YiJie Dong

Stiffness of the surrounding tissue of breast lesions evaluated by ultrasound elastography.

ObjectiveTo evaluate the stiffness of the surrounding tissue of breast lesions using the strain ratio assessment method by ultrasound (US) elastography.MethodsThis was an institutional ethics committee approved prospective study. A total of 127 breast lesions in 118 women (mean age 48.23 ± 14.32, range 20–90) were examined with conventional and elastographic US. The strain ratio assessment method was utilized to semi-quantitatively evaluate the stiffness of the breast lesions and the surrounding tissue.ResultsFifty-five lesions were malignant and 72 were benign. The strain ratio of the surrounding tissue was significantly higher in malignant cases (1.49 ± 0.67) than in benign ones (1.17 ± 0.44) (P = 0.001), and yielded an Az value of 0.669 in the diagnosis of breast lesions. There was a significant high positive correlation between the strain ratio of the lesion and the strain ratio of the surrounding tissue in the malignant group (r = 0.740, P < 0.001), and a significant moderate positive correlation in the benign group (r = 0.595, P < 0.001).ConclusionThe stiffness of the surrounding tissue of malignant breast lesions was higher than that of benign lesions. The strain ratio of the surrounding tissue and the lesions was significantly correlated, and has potential for breast lesion diagnosis.Key Points• Stiffness of the surrounding tissue of malignant breast lesions was increased.• Stiffness of the surrounding tissue correlated with stiffness of breast lesions.• Stiffness of the surrounding tissue has potential use in diagnosis of breast lesions.

Role of Acoustic Shear Wave Velocity Measurement in Characterization of Breast Lesions

To analyze the value of acoustic radiation force impulse imaging quantification in characterization of breast lesions and to analyze the stiffness of glandular and subcutaneous fatty tissue in benign and malignant lesions.

NONHSAT076754 aids ultrasonography in predicting lymph node metastasis and promotes migration and invasion of papillary thyroid cancer cells

Lymph node metastasis (LNM) is the primary challenge in papillary thyroid cancer (PTC). Recurrent cancerous lymph nodes require repeated surgeries, which increases the risk for surgical complications. Thus, the evaluation of LNM before surgery is important. Ultrasonography is the most convenient way to examine cervical LNM, but the sensitivity of ultrasonography in the identification of LNM in cases of PTC is extremely low. A series of lncRNAs (long noncoding RNAs) have been reported as candidate biomarkers in a variety of tumors. This study detected the lncRNA NONHSAT076754 in PTC and analyzed the correlation of NONHSAT076754 with the clinicopathological and ultrasonographic characteristics of patients with PTC. The value of NONHSAT076754 as an auxiliary diagnostic biomarker for use along with ultrasonography in the differentiation of LNM in PTC was assessed. Additionally, the biological function of NONHSAT076754 in PTC cells was demonstrated. Our study indicated that NONHSAT076754 promotes migration and invasiveness of PTC and serves as a valuable auxiliary biomarker that can be used along with ultrasonography in the prediction of cervical LNM.

Size and Ultrasound Features Affecting Results of Ultrasound-Guided Fine-Needle Aspiration of Thyroid Nodules

Our goal was to assess the diagnostic efficacy of ultrasound (US)‐guided fine‐needle aspiration (FNA) of thyroid nodules according to size and US features.

Ultrasonography is valuable in evaluation of papillary thyroid microcarcinoma based on 5 mm tumor size

Introduction: Fine-needle aspiration was once done in suspected malignant thyroid nodules more than 5 mm in diameter. Five millimeter has been applied in many studies as the cut off tumor size in recent years. In this study, we would like to analyze the clinicopathological and ultrasonographic features of papillary thyroid microcarcinoma (PTMC) ≤5 mm and >5 mm with the aim of finding out the diagnostic value of ultrasonography. Subjects and Methods: A total of 291 patients from January 2012 to October 2014 who underwent an ultrasound examination and were postoperatively diagnosed as PTMC were enrolled in the study. The patients were divided into Group A (≤5 mm) and Group B (>5 mm, ≤10 mm) based on diameter. The clinicopathological and ultrasonographic features of the two groups were statistically analyzed. Results: In total, 291 thyroid tumors were analyzed in 291 patients. In patients who were identified with multiple tumors, the largest nodule in size was used for analysis. PTMC >5 mm in diameter were found with a higher incidence of lymph node metastasis and advanced tumor-node-metastasis (TNM) Stage (III/IV) with a significant difference, also with a larger part of multiple tumors compared to PTMC <5 mm. Of all the ultrasonographic features studied, calcification and peripheral halo were more significantly correlated with PTMC >5 mm. The presence of vascularity and blood supply were both associated with the tumor size. Conclusion: Larger tumor size of PTMC is more likely to involve in lymph node metastasis and advanced TNM stage. Correlation of tumor size with calcification, peripheral halo, vascularity, and blood supply do exist in PTMC. Ultrasound is of great value in the evaluation of PTMC.

Breast strain elastography: Observer variability in data acquisition and interpretation

OBJECTIVE To analyze the observer reproducibility of breast strain elastography in elasticity image acquisition and elasticity image interpretation. METHODS This was an institutional ethics committee approved prospective study. One hundred twenty-four breast lesions in 118 women (mean age 45.39 ± 12.97 years old, range 21-77 years old) were examined with strain elastography by two blinded radiologists in turn. Three blinded observers separately reviewed and recorded the elasticity score of each lesion obtained by the two performers. The interobserver reproducibility of elasticity image acquisition between the two performers, the interobserver and intraobserver reproducibility of elasticity image interpretation among observers were evaluated. The diagnostic performance of strain elastography was compared between the two performers. RESULTS Fifty-three lesions were malignant and 71 were benign. The interobserver kappa value was 0.438 for the elasticity score between the two performers. Between the three observers, the overall interobserver and intraobserver kappa value was 0.365 and 0.655, respectively. There was no significant difference of the area under the receiver operator characteristic curve (Az) value for the elasticity score between performer 1 and 2 (P = 0.143). CONCLUSIONS Our results suggested moderate interobserver reproducibility in breast strain elasticity image acquisition, poor interobserver and good intraobserver agreement in image interpretation.

Twisted Gastrulation BMP Signaling Modulator 1 Regulates Papillary Thyroid Cancer Cell Motility and Proliferation

Bone morphogenetic proteins (BMPs) are growth factors that have important functions in cell proliferation, migration and differentiation. To date, BMP pathway activation has been found in multiple human tumors and is associated with enhanced malignant tumor growth and metastasis. BMP activity is tightly regulated by a family of soluble extracellular secreted BMP modulators. Twisted gastrulation BMP signaling modulator 1 (TWSG1) is a direct BMP regulator that is required for the full signaling activity of BMPs. However, the functions and mechanisms of TWSG1 in papillary thyroid cancer (PTC) metastasis have not been reported. TWSG1 expression was detected in 44 PTC tissues with lymph node metastasis (LNM) and 56 PTC tissues without LNM using quantitative real-time polymerase chain reaction (qRT-PCR). Gain- and loss-of-function approaches were used to assess the biological function of TWSG1 in PTC cells. Matrigel assays demonstrated the effect of tumor cell-derived TWSG1 on endothelial cell function. Our results showed that TWSG1 expression was significantly enhanced in PTC with LNM compared to that in PTC without LNM. TWSG1 knockdown inhibited migration, invasion and proliferation of PTC cells. Additionally, TWSG1 suppression impaired the tumor cell-induced endothelial cell sprout formation. We found that TWSG1 signaling may be transduced by the BMP target transcription factor inhibitor of DNA binding 1 (Id1) and matrix metalloproteinases (MMPs) 2 and 9. In conclusion, TWSG1 was highly expressed in metastasized PTC; tumor growth, migration and invasion were dependent on TWSG1, and it may be a new diagnostic and therapeutic target for PTC.

Blood flow resistance in lesion vessels and normal host vessels evaluated by pulsed Doppler ultrasound

Blood flow rate in the microcirculation is proportional to the arteriole-venule pressure difference and inversely proportional to the blood flow resistance (BFR). Generally, the BFR studies to date have focused on using invasive methods and were carried out in non-physiological conditions. Moreover, few studies have been concerned with the relationships of BFR between the tumor vessels and the normal host vessels. The present study investigated the BFR in malignant lesion vessels, benign lesion vessels and normal host vessels in physiological conditions using pulsed Doppler ultrasound as a tool and the thyroid as a model, A total of 133 patients with thyroid nodules were included in the study. The results revealed that most of the BFR parameters were higher in malignant lesion vessels than in benign lesion vessels (P=0.001-0.029), as well as lower in normal host vessels than in malignant or benign lesion vessels (P=0.000-0.017); Low to moderate significant positive correlations of BFR between benign lesion vessels and normal host vessels were also found (r=0.358-0.480, P=0.000 for all). Finally and interestingly, low negative correlations between the malignant nodule sizes and some of the BFR parameters were revealed, though these correlations were not statistically significant (r=-0.205--0.261, P=0.108-0.211). Our results suggested that pulsed Doppler ultrasound could be successfully used to measure BFR in physiological conditions and to reveal the BFR relationship between lesion vessels and normal host vessels, as well as the relationship between the lesion sizes and the BFR.