ISSN:2167-7964

Journal of Radiology
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  • Research Article   
  • OMICS J Radiol,
  • DOI: 10.4172/2167-7964.1000321

Comparison between Dynamic Contrast-Enhanced Magnetic Resonance (DCE-MR) and Dynamic Contrast-Enhanced Ultrasound (DCE-US) in the Imaging of Pediatric Extra-Cranial Tumor

Wendy WM Lam1*, Janice JK Ip1, Candy YC Mui1, Daniel Cheuk2 and Godfrey CF Chan2
1Department of Radiology, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, PR China
2Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
*Corresponding Author : Wendy WM Lam, Department of Radiology, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, PR China, Tel: +85222555488, Email: lamwendy60@yahoo.com.hk

Received Date: Jun 08, 2020 / Accepted Date: Jul 03, 2020 / Published Date: Jul 10, 2020

Abstract

Background: Dynamic contrast-enhanced magnetic resonance imaging (DCE-MR) is becoming a widely accepted complementary method for diagnosing cancers. This technique is useful to predict and monitor the tumor response to the therapy, but it takes a longer scanning time and may not be readily available in some places. The use of dynamic contrast-enhanced ultrasound (DCE-US) is a new functional technique enabling a quantitative assessment of solid tumor perfusion in adults. Its usefulness in pediatric patients had not been determined.

Objective: To compare DCE-US curve parameters with different curve patterns of DCE-MR and assess if it can achieve the same purpose as in DCE-MR; and to explore the potential role and benefits of DCE-US in the diagnosis and treatment monitoring of pediatric extra-cranial tumors.

Methods: Children with suspected extra-cranial solid tumors, including newly diagnosed or follow-up cases of confirmed tumors, were recruited. DCE-MR was performed, and enhancement curves were plotted and categorized into type 1, 2 and 3 curves. DCE-US was then performed afterwards. Their enhancement curves and parameters were compared. The change in DCE-MR curve patterns, tumor size, predicted tumor activities and DCE-US parameters were correlated with histologic sections of the resected specimens or PET-CT in follow-up cases.

Results: There were total 26 studies, involving 17 patients (M=9, F=8) with average age 4.8 years old (range: 1-19 years old). Average scanning time was 15 minutes in DCE-US and 30-45 minutes in DCE-MR. DCE-US curve parameters correlated significantly with cases with type 3 DCE-MR curve, which had a larger slope of increase and peak intensity. For follow-up cases (n=6), DCE-MR curves changed from type 3 curve to type 1 or 2 curves in 4 cases, and there was no change in curve pattern in 2 cases. All tumors decreased in size after treatment. The slope of increase and peak intensity for DCE-US curves showed strong positive correlation with tumor size (R= 0.52 and R = 0.56). Time to peak for DCE-US curves showed strong negative correlation with tumor size (R=-0.73). DCE-MR predicted tumor activities were correlated closely with pathology or PET-CT findings (accuracy = 83.3%). DCE-US showed an increase in half-time (100%), wash-in time (83.3%) and time to peak (83.3%) in post-treatment cases, which were correlated closely with pathology or PET-CT findings.

Conclusion: US contrast is safe and easy to use in children. DCE-US curve parameters showed statistically significant correlation with type 3 DCE-MR curve, suggesting that they might have comparable utility in aggressive malignant tumors. Serial DCE-US, which has a shorter scanning time and easily available, may have a role in the monitoring of treatment response of pediatric extra-cranial tumor, resulting in more potential benefits for pediatric patients.

Keywords: Dynamic contrast; Dynamic contrast ultrasound; Extracranial tumor; Children; Pediatric

Citation: Lam WWM, Ip JJK, Mui CYC, Cheuk D, Chan GCF (2020) Comparison between Dynamic Contrast-enhanced Magnetic Resonance (DCE-MR) and Dynamic Contrast-Enhanced Ultrasound (DCE-US) in the Imaging of Pediatric Extra-Cranial Tumor. OMICS J Radiol 9: 1000321. Doi: 10.4172/2167-7964.1000321

Copyright: © 2020 Lam WWW, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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