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November 12, 2020 — Frontiers in Oncology


Introduction: Worldwide, the incidence and mortality of lung cancer are at the highest levels, and the most lesions are located in the lung periphery. Despite extensive screening and diagnosis, the pathologic types of peripheral pulmonary lesions (PPLs) are difficult to diagnose by noninvasive examination. This study aimed to identify a novel index—time difference of arrival (TDOA)—to discriminate between benign inflammation and malignant PPLs.

Methods: Using contrast-enhanced ultrasound (CEUS), we retrospectively analyzed 96 patients with PPLs who had undergone biopsy to confirm the pathologic types. All data were collected from Dazhou Central Hospital between December 2012 and July 2019. The parameters of CEUS were analyzed by two assistant chief physicians of ultrasound diagnosis. Area under the receiver operating characteristic curve analysis, sensitivity, specificity, positive predictive value, and negative predictive value were calculated to assess the diagnostic ability of different indices.

Results: We found that the TDOA significantly distinguished benign inflammation from malignant lesions. The TDOA was markedly increased in patients with malignant lesions than benign inflammation lesions (P < 0.001). Compared with conventional time-intensity curve (TIC) indices, TDOA showed high diagnostic accuracy (area under the curve = 0.894). Moreover, conventional diagnostic indices did not affect the diagnostic performance of TDOA by adjusting the receiver operating characteristic curve.

Conclusion: TDOA is feasible for the diagnosis of benign inflammation and malignant PPLs.

Authors: Min Tang1, Qianrong Xie2, Jiasi Wang2, Xiaoyu Zhai3, Hong Lin4, Xiaoxue Zheng1, Guoli Wei1, Yan Tang1, Fanwei Zeng1, Yanpeng Chu2, Jianqiong Song1, Jianqiang Cai5 and Fanxin Zeng2

1Department of Ultrasound Imaging, Dazhou Central Hospital, Dazhou, China; 2Department of Clinical Research Center, Dazhou Central Hospital, Dazhou, China; 3Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Thoracic Medical Oncology, Peking University Cancer Hospital and Institute, Beijing, China; 4Department of Public Health Information, Sichuan Center for Disease Control and Prevention, Chengdu, China, 5Department of Hepatobiliary Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

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