Katarzyna Dobruch-Sobczak, M.D.-Ph.D.

Department of Ultrasound (ZU)
Division of Biomechanics (PB)
position: main specialist
telephone: (+48) 22 826 12 81 ext.: 486
room: 514
e-mail: ksobczak

Supervision of doctoral theses
1.2017-09-28
co-supervisor
Byra Michał Klasyfikacja zmian nowotworowych piersi na podstawie własności statystycznych ech ultradźwiękowych1254
 

Recent publications
1.Piotrzkowska-Wróblewska H., Dobruch-Sobczak K., Klimonda Z., Karwat P., Roszkowska-Purska K., Gumowska M., Litniewski J., Monitoring breast cancer response to neoadjuvant chemotherapy with ultrasound signal statistics and integrated backscatter , PLOS ONE, ISSN: 1932-6203, DOI: 10.1371/journal.pone.0213749, Vol.14, No.3, pp.1-15, 2019
Abstract:

Background Neoadjuvant chemotherapy (NAC) is used in patients with breast cancer to reduce tumor focus, metastatic risk, and patient mortality. Monitoring NAC effects is necessary to capture resistant patients and stop or change treatment. The existing methods for evaluating NAC results have some limitations. The aim of this study was to assess the tumor response at an early stage, after the first doses of the NAC, based on the variability of the backscattered ultrasound energy, and backscatter statistics. The backscatter statistics has not previously been used to monitor NAC effects. Methods The B-mode ultrasound images and raw radio frequency data from breast tumors were obtained using an ultrasound scanner before chemotherapy and 1 week after each NAC cycle. The study included twenty-four malignant breast cancers diagnosed in sixteen patients and qualified for neoadjuvant treatment before surgery. The shape parameter of the homodyned K distribution and integrated backscatter, along with the tumor size in the longest dimension, were determined based on ultrasound data and used as markers for NAC response. Cancer tumors were assigned to responding and non-responding groups, according to histopathological evaluation, which was a reference in assessing the utility of markers. Statistical analysis was performed to rate the ability of markers to predict the final NAC response based on data obtained after subsequent therapeutic doses. Results Statistically significant differences (p<0.05) between groups were obtained after 2, 3, 4, and 5 doses of NAC for quantitative ultrasound markers and after 5 doses for the assessment based on maximum tumor dimension. Statistical analysis showed that, after the second and third NAC courses the classification based on integrated backscatter marker was characterized by an AUC of 0.69 and 0.82, respectively. The introduction of the second quantitative marker describing the statistical properties of scattering increased the corresponding AUC values to 0.82 and 0.91. Conclusions Quantitative ultrasound information can characterize the tumor's pathological response better and at an earlier stage of therapy than the assessment of the reduction of its dimensions. The introduction of statistical parameters of ultrasonic backscatter to monitor the effects of chemotherapy can increase the effectiveness of monitoring and contribute to a better personalization of NAC therapy.

Affiliations:
Piotrzkowska-Wróblewska H.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
Klimonda Z.-IPPT PAN
Karwat P.-IPPT PAN
Roszkowska-Purska K.-other affiliation
Gumowska M.-other affiliation
Litniewski J.-IPPT PAN
2.Klimonda Z., Karwat P., Dobruch-Sobczak K., Piotrzkowska-Wróblewska H., Litniewski J., Breast-lesions characterization using Quantitative Ultrasound features of peritumoral tissue, Scientific Reports, ISSN: 2045-2322, DOI: 10.1038/s41598-019-44376-z, Vol.9, No.7963, pp.1-9, 2019
Abstract:

The presented studies evaluate for the first time the efficiency of tumour classification based on the quantitative analysis of ultrasound data originating from the tissue surrounding the tumour. 116 patients took part in the study after qualifying for biopsy due to suspicious breast changes. The RF signals collected from the tumour and tumour-surroundings were processed to determine quantitative measures consisting of Nakagami distribution shape parameter, entropy, and texture parameters. The utility of parameters for the classification of benign and malignant lesions was assessed in relation to the results of histopathology. The best multi-parametric classifier reached an AUC of 0.92 and of 0.83 for outer and intra-tumour data, respectively. A classifier composed of two types of parameters, parameters based on signals scattered in the tumour and in the surrounding tissue, allowed the classification of breast changes with sensitivity of 93%, specificity of 88%, and AUC of 0.94. Among the 4095 multi-parameter classifiers tested, only in eight cases the result of classification based on data from the surrounding tumour tissue was worse than when using tumour data. The presented results indicate the high usefulness of QUS analysis of echoes from the tissue surrounding the tumour in the classification of breast lesions.

Affiliations:
Klimonda Z.-IPPT PAN
Karwat P.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
Piotrzkowska-Wróblewska H.-IPPT PAN
Litniewski J.-IPPT PAN
3.Dobruch-Sobczak K., Piotrzkowska-Wróblewska H., Klimonda Z., Roszkowska-Purska K., Litniewski J., Ultrasound echogenicity reveals the response of breast cancer to chemotherapy, Clinical Imaging , ISSN: 0899-7071, DOI: 10.1016/j.clinimag.2019.01.021, Vol.55, pp.41-46, 2019
Abstract:

Purpose: To evaluate the ultrasound (US) response in patients with breast cancer (BC) during neoadjuvant chemotherapy (NAC). Methods: Prospective US analysis was performed on 19 malignant tumors prior to NAC treatment and 7days after each first four courses of NAC in 13 patients (median age=57years). Echogenicity, size, vascularity, and sonoelastography were measured and compared with posttreatment scores of residual cancers burden. Results: Changes in the echogenicity of tumors after 3 courses of NAC had the most statistically strong correlation with the percentage of residual malignant cells used in histopathology to assess the response to treatment (odds ratio=60, p < 0.05). Changes in lesion size and elasticity were also significant (p < 0.05). Conclusions: There is a statistically significant relationship between breast tumors' echogenicity in US, neoplasm size, and stiffness and the response to NAC. In particular, our results show that the change in tumor echogenicity could predict a pathological response with satisfactory accuracy and may be considered in NAC monitoring.

Keywords:

Breast ultrasonography, Neoadjuvant chemotherapy, Clinical response, Breast cancer, Sonoelastography

Affiliations:
Dobruch-Sobczak K.-IPPT PAN
Piotrzkowska-Wróblewska H.-IPPT PAN
Klimonda Z.-IPPT PAN
Roszkowska-Purska K.-other affiliation
Litniewski J.-IPPT PAN
4.Dobruch-Sobczak K., Piotrzkowska-Wróblewska H., Klimoda Z., Secomski W., Karwat P., Markiewicz-Grodzicka E., Kolasińska-Ćwikła A., Roszkowska-Purska K., Litniewski J., Monitoring the response to neoadjuvant chemotherapy in patients with breast cancer using ultrasound scattering coefficient: A preliminary report , Journal of Ultrasonography, ISSN: 2084-8404, DOI: 10.15557/JoU.2019.0013, Vol.19, No.77, pp.89-97, 2019
Abstract:

Objective: Neoadjuvant chemotherapy was initially used in locally advanced breast cancer, and currently it is recommended for patients with Stage 3 and with early-stage disease with human epidermal growth factor receptors positive or triple-negative breast cancer. Ultrasound imaging in combination with a quantitative ultrasound method is a novel diagnostic approach. Aim of study: The aim of this study was to analyze the variability of the integrated backscatter coefficient, and to evaluate their use to predict the effectiveness of treatment and compare to ultrasound examination results. Material and method: Ten patients (mean age 52.9) with 13 breast tumors (mean dimension 41 mm) were selected for neoadjuvant chemotherapy. Ultrasound was performed before the treatment and one week after each course of neoadjuvant chemotherapy. The dimensions were assessed adopting the RECIST criteria. Tissue responses were classified as pathological response into the following categories: not responded to the treatment (G1, cell reduction by ≤9%) and responded to the treatment partially: G2, G3, G4, cell reduction by 10–29% (G2), 30–90% (G3), >90% (G4), respectively, and completely. Results: In B-mode examination partial response was observed in 9/13 cases (completely, G1, G3, G4), and stable disease was demonstrated in 3/13 cases (completely, G1, G4). Complete response was found in 1/13 cases. As for backscatter coefficient, 10/13 tumors (completely, and G2, G3, and G4) were characterized by an increased mean value of 153%. Three tumors 3/13 (G1) displayed a decreased mean value of 31%. Conclusion: The variability of backscatter coefficient, could be associated with alterations in the structure of the tumor tissue during neoadjuvant chemotherapy. There were unequivocal differences between responded and non-responded patients. The backscatter coefficient analysis correlated better with the results of histopathological verification than with the B-mode RECIST criteria.

Keywords:

integrated backscatter coefficient (IBSCs), neoadjuvant chemotherapy (NAC), breast cancer, ultrasound

Affiliations:
Dobruch-Sobczak K.-IPPT PAN
Piotrzkowska-Wróblewska H.-IPPT PAN
Klimoda Z.-IPPT PAN
Secomski W.-IPPT PAN
Karwat P.-IPPT PAN
Markiewicz-Grodzicka E.-Oncology Institute (PL)
Kolasińska-Ćwikła A.-Institute of Oncology (PL)
Roszkowska-Purska K.-other affiliation
Litniewski J.-IPPT PAN
5.Piotrzkowska-Wróblewska H., Dobruch-Sobczak K., Byra M., Nowicki A., Open access database of raw ultrasonic signals acquired from malignant and benign breast lesions, Medical Physics, ISSN: 0094-2405, DOI: 10.1002/mp.12538, Vol.44, No.9, pp.1-5, 2017
Abstract:

Purpose: The aim of this paper is to provide access to a database consisting of the raw radio-frequency ultrasonic echoes acquired from malignant and benign breast lesions. The database is freely available for study and signal analysis.
Acquisition and validation methods: The ultrasonic radio-frequency echoes were recorded from breast focal lesions of patients of the Institute of Oncology in Warsaw. The data were collected between 11/2013 and 10/2015. Patients were examined by a radiologist with 18 yr’ experience in the ultrasonic examination of breast lesions. The set of data includes scans from 52 malignant and 48 benign breast lesions recorded in a group of 78 women. For each lesion, two individual orthogonal scans from the pathological region were acquired with the Ultrasonix SonixTouch Research ultrasound scanner using the L14-5/38 linear array transducer. All malignant lesions were histologically assessed by core needle biopsy. In the case of benign lesions, part of them was histologically assessed and another part was observed over a 2-year period. Data format and usage notes: The radio-frequency echoes were stored in Matlab file format. For each scan, the region of interest was provided to correctly indicate the lesion area. Moreover, for each lesion, the BI-RADS category and the lesion class were included. Two code examples of data manipulation are presented. The data can be downloaded via the Zenodo repository (https://doi.org/10.5281/zenodo.545928) or the website http ://bluebox.ippt.gov.pl/~hpiotrzk.
Potential applications: The database can be used to test quantitative ultrasound techniques and ultrasound image processing algorithms, or to develop computer-aided diagno sis systems.

Keywords:

breast lesions, dataset, ultrasonic signals, ultrasonography

Affiliations:
Piotrzkowska-Wróblewska H.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
Byra M.-IPPT PAN
Nowicki A.-IPPT PAN
6.Dobruch-Sobczak K., Piotrzkowska-Wróblewska H., Roszkowska-Purska K., Nowicki A., Jakubowski W., Usefulness of combined BI-RADS analysis and Nakagami statistics of ultrasound echoes in the diagnosis of breast lesions, Clinical Radiology, ISSN: 0009-9260, DOI: 10.1016/j.crad.2016.11.009, Vol.72, pp.339.e7-339.e15, 2017
Abstract:

AIM: To develop a method combining the statistics of the ultrasound backscatter and the Breast Imaging-Reporting and Data System (BI-RADS) classification to enhance the differentiation of breast tumours.
MATERIALS AND METHODS: The Nakagami shape parameter m was used to characterise the scatter properties of breast tumours. Raw data from the radiofrequency (RF) echo-signal and Bmode images from 107 (32 malignant and 75 benign) lesions and their surrounding tissue were recorded. Three different characteristic values of the shape parameters of m (maximum [mLmax], minimum [mLmin] and average [mLavg]) and differences between m parameters (Dmmax, Dmmin, Dmavg) of the lesions and their surrounding tissues were assessed. A lesion with a BI-RADS score of 3 was considered benign, while a lesion with a score of 4 was considered malignant (a cut-off of BI-RADS 3/4 was set for all patients).
RESULTS: The area under the receiver operating characteristic (ROC) curve (AUC) was equal to 0.966 for BI-RADS, with 100% sensitivity and 54.67% specificity. All malignant lesions were diagnosed correctly, whereas 34 benign lesions were biopsied unnecessarily. In assessing the Nakagami statistics, the sum of the sensitivity and specificity was the best for mLavg (62.5% and 93.33%, respectively). Only four of 20 lesions were found over the cut-off value in BI-RADS of 4a. When comparing the differences in m parameters, Dmavg had the highest sensitivity of 90% (only three of 32 lesions were false negative). These three lesions were classified as BIRADS category 4c. The combined use of B-mode and mLmin parameter improve the AUC up to 0.978 (pĽ0.088), compared to BI-RADS alone.
CONCLUSION: The combination of the parametric imaging and the BI-RADS assessment does not significantly improve the differentiation of breast lesions, but it has the potential to better identify the group of patients with mainly benign lesions that have a low level of suspicion for malignancy with a BI-RADS score of 4a.

Affiliations:
Dobruch-Sobczak K.-IPPT PAN
Piotrzkowska-Wróblewska H.-IPPT PAN
Roszkowska-Purska K.-other affiliation
Nowicki A.-IPPT PAN
Jakubowski W.-other affiliation
7.Nowicki A., Dobruch-Sobczak K., Introduction to tissue shear wave elastography, HYDROACOUSTICS, ISSN: 1642-1817, Vol.20, pp.129-138, 2017
Abstract:

Ultrasonic elastography is a technique allowing imaging of the elastic properties of tissue. There are two basic techniques of elastographic imaging; compressional - displaying the evaluation of tissue deformation under the external stress; and dynamic, tracking the propagation velocity of the shear wave generated by the acoustic radiation force. Soft tissue bulk modulus varies, from a few to several GPa, whereas the shear modulus is significantly smaller, not exceeding a few hundred Pa for adipose tissue, breast or liver, up to several hundred kPa for hard tissue. Forces generated in the tissue due to the external, axial piston-like stresses depend mainly on the shear modulus. In Shear Wave Elastography, long, several tens of microseconds, ultrasonic pulses successively focused at several depths are sent: generating a conical wave front moving with the supersonic velocity, depending on the tissue stiffness. Velocity of propagation of shear wave depends on the shear modulus μ and the modulus of elasticity E of the examined tissue is equal to E=3μ.

Keywords:

elastography, ultrasonic imaging, thyroid, breast

Affiliations:
Nowicki A.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
8.Byra M., Nowicki A., Piotrzkowska-Wróblewska H., Dobruch-Sobczak K., Classification of breast lesions using segmented quantitative ultrasound maps of homodyned K distribution parameters, Medical Physics, ISSN: 0094-2405, DOI: 10.1118/1.4962928, Vol.43, No.10, pp.5561-5569, 2016
Abstract:

Purpose:
Statistical modeling of an ultrasound backscattered echo envelope is used for tissue characterization. However, in the presence of complex structures within the analyzed area, estimation of parameters is disturbed and unreliable, e.g., in the case of breast tumor classification. In order to improve the differentiation of breast lesions, the authors proposed a method based on the segmentation of homodyned K distribution parameter maps. Regions within lesions of different scattering properties were extracted and analyzed. In order to improve the classification, the best-performing features were selected from various regions and then combined.

Methods:
A radio-frequency data set consisting of 103 breast lesions was used in the authors’ analysis. Maps of homodyned K distribution parameters were created using an algorithm based on signal-to-noise ratio, kurtosis, and skewness of fractional-order envelope moments. A Markov random field model was used to segment parametric maps. Features of different segments were extracted and evaluated based on bootstrapping and the receiver operating characteristic curve. To determine the best-performing feature subset, the authors applied the joint mutual information criterion.

Results:
It was found that there were individual features which performed better than the ones commonly used for lesion characterization, like the parameter obtained through averaging of values over the whole lesion. The authors selected and discussed the best-performing features. Properties of different extracted regions were important and improved the distinction between benign and malignant tumors. The best performance was obtained by combining four features with the area under the receiver operating curve of 0.84.

Conclusions:
The study showed that the analysis of internal changes in lesion parametric maps leads to a better classification of breast tumors. The authors recommend combining multiple features for characterization, instead of using only one parameter, especially in the case of heterogeneous lesions.

Keywords:

Cancer, Ultrasonography, Backscattering, Data sets, Medical image noise

Affiliations:
Byra M.-IPPT PAN
Nowicki A.-IPPT PAN
Piotrzkowska-Wróblewska H.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
9.Dobruch-Sobczak K., Bakuła-Zalewska E., Gumińska A., Słapa R. Z., Mlosek K., Wareluk P., Jakubowski W., Dedecjus M., Diagnostic performance of shear wave elastography parameters alone and in combination with conventional b-mode ultrasound parameters for the characterization of thyroid nodules: a prospective, dual-center study, ULTRASOUND IN MEDICINE AND BIOLOGY, ISSN: 0301-5629, DOI: 10.1016/j.ultrasmedbio.2016.07.010, Vol.42, No.12, pp.2803-2811, 2016
Abstract:

The aims of our study were to determine whether shear wave elastography (SWE) can improve the conventional B-mode differentiation of thyroid lesions, determine the most accurate SWE parameter for differentiation and assess the influence of microcalcifications and chronic autoimmune thyroiditis on SWE values. We examined 119 patients with 169 thyroid nodules who prospectively underwent B-mode ultrasound and SWE using the same ultrasound machine. The parameters assessed using SWE were: mean elasticity within the entire lesion (SWE-whole) and mean (SWE-mean) and maximum (SWE-max) elasticity for a 2-mm-diameter region of interest in the stiffest portion of the lesion, excluding microcalcifications. The discriminant powers of a generalized estimating equation model including B-mode parameters only and a generalized estimation equation model including both B-mode and SWE parameters were assessed and compared using the area under the receiver operating characteristic curve, in association with pathologic verification. In total, 50 and 119 malignant and benign lesions were detected. In generalized estimated equation regression, the B-mode parameters associated with higher odds ratios (ORs) for malignant lesions were microcalcifications (OR = 4.3), hypo-echogenicity (OR = 3.13) and irregular margins (OR = 10.82). SWE-max was the only SWE independent parameter in differentiating between malignant and benign tumors (OR = 2.95). The area under the curve for the B-mode model was 0.85, whereas that for the model combining B-mode and SWE parameters was 0.87. There was no significant difference in mean SWE values between patients with and without chronic autoimmune thyroiditis. The results of the present study suggest that SWE is a valuable tool for the characterization of thyroid nodules, with SWE-max being a significant parameter in differentiating benign and malignant lesions, independent of conventional B-mode parameters. The combination of SWE parameters and conventional B-mode parameters does not significantly improve the diagnosis of malignant thyroid nodules. The presence of microcalcifications can influence the SWE-whole value, whereas the presence of chronic autoimmune thyroiditis may not.

Keywords:

Shear wave elastography, B-Mode ultrasound, Thyroid nodules, Diagnostic performance, Malignant, Benign

Affiliations:
Dobruch-Sobczak K.-other affiliation
Bakuła-Zalewska E.-Institute of Oncology (PL)
Gumińska A.-other affiliation
Słapa R. Z.-other affiliation
Mlosek K.-Medical University of Warsaw (PL)
Wareluk P.-Medical University of Warsaw (PL)
Jakubowski W.-other affiliation
Dedecjus M.-Institute of Oncology (PL)
10.Nowicki A., Dobruch-Sobczak K., Introduction to ultrasound elastography, Journal of Ultrasonography, ISSN: 2084-8404, DOI: 10.15557/JoU.2016.0013, Vol.16, pp.113-124, 2016
Abstract:

For centuries tissue palpation has been an important diagnostic tool. During palpation, tumors are felt as tissues harder than the surrounding tissues. The significance of palpation is related to the relationship between mechanical properties of different tissue lesions. The assessment of tissue stiffness through palpation is based on the fact that mechanical properties of tissues are changing as a result of various diseases. A higher tissue stiffness translates into a higher elasticity modulus. In the 90’s, ultrasonography was extended by the option of examining the stiffness of tissue by estimating the difference in backscattering of ultrasound in compressed and non-compressed tissue. This modality is referred to as the static, compression elastography and is based on tracking the deformation of tissue subjected to the slowly varying compression through the recording of the backscattered echoes. The displacement is estimated using the methods of cross-correlation between consecutive ultrasonic lines of examined tissue, so calculating the degree of similarity of ultrasonic echoes acquired from tissue before and after the compression was applied. The next step in the development of ultrasound palpation was to apply the local remote tissue compression by using the acoustic radiation force generated through the special beam forming of the ultrasonic beam probing the tissue. The acoustic radiation force causes a slight deformation the tissue thereby forming a shear wave propagating in the tissue at different speeds dependent on the stiffness of the tissue. Shear wave elastography, carries great hopes in the field of quantitative imaging of tissue lesions. This article describes the physical basis of both elastographic methods: compression elastography and shear wave elastography.

Keywords:

elastography, static sonoelastography, dynamic sonoelastography, ultrasonography

Affiliations:
Nowicki A.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
11.Piotrzkowska-Wroblewska H., Dobruch-Sobczak K., Litniewski J., Chrapowicki E., Roszkowska-Purska K., Nowicki A., Differentiation of the breast lesions using statistics of backscattered echoes, HYDROACOUSTICS, ISSN: 1642-1817, Vol.19, pp.319-328, 2016
Abstract:

The purpose of this study was to evaluate the accuracy of statistical properties of the backscttered ultrasound in differential diagnosis of the breast lesions. The B-mode images together with the appropriate RF echoes from the breast lesions and surrounding tissues were collected. The RF data were processed for the statistics of the backscattered echo signals using K and Nakagami distributions characterized by the M and m parameters, respectively. Based on both, M and m parameters, a set of 18 parameters was derived.

From the point of view of the sensitivity of detection of the cancer the best score was obtained using maximum value of M parameter, the best specificity was received using the differential Nakagami parameter (the differential values between lesions and surrounding tissues). In conclusion the quantitative sonography is a method which has potential to be a complementary tool for classification of the breast lesions.

Keywords:

quantitative ultrasound, breast cancer, Nakagami distribution, K dstribution

Affiliations:
Piotrzkowska-Wroblewska H.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
Litniewski J.-IPPT PAN
Chrapowicki E.-Center of Oncology Memorial Institute (PL)
Roszkowska-Purska K.-other affiliation
Nowicki A.-IPPT PAN
12.Dobruch-Sobczak K., Nowicki A., Role of shear wave sonoelastography in differentiation between focal breast lesions, ULTRASOUND IN MEDICINE AND BIOLOGY, ISSN: 0301-5629, DOI: 10.1016/j.ultrasmedbio.2014.08.024, Vol.41, No.2, pp.366-374, 2015
Abstract:

Our goal in this study was to evaluate the relevance of shear wave sonoelastography (SWE) in the differential diagnosis of masses in the breast with respect to ultrasound (US). US and SWE were performed (Aixplorer System, SuperSonic Imagine, Aix en Provence, France) in 76 women (aged 24 to 85) with 84 lesions (43 malignant, 41 benign). The study included BI-RADS-US (Breast Imaging Reporting and Data System for Ultrsound) category 3–5 lesions. In elastograms, the following values were calculated: mean elasticity in lesions (Eav.l) and in fat tissue (Eav.f.) and maximal (Emax.adj.) and mean (Eav.adj.) elasticity in lesions and adjacent tissues. The sensitivity and specificity of the BI-RADS category 4a/4b cutoff value were 97.7% and 90.2%. For an Eav.adj. of 68.5 kPa, the cutoff sensitivity was 86.1% and the specificity was 87.8%, and for an Emax.adj. of 124.1 kPa, 74.4% and 92.7%, respectively. For BI-RADS-US category 3 lesions, Eav.l, Emax.adj. and Eav.adj. were below cutoff levels. On the basis of our findings, Eav.adj. had lower sensitivity and specificity compared with US. Emax.adj. improved the specificity of breast US with loss of sensitivity.

Keywords:

Breast ultrasound, Shear wave sonoelastography, Young's modulus, Focal breast lesions

Affiliations:
Dobruch-Sobczak K.-IPPT PAN
Nowicki A.-IPPT PAN
13.Słapa R.Z., Kasperlik-Załuska A.A., Migda B., Otto M., Dobruch-Sobczak K., Jakubowski W.S., Echogenicity of benign adrenal focal lesions on imaging with new ultrasound techniques – report with pictorial presentation, Journal of Ultrasonography, ISSN: 2084-8404, DOI: 10.15557/JoU.2015.0034, Vol.15, pp.368-376, 2015
Abstract:

Aim: The aim of the research was to assess the echogenicity of benign adrenal focal lesions using new ultrasound techniques. Material and method: 34 benign adrenal masses in 29 patients were analyzed retrospectively. The examinations were conducted using Aplio XG (Toshiba, Japan) ultrasound scanner with a convex probe 1–6 MHz in the B-mode presentation with the combined use of new ultrasound techniques: harmonic imaging and spatial compound sonography. The size of the adrenal tumors, their echogenicity and homogeneity were analyzed. Statistical analysis was conducted using the STATISTICA 10 software. Results: The following adrenal masses were assessed: 12 adenomas, 10 nodular hyperplasias of adrenal cortex, 7 myelolipomas, 3 pheochromocytomas, a hemangioma with hemorrhage and a cyst. The mean diameter of nodular hyperplasia of adrenal cortex was not statistically different from that of adenomas (p = 0.075). The possibility of differentiating between nodular hyperplasia and adenoma using the parameter of hypoechogenicity or homogeneity of the lesion was demonstrated with the sensitivity and specificity of 100% and 41.7%, respectively. The larger the benign adrenal tumor was, the more frequently did it turn out to have a mixed and inhomogenous echogenicity (p < 0.05; ROC areas under the curve: 0.832 and 0.805, respectively). Conclusions: A variety of echogenicity patterns of benign adrenal focal lesions was demonstrated. The image of an adrenal tumor correlates with its size. The ultrasound examination, apart from its indisputable usefulness in detecting and monitoring adrenal tumors, may also allow for the differentiation between benign lesions. However, for lesions found incidentally an algorithm for the assessment of adrenal incidentalomas is applicable, which includes computed tomography and magnetic resonance imaging.

Keywords:

adrenal glands, adrenal masses, ultrasound, echogenicity

Affiliations:
Słapa R.Z.-other affiliation
Kasperlik-Załuska A.A.-other affiliation
Migda B.-other affiliation
Otto M.-other affiliation
Dobruch-Sobczak K.-IPPT PAN
Jakubowski W.S.-other affiliation
14.Słapa R.Z., Jakubowski W.S., Dobruch-Sobczak K., Kasperlik-Załuska A.A., Standards of ultrasound imaging of the adrenal glands, Journal of Ultrasonography, ISSN: 2084-8404, DOI: 10.15557/JoU.2015.0035, Vol.15, pp.377-387, 2015
Abstract:

Adrenal glands are paired endocrine glands located over the upper renal poles. Adrenal pathologies have various clinical presentations. They can coexist with the hyperfunction of individual cortical zones or the medulla, insufficiency of the adrenal cortex or retained normal hormonal function. The most common adrenal masses are tumors incidentally detected in imaging examinations (ultrasound, tomography, magnetic resonance imaging), referred to as incidentalomas. They include a range of histopathological entities but cortical adenomas without hormonal hyperfunction are the most common. Each abdominal ultrasound scan of a child or adult should include the assessment of the suprarenal areas. If a previously non-reported, incidental solid focal lesion exceeding 1 cm (incidentaloma) is detected in the suprarenal area, computed tomography or magnetic resonance imaging should be conducted to confirm its presence and for differentiation and the tumor functional status should be determined. Ultrasound imaging is also used to monitor adrenal incidentaloma that is not eligible for a surgery. The paper presents recommendations concerning the performance and assessment of ultrasound examinations of the adrenal glands and their pathological lesions. The article includes new ultrasound techniques, such as tissue harmonic imaging, spatial compound imaging, three-dimensional ultrasound, elastography, contrast-enhanced ultrasound and parametric imaging. The guidelines presented above are consistent with the recommendations of the Polish Ultrasound Society.

Keywords:

adrenal glands, adrenal masses, ultrasound, standards

Affiliations:
Słapa R.Z.-other affiliation
Jakubowski W.S.-other affiliation
Dobruch-Sobczak K.-IPPT PAN
Kasperlik-Załuska A.A.-other affiliation
15.Dobruch-Sobczak K., Gumińska A., Bakuła-Zalewska E., Mlosek K., Słapa R.Z., Wareluk P., Krauze A., Ziemiecka A., Migda B., Jakubowski W., Dedecjus M., Shear wave elastography in medullary thyroid carcinoma diagnostics, Journal of Ultrasonography, ISSN: 2084-8404, DOI: 10.15557/JoU.2015.0033, Vol.15, pp.358-367, 2015
Abstract:

Shear wave elastography (SWE) is a modern method for the assessment of tissue stiffness. There has been a growing interest in the use of this technique for characterizing thyroid focal lesions, including preoperative diagnostics. Aim: The aim of the study was to assess the clinical usefulness of SWE in medullary thyroid carcinoma (MTC) diagnostics. Materials and methods: A total of 169 focal lesions were identified in the study group (139 patients), including 6 MTCs in 4 patients (mean age: 45 years). B-mode ultrasound and SWE were performed using Aixplorer (SuperSonic, Aix-en-Provence), with a 4–15 MHz linear probe. The ultrasound was performed to assess the echogenicity and echostructure of the lesions, their margin, the halo sign, the height/width ratio (H/W ratio), the presence of calcifications and the vascularization pattern. This was followed by an analysis of maximum and mean Young’s (E) modulus values for MTC (EmaxLR, EmeanLR) and the surrounding thyroid tissues (EmaxSR, EmeanSR), as well as mean E-values (EmeanLRz) for 2 mm region of interest in the stiffest zone of the lesion. The lesions were subject to pathological and/or cytological evaluation. Results: The B-mode assessment showed that all MTCs were hypoechogenic, with no halo sign, and they contained micro- and/ or macrocalcifications. Ill-defined lesion margin were found in 4 out of 6 cancers; 4 out of 6 cancers had a H/W ratio > 1. Heterogeneous echostructure and type III vascularity were found in 5 out of 6 lesions. In the SWE, the mean value of EmaxLR for all of the MTCs was 89.5 kPa and (the mean value of EmaxSR for all surrounding tissues was) 39.7 kPa Mean values of EmeanLR and EmeanSR were 34.7 kPa and 24.4 kPa, respectively. The mean value of EmeanLRz was 49.2 kPa. Conclusions: SWE showed MTCs as stiffer lesions compared to the surrounding tissues. The lesions were qualified for fine needle aspiration biopsy based on B-mode assessment. However, the diagnostic algorithm for MTC is based on the measurement of serum calcitonin levels, B-mode ultrasound and FNAB.

Keywords:

medullary thyroid carcinoma, thyroid, ultrasound, shear wave elastography

Affiliations:
Dobruch-Sobczak K.-IPPT PAN
Gumińska A.-other affiliation
Dedecjus M.-Institute of Oncology (PL)
Bakuła-Zalewska E.-Institute of Oncology (PL)
Mlosek K.-Medical University of Warsaw (PL)
Słapa R.Z.-other affiliation
Wareluk P.-Medical University of Warsaw (PL)
Krauze A.-other affiliation
Ziemiecka A.-other affiliation
Migda B.-other affiliation
Jakubowski W.-other affiliation
16.Dobruch-Sobczak K., Jędrzejowski M., Jakubowski W., Trzebińska A., Błędy i pomyłki w diagnostyce ultrasonograficznej tarczycy, Journal of Ultrasonography, ISSN: 2084-8404, DOI: 10.15557/JoU.2014.0006, Vol.14, pp.61-73, 2014
Abstract:

Ultrasound examination of the thyroid gland permits to evaluate its size, echogenicity, margins, and stroma. An abnormal ultrasound image of the thyroid, accompanied by other diagnostic investigations, facilitates therapeutic decision-making. The ultrasound image of a normal thyroid gland does not change substantially with patient’s age. Nevertheless, erroneous impressions in thyroid imaging reports are sometimes encountered. These are due to diagnostic pitfalls which cannot be prevented by either the continuing development of the imaging equipment, or the growing experience and skill of the practitioners. Our article discusses the most common mistakes encountered in US diagnostics of the thyroid, the elimination of which should improve the quality of both the ultrasound examination itself and its interpretation. We have outlined errors resulting from a faulty examination technique, the similarity of the neighboring anatomical structures, and anomalies present in the proximity of the thyroid gland. We have also pointed out the reasons for inaccurate assessment of a thyroid lesion image, such as having no access to clinical data or not taking them into account, as well as faulty qualification for a fine needle aspiration biopsy. We have presented guidelines aimed at limiting the number of misdiagnoses in thyroid diseases, and provided sonograms exemplifying diagnostic mistakes.

Keywords:

thyroid, ultrasound imaging, medical mistakes, thyroid diseases, fine needle biopsy

Affiliations:
Dobruch-Sobczak K.-other affiliation
Jędrzejowski M.-other affiliation
Jakubowski W.-other affiliation
Trzebińska A.-other affiliation
17.Trzebińska A., Dobruch-Sobczak K., Jakubowski W., Jędrzejowski M., Standardy badań ultrasonograficznych Polskiego Towarzystwa Ultrasonograficznego – aktualizacja. Badanie ultrasonograficzne tarczycy oraz biopsja tarczycy pod kontrolą ultrasonografii, Journal of Ultrasonography, ISSN: 2084-8404, DOI: 10.15557/JoU.2014.0005, Vol.14, pp.49-60, 2014
Abstract:

Ultrasonography is a primary imaging technique in patients with suspected thyroid disease. It allows to assess the location, size and echostructures of the thyroid gland as well as detect focal lesions, along with indication of their size, echogenicity, echostructure and vascularity. Based on these features, ultrasound examination allows to predict abnormal focal lesions for biopsy and monitor the biopsy needle track. This paper presents the standards of thyroid ultrasound examination regarding ultrasound apparatus technical requirements, scanning techniques, readings, measurements, and the description of the examination. It discusses the ultrasound features of increased malignancy risk in focal lesions (nodules) found in the thyroid gland. It presents indications for fine needle aspiration biopsy of the thyroid gland for the visibility of single nodules (focal lesions) and numerous lesions as well as discusses contraindications for thyroid biopsy. It describes the biopsy technique, possible complications and rules for post-biopsy monitoring of benign lesions. The paper is an update of the Standards of the Polish Ultrasound Society issued in 2011. It has been prepared on the basis of current literature, taking into account the information contained in the following publications: Thyroid ultrasound examination and Recommendations of the Polish Ultrasound Society for the performance of the FNAB of the thyroid.

Keywords:

ultrasound imaging, thyroid, standards, thyroid diseases, fine needles biopsy

Affiliations:
Trzebińska A.-other affiliation
Dobruch-Sobczak K.-other affiliation
Jakubowski W.-other affiliation
Jędrzejowski M.-other affiliation

List of chapters in recent monographs
1.
494
Klimonda Z., Dobruch-Sobczak K., Piotrzkowska-Wróblewska H., Tymkiewicz R., Litniewski J., Postępy Akustyki 2016, rozdział: Obrazowanie tłumienia ultradźwięków w tkance nowotworowej, Polskie Towarzystwo Akustyczne, Oddział Warszawski, Warszawa, Poland, pp.39-48, 2016
2.
495
Litniewski J., Klimonda Z., Karwat P., Piotrzkowska-Wróblewska H., Dobruch-Sobczak K., Tymkiewicz R., Gambin B., Postępy Akustyki 2016, rozdział: Cancer malignancy sonic markers, Polskie Towarzystwo Akustyczne, Oddział Warszawski, Warszawa, Poland, pp.49-60, 2016

Conference papers
1.Dobruch-Sobczak K.S., Piotrzkowska-Wróblewska H., Klimonda Z., Gumowska M.E., Litniewski J., Ultrasound echogenicity reveals the response of breast cancer to chemotherapy, ECR 2019, EUROPEAN CONGRESS OF RADIOLOGY, 2019-02-27/03-03, Wiedeń (AT), DOI: 10.26044/ecr2019/C-1007, pp.1-15, 2019
2.Byra M., Sznajder T., Korzinek D., Piotrzkowska-Wróblewska H., Dobruch-Sobczak K., Nowicki A., Marasek K., Impact of Ultrasound Image Reconstruction Method on Breast Lesion Classification with Deep Learning. Pattern Recognition and Image Analysis, IbPRIA 2019, 9th Iberian Conference on Pattern Recognition and Image Analysi, 2019-07-01/07-04, Madryt (ES), pp.41-52, 2019
Abstract:

In this work we investigate the usefulness and robustness of transfer learning with deep convolutional neural networks (CNNs) for breast lesion classification in ultrasound (US). Deep learning models can be vulnerable to adversarial examples, engineered input image pixel intensities perturbations that force models to make classification errors. In US imaging, distribution of US image pixel intensities relies on applied US image reconstruction algorithm. We explore the possibility of fooling deep learning models for breast mass classification by modifying US image reconstruction method. Raw radio-frequency US signals acquired from malignant and benign breast masses were used to reconstruct US images, and develop classifiers using transfer learning with the VGG19, InceptionV3 and InceptionResNetV2 CNNs. The areas under the receiver operating characteristic curve (AUCs) obtained for each deep learning model developed and evaluated using US images reconstructed in the same way were equal to approximately 0.85, and there were no associated differences in AUC values between the models (DeLong test p-values > 0.15). However, due to small modifications of the US image reconstruction method the AUC values for the models utilizing the VGG19, InceptionV3 and InceptionResNetV2 CNNs significantly decreased to 0.592, 0.584 and 0.687, respectively. Our study shows that the modification of US image reconstruction algorithm can have significant negative impact on classification performance of deep models. Taking into account medical image reconstruction algorithms may help develop more robust deep learning computer aided diagnosis systems.

Keywords:

Adversarial attacks, Breast lesion classification, Computer aided diagnosis, Deep learning, Robustness, Ultrasound imaging, Transfer learning

Affiliations:
Byra M.-IPPT PAN
Sznajder T.-other affiliation
Korzinek D.-Polish-Japanese Academy of Information Technology (PL)
Piotrzkowska-Wróblewska H.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
Nowicki A.-IPPT PAN
Marasek K.-Polish-Japanese Academy of Information Technology (PL)
3.Piotrzkowska-Wróblewska H., Klimonda Z., Dobruch-Sobczak K., Karwat P., Secomski W., Litniewski J., Quantitative Ultrasound for Chemotherapy Monitoring, IEEE 2018, IEEE Joint Conference - Acoustics, 2018-09-11/09-14, Ustka (PL), DOI: 10.1109/ACOUSTICS.2018.8502336, pp.268-271, 2018
Abstract:

Neoadjuvant chemotherapy (NAC) is used in breast cancer patients to reduce tumor size, decrease the risk of local recurrence, and diminish the likelihood of metastases, all of which reduce patient mortality. Assessment of the response to NAC at an early stage of treatment allows therapy to be personalized. The quantitative ultrasound method is a novel diagnostic approach with great potential to improve outcomes for breast cancer patients. The aim of this study was to analyze the variability of the integrated backscatter coefficient (IBSC) in the context of the assessment of changes in tumor tissue structure resulting from chemotherapy, and to evaluate use of IBSC to predict the effectiveness of treatment. Ultrasound data (B-mode images and raw ultrasonic radio frequency signals RF) were collected from cancerous tumors from patients intended to NAC before starting treatment and a week after each chemotherapy dose. Data were processed to generate IBSC maps and to determine IBSC mean values. The assessment of tumors using IBSC, in comparison with histopathological verification, showed that IBSC changes can be associated with changes which tumor structure changes during NAC. IBSC analysis correlated better with the results of histopathological verification than B-mode imaging.

Affiliations:
Piotrzkowska-Wróblewska H.-IPPT PAN
Klimonda Z.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
Karwat P.-IPPT PAN
Secomski W.-IPPT PAN
Litniewski J.-IPPT PAN
4.Klimonda Z., Dobruch-Sobczak K., Piotrzkowska-Wróblewska H., Karwat P., Litniewski J., Quantitative Ultrasound of Tumor Surrounding Tissue for Enhancement of Breast Cancer Diagnosis, IWBBIO 2018, 6th International Work-Conference, 2018-04-25/04-27, Granada (ES), DOI: 10.1007/978-3-319-78759-6_18, Vol.10814, pp.186-197, 2018
Abstract:

Breast cancer is one of the leading causes of cancer-related death in female patients. The quantitative ultrasound techniques being developed recently provide useful information facilitating the classification of tumors as malignant or benign. Quantitative parameters are typically determined on the basis of signals scattered within the tumor. The present paper demonstrates the utility of quantitative data estimated based on signal backscatter in the tissue surrounding the tumor. Two quantitative parameters, weighted entropy and Nakagami shape parameter were calculated from the backscatter signal envelope. The ROC curves and the AUC parameter values were used to assess their ability to classify neoplastic lesions. Results indicate that data from tissue surrounding the tumor may characterize it better than data from within the tumor. AUC values were on average 18% higher for parameters calculated from data collected from the tissue surrounding the lesion than from the data from the lesion itself.

Keywords:

uantitative ultrasound, Tissue characterisation, Tumor classification

Affiliations:
Klimonda Z.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
Piotrzkowska-Wróblewska H.-IPPT PAN
Karwat P.-IPPT PAN
Litniewski J.-IPPT PAN
5.Byra M., Piotrzkowska-Wróblewska H., Dobruch-Sobczak K., Nowicki A., Combining Nakagami imaging and convolutional neural network for breast lesion classification, IUS 2017, IEEE International Ultrasonics Symposium, 2017-09-06/09-09, Washington (US), DOI: 10.1109/ULTSYM.2017.8092154, pp.1-4, 2017
Abstract:

In this paper we propose a computer-aided diagnosis system for the breast lesion classification. Our approach is based on quantitative ultrasound and deep learning. We used the Nakagami imaging to create parametric maps of breast lesions that illustrate tissue scattering properties. For this task the sliding window technique was applied. The Nakagami parameter was calculated using the maximum likelihood estimator. Next, we used the Nakagami parameter maps to train a convolutional neural network. Classification performance was evaluated by 5-fold cross-validation. We obtained the area under the receiver operating characteristic curve equal to 0.91. The results showed that our approach is useful to distinguishing between malignant and benign breast lesions. The proposed method serves as a general approach for tissue characterization and differentiation. The Nakagami parameter used in this study can be replaced with other QUS parameters and the neural network can be trained in a similar fashion.

Keywords:

Nakagami imaging, quantitative ultrasound, convolutional neural networks, breast lesion classification, deep learning

Affiliations:
Byra M.-IPPT PAN
Piotrzkowska-Wróblewska H.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
Nowicki A.-IPPT PAN
6.Byra M., Nowicki A., Piotrzkowska H., Dobruch-Sobczak K., Litniewski J., Correcting the influence of tissue attenuation on Nakagami distribution shape parameter estimation, IUS 2015, IEEE International Ultrasonics Symposium, 2015-10-21/10-24, Taipei (TW), DOI: 10.1109/ULTSYM.2015.0408, pp.P1B6-3-4, 2015
Abstract:

Nakagami distribution is used to model the statistical properties of backscattered echoes in tissue. The proper estimate requires the compensation of attenuation along each scanning line. Attenuation of the wave results in decreasing of the envelope mean intensity with depth what modifies the Nakagami scale parameter. This phenomenon violates the assumption that envelope samples within region of interest are identically distributed and disrupts estimation. Here, we investigate the influence of wave attenuation on Nakagami shape parameter estimators for various scattering scenarios, attenuation coefficients and region of interest size. Three methods are proposed to solve this issue. Scans of a thyroid and of a breast lesion are analyzed. It was found that proposed methods improved the estimation, especially when larger regions were used to collect envelope samples.

Keywords:

ultrasound, breast cancer, Nakagami distribution

Affiliations:
Byra M.-IPPT PAN
Nowicki A.-IPPT PAN
Piotrzkowska H.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
Litniewski J.-IPPT PAN
7.Nowicki A., Piotrzkowska H., Dobruch-Sobczak K., Litniewski J., Byra M., Gambin B., Kruglenko E., Differentiation of normal tissue and tissue lesions using statistical properties of backscattered ultrasound in breast, IUS 2015, IEEE International Ultrasonics Symposium, 2015-10-21/10-24, Taipei (TW), DOI: 10.1109/ULTSYM.2015.0417, pp.P1B6-15-4, 2015
Abstract:

The aim of the study was finding the relationship between BIRADS classification combined with envelope K and Nakagami statistics of the echoes backscattered in the breast tissue in vivo and the histological data. 107 breast lesions were examined. Both, the RF echo-signal and B-mode images from the lesions and surrounding tissue were recorded. The analysis method was based on the combining data from BIRADS classifications and both distributions parameters. 107 breasts lesions - 32 malignant and 75 benign - were examined. When only BIRADS classification was used all malignant lesions were diagnosed correctly, however 34 benign lesions were sent for the biopsy unnecessarily. For K distribution the sensitivity and specificity were 78.13%, and 86.67% while for Nakagami statistics the sensitivity and specificity were 62.50% and 93.33%, respectively. Combined K and BIRADS resulted in sensitivity of 96.67% and specificity 60%. Combined BIRADS (3/4a cut-off) plus Nakagami statistics showed 100% of sensitivity with specificity equal 57.33%, decreasing the number of lesions which were biopsied from 34 to 28.

Keywords:

breast cancer, quantitative ultrasound, BIRADS

Affiliations:
Nowicki A.-IPPT PAN
Piotrzkowska H.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
Litniewski J.-IPPT PAN
Byra M.-IPPT PAN
Gambin B.-IPPT PAN
Kruglenko E.-IPPT PAN
8.Piotrzkowska H., Nowicki A., Litniewski J., Gambin B., Dobruch-Sobczak K., Breast carcinoma tissues characterization using statistics of ultrasonic backscatter, FA2014, 7th FORUM ACUSTICUM 2014, 2014-09-07/09-12, Kraków (PL), No.SS27_7, pp.1-9, 2014
Abstract:

The Ultrasonix SonixTouch scanner with the special RF block was used to collect Bmode images together with appropriate RF echoes from the pathological and healthy breasts regions of patients with diagnosed malignant and benign breast lesions. The RF data were processed for the statistics of the backscattered echo signals assessment (K distribution and effective density of scatterers – M and Nakagami distribution and its shape parameter m). The comparison of signals recorded from malignant and healthy tissues showed, that in 80% of examined cases the values of the statistical parameters M were higher for carcinomas tissues than for healthy tissue. Beside of that in the case of benign lesions obtained results was able to distinguish the fibroadenoma from the other with probability of 75%.

Keywords:

quantitative ultrasound, breast cancer, statistics

Affiliations:
Piotrzkowska H.-IPPT PAN
Nowicki A.-IPPT PAN
Litniewski J.-IPPT PAN
Gambin B.-IPPT PAN
Dobruch-Sobczak K.-other affiliation

Conference abstracts
1.Dobruch-Sobczak K., Piotrzkowska-Wróblewska H., Klimonda Z., Karwat P., Litniewski J., Roszkowska-Purska K., Markiewicz-Grodzicka E., Quantitative ultrasound parameters assessment of advanced breast cancer in evaluation the response to neoadjuvant chemotherapy, 11TH EUROPEAN BREAST CANCER CONFERENCE, 2018-03-21/03-23, Barcelona (ES), DOI: 10.1016/S0959-8049(18)30674-9, Vol.92, pp.149-150, 2018
Abstract:

Background: Monitoring of response to neoadjuvant chemotherapy (NAC) in advanced breast cancer is crucial for assessing the effectiveness of the treatment and overall survival. The purpose of this study was to investigate the ability of classical ultrasound (US) examination and quantitative ultrasound (QU) parameters to predict the therapy response comparing to histology results after surgical treatment. Material and Methods: Two ultrasound backscatter parameters: the integrated backscatter coefficient, (IBSC) and shape parameter (M) of the homodyned K distribution, were estimated from ultrasonic radiofrequency (RF) signals. Sixteen patient with 22 breast cancer tumor treated with NAC sequential Anthracyclines and Taxanes were prospectively assessed. Data were acquired using 5–14 MHz array transducer, pre-chemotherapy, and four times during treatment (one week after the subsequent courses). The US results were compared with histological response analyzing the stromal changes and the cellularity of the tumor. Results: An increase in IBSC and decrease M parameters was observed in 80% of tumors with complete response after chemotherapy. It correlates with increasing the stromal elements, fibrosis, and elastosis. In patients with partial response, the parameters IBSC and M parameters did not change during subsequent cycles of treatment and allow predicting partial response in 70% of tumors. In pathological results, a similar cluster of cells without fibrosis and elastosis were observed. Conclusions: Ultrasound parameters derived from the RF data give the promise to predict the tumor response to NAC and better personalize the therapy using US QU examination. This study was supported by the National Science Centre, Poland, grant 2016/23/B/ST8/03391. No conflict of interest

Affiliations:
Dobruch-Sobczak K.-other affiliation
Piotrzkowska-Wróblewska H.-IPPT PAN
Klimonda Z.-IPPT PAN
Karwat P.-IPPT PAN
Litniewski J.-IPPT PAN
Roszkowska-Purska K.-other affiliation
Markiewicz-Grodzicka E.-Oncology Institute (PL)
2.Klimonda Z., Dobruch-Sobczak K., Piotrzkowska-Wróblewska H., Tymkiewicz R., Litniewski J., Ultrasound attenuation imaging of tumor tissue, OSA 16, LXIII Otwarte Seminarium z Akustyki, 2016-09-13/09-16, Białowieża (PL), DOI: 10.1515/aoa-2016-0059, pp.619-620, 2016
Keywords:

attenuation estimation, parametric imaging

Affiliations:
Klimonda Z.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
Piotrzkowska-Wróblewska H.-IPPT PAN
Tymkiewicz R.-IPPT PAN
Litniewski J.-IPPT PAN
3.Litniewski J., Klimonda Z., Karwat P., Piotrzkowska-Wróblewska H., Dobruch-Sobczak K., Tymkiewicz R., Gambin B., Cancer Malignancy Sonic Markers, OSA 16, LXIII Otwarte Seminarium z Akustyki, 2016-09-13/09-16, Białowieża (PL), DOI: 10.1515/aoa-2016-0059, No.3, pp.622, 2016
4.Nowicki A., Dobruch-Sobczak K., Piotrzkowska H., Litniewski J., Gambin B., Roszkowska K., Chrapowicki E., Clinical Validation of the Statistical Analysis of US RF Signals in Differentiation of the Breast Lesions, AIUM 2015, Ultrasound in Medicine and Biology Annual Convention, 2015-03-21/03-25, Lake Buena Vista (US), DOI: 10.1016/j.ultrasmedbio.2014.12.403, Vol.41, No.4S, Special issue: 2015 AIUM Annual Convention and Preconvention Program Hosting WFUMB Congress, ABSTRACT 2088809, pp.S98-S99, 2015
Abstract:

The scattering is the fundamental phenomena used for US imaging of specific organs. In this study the method searching for best fitted statistical distribution of the acquired echoes from the breast tissue is discussed, especially addressing the ‘‘effective’’ number of scatterers. The aim of the study was finding the relationship between the specific properties of statistics of envelope of the ultrasonic echoes backscattered in the breast tissue in vivo, and its morphological properties for normal tissue and the pathological lesions.
Methods: 72 patients with 83 suspicious breast lesions (BIRADS 3, 4, 5) were examined. The analysis method was based on the parametric imaging representing a map of local statistical properties of the scattering of ultrasound waves in normal and pathological tissues. Both, the RF echo-signal and B-mode images from the lesions and surrounding tissue were recorded. The statistics of backscattered speckle-like echoes envelopes were modelled using K and Nakagami distributions. For all lesions the set of sub-ROIs covering full lesion was chosen. The statistical analysis was done for every sub-ROI separately. The shape parameters were calculated including the compensation for TGC applied and for the attenuation.
Results: The evaluation of all 83 breasts lesions revealed 23 malignant and 60 benign lesions. Typically, both, shape parameters for malignant lesions were statistically larger than for surrounding tissue. On the other hand, the benign lesions revealed much larger variance of the parameters comparing to the surrounding and malignant tissue. The sensitivity and specificity of B-mode imaging with the cut-off points BIRADS-4a/4b were 93%, 86%. For K and Nakagami distributions obtained sensitivity and specificity were respectively 85% and 91%.
Conclusions: The quantitative measurements of the breast tissue backscattering statistical properties improve the specificity of B-mode examinations and can be helpful in the differentiation the character of the breast lesions. It was proved that the range of the shape parameters appears to be rather large and can not be interpreted without taking into account the corresponding values in the surrounding ‘‘normal’’ tissue.

Keywords:

breast cancer, ultrasound, RF echo-signal

Affiliations:
Nowicki A.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
Piotrzkowska H.-IPPT PAN
Litniewski J.-IPPT PAN
Gambin B.-IPPT PAN
Roszkowska K.-other affiliation
Chrapowicki E.-Center of Oncology Memorial Institute (PL)
5.Gambin B., Kruglenko E., Byra M., Nowicki A., Piotrzkowska H., Dobruch-Sobczak K., Changes in ultrasound echoes of a breast tissue in vivo after exposure to heat - a case study, PCM-CMM 2015, 3rd Polish Congress of Mechanics and 21st Computer Methods in Mechanics, 2015-09-08/09-11, Gdańsk (PL), pp.217-218, 2015
Abstract:

A B-mode ultrasonography provides structural information on the tissue under investigation encoding the echo strength in gray scale in a two-dimensional image. Interpretation of the B-mode image of breast tissue is done by a physician. The analysis of statistical properties of backscattered RF signal has been recently applied successfully to distinct healthy tissue from tissue lesions regions as a new method of quantitative ultrasound (QUS). Up till now, the most reliable results were obtained for liver and renal tissue lesions, because their normal, healthy structures are nearly homogeneous while a heterogeneous breast tissue classification is still an open issue. The recent study revealed that the medium contraction and expansion induced by a temperature change may cause variations in the relative position of scatterers in a tissue. We have developed a new procedure of heating the patient breast and allowing to observe and record in vivo the influence of temperature changes on a B-mode image and properties of unprocessed radio frequency (RF) backscattered echoes. The initial, feasibility studies of influence of the temperature increase in breast tissue on the intensity, spectrum and statistics of ultrasonic echoes will be discussed.

Keywords:

breast tissue, RF signal, backscattered signal amplitude statistics, spectral properties

Affiliations:
Gambin B.-IPPT PAN
Kruglenko E.-IPPT PAN
Byra M.-IPPT PAN
Nowicki A.-IPPT PAN
Piotrzkowska H.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
6.Dobruch-Sobczak K., Gumińska A., Bakuła-Zalewska E., Piotrzkowska H., Mlosek K., Słapa R.Z., Wareluk P., Migda B., Olszewski W., Jakubowski W., Nowicki A., Dedecjus M., Wartość sonoelastografii fali poprzecznej (SWE) w szacowaniu ryzyka złośliwości zmian ogniskowych tarczycy, V Konferencja Rak Tarczycy i inne nowotwory zlośliwe układu wydzielania wewnętrznego, 2015-11-14/11-17, Wisła (PL), Vol.66, pp.1, 2015
7.Dobruch-Sobczak K., Gumińska A., Bakuła-Zalewska E., Kaczor A., Piotrzkowska H., Jakubowski W., Nowicki A., Dedecjus M., Zastosowanie elastografii fali poprzecznej w diagnostyce raka rdzeniastego tarczycy, V Konferencja Rak Tarczycy i inne nowotwory zlośliwe układu wydzielania wewnętrznego, 2015-11-14/11-17, Wisła (PL), DOI: 10.15557/JoU.2015.003, Vol.66, No.15, pp.358-367, 2015
Abstract:

Elastografia fali poprzecznej jest nowoczesną metodą oceny sztywności tkanek. Obserwuje się wzrost zainteresowania tą techniką w różnicowaniu charakteru zmian ogniskowych w tarczycy również w diagnostyce przedoperacyjnej. Cel pracy: Celem niniejszej pracy była ocena klinicznej przydatności elastografi i fali poprzecznej w diagnostyce raka rdzeniastego tarczycy (RRT). Materiał i metoda: W badanej grupie 139 pacjentów stwierdzono 169 zmian ogniskowych, a u 4 pacjentów (średni wiek: 45 lat) rozpoznano 6 RRT. Wykonano USG B-mode oraz elastografię fali poprzecznej aparatem Aixplorer (Super-Sonic, Aix-en-Provence), głowicą liniową o częstotliwości 4–15 MHz. W USG oceniano echogeniczność i echo strukturę zmian, ich brzegi, objaw „halo”, stosunek wysokości dogłębokości (W/G), obecność zwapnień oraz wzorzec unaczynienia. Następnie analizowano: maksymalne i średnie wartości modułu Younga (E) dla największego ROI dla RRT (EmaxLR, EmeanLR ) oraz dla otaczających tkanek w miąższu gruczołu (EmaxSR , EmeanSR), a także średnie wartości E (EmeanLRz) dla 2 mm obszaru zainteresowania z najsztywniejszej części zmiany. Zmiany zweryfikowano histopatologicznie i/lub cytologicznie. Wyniki: W ocenie B-mode wszystkie RRT były hipoechogeniczne, bez obecności objawu „halo”, oraz zawierał y mikro- i/lub makrozwapnienia. Nieostre granice zmiany obecne były w 4 z 6 raków. Wartość ilorazu WG >1 dotyczył a 4 na 6 zmian. Niejednorodną echo strukturę oraz typ III unaczynienia stwierdzono w 5 na 6 zmian. W SWE średnia wartość E maxLR w obrębie RRT wynosił a 89,5 kPa, w otoczeniu – 39,7 kPa. Średnie wartości E meanLR , E meanSR wynosił y odpowiednio: 34,6 kPa i 24,4 kPa. Wartość średnia E meanLRz=49,2 kPa. Wnioski: W SWE RRT przedstawiały się jako zmiany sztywniejsze w porównaniu z otaczającymi tkankami. W ocenie B-mode spełniały wskazania do biopsji spiracyjnej cienkoigłowej. Jednak algorytm diagnostyczny RRT opiera się na pomiarze stężenia kalcytoniny w surowicy krwi, ocenie USG B-mode oraz biopsji.

Keywords:

rak rdzeniasty, tarczyca, badanie USG, sonoelastografia fali poprzecznej

Affiliations:
Dobruch-Sobczak K.-IPPT PAN
Gumińska A.-other affiliation
Bakuła-Zalewska E.-Institute of Oncology (PL)
Kaczor A.-other affiliation
Piotrzkowska H.-IPPT PAN
Jakubowski W.-other affiliation
Nowicki A.-IPPT PAN
Dedecjus M.-Institute of Oncology (PL)