Ultrasound diagnostics is one of the most versatile methods of medical imaging, which is dynamically developing and plays an extremely important role in modern oncology. Its importance is especially growing in the context of the global emphasis on early detection of malignant neoplasms, because timely diagnosis directly affects the choice of treatment tactics, the prognosis of patients. Ultrasound is widely used as a method of primary screening, confirmatory diagnosis and navigation of invasive procedures, which makes it an integral part of the multidisciplinary oncological approach.
One of the key advantages of the ultrasound method is its non-invasiveness and complete absence of ionizing radiation, which allows the safe use of ultrasound for multiple examinations, dynamic monitoring and screening programs, in particular in pregnant women, children and patients with chronic diseases. High availability, relatively low cost of the study, the possibility of performing in real time and portability of devices significantly expand the scope of ultrasound compared to other imaging methods. In addition, ultrasound allows for bedside imaging and rapid integration of the data into clinical decision-making.
In the context of cancer screening, ultrasound demonstrates high sensitivity in detecting structural changes in tissues at early stages of tumor development. This is especially true for breast, thyroid, liver, kidney, ovarian, prostate, and lymph node cancers. Ultrasound allows for assessment of the shape, contours, echostructure, internal heterogeneity of tumors, their relationship to surrounding tissues, and growth dynamics.
Modern ultrasound systems have significantly advanced beyond traditional grayscale imaging. An important breakthrough was the introduction of microcirculation recording technologies that allow for visualization of slow and small-diameter blood flow in vessels without the use of contrast agents. Since angiogenesis is a fundamental biological feature of malignant tumors, a detailed assessment of microvascular architecture allows to increase the accuracy of differentiation between benign and malignant formations, as well as to assess the aggressiveness of the tumor process.
An important place in modern oncological ultrasound diagnostics is occupied by elastography - a method that allows to assess the mechanical properties of tissues and, by the principle of action, brings ultrasound examination closer to the so-called "virtual palpation". The method is based on a well-known clinical principle: malignant neoplasms, as a rule, are characterized by greater stiffness compared to the surrounding unchanged tissues.
Compression (strain) elastography is based on the analysis of tissue deformation in response to external mechanical impact, which is carried out by the sensor or by the patient's natural movements (breathing, vascular pulsation). The method allows to assess the relative stiffness of tissues by comparing different areas within the zone of interest. Compression elastography has the greatest diagnostic value in the study of: thyroid gland (nodular formations), mammary glands (differentiation of benign and malignant formations), superficial lymph nodes, soft tissues, prostate gland (mainly with transrectal access). At the same time, this method is operator-dependent and has limitations in the study of deeply located organs or structures. Shear wave elastography (SWE) is based on the generation of shear waves in tissues by an ultrasonic pulse and measuring the speed of their propagation, which allows obtaining quantitative stiffness indicators (in kPa or m/s). This method is characterized by high reproducibility and less dependence on the subjective factor. Shear wave elastography is widely used in the assessment of: liver (fibrosis, cirrhosis, focal lesions), breast, thyroid, pancreas, kidneys and spleen (in selected clinical situations), tumors of various localization, in particular deep or difficult to access for compression elastography.
The use of both elastography methods in combination with B-mode and Doppler significantly increases the specificity of ultrasound diagnostics in oncology, contributes to a more accurate determination of the risk of malignancy of neoplasms, allows optimizing indications for invasive interventions and reducing the number of unfounded biopsies and false-positive diagnostic conclusions.
Contrast-enhanced ultrasound is another important tool in modern oncology. The use of ultrasound contrast agents based on microbubbles allows for a detailed analysis of the microcirculation and perfusion of tumors in real time. This opens up opportunities for accurate differential diagnosis of focal lesions, especially in the liver, kidneys and pancreas, as well as for assessing the effectiveness of chemo-, immuno- and targeted therapies by monitoring changes in tumor vascularization.
An equally important advantage of ultrasound is its role in navigating invasive procedures r. Modern functions of improved visualization of the needle allow to clearly track its position even with difficult anatomical accesses. The use of special biopsy tips, which are attached directly to the ultrasound sensor, ensures high accuracy of targeted biopsy, increases the safety of interventions and reduces the dependence of the result on the experience of the operator. This is of fundamental importance for morphological verification of the diagnosis, which remains the “gold standard” in oncology.
The key technical feature that determines the effectiveness of all the listed technologies is the use of high-quality single-crystal ultrasound sensors. Due to the homogeneous crystalline structure, such sensors provide a wider frequency range, increased sensitivity and a significantly better signal-to-noise ratio. This allows to obtain images with high spatial and contrast resolution, clearly visualize small tumor formations, microvessels and minimal changes in tissue stiffness.
Thus, ultrasound diagnostics in oncology today is not just an auxiliary method, but a full-fledged high-tech platform for screening, early detection, risk stratification and monitoring of treatment of malignant diseases. The combination of a doctor's clinical experience with modern ultrasound technologies creates the prerequisites for more accurate, safe and personalized oncological care.
