Perfluorobutane CEUS for early-stage cervical lymphoma: diagnostic value of the postvascular phase starfield sign
Abstract Early differentiation of cervical lymphoma from benign lymphadenopathy remains challenging on conventional imaging. This study assesses the diagnostic efficacy of perfluorobutane contrast-enhanced ultrasound (CEUS) in differentiating early-stage cervical lymphoma from benign lymph nodes (LN...
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Nature Portfolio
2025-08-01
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| Online Access: | https://doi.org/10.1038/s41598-025-13771-0 |
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| author | Xia Liang Xian-Tao Zeng Zhi-Liang Hong Xiao-Ying Lin Miao-jiao Su Jian-Chuan Yang Song-Song Wu |
| author_facet | Xia Liang Xian-Tao Zeng Zhi-Liang Hong Xiao-Ying Lin Miao-jiao Su Jian-Chuan Yang Song-Song Wu |
| author_sort | Xia Liang |
| collection | DOAJ |
| description | Abstract Early differentiation of cervical lymphoma from benign lymphadenopathy remains challenging on conventional imaging. This study assesses the diagnostic efficacy of perfluorobutane contrast-enhanced ultrasound (CEUS) in differentiating early-stage cervical lymphoma from benign lymph nodes (LNs). From November 2023 to January 2025 we prospectively enrolled patients suspected of having cervical lymphoma based on ultrasound (US) findings and scheduled for LN biopsy. All patients underwent CEUS to evaluate LN vascular (5–60 s post-injection) and postvascular (10–30 min post-injection) phases before biopsy. Histopathology served as the reference standard. Diagnostic performance metrics, including sensitivity, specificity, and accuracy, were calculated. Logistic regression analyzed the area under the receiver operating characteristic curve (AUC) for US, CEUS, and combined features. Forty-seven LNs (23 lymphomas, 24 benign) were analyzed. The sensitivity of the postvascular phase starfield sign was 91.30%, specificity was 83.33%, positive predictive value was 84.00%, negative predictive value was 90.91%, and the AUC was 0.87 (95% CI 0.76–0.98). The AUC for CEUS was 0.89 (95% CI 0.79–1.00), and the AUC for the combination of postvascular phase and US features was 0.92 (95% CI 0.82–1.00), significantly higher than that for US features alone (AUC, 0.68; 95% CI 0.53–0.84; P < 0.05). Perflubutane CEUS can effectively distinguish between cervical lymphoma and benign LNs. The postvascular phase starfield sign demonstrates significant diagnostic efficacy and could improve clinical management strategies. |
| format | Article |
| id | doaj-art-42a96ca8b707433fb9b2e0a74ef98b42 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-42a96ca8b707433fb9b2e0a74ef98b422025-08-20T03:46:00ZengNature PortfolioScientific Reports2045-23222025-08-0115111010.1038/s41598-025-13771-0Perfluorobutane CEUS for early-stage cervical lymphoma: diagnostic value of the postvascular phase starfield signXia Liang0Xian-Tao Zeng1Zhi-Liang Hong2Xiao-Ying Lin3Miao-jiao Su4Jian-Chuan Yang5Song-Song Wu6Shengli Clinical Medical College of Fujian Medical UniversityShengli Clinical Medical College of Fujian Medical UniversityShengli Clinical Medical College of Fujian Medical UniversityShengli Clinical Medical College of Fujian Medical UniversityShengli Clinical Medical College of Fujian Medical UniversityShengli Clinical Medical College of Fujian Medical UniversityShengli Clinical Medical College of Fujian Medical UniversityAbstract Early differentiation of cervical lymphoma from benign lymphadenopathy remains challenging on conventional imaging. This study assesses the diagnostic efficacy of perfluorobutane contrast-enhanced ultrasound (CEUS) in differentiating early-stage cervical lymphoma from benign lymph nodes (LNs). From November 2023 to January 2025 we prospectively enrolled patients suspected of having cervical lymphoma based on ultrasound (US) findings and scheduled for LN biopsy. All patients underwent CEUS to evaluate LN vascular (5–60 s post-injection) and postvascular (10–30 min post-injection) phases before biopsy. Histopathology served as the reference standard. Diagnostic performance metrics, including sensitivity, specificity, and accuracy, were calculated. Logistic regression analyzed the area under the receiver operating characteristic curve (AUC) for US, CEUS, and combined features. Forty-seven LNs (23 lymphomas, 24 benign) were analyzed. The sensitivity of the postvascular phase starfield sign was 91.30%, specificity was 83.33%, positive predictive value was 84.00%, negative predictive value was 90.91%, and the AUC was 0.87 (95% CI 0.76–0.98). The AUC for CEUS was 0.89 (95% CI 0.79–1.00), and the AUC for the combination of postvascular phase and US features was 0.92 (95% CI 0.82–1.00), significantly higher than that for US features alone (AUC, 0.68; 95% CI 0.53–0.84; P < 0.05). Perflubutane CEUS can effectively distinguish between cervical lymphoma and benign LNs. The postvascular phase starfield sign demonstrates significant diagnostic efficacy and could improve clinical management strategies.https://doi.org/10.1038/s41598-025-13771-0PerflubutaneCervical lymphomaContrast-enhanced ultrasoundPostvascular phaseLymph nodeStarfield sign |
| spellingShingle | Xia Liang Xian-Tao Zeng Zhi-Liang Hong Xiao-Ying Lin Miao-jiao Su Jian-Chuan Yang Song-Song Wu Perfluorobutane CEUS for early-stage cervical lymphoma: diagnostic value of the postvascular phase starfield sign Scientific Reports Perflubutane Cervical lymphoma Contrast-enhanced ultrasound Postvascular phase Lymph node Starfield sign |
| title | Perfluorobutane CEUS for early-stage cervical lymphoma: diagnostic value of the postvascular phase starfield sign |
| title_full | Perfluorobutane CEUS for early-stage cervical lymphoma: diagnostic value of the postvascular phase starfield sign |
| title_fullStr | Perfluorobutane CEUS for early-stage cervical lymphoma: diagnostic value of the postvascular phase starfield sign |
| title_full_unstemmed | Perfluorobutane CEUS for early-stage cervical lymphoma: diagnostic value of the postvascular phase starfield sign |
| title_short | Perfluorobutane CEUS for early-stage cervical lymphoma: diagnostic value of the postvascular phase starfield sign |
| title_sort | perfluorobutane ceus for early stage cervical lymphoma diagnostic value of the postvascular phase starfield sign |
| topic | Perflubutane Cervical lymphoma Contrast-enhanced ultrasound Postvascular phase Lymph node Starfield sign |
| url | https://doi.org/10.1038/s41598-025-13771-0 |
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