Single-center study: dynamic contrast-enhanced ultrasound in the diagnostic assessment of carotid body tumors

• Published in: Quantitative imaging in medicine and surgery Vol. 10; no. 9; pp. 1739 - 1747
• Main Authors: Schwarze, Vincent, Marschner, Constantin, Negrao De Figueiredo, Giovanna, Ingrisch, Michael, Rübenthaler, Johannes, Clevert, Dirk-André
• Format: Journal Article
• Language: English
• Published: China AME Publishing Company 01.09.2020
• Subjects: Original; Carotid body tumor (CBT); neck; neoplasms; diagnostic imaging
• ISSN: 2223-4292; 2223-4306
• DOI: 10.21037/QIMS-19-920

Carotid body tumors (CBTs) depict the most common paraganglioma of the head and neck that can metastasize in up to 15% of cases. They develop either sporadically or hereditarily and may produce catecholamines ("functioning CBTs") resulting in associated symptoms like headache, palpitations or flush. Non-functioning CBTs usually present as slowly and often tender growing mass which may affect adjacent cranial nerves. CBTs can be visualized by ultrasound, CT, MRI or angiography. Pre-surgical interventional embolization, surgical resection and radiation therapy are therapeutical options. The aim of this retrospective single-center study is to assess the safe and real-time evaluation of CBTs by contrast-enhanced ultrasound (CEUS). Ten patients with CBT were included in this study on whom CEUS was performed between 2007-2018 (mean age: 62 years). In 6/10 patients, results were confirmed by MRI, 4/12 patients underwent subsequent angiography. CEUS was performed and interpreted by a single consultant radiologist with experience since 2000 (EFSUMB level 3). VueBox software was used for standardized perfusion quantification. CEUS allowed to detect all CBTs and visualize intratumoral microcirculation. Perfusion quantification was performed in 6/10 cases. CBTs showed significantly reduced peak-enhancement (PE), reduced wash-in perfusion index (WiPI) and significantly elevated time to peak (TTP) compared to common carotid arteries (CCA). CEUS is a useful and safe tool for identifying CBTs and evaluating intratumoral microperfusion at high spatial and temporal resolutions in real-time. In addition to conventional ultrasound, CT, MRI and digital substraction angiography (DSA), CEUS may be implemented in the future diagnostic work-up and follow-up of CBT patients.