Priscilla Machado

Initial Evaluation of Lymphosonography to Identify Sentinel Lymph Nodes in Cervical and Vulvar Cancer Patients

ABSTRACT The objective of this pilot study was to identify sentinel lymph nodes (SLN) in cervical or vulvar cancer subjects scheduled for surgery using lymphosonography, comparing the findings with pathology. The contrast agent Sonazoid was administered subcutaneously around the tumor, and real‐time contrast‐enhanced ultrasound was performed to identify SLNs. Eleven SLNs were surgically excised, while lymphosonography identified 17 SLNs in 5 subjects. Comparing surgically excised SLNs and those identified by lymphosonography showed that 10 out of 11 SLNs (or 91%) were identified by lymphosonography. Lymphosonography identified all the benign SLNs and 2 out of the 3 malignant SLNs.

Evaluation of Uterine Fibroid Vascularity Using Contrast-Enhanced Ultrasound in Comparison with Contrast-Enhanced Magnetic Resonance Imaging

The aim of the work described here was to assess uterine fibroid vascularity using contrast-enhanced ultrasound (CEUS) as compared with magnetic resonance imaging (MRI). Forty women diagnosed with symptomatic uterine fibroids scheduled for uterine artery embolization (UAE) were enrolled in this institutional review board-approved study. Before UAE, participants underwent CEUS examination with an Aplio i800 scanner (Canon Medical Systems, Tustin, CA, USA) with curvilinear array (8C1). CEUS was performed using 2.0 mL of the ultrasound contrast agent Lumason (Bracco, Milan, Italy) administered intravenously. Digital CEUS clips were acquired and randomized offline, and fibroids were characterized as hyper- or hypovascular. MRI was used as reference standard for fibroid vascularity and compared with CEUS. Results were analyzed using McNemar's test. Forty participants were enrolled in the trial. One patient did not proceed with the UAE procedure and one patient refused pre-procedure MRI because of claustrophobia. Therefore, 38 participants underwent CEUS and MRI examinations before UAE. Hypervascular fibroids were seen on MRI and CEUS in 24 and 26 participants, respectively. Hypovascular fibroids were seen with MRI and CEUS in 14 and 12 participants, respectively. Fibroids characterized as hypovascular in two participants by MRI were characterized as hypervascular by CEUS. CEUS and MRI findings were similar in 36 of 38 participants, corresponding to an accuracy of 95% (p = 0.62). Contrast-enhanced ultrasound can accurately assess uterine fibroid vascularity, serving as a potential alternative to MRI in determination of the vascularity of uterine fibroids.