From benign lipoma to G3 liposarcoma: contrast-enhanced ultrasound reveals tumor microperfusion and indicates malignancy

Objective - Lipomatous soft tissue tumors (STT), ranging from benign lipomas to malignant liposarcomas, require accurate differentiation for timely treatment. Complementary to MRI, Contrast-enhanced ultrasound (CEUS) is emerging as a promising tool, providing insight into tumor microperfusion in rea...

Full description

Saved in:
Bibliographic Details
Main Authors: Mick, Paul (Author) , Rohner, Marie (Author) , Renkawitz, Tobias (Author) , Lehner, Burkhard (Author) , Geisbüsch, Andreas (Author) , Tsitlakidis, Stefanos (Author) , Hariri, Mustafa (Author) , Deisenhofer, Julian (Author) , Müller, Michelle (Author) , Doll, Julian (Author)
Format: Article (Journal)
Language:English
Published: September 2024
In: Ultrasound in medicine & biology
Year: 2024, Volume: 50, Issue: 9, Pages: 1472-1478
ISSN:1879-291X
DOI:10.1016/j.ultrasmedbio.2024.05.028
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.ultrasmedbio.2024.05.028
Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S0301562924002345
Get full text
Author Notes:Paul Mick, Marie Rohner, Tobias Renkawitz, Burkhard Lehner, Andreas Geisbüsch, Stefanos Tsitlakidis, Mustafa Hariri, Julian Deisenhofer, Michelle Müller, Julian Doll
Description
Summary:Objective - Lipomatous soft tissue tumors (STT), ranging from benign lipomas to malignant liposarcomas, require accurate differentiation for timely treatment. Complementary to MRI, Contrast-enhanced ultrasound (CEUS) is emerging as a promising tool, providing insight into tumor microperfusion in real-time. This study aims to explore the potential of preoperative CEUS in differentiating benign lipomatous tumors from malignant liposarcoma subtypes. - Methods - Eighty-seven patients with lipomatous STT scheduled for surgery were enrolled. Clinical and MRI assessments were conducted to obtain general tumor characteristics. CEUS was used for a standardized tumor perfusion evaluation. Perfusion analysis included peak enhancement, rise time, wash-in perfusion index, and wash-out rate, reflecting the perfusion kinetics. Histopathological results were obtained for every STT and compared to perfusion characteristics. - Results - In total, 48 lipoma, 23 ALT and 11 liposarcoma were identified. Significant differences in tumor microperfusion were demonstrated, with higher perfusion levels indicating higher malignancy (Peak enhancement [a.u.] of Lipoma: 145 ± 238; ALT: 268 ± 368; Liposarcoma: 3256 ± 4333; p (ALT vs. Liposarcoma) < 0.001). A perfusion-based identification of a benign lipoma or ALT versus sarcoma resulted in a positive predictive value of 93%. Patient-related factors (age, gender, BMI, ASA score, smoking status) had no significant impact on the CEUS-based perfusion parameters. - Conclusion - Our study suggests CEUS as a capable non-invasive tool for improving preoperative assessment of lipomatous STT. It can assist in the distinction between benign and malignant STT, accelerating treatment decisions and enhancing patient outcomes. Significant correlations between CEUS-derived parameters and malignancy highlight its risk assessment potential.
Item Description:Online verfügbar: 9. Juli 2024, Artikelversion: 2. August 2024
Gesehen am 14.01.2025
Physical Description:Online Resource
ISSN:1879-291X
DOI:10.1016/j.ultrasmedbio.2024.05.028