Morris M A, Ring C M, Managuli R, Saboury B, Mehregan D, Siegel E, Dasgeb B
Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Department of Radiology, Baltimore Veteran's Affairs Medical Center, Baltimore, MD, USA.
Skin Res Technol. 2018 May;24(2):242-247. doi: 10.1111/srt.12420. Epub 2017 Oct 25.
To evaluate the feasibility of using quantitative texture features computed from high frequency ultrasound and ultrasound elastography (USE) images in the discrimination of benign from malignant skin lesions.
A commercial ultrasound system with a 14 MHz transducer was used to visualize skin lesions requiring biopsy on clinical evaluation. Patients were enrolled over a 6-month period and imaged prospectively by operators blind to the histopathologic diagnosis. Anatomic ultrasound and USE imaging of the skin lesions was performed using a 2-4 mm gel standoff pad before biopsy and histopathologic evaluation. The ElastoAnalysis software developed for the texture analysis of USE images was provided by Hitachi. The software computes thirteen texture features within a region of interest (ROI), which have demonstrated promise in diagnostic characterization of liver fibrosis staging and in quantitative elastography of breast cancer. This approach has not yet been studied in the quantitative assessment of skin cancer. Results were retrospectively compared to the histopathologic diagnosis and a diagnostic criteria with the goal of maximizing sensitivity was evaluated for each textural feature.
Of the 37 lesions included, among 30 patients who participated, 12 lesions were malignant and 25 were benign. Eleven out of thirteen textural metrics computed by the software were useful in differentiating benign from malignant lesions with 100% sensitivity and specificities ranging from 28% to 85%.
This feasibility study demonstrated that feature analysis of USE may be useful in quantitatively differentiating cancerous from benign primary solitary skin lesions prior to biopsy.
评估利用高频超声和超声弹性成像（USE）图像计算得到的定量纹理特征来鉴别良性和恶性皮肤病变的可行性。
使用配备14MHz换能器的商用超声系统对经临床评估需要活检的皮肤病变进行可视化检查。在6个月期间招募患者，并由对组织病理学诊断不知情的操作人员进行前瞻性成像。在活检和组织病理学评估前，使用2-4mm的凝胶间隔垫对皮肤病变进行解剖超声和USE成像。用于USE图像纹理分析的ElastoAnalysis软件由日立公司提供。该软件在感兴趣区域（ROI）内计算13个纹理特征，这些特征在肝纤维化分期的诊断特征描述和乳腺癌的定量弹性成像中已显示出前景。这种方法尚未在皮肤癌的定量评估中进行研究。将结果与组织病理学诊断进行回顾性比较，并针对每个纹理特征评估以最大化敏感性为目标的诊断标准。
在参与的30例患者中的37个病变中，12个病变为恶性，25个为良性。软件计算的13个纹理指标中有11个可用于区分良性和恶性病变，敏感性为100%，特异性范围为28%至85%。
这项可行性研究表明，USE的特征分析在活检前定量区分原发性孤立性皮肤病变的癌性和良性方面可能有用。
