1
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Navarro-Becerra JA, Castillo JI, Di Ruzza F, Borden MA. Monodispersity Increases Adhesion Efficiency and Specificity for Ultrasound-Targeted Microbubbles. ACS Biomater Sci Eng 2023; 9:991-1001. [PMID: 36153974 DOI: 10.1021/acsbiomaterials.2c00528] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Ultrasound molecular imaging with targeted microbubbles (MBs) can be used to noninvasively diagnose, monitor, and study the progression of different endothelial-associated diseases. Acoustic radiation force (Frad) can initiate and enhance MB adhesion at the target site. The goal of this study was to elucidate the effects of various MB parameters on Frad targeting. Monodisperse or polydisperse MBs with the immune-stealth cloaked (buried)-ligand architecture were conjugated with targeting RGD or nonspecific isotype control RAD peptides and then pumped through an αvβ3 integrin-coated microvessel phantom at a wall shear stress of 3.5 dyn/cm2. Targeting was assessed by measuring MB attachment for varying Frad time and frequency, as well as MB concentration and size distribution. We first confirmed that primary Frad is necessary to target the cloaked-ligand MBs. MB targeting increased monotonically with αvβ3 integrin density and Frad time. MB attachment and, to a lesser extent specificity, also increased when driven by Frad near resonance. MB targeting increased with MB concentration, although a shift in behavior was observed with increasing MB-MB interactions and aggregations forming from secondary Frad effects as MB concentration was increased. These secondary Frad effects reduced targeting specificity. Finally, after having validated our approach by testing different parameters with the appropriate controls, we then determined the effects of monodispersity on adhesion efficiency and specific targeting. We observed that both MB targeting efficiency and specificity were greatly enhanced for monodisperse vs polydisperse MBs. Analysis of videomicroscopy images indicated that secondary Frad effects may have disproportionally inhibited targeting of polydisperse MBs. In conclusion, our in vitro results indicate that monodisperse MBs driven near resonance and at a low concentration (∼106 MB/mL) can be used to maximize the adhesion efficiency (up to 88%) and specificity of RGD-MB targeting.
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Affiliation(s)
- J Angel Navarro-Becerra
- Mechanical Engineering Department, University of Colorado Boulder, Boulder, Colorado 80309-0427, United States
| | - Jair I Castillo
- Biomedical Engineering Program, University of Colorado Boulder, Boulder, Colorado 80309-0427, United States
| | - Federico Di Ruzza
- Biomedical Engineering Program, University of Colorado Boulder, Boulder, Colorado 80309-0427, United States.,Chemical Science and Technology Department, University of Rome Tor Vergata, Roma 00133, Italy
| | - Mark A Borden
- Mechanical Engineering Department, University of Colorado Boulder, Boulder, Colorado 80309-0427, United States.,Biomedical Engineering Program, University of Colorado Boulder, Boulder, Colorado 80309-0427, United States
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2
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Borden MA, Shakya G, Upadhyay A, Song KH. Acoustic Nanodrops for Biomedical Applications. Curr Opin Colloid Interface Sci 2020; 50:101383. [PMID: 33100885 PMCID: PMC7581261 DOI: 10.1016/j.cocis.2020.08.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Acoustic nanodrops are designed to vaporize into ultrasound-responsive microbubbles, which presents certain challenges nonexistent for conventional nano-emulsions. The requirements of biocompatibility, vaporizability and colloidal stability has focused research on perfluorocarbons (PFCs). Shorter PFCs yield better vaporizability via their lower critical temperature, but they also dissolve more easily owing to their higher vapor pressure and solubility. Thus, acoustic nanodrops have required a tradeoff between vaporizability and colloidal stability in vivo. The recent advent of vaporizable endoskeletal droplets, which are both stable and vaporizable, may have solved this problem. The purpose of this review is to justify this premise by pointing out the beneficial properties of acoustic nanodrops, providing an analysis of vaporization and dissolution mechanisms, and reviewing current biomedical applications.
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Affiliation(s)
- Mark A. Borden
- Biomedical Engineering, Mechanical Engineering, University of Colorado, Boulder, USA
| | - Gazendra Shakya
- Biomedical Engineering, Mechanical Engineering, University of Colorado, Boulder, USA
| | - Awaneesh Upadhyay
- Biomedical Engineering, Mechanical Engineering, University of Colorado, Boulder, USA
| | - Kang-Ho Song
- Biomedical Engineering, Mechanical Engineering, University of Colorado, Boulder, USA
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3
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Supponen O, Upadhyay A, Lum J, Guidi F, Murray T, Vos HJ, Tortoli P, Borden M. The effect of size range on ultrasound-induced translations in microbubble populations. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2020; 147:3236. [PMID: 32486824 PMCID: PMC7205472 DOI: 10.1121/10.0001172] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 03/17/2020] [Accepted: 04/13/2020] [Indexed: 06/11/2023]
Abstract
Microbubble translations driven by ultrasound-induced radiation forces can be beneficial for applications in ultrasound molecular imaging and drug delivery. Here, the effect of size range in microbubble populations on their translations is investigated experimentally and theoretically. The displacements within five distinct size-isolated microbubble populations are driven by a standard ultrasound-imaging probe at frequencies ranging from 3 to 7 MHz, and measured using the multi-gate spectral Doppler approach. Peak microbubble displacements, reaching up to 10 μm per pulse, are found to describe transient phenomena from the resonant proportion of each bubble population. The overall trend of the statistical behavior of the bubble displacements, quantified by the total number of identified displacements, reveals significant differences between the bubble populations as a function of the transmission frequency. A good agreement is found between the experiments and theory that includes a model parameter fit, which is further supported by separate measurements of individual microbubbles to characterize the viscoelasticity of their stabilizing lipid shell. These findings may help to tune the microbubble size distribution and ultrasound transmission parameters to optimize the radiation-force translations. They also demonstrate a simple technique to characterize the microbubble shell viscosity, the fitted model parameter, from freely floating microbubble populations using a standard ultrasound-imaging probe.
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Affiliation(s)
- Outi Supponen
- Department of Mechanical and Process Engineering, ETH Zurich, Sonneggstrasse 3, 8092 Zurich, Switzerland
| | - Awaneesh Upadhyay
- Department of Mechanical Engineering, University of Colorado Boulder, 1111 Engineering Drive, Boulder, Colorado 80309, USA
| | - Jordan Lum
- Department of Mechanical Engineering, University of Colorado Boulder, 1111 Engineering Drive, Boulder, Colorado 80309, USA
| | - Francesco Guidi
- Department of Information Engineering, University of Florence, Via di S. Marta 3, 50139 Florence, Italy
| | - Todd Murray
- Department of Mechanical Engineering, University of Colorado Boulder, 1111 Engineering Drive, Boulder, Colorado 80309, USA
| | - Hendrik J. Vos
- Department of Biomedical Engineering, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Piero Tortoli
- Department of Information Engineering, University of Florence, Via di S. Marta 3, 50139 Florence, Italy
| | - Mark Borden
- Department of Mechanical Engineering, University of Colorado Boulder, 1111 Engineering Drive, Boulder, Colorado 80309, USA
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4
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Guidi F, Supponen O, Upadhyay A, Vos HJ, Borden MA, Tortoli P. Microbubble Radiation Force-Induced Translation in Plane-Wave Versus Focused Transmission Modes. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2019; 66:1856-1865. [PMID: 31449011 PMCID: PMC6900931 DOI: 10.1109/tuffc.2019.2937158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Due to the primary radiation force, microbubble displacement has been observed previously in the focal region of single-element and array ultrasound probes. This effect has been harnessed to increase the contact between the microbubbles and targeted endothelium for drug delivery and ultrasound molecular imaging. In this study, microbubble displacements associated with plane-wave (PW) transmission are thoroughly investigated and compared to those obtained in focused-wave (FW) transmission over a range of pulse repetition frequencies, burst lengths (BLs), peak negative pressures, and transmission frequencies. In PW mode, the displacements, depending upon the experimental conditions, are in some cases consistently higher (e.g., by 28%, when the longest BL was used at PRF = 4 kHz), and the axial displacements are spatially more uniform compared to FW mode. Statistical analysis on the measured displacements reveals a slightly different frequency dependence of statistical quantities compared to transient peak microbubble displacements, which may suggest the need to consider the size range within the tested microbubble population.
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Affiliation(s)
- Francesco Guidi
- Department of Information Engineering, University of Florence, Italy
| | - Outi Supponen
- Department of Mechanical Engineering, University of Colorado, Boulder, USA
| | - Awaneesh Upadhyay
- Department of Mechanical Engineering, University of Colorado, Boulder, USA
| | - Hendrik J. Vos
- Biomedical Engineering Thorax Center, Erasmus MC Rotterdam, The Netherlands
| | - Mark A. Borden
- Department of Mechanical Engineering, University of Colorado, Boulder, USA
| | - Piero Tortoli
- Department of Information Engineering, University of Florence, Italy
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5
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Acconcia CN, Leung BYC, Winch G, Wang J, Hynynen K, Goertz DE. Acoustic radiation force induced accumulation and dynamics of microbubbles on compliant surfaces. Phys Med Biol 2019; 64:135003. [PMID: 31082815 DOI: 10.1088/1361-6560/ab2163] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Ultrasound stimulated microbubbles have been shown to be capable of breaking up blood clots through micro-scale interactions occurring near the clot surface. However, only a small fraction of bubbles circulating in the bloodstream will be in close proximity to such boundaries, where they must be to elicit therapeutic effects. Here, the accumulation and subsequent behavior of microbubbles displaced from an overlying flow channel to a boundary under radiation forces were examined. Experimental data were acquired using a novel high speed microscopy configuration and simulations were conducted to provide insight into the accumulation process. There was broad agreement between experiments and simulations, both indicating that the size distribution and number of bubbles arriving at the boundary depended on channel flow rate, applied pressure, and bubble concentration. For example, higher flow rates and lower pressures favored the accumulation of larger bubbles relative to the native agent distribution. Moreover, bubble dynamics were dependent on the surface type, exhibiting rapid translation along agarose gel surfaces whereas on fibrin surfaces, they accumulated in localized regions inducing repetitive strain cycles. The results indicate that the process of bringing bubbles from within a vessel to a boundary is complex and should be an important consideration in the development of therapeutic applications such as sonothrombolysis.
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Affiliation(s)
- Christopher N Acconcia
- Department of Medical Biophysics, University of Toronto, Toronto, M5S 1A1, Canada. Sunnybrook Research Institute, 2075 Bayview Avenue, M4N 3M5, Toronto, Canada. These authors contributed equally
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6
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Blue LM, Guidi F, Vos HJ, Slagle CJ, Borden MA, Tortoli P. Plane-Wave Contrast Imaging: A Radiation Force Point of View. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2018; 65:2296-2300. [PMID: 29994658 PMCID: PMC6321741 DOI: 10.1109/tuffc.2018.2847899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Radiation force is known to produce microbubble axial displacements by an amount that depends on the transmit burst frequency, amplitude, and length, as well as the pulse repetition frequency (PRF). In the standard focused-imaging mode, the actual PRF experienced by each microbubble is low, because it is of the order of the frame rate (i.e., usually tens of Hertz). In the plane-wave imaging mode, however, the actual PRF is considerably higher, as it is equivalent to the transmit PRF (kiloHertz range). Furthermore, the radiation pressure is expected to be almost uniform over the field of view, and typically lower than the peak pressure experienced in the focused transmit (TX) mode. We have experimentally investigated the possible effects of radiation force in the plane-wave mode. Here, we report on preliminary findings that show that the acoustic radiation force is negligible only at lower TX levels. At higher TX amplitudes, the bubble displacements due to radiation force are comparable to those obtained for focused waves at the same PRF. In addition, the radiation force is nearly uniform over the field of view and increases as the TX burst central frequency approaches the resonance frequency of size-isolated microbubbles.
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Affiliation(s)
- Lauchlin M. Blue
- Department of Mechanical Engineering, University of Colorado at Boulder, Boulder, CO
| | - Francesco Guidi
- Department of Information Engineering, University of Florence, Florence, Italy
| | - Hendrik J. Vos
- Biomedical Engineering, Thorax Center, Erasmus MC, Rotterdam, The Netherlands
| | - Connor J. Slagle
- Department of Mechanical Engineering, University of Colorado at Boulder, Boulder, CO
| | - Mark A. Borden
- Department of Mechanical Engineering, University of Colorado at Boulder, Boulder, CO ()
| | - Piero Tortoli
- Department of Information Engineering, University of Florence, Florence, Italy ()
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7
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Acconcia CN, Wright A, Goertz DE. Translational dynamics of individual microbubbles with millisecond scale ultrasound pulses. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2018; 144:2859. [PMID: 30522286 DOI: 10.1121/1.5063353] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 09/24/2018] [Indexed: 06/09/2023]
Abstract
It is established that radiation forces can be used to transport ultrasound contrast agents, particularly for molecular imaging applications. However, the ability to model and control this process in the context of therapeutic ultrasound is limited by a paucity of data on the translational dynamics of encapsulated microbubbles under the influence of longer pulses. In this work, the translation of individual microbubbles, isolated with optical tweezers, was experimentally investigated over a range of diameters (1.8-8.8 μm, n = 187) and pressures (25, 50, 100, 150, and 200 kPa) with millisecond pulses. Data were compared with theoretical predictions of the translational dynamics, assessing the role of shell and history force effects. A pronounced feature of the displacement curves was an effective threshold size, below which there was only minimal translation. At higher pressures (≥150 kPa) a noticeable structure emerged where multiple local maxima occurred as a function of bubble size. The ability to accurately capture these salient features depended on the encapsulation model employed. In low Reynolds number conditions (i.e., low pressures, or high pressures, off-resonance) the inclusion of history force more accurately fit the data. After pulse cessation, bubbles exhibited substantial displacements consistent with the influence of history effects.
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Affiliation(s)
| | - Alex Wright
- Sunnybrook Research Institute, 2075 Bayview Avenue, M4N 3M5, Toronto, Canada
| | - David E Goertz
- Department of Medical Biophysics, University of Toronto, Toronto, M5S 1A1, Canada
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8
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Slagle CJ, Thamm DH, Randall EK, Borden MA. Click Conjugation of Cloaked Peptide Ligands to Microbubbles. Bioconjug Chem 2018; 29:1534-1543. [DOI: 10.1021/acs.bioconjchem.8b00084] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Connor J. Slagle
- Department of Mechanical Engineering, University of Colorado, Boulder, Colorado 80309, United States
| | | | | | - Mark A. Borden
- Department of Mechanical Engineering, University of Colorado, Boulder, Colorado 80309, United States
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9
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Nejad SM, Hosseini H, Akiyama H, Tachibana K. Reparable Cell Sonoporation in Suspension: Theranostic Potential of Microbubble. Am J Cancer Res 2016; 6:446-55. [PMID: 26941839 PMCID: PMC4775856 DOI: 10.7150/thno.13518] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 12/31/2015] [Indexed: 12/02/2022] Open
Abstract
The conjunction of low intensity ultrasound and encapsulated microbubbles can alter the permeability of cell membrane, offering a promising theranostic technique for non-invasive gene/drug delivery. Despite its great potential, the biophysical mechanisms of the delivery at the cellular level remains poorly understood. Here, the first direct high-speed micro-photographic images of human lymphoma cell and microbubble interaction dynamics are provided in a completely free suspension environment without any boundary parameter defect. Our real-time images and theoretical analyses prove that the negative divergence side of the microbubble's dipole microstreaming locally pulls the cell membrane, causing transient local protrusion of 2.5 µm in the cell membrane. The linear oscillation of microbubble caused microstreaming well below the inertial cavitation threshold, and imposed 35.3 Pa shear stress on the membrane, promoting an area strain of 0.12%, less than the membrane critical areal strain to cause cell rupture. Positive transfected cells with pEGFP-N1 confirm that the interaction causes membrane poration without cell disruption. The results show that the overstretched cell membrane causes reparable submicron pore formation, providing primary evidence of low amplitude (0.12 MPa at 0.834 MHz) ultrasound sonoporation mechanism.
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10
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Lindsey BD, Rojas JD, Dayton PA. On the relationship between microbubble fragmentation, deflation and broadband superharmonic signal production. ULTRASOUND IN MEDICINE & BIOLOGY 2015; 41:1711-25. [PMID: 25766572 PMCID: PMC4778426 DOI: 10.1016/j.ultrasmedbio.2014.12.668] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 12/18/2014] [Accepted: 12/20/2014] [Indexed: 05/19/2023]
Abstract
Acoustic angiography imaging of microbubble contrast agents uses the superharmonic energy produced from excited microbubbles and enables high-contrast, high-resolution imaging. However, the exact mechanism by which broadband harmonic energy is produced is not fully understood. To elucidate the role of microbubble shell fragmentation in superharmonic signal production, simultaneous optical and acoustic measurements were performed on individual microbubbles at transmit frequencies from 1.75 to 3.75 MHz and pressures near the shell fragmentation threshold for microbubbles of varying diameter. High-amplitude, broadband superharmonic signals were produced with shell fragmentation, whereas weaker signals (approximately 25% of peak amplitude) were observed in the presence of shrinking bubbles. Furthermore, when populations of stationary microbubbles were imaged with a dual-frequency ultrasound imaging system, a sharper decline in image intensity with respect to frame number was observed for 1-μm bubbles than for 4-μm bubbles. Finally, in a study of two rodents, increasing frame rate from 4 to 7 Hz resulted in decreases in mean steady-state image intensity of 27% at 1000 kPa and 29% at 1300 kPa. Although the existence of superharmonic signals when bubbles shrink has the potential to prolong the imaging efficacy of microbubbles, parameters such as frame rate and peak pressure must be balanced with expected re-perfusion rate to maintain adequate contrast during in vivo imaging.
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Affiliation(s)
- Brooks D Lindsey
- Joint Department of Biomedical Engineering, University of North Carolina-Chapel Hill and North Carolina State University, Raleigh, North Carolina, USA
| | - Juan D Rojas
- Joint Department of Biomedical Engineering, University of North Carolina-Chapel Hill and North Carolina State University, Raleigh, North Carolina, USA
| | - Paul A Dayton
- Joint Department of Biomedical Engineering, University of North Carolina-Chapel Hill and North Carolina State University, Raleigh, North Carolina, USA.
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11
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Segers T, de Jong N, Lohse D, Versluis M. Microbubbles for Medical Applications. MICROFLUIDICS FOR MEDICAL APPLICATIONS 2014. [DOI: 10.1039/9781849737593-00081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Ultrasound contrast agent (UCA) suspensions contain encapsulated microbubbles with radii ranging from 1 to 10 micrometers. The bubbles oscillate to the driving ultrasound pulse generating harmonics of the driving ultrasound frequency. This feature allows for the discrimination of non-linear bubble echoes from linear tissue echoes facilitating the visualization and quantification of blood perfusion in organs. Targeting the microbubbles to specific receptors in the body has led to molecular imaging application with ultrasound and targeted drug delivery with drug-loaded microbubbles. Traditional UCA production methods offer high yield but poor control over the microbubble size and uniformity. Medical ultrasound transducers typically operate at a single frequency, therefore only a small selection of bubbles resonates to the driving ultrasound pulse. Here we discuss recent lab-on-a-chip based production and sorting methods that have been shown to produce highly monodisperse bubbles, thereby improving the sensitivity of contrast-enhanced ultrasound imaging and molecular imaging with microbubbles. Moreover, monodisperse UCA show great potential for targeted drug delivery by the well-controlled bubble response.
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Affiliation(s)
- Tim Segers
- Physics of Fluids Group, MIRA Institute for Biomedical Technology and Technical Medicine, MESA+ Institute for Nanotechnology, University of Twente PO Box 217 7500 AE Enschede The Netherlands
| | - Nico de Jong
- Physics of Fluids Group, MIRA Institute for Biomedical Technology and Technical Medicine, MESA+ Institute for Nanotechnology, University of Twente PO Box 217 7500 AE Enschede The Netherlands
| | - Detlef Lohse
- Physics of Fluids Group, MIRA Institute for Biomedical Technology and Technical Medicine, MESA+ Institute for Nanotechnology, University of Twente PO Box 217 7500 AE Enschede The Netherlands
| | - Michel Versluis
- Physics of Fluids Group, MIRA Institute for Biomedical Technology and Technical Medicine, MESA+ Institute for Nanotechnology, University of Twente PO Box 217 7500 AE Enschede The Netherlands
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12
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Kooiman K, Vos HJ, Versluis M, de Jong N. Acoustic behavior of microbubbles and implications for drug delivery. Adv Drug Deliv Rev 2014; 72:28-48. [PMID: 24667643 DOI: 10.1016/j.addr.2014.03.003] [Citation(s) in RCA: 245] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 02/11/2014] [Accepted: 03/18/2014] [Indexed: 12/21/2022]
Abstract
Ultrasound contrast agents are valuable in diagnostic ultrasound imaging, and they increasingly show potential for drug delivery. This review focuses on the acoustic behavior of flexible-coated microbubbles and rigid-coated microcapsules and their contribution to enhanced drug delivery. Phenomena relevant to drug delivery, such as non-spherical oscillations, shear stress, microstreaming, and jetting will be reviewed from both a theoretical and experimental perspective. Further, the two systems for drug delivery, co-administration and the microbubble as drug carrier system, are reviewed in relation to the microbubble behavior. Finally, future prospects are discussed that need to be addressed for ultrasound contrast agents to move from a pre-clinical tool into a clinical setting.
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13
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Lin F, Cachard C, Mori R, Varray F, Guidi F, Basset O. Ultrasound contrast imaging: influence of scatterer motion in multi-pulse techniques. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2013; 60:2065-2078. [PMID: 24081255 DOI: 10.1109/tuffc.2013.2797] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
In ultrasound contrast imaging, many techniques based on multiple transmissions have been proposed to increase the contrast-to-tissue ratio (CTR). They are generally based on the response of static scatterers inside the imaged region. However, scatterer motion, for example in blood vessels, has an inevitable influence on multi-pulse techniques, which can either enhance or degrade the technique involved. This paper investigates the response of static nonlinear media insonated by multi-pulses with various phase shifts, and the influence of scatterer motion on multi-pulse techniques. Simulations and experimental results from a single bubble and clouds of bubbles show that the phase shift of the echoes backscattered from bubbles is dependent on the transmissions' phase shift, and that the bubble motion influences the efficiency of multi-pulse techniques: fundamental and second-harmonic amplitudes of the processed signal change periodically, exhibiting maximum or minimum values, according to scatterer motion. Furthermore, experimental results based on the second-harmonic inversion (SHI) technique reveal that bubble motion can be taken into account to regulate the pulse repetition frequency (PRF). With the optimal PRF, the CTR of SHI images can be improved by about 12 dB compared with second-harmonic images.
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14
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Paul S, Russakow D, Rodgers T, Sarkar K, Cochran M, Wheatley M. Determination of the interfacial rheological properties of a poly(DL-lactic acid)-encapsulated contrast agent using in vitro attenuation and scattering. ULTRASOUND IN MEDICINE & BIOLOGY 2013; 39:1277-91. [PMID: 23643050 PMCID: PMC3674163 DOI: 10.1016/j.ultrasmedbio.2013.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2012] [Revised: 02/06/2013] [Accepted: 02/11/2013] [Indexed: 05/22/2023]
Abstract
The stabilizing encapsulation of a microbubble-based ultrasound contrast agent (UCA) critically affects its acoustic properties. Polymers, which behave differently from materials commonly used (i.e., lipids or proteins) for monolayer encapsulation, have the potential for better stability and improved control of encapsulation properties. Air-filled microbubbles coated with poly(DL-lactic acid) (PLA) are characterized here using in vitro acoustic experiments and several models of encapsulation. The interfacial rheological properties of the encapsulation are determined according to each model using attenuation of ultrasound through a suspension of microbubbles. Then the model predictions are compared with scattered non-linear (sub- and second harmonic) responses. For this microbubble population (average diameter, 1.9 μm), the peak in attenuation measurement indicates a weighted-average resonance frequency of 2.5-3 MHz, which, in contrast to other encapsulated microbubbles, is lower than the resonance frequency of a free bubble of similar size (diameter, 1.9 μm). This apparently contradictory result stems from the extremely low surface dilational elasticity (around 0.01-0.07 N/m) and the reduced surface tension of the poly(DL-lactic acid) encapsulation, as well as the polydispersity of the bubble population. All models considered here are shown to behave similarly even in the non-linear regime because of the low surface dilational elasticity value. Pressure-dependent scattering measurements at two different excitation frequencies (2.25 and 3 MHz) revealed strongly non-linear behavior with 25-30 dB and 5-20 dB enhancements in fundamental and second-harmonic responses, respectively, for a contrast agent concentration of 1.33 μg/mL in the suspension. Sub-harmonic responses are registered above a relatively low generation threshold of 100-150 kPa, with up to 20 dB enhancement beyond that pressure. Numerical predictions from all models show good agreement with the experimentally measured fundamental response, but not with the experimental second-harmonic response. The characteristic features of sub-harmonic responses and the steady response beyond the threshold are matched well by model predictions. However, prediction of the threshold value depends on estimated properties and size distribution. The variation in size distribution from sample to sample leads to variation in estimates of encapsulation properties: the lowest estimated value for surface dilational viscosity better predicts the sub-harmonic threshold.
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Affiliation(s)
- Shirshendu Paul
- Mechanical Engineering, University of Delaware, Newark, DE 19716
| | - Daniel Russakow
- Mechanical Engineering, University of Delaware, Newark, DE 19716
| | - Tyler Rodgers
- Mechanical Engineering, University of Delaware, Newark, DE 19716
| | - Kausik Sarkar
- Mechanical Engineering, University of Delaware, Newark, DE 19716
- Mechanical and Aerospace Engineering, George Washington University, Washington, DC 20052
| | - Michael Cochran
- Biomedical Engineering, Drexel University, Philadelphia, PA 19104
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15
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Couture O, Fink M, Tanter M. Ultrasound contrast plane wave imaging. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2012; 59:2676-83. [PMID: 23221216 DOI: 10.1109/tuffc.2012.2508] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND Monitoring the accumulation of microbubbles within tissue vasculature with ultrasound allows both molecular and perfusion imaging. Unfortunately, conventional imaging with focused pulses can destroy a large fraction of the microbubbles it is trying to follow. Using coherent synthetic summation, ultrafast plane wave imaging could attain similar image quality, while reducing the peak acoustic pressure and bubble disruption. METHOD In these experiments, microbubbles were flowed in a wall-less vessel phantom. Images were obtained on a programmable clinical scanner with a set of line-per-line focused pulses for conventional contrast imaging and with compounded plane wave transmission adapted for nonlinear imaging. Imaging was performed between 14 and 650 kPa peak negative pressure at 7.5 MHz. The disruption of the microbubbles was evaluated by comparing the microbubble intensity before and after acquisition of a set of 100 images at various pressures. RESULTS The acoustic intensity required to disrupt 50% of the microbubbles was 24 times higher with plane-wave imaging compared with conventional focused pulses. Although both imaging approaches yield similar resolution, at the same disruption level, plane-wave imaging showed better contrast. In particular, at similar disruption ratio (50% after 100 images), contrast-pulse sequencing (CPS) performed with plane waves displayed an improvement of 11 dB compared with conventional nonlinear imaging. CONCLUSION In each resolution cell of the image, plane-wave imaging spread the spatial peak acoustic intensity over more pulses, reducing the peak pressure and, hence, preserving the microbubbles. This method could contribute to molecular imaging by allowing the continuous monitoring of the accumulation of microbubbles with improved contrast.
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Ménigot S, Girault JM, Voicu I. Optimisation des paramètres fréquentiels du signal d’émission appliquée à l’imagerie de contraste ultrasonore du second harmonique. Ing Rech Biomed 2012. [DOI: 10.1016/j.irbm.2012.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sciallero C, Paradossi G, Trucco A. A preliminary in vitro assessment of polymer-shelled microbubbles in contrast-enhanced ultrasound imaging. ULTRASONICS 2012; 52:456-64. [PMID: 22133737 DOI: 10.1016/j.ultras.2011.10.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 09/27/2011] [Accepted: 10/19/2011] [Indexed: 05/05/2023]
Abstract
This paper focuses on the use of poly (vinyl alcohol)-shelled microbubbles as a contrast agent in ultrasound medical imaging. The objective was an in vitro assessment of the different working conditions and signal processing methods for the visual detection (especially in small vessels) of such microbubbles, while avoiding their destruction. Polymer-shelled microbubbles have recently been proposed as ultrasound contrast agents with some important advantages. The major drawback is a shell that is less elastic than that of the traditional lipidic microbubbles. Weaker echoes are expected, and their detection at low concentrations may be critical. In vitro experiments were performed with a commercial ultrasound scanner equipped with a dedicated acquisition board. A concentration of 100bubbles/mm(3), excitation pressure amplitudes from 120kPa to 320kPa, and a central frequency of 3MHz or 4.5MHz were used. Three multi-pulse techniques (i.e., pulse inversion, contrast pulse sequence based on three transmitted signals, and contrast pulse sequence in combination with the chirp pulse) were compared. The results confirmed that these microbubbles produce a weaker ultrasound response than lipidic bubbles with a reduced second-order nonlinear component. Nevertheless, these microbubbles can be detected by the contrast pulse sequence technique, especially when the chirp pulse is adopted. The best value of the contrast-to-tissue ratio was obtained at an excitation pressure amplitude of 230kPa: although this pressure amplitude is higher than what is typically used for lipidic microbubbles, it does not cause the rupture of the polymeric contrast agent.
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Affiliation(s)
- C Sciallero
- Department of Biophysical and Electronic Engineering (DIBE), University of Genoa, Via all'Opera Pia 11, Genova 16145, Italy.
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Moosavi Nejad S, Hosseini SHR, Akiyama H, Tachibana K. Optical observation of cell sonoporation with low intensity ultrasound. Biochem Biophys Res Commun 2011; 413:218-23. [PMID: 21875577 DOI: 10.1016/j.bbrc.2011.08.072] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Accepted: 08/13/2011] [Indexed: 11/18/2022]
Abstract
Sonoporation is a promising drug delivery technique with great potential in medicine. However, its applications have been limited mostly by the lack of understanding its underlying biophysical mechanism, partly due to the inadequacy of the existing models for coupling with highly sensitive imaging techniques to directly observe the actual precursor events of cell-microbubble interaction under low intensity ultrasound. Here, we introduce a new in vitro method utilizing capillary-microgripping system and micro-transducer to achieve maximum level of experimental flexibility for capturing real time highly magnified images of cell-microbubble interaction, hitherto unseen in this context. Insonation of isolated single cells and microbubbles parallel with high speed microphotography and fluorescence microscopy allowed us to identify dynamic responses of cell-membrane/microbubble in correlation with sonoporation. Our results showed that bubble motion and linear oscillation in close contact with the cell membrane can cause local deformation and transient porosity in the cell membrane without rupturing it. This method can also be used as an in situ gene/drug delivery system of targeted cells for non-invasive clinical applications.
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Affiliation(s)
- Seyedeh Moosavi Nejad
- Department of Anatomy, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan, Fukuoka 814-0180, Japan.
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Barlow E, Mulholland AJ, Gachagan A, Nordon A. A theoretical investigation of chirp insonification of ultrasound contrast agents. ULTRASONICS 2011; 51:725-33. [PMID: 21420138 DOI: 10.1016/j.ultras.2011.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Revised: 02/28/2011] [Accepted: 02/28/2011] [Indexed: 05/19/2023]
Abstract
A theoretical investigation of second harmonic imaging of an Ultrasound Contrast Agent (UCA) under chirp insonification is considered. By solving the UCA's dynamical equation analytically, the effect that the chirp signal parameters and the UCA shell parameters have on the amplitude of the second harmonic frequency are examined. This allows optimal parameter values to be identified which maximise the UCA's second harmonic response. A relationship is found for the chirp parameters which ensures that a signal can be designed to resonate a UCA for a given set of shell parameters. It is also shown that the shell thickness, shell viscosity and shell elasticity parameter should be as small as realistically possible in order to maximise the second harmonic amplitude. Keller-Herring, Second Harmonic, Chirp, Ultrasound Contrast Agent.
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Affiliation(s)
- Euan Barlow
- Department of Mathematics, University of Strathclyde, 26 Richmond Street, Glasgow G11XH, UK.
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Shen CC, Shi TY. Golay-encoded excitation for dual-frequency harmonic detection of ultrasonic contrast agents. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2011; 58:349-356. [PMID: 21342820 DOI: 10.1109/tuffc.2011.1812] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Golay-encoded excitation in combination with the third harmonic (3f₀) transmit phasing is examined for both signal-to-noise ratio (SNR) and contrast-to-tissue ratio (CTR) improvements in harmonic imaging of contrast microbubbles. To produce the cancellation pair of tissue harmonic signal in 3f₀ transmit phasing, the phase of the bit waveform is properly designed for both the fundamental and the 3f₀ transmit signals to provide the Golay encoding of the received harmonic responses. Results indicate that the proposed Golay excitation can effectively suppress the tissue harmonic amplitude to increase CTR. Meanwhile, the SNR of the contrast harmonic signal also improves because of the elongated waveform of Golay excitation. Nevertheless, the generation of marked range side-lobes of the bubble region would degrade the achievable SNR improvement and the image contrast, especially when the bit of Golay excitation increases. The range side-lobes could result from the nonlinear resonance of the microbubbles that interferes with the phase modulation of the Golay encoding.
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Affiliation(s)
- Che-Chou Shen
- Department of Electrical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan.
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Guidi F, Vos HJ, Mori R, de Jong N, Tortoli P. Microbubble characterization through acoustically induced deflation. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2010; 57:193-202. [PMID: 20040446 DOI: 10.1109/tuffc.2010.1398] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Ultrasound contrast agents (UCA) populations are typically polydisperse and contain microbubbles with radii over a given range. Although the behavior of microbubbles of certain sizes might be masked by the behavior of others, the acoustic characterization of UCA is typically made on full populations. In this paper, we have combined acoustic and optical methods to investigate the response of isolated lipid-shelled microbubbles to low-pressure (49 and 62 kPa peak negative pressure) ultrasound tone bursts. These bursts induced slow deflation of the microbubbles. The experimental setup included a microscope connected to a fast camera acquiring one frame per pulse transmitted by a single-element transducer. The behavior of each bubble was measured at multiple frequencies, by cyclically changing the transmission frequency over the range of 2 to 4 MHz during subsequent pulse repetition intervals. The bubble echoes were captured by a second transducer and coherently recorded. More than 50 individual microbubbles were observed. Microbubbles with radii larger than 3 mum did not experience any size reduction. Smaller bubbles slowly deflated, generally until the radius reached a value around 1.4 microm, independent of the initial microbubble size. The detected pressure amplitude backscattered at 2.5 cm distance was very low, decreasing from about 5 Pa down to 1 Pa at 2 MHz as the bubbles deflated. The resonant radius was evaluated from the echo amplitude normalized with respect to the geometrical cross section. At 2-MHz excitation, deflating microbubbles showed highest normalized echo when the radius was 2.2 microm while at higher excitation frequencies, the resonant radius was lower. The relative phase shift of the echo during the deflation process was also measured. It was found to exceed pi/2 in all cases. A heuristic procedure based on the analysis of multiple bubbles of a same population was used to estimate the undamped natural frequency. It was found that a microbubble of 1.7 microm has an undamped natural frequency of 2 MHz. The difference between this size and the resonant radius is discussed as indicative of significant damping.
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Affiliation(s)
- Francesco Guidi
- Department of Electronics and Telecommunications, Universita degli Studi di Firenze, Florence, Italy.
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Liao AH, Shen CC, Li PC. Potential contrast improvement in ultrasound pulse inversion imaging using EMD and EEMD. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2010; 57:317-326. [PMID: 20178898 DOI: 10.1109/tuffc.2010.1412] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Ultrasound nonlinear imaging using microbubble-based contrast agents has been widely investigated. Nonetheless, its contrast is often reduced by the nonlinearity of acoustic wave propagation in tissue. In this paper, we explore the use of empirical mode decomposition (EMD) and ensemble empirical mode decomposition (EEMD) in the Hilbert-Huang transform (HHT) for possible contrast improvement. The HHT is designed for analyzing nonlinear and nonstationary data, whereas EMD is a method associated with the HHT that allows decomposition of data into a finite number of intrinsic modes. The hypothesis is that the nonlinear signal from microbubbles and the tissue nonlinear signal can be better differentiated with EMD and EEMD, thus making contrast improvement possible. Specifically, we tested this method on pulse-inversion nonlinear imaging, which is generally regarded as one of the most effective nonlinear imaging methods. The results show that the contrast-to-tissue ratios at the fundamental and second-harmonic frequencies were improved by 10.2 and 4.3 dB, respectively, after EEMD. Nonetheless, image artifacts also appeared, and hence further investigation is needed before EMD and EEMD can be applied in practical applications of ultrasound nonlinear imaging.
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Affiliation(s)
- Ai-Ho Liao
- Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan
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Andersen KS, Jensen JA. Ambient pressure sensitivity of microbubbles investigated through a parameter study. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2009; 126:3350-8. [PMID: 20000949 DOI: 10.1121/1.3242359] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Measurements on microbubbles clearly indicate a relation between the ambient pressure and the acoustic behavior of the bubble. The purpose of this study was to optimize the sensitivity of ambient pressure measurements, using the subharmonic component, through microbubble response simulations. The behavior of two microbubbles corresponding to two different contrast agents was investigated as a function of driving pulse and ambient overpressure p(ov). Simulations of Levovist using a rectangular driving pulse show an almost linear reduction in the subharmonic component as p(ov) is increased. For a 20 cycle driving pulse, a reduction of 4.6 dB is observed when changing p(ov) from 0 to 25 kPa. Increasing the pulse duration makes the reduction even clearer. For a pulse with 64 cycles, the reduction is 9.9 dB. This simulation is in good correspondence with measurement results presented in the literature. Further simulations of Levovist show that also the shape and the acoustic pressure of the driving pulse are very important factors. The best pressure sensitivity of Levovist was found to be 0.88 dB/kPa. For Sonazoid, a sensitivity of 1.14 dB/kPa has been found, although the reduction is not completely linear as a function of the ambient pressure.
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Affiliation(s)
- Klaus Scheldrup Andersen
- Department of Electrical Engineering, Center for Fast Ultrasound Imaging, Technical University of Denmark, Building 348, 2800 Kgs. Lyngby, Denmark
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Thomas DH, Butler MB, Anderson T, Steel R, Pye SD, Poland M, Brock-Fisher T, McDicken WN, Sboros V. Single microbubble response using pulse sequences: initial results. ULTRASOUND IN MEDICINE & BIOLOGY 2009; 35:112-119. [PMID: 18845380 DOI: 10.1016/j.ultrasmedbio.2008.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2008] [Revised: 05/26/2008] [Accepted: 07/23/2008] [Indexed: 05/26/2023]
Abstract
The study of acoustic scattering by single microbubbles has the potential to offer improved signal processing techniques. A microacoustic system that employs a hydrodynamically-focused flow was used to detect radiofrequency (RF) backscatter from single microbubbles. RF data were collected using a commercial scanner. Results are presented for two agents, namely Definity (Lantheus Medical Imaging, N. Billerica, MA, USA) and biSphere (Point Biomedical Corp, San Carlos, CA, USA). The agents were insonified with amplitude-modulated pulses, and it was observed in both agents that a subpopulation of microbubbles did not produce a measurable echo from the first-half amplitude pulse, but did produce a response from the full amplitude pulse and from a subsequent half amplitude pulse. The number of microbubbles in this subpopulation was seen to increase with increasing transmit amplitude. These results do not bear out the simple theory of microbubble-pulse sequence interaction and invite a reassessment of signal processing approaches.
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Affiliation(s)
- D H Thomas
- Department of Medical Physics and Medical Engineering, University of Edinburgh, Edinburgh, UK.
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The use of microbubbles in Doppler ultrasound studies. Med Biol Eng Comput 2008; 47:827-38. [DOI: 10.1007/s11517-008-0423-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2008] [Accepted: 10/28/2008] [Indexed: 10/21/2022]
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Shen CC, Yeh CK, Chen WS, Wang HW. The effect of third harmonic transmit phasing on contrast agent responses for CTR improvement. Phys Med Biol 2008; 53:6179-94. [PMID: 18854607 DOI: 10.1088/0031-9155/53/21/019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Schmidt BJ, Sousa I, van Beek AA, Böhmer MR. Adhesion and ultrasound-induced delivery from monodisperse microbubbles in a parallel plate flow cell. J Control Release 2008; 131:19-26. [DOI: 10.1016/j.jconrel.2008.06.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2008] [Revised: 06/20/2008] [Accepted: 06/25/2008] [Indexed: 10/21/2022]
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Sboros V. Response of contrast agents to ultrasound. Adv Drug Deliv Rev 2008; 60:1117-36. [PMID: 18486270 DOI: 10.1016/j.addr.2008.03.011] [Citation(s) in RCA: 138] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2008] [Accepted: 03/04/2008] [Indexed: 11/29/2022]
Abstract
Microbubbles are used as ultrasonic contrast agents that enhance the ultrasound signals of the vascular bed. The recent development of site-targeted microbubbles opened up the possibility for molecular imaging as well as localised drug and gene delivery. Initially the microbubbles' physical properties and their response to the ultrasound beam were not fully understood. However, the introduction of fast acquisition microscopy has allowed the observation of the microbubble behaviour in the presence of ultrasound. In addition, acoustical techniques can determine the scatter of single microbubbles. Sonoporation experiments promise high-specificity drug and gene delivery, but the responsible physical mechanisms, particularly for in vivo applications, are not fully understood. An improvement of microbubble technology may address variability related problems in both imaging and drug/gene delivery.
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Affiliation(s)
- Vassilis Sboros
- Medical Physics, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh, EH16 4SB, UK.
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