@article{WojcinskiDupontSchmidtetal.2012,
  author    = {Wojcinski, Sebastian and Dupont, Jennifer and Schmidt, Werner and Cassel, Michael and Hillemanns, Peter},
  title     = {Real-time ultrasound elastography in 180 axillary lymph nodes elasticity distribution in healthy lymph nodes and prediction of breast cancer metastases},
  series = {BMC medical imaging},
  volume    = {12},
  journal   = {BMC medical imaging},
  publisher = {BioMed Central},
  address   = {London},
  issn      = {1471-2342},
  doi       = {10.1186/1471-2342-12-35},
  pages     = {10},
  year      = {2012},
  abstract  = {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.},
  language  = {en}
}
@article{WojcinskiCasselFarrokhetal.2012,
  author    = {Wojcinski, Sebastian and Cassel, Michael and Farrokh, Andre and Soliman, Amr A. and Hille, Ursula and Schmidt, Werner and Degenhardt, Friedrich and Hillemanns, Peter},
  title     = {Variations in the elasticity of breast tissue during the menstrual cycle determined by real-time sonoelastography},
  series = {Journal of ultrasound in medicine},
  volume    = {31},
  journal   = {Journal of ultrasound in medicine},
  number    = {1},
  publisher = {American Institute of Ultrasound in Medicine},
  address   = {Laurel},
  issn      = {0278-4297},
  pages     = {63 -- 72},
  year      = {2012},
  abstract  = {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.},
  language  = {en}
}
@misc{WojcinskiDupontSchmidtetal.2012,
  author    = {Wojcinski, Sebastian and Dupont, Jennifer and Schmidt, Werner and Cassel, Michael and Hillemanns, Peter},
  title     = {Real-time ultrasound elastography in 180 axillary lymph nodes},
  series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  journal   = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  number    = {626},
  issn      = {1866-8364},
  doi       = {10.25932/publishup-43158},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-431584},
  pages     = {12},
  year      = {2012},
  abstract  = {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.},
  language  = {en}
}