy and yield of FNAB.
AB - Background: Despite the usefulness of elastography in assessing the stiffness/elasticity of tissues, and its proven diagnostic accuracy in thyroid, breast, and prostate cancers, among others, it is not yet applied in transthoracic ultrasound (TUS) scans to investigate lung nodules. Purpose: To investigate the potential clinical utility of TUS elastography in diagnosing lung cancer proven by fine-needle aspiration biopsy (FNAB). Material and Methods: TUS elastography was performed in 95 consecutive patients (71 men, 24 women; age, 62.84 ± 7.37 years) with lesions suspected of involving the chest wall or the pleura detected on chest X-ray or computed tomography (CT). Patients with pleural effusions were not enrolled, but were further evaluated by pleural fluid cytology. Patients were excluded from the study if a diagnosis had already been made based on sputum cytology and/or broncho-scopic histology (making TUS biopsy unnecessary) or if their lung lesions could not be visualized under standard US. Under FNAB, 34 consolidations were ascribed to pneumonia and 65 to cancer. Under TUS, tissue stiffness, detected using a convex multifrequency 2-8-mHz probe and a MyLab ™Twice - ElaXto, was scored from 1 (greatest elasticity) to 5 (no elasticity). Subpleural solid masses (2-5 cm) were initially detected by TUS and subsequently assessed by FNAB. Results: Histological diagnoses were: small cell lung cancer (4/61), adenocarcinoma (29/61), squamous cell carcinoma (SCC) (12/61), large cell lung carcinoma (12/61), and lymphomas (4/61). Patients' age and mass sizes (3.06 ± 0.88 cm) were not significantly associated with any histological type. A significant lower elasticity of SCC (4.67 ±0.492) was observed versus other types of lung cancer (P <0.005), and versus pneumonia (2.35 ± 0.48). Conclusion: Since only squamous cell lung carcinoma displays the feature of significantly reduced elasticity, and since no clear-cut diagnostic key is yet available, the clinical usefulness of TUS elastography is currently limited with a view to characterizing tumors. Nevertheless, it does enable good non-invasive imaging of lung nodules, providing information on their stiffness, and can improve the accuracy and yield of FNAB.
KW - FNAB
KW - Lung cancer
KW - Pleural
KW - Ultrasound elastography
UR - http://www.scopus.com/inward/record.url?scp=84939459480&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84939459480&partnerID=8YFLogxK
U2 - 10.1177/0284185114538424
DO - 10.1177/0284185114538424
M3 - Article
C2 - 24951615
AN - SCOPUS:84939459480
VL - 56
SP - 798
EP - 805
JO - Acta Radiologica
JF - Acta Radiologica
SN - 0284-1851
IS - 7
ER -