Ultrasound and ovarian cancer screening: is there a future?

Time-intensity-curve Analysis and Tumor Extravasation of Nanobubble Ultrasound Contrast Agents

Our group recently presented a simple strategy using the non-ionic surfactant, Pluronic, as a size control excipient to produce nanobubbles in the 100-nm range, which exhibited stability and echogenicity on par with clinically available microbubbles. The objective of the present study was to evaluate biodistribution and extravasation of the Pluronic-stabilized lipid nanobubbles compared with microbubbles in 2 experimental tumor models in mice. Standard lipid-stabilized perfluoropropane bubbles (Pluronic L10) and lipid-stabilized perfluoropropane nanobubbles were intravenously injected into mice bearing either an orthotopic mouse breast cancer (BC4 T1) or subcutaneous mouse ovarian cancer (OVCAR-3) through the tail vein to perform perfusion dynamic studies. No significant differences between the nanobubble and microbubble groups were observed in the peak enhancement of the 3 tested regions (tumor, liver and kidney). However, the decay rates of nanobubble in the tumor and kidney of BC4 T1-bearing mice, as well as in mice with OVRCAR-3 tumors were significantly slower than those of the microbubble. To quantify extravasation, fluorescently labeled bubbles were intravenously injected into mice bearing the same tumors. Histologic analysis showed that nanobubbles were retained in tumor tissue to a greater extent compared with microbubbles in both tumor models at the 3-h time point. Our results demonstrate unique nanobubble behavior compared with microbubbles and support augmented application of these agents in ultrasound molecular imaging and drug delivery beyond the tumor vasculature.

Comparison of diagnostic values between CA125 combined with CA199 and ultrasound combined with CT in ovarian cancer

Application values of CA125 combined with CA199 and ultrasound combined with computed tomography (CT) in the clinical diagnosis of ovarian cancer were compared. A retrospective analysis was performed on 168 ovarian cancer patients admitted to the Department of Gynecology in Jining No.1 People's Hospital from July 2013 to March 2016. Of the patients 107 with malignant tumors were in the malignant group, and 61 patients with benign tumors were in the benign group. Another 98 healthy controls in the same period were in the normal group. Chemiluminescence was used for the detection of levels of tumor markers CA125 and CA199 in the serum of all patients. CA125 combined with CA199 and color Doppler ultrasound combined with CT scan were used to diagnose and analyze the sensitivity, specificity, accuracy, and positive detection rate of ovarian cancer patients at different stages. The sensitivity, specificity and diagnostic coincidence rate of ultrasound combined with CT in the diagnosis of ovarian cancer were 97.20, 80.32 and 91.07%, respectively, which were significantly higher than the 92.52, 73.77 and 85.71% of serum CA125 combined with CA199. The positive detection rate of ultrasound combined with CT in the early diagnosis of ovarian cancer was 93.55%, higher than 83.87% of CA125 combined with CA199. The sensitivity, specificity, coincidence rate and positive detection rate of ultrasound combined with CT in the diagnosis were higher than those of CA125 combined with CA199. In the actual diagnosis process, these two diagnostic schemes can be selectively and comprehensively applied, so as to make a correct diagnosis, which is of great significance for reducing patient mortality.

Ultrasound molecular imaging of ovarian cancer with CA-125 targeted nanobubble contrast agents

Ultrasound is frequently utilized in diagnosis of gynecologic malignancies such as ovarian cancer. Because epithelial ovarian cancer (EOC) is often characterized by overexpression of cancer antigen 125 (CA-125), ultrasound contrast agents able to target this molecular signature could be a promising complementary strategy. In this work, we demonstrate application of CA-125-targeted echogenic lipid and surfactant-stabilized nanobubbles imaged with standard clinical contrast harmonic ultrasound for imaging of CA-125 positive OVCAR-3 tumors in mice. Surface functionalization of the nanobubbles with a CA-125 antibody achieved rapid significantly (P < 0.05) enhanced tumor accumulation, higher peak ultrasound signal intensity and slower wash out rates in OVCAR-3 tumors compared to CA-125 negative SKOV-3 tumors. Targeted nanobubbles also exhibited increased tumor retention and prolonged echogenicity compared to untargeted nanobubbles. Data suggest that ultrasound molecular imaging using CA-125 antibody-conjugated nanobubbles may contribute to improved diagnosis of EOC.