Comparison of Contrast-Enhanced Ultrasonography to Color Doppler Ultrasound in Evaluation of Carotid Body Tumors

Guangchao Gu; Xiaoyan Zhang; Junyue Shen; Shayan Gulidanna; Qiong Gao; Jiang Shao; Bao Liu; Bo Zhang; Yuehong Zheng

doi:10.3389/fonc.2022.872890

Comparison of Contrast-Enhanced Ultrasonography to Color Doppler Ultrasound in Evaluation of Carotid Body Tumors

Front Oncol. 2022 Apr 11:12:872890. doi: 10.3389/fonc.2022.872890. eCollection 2022.

Authors

Guangchao Gu¹, Xiaoyan Zhang², Junyue Shen^{1

3

4}, Shayan Gulidanna^{1

3}, Qiong Gao², Jiang Shao¹, Bao Liu¹, Bo Zhang^{2

5}, Yuehong Zheng^{1

6}

Affiliations

¹ Department of Vascular Surgery, Peking Union Medical College Hospital, Beijing, China.
² Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Beijing, China.
³ School of Medicine, Tsinghua University, Beijing, China.
⁴ Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing, China.
⁵ Department of Ultrasound, China-Japan Friendship Hospital, Beijing, China.
⁶ State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.

Abstract

Objective: The objectives of this study were to prospectively 1) explore the characteristics and enhanced patterns of carotid body tumors (CBTs) at color Doppler ultrasound (CDU) and contrast-enhanced ultrasonography (CEUS) qualitatively and quantitatively and 2) compare CDU and CEUS for their morphology and vascularity signature.

Methods: CDU and CEUS with Sonovue^® were used to evaluate 25 CBT lesions. The comparison between these ultrasonic modalities included the size, Shamblin type, vascularity, and feeding vessels of the lesion areas. The time-intensity curve (TIC) analysis was used to obtain the dynamics of the contrast-enhancement features of CBTs.

Results: The TIC analysis presented a fast wash-in [wash-in time: 3.00 ± 1.10 s, mean ± SD] and slow wash-out [wash-out time: 58.79 ± 24.21 s, mean ± SD] pattern in the CBT lesions, with a high area under the curve (AUC) of 669.68 ± 143.46 mm² (mean ± SD). In comparison with CDU, CEUS was superior in identifying Shamblin type I or III CBT lesions (χ² = 17.389, p=0.002). It detected a significant difference in the AUC between moderate and marked vascularity groups (563.33 ± 102.63 vs. 707.22 ± 138.81, t=-2.311, p=0.031.), while CDU observed no significant difference between these two groups. Although CDU was more sensitive than CEUS in detecting feeding vessels (100% vs. 88%), CEUS better visualized the origins of feeding vessels (χ² = 9.162, p=0.010).

Conclusion: CEUS can better investigate the Shamblin type and vascularity of CBT lesions than CDU. CBTs displayed a fast wash-in, slow wash-out pattern with high AUC in the TIC analysis in the CEUS mode. CDU is more sensitive in detecting feeding vessels than CEUS, while CEUS can better visualize the origins of feeding vessels.

Keywords: carotid body tumor; color Doppler ultrasound; contrast-enhanced ultrasound; morphology; time–intensity curve; vascularity.