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Li S, Tsui PH, Wu W, Zhou Z, Wu S. Multimodality quantitative ultrasound envelope statistics imaging based support vector machines for characterizing tissue scatterer distribution patterns: Methods and application in detecting microwave-induced thermal lesions. ULTRASONICS SONOCHEMISTRY 2024; 107:106910. [PMID: 38772312 PMCID: PMC11128516 DOI: 10.1016/j.ultsonch.2024.106910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 05/01/2024] [Accepted: 05/13/2024] [Indexed: 05/23/2024]
Abstract
Ultrasound envelope statistics imaging, including ultrasound Nakagami imaging, homodyned-K imaging, and information entropy imaging, is an important group of quantitative ultrasound techniques for characterizing tissue scatterer distribution patterns, such as scatterer concentrations and arrangements. In this study, we proposed a machine learning approach to integrate the strength of multimodality quantitative ultrasound envelope statistics imaging techniques and applied it to detecting microwave ablation induced thermal lesions in porcine liver ex vivo. The quantitative ultrasound parameters included were homodyned-K α which is a scatterer clustering parameter related to the effective scatterer number per resolution cell, Nakagami m which is a shape parameter of the envelope probability density function, and Shannon entropy which is a measure of signal uncertainty or complexity. Specifically, the homodyned-K log10(α), Nakagami-m, and horizontally normalized Shannon entropy parameters were combined as input features to train a support vector machine (SVM) model to classify thermal lesions with higher scatterer concentrations from normal tissues with lower scatterer concentrations. Through heterogeneous phantom simulations based on Field II, the proposed SVM model showed a classification accuracy above 0.90; the area accuracy and Dice score of higher-scatterer-concentration zone identification exceeded 83% and 0.86, respectively, with the Hausdorff distance <26. Microwave ablation experiments of porcine liver ex vivo at 60-80 W, 1-3 min showed that the SVM model achieved a classification accuracy of 0.85; compared with single log10(α),m, or hNSE parametric imaging, the SVM model achieved the highest area accuracy (89.1%) and Dice score (0.77) as well as the smallest Hausdorff distance (46.38) of coagulation zone identification. We concluded that the proposed multimodality quantitative ultrasound envelope statistics imaging based SVM approach can enhance the capability to characterize tissue scatterer distribution patterns and has the potential to detect the thermal lesions induced by microwave ablation.
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Affiliation(s)
- Sinan Li
- Department of Biomedical Engineering, College of Chemistry and Life Sciences, Beijing University of Technology, Beijing, China
| | - Po-Hsiang Tsui
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Liver Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Research Center for Radiation Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Weiwei Wu
- College of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Zhuhuang Zhou
- Department of Biomedical Engineering, College of Chemistry and Life Sciences, Beijing University of Technology, Beijing, China.
| | - Shuicai Wu
- Department of Biomedical Engineering, College of Chemistry and Life Sciences, Beijing University of Technology, Beijing, China.
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Haghi H, Kolios MC. Numerical investigation of the effect of bubble properties on the linear resonance frequency shift due to inter-bubble interactions in ultrasonically excited lipid coated microbubbles. ULTRASONICS SONOCHEMISTRY 2024; 104:106831. [PMID: 38428306 PMCID: PMC10912878 DOI: 10.1016/j.ultsonch.2024.106831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/14/2024] [Accepted: 02/22/2024] [Indexed: 03/03/2024]
Abstract
Ultrasonically excited microbubbles (MBs) have numerous applications in various fields, such as drug delivery, and imaging. Ultrasonically excited MBs are known to be nonlinear oscillators that generate secondary acoustic emissions in the media when excited by a primary ultrasound wave. The propagation of acoustic waves in the liquid is limited to the speed of sound, resulting in each MB receiving the primary and secondary waves at different times depending on their distance from the ultrasound source and the distance between MBs. These delays are referred to as primary and secondary delays, respectively. A previous study demonstrated that the inclusion of secondary delays in a model describing the interactions between MBs exposed to ultrasound results in an increase in the linear resonance frequency of MBs as they approach each other. This work investigates the impact of various MB properties on the change in linear resonance frequency resulting from changes in inter-bubble distances. The effects of shell properties, including the initial surface tension, surface dilatational viscosity of the shell monolayer, elastic compression modulus of the shell, and the initial radius of the MBs, are examined. MB size is a significant factor influencing the rate of linear resonance frequency increase with increasing concentration. Moreover, it is found that the shell properties of MBs play a negligible role in the rate of change in linear resonance frequency of MBs as the inter-bubble distances change.The findings of this study have implications for various applications of MBs in the biomedical field. By understanding the impact of inter-bubble distances and shell properties on the linear resonance frequency of MBs, the utilization of MBs in applications reliant on their resonant behavior can be optimized.
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Affiliation(s)
- Hossein Haghi
- Toronto Metropolitan University, 350 Victoria Street, Toronto, Ontario, Canada; Institute for Biomedical Engineering, Science and Technology (iBEST), a partnership between St. Michael's Hospital and Toronto Metropolitan University, 209 Victoria St, Toronto, Ontario, Canada.
| | - Michael C Kolios
- Toronto Metropolitan University, 350 Victoria Street, Toronto, Ontario, Canada; Institute for Biomedical Engineering, Science and Technology (iBEST), a partnership between St. Michael's Hospital and Toronto Metropolitan University, 209 Victoria St, Toronto, Ontario, Canada
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3
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Liu H, Wen Z, Liu Z, Yang Y, Wang H, Xia X, Ye J, Liu Y. Unlocking the potential of amorphous calcium carbonate: A star ascending in the realm of biomedical application. Acta Pharm Sin B 2024; 14:602-622. [PMID: 38322345 PMCID: PMC10840486 DOI: 10.1016/j.apsb.2023.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/16/2023] [Accepted: 08/20/2023] [Indexed: 02/08/2024] Open
Abstract
Calcium-based biomaterials have been intensively studied in the field of drug delivery owing to their excellent biocompatibility and biodegradability. Calcium-based materials can also deliver contrast agents, which can enhance real-time imaging and exert a Ca2+-interfering therapeutic effect. Based on these characteristics, amorphous calcium carbonate (ACC), as a brunch of calcium-based biomaterials, has the potential to become a widely used biomaterial. Highly functional ACC can be either discovered in natural organisms or obtained by chemical synthesis However, the standalone presence of ACC is unstable in vivo. Additives are required to be used as stabilizers or core-shell structures formed by permeable layers or lipids with modified molecules constructed to maintain the stability of ACC until the ACC carrier reaches its destination. ACC has high chemical instability and can produce biocompatible products when exposed to an acidic condition in vivo, such as Ca2+ with an immune-regulating ability and CO2 with an imaging-enhancing ability. Owing to these characteristics, ACC has been studied for self-sacrificing templates of carrier construction, targeted delivery of oncology drugs, immunomodulation, tumor imaging, tissue engineering, and calcium supplementation. Emphasis in this paper has been placed on the origin, structural features, and multiple applications of ACC. Meanwhile, ACC faces many challenges in clinical translation, and long-term basic research is required to overcome these challenges. We hope that this study will contribute to future innovative research on ACC.
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Affiliation(s)
- Han Liu
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, China
- Beijing Key Laboratory of Drug Delivery Technology and Novel Formulation, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, China
| | - Zhiyang Wen
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, China
- Beijing Key Laboratory of Drug Delivery Technology and Novel Formulation, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, China
| | - Zihan Liu
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, China
- Beijing Key Laboratory of Drug Delivery Technology and Novel Formulation, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, China
| | - Yanfang Yang
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, China
- Beijing Key Laboratory of Drug Delivery Technology and Novel Formulation, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, China
| | - Hongliang Wang
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, China
- Beijing Key Laboratory of Drug Delivery Technology and Novel Formulation, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, China
| | - Xuejun Xia
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, China
- Beijing Key Laboratory of Drug Delivery Technology and Novel Formulation, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, China
| | - Jun Ye
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, China
- Beijing Key Laboratory of Drug Delivery Technology and Novel Formulation, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, China
| | - Yuling Liu
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, China
- Beijing Key Laboratory of Drug Delivery Technology and Novel Formulation, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, China
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Rajora MA, Dhaliwal A, Zheng M, Choi V, Overchuk M, Lou JWH, Pellow C, Goertz D, Chen J, Zheng G. Quantitative Pharmacokinetics Reveal Impact of Lipid Composition on Microbubble and Nanoprogeny Shell Fate. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2304453. [PMID: 38032129 PMCID: PMC10811482 DOI: 10.1002/advs.202304453] [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] [Received: 07/03/2023] [Revised: 10/19/2023] [Indexed: 12/01/2023]
Abstract
Microbubble-enabled focused ultrasound (MB-FUS) has revolutionized nano and molecular drug delivery capabilities. Yet, the absence of longitudinal, systematic, quantitative studies of microbubble shell pharmacokinetics hinders progress within the MB-FUS field. Microbubble radiolabeling challenges contribute to this void. This barrier is overcome by developing a one-pot, purification-free copper chelation protocol able to stably radiolabel diverse porphyrin-lipid-containing Definity® analogues (pDefs) with >95% efficiency while maintaining microbubble physicochemical properties. Five tri-modal (ultrasound-, positron emission tomography (PET)-, and fluorescent-active) [64 Cu]Cu-pDefs are created with varying lipid acyl chain length and charge, representing the most prevalently studied microbubble compositions. In vitro, C16 chain length microbubbles yield 2-3x smaller nanoprogeny than C18 microbubbles post FUS. In vivo, [64 Cu]Cu-pDefs are tracked in healthy and 4T1 tumor-bearing mice ± FUS over 48 h qualitatively through fluorescence imaging (to characterize particle disruption) and quantitatively through PET and γ-counting. These studies reveal the impact of microbubble composition and FUS on microbubble dissolution rates, shell circulation, off-target tissue retention (predominantly the liver and spleen), and FUS enhancement of tumor delivery. These findings yield pharmacokinetic microbubble structure-activity relationships that disrupt conventional knowledge, the implications of which on MB-FUS platform design, safety, and nanomedicine delivery are discussed.
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Affiliation(s)
- Maneesha A. Rajora
- Princess Margaret Cancer CentreUniversity Health NetworkTorontoOntarioM5G 1L7Canada
- Institute of Biomedical EngineeringUniversity of TorontoTorontoOntarioM5G 1L7Canada
| | - Alexander Dhaliwal
- Princess Margaret Cancer CentreUniversity Health NetworkTorontoOntarioM5G 1L7Canada
- Department of Medical BiophysicsUniversity of TorontoTorontoOntarioM5G 1L7Canada
| | - Mark Zheng
- Princess Margaret Cancer CentreUniversity Health NetworkTorontoOntarioM5G 1L7Canada
| | - Victor Choi
- Princess Margaret Cancer CentreUniversity Health NetworkTorontoOntarioM5G 1L7Canada
| | - Marta Overchuk
- Princess Margaret Cancer CentreUniversity Health NetworkTorontoOntarioM5G 1L7Canada
- Institute of Biomedical EngineeringUniversity of TorontoTorontoOntarioM5G 1L7Canada
- Joint Department of Biomedical EngineeringUniversity of North Carolina at Chapel Hill and North Carolina State UniversityChapel HillNC27599USA
| | - Jenny W. H. Lou
- Princess Margaret Cancer CentreUniversity Health NetworkTorontoOntarioM5G 1L7Canada
- Department of Medical BiophysicsUniversity of TorontoTorontoOntarioM5G 1L7Canada
| | - Carly Pellow
- Princess Margaret Cancer CentreUniversity Health NetworkTorontoOntarioM5G 1L7Canada
- Department of Medical BiophysicsUniversity of TorontoTorontoOntarioM5G 1L7Canada
- Sunnybrook Research InstituteTorontoOntarioM4N 3M5Canada
| | - David Goertz
- Department of Medical BiophysicsUniversity of TorontoTorontoOntarioM5G 1L7Canada
- Sunnybrook Research InstituteTorontoOntarioM4N 3M5Canada
| | - Juan Chen
- Princess Margaret Cancer CentreUniversity Health NetworkTorontoOntarioM5G 1L7Canada
| | - Gang Zheng
- Princess Margaret Cancer CentreUniversity Health NetworkTorontoOntarioM5G 1L7Canada
- Institute of Biomedical EngineeringUniversity of TorontoTorontoOntarioM5G 1L7Canada
- Department of Medical BiophysicsUniversity of TorontoTorontoOntarioM5G 1L7Canada
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Liao W, Que Q, Wen R, Lin P, Chen Y, Pang J, Guo D, Wen D, Yang H, He Y. Comparison of the Feasibility and Diagnostic Performance of ACR CEUS LI-RADS and a Modified CEUS LI-RADS for HCC in Examinations Using Sonazoid. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:2501-2511. [PMID: 37269244 DOI: 10.1002/jum.16282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/07/2023] [Accepted: 05/02/2023] [Indexed: 06/05/2023]
Abstract
OBJECTIVES The present study aimed to determine the feasibility of the American College of Radiology's (ACR) contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) (version 2017) in examinations using Sonazoid and compare its diagnostic performance with that of modified LI-RADS in patients at high risk of hepatocellular carcinoma (HCC). METHODS This retrospective study's sample population consisted of 137 participants with a total of 140 nodules who underwent CEUS with Sonazoid and pathological confirmation via surgery or biopsy from January 2020 to February 2022. The lesions were evaluated and classified based on the reference standards (ie, ACR CEUS LI-RADS and modified LI-RADS). The overall diagnostic capabilities of the two systems were evaluated in terms of accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) with 95% confidence intervals (CIs). RESULTS The participants had a median age of 51 years and an interquartile range of 43-58 years. Regarding LR-5 as a predictor of HCC, the accuracy results of the ACR LI-RADS and modified LI-RADS algorithms were 72.9 and 71.4%, respectively (P = .50). The sensitivity of both systems was the same (69.7%; 95% CI: 60.7-77.8%). Regarding LR-M as a predictor of non-HCC malignancy, the diagnostic performance of the algorithms was the same, with accuracy and sensitivity results of 76.4 and 73.3%, respectively (95% CI: 44.9-92.2%). CONCLUSION The findings indicate that modified LI-RADS had a moderate level of diagnostic performance for HCC in examinations using Sonazoid, which was comparable to ACR LI-RADS.
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Affiliation(s)
- Wei Liao
- Department of Medical Ultrasound, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Qiao Que
- Department of Medical Ultrasound, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Rong Wen
- Department of Medical Ultrasound, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Peng Lin
- Department of Medical Ultrasound, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yuji Chen
- Department of Medical Ultrasound, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jinshu Pang
- Department of Medical Ultrasound, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Danxia Guo
- Department of Medical Ultrasound, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Dongyue Wen
- Department of Medical Ultrasound, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Hong Yang
- Department of Medical Ultrasound, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Guangxi Zhuang Autonomous Region Engineering Research Center for Artificial Intelligence Analysis of Multimodal Tumor Images, Nanning, China
| | - Yun He
- Department of Medical Ultrasound, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- Guangxi Zhuang Autonomous Region Engineering Research Center for Artificial Intelligence Analysis of Multimodal Tumor Images, Nanning, China
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Li MH, Li WW, He L, Li JF, Zhang SY. Quantitative evaluation of colorectal tumour vasculature using contrast-enhanced ultrasound: Correlation with angiogenesis and prognostic significance. World J Gastrointest Surg 2023; 15:2052-2062. [PMID: 37901730 PMCID: PMC10600759 DOI: 10.4240/wjgs.v15.i9.2052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/11/2023] [Accepted: 07/26/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Ultrasound is a vital tool for the diagnosis and management of colorectal cancer (CRC). Contrast-enhanced ultrasound (CEUS) is a non-invasive, safe, and cost-effective method for evaluating tumour blood vessels, that play a crucial role in tumour growth and progression. AIM To explore CEUS's role in the quantitative evaluation of CRC blood vessels and their correlation with angiogenesis markers and prognosis. METHODS This study prospectively enrolled 100 patients with CRC confirmed by histopathology. All patients received preoperative CEUS examinations. Quantitative parameters, such as peak intensity (PI), time to peak (TTP), and area under the curve (AUC), were derived from time-intensity curve (TIC) analysis. Tumour tissue samples were obtained during surgery and examined immunohistochemically to assess the expression of angiogenesis markers, including vascular endothelial growth factor (VEGF) and microvessel density (MVD). The correlation between CEUS parameters, angiogenesis markers, and clinicopathological features was evaluated using appropriate statistical tests. RESULTS Quantitative CEUS parameters (PI, TTP, and AUC) showed significant correlations with VEGF expression (P < 0.001) and MVD (P < 0.001), indicating a strong link between tumour blood vessels and angiogenesis. Increased PI, reduced TTP, and expanded AUC values were significantly related to higher tumour stage (P < 0.001), lymph node metastasis (P < 0.001), and distant metastasis (P < 0.001). Furthermore, these parameters were recognized as independent predictors of overall survival and disease-free survival in multivariate analysis (P < 0.001). CONCLUSION CEUS has a high potential in guiding treatment planning and predicting patient outcomes. However, more comprehensive, multicentre studies are required to validate the clinical utility of CEUS in CRC management.
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Affiliation(s)
- Ming-Hui Li
- Department of Ultrasound, Tumor Hospital Affiliated to Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Regions, China
| | - Wei-Wei Li
- Department of Ultrasound, Tumor Hospital Affiliated to Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Regions, China
| | - Ling He
- Department of Ultrasound, Tumor Hospital Affiliated to Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Regions, China
| | - Jian-Fang Li
- Department of Medical Imaging, Baoding Maternal and Child Health Hospital, Baoding 071023, Hebei Province, China
| | - Sun-Yan Zhang
- Department of Ultrasonography, Nantong Haimen District People’s Hospital, Nantong 226100, Jiangsu Province, China
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Qin X, Zhu J, Tu Z, Ma Q, Tang J, Zhang C. Contrast-Enhanced Ultrasound with Deep Learning with Attention Mechanisms for Predicting Microvascular Invasion in Single Hepatocellular Carcinoma. Acad Radiol 2023; 30 Suppl 1:S73-S80. [PMID: 36567144 DOI: 10.1016/j.acra.2022.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022]
Abstract
RATIONALE AND OBJECTIVES Prediction of microvascular invasion (MVI) status of hepatocellular carcinoma (HCC) holds clinical significance for decision-making regarding the treatment strategy and evaluation of patient prognosis. We developed a deep learning (DL) model based on contrast-enhanced ultrasound (CEUS) to predict MVI of HCC. MATERIALS AND METHODS We retrospectively analyzed the data for single primary HCCs that were evaluated with CEUS 1 week before surgical resection from December 2014 to February 2022. The study population was divided into training (n = 198) and test (n = 54) cohorts. In this study, three DL models (Resnet50, Resnet50+BAM, Resnet50+SE) were trained using the training cohort and tested in the test cohort. Tumor characteristics were also evaluated by radiologists, and multivariate regression analysis was performed to determine independent indicators for the development of predictive nomogram models. The performance of the three DL models was compared to that of the MVI prediction model based on radiologist evaluations. RESULTS The best-performing model, ResNet50+SE model achieved the ROC of 0.856, accuracy of 77.2, specificity of 93.9%, and sensitivity of 52.4% in the test group. The MVI prediction model based on a combination of three independent predictors showed a C-index of 0.729, accuracy of 69.4, specificity of 73.8%, and sensitivity of 62%. CONCLUSION The DL algorithm can accurately predict MVI of HCC on the basis of CEUS images, to help identify high-risk patients for the assist treatment.
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Affiliation(s)
- Xiachuan Qin
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, AH, China, 230022; Department of Ultrasound, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College (University), Nan Chong, Sichuan, China
| | - Jianhui Zhu
- Anhui Provincial Key Laboratory of Multimodal Cognitive Computation, School of Computer Science and Technology, Anhui University, Hefei, Anhui, China
| | - Zhengzheng Tu
- Anhui Provincial Key Laboratory of Multimodal Cognitive Computation, School of Computer Science and Technology, Anhui University, Hefei, Anhui, China
| | - Qianqing Ma
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, AH, China, 230022
| | - Jin Tang
- Anhui Provincial Key Laboratory of Multimodal Cognitive Computation, School of Computer Science and Technology, Anhui University, Hefei, Anhui, China
| | - Chaoxue Zhang
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Hefei, AH, China, 230022.
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Shi L, Wu D, Yang X, Yan C, Huang P. Contrast-Enhanced Ultrasound and Strain Elastography for Differentiating Benign and Malignant Parotid Tumors. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2023; 44:419-427. [PMID: 36731495 PMCID: PMC10629480 DOI: 10.1055/a-1866-4633] [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] [Received: 02/03/2022] [Accepted: 05/21/2022] [Indexed: 06/18/2023]
Abstract
OBJECTIVES Preoperative differentiation between benign parotid tumors (BPT) and malignant parotid tumors (MPT) is crucial for treatment decisions. The purpose of this study was to investigate the benefits of combining contrast-enhanced ultrasound (CEUS) and strain elastography (SE) for preoperative differentiation between BPT and MPT. METHODS A total of 115 patients with BPT (n=72) or MPT (n=43) who underwent ultrasound (US), SE, and CEUS were enrolled. US and CEUS features and the elasticity score were evaluated. Receiver operating characteristic curve (ROC) analysis was used to assess the diagnostic performance of SE, CEUS, and SE + CEUS with respect to identifying MPT from BPT. RESULTS Solitary presentation, larger diameter, irregular shape, ill-defined margin, heterogeneous echogenicity, and calcification on US and higher elasticity score on SE had a significant association with malignancy. MPT also presented an unclear margin, larger size after enhancement, and "fast-in and fast-out" pattern on CEUS. The combination of SE and CEUS was effective for differentiating MPT from BPT (AUC: 0.88, 0.80-0.95), with a sensitivity of 86.0%, specificity of 88.9%, and accuracy of 87.8%, which were significantly higher than the values for SE (AUC: 0.75, 0.66-0.85) and CEUS (AUC: 0.82, 0.73-0.91) alone. CONCLUSION The combination of CEUS and SE is valuable for distinguishing MPT from BPT.
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Affiliation(s)
- Liuhong Shi
- Department of Ultrasound in Medicine, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, China
| | - Dingting Wu
- Nutrition Division, The Fourth Affiliated Hospital Zhejiang University School of Medicine, Yiwu, China
| | - Xu Yang
- Pathology, Zhejiang University School of Medicine First Affiliated Hospital, Hangzhou, China
| | - Caoxin Yan
- Department of Ultrasound in Medicine, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, China
| | - Pintong Huang
- Department of Ultrasound in Medicine, Zhejiang University School of Medicine Second Affiliated Hospital, Hangzhou, China
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9
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Xue ES, Su HZ, Li ZY, Hong LC, Lin WJ, Chen C, Guo J, Fang ZY. Contrast-Enhanced Ultrasound Imaging: Novel Method for the Evaluation of Chronic Alcohol-Induced Testicular Damage. ULTRASOUND IN MEDICINE & BIOLOGY 2023:S0301-5629(23)00165-5. [PMID: 37271681 DOI: 10.1016/j.ultrasmedbio.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The goals of this study were to determine whether contrast-enhanced ultrasound (CEUS) imaging could be used for assessment of chronic alcohol-induced testicular damage (CAITD) and to explore the relationships between the laboratory and pathological findings of CAITD and the quantitative parameters of CEUS. METHODS Thirty-six rabbits were randomly divided into a chronic ethanol exposure (CEE) group and negative control (NC) group, which were further randomly divided into six groups with equal numbers of rabbits by period of exposure (30 d, 60 d, 90 d). All rabbits underwent conventional US and CEUS imaging at the end of the induction period. Blood and histological specimens were collected for laboratory and pathological examination. RESULTS The peak intensity (PI) and area under the curve (AUC) for the CEUS parameters decreased as CAITD progressed (p < 0.05). Both PI and AUC were positively correlated with the Johnsen score (r= 0.945 and 0.898, respectively, all p values <0.001) and the mean epithelium thickness of the seminiferous tubule (METST) (r= 0.927 and 0.881, respectively, all p values <0.001) of the testis, and negatively correlated with the serum levels of endothelin-1 (ET-1) (r = -0.940 and -0.899, respectively, all p values <0.001) and nitric oxide (NO) (r = -0.894 and -0.954, respectively, all p values <0.001), as well as the testicular tissue content of malondialdehyde (MDA) (r = -0.894 and -0.945, respectively, all p values <0.001). CONCLUSION CEUS imaging can be used for monitoring organ perfusion of the testis to quantify the development of CAITD.
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Affiliation(s)
- En-Sheng Xue
- Department of Ultrasound, Fujian Medical University Union Hospital, Fuzhou, China.
| | - Huan-Zhong Su
- Department of Ultrasound, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Zhi-Yong Li
- Department of Ultrasound, Fujian Medical University Union Hospital, Fuzhou, China
| | - Long-Cheng Hong
- Department of Ultrasound, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Wen-Jin Lin
- Department of Ultrasound, Fujian Medical University Union Hospital, Fuzhou, China
| | - Cong Chen
- Department of Ultrasound, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jie Guo
- Department of Ultrasound, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Zhen-Yan Fang
- Department of Ultrasound, Fujian Medical University Union Hospital, Fuzhou, China
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10
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Lin WC, Chang CW, Chen MJ, Wang HY. Intestinal Ultrasound in Inflammatory Bowel Disease: A Novel and Increasingly Important Tool. J Med Ultrasound 2023; 31:86-91. [PMID: 37576427 PMCID: PMC10413392 DOI: 10.4103/jmu.jmu_84_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/18/2022] [Accepted: 10/26/2022] [Indexed: 08/15/2023] Open
Abstract
New and efficacious medical therapies have become available that have greatly enhanced clinicians' ability to manage inflammatory bowel diseases (IBDs). IBD activity should be assessed regularly in scheduled examinations as the part of a treat-to-target strategy for IBD care. The gold-standard approach to investigating IBD is colonoscopy, but this is an invasive procedure. Intestinal ultrasound (IUS) has played a crucial role in recent years regarding the assessment of IBD activity because it is noninvasive, safe, reproducible, and inexpensive. IUS findings could inform changes in therapeutic interventions for IBDs; this would necessitate fewer endoscopies and enable faster decision-making processes. Furthermore, patients are accepting and tolerant of IUS examinations. This review outlines the current evidence and gives indication regarding the use of IUS in the management of IBDs.
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Affiliation(s)
- Wei-Chen Lin
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
- Mackay Medical College, Taipei, Taiwan
| | - Chen-Wang Chang
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
- Mackay Medical College, Taipei, Taiwan
| | - Ming-Jen Chen
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
- Mackay Medical College, Taipei, Taiwan
| | - Horng-Yuan Wang
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
- Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
- Mackay Medical College, Taipei, Taiwan
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11
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Liao Z, Tang C, Luo R, Gu X, Zhou J, Gao J. Current Concepts of Precancerous Lesions of Hepatocellular Carcinoma: Recent Progress in Diagnosis. Diagnostics (Basel) 2023; 13:diagnostics13071211. [PMID: 37046429 PMCID: PMC10093043 DOI: 10.3390/diagnostics13071211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023] Open
Abstract
The most common cause of hepatocellular carcinoma (HCC) is chronic hepatitis and cirrhosis. It is proposed that precancerous lesions of HCC include all stages of the disease, from dysplastic foci (DF), and dysplastic nodule (DN), to early HCC (eHCC) and progressed HCC (pHCC), which is a complex multi-step process. Accurately identifying precancerous hepatocellular lesions can significantly impact the early detection and treatment of HCC. The changes in high-grade dysplastic nodules (HGDN) were similar to those seen in HCC, and the risk of malignant transformation significantly increased. Nevertheless, it is challenging to diagnose precancerous lesions of HCC. We integrated the literature and combined imaging, pathology, laboratory, and other relevant examinations to improve the accuracy of the diagnosis of precancerous lesions.
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Affiliation(s)
- Ziyue Liao
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Chongqing Medical University, No. 76 Linjiang Road, Yuzhong District, Chongqing 400010, China
| | - Cuiping Tang
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Chongqing Medical University, No. 76 Linjiang Road, Yuzhong District, Chongqing 400010, China
| | - Rui Luo
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Chongqing Medical University, No. 76 Linjiang Road, Yuzhong District, Chongqing 400010, China
| | - Xiling Gu
- Department of Pathology, The Second Affiliated Hospital of Chongqing Medical University, No. 76 Linjiang Road, Yuzhong District, Chongqing 400010, China
| | - Jun Zhou
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, No. 76 Linjiang Road, Yuzhong District, Chongqing 400010, China
| | - Jian Gao
- Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Chongqing Medical University, No. 76 Linjiang Road, Yuzhong District, Chongqing 400010, China
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12
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Huang B, Xie H, Li Z. Microfluidic Methods for Generation of Submicron Droplets: A Review. MICROMACHINES 2023; 14:638. [PMID: 36985045 PMCID: PMC10056697 DOI: 10.3390/mi14030638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
Submicron droplets are ubiquitous in nature and widely applied in fields such as biomedical diagnosis and therapy, oil recovery and energy conversion, among others. The submicron droplets are kinetically stable, their submicron size endows them with good mobility in highly constricted pathways, and the high surface-to-volume ratio allows effective loading of chemical components at the interface and good heat transfer performance. Conventional generation technology of submicron droplets in bulk involves high energy input, or relies on chemical energy released from the system. Microfluidic methods are widely used to generate highly monodispersed micron-sized or bigger droplets, while downsizing to the order of 100 nm was thought to be challenging because of sophisticated nanofabrication. In this review, we summarize the microfluidic methods that are promising for the generation of submicron droplets, with an emphasize on the device fabrication, operational condition, and resultant droplet size. Microfluidics offer a relatively energy-efficient and versatile tool for the generation of highly monodisperse submicron droplets.
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13
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Lin JM, Huang GF, Xie QC, Lyu GR, Lin J, Huang SS, Chen YL. Application of B-flow imaging and its enhanced mode in perforator mapping. Clin Radiol 2023; 78:387-393. [PMID: 36863882 DOI: 10.1016/j.crad.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 01/17/2023] [Accepted: 01/20/2023] [Indexed: 02/11/2023]
Abstract
AIM To explore the value of B-flow (B-mode blood flow) imaging and its enhanced mode in perforator mapping. MATERIALS AND METHODS Before surgery, B-flow imaging, enhanced B-flow imaging, colour Doppler flow imaging (CDFI), and contrast-enhanced ultrasound (CEUS) were used to detect the skin-perforating vessels and small vessels in the fat layer of the donor site. Taking the intra-operative results as the reference standard, the diagnostic consistency and efficiency of the four modes were compared. Statistical analysis was performed using the Friedman M-test, Cochran's Q-test, and the Z-test. RESULTS Thirty flaps were excised, with 34 skin-perforating vessels and 25 non-skin-perforating vessels, as confirmed during surgery. In order of the number of skin-perforating vessels detected, the results showed that enhanced B-flow imaging detected more vessels than B-flow imaging and CDFI (all p<0.05), CEUS detected more vessels than B-flow imaging and CDFI (all p<0.05), B-flow imaging detected more vessels than CDFI (p<0.05). All four modes had remarkable and satisfactory diagnostic consistency and effectiveness, but B-flow imaging was the best (sensitivity 100%, specificity 92%, Youden index 0.92). In order of the number of small vessels in the fat layer detected, the results showed that enhanced B-flow imaging detected more vessels than CEUS, B-flow imaging, and CDFI (all p<0.05). CEUS detected more vessels than B-flow imaging and CDFI (all p<0.05). CONCLUSION B-flow imaging is an alternative method for perforator mapping. Enhanced B-flow imaging can reveal the microcirculation of flaps.
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Affiliation(s)
- J-M Lin
- Department of Ultrasound, Jinjiang Municipal Hospital, China
| | - G-F Huang
- Department of Ultrasound, Jinjiang Municipal Hospital, China
| | - Q-C Xie
- Department of Ultrasound, Jinjiang Municipal Hospital, China
| | - G-R Lyu
- Department of Ultrasound, Jinjiang Municipal Hospital, China; Collaborative Innovation Center for Maternal and Infant Health Service Application Technology, Quanzhou Medical College, China.
| | - J Lin
- Department of Ultrasound, Jinjiang Municipal Hospital, China
| | - S-S Huang
- Department of Ultrasound, Jinjiang Municipal Hospital, China
| | - Y-L Chen
- Department of Ultrasound, Jinjiang Municipal Hospital, China
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14
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Tang Y, Tang S, Huang C, Klippel P, Ma C, Caso N, Chen S, Jing Y, Yao J. High-fidelity deep functional photoacoustic tomography enhanced by virtual point sources. PHOTOACOUSTICS 2023; 29:100450. [PMID: 36685991 PMCID: PMC9852650 DOI: 10.1016/j.pacs.2023.100450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/19/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Photoacoustic tomography (PAT), a hybrid imaging modality that acoustically detects the optical absorption contrast, is a promising technology for imaging hemodynamic functions in deep tissues far beyond the traditional optical microscopy. However, the most clinically compatible PAT often suffers from the poor image fidelity, mostly due to the limited detection view of the linear ultrasound transducer array. PAT can be improved by employing highly-absorbing contrast agents such as droplets and nanoparticles, which, however, have low clinical translation potential due to safety concerns and regulatory hurdles imposed by these agents. In this work, we have developed a new methodology that can fundamentally improve PAT's image fidelity without hampering any of its functional capability or clinical translation potential. By using clinically-approved microbubbles as virtual point sources that strongly and isotropically scatter the local pressure waves generated by surrounding hemoglobin, we can overcome the limited-detection-view problem and achieve high-fidelity functional PAT in deep tissues, a technology referred to as virtual-point-source PAT (VPS-PAT). We have thoroughly investigated the working principle of VPS-PAT by numerical simulations and in vitro phantom experiments, clearly showing the signal origin of VPSs and the resultant superior image fidelity over traditional PAT. We have also demonstrated in vivo applications of VPT-PAT for functional small-animal studies with physiological challenges. We expect that VPS-PAT can find broad applications in biomedical research and accelerated translation to clinical impact.
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Affiliation(s)
- Yuqi Tang
- Photoacoustic Imaging Lab, Department of Biomedical Engineering, Duke University, Durham, NC, the United States of America
| | - Shanshan Tang
- Ultrasound Imaging Lab, Department of Biomedical Engineering, Mayo Clinic, Rochester, MN, the United States of America
| | - Chengwu Huang
- Ultrasound Imaging Lab, Department of Biomedical Engineering, Mayo Clinic, Rochester, MN, the United States of America
| | - Paul Klippel
- Graduate Program in Acoustic and Department of Biomedical Engineering, Pennsylvania State University, University Park, PA, the United States of America
| | - Chenshuo Ma
- Photoacoustic Imaging Lab, Department of Biomedical Engineering, Duke University, Durham, NC, the United States of America
| | - Nathan Caso
- Graduate Program in Acoustic and Department of Biomedical Engineering, Pennsylvania State University, University Park, PA, the United States of America
| | - Shigao Chen
- Ultrasound Imaging Lab, Department of Biomedical Engineering, Mayo Clinic, Rochester, MN, the United States of America
| | - Yun Jing
- Graduate Program in Acoustic and Department of Biomedical Engineering, Pennsylvania State University, University Park, PA, the United States of America
| | - Junjie Yao
- Photoacoustic Imaging Lab, Department of Biomedical Engineering, Duke University, Durham, NC, the United States of America
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15
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Nogueira Aires LP, Gasser B, Silva P, Del’Aguila-Silva P, Yamada DI, Carneiro RK, Bressianini Lima B, Padilha-Nakaghi LC, Ramirez Uscategui RA, Spada S, Russo M, Rossi Feliciano MA. Ovarian contrast-enhanced ultrasonography and Doppler fluxometry in bitches during the postovulatory estrus and corpora lutea formation. Theriogenology 2022; 194:162-170. [DOI: 10.1016/j.theriogenology.2022.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022]
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16
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Yusefi H, Helfield B. The influence of inter-bubble spacing on the resonance response of ultrasound contrast agent microbubbles. ULTRASONICS SONOCHEMISTRY 2022; 90:106191. [PMID: 36223708 PMCID: PMC9563339 DOI: 10.1016/j.ultsonch.2022.106191] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/29/2022] [Accepted: 10/05/2022] [Indexed: 06/06/2023]
Abstract
Ultrasound-driven microbubbles, typically between 1 and 8 µm in diameter, are resonant scatterers that are employed as diagnostic contrast agents and emerging as potentiators of targeted therapies. Microbubbles are administered in populations whereby their radial dynamics - key to their effectiveness - are greatly affected by intrinsic (e.g. bubble size) and extrinsic (e.g. boundaries) factors. In this work, we aim to understand how two neighbouring microbubbles influence each other. We developed a finite element model of a system of two individual phospholipid-encapsulated microbubbles vibrating in proximity to each other to study the effect of inter-bubble distance on microbubble radial resonance response. For the case of two equal-sized and identical bubbles, each bubble exhibits a decrease between 7 and 10% in the frequency of maximum response (fMR) and an increase in amplitude of maximum response (AMR) by 9-11% as compared to its isolated response in free-space, depending on the bubble size examined. For a system of two unequal-sized microbubbles, the large bubble shows no significant change, however the smaller microbubble shows an increase in fMR by 7-11% and a significant decrease in AMR by 38-52%. Furthermore, in very close proximity the small bubble shows a secondary off-resonance peak at the corresponding fMR of its larger companion microbubble. Our work suggests that frequency-dependent microbubble response is greatly affected by the presence of another bubble, which has implications in both imaging and therapy applications. Furthermore, our work suggests a mechanism by which nanobubbles show significant off-resonance vibrations in the clinical frequency range, a behaviour that has been observed experimentally but heretofore unexplained.
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Affiliation(s)
- Hossein Yusefi
- Department of Physics, Concordia University, Montreal, Quebec H4B 1R6, Canada
| | - Brandon Helfield
- Department of Physics, Concordia University, Montreal, Quebec H4B 1R6, Canada; Department of Biology, Concordia University, Montreal, Quebec H4B 1R6, Canada.
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17
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Bartlett DJ, Ramos GP, Fletcher JG, Bruining DH. Imaging Evaluation of Inflammatory Bowel Disease Complications. Gastrointest Endosc Clin N Am 2022; 32:651-673. [PMID: 36202508 DOI: 10.1016/j.giec.2022.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Inflammatory bowel disease (IBD) is a chronic inflammatory condition that can progress to fibrostenotic and penetrating complications. Cross-sectional imaging is often needed for accurate diagnosis of IBD complication and for planning the appropriate management strategy. Computed tomography enterography, magnetic resonance enterography, and IBD ultrasound have become key tools for clinicians and interventional endoscopists. This article highlights and discusses various radiologic imaging techniques and their application to the diagnosis and management of IBD complications.
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Affiliation(s)
- David J Bartlett
- Department of Radiology, Mayo Clinic College of Medicine, 200 1st Street, SW, Rochester, MN 55905, USA; Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 1st Street, SW, Rochester, MN 55905, USA
| | - Guilherme Piovezani Ramos
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 1st Street, SW, Rochester, MN 55905, USA
| | - Joel G Fletcher
- Department of Radiology, Mayo Clinic College of Medicine, 200 1st Street, SW, Rochester, MN 55905, USA
| | - David H Bruining
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 1st Street, SW, Rochester, MN 55905, USA.
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18
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Leow KS, Kwok CY, Low HM, Lohan R, Lim TC, Low SCA, Tan CH. Algorithm‐based approach to focal liver lesions in contrast‐enhanced ultrasound. Australas J Ultrasound Med 2022; 25:142-153. [DOI: 10.1002/ajum.12306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Kheng Song Leow
- Department of Radiology Woodlands Health Campus 2 Yishun Central 2, Tower E, Level 5 Singapore Singapore
| | - Christine Ying Kwok
- Department of Diagnostic Radiology Tan Tock Seng Hospital 11 Jalan Tan Tock Seng Singapore 308433 Singapore
| | - Hsien Min Low
- Department of Diagnostic Radiology Tan Tock Seng Hospital 11 Jalan Tan Tock Seng Singapore 308433 Singapore
| | - Rahul Lohan
- Department of Diagnostic Radiology Khoo Teck Puat Hospital 90 Yishun Central Singapore Singapore
| | - Tze Chwan Lim
- Department of Radiology Woodlands Health Campus 2 Yishun Central 2, Tower E, Level 5 Singapore Singapore
| | - Su Chong Albert Low
- Department of Diagnostic Radiology Singapore General Hospital Outram Road Singapore 169608 Singapore
| | - Cher Heng Tan
- Department of Diagnostic Radiology Tan Tock Seng Hospital 11 Jalan Tan Tock Seng Singapore 308433 Singapore
- Lee Kong Chian School of Medicine Nanyang Technological University Singapore Singapore
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19
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Wang H, Picchio ML, Calderón M. One stone, many birds: Recent advances in functional nanogels for cancer nanotheranostics. WILEY INTERDISCIPLINARY REVIEWS. NANOMEDICINE AND NANOBIOTECHNOLOGY 2022; 14:e1791. [PMID: 35338603 PMCID: PMC9540470 DOI: 10.1002/wnan.1791] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/28/2022] [Accepted: 03/01/2022] [Indexed: 12/18/2022]
Abstract
Inspired by the development of nanomedicine and nanotechnology, more and more possibilities in cancer theranostic have been provided in the last few years. Emerging therapeutic modalities like starvation therapy, chemodynamic therapy, and tumor oxygenation have been integrated with diagnosis, giving a plethora of theranostic nanoagents. Among all of them, nanogels (NGs) show superiority benefiting from their unique attributes: high stability, high water-absorption, large specific surface area, mechanical strength, controlled responsiveness, and high encapsulation capacity. There have been a vast number of investigations supporting various NGs combining drug delivery and multiple bioimaging techniques, encompassing photothermal imaging, photoacoustic imaging, fluorescent imaging, ultrasound imaging, magnetic resonance imaging, and computed tomography. This review summarizes recent advances in functional NGs for theranostic nanomedicine and discusses the challenges and future perspectives of this fast-growing field. This article is categorized under: Therapeutic Approaches and Drug Discovery > Emerging Technologies Therapeutic Approaches and Drug Discovery > Nanomedicine for Oncologic Disease Nanotechnology Approaches to Biology > Nanoscale Systems in Biology Diagnostic Tools > In Vivo Nanodiagnostics and Imaging.
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Affiliation(s)
- Huiyi Wang
- POLYMAT, Applied Chemistry Department, Faculty of Chemistry, University of the Basque Country, UPV/EHU, Donostia-San Sebastián, Spain
| | - Matias L Picchio
- POLYMAT, Applied Chemistry Department, Faculty of Chemistry, University of the Basque Country, UPV/EHU, Donostia-San Sebastián, Spain
| | - Marcelo Calderón
- POLYMAT, Applied Chemistry Department, Faculty of Chemistry, University of the Basque Country, UPV/EHU, Donostia-San Sebastián, Spain.,IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
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20
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Kim S, Chughtai K, Brahmbhatt A, Rubens D, Dogra V. Contrast-Enhanced Ultrasound as a Problem-Solving Modality: Tips and Tricks. Ultrasound Q 2022; 38:103-115. [PMID: 35426378 DOI: 10.1097/ruq.0000000000000604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Contrast-enhanced ultrasound (CEUS) continues to be an ever-growing tool in radiation-free imaging. While it has been widely used in cardiac imaging, CEUS has only recently become an Food and Drug Administration-approved and viable modality for evaluation of abdominal structures. Ultrasound contrast agents are nontoxic, microbubble-based vascular agents and can be used to reliably assess enhancement patterns of various lesions in real time. In particular, it's non nephrotoxic nature makes CEUS a particularly important tool in renal failure patients requiring serial follow-up. This review provides a comprehensive discussion on the utility of CEUS agents, imaging techniques, comparison with traditional cross-sectional imaging modalities, and its application in diagnosing kidney and liver lesions. This pictorial review is illustrated with cases of renal and hepatic lesions that the practicing radiologist should become familiar with as CEUS becomes increasingly popular.
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Affiliation(s)
- Solomon Kim
- Department of Imaging Sciences, Strong Memorial Hospital, Rochester, NY
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21
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Gumus M, Oommen KC, Squires JH. Contrast-enhanced ultrasound of the neonatal brain. Pediatr Radiol 2022; 52:837-846. [PMID: 34333692 DOI: 10.1007/s00247-021-05157-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/03/2021] [Accepted: 07/12/2021] [Indexed: 12/13/2022]
Abstract
Cranial US is an integral component of evaluating the neonatal brain, especially in the setting of critically ill infants and in the emergency setting, because cranial US can be performed portably at the bedside, is safe, and can be repeated whenever needed. Contrast-enhanced ultrasound (CEUS) involves intravenously injecting microbubbles to allow for improved visibility of large and small vessels to assess vascularity and is becoming a widespread technique to improve diagnostic performance of US across a broad spectrum of applications. CEUS has the potential to add value to routine brain US and become a useful adjunct to MRI in infants in need of bedside imaging. In this review we describe the basics of US contrast agents and CEUS technique, including safety considerations, and detail the potential clinical uses of brain CEUS.
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Affiliation(s)
- Memduha Gumus
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Kevin C Oommen
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Judy H Squires
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
- Department of Pediatric Radiology, UPMC Children's Hospital of Pittsburgh, 2nd Floor Radiology, 4401 Penn Ave., Pittsburgh, PA, 15224, USA.
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22
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Contrast-enhanced ultrasound of the kidneys: principles and potential applications. Abdom Radiol (NY) 2022; 47:1369-1384. [PMID: 35150315 DOI: 10.1007/s00261-022-03438-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 02/07/2023]
Abstract
Contrast-enhanced ultrasound (CEUS) is an extension and an enhanced form of ultrasound that allows real-time evaluation of the various structures in different vascular phases. The last decade has witnessed a widespread expansion of CEUS applications beyond the liver. It has shown fair potential in kidneys and its diagnostic efficacy is comparable to CT and MRI. Ultrasound is the well-accepted screening modality for renal pathologies, however, it underperforms in the characterization of the renal masses. CEUS can be beneficial in such cases as it can help in the characterization of such incidental masses in the same sitting. It has an excellent safety profile with no risk of radiation or contract-related nephropathy. It can aid in the correct categorization of renal cysts into one of the Bosniak classes and has proven its worth especially in complex cysts or indeterminate renal masses (especially Bosniak Category IIF and III). Few studies also describe its potential role in solid masses and in differentiating benign from malignant masses. Other areas of interest include infections, infarctions, trauma, follow-up of local ablative procedures, and VUR. Through this review, the readers shall get an insight into the various applications of CEUS in kidneys, with imaging examples.
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23
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Zhong X, Peng J, Xie Y, Shi Y, Long H, Su L, Duan Y, Xie X, Lin M. A nomogram based on multi-modal ultrasound for prediction of microvascular invasion and recurrence of hepatocellular carcinoma. Eur J Radiol 2022; 151:110281. [PMID: 35395542 DOI: 10.1016/j.ejrad.2022.110281] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/01/2022] [Accepted: 03/28/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To establish and validate a nomogram based on multi-modal ultrasound for preoperative prediction of microvascular invasion (MVI) in hepatocellular carcinoma (HCC), and to assess the ability thereof to stratify recurrence-free survival (RFS). METHODS A total of 287 HCC patients undergoing surgical resection were prospectively enrolled, including 210 patients in the training cohort and 77 patients in the test cohort. All patients underwent conventional ultrasound, contrast-enhanced ultrasonography, and shear wave elastography examinations within one week before surgery. Taking histopathological examination result as the reference standard, independent factors associated with MVI in HCC were determined by logistic regression and a nomogram was established and further evaluated. The Kaplan-Meier method was used to analyze the prognostic value of histologic MVI status and nomogram-predicted MVI status. RESULTS Multivariate analysis showed that tumor diameter, echogenicity, tumor shape, arterial phase peritumoral enhancement and enhancement level in portal venous phase were independent predictors of MVI (all p < 0.05). The nomogram based on these variables showed good discrimination and calibration with the areas under the receiver operating characteristic curve (AUC) of 0.821 (0.762-0.870) and 0.789 (0.681-0.874) in the training and test cohorts. There was a significant difference in RFS between the nomogram-predicted MVI positive and the nomogram-predicted MVI negative groups in training and test cohorts (p < 0.001 and p = 0.004 respectively). CONCLUSIONS The multimodal ultrasound features were effective imaging markers for preoperative prediction of MVI of HCC and the nomogram might be an effective tool to stratify the risk of recurrence and guide the individualized treatment of HCC.
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Affiliation(s)
- Xian Zhong
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Jianyun Peng
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Yuhua Xie
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Yifan Shi
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Haiyi Long
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Liya Su
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Yu Duan
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Xiaoyan Xie
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Manxia Lin
- Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
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Lee SC, Tchelepi H, Khadem N, Desai B, Yamashita M, Hovanessian-Larsen L. Imaging of Benign and Malignant Breast Lesions Using Contrast-Enhanced Ultrasound: A Pictorial Essay. Ultrasound Q 2022; 38:2-12. [PMID: 35239626 DOI: 10.1097/ruq.0000000000000574] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Contrast-enhanced ultrasound is a promising noninvasive imaging technique for evaluating benign and malignant breast lesions, as contrast provides information about perfusion and microvasculature. Contrast-enhanced ultrasound is currently off-label use in the breast in the United States, but its clinical and investigational use in breast imaging is gaining popularity. It is important for radiologists to be familiar with the imaging appearances of benign and malignant breast masses using contrast-enhanced ultrasound. This pictorial essay illustrates enhancement patterns of various breast masses from our own experience. Pathologies include subtypes of invasive breast cancer, fibroadenomas, papillary lesions, fibrocystic change, and inflammatory processes. Contrast-enhanced ultrasound pitfalls and limitations are discussed.
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Affiliation(s)
- Sandy C Lee
- Department of Radiology, Keck School of Medicine, University of Southern California
| | - Hisham Tchelepi
- Department of Radiology, Keck School of Medicine, University of Southern California
| | - Nasim Khadem
- Department of Radiology, VA Long Beach Medical Center, Long Beach, CA
| | - Bhushan Desai
- Department of Radiology, Keck School of Medicine, University of Southern California
| | - Mary Yamashita
- Department of Radiology, Keck School of Medicine, University of Southern California
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25
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Zhao D, He N, Shao YQ, Yu XL, Chu J, Yang G. The diagnostic value of contrast-enhanced ultrasound for cervical tuberculous lymphadenitis. Clin Hemorheol Microcirc 2022; 81:69-79. [PMID: 35001882 PMCID: PMC9108573 DOI: 10.3233/ch-211355] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE: To investigate the value of contrast-enhanced ultrasound (CEUS) for the diagnosis of cervical tuberculous lymphadenitis (CTL). METHODS: The cohort study included 203 consecutive patients diagnosed with cervical lymph node. Before pathological or laboratory confirmation, all patients underwent CEUS examination, and the imaging findings were analyzed afterward. The diagnostic efficiency of the CEUS imaging findings of CTL was evaluated. RESULTS: Nighty-seven patients of the 203 (47.8%) were pathologically or laboratory confirmed with a CTL diagnosis while the remainder (52.2%) were diagnosed with non-tuberculous lymphadenitis. Regarding the imaging findings of CEUS, it was more common in CTL patients to find a pattern of heterogeneous enhancement inside the lymph nodes relative to non-tuberculous patients [81.44% (79/97) vs 15.09% (16/106), P < 0.01]. The sensitivity of the feature in diagnosis for CTL was 81.44% and the specificity was 84.91%, resepectively. Furthermore, a pattern of peripheral rim-like enhancement had been notable in CTL patients compared with non-tuberculous patients [86.60% (84/97) vs 12.26% (13/106), P < 0.01], associating with a diagnostic sensitivity of 86.60% and a specificity of 87.74%. When it came to the combination of both imaging findings mentioned above, the features were more prominent in CTL patients than compared with non-tuberculous patients [74.23% (72/97) vs 5.66% (6/106), P < 0.01], with a diagnostic sensitivity of 74.23% and a high specificity of 94.34%. Regarding area under curve (AUC) for the ROC analysis, the feature of internal heterogeneous enhancement, peripheral rim-like enhancement, and both features were 0.832, 0.872, and 0.843. CONCLUSIONS: CEUS patterns of heterogeneous enhancement and peripheral rim-like enhancement of lymph nodes are helpful characteristics for the diagnosis of CTL.
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Affiliation(s)
- Dan Zhao
- Department of Ultrasonography, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou Red Cross Hospital, Tuberculosis Diagnostic and Treatment Center of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Ning He
- Department of Ultrasonography, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou Red Cross Hospital, Tuberculosis Diagnostic and Treatment Center of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Ya-Qin Shao
- Department of Ultrasonography, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou Red Cross Hospital, Tuberculosis Diagnostic and Treatment Center of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Xiu-Lei Yu
- Department of Ultrasonography, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou Red Cross Hospital, Tuberculosis Diagnostic and Treatment Center of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Jie Chu
- Department of Ultrasonography, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou Red Cross Hospital, Tuberculosis Diagnostic and Treatment Center of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Gaoyi Yang
- Department of Ultrasonography, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou Red Cross Hospital, Tuberculosis Diagnostic and Treatment Center of Zhejiang Province, Hangzhou, Zhejiang, China
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26
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Barr RG. Use of lumason/sonovue in contrast-enhanced ultrasound of the kidney for characterization of renal masses-a meta-analysis. Abdom Radiol (NY) 2022; 47:272-287. [PMID: 34623494 DOI: 10.1007/s00261-021-03295-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 01/04/2023]
Abstract
Indeterminate renal masses are a common clinical problem. CEUS has several advantages to characterize both cystic and solid renal masses including thin slice thickness, excellent background subtraction, and real-time imaging with a high frame rate. The ultrasound contrast agents are not nephrotoxic and can be used in patients with renal insufficiency and obstruction. The Bosniak classification has been developed for use in CT and MRI. A CEUS Bosniak classification has not yet been developed. This meta-analysis reviews the results of renal mass characterization using Lumason/Sonovue in characterizing renal solid and cystic masses. For complex cystic renal lesions (419 patients; 436 lesions), the pooled sensitivity and specificity of CEUS were 95% (95% CI: 91%, 99%) and 84% (95% CI: 77%, 90%) and for solid lesions (331 patients; 341 lesions), the pooled sensitivity and specificity of CEUS were 98% (95% CI: 95%, 100%) and 78% (95% CI: 68%, 88%), respectively.
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27
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Rauch S. Contrast media and side effects. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00189-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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28
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Park J, Lee JM, Kim TH, Yoon JH. Imaging Diagnosis of HCC: Future directions with special emphasis on hepatobiliary MRI and contrast-enhanced ultrasound. Clin Mol Hepatol 2021; 28:362-379. [PMID: 34955003 PMCID: PMC9293611 DOI: 10.3350/cmh.2021.0361] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/21/2021] [Indexed: 11/16/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is a unique cancer entity that can be noninvasively diagnosed using imaging modalities without pathologic confirmation. In 2018, several major guidelines for HCC were updated to include hepatobiliary contrast agent magnetic resonance imaging (HBA-MRI) and contrast-enhanced ultrasound (CEUS) as major imaging modalities for HCC diagnosis. HBA-MRI enables the achievement of high sensitivity in HCC detection using the hepatobiliary phase (HBP). CEUS is another imaging modality with real-time imaging capability, and it is reported to be useful as a second-line modality to increase sensitivity without losing specificity for HCC diagnosis. However, until now, there is an unsolved discrepancy among guidelines on whether to accept “HBP hypointensity” as a definite diagnostic criterion for HCC or include CEUS in the diagnostic algorithm for HCC diagnosis. Furthermore, there is variability in terminology and inconsistencies in the definition of imaging findings among guidelines; therefore, there is an unmet need for the development of a standardized lexicon. In this article, we review the performance and limitations of HBA-MRI and CEUS after guideline updates in 2018 and briefly introduce some future aspects of imaging-based HCC diagnosis.
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Affiliation(s)
- Junghoan Park
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jeong Min Lee
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea.,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Tae-Hyung Kim
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Jeong Hee Yoon
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea
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29
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Zhao D, Wen BP, Xu SY. Extramammary Paget's Disease in the Genital Area of a Male: A Case Report and Review of the Literature. Front Oncol 2021; 11:713786. [PMID: 34804917 PMCID: PMC8599444 DOI: 10.3389/fonc.2021.713786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/13/2021] [Indexed: 12/07/2022] Open
Abstract
Extramammary Paget's disease (EMPD) is an uncommon intraepithelial malignancy that is rarely found in the male. Currently, there is very little knowledge pertaining to EMPD imaging, particularly in cases that involve the scrotum. Here, a 67-year-old man with lichenification on his left scrotum confirmed to be EMPD was reviewed. Bloodwork did not return a positive result, but syphilis-specific antibodies were found. Conventional high-frequency ultrasound (US) and contrast-enhanced ultrasound (CEUS) imaging were utilized to determine the lesion size and blood perfusion. In the present case, the lesion's size and involvement were vividly depicted by CEUS, while results obtained by conventional US were grossly underestimated. Consequently, multimodal imaging assessment is likely to provide more accurate diagnoses for uncommon diseases, such as EMPD, and to aid in clinical decision-making.
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Affiliation(s)
- Dan Zhao
- Department of Medical Ultrasound, Hangzhou Red Cross Hospital, Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou, China
| | - Bo-ping Wen
- Department of Medical Ultrasound, Hangzhou Red Cross Hospital, Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine, Hangzhou, China
| | - Sen-yin Xu
- Deparment of Ultrasound, Zhejiang Hospital, Hangzhou, China
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30
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Meola M, Ibeas J, Lasalle G, Petrucci I. Basics for performing a high-quality color Doppler sonography of the vascular access. J Vasc Access 2021; 22:18-31. [PMID: 34320855 PMCID: PMC8607315 DOI: 10.1177/11297298211018060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 04/22/2021] [Indexed: 11/23/2022] Open
Abstract
In the last years, the systematic use of ultrasound mapping of the upper limb vascular network before the arteriovenous fistula (AVF) implantation, access maturation, and clinical management of late complications is widespread and expanding. Therefore, a good knowledge of theoretical outlines, instrumentation, and operative settings is undoubtedly required for a thorough examination. In this review, the essential Doppler parameters, B-Mode setting, and Doppler applications are considered. Basic concepts on the Doppler shift equation, angle correction, settings on pulse repetition frequency, operative Doppler frequency, gain are reported to ensure adequate and correct sampling of blood flow velocity. A brief analysis of the Doppler inherent artefacts (as random noise, blooming, aliasing, and motion artefacts) and the adjustment setting to minimize or eliminate the confounding artefacts are also considered. Doppler aliasing occurs when the pulse repetition frequency is set too low. This artefact is particularly frequent in vascular access sampling due to the high velocities range registered in the fistula's different segments. Aliasing should be recognized because its correction is crucial to analyse the Doppler signals correctly. Recent advances in instrumentation are also considered about a potential purchase of a portable ultrasound machine or a top-of-line, high-end, or mid-range ultrasound system. Last, the pulse wave Doppler setting for vascular access B-Mode and Doppler assessment is summarized.
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Affiliation(s)
- Mario Meola
- Sant’Anna School of Advanced Studies,
Pisa, Italy
| | - Jose Ibeas
- Consorcio Corporacion Sanitaria Parc
Tauli, Sabadell, Barcelona, Spain
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31
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Sridharan A, Hwang M, Kutty S, McCarville MB, Paltiel HJ, Piskunowicz M, Shellikeri S, Silvestro E, Taylor GA, Didier RA. Translational research in pediatric contrast-enhanced ultrasound. Pediatr Radiol 2021; 51:2425-2436. [PMID: 33991196 DOI: 10.1007/s00247-021-05095-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/21/2021] [Accepted: 04/28/2021] [Indexed: 10/21/2022]
Abstract
The role of contrast-enhanced ultrasound (CEUS) imaging is being widely explored by various groups for its use in the pediatric population. Clinical implementation of new diagnostic or therapeutic techniques requires extensive and meticulous preclinical testing and evaluation. The impact of CEUS will be determined in part by the extent to which studies are oriented specifically toward a pediatric population. Rather than simply applying principles and techniques used in the adult population, these studies are expected to advance and augment preexisting knowledge with pediatric-specific information. To further develop this imaging modality for use in children, pediatric-focused preclinical research is essential. In this paper we describe the development and implementation of the pediatric-specific preclinical animal and phantom models that are being used to evaluate CEUS with the goal of clinical translation to children.
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Affiliation(s)
- Anush Sridharan
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.
| | - Misun Hwang
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Shelby Kutty
- Taussig Heart Center, Johns Hopkins University, Baltimore, MD, USA
| | - M Beth McCarville
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Harriet J Paltiel
- Department of Radiology, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | | | - Sphoorti Shellikeri
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA
| | - Elizabeth Silvestro
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA
| | - George A Taylor
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA
- Harvard Medical School, Boston, MA, USA
| | - Ryne A Didier
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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32
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Ntoulia A, Barnewolt CE, Doria AS, Ho-Fung VM, Lorenz N, Mentzel HJ, Back SJ. Contrast-enhanced ultrasound for musculoskeletal indications in children. Pediatr Radiol 2021; 51:2303-2323. [PMID: 33783575 DOI: 10.1007/s00247-021-04964-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/02/2020] [Accepted: 01/07/2021] [Indexed: 12/14/2022]
Abstract
The increasing use of contrast-enhanced ultrasound (CEUS) has opened exciting new frontiers for musculoskeletal applications in adults and children. The most common musculoskeletal-related CEUS applications in adults are for detecting inflammatory joint diseases, imaging skeletal muscles and tendon perfusion, imaging postoperative viability of osseous and osseocutaneous tissue flaps, and evaluating the malignant potential of soft-tissue masses. Pediatric musculoskeletal-related CEUS has been applied for imaging juvenile idiopathic arthritis and Legg-Calvé-Perthes disease and for evaluating femoral head perfusion following surgical hip reduction in children with developmental hip dysplasia. CEUS can improve visualization of the capillary network in superficial and deep tissues and also in states of slow- or low-volume blood flow. In addition, measurements of blood flow imaging parameters performed by quantitative CEUS are valuable when monitoring the outcome of treatment interventions. In this review article we present current experience regarding a wide range of CEUS applications in musculoskeletal conditions in adults and children, with emphasis on the latter, and discuss imaging techniques and CEUS findings in musculoskeletal applications.
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Affiliation(s)
- Aikaterini Ntoulia
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.
| | - Carol E Barnewolt
- Department of Radiology, Boston Children's Hospital, Harvard University, Boston, MA, USA
| | - Andrea S Doria
- Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Victor M Ho-Fung
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.,Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Norbert Lorenz
- Children's Hospital, Dresden Municipal Hospital, Teaching-Hospital of Technical University, Dresden, Germany
| | - Hans-Joachim Mentzel
- Section of Pediatric Radiology, Institute of Diagnostic and Interventional Radiology, University Hospital of Jena, Jena, Germany
| | - Susan J Back
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.,Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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33
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Rousou C, Schuurmans CCL, Urtti A, Mastrobattista E, Storm G, Moonen C, Kaarniranta K, Deckers R. Ultrasound and Microbubbles for the Treatment of Ocular Diseases: From Preclinical Research towards Clinical Application. Pharmaceutics 2021; 13:pharmaceutics13111782. [PMID: 34834196 PMCID: PMC8624665 DOI: 10.3390/pharmaceutics13111782] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/08/2021] [Accepted: 10/09/2021] [Indexed: 12/26/2022] Open
Abstract
The unique anatomy of the eye and the presence of various biological barriers make efficacious ocular drug delivery challenging, particularly in the treatment of posterior eye diseases. This review focuses on the combination of ultrasound and microbubbles (USMB) as a minimally invasive method to improve the efficacy and targeting of ocular drug delivery. An extensive overview is given of the in vitro and in vivo studies investigating the mechanical effects of ultrasound-driven microbubbles aiming to: (i) temporarily disrupt the blood–retina barrier in order to enhance the delivery of systemically administered drugs into the eye, (ii) induce intracellular uptake of anticancer drugs and macromolecules and (iii) achieve targeted delivery of genes, for the treatment of ocular malignancies and degenerative diseases. Finally, the safety and tolerability aspects of USMB, essential for the translation of USMB to the clinic, are discussed.
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Affiliation(s)
- Charis Rousou
- Departments of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Heidelberglaan 8, 3584 CS Utrecht, The Netherlands; (C.C.L.S.); (E.M.); (G.S.)
- Division of Imaging and Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands; (C.M.); (R.D.)
- Correspondence:
| | - Carl C. L. Schuurmans
- Departments of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Heidelberglaan 8, 3584 CS Utrecht, The Netherlands; (C.C.L.S.); (E.M.); (G.S.)
- Department of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Heidelberglaan 8, 3584 CS Utrecht, The Netherlands
| | - Arto Urtti
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, 70210 Kuopio, Finland;
- Division of Pharmaceutical Biosciences, Faculty of Pharmacy, University of Helsinki, P.O. Box 56, 00014 Helsinki, Finland
- Institute of Chemistry, St. Petersburg State University, Universitetskii Pr. 26, Petrodvorets, 198504 St. Petersburg, Russia
| | - Enrico Mastrobattista
- Departments of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Heidelberglaan 8, 3584 CS Utrecht, The Netherlands; (C.C.L.S.); (E.M.); (G.S.)
| | - Gert Storm
- Departments of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Heidelberglaan 8, 3584 CS Utrecht, The Netherlands; (C.C.L.S.); (E.M.); (G.S.)
- Department of Biomaterials Science and Technology, University of Twente, 7500 AE Enschede, The Netherlands
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Chrit Moonen
- Division of Imaging and Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands; (C.M.); (R.D.)
| | - Kai Kaarniranta
- Department of Ophthalmology, Kuopio University Hospital, P.O. Box 100, 70029 Kuopio, Finland;
- Department of Ophthalmology, Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Roel Deckers
- Division of Imaging and Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands; (C.M.); (R.D.)
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Yang Y, Liu C, Yan J, Liu K. Perfluorobutane contrast-enhanced ultrasonography for the diagnosis of HCC: a systematic review and meta-analysis. Abdom Radiol (NY) 2021; 46:4619-4628. [PMID: 34086090 DOI: 10.1007/s00261-021-03141-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/06/2021] [Accepted: 05/22/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Perfluorobutane ultrasound contrast agent as a new type of contrast agent has a good performance in the diagnosis of hepatocellular carcinoma (HCC). This study aim to evaluate the accuracy and reliability of Perfluorobutane contrast-enhanced ultrasonography (P-CEUS) in the diagnosis of HCC with a systematic review and meta-analysis. METHODS Web of Science, EMBASE, Cochrane, Clinical Key, Wan Fang, CBM and CNKI databases were systematically searched and checked for studies using P-CEUS in HCC, from 2007 to 2020. Data necessary to construct 2 × 2 contingency tables were extracted from included studies. The QUADAS tool was utilized to assess the methodologic quality of the studies. Meta-analysis included data pooling, subgroup analyses, meta-regression and investigation of publication bias was comprehensively performed. RESULTS Nine studies were included in this meta-analysis and the overall diagnostic accuracy in characterization of HCC was as follows: pooled sensitivity, 0.90 (95% confidence interval: 0.82-0.95); pooled specificity, 0.97 (0.93-0.98); pooled positive likelihood ratio, 27.2 (14.1 to - 52.3); and pooled negative likelihood ratio, 0.10 (0.06-0.18). The area under the comprehensive receiving operation characteristic curve was 0.98 (0.97-0.99). CONCLUSION The sensitivity and specificity of P-CEUS are more valuable than other imaging techniques (such as computer tomography or magnetic resonance imaging). However, due to the large differences in the data samples collected in this study, statistical heterogeneity results. P-CEUS can significantly improve the diagnostic efficiency of previous contrast-enhanced ultrasound for HCC. PROSPERO registration number: PROSPERO (CRD42020200040).
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Affiliation(s)
- Yichun Yang
- Department of Ultrasound, Guangzhou University of Traditional Chinese Medicine First Affiliated Hospital, No. 16 Airport Road, Baiyun District, Guangzhou, 510000, China
| | - Chengkai Liu
- Department of Ultrasound, Guangzhou University of Traditional Chinese Medicine First Affiliated Hospital, No. 16 Airport Road, Baiyun District, Guangzhou, 510000, China
| | - Jin Yan
- Department of Ultrasound, Guangzhou University of Traditional Chinese Medicine First Affiliated Hospital, No. 16 Airport Road, Baiyun District, Guangzhou, 510000, China
| | - Kebing Liu
- Department of Ultrasound, Guangzhou University of Traditional Chinese Medicine First Affiliated Hospital, No. 16 Airport Road, Baiyun District, Guangzhou, 510000, China.
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35
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Chattaraj R, Hammer DA, Lee D, Sehgal CM. Multivariable Dependence of Acoustic Contrast of Fluorocarbon and Xenon Microbubbles under Flow. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:2676-2691. [PMID: 34112553 PMCID: PMC8355047 DOI: 10.1016/j.ultrasmedbio.2021.04.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 04/21/2021] [Accepted: 04/25/2021] [Indexed: 06/12/2023]
Abstract
Microbubbles (MBs) are 1 to 10 µm gas particles stabilized by an amphiphilic shell capable of responding to biomedical ultrasound with strong acoustic signals, allowing them to be commonly used in ultrasound imaging and therapy. The composition of both the shell and the core determines their stability and acoustic properties. While there has been extensive characterization of the dissolution, oscillation, cavitation, collapse and therefore, ultrasound contrast of MBs under static conditions, few reports have examined such behavior under hydrodynamic flow. In this study, we evaluate the interplay of ultrasound parameters (five different mechanical indices [MIs]), MB shell parameter (shell stiffness), type of gas (perfluorocarbon for diagnostic imaging and xenon as a therapeutic gas), and a flow parameter (flow rate) on the ultrasound signal of phospholipid-stabilized MBs flowing through a latex tube embedded in a tissue-mimicking phantom. We find that the contrast gradient (CG), a metric of the rate of decay of contrast along the length of the tube, and the contrast peak (CP), the location where the maximum contrast is reached, depend on the conditions of flow, imaging, and MB material. For instance, while the contrast near the flow inlet of the field of view is highest for a softer shell (dipalmitoylphosphatidylcholine [DPPC], C16) than for stiffer shells (distearoylphosphatidylcholine [DSPC], C18, and dibehenoylphosphatidylcholine [DBPC], C22), the contrast decay is also faster; stiffer shells provide more resistance and hence lead to slower MB dissolution/destruction. At higher flow rates, the CG is low for a fixed length of time because each MB is exposed to ultrasound for a shorter period. The CG becomes high for low flow rates, especially at high incident pressures (high MI), causing more MB destruction closer to the inlet of the field of view. Also, the CP shifts toward the inlet at low flow rates, high MIs, and low shell stiffness. We also report the first demonstration of sustained ultrasound flow imaging of a water-soluble, therapeutic gas MB (xenon). We find that an increased MB concentration is necessary for obtaining the same signal magnitude for xenon MBs. In summary, this study builds a framework depicting how multiple variables simultaneously affect the evolution of MB ultrasound contrast under flow. Depending on the MB composition, imaging conditions, transducer positioning, and image processing, building on such a framework could potentially allow for extraction of additional diagnostic information than is commonly analyzed for physiological flow.
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Affiliation(s)
- Rajarshi Chattaraj
- Department of Chemical and Biomolecular Engineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Daniel A Hammer
- Department of Chemical and Biomolecular Engineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Daeyeon Lee
- Department of Chemical and Biomolecular Engineering, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Chandra M Sehgal
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
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36
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Abstract
In multimodal radiologic imaging, contrast-enhanced ultrasound (CEUS) is increasingly used. One of the advantages of CEUS is the possibility of repeated application of contrast media without decreasing renal function or affecting the thyroid gland. Small solid liver lesions can be diagnosed and detected with high accuracy. Moreover, solid lesions in other abdominal organs can also be characterized. Frequent applications for solid lesions in the near field concern thyroid tumors and lymph nodes. For prostate diagnostics, CEUS can be used with an endorectal probe and perfusion imaging. This review explains how the additional (semi-)quantitative perfusion analysis, especially time-intensity curve (TIC) analyses, and wash-in/wash-out kinetics of integrated or external perfusion software programs facilitate new options in dynamic assessment of microvascularization during tumor follow-up care and even minimally invasive tumor therapy.
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Affiliation(s)
- Ernst-Michael Jung
- Institute of Radiology, Interdisciplinary Department for Ultrasound, University Medical Center, Regensburg, Germany. .,Institut für Röntgendiagnostik/Interdisziplinäres Ultraschallzentrum, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany
| | - Isabel Wiesinger
- Institute of Neuroradiology, Bezirksklinikum Regensburg, Regensburg, Germany
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Pohlman RM, Hinshaw JL, Ziemlewicz TJ, Lubner MG, Wells SA, Lee FT, Alexander ML, Wergin KL, Varghese T. Differential Imaging of Liver Tumors before and after Microwave Ablation with Electrode Displacement Elastography. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:2138-2156. [PMID: 34011451 PMCID: PMC8243838 DOI: 10.1016/j.ultrasmedbio.2021.03.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 05/17/2023]
Abstract
Liver cancer is a leading cause of cancer-related deaths; however, primary treatment options such as surgical resection and liver transplant may not be viable for many patients. Minimally invasive image-guided microwave ablation (MWA) provides a locally effective treatment option for these patients with an impact comparable to that of surgery for both cancer-specific and overall survival. MWA efficacy is correlated with accurate image guidance; however, conventional modalities such as B-mode ultrasound and computed tomography have limitations. Alternatively, ultrasound elastography has been used to demarcate post-ablation zones, yet has limitations for pre-ablation visualization because of variability in strain contrast between cancer types. This study attempted to characterize both pre-ablation tumors and post-ablation zones using electrode displacement elastography (EDE) for 13 patients with hepatocellular carcinoma or liver metastasis. Typically, MWA ablation margins of 0.5-1.0 cm are desired, which are strongly correlated with treatment efficacy. Our results revealed an average estimated ablation margin inner quartile range of 0.54-1.21 cm with a median value of 0.84 cm. These treatment margins lie within or above the targeted ablative margin, indicating the potential to use EDE for differentiating index tumors and ablated zones during clinical ablations. We also obtained a high correlation between corresponding segmented cross-sectional areas from contrast-enhanced computed tomography, the current clinical gold standard, when compared with EDE strain images, with r2 values of 0.97 and 0.98 for pre- and post-ablation regions.
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Affiliation(s)
- Robert M Pohlman
- Department of Electrical and Computer Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA; Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
| | - James L Hinshaw
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Timothy J Ziemlewicz
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Meghan G Lubner
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Shane A Wells
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Fred T Lee
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Marci L Alexander
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Kelly L Wergin
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Tomy Varghese
- Department of Electrical and Computer Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA; Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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Newsome IG, Kierski TM, Pang G, Yin J, Yang J, Cherin E, Foster FS, Carnevale CA, Demore CEM, Dayton PA. Implementation of a Novel 288-Element Dual-Frequency Array for Acoustic Angiography: In Vitro and In Vivo Characterization. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2021; 68:2657-2666. [PMID: 33872146 PMCID: PMC8375591 DOI: 10.1109/tuffc.2021.3074025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Acoustic angiography is a superharmonic contrast-enhanced ultrasound imaging method that produces high-resolution, 3-D maps of the microvasculature. Previous acoustic angiography studies have used twoelement, annular,mechanicallyactuated transducers(called "wobblers") to image microvasculature in preclinical tumor models with high contrast-to-tissue ratio and resolution, but these earlywobbler transducerscould not achieve the depth and sensitivity required for clinical acoustic angiography. In this work, we present a system for performing acoustic angiography with a novel dual-frequency(DF) transducer-a coaxially stacked DF array (DFA). We evaluate the DFA system bothin vitro andin vivo and demonstrate improvements in sensitivity and imaging depth up to 13.1 dB and 10 mm, respectively, compared with previous wobbler probes.
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Yan M, Xu D, Chen L, Zhou L. Comparative Study of Qualitative and Quantitative Analyses of Contrast-Enhanced Ultrasound and the Diagnostic Value of B-Mode and Color Doppler for Common Benign Tumors in the Parotid Gland. Front Oncol 2021; 11:669542. [PMID: 34307139 PMCID: PMC8292955 DOI: 10.3389/fonc.2021.669542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 06/17/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose To preliminarily identify three common benign parotid gland tumors: pleomorphic adenomas (PA), Warthin tumors (WT), and basal cell adenomas (BCA) by qualitative and quantitative analyses using contrast-enhanced ultrasound (CEUS). Methods Preoperative images of parotid gland masses were analyzed, including 129 cases of ultrasonography (US) and color Doppler sonography (CDS) and 110 cases of qualitative and quantitative CEUS. The diagnosis was confirmed by postsurgical pathology outcomes. Results PA presented low and heterogeneous enhancement and echo-free area, whereas most WT and BCA presented with high and relatively homogeneous enhancement. Compared with WT and BCA groups, a “slow in” pattern was more common in the PA group and a “slow out” pattern was more frequently noted in the WT group than in the PA and BCA groups. The unique features of qualitative CEUS in the PA group enable distinguishing PA from the 2 other groups. The further distinction among the groups was made based on quantitative parameters of time-intensity curves (TICs), which revealed that the mean peak intensity (PI), mean transit time (MTT), the area under the curve (AUC), and time from peak to one half (HT) exhibited significant differences. ROC analysis was next applied to determine the optimal cutoff points to predict the diagnostic tendency among the groups. When the rising slope (RS) was >2.145, the possibility of BCA was greater than WT. Conclusions CEUS ultrasound is of significant value in the differential diagnosis of the 3 common benign parotid gland masses.
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Affiliation(s)
- Meiying Yan
- Department of Radiology (Ultrasound), Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Dong Xu
- Department of Radiology (Ultrasound), Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Liyu Chen
- Department of Radiology (Ultrasound), Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China
| | - Lingyan Zhou
- Department of Radiology (Ultrasound), Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, China.,Key Laboratory of Head & Neck Cancer Translational Research of Zhejiang Province, Hangzhou, China
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40
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Akbar A, Pillalamarri N, Jonnakuti S, Ullah M. Artificial intelligence and guidance of medicine in the bubble. Cell Biosci 2021; 11:108. [PMID: 34108005 PMCID: PMC8191053 DOI: 10.1186/s13578-021-00623-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/04/2021] [Indexed: 02/06/2023] Open
Abstract
Microbubbles are nanosized gas-filled bubbles. They are used in clinical diagnostics, in medical imaging, as contrast agents in ultrasound imaging, and as transporters for targeted drug delivery. They can also be used to treat thrombosis, neoplastic diseases, open arteries and vascular plaques and for localized transport of chemotherapies in cancer patients. Microbubbles can be filled with any type of therapeutics, cure agents, growth factors, extracellular vesicles, exosomes, miRNAs, and drugs. Microbubbles protect their cargo from immune attack because of their specialized encapsulated shell composed of lipid and protein. Filled with curative medicine, they could effectively circulate through the whole body safely and efficiently to reach the target area. The advanced bubble-based drug-delivery system, integrated with artificial intelligence for guidance, holds great promise for the targeted delivery of drugs and medicines.
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Affiliation(s)
- Asma Akbar
- Institute for Immunity and Transplantation, Stem Cell Biology and Regenerative Medicine, School of Medicine, Stanford University, Palo Alto, CA, 94304, USA
- Molecular Medicine, Department of Biomedical Innovation and Bioengineering, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Nagavalli Pillalamarri
- Institute for Immunity and Transplantation, Stem Cell Biology and Regenerative Medicine, School of Medicine, Stanford University, Palo Alto, CA, 94304, USA
| | - Sriya Jonnakuti
- Institute for Immunity and Transplantation, Stem Cell Biology and Regenerative Medicine, School of Medicine, Stanford University, Palo Alto, CA, 94304, USA
| | - Mujib Ullah
- Institute for Immunity and Transplantation, Stem Cell Biology and Regenerative Medicine, School of Medicine, Stanford University, Palo Alto, CA, 94304, USA.
- Molecular Medicine, Department of Biomedical Innovation and Bioengineering, School of Medicine, Stanford University, Palo Alto, CA, USA.
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41
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Zhao D, Shao YQ, Hu J, Liu D, Tang W, He N. Role of contrast-enhanced ultrasound guidance in core-needle biopsy for diagnosis of cervical tuberculous lymphadenitis. Clin Hemorheol Microcirc 2021; 77:381-389. [PMID: 33337357 DOI: 10.3233/ch-201038] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To investigate the diagnostic value of core-needle biopsy (CNB) guided by contrast-enhanced ultrasound (CEUS) in cervical tuberculous lymphadenitis (CTL). METHODS 178 patients with pathological confirmation of CTL were retrospectively enrolled. All of them had undergone CNB prior to the final surgery. According to the different ways of puncture guidance, they were divided into two groups: conventional ultrasound (US) group (n = 81) and CEUS group (n = 97). The comparison of diagnostic efficacy between two groups was compared and analyzed. RESULTS Among the 178 patients, 146 were directly diagnosed as CTL by CNB, including 59 patients in CEUS group and 87 patients in US group. The diagnostic accuracy were 89.7% (87/97) and 72.8% (59/81), respectively (P < 0.01). For subgroup analyses, differences among diagnostic efficacy ascribed to the different guiding methods were significant in medium size group (>2.0 cm and ≤3.0 cm) and large size group (>3.0 cm), 91.7% for CEUS group vs. 69.0% for US group (P < 0.05) and 84.4% for CEUS group vs. 57.7% for US group (P < 0.05), respectively. CONCLUSIONS In the diagnosis of CTL, compared with the US-guided CNB, CEUS-guided CNB have certain advantages, especially for larger lymph nodes.
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Affiliation(s)
- Dan Zhao
- Department of Ultrasonography, Zhejiang Integrated Traditional and Western Medicine Hospital, Hangzhou Red Cross Hospital, Tuberculosis Diagnostic and Treatment Center of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Ya-Qin Shao
- Department of Ultrasonography, Zhejiang Integrated Traditional and Western Medicine Hospital, Hangzhou Red Cross Hospital, Tuberculosis Diagnostic and Treatment Center of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Jun Hu
- Department of Ultrasonography, Zhejiang Integrated Traditional and Western Medicine Hospital, Hangzhou Red Cross Hospital, Tuberculosis Diagnostic and Treatment Center of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Dan Liu
- Department of Ultrasonography, Zhejiang Integrated Traditional and Western Medicine Hospital, Hangzhou Red Cross Hospital, Tuberculosis Diagnostic and Treatment Center of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Wei Tang
- Department of Ultrasonography, Zhejiang Integrated Traditional and Western Medicine Hospital, Hangzhou Red Cross Hospital, Tuberculosis Diagnostic and Treatment Center of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Ning He
- Department of Ultrasonography, Zhejiang Integrated Traditional and Western Medicine Hospital, Hangzhou Red Cross Hospital, Tuberculosis Diagnostic and Treatment Center of Zhejiang Province, Hangzhou, Zhejiang, China
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Ferretti F, Cannatelli R, Ardizzone S, Maier JA, Maconi G. Ultrasonographic Evaluation of Intestinal Fibrosis and Inflammation in Crohn's Disease. The State of the Art. Front Pharmacol 2021; 12:679924. [PMID: 33981246 PMCID: PMC8107820 DOI: 10.3389/fphar.2021.679924] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 04/09/2021] [Indexed: 12/16/2022] Open
Abstract
The evaluation of the degree of inflammation and fibrosis, intrinsic elements in intestinal wall damage of Crohn’s disease, is essential to individuate the extent of the lesions and the presence of strictures. This information will contribute to the choice of the appropriate therapeutic approach, the prediction of the response to therapy and the course of the disease. The accurate evaluation of the extent and severity of inflammation and/or fibrosis in Crohn’s disease currently requires histopathological analysis of the intestinal wall. However, in clinical practice and research, transmural assessment of the intestinal wall with cross sectional imaging is increasingly used for this purpose. The B-mode ultrasonograhic characteristics of the intestinal wall, the assessment of its vascularization by color Doppler and I.V. contrast agents, and the evaluation of the mechanical and elastic properties by sonoelastography, may provide useful and accurate information on the severity and extent of inflammation and intestinal fibrosis in Crohn’s disease. The purpose of this review is to provide an update on current sonographic methods to discriminate inflammation and fibrosis in Crohn’s disease.
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Affiliation(s)
- Francesca Ferretti
- Gastroenterology Unit-ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Rosanna Cannatelli
- Gastroenterology Unit-ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Sandro Ardizzone
- Gastroenterology Unit-ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Jeanette A Maier
- General Pathology-Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Maconi
- Gastroenterology Unit-ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences (DIBIC) L. Sacco, Università degli Studi di Milano, Milan, Italy
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Cantisani V, Bertolotto M, Clevert DA, Correas JM, Drudi FM, Fischer T, Gilja OH, Granata A, Graumann O, Harvey CJ, Ignee A, Jenssen C, Lerchbaumer MH, Ragel M, Saftoiu A, Serra AL, Stock KF, Webb J, Sidhu PS. EFSUMB 2020 Proposal for a Contrast-Enhanced Ultrasound-Adapted Bosniak Cyst Categorization - Position Statement. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2021; 42:154-166. [PMID: 33307594 DOI: 10.1055/a-1300-1727] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The well-established Bosniak renal cyst classification is based on contrast-enhanced computed tomography determining the malignant potential of cystic renal lesions. Ultrasound has not been incorporated into this pathway. However, the development of ultrasound contrast agents coupled with the superior resolution of ultrasound makes it possible to redefine the imaging of cystic renal lesions. In this position statement, an EFSUMB Expert Task Force reviews, analyzes, and describes the accumulated knowledge and limitations and presents the current position on the use of ultrasound contrast agents in the evaluation of cystic renal lesions.
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Affiliation(s)
- Vito Cantisani
- Department of Radiology, "Sapienza" University of Rome, Rome, Italy
| | - Michele Bertolotto
- Department of Radiology, University of Trieste, Ospedale di Cattinara, Trieste, IT
| | - Dirk-André Clevert
- Department of Clinical Radiology, University of Munich-Großhadern Campus, Munich, Germany
| | - Jean-Michel Correas
- Service de Radiologie adultes, Hôpital Necker, Université Paris Descartes, Paris, France
| | | | - Thomas Fischer
- Department of Radiology, University Berlin, Charité, Berlin, Germany
| | - Odd Helge Gilja
- Haukeland University Hospital, National Centre for Ultrasound in Gastroenterology, Bergen, Norway
| | - Antonio Granata
- Nephrology and Dialysis Unit, Emergency Hospital "Cannizzaro", Catania - Italy
| | - Ole Graumann
- Research and Innovation Unit of Radiology, University of Southern Denmark, Odense C, Denmark
| | - Christopher J Harvey
- Department of Imaging, Imperial College NHS Healthcare Trust, London, United Kingdom of Great Britain and Northern Ireland
| | - Andre Ignee
- Innere Medizin 2, Caritas-Krankenhaus, Bad Mergentheim, Germany
| | - Christian Jenssen
- Klinik für Innere Medizin, Krankenhaus Märkisch Oderland Strausberg/Wriezen, Germany
| | - Markus Herbert Lerchbaumer
- Department of Radiology, Charité Centrum 6 - Diagnostische und interventionelle Radiologie und Nuklearmedizin, Berlin, Germany
| | - Matthew Ragel
- Radiology Department, Aintree University Hospitals NHS Foundation Trust, Liverpool, United Kingdom of Great Britain and Northern Ireland
| | - Adrian Saftoiu
- Research Center in Gastroenterology and Hepatology, University of Medicine and Pharmacy Craiova, Romania
| | - Andreas L Serra
- Department of Internal Medicine and Nephrology, Klinik Hirslanden, Zürich, Switzerland
| | | | - Jolanta Webb
- Radiology Department, Aintree University Hospitals NHS Foundation Trust, Liverpool, United Kingdom of Great Britain and Northern Ireland
| | - Paul S Sidhu
- Department of Radiology, King's College Hospital London, United Kingdom of Great Britain and Northern Ireland
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Yang R, Lu Q, Xu J, Huang J, Gao B, Zhang H, Zhou J, Du L, Yan F. Value of Contrast-Enhanced Ultrasound in the Differential Diagnosis of Focal Splenic Lesions. Cancer Manag Res 2021; 13:2947-2958. [PMID: 33833578 PMCID: PMC8021137 DOI: 10.2147/cmar.s300601] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/08/2021] [Indexed: 02/05/2023] Open
Abstract
Purpose To identify and validate contrast-enhanced ultrasound (CEUS) features for differentiating malignant from benign splenic lesions. Patients and Methods Splenic lesions in 123 patients who underwent conventional ultrasound (B-mode US) and CEUS were included in this study. Two radiologists evaluated the sonograms of B-mode and CEUS. Statistical analysis was performed to identify significant imaging predictors for splenic malignant lesions. Two other radiologists independently reviewed B-mode and CEUS sonograms and diagnosed the lesions based on proposed criteria as 1) benign, 2) probably benign, 3) probably malignant or 4) malignant. The diagnostic efficiency between B-mode US and CEUS was compared. Results Common imaging findings of malignant lesions included hypoechoic, ill-defined margin, absence of cystic/necrotic portion, presence of splenomegaly on B-mode US, and hypoenhancement, rapid washout and presence of intralesional vessels on CEUS (P < 0.05). Among them, three independent features were identified using multivariate logistic regression analysis: hypoechoic pattern, hypoenhancement pattern and intralesional vessels. When three of these findings were combined as a predictor for splenic malignant lesions, 22 (55.0%) of 40 malignant splenic lesions were identified with a specificity of 100%. The diagnostic performance of two readers using receiver operating characteristic curve analysis was 0.622 and 0.533, respectively, for B-mode US, which was significantly improved to 0.908 and 0.906 for CEUS (P < 0.001). The degree of other diagnostic efficiency and inter-reader agreement also increased with CEUS compared to B-mode US. Conclusion CEUS may provide more useful information than B-mode US and improve the diagnosis efficiency for distinguishing malignant from benign splenic lesions.
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Affiliation(s)
- Rui Yang
- Ultrasound Department, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China.,Laboratory of Ultrasound Imaging, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Qiang Lu
- Ultrasound Department, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Jinshun Xu
- Ultrasound Department, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China.,Laboratory of Ultrasound Imaging, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Jiayan Huang
- Ultrasound Department, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Binyang Gao
- Ultrasound Department, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China.,Laboratory of Ultrasound Imaging, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Huan Zhang
- Ultrasound Department, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China.,Laboratory of Ultrasound Imaging, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Jie Zhou
- Ultrasound Department, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China.,Laboratory of Ultrasound Imaging, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Lanxin Du
- Ultrasound Department, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Feng Yan
- Laboratory of Ultrasound Imaging, West China Hospital of Sichuan University, Chengdu, Sichuan, People's Republic of China
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Bitterer F, Hornung M, Platz Batista da Silva N, Schlitt HJ, Stroszczynski C, Wege AK, Jung EM. In vivo detection of breast cancer liver metastases in humanized tumour mice using tumour specific contrast agent BR55®. Clin Hemorheol Microcirc 2021; 76:559-572. [PMID: 32924994 DOI: 10.3233/ch-200898] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To investigate the diagnostic accuracy of high-resolution ultrasound (HRU) for the detection of hepatic metastases of breast cancer in a humanized tumour mouse (HTM) using clinical standard technology. In addition, the efficiency of standard contrast-enhanced ultrasound (CEUS) [microbubbles of sulphur hexafluoride] and CEUS using a novel VEGFR2-targeted contrast agent [BR55®] was examined. METHODS A total of 14 HTM were sonographically examined twice. In addition to a human immune system, the animals developed hepatic tumour lesions after intrahepatic injection of BT-474 breast cancer cells. Digital cine loops from the arterial phase (15-35 sec), the portal venous phase (35-90 sec) and the late phase (3-15 min) of the entire liver were analysed. Data were correlated to histopathology. RESULTS After 9 months, half of the mice (7/14) revealed the development of hepatic breast cancer metastases. The detection limit was 1 mm tumour diameter. In particular, the use of targeted contrast media reduced the needed tumour diameter and helped to precisely classify tumour tissue. In 93% (13/14), the findings of ultrasound could be approved by histological examination by the pathologist. CONCLUSIONS This study in HTM demonstrated the high feasibility of tumour specific contrast media and standard HRU contrast agents to detect early liver metastases.
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Affiliation(s)
- Florian Bitterer
- Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | - Matthias Hornung
- Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | | | - Hans J Schlitt
- Department of Surgery, University Hospital Regensburg, Regensburg, Germany
| | | | - Anja K Wege
- Department of Gynecology and Obstetrics, University Medical Center Regensburg, Regensburg, Germany
| | - Ernst-Michael Jung
- Department of Radiology, University Hospital Regensburg, Regensburg, Germany
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Zhang F, Jin L, Li G, Jia C, Shi Q, Du L, Wu R. The role of contrast-enhanced ultrasound in the diagnosis of malignant non-mass breast lesions and exploration of diagnostic criteria. Br J Radiol 2021; 94:20200880. [PMID: 33560894 DOI: 10.1259/bjr.20200880] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To assess the value of contrast-enhanced ultrasound (CEUS) for diagnosing malignant non-mass breast lesions (NMLs) and to explore the CEUS diagnostic criteria. METHODS A total of 116 patients with 119 NMLs detected by conventional US were enrolled. Histopathological results were used as the reference standard. The enhancement characteristics of NMLs in CEUS were compared between malignant and benign NMLs. The CEUS diagnostic criteria for malignant NMLs were established using independent diagnostic indicators identified by binary logistic regression analysis. The diagnostic performance of Breast Imaging Reporting and Data System-US (BI-RADS-US), CEUS, and BI-RADS-US combined with CEUS was evaluated and compared. RESULTS Histopathological results showed 63 and 56 benign and malignant NMLs. Enhancement degree (OR = 5.75, p = 0.003), enhancement area (OR = 4.25, p = 0.005), and radial or penetrating vessels (OR = 7.54, p = 0.003) were independent diagnostic indicators included to establish the CEUS diagnostic criteria. The sensitivity and specificity of BI-RADS-US, CEUS, and BI-RADS-US combined with CEUS were 100 and 30.2%, 80.4 and 74.6%, and 94.6 and 77.8%, respectively; the corresponding areas under the receiver operating characteristic curve (AUC) were 0.819, 0.775, and 0.885, respectively. CONCLUSIONS CEUS has a high specificity in malignant NML diagnosis based on the diagnostic criteria including enhancement degree, enhancement area, and radial or penetrating vessels, but with lower sensitivity than BI-RADS-US. The combination of CEUS and BI-RADS-US is an effective diagnostic tool with both high sensitivity and specificity for the diagnosis of malignant NMLs. ADVANCES IN KNOWLEDGE In this study, we assessed the diagnostic value of CEUS for malignant NMLs and constructed a feasible diagnostic criterion. We further revealed that the combination of CEUS and BI-RADS-US has a high diagnostic value for malignant NMLs.
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Affiliation(s)
- Fan Zhang
- Department of Ultrasound, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.,Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lifang Jin
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Gang Li
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chao Jia
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiusheng Shi
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lianfang Du
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rong Wu
- Department of Ultrasound, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.,Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Pellow C, Tan J, Chérin E, Demore CEM, Zheng G, Goertz DE. High frequency ultrasound nonlinear scattering from porphyrin nanobubbles. ULTRASONICS 2021; 110:106245. [PMID: 32932144 DOI: 10.1016/j.ultras.2020.106245] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 08/14/2020] [Accepted: 09/02/2020] [Indexed: 06/11/2023]
Abstract
Emerging contrast imaging studies have highlighted the potential of nanobubbles for both intravascular and extravascular applications. Reports to date on nanobubbles have generally utilized low frequencies (<12 MHz), high concentrations (>109 mL-1), and B-mode or contrast-mode on preclinical and clinical systems. However, none of these studies directly examined nanobubble acoustic signatures systematically to implement nonlinear imaging schemes in a methodical manner based on nanobubble behaviour. Here, nanobubble nonlinear behaviour is investigated at high frequencies (12.5, 25, 30 MHz) and low concentration (106 mL-1) in a channel phantom, with different pulse types in single- and multi-pulse sequences to examine behaviour under conditions relevant to high frequency imaging. Porphyrin nanobubbles are demonstrated to initiate nonlinear scattering at high frequencies in a pressure-threshold dependent manner, as previously observed at low frequencies. This threshold behaviour was then utilized to demonstrate enhanced nanobubble imaging with pulse inversion, amplitude modulation, and a combination of the two, progressing towards the improved sensitivity and expanded utility of these ultrasound contrast agents.
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Affiliation(s)
- Carly Pellow
- Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 1L7, Canada; Princess Margaret Cancer Research Centre, 101 College St., Toronto, ON M5G 0A3, Canada; Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada.
| | - Josephine Tan
- Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 1L7, Canada; Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
| | - Emmanuel Chérin
- Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
| | - Christine E M Demore
- Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 1L7, Canada; Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
| | - Gang Zheng
- Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 1L7, Canada; Princess Margaret Cancer Research Centre, 101 College St., Toronto, ON M5G 0A3, Canada
| | - David E Goertz
- Department of Medical Biophysics, University of Toronto, Toronto, ON M5G 1L7, Canada; Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
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48
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Krishnan K, Bhutani MS, Aslanian HR, Melson J, Navaneethan U, Pannala R, Parsi MA, Schulman AR, Sethi A, Sullivan S, Trikudanathan G, Trindade AJ, Watson RR, Maple JT, Lichtenstein DR. Enhanced EUS imaging (with videos). Gastrointest Endosc 2021; 93:323-333. [PMID: 33129492 DOI: 10.1016/j.gie.2020.06.075] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 06/14/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS EUS remains a primary diagnostic tool for the evaluation of pancreaticobiliary disease. Although EUS combined with FNA or biopsy sampling is highly sensitive for the diagnosis of neoplasia within the pancreaticobiliary tract, limitations exist in specific clinical settings such as chronic pancreatitis. Enhanced EUS imaging technologies aim to aid in the detection and diagnosis of lesions that are commonly evaluated with EUS. METHODS We reviewed technologies and methods for enhanced imaging during EUS and applications of these methods. Available data regarding efficacy, safety, and financial considerations are summarized. RESULTS Enhanced EUS imaging methods include elastography and contrast-enhanced EUS (CE-EUS). Both technologies have been best studied in the setting of pancreatic mass lesions. Robust data indicate that neither technology has adequate specificity to serve as a stand-alone test for pancreatic malignancy. However, there may be a role for improving the targeting of sampling and in the evaluation of peritumoral lymph nodes, inflammatory pancreatic masses, and masses with nondiagnostic FNA or fine-needle biopsy sampling. Further, novel applications of these technologies have been reported in the evaluation of liver fibrosis, pancreatic cysts, and angiogenesis within neoplastic lesions. CONCLUSIONS Elastography and CE-EUS may improve the real-time evaluation of intra- and extraluminal lesions as an adjunct to standard B-mode and Doppler imaging. They are not a replacement for EUS-guided tissue sampling but provide adjunctive diagnostic information in specific clinical situations. The optimal clinical use of these technologies continues to be a focus of ongoing research.
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Affiliation(s)
- Kumar Krishnan
- Division of Gastroenterology, Department of Internal Medicine, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Manoop S Bhutani
- Department of Gastroenterology Hepatology and Nutrition, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Harry R Aslanian
- Section of Digestive Diseases, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Joshua Melson
- Division of Digestive Diseases, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | | | - Rahul Pannala
- Department of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, Arizona, USA
| | - Mansour A Parsi
- Section for Gastroenterology and Hepatology, Tulane University Health Sciences Center, New Orleans, Louisiana, USA
| | - Allison R Schulman
- Department of Gastroenterology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Amrita Sethi
- New York-Presbyterian Medical Center/Columbia University Medical Center, New York, New York, USA
| | - Shelby Sullivan
- Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Guru Trikudanathan
- Department of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA
| | - Arvind J Trindade
- Department of Gastroenterology, Zucker School of Medicine at Hofstra/Northwell, Long Island Jewish Medical Center, New Hyde Park, New York, USA
| | - Rabindra R Watson
- Department of Gastroenterology, Interventional Endoscopy Services, California Pacific Medical Center, San Francisco, California, USA
| | - John T Maple
- Division of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | | | - David R Lichtenstein
- Division of Gastroenterology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
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49
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Huang S, Zhao Y, Jiang X, Lin N, Zhang M, Wang H, Zheng A, Ma X. Clinical Utility of Contrast-enhanced Ultrasound for the Diagnosis of Lymphadenopathy. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:869-879. [PMID: 33487474 DOI: 10.1016/j.ultrasmedbio.2020.12.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 02/05/2023]
Abstract
This meta-analysis aimed to evaluate the diagnostic accuracy of contrast-enhanced ultrasonography (CEUS) in identifying lymphazdenopathy. PubMed, Web of Science, Embase and the Cochrane Library were searched for relevant articles through September 2020. A total of 16 articles, which included 1787 participants, were analyzed. The summary sensitivity, specificity, positive likelihood ratio (LR), negative LR and diagnostic odds ratio of CEUS for diagnosing lymphadenopathy were 0.88 (0.86-0.90), 0.90 (0.88-0.92), 6.04 (3.67-9.95), 0.15 (0.10-0.21) and 47.38 (23.45-95.66), respectively. The summary receiver operating characteristic (SROC) area under the curve (AUC) was 0.9405. After omitting outliers identified in a bivariate box plot and forest plot, heterogeneity was decreased, and the pooled sensitivity and specificity were 0.87 (0.84-0.90) and 0.87 (0.84-0.90), respectively. Furthermore, the SROC AUC was 0.9327. In conclusion, CEUS has the potential to be a valuable tool for characterizing lymphadenopathy and could provide clinical decision support.
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Affiliation(s)
- Siyang Huang
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Tumor Targeted and Immune Therapy, Clinical Research Center for Breast, State Key Laboratory of Biotherapy, West China Hospital, Sichuan, Chengdu, China
| | - Yunuo Zhao
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Xian Jiang
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China; Laboratory of Tumor Targeted and Immune Therapy, Clinical Research Center for Breast, State Key Laboratory of Biotherapy, West China Hospital, Sichuan, Chengdu, China
| | - Nan Lin
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Mingxuan Zhang
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Hang Wang
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Aiping Zheng
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Xuelei Ma
- Department of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
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50
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Goncin U, Ton N, Reddy A, El Kaffas A, Brinkmann M, Machtaler S. Contrast-enhanced ultrasound imaging for assessing organ perfusion in rainbow trout (Oncorhynchus mykiss). THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 750:141231. [PMID: 33182180 DOI: 10.1016/j.scitotenv.2020.141231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 06/11/2023]
Abstract
Contrast-enhanced ultrasound (CEUS) imaging has great potential as a non-lethal, inexpensive monitoring tool in aquatic toxicology. It is a well-established clinical imaging approach that combines real-time, quantitative assessment of organ blood flow, with morphological data. In humans, it has been extensively used to measure changes in blood flow that can be attributed to cancer, inflammation, and other biological abnormalities. However, it has yet to be explored as a tool for fish physiology or environmental toxicology. In this study, our goal was to determine if CEUS could be used to visualize and measure blood flow in the liver of a rainbow trout. All rainbow trout received two injections of an ultrasound contrast agent, microbubbles. A subset received a third injection after administration of propranolol, a non-specific beta1 & 2-blocker, to determine if changes in blood flow could be detected. Ultrasound contrast time-intensity curves (TIC) were obtained, fit to a lognormal model, and different perfusion parameters were calculated. Contrast enhancement was observed in all rainbow trout livers, with high percentage between repeated measurements, including blood flow (80.6 ± 27.3%), area under the curve (73.2 ± 14%), blood volume (84 ± 14.2%) and peak enhancement (86.7 ± 7.5%). After administration of propranolol, we detected a non-significant (p > 0.05) increase in area under the curve (102.6 ± 44.2%), peak enhancement (77.3 ± 106.4), blood volume (48.2 ± 74.5%), and decrease in hepatic blood flow (-17.3 ± 37.1%). These data suggest that CEUS imaging is suitable to measure organ blood flow in fish, and demonstrates tremendous potential for exploring different organs, fish species, and effects of chemical contaminants in future studies.
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Affiliation(s)
- Una Goncin
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Ngoc Ton
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Ashwin Reddy
- Department of Radiology, Stanford University, School of Medicine, Stanford, CA, USA
| | - Ahmed El Kaffas
- Department of Radiology, Stanford University, School of Medicine, Stanford, CA, USA
| | - Markus Brinkmann
- School of Environment and Sustainability (SENS), University of Saskatchewan, Saskatoon, Canada; Toxicology Centre, University of Saskatchewan, Saskatoon, Canada; Global Institute for Water Security (GIWS), University of Saskatchewan, Saskatoon, Canada
| | - Steven Machtaler
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
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