S166 Ultrasound in Medicine and Biology Volume 35, Number 8S, 2009

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Sonomorphologic Changes of Lymph Nodes and Lymph NodeMetastases Following Chemo and/or Radiation TherapyHans J Welkoborsky, Dept. of Otorhinolaryngology, Head and NeckSurgery, Nordstadt Clinic, Academic Hospital, Hannover, Germany,GermanyLothar Bauer, Dept. of Otorhinolaryngology, Head and NeckSurgery, Nordstadt Clinic, Academic Hospital, Hannover, Germany,GermanyHartmut Mobius, Dept. of Otorhinolaryngology, Head and NeckSurgery, Nordstadt Clinic, Academic Hospital, Hannover, Germany,GermanyMirko Rodriguez-Kayser, Dept. of Otorhinolaryngology, Head andNeck Surgery, Nordstadt Clinic, Academic Hospital, Hannover,Germany, Germany

Purpose: The diagnostic accuracy of ultrasonography in the detectionof lymph node metastases (LN mets) is unmistakable in the literature.However, currently not many studies have investigated the sonomor-phologic changes of lymph nodes or LN mets during chemotherapy orradiation therapy which might influence the posttherapeutic manage-ment of tumor patients.Patients and Methods: In a prospective study 50 patients with squa-mous cell carcinoma of the oro- or hypopharynx were examined. Thefollowing sonographic features were evaluated: i.e. shape, size, bor-ders, echogenicity, hilar structure, microcalcification, necrotic areas,and perfusion pattern of the nodes. All patients underwent neck dis-section with LN mets were histologically confirmed. Another 50 pa-tients in which lymph nodes following radiation therapy occurred wereexamined by ultrasonography. All underwent surgical neck explora-tion. In 37 of them metastases were confirmed histologically. Thesonomorphologic characteristics of recurrent LN mets were similar tothose in the pretreatment group. Nevertheless more scar tissue andfibrosis occurred after radiation.Conclusions: Ultrasonography provides most useful information in theposttherapeutic surveillance of patients with tumors in the head andneck. The sonomorphologic characteristics of LN recurrences arenearly equal to those in the untreated neck. Although fibrosis and scartissue occur frequently following radiation and/or operation, the sen-sitivity and overall accuracy of sonography in the detection of LNrecurrences achieves more than 90% which is similar or even betterthan that of other imaging techniques.

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Prenatal Screening – Towards Safer Pregnancies!Azizul Islam, Square Hospitals Ltd., Bangladesh

Objectives/Background:The purposes of this presentation are –1) To evaluate of fetal health to exclude chromosomal defect during 1st& 2nd trimester of pregnancy.2) To identify ‘at risk’ of pregnancy members of a population toevaluate Chromosomal and / or Structural abnormalities fetuses. Oth-erwise the majority of abnormalities would go undetected.Materials and Methods: Combination of these tests are used forprenatal screening, namely – 1) Ultrasound, 2) Biochemical tests and 3)Maternal age.The disorders screened during pregnancy are – Trisomy 21, 18 & 13;Triploidy, NTD etc.Maternal age, Nuchal Translucency, CRL or BPD by Ultrasound,Triple tests, Quad tests etc. are used as parameter.Results: Only mother age can detect about 50%.Along NT sonogram can detect only about 70%.

NT combined with free �hCG & PAPP-A gives highest 90-95%.

The 1st trimester screen’s detection rate is approximately 90-95% withFPR is about 5%.The 2nd trimester detection rate is approximately 75-79% with FPR 7.5– 8.5%.The 1st trimester test is more accurate than 2nd trimester screeningmethods.Conclusion: Advantage of screening is that referred cases for invasivetesting are substantially reduced.Only screen positive tests can refer for confirmatory Invasive tech-niques.These tests provide an ample opportunity for the couple to decide &take judicious judgment.With the exclusive step by step help of prenatal screening can contrib-ute at early stage of pregnancy to a safer outcome of pregnancy.Keywords: * At risk group, *Invasive & non-invasive techniques.

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Effects of Intraperitoneal Chemotherapy on Uterine Blood Flowin Patients with Postmenopausal Cervical Carcinoma Evaluatedby Color Doppler UltrasonographyJianguo Huang, Ultrasound Department of Hubei Cancer Hospital,ChinaLi Zha, Ultrasound Department of Hubei Cancer Hospital, ChinaShu-e Zeng, Ultrasound Department of Hubei Cancer Hospital,China

Objective: To evaluate cervical cancer hemodynamic changes afterintraperitoneal chemotherapy, and its clinical significance using colorDoppler ultrasonography.Methods: Cis-platinum diaminodichloride (PDD) 100-120mg/m 2 wasinjected into the patients with cervical squamous cell carcinoma, PDD80-100mg/m2and 5-FU 1.5g per time were injected into the patients withcervical adenocacinoma. 1000-1500ml physiological saline in which themedicine was dissolved was once injected into the abdominal cavity byintraperitoneal puncturing. The course of treatment were 1-4 times. ColorDoppler ultrasonography was performed in 58 patients with postmeno-pausal cervical carcinoma treated with intraperitoneal chemotherapy.Results: Chemotherapy caused the peak-systonic blood flow velocityof uterine artery decreased. The blood signals inside and around thetumor decreased. Uterine artery was not detected by color Dopplerultrasound in 50%(29/58) patients, and the echo from cervical bloodvessel was normal in 81%(47/58) patients. After chemotherapy, theuterine artery RI values detected �0.6 was 79% (23/29). The uterineartery peak-systonic blood flow velocity was � 40cm/s in 93% (27/29)patients. All the above parameters, compared with the parametersbefore chemotherapy, were markedly different (P�0.01). The decreaseof intratumoral vascularity and reduction of blood flow velocity ofuterine artery with increase RI during the chemotherapy were associ-ated with better results. However, persistence of excessive vascularityat the end of chemotherapy needed further treatment.Conclusions: These results suggested that color Doppler ultrasonog-raphy might be useful in the early assessment of vascular therapeuticresponse to chemotherapy. Modifying the treatment schedules accord-ing to early therapeutic response may help achieve better outcome.

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Role of Ultrasound in the Evaluation and Care of Women withExtranodal Non-Hodgkin’s Lymphoma (NHL)Olga V Kamaeva, N.N. Blokhin Cancer Research Center RAMS,RussiaMarina A Chekalova, N.N. Blokhin Cancer Research Center RAMS,RussiaAnna G Kedrova, N.N. Blokhin Cancer Research Center RAMS,

Russia