RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin · 2026
Diagnostic Value of Dynamic Contrast Enhanced Ultrasound (CEUS) with Time Intensity Curve (TIC) Analysis for Differentiating Musculoskeletal Benign and Malignant Soft Tissue Tumors.
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Brandenstein Moritz Konstantin, Greiner Barbara, Hammer Simone, Kupke Laura S, Zhang Liang, Napodano Gerardo, Strotzer Quirin, Sieber Irmgard, Knott Michael, Mayr Vinzenz, Stroszczynski Christian, Jung Ernst Michael
Аннотация
PURPOSE: This retrospective study evaluated the diagnostic performance of contrast-enhanced ultrasound (CEUS) combined with time-intensity curve (TIC) analysis for differentiating benign from malignant soft tissue lesions.
MATERIALS AND METHODS: CEUS was performed using a linear transducer (5-18 MHz) after a bolus injection of 1.4 - 2.4 ml sulfur hexafluoride microbubbles. Quantitative perfusion parameters including arrival time (AT), time-to-peak (TTP), and area under the curve (AUC) were obtained by system integrated TIC-analysis using intralesional and perilesional regions of interest. Qualitative wash-in and wash-out dynamics were also assessed. Histology, CT and MRI served as reference standards.
RESULTS: Ninety lesions were included, comprising 51 benign (lipomas, fibromatoses, inflammatory lesions, lymph nodes and schwannomas) and 39 malignant tumors (sarcomas, lymphomas, metastases). Malignant lesions demonstrated significantly shorter TTP (mean: 15.3 ± 6.6 s vs. 29.8 ± 13.3 s) and a higher prevalence of rapid wash-in (mean: 71.2% vs 13.7%). AT tended to be shorter in malignant lesions. AUC were generally higher in malignant lesions. TIC patterns differed characteristically: benign lesions showed gradual, homogeneous enhancement, whereas malignant tumors exhibited steep early enhancement followed by wash-out.
CONCLUSION: CEUS represents a valuable adjunctive imaging modality for the characterization of soft tissue tumors. Shortened TTP and rapid wash-in/wash-out represent the most reliable malignancy indicators. Therefore, CEUS may support clinical decision making and biopsy planning.
KEY POINTS: · CEUS reliably helps to differentiate benign and malignant soft tissue tumors.. · Rapid wash-in and wash-out strongly indicate malignancy.. · Time-to-peak is the most robust quantitative TIC parameter.. · CEUS may improve planning of ultrasound-guided biopsies..
CITATION FORMAT: · Brandenstein MK, Greiner B, Hammer S et al. Diagnostic Value of Dynamic Contrast Enhanced Ultrasound (CEUS) with Time Intensity Curve (TIC) Analysis for Differentiating Musculoskeletal Benign and Malignant Soft Tissue Tumors. Rofo 2026; DOI 10.1055/a-2923-4597.
MATERIALS AND METHODS: CEUS was performed using a linear transducer (5-18 MHz) after a bolus injection of 1.4 - 2.4 ml sulfur hexafluoride microbubbles. Quantitative perfusion parameters including arrival time (AT), time-to-peak (TTP), and area under the curve (AUC) were obtained by system integrated TIC-analysis using intralesional and perilesional regions of interest. Qualitative wash-in and wash-out dynamics were also assessed. Histology, CT and MRI served as reference standards.
RESULTS: Ninety lesions were included, comprising 51 benign (lipomas, fibromatoses, inflammatory lesions, lymph nodes and schwannomas) and 39 malignant tumors (sarcomas, lymphomas, metastases). Malignant lesions demonstrated significantly shorter TTP (mean: 15.3 ± 6.6 s vs. 29.8 ± 13.3 s) and a higher prevalence of rapid wash-in (mean: 71.2% vs 13.7%). AT tended to be shorter in malignant lesions. AUC were generally higher in malignant lesions. TIC patterns differed characteristically: benign lesions showed gradual, homogeneous enhancement, whereas malignant tumors exhibited steep early enhancement followed by wash-out.
CONCLUSION: CEUS represents a valuable adjunctive imaging modality for the characterization of soft tissue tumors. Shortened TTP and rapid wash-in/wash-out represent the most reliable malignancy indicators. Therefore, CEUS may support clinical decision making and biopsy planning.
KEY POINTS: · CEUS reliably helps to differentiate benign and malignant soft tissue tumors.. · Rapid wash-in and wash-out strongly indicate malignancy.. · Time-to-peak is the most robust quantitative TIC parameter.. · CEUS may improve planning of ultrasound-guided biopsies..
CITATION FORMAT: · Brandenstein MK, Greiner B, Hammer S et al. Diagnostic Value of Dynamic Contrast Enhanced Ultrasound (CEUS) with Time Intensity Curve (TIC) Analysis for Differentiating Musculoskeletal Benign and Malignant Soft Tissue Tumors. Rofo 2026; DOI 10.1055/a-2923-4597.