Diagnosis And Proliferative Assessment Of Soft Tissue Sarcoma By Contrast-enhanced Ultrasonography

Diagnostic Value of Contrast-Enhanced Ultrasound for Differential Diagnosis of Malignant and Benign Soft Tissue Masses: A Meta-AnalysisObjective To investigate the value of the differential diagnosis of contrast-enhanced ultrasound(CEUS)in benign and malignant soft tissue mass(STM).Methods Through a comprehensive search of Pub Med,Ovid,Cochrane and web of science,the relevant studies published before March 24,2020 were identified and the relevant data were extracted.The data of sensitivity,specificity,positive and negative likelihood ratio(LR),diagnostic odds ratio(DOR)and total area under the curve(AUC)of CEUS in the differential diagnosis of STM were compiled and analyzed by Meta-disc and Stata software.Results According to the screen criteria,5 studies,containing 747 patients,were selected.In the differential diagnosis of benign and malignant STM,the pooled data regarding sensitivity and specificity of CEUS were 76%(95% CI,71-81%;I2 =74.5%)and 67%(95% CI,62-71%;I2 =36.5%),respectively.The DOR was7.37(95% CI,3.78-14.35;I2 = 66.6%).The overall AUC was 0.77(SE,0.0392).Subgroup analysis manifested that different index tests of CEUS resulted in different diagnostic performance.Conclusion CEUS is an effective method for the differential diagnosis between benign and malignant STM.Correlation Between Ultrasonographic Features and Ki-67 Labeling Index in Soft Tissue SarcomaObjective To explore the relationship between ultrasound features and Ki-67 labeling index of soft tissue sarcoma(STS).Method 46 patients with 47 lesions diagnosed as STS,between September 2014 and April 2020,were enrolled in the study.We utilized point-biserial correlation analysis and Spearman’s correlation analysis to examining the relationship between the ultrasound features and the Ki-67 labeling index of STS.Then,we statistically analysed the differences of ultrasound features between high and low Ki-67 proliferation groups with independent t test,Wilcoxon rank-sum test and Fisher’s exact test.Finally,we estimated the optimal cut-off points of ultrasound features revealing significant differences using the maximum Youden index.Result We found a moderate correlation between the vascular density grade and the Ki-67 labeling index(ρ=0.409,P = 0.004)in this study.In addition,other ultrasound features were irrelevant to the Ki-67 labeling index.The cut-off for differentiating low and high proliferation groups was grade II according to the best Youden index.The area under receiver operating characteristic curve was 0.74(p=0.011)with a sensitivity of 60.6% and specificity of 78.6%.Conclusions Only the vascular density grade of STS had a weak positive correlation with Ki-67 LI,and might be capable of predicting the proliferation of STS.Other ultrasonographic features of STS such as shape and tumor margin have no correlation with Ki-67 LI.Correlation Between Quantitative Parameters of CEUS and Ki-67 Labeling Index in Soft Tissue SarcomaObjective To investigate the correlation between quantitative parameters of contrast-enhanced ultrasound(CEUS)and Ki-67 labeling index in soft tissue sarcoma(STS).Method From January 2019 to November 2020,25 patients with STS underwent CEUS examination.The relationship between the Ki-67 labeling index of STS and the quantitative parameters of CEUS was studied by point two column correlation analysis and Spearman correlation analysis.Independent t test,Wilcoxon rank sum test and Fisher’s exact test were used to analyze the differences of quantitative parameters of CEUS between the two groups.According to the maximum Youden index,the best “cut-off” point of ultrasound features with significant difference was determined.Result There was a moderate positive correlation between RT of STS and Ki-67proliferation(high / low).The correlation coefficient was 0.504(P = 0.01).In addition,other CEUS quantitative parameters were not related to Ki-67 index.According to the best Youden index,the best “cut-off” to distinguish low proliferation group from high proliferation group was 10.84 seconds.The sensitivity and specificity of RT were 86.7% and 80%,respectively.The area under ROC curve was0.797(P = 0.014).Conclusion The CEUS quantitative parameter RT of STS is positively correlated with Ki-67 index,which can predict the proliferation of STS.