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Kadakia A, Zhang J, Yao X, Zhou Q, Heiferman MJ. Ultrasound in ocular oncology: Technical advances, clinical applications, and limitations. Exp Biol Med (Maywood) 2023; 248:371-379. [PMID: 37212384 PMCID: PMC10281622 DOI: 10.1177/15353702231169539] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023] Open
Abstract
Due to its accessibility and ability for real-time image acquisition of ocular structures, ultrasound has high utility in the visualization of the eye, especially in ocular oncology. In this minireview, we summarize the technical rationale and applications of ultrasound modalities, A-scan, B-scan, high-frequency ultrasound biomicroscopy (UBM), and Doppler measurement. A-scan ultrasound uses a transducer of 7-11 MHz, making it useful for determining the echogenicity of ocular tumors (7-8 MHz) and measuring the axial length of the eye (10-11 MHz). B-scan ultrasound operates at 10-20 MHz, which can be used for measuring posterior ocular tumors while UBM operates at 40-100 MHz to evaluate anterior ocular structures. Doppler ultrasonography allows for the detection of tumor vascularization. While ultrasonography has numerous clinical applications due to its favorable penetration compared with optical coherence tomography, it is still limited by its relatively lower resolution. Ultrasound also requires an experienced sonographer due to the need for accurate probe localization to areas of interest.
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Affiliation(s)
- Arya Kadakia
- Department of Ophthalmology and Visual
Sciences, Illinois Eye and Ear Infirmary, University of Illinois Chicago, Chicago, IL 60612,
USA
| | - Junhang Zhang
- Department of Biomedical Engineering, Viterbi
School of Engineering, University of Southern California, Los Angeles, CA 90089, USA
| | - Xincheng Yao
- Department of Ophthalmology and Visual
Sciences, Illinois Eye and Ear Infirmary, University of Illinois Chicago, Chicago, IL 60612,
USA
- Department of Biomedical Engineering,
University of Illinois Chicago, Chicago, IL 60607, USA
| | - Qifa Zhou
- Department of Biomedical Engineering, Viterbi
School of Engineering, University of Southern California, Los Angeles, CA 90089, USA
| | - Michael J Heiferman
- Department of Ophthalmology and Visual
Sciences, Illinois Eye and Ear Infirmary, University of Illinois Chicago, Chicago, IL 60612,
USA
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Blohm KO, Tichy A, Nell B. Clinical utility, dose determination, and safety of ocular contrast-enhanced ultrasonography in horses: A pilot study. Vet Ophthalmol 2019; 23:331-340. [PMID: 31799804 PMCID: PMC7155076 DOI: 10.1111/vop.12730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/21/2019] [Accepted: 11/08/2019] [Indexed: 12/29/2022]
Abstract
Objective To determine efficacy of contrast‐enhanced ultrasonography (CEUS) using different sulfur hexafluoride (SF6) doses to assess blood flow and perfusion in equine eyes and to evaluate safety of SF6 in horses. Procedures Ocular B‐mode and contrast‐enhanced ultrasonography were performed bilaterally in nine sedated university‐owned horses. Intravenous SonoVue® bolus injections of 5, 10, 15, 20, 25, and 30 mL were administered for 2/18, 5/18, 6/18, 3/18, 1/18, and 1/18 eyes, respectively. Doses were increased based on ascending bodyweight. Each eye within one horse was examined utilizing a different dose. Qualitative blood flow and quantitative perfusion were analyzed. Heart and respiratory rates were monitored nonsedated, sedated, and during first and second minutes of CEUS. Results Qualitative contrast enhancement (CE) was visible in 7/9 animals. Quantitative CE was measurable bilaterally in four horses, unilaterally in three individuals, and not detected in two animals. In all horses with unilateral CE, the positive eye received the higher dose. Fifteen mL dose resulted in significantly shorter time to peak than 10 mL (P < .05). Peak intensity, maximum signal increase, and corresponding area under the curve were significantly higher for 15 and 20 mL doses compared with 10 mL (P < .05). Uveal and retinal tissues were enhanced frequently. Twenty‐five and 30 mL doses revealed no CE. Only sedation reduced heart rates significantly (P < .05). Clinically relevant changes in respiratory rates or adverse reactions following SF6 application were not observed. Conclusions Contrast enhancement was in most instances dose‐dependent. Fifteen mL appeared appropriate to assess equine ocular perfusion. The reliability in horses remains questionable; however, CEUS was well‐tolerated.
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Affiliation(s)
- Klaas-Ole Blohm
- Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Alexander Tichy
- Department of Biomedical Sciences, University of Veterinary Medicine, Vienna, Austria
| | - Barbara Nell
- Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
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Blohm KO, Hittmair KM, Tichy A, Nell B. Quantitative, noninvasive assessment of intra- and extraocular perfusion by contrast-enhanced ultrasonography and its clinical applicability in healthy dogs. Vet Ophthalmol 2019; 22:767-777. [PMID: 30773789 PMCID: PMC6899557 DOI: 10.1111/vop.12648] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 11/02/2018] [Accepted: 01/02/2019] [Indexed: 11/30/2022]
Abstract
Objective To assess quantitative perfusion of intra‐ and extraocular regions of interest (ROIs) in conscious, healthy dogs utilizing contrast‐enhanced ultrasonography (CEUS); to compare varying enhancement with the first and second bolus injection and in the right and left eye; and to determine the most appropriate examination time. Procedures Gray scale ultrasonography and contrast harmonic imaging using sulfur hexafluoride were performed randomly assigned in both eyes in 10 university‐owned beagles. Perfusion parameters including slope time, time to peak (TTP), peak intensity (PI), and area under the curve (AUC) were measured at individually drawn ROIs (retrobulbar cone = ROI 1, choroid‐retina complex = ROI 2, medial = ROI 3, and lateral anterior uvea = ROI 4). Results Time‐intensity curve parameters revealed no significant differences in eyes examined by the first or second bolus injection (P > 0.05) or in the right or left eye (P > 0.05). Pooled data from all eyes were analyzed. Peak intensity of ROI 2 was significantly higher compared to all other ROIs (P < 0.001). Area under the curve at ROI 2 was significantly higher compared to all other ROIs (P < 0.05), and AUC at ROI 1 was significantly higher than at ROI 4 (P < 0.05). No significant differences in TTP were observed between different ROIs (P > 0.05). Ratios relative to different ROI sizes showed fastest enhancement in the retrobulbar cone and most intense perfusion in the anterior uveal regions. The first minute after contrast injection provided the highest diagnostic value. Conclusion Quantitative perfusion in nondiseased canine eyes revealed consistent parameters. Application of standardized CEUS protocols may be a promising diagnostic tool to differentiate ocular lesions.
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Affiliation(s)
- Klaas-Ole Blohm
- Department for Companion Animals and Horses, Ophthalmology Service, University of Veterinary Medicine, Vienna, Austria
| | - Katharina M Hittmair
- Department for Companion Animals and Horses, Diagnostic Imaging, University of Veterinary Medicine, Vienna, Austria
| | - Alexander Tichy
- Department of Biomedical Sciences, University of Veterinary Medicine, Vienna, Austria
| | - Barbara Nell
- Department for Companion Animals and Horses, Ophthalmology Service, University of Veterinary Medicine, Vienna, Austria
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Establishment of human metastatic colorectal cancer model in rabbit liver: A pilot study. PLoS One 2017; 12:e0177212. [PMID: 28475639 PMCID: PMC5419650 DOI: 10.1371/journal.pone.0177212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Accepted: 04/24/2017] [Indexed: 02/06/2023] Open
Abstract
Rationale and objectives To develop a human metastatic colorectal cancer (mCRC) model in a rabbit liver. Materials and methods Immunosuppression in 4 adult New Zealand White rabbits weighing 3.5 to 4.5 kg was induced with daily subcutaneous injection of 15 mg/kg Cyclosporine A (CsA). On day 3 open mini-laparotomy was performed and 0.2 ml (1.8x105 cells) suspension of HCT-116 and HT-29 human CRC cells were injected into the left and right medial lobe respectively. On day 10 the CsA dose was reduced to 10 mg/kg daily maintenance dose. Rabbits were weighed weekly, closely monitored for CsA side effects (weight loss, gingival hyperplasia and gut modification). Rabbits were sacrificed 5, 6, 7, and 8 weeks after cells injection. Liver tumors were collected for histopathology and immunohistochemical analysis. Results HT-29 Tumor growth was observed in 3 rabbits (75%). Tumors measured 3, 4 and 6 mm after 5, 6 and 8 weeks respectively. Microscopically, tumors contained hyperchromatic, pleomorphic cells that stained for monoclonal carcinoembryonic antigen (CEA), polyclonal CEA, cytokeratin 20, vascular markers (CD31, CD34), and vascular endothelial growth factor (VEGF) by immunohistochemistry, supporting involvement by the poorly differentiated HT-29 colorectal cancer cell line. No gross tumor growth or microscopic viability was observed from HCT-116 cell injection. CsA extra-hepatic manifestations included minimal gum hyperplasia and decrease in gut motility in 3 rabbits (75%), which was treated with Azithromycin 15 mg/kg and Cisapride 0.5 mg/kg every 12 hours, respectively. Conclusion We successfully developed a human metastatic colon cancer model in immunosuppressed rabbit liver using HT-29 cells.
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Animal Models of Uveal Melanoma: Methods, Applicability, and Limitations. BIOMED RESEARCH INTERNATIONAL 2016; 2016:4521807. [PMID: 27366747 PMCID: PMC4913058 DOI: 10.1155/2016/4521807] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 05/08/2016] [Indexed: 02/06/2023]
Abstract
Animal models serve as powerful tools for investigating the pathobiology of cancer, identifying relevant pathways, and developing novel therapeutic agents. They have facilitated rapid scientific progress in many tumor entities. However, for establishing a powerful animal model of uveal melanoma fundamental challenges remain. To date, no animal model offers specific genetic attributes as well as histologic, immunologic, and metastatic features of uveal melanoma. Syngeneic models with intraocular injection of cutaneous melanoma cells may suit best for investigating immunologic/tumor biology aspects. However, differences between cutaneous and uveal melanoma regarding genetics and metastasis remain problematic. Human xenograft models are widely used for evaluating novel therapeutics but require immunosuppression to allow tumor growth. New approaches aim to establish transgenic mouse models of spontaneous uveal melanoma which recently provided preliminary promising results. Each model provides certain benefits and may render them suitable for answering a respective scientific question. However, all existing models also exhibit relevant limitations which may have led to delayed research progress. Despite refined therapeutic options for the primary ocular tumor, patients' prognosis has not improved since the 1970s. Basic research needs to further focus on a refinement of a potent animal model which mimics uveal melanoma specific mechanisms of progression and metastasis. This review will summarise and interpret existing animal models of uveal melanoma including recent advances in the field.
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Tumor Volumes in Choroidal Melanoma: Agreement Between Three-Dimensional Ultrasound and Two Mathematical Models. Am J Ophthalmol 2016; 166:181-188. [PMID: 27066723 DOI: 10.1016/j.ajo.2016.03.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 03/30/2016] [Accepted: 03/31/2016] [Indexed: 11/23/2022]
Abstract
PURPOSE To determine the degree of agreement between 2 mathematical models and 3-dimensional ultrasonography (3DUS) in estimating choroidal melanoma tumor volumes. DESIGN Reliability analysis. METHODS Tumor measurements estimated by 2 mathematical models (designated Formula 1 and Formula 2) were compared to those obtained by 3DUS in 45 consecutive patients with primary choroidal melanoma to determine the percentage agreement between the models and 3DUS. RESULTS Both formulas tended to overestimate the tumor volume. Overall, the mean volume differences between 3DUS and Formula 1 and between 3DUS and Formula 2, respectively, were 51.7 mm(3) (95% confidence interval [CI], 187.6 to 84.3) and 23.8 mm(3) (95% CI, 122.5 to 74.8). Excluding mushroom-shaped tumors, the mean volume differences were 52.0 mm(3) (95% CI, 194.9 to 91.0) and 23.0 mm(3) (95% CI, 127.0 to 81.0), respectively. In mushroom-shaped tumors, mean volume differences were 49.9 mm(3) (95% CI, 135.7 to 35.9) and 29.3 mm(3) (95% CI, 87.6 to 29.0), respectively. CONCLUSIONS The agreement between these mathematical models and the measured 3DUS volume was high. The data obtained in this study show that both formulas provide a simple, fast, and accurate method of estimating tumor volumes in the clinical setting, suggesting that these models could be used as a reliable and inexpensive alternative to time-consuming procedures such as 3DUS or magnetic resonance imaging. The accurate tumor volume values provided by these formulas may help to provide more reliable estimates of tumor regression or regrowth following globe-preserving treatment of choroidal melanomas, and may be a valuable prognostic indicator.
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Effects of Zeaxanthin on Growth and Invasion of Human Uveal Melanoma in Nude Mouse Model. J Ophthalmol 2015; 2015:392305. [PMID: 26682063 PMCID: PMC4670663 DOI: 10.1155/2015/392305] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 10/26/2015] [Indexed: 01/04/2023] Open
Abstract
Uveal melanoma cells were inoculated into the choroid of nude mice and treated with or without intraocular injection of zeaxanthin. After 21 days, mice were sacrificed and the eyes enucleated. Histopathological analysis was performed in hematoxylin and eosin stained frozen sections. Melanoma developed rapidly in the control group (without treatment of zeaxanthin). Tumor-bearing eye mass and tumor mass in the control group were significantly greater than those in zeaxanthin treated group. Melanoma in the controlled eyes occupied a large part of the eye, was epithelioid in morphology, and was with numerous mitotic figures. Scleral perforation and extraocular extension were observed in half of the eyes. Melanomas in zeaxanthin treated eyes were significantly smaller with many necrosis and apoptosis areas and no extraocular extension could be found. Quantitative image analysis revealed that the tumor size was reduced by 56% in eyes treated with low dosages of zeaxanthin and 92% in eyes treatment with high dosages of zeaxanthin, as compared to the controls. This study demonstrated that zeaxanthin significantly inhibits the growth and invasion of human uveal melanoma in nude mice, suggesting that zeaxanthin may be a promising agent to be explored for the prevention and treatment of uveal melanoma.
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Cao J, Jager MJ. Animal Eye Models for Uveal Melanoma. Ocul Oncol Pathol 2015; 1:141-50. [PMID: 27172424 DOI: 10.1159/000370152] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 11/26/2014] [Indexed: 12/21/2022] Open
Abstract
Animal models play an important role in understanding tumor growth and may be used to develop novel therapies against human malignancies. The significance of the results from animal experiments depends on the selection of the proper model. Many attempts have been made to create appropriate animal models for uveal melanoma and its characteristic metastatic behavior. One approach is to use transgenic animal models or to implant tumor cells. A variety of tumor types have been used for this purpose: tumor cells, such as Greene melanoma, murine B16 melanoma, and human uveal melanoma cells, may be implanted in the eyes of hamsters, rats, rabbits, and mice, among others. Various inoculation routes, including into the anterior chamber and posterior compartment, and retro-orbitally, have been applied to obtain tumor growth mimicking ocular uveal melanoma. However, when we choose animal models, we must be conscious of many disadvantages, such as variable tumor growth, or the need for immunosuppression in xenogeneic grafts. In this paper, we will discuss the various eye models.
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Affiliation(s)
- Jinfeng Cao
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands; Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, PR China
| | - Martine J Jager
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
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Lindsey BD, Rojas JD, Martin KH, Shelton SE, Dayton PA. Acoustic characterization of contrast-to-tissue ratio and axial resolution for dual-frequency contrast-specific acoustic angiography imaging. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2014; 61:1668-87. [PMID: 25265176 PMCID: PMC8375273 DOI: 10.1109/tuffc.2014.006466] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Recently, dual-frequency transducers have enabled high-spatial-resolution and high-contrast imaging of vasculature with minimal tissue artifacts by transmitting at a low frequency and receiving broadband superharmonic echoes scattered by microbubble contrast agents. In this work, we examine the imaging parameters for optimizing contrast-to-tissue ratio (CTR) for dual-frequency imaging and the relationship with spatial resolution. Confocal piston transducers are used in a water bath setup to measure the SNR, CTR, and axial resolution for ultrasound imaging of nonlinear scattering of microbubble contrast agents when transmitting at a lower frequency (1.5 to 8 MHz) and receiving at a higher frequency (7.5 to 25 MHz). Parameters varied include the frequency and peak negative pressure of transmitted waves, center frequency of the receiving transducer, microbubble concentration, and microbubble size. CTR is maximized at the lowest transmission frequencies but would be acceptable for imaging in the 1.5 to 3.5 MHz range. At these frequencies, CTR is optimized when a receiving transducer with a center frequency of 10 MHz is used, with the maximum CTR of 25.5 dB occurring when transmitting at 1.5 MHz with a peak negative pressure of 1600 kPa and receiving with a center frequency of 10 MHz. Axial resolution is influenced more heavily by the receiving center frequency, with a weak decrease in measured pulse lengths associated with increasing transmit frequency. A microbubble population containing predominately 4-μm-diameter bubbles yielded the greatest CTR, followed by 1- and then 2-μm bubbles. Varying concentration showed little effect over the tested parameters. CTR dependence on transmit frequency and peak pressure were confirmed through in vivo imaging in two rodents. These findings may lead to improved imaging of vascular remodeling in superficial or luminal cancers such as those of the breast, prostate, and colon.
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