ERRORS IN ULTRASOUND DIAGNOSIS OF GYNECOLOGIC CANCER: ANALYSIS OF CAUSES
Vostrov A.N., Stepanov S.O., Mitina L.A., Novikova E.G.,
Malsagova Kh.R., Kaprin A.D.
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Malignant tumors of reproductive system are the most incident cancers in women (more than 35% in total). Because of its validity, non-invasiveness, safety, accessibility, repeatability, and relative simplicity nowadays ultrasonography is one of the leading diagnostic methods in gynecologic oncology. However, despite high resolving power of this method, the frequency of errors in topical diagnosis of pelvic lesions, their characterization, and degree of tumor spread assessment remains around 10-30%. Purpose. To identify and analyze causes of errors in ultrasound diagnosis in gynecologic oncology. Materials and methods. We analyzed pre-operative ultrasound protocols from 1167 women with cervical cancer, endometrial cancer, and ovarian cancer who were getting treatment at our facility. Ultrasound results were compared with intraoperative data and pathology results. Results. We analyzed causes of 68 subjective and objective errors in assessing local and distant spread of the tumor. Objective errors were predominantly associated with the limit of the scanner resolving power and the subjective ones were related to the ultrasound exam technique and incorrect interpretation of the results by a specialist.
Conclusion. Incorrect interpretation of ultrasound data associated with subjective causes results in incomplete, partially wrong or wrong diagnosis. Frequency of objective errors can be decreased with proper equipping of ultrasound departments while frequency of subjective errors can be decreased with proper ultrasound exam technique. |
P.A. Hertsen Moscow Oncology Research Center.
Moscow, Russia. |
Keywords: cervical cancer, endometrial cancer, ovarian cancer, ultrasound diagnosis, errors in ultrasound diagnosis.
Corresponding author: Vostrov A.N., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript
For citation: Vostrov A.N., Stepanov S.O., Mitina L.A., Novikova E.G., Malsagova Kh.R., Kaprin A.D. Errors in ultrasound diagnosis of gynecologic cancer: analysis of causes. REJR 2020; 10(2):160-167. DOI:10.21569/2222-7415-2020-10-2-160-167.
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Received: 11.05.20 Accepted: 19.06.20
Exploring the possibilities of Ultrasonic Shear Wave Elastography (SWE) in controlling the formation of bone calluses at different stages of its development.
Material and methods. A study of 51 patients (29 men, 22 women from 17 to 65 years) with fractures of long tubular bones of the upper and lower limbs was conducted. Ultrasound tests were performed on the SuperSonic Aixplorer (France) device with an assessment of tissue stiffness in the kPa and the use of multifrequency probes 2-15 MHz. In the area of the fracture scanned bone corn, surrounding soft tissues and vessels, excluded interposition. The formation of bone calluses was studied at different stages of its development, from 0-7 days to 6 months.
Results. According to the SWE, the most intensive increase in bone calluses is in the first 1.5 months after the fracture, followed by the build-up of bone calluses. For each stage of bone callos formation determined sensitivity, specificity of the method of SWE.
Discussion. The use of the SWE method to control the formation of bone calluses is possible from the first days after bone fracture. The stiffness of bone calluses at SWE is determined in the kPa. Ultrasound also allows you to study the condition of bone fragments, surrounding tissues and vessels. Conducting ultrasound with the use of SWE, dopplerography allows in dynamics to trace the formation of bone calluses in all three stages of its development.
Conclusion. SWE wave allows to determine the stiffness of the bone calluses in the dynamics, starting from the first days after the fracture and to its complete formation. SWE implements a new approach to assess the stiffness of bone calluses, which allows to get accurate quantitative results in real time. The sensitivity and specificity of the SWE in determining the stiffness of bone calluses is highest in the first – connective tissue stage of its formation (94% and 90% respectively).