Acurácia da elastografia no diagnóstico do câncer de mama em nódulos mamários biopsiados ao ultrassom
Autor(a) principal: | |
---|---|
Data de Publicação: | 2020 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da PUC_RS |
Texto Completo: | http://tede2.pucrs.br/tede2/handle/tede/9851 |
Resumo: | Introduction: Breast cancer is the most incident malignant neoplasm in women, representing 25% of cancer cases worldwide. If diagnosed at the early stages, with lesions smaller than 2 millimeters, breast cancer has better prognosis and higher cure rates. The imaging data to diagnose and screening breast cancer presents a high percentage of false positive and false negative results. Therefore, new alternative methods more accurate and less invasive have arising to investigate and define the breast pathology. Ultrasound elastography can provide additional breast disease diagnostic information, based on the tissue stiffness instead of only to consider the anatomic characteristics. It has the potential of quantifying the lesion stiffness, through a coupled software in the conventional ultrasound device, allowing evaluating different tissues according to the compressibility variation, being free of ionizing radiation. Since it is a still a recent technique, it is not used in the routine evaluation of breast nodules, in spite of being non-invasive, and can reduce the number of nodules biopsies with clinical and image evidence of benignity. Objective: Verify elastography acuity in the differential diagnosis of breast nodules diagnosed by ultrasound, comparing the differences between malignant and benign findings. Methods: Records data were obtained from patients attending HUSM Breast Ultrasound Section, between March 2013 and December 2018, which underwent ultrasound with elastography, and nodule biopsy afterwards. The histopathological results were considered as golden standard technique for comparison. The variables sex, age, location of the lesion and type of biopsy obtained were presented as a percentage, and the chi-square test was applied to evaluate the relationship between type B ultrasound data with elastography and the other variables. Results: 575 medical records were analyzed and of these, 573 cases were included in the study. Two hundred and thirty four were malignant nodules, 312 were benign nodules and in 24 samples, the results were indeterminate. A significant association was observed between the images obtained by high density elastography with malignant neoplasm (p<0,001) as well as an association between low density elastography with benign nodules (p<0,001). The sensitivity and specificity of the method were 94% and 57%, respectively, with an accuracy of 75%. Conclusion: Elastography is a method that can complement mode-B ultrasound, which will help to avoid unnecessary biopsies. |
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Machado, Denise Cantarellihttp://lattes.cnpq.br/3647042041612695http://lattes.cnpq.br/0817844696407154Kettner, Joanine Girardi2021-09-15T13:23:31Z2020-07-20http://tede2.pucrs.br/tede2/handle/tede/9851Introduction: Breast cancer is the most incident malignant neoplasm in women, representing 25% of cancer cases worldwide. If diagnosed at the early stages, with lesions smaller than 2 millimeters, breast cancer has better prognosis and higher cure rates. The imaging data to diagnose and screening breast cancer presents a high percentage of false positive and false negative results. Therefore, new alternative methods more accurate and less invasive have arising to investigate and define the breast pathology. Ultrasound elastography can provide additional breast disease diagnostic information, based on the tissue stiffness instead of only to consider the anatomic characteristics. It has the potential of quantifying the lesion stiffness, through a coupled software in the conventional ultrasound device, allowing evaluating different tissues according to the compressibility variation, being free of ionizing radiation. Since it is a still a recent technique, it is not used in the routine evaluation of breast nodules, in spite of being non-invasive, and can reduce the number of nodules biopsies with clinical and image evidence of benignity. Objective: Verify elastography acuity in the differential diagnosis of breast nodules diagnosed by ultrasound, comparing the differences between malignant and benign findings. Methods: Records data were obtained from patients attending HUSM Breast Ultrasound Section, between March 2013 and December 2018, which underwent ultrasound with elastography, and nodule biopsy afterwards. The histopathological results were considered as golden standard technique for comparison. The variables sex, age, location of the lesion and type of biopsy obtained were presented as a percentage, and the chi-square test was applied to evaluate the relationship between type B ultrasound data with elastography and the other variables. Results: 575 medical records were analyzed and of these, 573 cases were included in the study. Two hundred and thirty four were malignant nodules, 312 were benign nodules and in 24 samples, the results were indeterminate. A significant association was observed between the images obtained by high density elastography with malignant neoplasm (p<0,001) as well as an association between low density elastography with benign nodules (p<0,001). The sensitivity and specificity of the method were 94% and 57%, respectively, with an accuracy of 75%. Conclusion: Elastography is a method that can complement mode-B ultrasound, which will help to avoid unnecessary biopsies.Introdução: O câncer de mama é a neoplasia mais incidente em mulheres, representando 25% do total de casos de câncer no mundo. Quando identificado em estágios iniciais, com lesões menores de dois centímetros de diâmetro, o câncer de mama apresenta melhor prognóstico e elevado percentual de cura. Diante dos ainda altos índices de falso-positivos e falso-negativos nos exames de imagem utilizados para diagnóstico e rastreio do câncer de mama, novos exames surgem como alternativas para investigações mais precisas e menos invasivas. A elastografia ultrassonográfica é uma técnica relativamente nova que pode fornecer informação diagnóstica adicional da patologia mamária, baseada na rigidez do tecido ao invés da estrutura anatômica, com potencial de quantificar a rigidez de uma lesão, por meio de um software acoplado a um aparelho de ultrassom convencional, permitindo a avaliação de diferentes tecidos conforme a variação da sua compressibilidade, sendo isenta de radiações ionizantes. Por ser uma técnica relativamente recente, é pouco utilizada na avaliação de rotina de nódulos mamários, podendo significar um método não invasivo que venha a ser utilizado no diagnóstico, reduzindo assim o número de biópsias em nódulos com evidências clínicas e imaginológicas de benignidade. Objetivos: Verificar a acuidade da técnica de elastografia no diagnóstico diferencial de nódulos mamários, previamente diagnosticados por meio de ultrassom, comparando a sua aplicabilidade na diferenciação entre lesões malignas e benignas. Métodos: Foram analisados prontuários de pacientes atendidas no Serviço de Ultrassonografia Mamária do Hospital Universitário de Santa Maria - HUSM, entre março de 2013 e dezembro de 2018, que realizaram ultrassonografia modo-B com elastografia e tiveram nódulos mamários diagnosticados, com a posterior realização de biópsia. Os resultados histopatológicos foram considerados técnica padrão-ouro para comparação. As variáveis sexo, idade, localização da lesão e tipo de biopsia obtida foram apresentadas em percentagem e para avaliação da relação entre os dados de ultrassonografia tipo B e elastografia com as demais variáveis foi aplicado o teste do qui-quadrado. Resultados: Foram analisados 575 prontuários e destes, 573 casos foram incluídos no estudo. Duzentos e trinta e quatro eram nódulos malignos, 312 possuíam nódulos benignos e em 24 amostras os resultados foram indeterminados. Foi observada uma associação significativa entre as imagens obtidas pela elastografia de alta densidade e a presença de neoplasia maligna (p<0,001), assim como entre a elastografia de baixa densidade e a presença de nódulos benignos (p<0,001). A sensibilidade e a especificidade do método foram de 94% e 57%, respectivamente, com uma acurácia de 75%. Conclusão: A elastografia é um método que pode complementar a ultrassonografia modo-B, ajudando a evitar biópsias desnecessárias.Submitted by PPG Medicina e Ciências da Saúde (medicina-pg@pucrs.br) on 2021-09-14T13:55:05Z No. of bitstreams: 1 tese corrigida.pdf: 2511682 bytes, checksum: aee0059c0676762c21bc37fb39855a0b (MD5)Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2021-09-15T13:15:02Z (GMT) No. of bitstreams: 1 tese corrigida.pdf: 2511682 bytes, checksum: aee0059c0676762c21bc37fb39855a0b (MD5)Made available in DSpace on 2021-09-15T13:23:31Z (GMT). No. of bitstreams: 1 tese corrigida.pdf: 2511682 bytes, checksum: aee0059c0676762c21bc37fb39855a0b (MD5) Previous issue date: 2020-07-20application/pdfhttp://tede2.pucrs.br:80/tede2/retrieve/182004/TES_JOANINE_GIRARDI_KETTNER_CONFIDENCIAL.pdf.jpgporPontifícia Universidade Católica do Rio Grande do SulPrograma de Pós-Graduação em Medicina e Ciências da SaúdePUCRSBrasilEscola de MedicinaUltrassonografia MamáriaElastografiaCâncer de MamaBreast UltrasonographyElastographyBreast CancerCIENCIAS DA SAUDE::MEDICINAAcurácia da elastografia no diagnóstico do câncer de mama em nódulos mamários biopsiados ao ultrassominfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisTrabalho será publicado como artigo ou livro60 meses15/09/2026-721401722658532398500500500-224747486637135387-969369452308786627info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_RSinstname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)instacron:PUC_RSTHUMBNAILTES_JOANINE_GIRARDI_KETTNER_CONFIDENCIAL.pdf.jpgTES_JOANINE_GIRARDI_KETTNER_CONFIDENCIAL.pdf.jpgimage/jpeg4077http://tede2.pucrs.br/tede2/bitstream/tede/9851/4/TES_JOANINE_GIRARDI_KETTNER_CONFIDENCIAL.pdf.jpg6ab9789dc5855e1000481a9743a5abb7MD54TEXTTES_JOANINE_GIRARDI_KETTNER_CONFIDENCIAL.pdf.txtTES_JOANINE_GIRARDI_KETTNER_CONFIDENCIAL.pdf.txttext/plain1900http://tede2.pucrs.br/tede2/bitstream/tede/9851/3/TES_JOANINE_GIRARDI_KETTNER_CONFIDENCIAL.pdf.txt649deee271bcc44a0e8648b157adc494MD53ORIGINALTES_JOANINE_GIRARDI_KETTNER_CONFIDENCIAL.pdfTES_JOANINE_GIRARDI_KETTNER_CONFIDENCIAL.pdfapplication/pdf386513http://tede2.pucrs.br/tede2/bitstream/tede/9851/2/TES_JOANINE_GIRARDI_KETTNER_CONFIDENCIAL.pdf0a1c5a055dce560e1c3ff95e8b25b452MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-8590http://tede2.pucrs.br/tede2/bitstream/tede/9851/1/license.txt220e11f2d3ba5354f917c7035aadef24MD51tede/98512021-09-15 12:00:27.561oai:tede2.pucrs.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://tede2.pucrs.br/tede2/PRIhttps://tede2.pucrs.br/oai/requestbiblioteca.central@pucrs.br||opendoar:2021-09-15T15:00:27Biblioteca Digital de Teses e Dissertações da PUC_RS - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)false |
dc.title.por.fl_str_mv |
Acurácia da elastografia no diagnóstico do câncer de mama em nódulos mamários biopsiados ao ultrassom |
title |
Acurácia da elastografia no diagnóstico do câncer de mama em nódulos mamários biopsiados ao ultrassom |
spellingShingle |
Acurácia da elastografia no diagnóstico do câncer de mama em nódulos mamários biopsiados ao ultrassom Kettner, Joanine Girardi Ultrassonografia Mamária Elastografia Câncer de Mama Breast Ultrasonography Elastography Breast Cancer CIENCIAS DA SAUDE::MEDICINA |
title_short |
Acurácia da elastografia no diagnóstico do câncer de mama em nódulos mamários biopsiados ao ultrassom |
title_full |
Acurácia da elastografia no diagnóstico do câncer de mama em nódulos mamários biopsiados ao ultrassom |
title_fullStr |
Acurácia da elastografia no diagnóstico do câncer de mama em nódulos mamários biopsiados ao ultrassom |
title_full_unstemmed |
Acurácia da elastografia no diagnóstico do câncer de mama em nódulos mamários biopsiados ao ultrassom |
title_sort |
Acurácia da elastografia no diagnóstico do câncer de mama em nódulos mamários biopsiados ao ultrassom |
author |
Kettner, Joanine Girardi |
author_facet |
Kettner, Joanine Girardi |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Machado, Denise Cantarelli |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/3647042041612695 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/0817844696407154 |
dc.contributor.author.fl_str_mv |
Kettner, Joanine Girardi |
contributor_str_mv |
Machado, Denise Cantarelli |
dc.subject.por.fl_str_mv |
Ultrassonografia Mamária Elastografia Câncer de Mama |
topic |
Ultrassonografia Mamária Elastografia Câncer de Mama Breast Ultrasonography Elastography Breast Cancer CIENCIAS DA SAUDE::MEDICINA |
dc.subject.eng.fl_str_mv |
Breast Ultrasonography Elastography Breast Cancer |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::MEDICINA |
description |
Introduction: Breast cancer is the most incident malignant neoplasm in women, representing 25% of cancer cases worldwide. If diagnosed at the early stages, with lesions smaller than 2 millimeters, breast cancer has better prognosis and higher cure rates. The imaging data to diagnose and screening breast cancer presents a high percentage of false positive and false negative results. Therefore, new alternative methods more accurate and less invasive have arising to investigate and define the breast pathology. Ultrasound elastography can provide additional breast disease diagnostic information, based on the tissue stiffness instead of only to consider the anatomic characteristics. It has the potential of quantifying the lesion stiffness, through a coupled software in the conventional ultrasound device, allowing evaluating different tissues according to the compressibility variation, being free of ionizing radiation. Since it is a still a recent technique, it is not used in the routine evaluation of breast nodules, in spite of being non-invasive, and can reduce the number of nodules biopsies with clinical and image evidence of benignity. Objective: Verify elastography acuity in the differential diagnosis of breast nodules diagnosed by ultrasound, comparing the differences between malignant and benign findings. Methods: Records data were obtained from patients attending HUSM Breast Ultrasound Section, between March 2013 and December 2018, which underwent ultrasound with elastography, and nodule biopsy afterwards. The histopathological results were considered as golden standard technique for comparison. The variables sex, age, location of the lesion and type of biopsy obtained were presented as a percentage, and the chi-square test was applied to evaluate the relationship between type B ultrasound data with elastography and the other variables. Results: 575 medical records were analyzed and of these, 573 cases were included in the study. Two hundred and thirty four were malignant nodules, 312 were benign nodules and in 24 samples, the results were indeterminate. A significant association was observed between the images obtained by high density elastography with malignant neoplasm (p<0,001) as well as an association between low density elastography with benign nodules (p<0,001). The sensitivity and specificity of the method were 94% and 57%, respectively, with an accuracy of 75%. Conclusion: Elastography is a method that can complement mode-B ultrasound, which will help to avoid unnecessary biopsies. |
publishDate |
2020 |
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2020-07-20 |
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2021-09-15T13:23:31Z |
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por |
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500 500 500 |
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Pontifícia Universidade Católica do Rio Grande do Sul |
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Programa de Pós-Graduação em Medicina e Ciências da Saúde |
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PUCRS |
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Pontifícia Universidade Católica do Rio Grande do Sul |
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