TY  - JOUR
A1  - Wojcinski, Sebastian
A1  - Cassel, Michael
A1  - Farrokh, Andre
A1  - Soliman, Amr A.
A1  - Hille, Ursula
A1  - Schmidt, Werner
A1  - Degenhardt, Friedrich
A1  - Hillemanns, Peter
T1  - Variations in the elasticity of breast tissue during the menstrual cycle determined by real-time sonoelastography
JF  - Journal of ultrasound in medicine
N2  - Objectives-The purpose of this study was to determine the dependence of breast tissue elasticity on the menstrual cycle of healthy volunteers by means of real-time sonoelastography.
 Methods-Twenty-two healthy volunteers (aged 18-33 years) were examined once weekly during two consecutive menstrual cycles using sonoelastography. Group 1 (n = 10) was not taking hormonal medication; group 2 (n = 12) was taking oral contraceptives.
 Results-The breast parenchyma appeared softer than the dermis and harder than the adipose tissue, and elasticity varied over the menstrual cycle and between groups. Group 1 (no hormone intake) showed continuously increasing elasticity with relatively soft breast parenchyma in the menstrual and follicular phases and harder parenchyma in the luteal phase (P = .012). Group 2 (oral contraceptives) showed no statistically significant changes in breast parenchymal elasticity according to sonoelastography. The parenchyma was generally softer in group 1 compared with group 2 throughout the menstrual cycle (P = .033). The dermis, the subcutaneous adipose tissue, and the pectoralis major muscle showed no changes in elasticity. Comparison of measurements made during the first and the second menstrual cycles showed similar patterns of elasticity in both groups.
 Conclusions-Sonoelastography is a reproducible method that can be used to determine the dependence of breast parenchyma elasticity on the menstrual cycle and on the intake of hormonal contraceptives.
KW  - breast tissue
KW  - elasticity imaging
KW  - real-time tissue elastography
KW  - sonoelastography
Y1  - 2012
SN  - 0278-4297
SN  - 1550-9613
VL  - 31
IS  - 1
SP  - 63
EP  - 72
PB  - American Institute of Ultrasound in Medicine
CY  - Laurel
ER  - 
TY  - JOUR
A1  - Wojcinski, Sebastian
A1  - Dupont, Jennifer
A1  - Schmidt, Werner
A1  - Cassel, Michael
A1  - Hillemanns, Peter
T1  - Real-time ultrasound elastography in 180 axillary lymph nodes  elasticity distribution in healthy lymph nodes and prediction of breast cancer metastases
JF  - BMC medical imaging
N2  - Background: To determine the general appearance of normal axillary lymph nodes (LNs) in real-time tissue sonoelastography and to explore the method's potential value in the prediction of LN metastases.
 Methods: Axillary LNs in healthy probands (n=165) and metastatic LNs in breast cancer patients (n=15) were examined with palpation, B-mode ultrasound, Doppler and sonoelastography (assessment of the elasticity of the cortex and the medulla). The elasticity distributions were compared and sensitivity (SE) and specificity (SP) were calculated. In an exploratory analysis, positive and negative predictive values (PPV, NPV) were calculated based upon the estimated prevalence of LN metastases in different risk groups.
 Results: In the elastogram, the LN cortex was significantly harder than the medulla in both healthy (p=0.004) and metastatic LNs (p=0.005). Comparing healthy and metastatic LNs, there was no difference in the elasticity distribution of the medulla (p=0.281), but we found a significantly harder cortex in metastatic LNs (p=0.006). The SE of clinical examination, B-mode ultrasound, Doppler ultrasound and sonoelastography was revealed to be 13.3%, 40.0%, 14.3% and 60.0%, respectively, and SP was 88.4%, 96.8%, 95.6% and 79.6%, respectively. The highest SE was achieved by the disjunctive combination of B-mode and elastographic features (cortex >3mm in B-mode or blue cortex in the elastogram, SE=73.3%). The highest SP was achieved by the conjunctive combination of B-mode ultrasound and elastography (cortex >3mm in B-mode and blue cortex in the elastogram, SP=99.3%).
 Conclusions: Sonoelastography is a feasible method to visualize the elasticity distribution of LNs. Moreover, sonoelastography is capable of detecting elasticity differences between the cortex and medulla, and between metastatic and healthy LNs. Therefore, sonoelastography yields additional information about axillary LN status and can improve the PPV, although this method is still experimental.
KW  - Breast ultrasound
KW  - Axillary lymph nodes
KW  - Sonoelastography
KW  - Real-time tissue elastography
KW  - Cancer detection
KW  - Elasticity imaging
KW  - HI-RTE
KW  - Lymph node metastases
Y1  - 2012
U6  - https://doi.org/10.1186/1471-2342-12-35
SN  - 1471-2342
VL  - 12
PB  - BioMed Central
CY  - London
ER  -