Predição de malignidade de neoplasmas cutâneos e subcutâneos de cães por meio de ultrassonografia modo-B, Doppler e elastografia ARFI
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2022-01-20
Autores
da Cruz, Igor Cezar Kniphoff [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Os neoplasmas cutâneos e subcutâneos são muito prevalentes em cães, variando desde lesões benignas até altamente agressivas e metastáticas. O diagnóstico é obtido por histopatologia, porém é uma técnica invasiva que pode demorar para obtenção do resultado, retardando o início do tratamento adequado. Dessa forma, necessita-se exames não invasivos que possam auxiliar no diagnóstico precoce desse tipo de câncer. O objetivo deste estudo foi verificar a acurácia dos métodos ultrassonográficos na predição de malignidade de neoplasmas cutâneos e subcutâneos de cães, além de verificar os valores preditivos associando as diferentes técnicas. Ainda, objetivou-se realizar a caracterização destes neoplasmas utilizando as três técnicas realizadas. Foram diagnosticados 21 histotipos diferentes e, pelo modo B, verificou-se associação entre ecotextura heterogênea, invasividade, presença de pontos hiperecogênicos e de áreas cavitárias com malignidade. Foi verificado aumento do índice de pulsatilidade nas neoplasias malignas pelo Doppler (valor de corte > 0,93). Pela elastografia, a malignidade foi associada a tecidos não deformáveis e com velocidade de onda de cisalhamento > 3,52 m/s. Protocolos de avaliação foram propostos associando 4, 5, 6 ou 7 características preditivas de malignidade, e a caracterização foi realizada para todos os histotipos que apresentaram pelo menos dois casos. Concluiu-se que os métodos ultrassonográficos são promissores e eficazes na predição de malignidade nesses tipos de neoplasmas e que a associação de métodos pode aumentar a especificidade dos resultados.
Cutaneous and subcutaneous neoplasms are very prevalent in dogs, ranging from benign to highly aggressive and metastatic lesions. The diagnosis is obtained by histopathology, but it is an invasive technique that can take time to obtain the result, delaying the beginning of the appropriate treatment. Thus, non-invasive tests are needed that can help in the early diagnosis of this type of cancer. The aim of this study was to verify the accuracy of ultrasound methods in predicting malignancy of cutaneous and subcutaneous neoplasms in dogs, in addition to verifying the predictive values associating the different techniques. Still, the objective was to carry out the characterization of these neoplasms using the three techniques performed. Twenty-one different histotypes were diagnosed and, using the B mode, there was an association between heterogeneous echotexture, invasiveness, presence of hyperechogenic points and cavity areas with malignancy. An increase in the pulsatility index was observed in malignant neoplasms by Doppler (cutoff value > 0.93). By elastography, malignancy was associated with non-deformable tissues and with shear wave velocity > 3.52 m/s. Assessment protocols were proposed associating 4, 5, 6 or 7 predictive features of malignancy, and characterization was performed for all histotypes that presented at least two cases. It was concluded that ultrasound methods are promising and effective in predicting malignancy in these types of neoplasms and that the association of methods can increase the specificity of the results.
Cutaneous and subcutaneous neoplasms are very prevalent in dogs, ranging from benign to highly aggressive and metastatic lesions. The diagnosis is obtained by histopathology, but it is an invasive technique that can take time to obtain the result, delaying the beginning of the appropriate treatment. Thus, non-invasive tests are needed that can help in the early diagnosis of this type of cancer. The aim of this study was to verify the accuracy of ultrasound methods in predicting malignancy of cutaneous and subcutaneous neoplasms in dogs, in addition to verifying the predictive values associating the different techniques. Still, the objective was to carry out the characterization of these neoplasms using the three techniques performed. Twenty-one different histotypes were diagnosed and, using the B mode, there was an association between heterogeneous echotexture, invasiveness, presence of hyperechogenic points and cavity areas with malignancy. An increase in the pulsatility index was observed in malignant neoplasms by Doppler (cutoff value > 0.93). By elastography, malignancy was associated with non-deformable tissues and with shear wave velocity > 3.52 m/s. Assessment protocols were proposed associating 4, 5, 6 or 7 predictive features of malignancy, and characterization was performed for all histotypes that presented at least two cases. It was concluded that ultrasound methods are promising and effective in predicting malignancy in these types of neoplasms and that the association of methods can increase the specificity of the results.
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Oncologia, Diagnóstico por imagem, Câncer de pele, Canino