dr inż. Hanna Piotrzkowska-Wróblewska

Zakład Ultradźwięków (ZU)
Pracownia Mikroskopii Akustycznej (PMAk)
stanowisko: adiunkt
telefon: (+48) 22 826 12 81 wew.: 486
pokój: 519
e-mail: hpiotrzk

Doktorat
2013-05-24Wyznaczanie parametrów skóry ludzkiej in vivo za pomocą ultradźwięków wysokiej częstotliwości 
promotor -- prof. dr hab. Jerzy Litniewski, prof. IPPT
660
 
Ostatnie publikacje
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

Streszczenie:

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.

Afiliacje autorów:

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
40p.
2.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

Streszczenie:

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.

Słowa kluczowe:

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

Afiliacje autorów:

Dobruch-Sobczak K.-IPPT PAN
Piotrzkowska-Wróblewska H.-IPPT PAN
Klimonda Z.-IPPT PAN
Roszkowska-Purska K.-other affiliation
Litniewski J.-IPPT PAN
15p.
3.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

Streszczenie:

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.

Słowa kluczowe:

breast lesions, dataset, ultrasonic signals, ultrasonography

Afiliacje autorów:

Piotrzkowska-Wróblewska H.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
Byra M.-IPPT PAN
Nowicki A.-IPPT PAN
35p.
4.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

Streszczenie:

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.

Afiliacje autorów:

Dobruch-Sobczak K.-IPPT PAN
Piotrzkowska-Wróblewska H.-IPPT PAN
Roszkowska-Purska K.-other affiliation
Nowicki A.-IPPT PAN
Jakubowski W.-other affiliation
25p.
5.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

Streszczenie:

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.

Słowa kluczowe:

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

Afiliacje autorów:

Byra M.-IPPT PAN
Nowicki A.-IPPT PAN
Piotrzkowska-Wróblewska H.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
35p.
6.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

Streszczenie:

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.

Słowa kluczowe:

quantitative ultrasound, breast cancer, Nakagami distribution, K dstribution

Afiliacje autorów:

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
6p.
7.Piotrzkowska H., Litniewski J., Szymańska E., Nowicki A., Quantitative sonography of basal cell carcinoma, ULTRASOUND IN MEDICINE AND BIOLOGY, ISSN: 0301-5629, DOI: 10.1016/j.ultrasmedbio.2014.11.016, Vol.41, No.3, pp.748-759, 2015

Streszczenie:

A 30-MHz ultrasonic scanner was used to collect B-scan images together with appropriate radiofrequency echoes from diseased and healthy skin regions of patients with diagnosed basal cell carcinoma and pre-cancerous lesions (actinic keratosis). Radiofrequency data were processed to obtain the attenuation coefficient and statistics of the backscattered echo signal determination (K-distribution and effective density of scatterers [EDS]). The attenuation coefficient was significantly higher for patients with basal cell carcinoma than for healthy patients. Also, the pre-cancerous skin lesions had increased attenuation. The averaged EDS values for cancer lesions were significantly lower than those for pre-cancerous lesions and healthy skin. The successful differentiation between the tissue groups examined suggests the potential value of the attenuation coefficient and EDS for carcinoma characterization.

Słowa kluczowe:

Quantitative ultrasound, High frequency, Human skin, Skin lesions, K-distribution, Attenuation coefficient, Tissue characterization

Afiliacje autorów:

Piotrzkowska H.-IPPT PAN
Litniewski J.-IPPT PAN
Szymańska E.-other affiliation
Nowicki A.-IPPT PAN
35p.
8.Piotrzkowska H., Litniewski J., Szymańska E., Nowicki A., Ultrasonic Echosignal Applied to Human Skin Lesions Characterization, ARCHIVES OF ACOUSTICS, ISSN: 0137-5075, Vol.37, No.1, pp.103-108, 2012

Streszczenie:

The paper presents a classification of the healthy skin and the skin lesions (basal cell carcinoma) basing on a statistics of the envelope of ultrasonic echoes. The echoes envelopes distributions were modeled using Rayleigh and K-distribution. The distributions were compared with empirical data to find which of them better models the statistics of the echo-signal obtained from the human skin. The results indicated that the K-distribution provides a better fit. Also, a characteristic parameter of the K-distribution, the effective number of scatterers (M), was investigated. The values of the M parameter, obtained for the skin cancer (basal cell carcinoma), were lower as compared to those obtained for the healthy skin. The results indicate that the statistical quantitative ultrasound parameters have a potential for extracting information useful for characterization of the skin condition.

Słowa kluczowe:

statistics, K-distribution, Rayleigh distribution, ultrasonic scattering, human dermis

Afiliacje autorów:

Piotrzkowska H.-IPPT PAN
Litniewski J.-IPPT PAN
Szymańska E.-other affiliation
Nowicki A.-IPPT PAN
15p.
9.Piotrzkowska H., Litniewski J., Szymańska E., Nowicki A., Statistical Analysis of Ultrasound Echo for Skin Lesions Classification, HYDROACOUSTICS, ISSN: 1642-1817, Vol.15, pp.171-178, 2012

Streszczenie:

Propagation of ultrasonic waves in the tissue is sensitive to the alternation of tissue composition and structure.. This paper presents the classification of healthy skin and skin lesions (basal cell carcinoma (BCC)) based on statistic parameters of the envelope of echosignal. The statistics of envelope of the ultrasonic signal was modeled using Rayleigh and non-Rayleigh (the K-distribution) statistics. Furthermore the characteristic parameter of K-distribution, the effective number of scaterrers (M) was investigated.
Comparison of the results obtained for region of the skin where the BCC was diagnosed and the regions of healthy skin has shown differences in the values of M parameter. These results indicate that this parameter has the potential for extracting information useful for characterizing skin lesions.

Słowa kluczowe:

high frequency, ultrasound, basall cell carcinoma, ststistics

Afiliacje autorów:

Piotrzkowska H.-IPPT PAN
Litniewski J.-IPPT PAN
Szymańska E.-other affiliation
Nowicki A.-IPPT PAN
4p.
10.Piotrzkowska H., Litniewski J., Szymańska E., Lewandowski M., Nowicki A., Statistics of envelope of high frequency ultrasound signal backscattered in human dermis, HYDROACOUSTICS, ISSN: 1642-1817, Vol.13, pp.205-214, 2010

Streszczenie:

The scattering of ultrasonic waves depends on the size, shape, acoustical properties and concentration of scatterers in tissue. In these study K distribution of the ultrasound backscatter envelope was used to assess the structural properties of the skin tissue. The custom-designed high frequency ultrasonic scanner was applied to obtain RF B-scans of the skin in vivo at the frequency of 20-30MHz.
The results are encouraging. The K distribution models the envelope statistics very well. The parameters of the K-distribution, namely, the effective number of scatterers may be useful for the skin characterization.

Słowa kluczowe:

skin characterization, ultrasound, K distribution

Afiliacje autorów:

Piotrzkowska H.-IPPT PAN
Litniewski J.-IPPT PAN
Szymańska E.-other affiliation
Lewandowski M.-IPPT PAN
Nowicki A.-IPPT PAN
6p.
11.Piotrzkowska H., Litniewski J., Lewandowski M., Szymańska E., Nowicki A., Use of quantitative ultrasound to measure acoustic properties of human skin, ARCHIVES OF ACOUSTICS, ISSN: 0137-5075, Vol.34, No.4, pp.471-480, 2009

Streszczenie:

The scattering of ultrasonic waves depends on the size, shape, acoustical properties and concentration of scatterers in the tissue. The spectrum of the ultrasonic backscatter can be used to characterize non-invasively the structural and mechanical properties of tissue. We intend to apply the custom-designed high-frequency ultrasonic scanner for the skin and cutaneous lesions characterization by evaluating their attenuating and scattering properties. In this pilot study, we have explored the possibility of extracting the human skin backscattering coefficient (BC) from the ultrasonic B-scans obtained in vivo at 20–30 MHz. The measured BC values of normal skin (dermis) agree well with the published data. We have found also that the spatial resolution of the BC determination using our scanner is sufficient (aprox. 1 mm2) to characterize small skin lesions and assess their penetration depth.

Słowa kluczowe:

attenuation coefficient, backscattering coefficient, dermis

Afiliacje autorów:

Piotrzkowska H.-IPPT PAN
Litniewski J.-IPPT PAN
Lewandowski M.-IPPT PAN
Szymańska E.-other affiliation
Nowicki A.-IPPT PAN
9p.

Lista rozdziałów w ostatnich monografiach
1.
572
Doubrovina O., Tymkiewicz R., Piotrzkowska-Wróblewska H., Gambin B., Aktualności Inżynierii Akustycznej i Biomedycznej, rozdział: Linking of structural parameters to properties of ultrasound backscattered signals by the threads phantoms study, Polskie Towarzystwo Akustyczne, Oddział w Krakowie, I, pp.67-79, 2018
2.
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
3.
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
4.
496
Piotrzkowska-Wróblewska H., Litniewski J., Postępy Akustyki 2016, rozdział: Wpływ własności rozproszeniowych ośrodka na wartości efektywnej liczby rozpraszaczy, Polskie Towarzystwo Akustyczne, Oddział Warszawski, Warszawa, Poland, Instytut Podstawowych Problemów Techniki PAN, pp.61-72, 2016
5.
248
Piotrzkowska H., Litniewski J., Nowicki A., Szymańska E., Acoustical Imaging, rozdział: STATISTICAL PROPERTIES OF ECHOSIGNAL OBTAINED FROM HUMAN DERMIS IN VIVO, Springer, Nowicki A., Litniewski J., Kujawska T. (Eds.), 31, pp.123-133, 2012

Prace konferencyjne
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.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

Streszczenie:

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.

Afiliacje autorów:

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
15p.
3.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

Streszczenie:

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.

Słowa kluczowe:

uantitative ultrasound, Tissue characterisation, Tumor classification

Afiliacje autorów:

Klimonda Z.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
Piotrzkowska-Wróblewska H.-IPPT PAN
Karwat P.-IPPT PAN
Litniewski J.-IPPT PAN
4.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

Streszczenie:

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.

Słowa kluczowe:

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

Afiliacje autorów:

Byra M.-IPPT PAN
Piotrzkowska-Wróblewska H.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
Nowicki A.-IPPT PAN
15p.
5.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

Streszczenie:

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.

Słowa kluczowe:

ultrasound, breast cancer, Nakagami distribution

Afiliacje autorów:

Byra M.-IPPT PAN
Nowicki A.-IPPT PAN
Piotrzkowska H.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
Litniewski J.-IPPT PAN
15p.
6.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

Streszczenie:

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.

Słowa kluczowe:

breast cancer, quantitative ultrasound, BIRADS

Afiliacje autorów:

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
15p.
7.Litniewski J., Piotrzkowska H., Nowicki A., Szymańska E., Statistics of envelope of Ultrasonic Backscatter from Basal Cell Carcinoma and Actinic Keratosis lesion, IUS 2014, IEEE International Ultrasonics Symposium, 2014-09-03/09-06, Chicago (US), DOI: 10.1109/ULTSYM.2014.0474, pp.1908-1911, 2014

Streszczenie:

Basal cell carcinoma is the most common cutaneous malignancy, representing 80% of all skin cancer cases. The quantitative ultrasound can provide information potentially helpful in diagnosing. The goal of this study was to find the quantitative measure of the skin tissue backscattering properties that could be used for differentiating the changes of tissue structure induced by Basal Cell Carcinoma (BCC) and precancerous lesions - Actinic Keratosis (AK). The study presents the results concerning the statistical properties of ultrasonic echoes scattered in cancer lesions and attenuation coefficient determined from the backscatter.

Słowa kluczowe:

tissue characterization, quantitative ultrasound,skin lesions, statistical distribution, attenuation coefficient

Afiliacje autorów:

Litniewski J.-IPPT PAN
Piotrzkowska H.-IPPT PAN
Nowicki A.-IPPT PAN
Szymańska E.-other affiliation
10p.
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

Streszczenie:

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%.

Słowa kluczowe:

quantitative ultrasound, breast cancer, statistics

Afiliacje autorów:

Piotrzkowska H.-IPPT PAN
Nowicki A.-IPPT PAN
Litniewski J.-IPPT PAN
Gambin B.-IPPT PAN
Dobruch-Sobczak K.-other affiliation
9.Piotrzkowska H., Litniewski J., Nowicki A., Szymańska E., Basal Cell Carcinoma Lesions Characterization With Ultrasound, IUS 2012, IEEE International Ultrasonics Symposium, 2012-10-07/10-10, Dresden (DE), DOI: 10.1109/ULTSYM.2012.0596, pp.1-6, 2012

Streszczenie:

Quantitative ultrasounds were applied for the detection and assessment of skin lesions. 30MHz ultrasonic scanner was used to collect B-scan images together with appropriate RF echoes from the pathological and healthy skin regions of skin of patients with diagnosed Basal Cell Carcinoma and precancerous states. The RF data were processed for the attenuation coefficient and statistics assessment (K distribution and effective number of scatterers – M). For patients with BCC the attenuation coefficient was significantly higher than for the healthy skin ones. Also, precancerous skin lesions revealed increased attenuation. The averaged M parameter for cancer lesions was significantly lower than for precancerous states and healthy skin. Similar results were obtained from numerical simulations of the ultrasonic echoes scattered in skin and skin lesions.

Słowa kluczowe:

skin cancer, K distribution, effective number of scatterers, high frequency ultrasound

Afiliacje autorów:

Piotrzkowska H.-IPPT PAN
Litniewski J.-IPPT PAN
Nowicki A.-IPPT PAN
Szymańska E.-other affiliation
10p.
10.Piotrzkowska H., Litniewski J., Szymańska E., Nowicki A., Skin lesions assessment using attenuating and statistical properties of the backscattered ultrasound, IUS 2011, IEEE International Ultrasonics Symposium, 2011-10-18/10-21, Orlando (US), DOI: 10.1109/ULTSYM.2011.0338, pp.1368-1371, 2011

Streszczenie:

While the needles biopsy is still the gold standard in skin cancer diagnosis there is a growing interest in application of the high frequency ultrasound for the skin lesions detection and their thickness assessment. The quantitative ultrasound can provide additional information, potentially helpful in diagnosis. The purpose of this study was to assess the usefulness of the attenuating and statistical properties of the backscattered ultrasounds for the skin tissues characterization. The paper presents the classification of the healthy skin and skin lesions (BCC-basal cell carcinoma and AK-actinic keratosis). For patients with BCC the attenuation coefficient was significantly higher than for the healthy ones. Also, precancerous skin lesions revealed increased attenuation. The statistical properties were different for BCC comparing to AK lesions and healthy skin.

Słowa kluczowe:

basal cell carcinoma, actinic keratosis, attenuation coefficient, statistical properties, high frequency ultrasound

Afiliacje autorów:

Piotrzkowska H.-IPPT PAN
Litniewski J.-IPPT PAN
Szymańska E.-other affiliation
Nowicki A.-IPPT PAN
10p.
11.Piotrzkowska H., Characterization of human skin using statistics of backscattered signal envelope, 57 Otwarte Seminarium z Akustyki, 2010-09-20/09-24, Gliwice (PL), pp.149-152, 2010

Streszczenie:

The scattering of ultrasonic waves depends on the size, shape, acoustical properties and concentration of scatterers in tissue. In these study the statistics of envelope of signal was used to assess the structural properties of the skin tissue. Ultrasound backscatter data were obtained from healthy and pathological human dermis in vivo. The signal envelope statistics were examined by fitting the Rayleigh and K distributions. The fit between the K distribution and the data shown much smaller error than the Rayleigh model. The parameter of the K-distribution, namely, the effective number of scatterer was calculated and the potential of the effective number of scatterers to distinguish between normal and disease tissues was investigated. Obtained results indicate that the parameter of the K-distribution maybe useful in classification of the skin lesions.

Słowa kluczowe:

high frequency, ultrasound, skin, K distribution

Afiliacje autorów:

Piotrzkowska H.-IPPT PAN

Abstrakty konferencyjne
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

Streszczenie:

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

Afiliacje autorów:

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.Doubrovina O., Gambin B., Piotrzkowska-Wróblewska H., The backscattered ultrasound signal wavelet decomposition applied to recognize of regular positioning of scatterers in a sonicated medium, AMADE-2018, ANALYTICAL METHODS OF ANALYSIS AND DIFFERENTIAL EQUATIONS, Materials of the 9th International Workshop, 2018-09-17/09-21, Minsk (BY), No.1, pp.29, 2018
3.Doubrovina O., Tymkiewicz R., Piotrzkowska-Wróblewska H., Gambin B., Linking of structural parameters to properties of ultrasound backscattered signals by the threads phantoms study, IAB2018, XXII Konferencja Inżynierii Akustycznej i Biomedycznej, 2018-04-10/04-13, Kraków-Zakopane (PL), No.1, pp.26, 2018

Streszczenie:

The soft tissue structure possess the multi-scale anatomical inhomogeneities. There
are many types of tissues, where one can recognize at least two main scales: millimeter
scale and micrometer scale which are the basic scattering structures for an ultrasound
wave of the diagnostic frequency range penetrating the tissue . The millimeter scale
is due to the existence of quasi-periodic blocks of cells forming semi-regular lobules
e.g.in the anatomical units of the liver tissue, and the micrometer scale is formed with
many small scatterers like cell walls or large cell nuclei. The breaking of anatomical
structure is often caused by the beginning of the cancer process. It is very important
and unresolved problem to find any tools in qualitative ultrasound to recognize this two
type of scattering. To this end some phantom experiment were performed. 3D thread
structure in the form of nylon threads with a thickness of 0.1 mm (or of 0.35 mm) placed
at regular periodic structure with distances of 1 mm (or of 1.5 mm) was immersed in
the water. This threads structure was used as a model to analyse the properties of
ultrasound signal echoes registered with the use of different transducers, both focusing
and plane ones. The range of carried frequencies for used transducers were of 1MHz to
15 MHz. Additionally, the threads structure with threads of of 0.35 mm thickness and
located in distances of 1.5 mm, immersed in an oil and starch gel instead of the water
were .was used to analyse the influence of the background medium properties on the
ultrasound backscattering signals. Having measured pulse properties of a transducer
and applied the wavelet analysis to the registered signals the identification of the threads
positions in space, namely MSS (Mean Scatterer Spacing) was calculated and some
aspects of the differences between scattering and reflection phenomena were discussed
as a function of ratio between pulse length and geometrical parameters, i.e. threads
thickness and distances between them.

Afiliacje autorów:

Doubrovina O.-Belarussian State University (BY)
Tymkiewicz R.-IPPT PAN
Piotrzkowska-Wróblewska H.-IPPT PAN
Gambin B.-IPPT PAN
4.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

Słowa kluczowe:

attenuation estimation, parametric imaging

Afiliacje autorów:

Klimonda Z.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
Piotrzkowska-Wróblewska H.-IPPT PAN
Tymkiewicz R.-IPPT PAN
Litniewski J.-IPPT PAN
5.Piotrzkowska-Wróblewska H., Litniewski J., Influece of Scattering Conditions of the Medium on the Value of the Effective Number of Scatters, OSA 16, LXIII Otwarte Seminarium z Akustyki, 2016-09-13/09-16, Białowieża (PL), DOI: 10.1515/aoa-2016-0059, No.3, pp.625, 2016
6.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
7.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

Streszczenie:

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.

Słowa kluczowe:

breast cancer, ultrasound, RF echo-signal

Afiliacje autorów:

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)
8.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

Streszczenie:

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.

Słowa kluczowe:

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

Afiliacje autorów:

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
9.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
10.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

Streszczenie:

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.

Słowa kluczowe:

rak rdzeniasty, tarczyca, badanie USG, sonoelastografia fali poprzecznej

Afiliacje autorów:

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)