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Sultan LR, Alves AGF, Morgan TA, Sridharan A, Batley M, Darge K, Sankar WN, Back SJ. A novel quantitative approach to evaluate femoral head perfusion by contrast-enhanced ultrasound: A pilot study in infants with developmental dysplasia of the hip. IEEE INTERNATIONAL ULTRASONICS SYMPOSIUM : [PROCEEDINGS]. IEEE INTERNATIONAL ULTRASONICS SYMPOSIUM 2023; 2023:10.1109/ius51837.2023.10307817. [PMID: 38264340 PMCID: PMC10805098 DOI: 10.1109/ius51837.2023.10307817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Avascular necrosis (AVN) is a major morbidity that can occur after surgical reduction of a hip with developmental dysplasia. Early detection of changes in femoral head perfusion during surgery may help detect a hip at risk for AVN and guide intraoperative management. Contrast-enhanced ultrasound (CEUS) can be employed for visualization of femoral head perfusion. In this study we evaluate a quantitative CEUS technique to assess femoral head perfusion pre- and post-surgical reduction. CEUS images were obtained following a bolus injection of an ultrasound contrast agent, prior to and again following surgical reduction and casting. An image processing technique called delta projection was used to quantify hip perfusion, measuring peak enhancement (PE) and perfusion index (PI). We analyzed CEUS images of the hips of eight patients, including seven females, whose ages ranged from 4 months to 1 year. In five hips, perfusion increased following surgery, with a mean pre-surgery PE of 6.7 ±2.5(± SE) and PI of 10.5 ±6.3; and a post-reduction PE of 13.1±6.1 (p=0.07) and PI of 14.2 ±6.2 (p=0.008). The change in contrast visualization was observed to be greater within the central aspect of the cartilaginous femoral epiphysis. The proposed technique can quantify pre- and post-surgical perfusion changes on CEUS images in patients with developmental dysplasia. This quantitative technique may provide a more objective and accurate assessment of changes in femoral head perfusion that may have the potential to be indicative of the risk of developing AVN.
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Affiliation(s)
- Laith R Sultan
- Children's Hospital of Philadelphia, Division of Body Imaging, Department of Radiology
| | - Andressa G F Alves
- Children's Hospital of Philadelphia, Division of Body Imaging, Department of Radiology
| | - Trudy A Morgan
- Children's Hospital of Philadelphia, Division of Body Imaging, Department of Radiology
| | - Anush Sridharan
- Children's Hospital of Philadelphia, Division of Body Imaging, Department of Radiology
| | - Morgan Batley
- Children's Hospital of Philadelphia, Division of Orthopedic Surgery, Department of Surgery
| | - Kassa Darge
- Children's Hospital of Philadelphia, Division of Body Imaging, Department of Radiology
- Perelman School of Medicine, University of Pennsylvania
| | - Wudbhav N Sankar
- Children's Hospital of Philadelphia, Division of Orthopedic Surgery, Department of Surgery
- Perelman School of Medicine, University of Pennsylvania
| | - Susan J Back
- Children's Hospital of Philadelphia, Division of Body Imaging, Department of Radiology
- Perelman School of Medicine, University of Pennsylvania
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D'Souza JC, Sultan LR, Hunt SJ, Gade TP, Karmacharya MB, Schultz SM, Brice AK, Wood AKW, Sehgal CM. Microbubble-enhanced ultrasound for the antivascular treatment and monitoring of hepatocellular carcinoma. Nanotheranostics 2019; 3:331-341. [PMID: 31687321 PMCID: PMC6821993 DOI: 10.7150/ntno.39514] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 09/26/2019] [Indexed: 12/13/2022] Open
Abstract
Background and Objective: Hepatocellular carcinoma (HCC) is the most common primary liver malignancy, and its current management relies heavily on locoregional therapy for curative therapy, bridge to transplant, and palliative therapy. Locoregional therapies include ablation and hepatic artery therapies such as embolization and radioembolization. In this study we evaluate the feasibility of using novel antivascular ultrasound (AVUS) as a noninvasive locoregional therapy to reduce perfusion in HCC lesions in a rat model and, monitor the effect with contrast-enhanced ultrasound imaging. Methods: HCC was induced in 36 Wistar rats by the ingestion of 0.01% diethylnitrosamine (DEN) for 12 weeks. Two therapy regimens of AVUS were evaluated. A primary regimen (n = 19) utilized 2-W/cm2, 3-MHz ultrasound (US) for 6 minutes insonation with 0.7 ml of microbubbles administered as an intravenous bolus. An alternate dose at half the primary intensity, sonication time, and contrast concentration was evaluated in 11 rats to assess the efficacy of a reduced dose. A control group (n = 6) received a sham therapy. Tumor perfusion was measured before and after AVUS with nonlinear contrast ultrasound (NLC) and power Doppler (PD). The quantitative perfusion measures included perfusion index (PI), peak enhancement (PE), time to peak (TTP), and perfusion area from NLC and PD scans. Total tumor area perfused during the scan was measured by a postprocessing algorithm called delta projection. Tumor histology was evaluated for signs of tissue injury and for vascular changes using CD31 immunohistochemistry. Results: DEN exposure induced autochthonous hepatocellular carcinoma lesions in all rats. Across all groups prior to therapy, there were no significant differences in the nonlinear contrast observations of peak enhancement and perfusion index. In the control group, there were no significant differences in any of the parameters after sham treatment. After the primary AVUS regimen, there were significant changes in all parameters (p ≤ 0.05) indicating substantial decreases in tumor perfusion. Peak enhancement in nonlinear contrast scans showed a 37.9% ± 10.1% decrease in tumor perfusion. Following reduced-dose AVUS, there were no significant changes in perfusion parameters, although there was a trend for the nonlinear contrast observations of peak enhancement and perfusion index to increase. Conclusion: This study translated low-intensity AVUS therapy into a realistic in vivo model of HCC and evaluated its effects on the tumor vasculature. The primary dose of AVUS tested resulted in significant vascular disruption and a corresponding reduction in tumor perfusion. A reduced dose of AVUS, on the other hand, was ineffective at disrupting perfusion but demonstrated the potential for enhancing tumor blood flow. Theranostic ultrasound, where acoustic energy and microbubbles are used to monitor the tumor neovasculature as well as disrupt the vasculature and treat lesions, could serve as a potent tool for delivering noninvasive, locoregional therapy for hepatocellular carcinoma.
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Affiliation(s)
- Julia C. D'Souza
- Ultrasound Research Laboratory, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 3620 Hamilton Walk, Philadelphia, PA 19104, USA
- Penn Image-Guided Interventions Lab, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 421 Curie Blvd, 646 BRB II/III Philadelphia, PA 19104, USA
| | - Laith R. Sultan
- Ultrasound Research Laboratory, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 3620 Hamilton Walk, Philadelphia, PA 19104, USA
| | - Stephen J. Hunt
- Ultrasound Research Laboratory, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 3620 Hamilton Walk, Philadelphia, PA 19104, USA
- Penn Image-Guided Interventions Lab, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 421 Curie Blvd, 646 BRB II/III Philadelphia, PA 19104, USA
| | - Terence P. Gade
- Penn Image-Guided Interventions Lab, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 421 Curie Blvd, 646 BRB II/III Philadelphia, PA 19104, USA
| | - Mrigendra B. Karmacharya
- Ultrasound Research Laboratory, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 3620 Hamilton Walk, Philadelphia, PA 19104, USA
| | - Susan M. Schultz
- Ultrasound Research Laboratory, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 3620 Hamilton Walk, Philadelphia, PA 19104, USA
| | - Angela K. Brice
- University Laboratory Animal Resources, University of Pennsylvania, 3800 Spruce Street, Philadelphia, PA 19104, USA
| | - Andrew K. W. Wood
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA
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Wood AKW, Sehgal CM. A review of low-intensity ultrasound for cancer therapy. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:905-28. [PMID: 25728459 PMCID: PMC4362523 DOI: 10.1016/j.ultrasmedbio.2014.11.019] [Citation(s) in RCA: 199] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 11/13/2014] [Accepted: 11/24/2014] [Indexed: 05/05/2023]
Abstract
The literature describing the use of low-intensity ultrasound in four major areas of cancer therapy-sonodynamic therapy, ultrasound-mediated chemotherapy, ultrasound-mediated gene delivery and anti-vascular ultrasound therapy-was reviewed. Each technique consistently resulted in the death of cancer cells, and the bio-effects of ultrasound were attributed primarily to thermal actions and inertial cavitation. In each therapeutic modality, theranostic contrast agents composed of microbubbles played a role in both therapy and vascular imaging. The development of these agents is important as it establishes a therapeutic-diagnostic platform that can monitor the success of anti-cancer therapy. Little attention, however, has been given either to the direct assessment of the mechanisms underlying the observed bio-effects or to the viability of these therapies in naturally occurring cancers in larger mammals; if such investigations provided encouraging data, there could be prompt application of a therapy technique in the treatment of cancer patients.
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Affiliation(s)
- Andrew K W Wood
- Department Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Chandra M Sehgal
- Department of Radiology, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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Fröhlich E, Muller R, Cui XW, Schreiber-Dietrich D, Dietrich CF. Dynamic contrast-enhanced ultrasound for quantification of tissue perfusion. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2015; 34:179-96. [PMID: 25614391 DOI: 10.7863/ultra.34.2.179] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Dynamic contrast-enhanced ultrasound (US) imaging, a technique that uses microbubble contrast agents with diagnostic US, has recently been technically summarized and reviewed by a European Federation of Societies for Ultrasound in Medicine and Biology position paper. However, the practical applications of this imaging technique were not included. This article reviews and discusses the published literature on the clinical use of dynamic contrast-enhanced US. This review finds that dynamic contrast-enhanced US imaging is the most sensitive cross-sectional real-time method for measuring the perfusion of parenchymatous organs noninvasively. It can measure parenchymal perfusion and therefore can differentiate between benign and malignant tumors. The most important routine clinical role of dynamic contrast-enhanced US is the prediction of tumor responses to chemotherapy within a very short time, shorter than using Response Evaluation Criteria in Solid Tumors criteria. Other applications found include quantifying the hepatic transit time, diabetic kidneys, transplant grafts, and Crohn disease. In addition, the problems involved in using dynamic contrast-enhanced US are discussed.
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Affiliation(s)
- Eckhart Fröhlich
- Department of Internal Medicine I, Karl-Olga-Krankenhaus Stuttgart, Academic Teaching Hospital of the University of Ulm, Germany (E.F.); Tropical Health Solutions Pty, Ltd, and Anton-Breinl Center, James Cook University, Townsville City, Queensland, Australia (R.M.); Sino-German Research Center of Ultrasound in Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China, and Department of Internal Medicine II, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany (X.-W.C., D.S.-D., C.F.D.)
| | - Reinhold Muller
- Department of Internal Medicine I, Karl-Olga-Krankenhaus Stuttgart, Academic Teaching Hospital of the University of Ulm, Germany (E.F.); Tropical Health Solutions Pty, Ltd, and Anton-Breinl Center, James Cook University, Townsville City, Queensland, Australia (R.M.); Sino-German Research Center of Ultrasound in Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China, and Department of Internal Medicine II, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany (X.-W.C., D.S.-D., C.F.D.)
| | - Xin-Wu Cui
- Department of Internal Medicine I, Karl-Olga-Krankenhaus Stuttgart, Academic Teaching Hospital of the University of Ulm, Germany (E.F.); Tropical Health Solutions Pty, Ltd, and Anton-Breinl Center, James Cook University, Townsville City, Queensland, Australia (R.M.); Sino-German Research Center of Ultrasound in Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China, and Department of Internal Medicine II, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany (X.-W.C., D.S.-D., C.F.D.)
| | - Dagmar Schreiber-Dietrich
- Department of Internal Medicine I, Karl-Olga-Krankenhaus Stuttgart, Academic Teaching Hospital of the University of Ulm, Germany (E.F.); Tropical Health Solutions Pty, Ltd, and Anton-Breinl Center, James Cook University, Townsville City, Queensland, Australia (R.M.); Sino-German Research Center of Ultrasound in Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China, and Department of Internal Medicine II, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany (X.-W.C., D.S.-D., C.F.D.)
| | - Christoph F Dietrich
- Department of Internal Medicine I, Karl-Olga-Krankenhaus Stuttgart, Academic Teaching Hospital of the University of Ulm, Germany (E.F.); Tropical Health Solutions Pty, Ltd, and Anton-Breinl Center, James Cook University, Townsville City, Queensland, Australia (R.M.); Sino-German Research Center of Ultrasound in Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China, and Department of Internal Medicine II, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany (X.-W.C., D.S.-D., C.F.D.).
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Angilè F, Vargo KB, Sehgal CM, Hammer DA, Lee D. Recombinant protein-stabilized monodisperse microbubbles with tunable size using a valve-based microfluidic device. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2014; 30:12610-8. [PMID: 25265041 PMCID: PMC4211726 DOI: 10.1021/la502610c] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 08/21/2014] [Indexed: 05/05/2023]
Abstract
Microbubbles are used as contrast enhancing agents in ultrasound sonography and more recently have shown great potential as theranostic agents that enable both diagnostics and therapy. Conventional production methods lead to highly polydisperse microbubbles, which compromise the effectiveness of ultrasound imaging and therapy. Stabilizing microbubbles with surfactant molecules that can impart functionality and properties that are desirable for specific applications would enhance the utility of microbubbles. Here we generate monodisperse microbubbles with a large potential for functionalization by combining a microfluidic method and recombinant protein technology. Our microfluidic device uses an air-actuated membrane valve that enables production of monodisperse microbubbles with narrow size distribution. The size of microbubbles can be precisely tuned by dynamically changing the dimension of the channel using the valve. The microbubbles are stabilized by an amphiphilic protein, oleosin, which provides versatility in controlling the functionalization of microbubbles through recombinant biotechnology. We show that it is critical to control the composition of the stabilizing agents to enable formation of highly stable and monodisperse microbubbles that are echogenic under ultrasound insonation. Our protein-shelled microbubbles based on the combination of microfluidic generation and recombinant protein technology provide a promising platform for ultrasound-related applications.
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Affiliation(s)
- Francesco
E. Angilè
- Department
of Chemical and Biomolecular Engineering and Department of Bioengineering, School
of Engineering and Applied Science, University
of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Kevin B. Vargo
- Department
of Chemical and Biomolecular Engineering and Department of Bioengineering, School
of Engineering and Applied Science, University
of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Chandra M. Sehgal
- Department
of Radiology, University of Pennsylvania
Medical Center, Philadelphia, Pennsylvania 19104, United States
| | - Daniel A. Hammer
- Department
of Chemical and Biomolecular Engineering and Department of Bioengineering, School
of Engineering and Applied Science, University
of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Daeyeon Lee
- Department
of Chemical and Biomolecular Engineering and Department of Bioengineering, School
of Engineering and Applied Science, University
of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
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6
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Maresca D, Skachkov I, Renaud G, Jansen K, van Soest G, de Jong N, van der Steen AFW. Imaging microvasculature with contrast-enhanced ultraharmonic ultrasound. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:1318-28. [PMID: 24613639 DOI: 10.1016/j.ultrasmedbio.2013.12.029] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 12/17/2013] [Accepted: 12/31/2013] [Indexed: 05/25/2023]
Abstract
Atherosclerotic plaque neovascularization was shown to be one of the strongest predictors of future cardiovascular events. Yet, the clinical tools for coronary wall microvasculature detection in vivo are lacking. Here we report an ultrasound pulse sequence capable of detecting microvasculature invisible in conventional intracoronary imaging. The method combines intravascular ultrasound with an ultrasound contrast agent, i.e., a suspension of microscopic vascular acoustic resonators that are small enough to penetrate the capillary bed after intravenous administration. The pulse sequence relies on brief chirp excitations to extract ultraharmonic echoes specific to the ultrasound contrast agent. We implemented the pulse sequence on an intravascular ultrasound probe and successfully imaged the microvasculature of a 6 days old chicken embryo respiratory organ. The feasibility of microvasculature imaging with intravascular ultrasound sets the stage for a translation of the method to studies of intra-plaque neovascularization detection in humans.
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Affiliation(s)
- David Maresca
- Biomedical Engineering Department, Thorax Centre, Erasmus University Medical Centre, Rotterdam, The Netherlands.
| | - Ilya Skachkov
- Biomedical Engineering Department, Thorax Centre, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Guillaume Renaud
- Biomedical Engineering Department, Thorax Centre, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Krista Jansen
- Biomedical Engineering Department, Thorax Centre, Erasmus University Medical Centre, Rotterdam, The Netherlands; Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
| | - Gijs van Soest
- Biomedical Engineering Department, Thorax Centre, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Nico de Jong
- Biomedical Engineering Department, Thorax Centre, Erasmus University Medical Centre, Rotterdam, The Netherlands; Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands; Imaging Science and Technology Department, Delft University of Technology, Delft, The Netherlands
| | - Antonius F W van der Steen
- Biomedical Engineering Department, Thorax Centre, Erasmus University Medical Centre, Rotterdam, The Netherlands; Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands; Imaging Science and Technology Department, Delft University of Technology, Delft, The Netherlands
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Saini R, Hoyt K. Recent developments in dynamic contrast-enhanced ultrasound imaging of tumor angiogenesis. ACTA ACUST UNITED AC 2014; 6:41-52. [PMID: 25221623 DOI: 10.2217/iim.13.74] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Angiogenesis is a critical process for tumor growth and metastatic dissemination. There is tremendous interest in the development of noninvasive methods for imaging tumor angiogenesis, and ultrasound (US) is an emerging platform technology to address this challenge. The introduction of intravascular microbubble contrast agents not only allows real-time visualization of tumor perfusion during an US examination, but they can be functionalized with specific ligands to permit molecular US imaging of angiogenic biomarkers that are overexpressed on the tumor endothelium. In this article, we will review current concepts and developing trends for US imaging of tumor angiogenesis, including relevant preclinical and clinicsal findings.
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Affiliation(s)
- Reshu Saini
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA ; Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kenneth Hoyt
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA ; Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL, USA ; Electrical & Computer Engineering, University of Alabama at Birmingham, Birmingham, AL, USA ; Comprehensive Cancer Center, University of Alabama at Birmingham, Volker Hall G082, 1670 University Boulevard, Birmingham, AL 35294, USA
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8
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Non-invasive quantification of tumor vascular architecture during docetaxel-chemotherapy. Breast Cancer Res Treat 2012; 134:1013-25. [DOI: 10.1007/s10549-012-2015-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Accepted: 02/29/2012] [Indexed: 10/28/2022]
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Assessment and monitoring tumor vascularity with contrast-enhanced ultrasound maximum intensity persistence imaging. Invest Radiol 2011; 46:187-95. [PMID: 21150790 DOI: 10.1097/rli.0b013e3181f9202d] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Contrast-enhanced ultrasound imaging is increasingly being used in the clinic for assessment of tissue vascularity. The purpose of our study was to evaluate the effect of different contrast administration parameters on the in vivo ultrasound imaging signal in tumor-bearing mice using a maximum intensity persistence (MIP) algorithm and to evaluate the reliability of in vivo MIP imaging in assessing tumor vascularity. The potential of in vivo MIP imaging for monitoring tumor vascularity during antiangiogenic cancer treatment was further evaluated. MATERIALS AND METHODS In intraindividual experiments, varying contrast microbubble concentrations (5 × 10⁵, 5 × 10⁶, 5 × 10⁷, 5 × 10⁸ microbubbles in 100 μL saline) and contrast injection rates (0.6, 1.2, and 2.4 mL/min) in subcutaneous tumor-bearing mice were applied and their effects on in vivo contrast-enhanced ultrasound MIP imaging plateau values were obtained using a dedicated small animal ultrasound imaging system (40 MHz). Reliability of MIP ultrasound imaging was tested following 2 injections of the same microbubble concentration (5 × 10⁷ microbubbles at 1.2 mL/min) in the same tumors. In mice with subcutaneous human colon cancer xenografts, longitudinal contrast-enhanced ultrasound MIP imaging plateau values (baseline and at 48 hours) were compared between mice with and without antiangiogenic treatment (antivascular endothelial growth factor antibody). Ex vivo CD31 immunostaining of tumor tissue was used to correlate in vivo MIP imaging plateau values with microvessel density analysis. RESULTS In vivo MIP imaging plateau values correlated significantly (P = 0.001) with contrast microbubble doses. At 3 different injection rates of 0.6, 1.2, and 2.4 mL/min, MIP imaging plateau values did not change significantly (P = 0.61). Following 2 injections with the same microbubble dose and injection rate, MIP imaging plateau values were obtained with high reliability with an intraclass correlation coefficient of 0.82 (95% confidence interval: 0.64, 0.94). In addition, in vivo MIP imaging plateau values significantly correlated (P = 0.01; R² = 0.77) with ex vivo microvessel density analysis. Tumor volumes in treated and nontreated mice did not change significantly (P = 0.22) within 48 hours. In contrast, the change of in vivo MIP imaging plateau values from baseline to 48 hours was significantly different (P = 0.01) in treated versus nontreated mice. CONCLUSIONS Contrast-enhanced ultrasound MIP imaging allows reliable assessment of tumor vascularity and monitoring of antiangiogenic cancer therapy in vivo, provided that a constant microbubble dose is administered.
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Perfusion in Peripheral Musculoskeletal Structures From Dynamic Volumetric Computed Tomography Using an En Bloc Approach. J Comput Assist Tomogr 2010; 34:626-32. [DOI: 10.1097/rct.0b013e3181d53258] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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11
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Wood AKW, Schultz SM, Lee WMF, Bunte RM, Sehgal CM. Antivascular ultrasound therapy extends survival of mice with implanted melanomas. ULTRASOUND IN MEDICINE & BIOLOGY 2010; 36:853-7. [PMID: 20381952 PMCID: PMC2905813 DOI: 10.1016/j.ultrasmedbio.2010.02.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Revised: 01/14/2010] [Accepted: 02/01/2010] [Indexed: 05/21/2023]
Abstract
The goal of this murine investigation was to evaluate the effect of an antivascular ultrasound treatment on the growth of an implanted melanoma and the consequent survival rate. After the intravenous injection of 0.2 mL ultrasound contrast agent (Definity), therapy (n = 15) was performed on 1-mL tumors for 3 min with low-intensity continuous ultrasound (3 MHz; 2.4 +/- 0.1 W cm(-2) [I(SATA)]); control mice (n = 17) received a sham treatment. Mice were euthanized once the tumor had reached 3 mL, and then survival percentage vs. time curves were plotted. The median survival time (time for tumor to reach 3 mL) for the treated group was 23 d and for the control group was 18 d; the difference was statistically significant (p <or= 0.0001). Antivascular ultrasound therapy reduced the growth rate of an implanted melanoma and increased survival time. The ultrasound therapy provides a further example of tumor vascular disruption, and its future clinical potential should be investigated.
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Affiliation(s)
- Andrew K W Wood
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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