Feliciano Marcus Antonio Rossi, Ramirez Ricardo Andrés Uscategui, Maronezi Marjury Cristina, Maciel Giovanna Serpa, Avante Michelle Lopes, Senhorello Igor Luiz Salardani, Mucédola Talita, Gasser Beatriz, Carvalho Cibele Figueira, Vicente Wilter Ricardo Russiano
UNESP-Universidade Estadual Paulista Julio de Mesquita Filho Faculdade de Ciencias Agrarias e Veterinarias, Campus Jaboticabal, Jaboticabal, Brazil.
UFRB-Universidade Federal do Recôncavo da Bahia, Cruz das Almas, Brazil.
Vet Radiol Ultrasound. 2018 Jul;59(4):444-452. doi: 10.1111/vru.12606. Epub 2018 Feb 11.
Due to the importance of presurgical, noninvasive, and accurate diagnostic tools in mammary carcinoma characterization, this prospective secondary observational cohort study was designed to evaluate and compare the diagnostic accuracy of B-mode, Doppler, contrast enhancement ultrasonography, or acoustic radiation force impulse-elastography in identifying mammary carcinomas types with high degree of malignancy. A total of 246 mammary carcinomas from 141 female dogs were analyzed using B-mode, Doppler, contrast enhancement ultrasonography, and acoustic radiation force impulse ultrasonography prior to their histopathological classification according to types (simple, complex, or special) and grade (I, II, or III). Qualitative and quantitative variables were compared between carcinoma types and grades by Fisher's or analysis of variance. Diagnostic performance was estimated by receiver-operating characteristic analysis, using histopathological classification as a reference. Deformability (acoustic radiation force impulse) had a diagnostic specificity of 100% and sensitivity of 12% in identifying special carcinomas. A width:length ratio greater than 0.53 can be suggestive of special carcinoma, with 80% sensitivity and 76% specificity. Contrast wash-in and peak enhancement times lower than 7.5 and 13.5 s, respectively, were indicative of complex carcinoma at 62% sensitivity and 60% specificity. Contrast wash-in, peak enhancement, and wash-out times greater than 6.5, 12.5, and 64.5 s, respectively; were indicative of grade II and III carcinoma at 68% sensitivity and 62% specificity. In conclusion, B-mode ultrasonography, contrast enhancement ultrasonography, and acoustic radiation force impulse-elastography enabled the identification of some of the characteristics of high-grade mammary carcinoma types and grades in female dogs with limited accuracy. The findings from this study may contribute to oncology research and clinical management canine patients.
由于术前、非侵入性和准确的诊断工具在乳腺癌特征描述中的重要性,本前瞻性二次观察队列研究旨在评估和比较B超、多普勒、对比增强超声或声辐射力脉冲弹性成像在识别高度恶性乳腺癌类型方面的诊断准确性。在根据类型(单纯型、复合型或特殊型)和分级(I级、II级或III级)进行组织病理学分类之前,使用B超、多普勒、对比增强超声和声辐射力脉冲超声对141只雌性犬的246例乳腺癌进行了分析。通过Fisher检验或方差分析比较癌类型和分级之间的定性和定量变量。以组织病理学分类为参考,通过受试者操作特征分析评估诊断性能。在识别特殊型癌方面,可变形性(声辐射力脉冲)的诊断特异性为100%,敏感性为12%。宽度与长度比大于0.53可能提示特殊型癌,敏感性为80%,特异性为76%。对比剂注入时间和峰值增强时间分别低于7.5秒和13.5秒,提示复合型癌,敏感性为62%,特异性为60%。对比剂注入时间、峰值增强时间和消退时间分别大于6.5秒、12.5秒和64.5秒,提示II级和III级癌,敏感性为68%,特异性为62%。总之,B超、对比增强超声和声辐射力脉冲弹性成像能够在有限的准确性下识别雌性犬高级别乳腺癌类型和分级的一些特征。本研究结果可能有助于犬类患者的肿瘤学研究和临床管理。