Vrijednost sonoelastografije u procjeni lezija uočenih magnetskom rezonancijom dojki nakon operacijskoga liječenja karcinoma dojke

doctoral thesis

• Title (english): The value of sonoelastography in assessment of lesions detected on magnetic resonance imaging of the breast after the surgical treatment of breast carcinoma
• Author: Eugen Divjak
• Mentor: Boris Brkljačić (mentor)
• Committee member: Gordana Ivanac (predsjednik povjerenstva)
• Committee member: Zoran Brnić (član povjerenstva)
• Committee member: Rado Žic (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2022-04-20, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Radiology
• Universal decimal classification (UDC): 616 - Pathology. Clinical medicine

Abstract

CILJ: Cilj istraživanja bio je usporediti kategorizaciju lezije dojke na poslijeoperacijskom pregledu magnetskom rezonancijom (MR) s kategorizacijom ciljanog „second-look“ ultrazvučnog (UZV) pregleda koristeći prikaz u B-modu te uz primjenu sonoelastografije posmičnog vala (SWE) radi utvrđivanja utjecaja SWE na odluku o biopsiji.

MATERIJALI I METODE: Uključeno je 90 pacijentica (dobi 29 – 83 godina, prosjek 57 godina), kojima je nakon kirurškog liječenja karcinoma dojke učinjen MR i ciljani UZV pregled, uključujući B-mod i SWE. Izmjereni su parametri tvrdoće uočene lezije (Emax, Emean, Emin), te učinjena biopsija širokom iglom radi patohistološke verifikacije. Ispitana je povezanost SWE tvrdoće s patohistološkim nalazom i MR osobinama lezija te razlika u kategorizaciji primjenom navedenih metoda.

REZULTATI: Od 90 lezija, patohistološkom analizom verificiran je recidiv u 43,3% lezija, dok je 56,7% lezija verificirano kao benigno. Recidivi karcinoma dojke pokazuju veću tvrdoću od benignih promjena – medijan (Q1-Q3): 182 kPa (128-199 kPa)
naspram 116 kPa (65-169). Analizom ROC krivulje dokazali smo kako SWE povećava dijagnostičku točnost UZV pregleda.

ZAKLJUČCI: Sonoelastografsko mjerenje tvrdoće lezije ima vrijednost u otkrivanju recidiva karcinoma dojke. SWE može povećati dijagnostičku točnost „second-look“ UZV pregleda. Rezultati postignuti kombinacijom MR, B-mod i SWE pregleda pokazuju visoku dijagnostičku točnost te se korelacija slikovnih nalaza preporučuje u procjeni nejasnih lezija.

Abstract (english)

AIM: The aim of the study was to investigate lesion characterization on postoperative magnetic resonance imaging (MRI) versus second-look ultrasound (US) using B-mode and shear-wave elastography (SWE) and determine the effect of SWE on decision to perform biopsy.

MATERIALS AND METHODS: Ninety female patients (age 29-83 years, mean 57 years) with history of breast carcinoma surgery, who underwent postoperative breast MRI and second-look US were enrolled. B-mode and SWE examinations were performed measuring lesion stiffness (Emax, Emean, Emin). Core-biopsy was performed for histopathological verification. Correlation between histological findings and SWE measurements, as well as MRI characteristics was investigated, along with differences between lesion categorization using different imaging methods.

RESULTS: Histopathological analysis confirmed carcinoma recurrence in 43,3% of lesions, while 56,7% were confirmed as benign. Carcinoma recurrences showed increased stiffness (median (Q1-Q3) 182 kPa (128-199 kPa) vs 116 kPa (65-169). ROC curve analysis proved that sonoelastography can increase diagnostic accuracy of second-look US.

CONCLUSIONS: SWE measurement of lesion stiffness is of value in breast carcinoma recurrence diagnosis. SWE can increase diagnostic accuracy of secondlook US. Results of combined MRI, B-mode US and SWE show high diagnostic
accuracy and correlation of imaging findings is recommended in assessment of challenging lesions.

• Keywords: Žena; Odrasla osoba; Srednje godine; Ostario; Star; 80 i više godina; ROC krivulja; Neoplazme dojke; Biopsija; Magnetska rezonancija; Karcinom
• Keywords (english): Female; Adult; Middle Aged; Aged; Aged; 80 and over; ROC Curve; Breast Neoplasms; Biopsy; Magnetic Resonance Imaging; Carcinoma
• Language: croatian
• URN:NBN: urn:nbn:hr:105:378318
• Project: Number: IP-2016-06-2997; Title: Sonoelastografija i magnetska rezonancija u dijagnostici i liječenju karcinoma dojke; Acronym: EL-MRI-BREAST; Leader: Boris Brkljačić; Jurisdiction: Croatia; Funder: HRZZ; Funding stream: IP
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Type of resource: Text
• Extent: 95 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-12-08 09:03:44