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Study on the characteristics of contrast-enhanced ultrasound and its utility in assessing the microvessel density in ovarian tumors or tumor-like lesions.

Wang J, Lv F, Fei X, Cui Q, Wang L, Gao X, Yuan Z, Lin Q, Lv Y, Liu A - Int. J. Biol. Sci. (2011)

Bottom Line: The PI and AUC in the malignant tumors were significantly higher than those in the benign tumors or tumor-like lesions (p=0.001 and =0.01, respectively).The MVD was 43.1 ± 20.4 in the benign tumors or tumor-like lesions and was 65.3 ± 22.3 in the malignant ones (p= 0.01).In both the benign and malignant groups, the PI and AUC were correlated significantly with the MVD (r=0.595, p = 0.001; r =0.533, p = 0.003, respectively).

View Article: PubMed Central - PubMed

Affiliation: Department of Ultrasound, the Chinese PLA General Hospital, Beijing 100853, China.

ABSTRACT
Angiogenesis is a critical factor in tumor growth and metastasis, and microvessel density (MVD) was an important parameter for assessing vessels in tumors. However, radiologic assessment of tumor vascularity is not yet well established. In our study, we aimed at investigating the efficacy of contrast-enhanced ultrasonography (CEUS) in exploring the vascularity of the ovarian tumors or tumor-like lesions to assess the relationship between the parameters of the peak intensity (PI) and area under curve (AUC) on CEUS and MVD in ovarian masses. Compared to the contrast-enhanced ultrasound technique, conventional ultrasound shows limitation in differentiating benign and malignant ovarian tumors. The former is promising in improving the sensitivity of detecting small vessels and blood flow in ovarian tumors. Our results showed clear differences in enhancement patterns between benign and malignant ovary tumors or tumor-like lesions. The PI and AUC in the malignant tumors were significantly higher than those in the benign tumors or tumor-like lesions (p=0.001 and =0.01, respectively). The MVD was 43.1 ± 20.4 in the benign tumors or tumor-like lesions and was 65.3 ± 22.3 in the malignant ones (p= 0.01). In both the benign and malignant groups, the PI and AUC were correlated significantly with the MVD (r=0.595, p = 0.001; r =0.533, p = 0.003, respectively). The PI and AUC in CEUS can reflect the MVD in ovarin tumors. The PI and AUC of the ovarian masses in the contrast transvaginal sonography show significant correlation with the angiogenesis and may help in assessing tumor vascularity in ovarian masses.

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The CEUS and MVD of a thecoma of the ovary. (A) Two-dimensional transvaginal ultrasound showed a heterogeneous hypoechoic mass (3.9 cm × 3.7 cm × 2.7 cm) in the left ovary. (B) Little scattered blood flow signal could be seen in CDFI. (C) CEUS showed slightly scattered enhancement within the ovarian tumor, earlier than surrounding ovarian tissue, the peak intensity of 11.88 dB, lower than 18.39 dB of the surrounding ovarian tissue. (Arrows indicate the mass and the boundaries of the ovary). (D)A region of interest (ROI) was taken from the mass and ovary respectively. (White ROI 1: the region of interest within the mass, blue ROI 2: region of interest within the ovarian tissue), drawing TIC (white and blue curves represent the TIC of the mass and ovary). (E)TIC showed AT 21.97 seconds, TTP 32.63 seconds, PI 11.88 dB, AUC 10.60, ROI 2 for the ovarian tissue: AT 24.20 seconds, TTP 40.41 seconds, PI 18.39 dB. AUC 18.04. (F) MVD (CD34 immunohistochemical staining, magnification 200×), scarce interstitial microvessels.
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Figure 1: The CEUS and MVD of a thecoma of the ovary. (A) Two-dimensional transvaginal ultrasound showed a heterogeneous hypoechoic mass (3.9 cm × 3.7 cm × 2.7 cm) in the left ovary. (B) Little scattered blood flow signal could be seen in CDFI. (C) CEUS showed slightly scattered enhancement within the ovarian tumor, earlier than surrounding ovarian tissue, the peak intensity of 11.88 dB, lower than 18.39 dB of the surrounding ovarian tissue. (Arrows indicate the mass and the boundaries of the ovary). (D)A region of interest (ROI) was taken from the mass and ovary respectively. (White ROI 1: the region of interest within the mass, blue ROI 2: region of interest within the ovarian tissue), drawing TIC (white and blue curves represent the TIC of the mass and ovary). (E)TIC showed AT 21.97 seconds, TTP 32.63 seconds, PI 11.88 dB, AUC 10.60, ROI 2 for the ovarian tissue: AT 24.20 seconds, TTP 40.41 seconds, PI 18.39 dB. AUC 18.04. (F) MVD (CD34 immunohistochemical staining, magnification 200×), scarce interstitial microvessels.

Mentions: The MVD by immunohistochemical assessment was 43.1 ± 20.4 in the benign tumors or tumor-like lesions, significantly lower than 65.3 ± 22.3 in the malignant ones (p=0.002, Figures 1F & 2F). PI and AUC were positively correlated with MVD in both benign and malignant groups (r=0.595 and r =0.533; p = 0.001 and p = 0.003, respectively; Figures 3A-B). The MVD difference between benign and malignant tumors was correlated with vascular endothelial cell activity and angiogenesis-related features inside tumors 25. We also found that vascular density changes were significantly different in benign and malignant groups. MVD was well correlated with tumor tissue blood perfusion in both groups, suggesting that the increased malignant tumors MVD can increase blood volume.


Study on the characteristics of contrast-enhanced ultrasound and its utility in assessing the microvessel density in ovarian tumors or tumor-like lesions.

Wang J, Lv F, Fei X, Cui Q, Wang L, Gao X, Yuan Z, Lin Q, Lv Y, Liu A - Int. J. Biol. Sci. (2011)

The CEUS and MVD of a thecoma of the ovary. (A) Two-dimensional transvaginal ultrasound showed a heterogeneous hypoechoic mass (3.9 cm × 3.7 cm × 2.7 cm) in the left ovary. (B) Little scattered blood flow signal could be seen in CDFI. (C) CEUS showed slightly scattered enhancement within the ovarian tumor, earlier than surrounding ovarian tissue, the peak intensity of 11.88 dB, lower than 18.39 dB of the surrounding ovarian tissue. (Arrows indicate the mass and the boundaries of the ovary). (D)A region of interest (ROI) was taken from the mass and ovary respectively. (White ROI 1: the region of interest within the mass, blue ROI 2: region of interest within the ovarian tissue), drawing TIC (white and blue curves represent the TIC of the mass and ovary). (E)TIC showed AT 21.97 seconds, TTP 32.63 seconds, PI 11.88 dB, AUC 10.60, ROI 2 for the ovarian tissue: AT 24.20 seconds, TTP 40.41 seconds, PI 18.39 dB. AUC 18.04. (F) MVD (CD34 immunohistochemical staining, magnification 200×), scarce interstitial microvessels.
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3101528&req=5

Figure 1: The CEUS and MVD of a thecoma of the ovary. (A) Two-dimensional transvaginal ultrasound showed a heterogeneous hypoechoic mass (3.9 cm × 3.7 cm × 2.7 cm) in the left ovary. (B) Little scattered blood flow signal could be seen in CDFI. (C) CEUS showed slightly scattered enhancement within the ovarian tumor, earlier than surrounding ovarian tissue, the peak intensity of 11.88 dB, lower than 18.39 dB of the surrounding ovarian tissue. (Arrows indicate the mass and the boundaries of the ovary). (D)A region of interest (ROI) was taken from the mass and ovary respectively. (White ROI 1: the region of interest within the mass, blue ROI 2: region of interest within the ovarian tissue), drawing TIC (white and blue curves represent the TIC of the mass and ovary). (E)TIC showed AT 21.97 seconds, TTP 32.63 seconds, PI 11.88 dB, AUC 10.60, ROI 2 for the ovarian tissue: AT 24.20 seconds, TTP 40.41 seconds, PI 18.39 dB. AUC 18.04. (F) MVD (CD34 immunohistochemical staining, magnification 200×), scarce interstitial microvessels.
Mentions: The MVD by immunohistochemical assessment was 43.1 ± 20.4 in the benign tumors or tumor-like lesions, significantly lower than 65.3 ± 22.3 in the malignant ones (p=0.002, Figures 1F & 2F). PI and AUC were positively correlated with MVD in both benign and malignant groups (r=0.595 and r =0.533; p = 0.001 and p = 0.003, respectively; Figures 3A-B). The MVD difference between benign and malignant tumors was correlated with vascular endothelial cell activity and angiogenesis-related features inside tumors 25. We also found that vascular density changes were significantly different in benign and malignant groups. MVD was well correlated with tumor tissue blood perfusion in both groups, suggesting that the increased malignant tumors MVD can increase blood volume.

Bottom Line: The PI and AUC in the malignant tumors were significantly higher than those in the benign tumors or tumor-like lesions (p=0.001 and =0.01, respectively).The MVD was 43.1 ± 20.4 in the benign tumors or tumor-like lesions and was 65.3 ± 22.3 in the malignant ones (p= 0.01).In both the benign and malignant groups, the PI and AUC were correlated significantly with the MVD (r=0.595, p = 0.001; r =0.533, p = 0.003, respectively).

View Article: PubMed Central - PubMed

Affiliation: Department of Ultrasound, the Chinese PLA General Hospital, Beijing 100853, China.

ABSTRACT
Angiogenesis is a critical factor in tumor growth and metastasis, and microvessel density (MVD) was an important parameter for assessing vessels in tumors. However, radiologic assessment of tumor vascularity is not yet well established. In our study, we aimed at investigating the efficacy of contrast-enhanced ultrasonography (CEUS) in exploring the vascularity of the ovarian tumors or tumor-like lesions to assess the relationship between the parameters of the peak intensity (PI) and area under curve (AUC) on CEUS and MVD in ovarian masses. Compared to the contrast-enhanced ultrasound technique, conventional ultrasound shows limitation in differentiating benign and malignant ovarian tumors. The former is promising in improving the sensitivity of detecting small vessels and blood flow in ovarian tumors. Our results showed clear differences in enhancement patterns between benign and malignant ovary tumors or tumor-like lesions. The PI and AUC in the malignant tumors were significantly higher than those in the benign tumors or tumor-like lesions (p=0.001 and =0.01, respectively). The MVD was 43.1 ± 20.4 in the benign tumors or tumor-like lesions and was 65.3 ± 22.3 in the malignant ones (p= 0.01). In both the benign and malignant groups, the PI and AUC were correlated significantly with the MVD (r=0.595, p = 0.001; r =0.533, p = 0.003, respectively). The PI and AUC in CEUS can reflect the MVD in ovarin tumors. The PI and AUC of the ovarian masses in the contrast transvaginal sonography show significant correlation with the angiogenesis and may help in assessing tumor vascularity in ovarian masses.

Show MeSH
Related in: MedlinePlus