dr n. med. Katarzyna Dobruch-Sobczak

Zakład Ultradźwięków (ZU)
Pracownia Biomechaniki (PB)
stanowisko: główny specjalista
telefon: (+48) 22 826 12 81 wew.: 486
pokój: 514
e-mail: ksobczak

Ostatnie publikacje
1.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.
2.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.
3.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.
4.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

Streszczenie:

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.

Słowa kluczowe:

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

Afiliacje autorów:

Dobruch-Sobczak K.-other affiliation
Bakuła-Zalewska E.-Maria Sklodowska-Curie Memorial Cancer Center and 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.-Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology (PL)
35p.
5.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

Streszczenie:

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.

Słowa kluczowe:

elastography, static sonoelastography, dynamic sonoelastography, ultrasonography

Afiliacje autorów:

Nowicki A.-IPPT PAN
Dobruch-Sobczak K.-IPPT PAN
10p.
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.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

Streszczenie:

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.

Słowa kluczowe:

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

Afiliacje autorów:

Dobruch-Sobczak K.-IPPT PAN
Nowicki A.-IPPT PAN
35p.
8.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

Streszczenie:

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.

Słowa kluczowe:

adrenal glands, adrenal masses, ultrasound, echogenicity

Afiliacje autorów:

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
10p.
9.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

Streszczenie:

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.

Słowa kluczowe:

adrenal glands, adrenal masses, ultrasound, standards

Afiliacje autorów:

Słapa R.Z.-other affiliation
Jakubowski W.S.-other affiliation
Dobruch-Sobczak K.-IPPT PAN
Kasperlik-Załuska A.A.-other affiliation
10p.
10.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

Streszczenie:

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.

Słowa kluczowe:

medullary thyroid carcinoma, thyroid, ultrasound, shear wave elastography

Afiliacje autorów:

Dobruch-Sobczak K.-IPPT PAN
Gumińska A.-other affiliation
Dedecjus M.-Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology (PL)
Bakuła-Zalewska E.-Maria Sklodowska-Curie Memorial Cancer Center and 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
10p.
11.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

Streszczenie:

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.

Słowa kluczowe:

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

Afiliacje autorów:

Dobruch-Sobczak K.-other affiliation
Jędrzejowski M.-other affiliation
Jakubowski W.-other affiliation
Trzebińska A.-other affiliation
4p.
12.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

Streszczenie:

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.

Słowa kluczowe:

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

Afiliacje autorów:

Trzebińska A.-other affiliation
Dobruch-Sobczak K.-other affiliation
Jakubowski W.-other affiliation
Jędrzejowski M.-other affiliation
4p.

Lista rozdziałów w ostatnich monografiach
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

Prace konferencyjne
1.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
2.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
3.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

Abstrakty konferencyjne
1.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
2.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
3.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)
4.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
5.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
6.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.-Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology (PL)
Kaczor A.-other affiliation
Piotrzkowska H.-IPPT PAN
Jakubowski W.-other affiliation
Nowicki A.-IPPT PAN
Dedecjus M.-Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology (PL)