Perfusion Patterns of Peripheral Pulmonary Metastasis Using Contrast-Enhanced Ultrasound (CEUS) and Their Correlation...

Area of Science:

• Radiology and Oncology
• Medical Imaging Techniques
• Cancer Diagnostics

Background:

• Pulmonary metastases are secondary malignant tumors in the lungs.
• Understanding their vascularization is crucial for diagnosis and treatment.
• Contrast-enhanced ultrasound (CEUS) offers a non-invasive method to assess tumor perfusion.

Purpose of the Study:

• To describe the perfusion patterns of pulmonary metastases using CEUS.
• To correlate CEUS findings with immunohistochemical CD34 staining for vascularization.

Main Methods:

• Retrospective analysis of 54 patients with pulmonary metastases undergoing CEUS.
• Evaluation of CEUS parameters: time to enhancement (TE), extent of enhancement (EE), homogeneity of enhancement (HE), and decrease of enhancement (DE).
• Immunohistochemical CD34 staining performed on 45 samples to assess endothelial vascularization.

Main Results:

• Bronchial arterial (BA) enhancement was observed in 92.6% of lesions, while pulmonary arterial (PA) enhancement was seen in 7.4%.
• Heterogeneous enhancement (51.86% homogeneous, 48.14% inhomogeneous) and rapid washout (98.1%) were common.
• CD34 staining confirmed a chaotic vascular pattern indicative of BA supply in all evaluated cases.

Conclusions:

• Pulmonary metastases typically exhibit BA enhancement and rapid washout on CEUS.
• CEUS demonstrates heterogeneous perfusion patterns in pulmonary metastases regarding EE and HE.
• PA enhancement on CEUS does not preclude the presence of BA neoangiogenesis.