Keywords:
Musculoskeletal soft tissue, Oncology, Ultrasound, Ultrasound-Power Doppler, Contrast agent-intravenous, Neoplasia
Authors:
A. De Marchi, S. Pozza, E. Brach del Prever, P. De Petro, P. Balocco, R. Piana, A. Linari, C. Faletti; Turin/IT
DOI:
10.1594/ecr2013/C-0983
Purpose
There is a wide variety of soft tissue masses that includes non neoplastic lesions,
benign and malignant tumours (fig 1).
In this field the imaging characterization remains problematic,
despite advances.
A systematic interdisciplinary approach can identify quiescent,
active and aggressive lesions,
achieve histological diagnosis based on the World Health Organization (WHO) classification system for tissue tumors [1],
allows a rapid clinical decision and optimises resources,
limiting errors,
delayed diagnosis,
excessive costs both financial and human.
Several imaging modalities have been used to assess soft-tissue tumors like radiograph,
nuclear medicine,
US,
CT,
MRI and PET.
However none of these approaches are reliable to distinguish benign from malignant [2].
The US represents a non invasive,
dynamic,
free of ionizing radiation,
rapid,
easy and relatively not expensive technique.
Malignant masses are characterized by anarchic vascularization related with neoangiogenesis [3].
The evaluation of presence/absence of vascularization could be an easy and early method to identify masses potentially malignant.
Power Doppler study identifies only major vessels,
but it’s unable to visualize the diffuse microvascular pathological network (fig.2).
We hypothesized that vascular enhancement identified by contrast-enhanced sonography (CEUS) could be useful to discriminate between benign and malignant lesions.