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Hu H, Zhao Y, He C, Qian L, Huang P. Ultrasonography of Hepatocellular Carcinoma: From Diagnosis to Prognosis. J Clin Transl Hepatol 2024; 12:516-524. [PMID: 38779517 PMCID: PMC11106354 DOI: 10.14218/jcth.2024.00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/15/2024] [Accepted: 04/07/2024] [Indexed: 05/25/2024] Open
Abstract
Hepatocellular carcinoma (HCC) is a prominent contributor to cancer-related mortality worldwide. Early detection and diagnosis of liver cancer can significantly improve its prognosis and patient survival. Ultrasound technology, serving has undergone substantial advances as the primary method of HCC surveillance and has broadened its scope in recent years for effective management of HCC. This article is a comprehensive overview of ultrasound technology in the treatment of HCC, encompassing early detection, diagnosis, staging, treatment evaluation, and prognostic assessment. In addition, the authors summarized the application of contrast-enhanced ultrasound in the diagnosis of HCC and assessment of prognosis. Finally, the authors discussed further directions in this field by emphasizing overcoming existing obstacles and integrating cutting-edge technologies.
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Affiliation(s)
- Huisen Hu
- Department of Ultrasound, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Department of Ultrasound, Lanxi People’s Hospital, Lanxi, Zhejiang, China
| | - Yonglei Zhao
- Department of Radiology, Sir Run Run Shaw Hospital (SRRSH), Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Chengbin He
- Department of Radiology, Sir Run Run Shaw Hospital (SRRSH), Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Lujie Qian
- The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Pintong Huang
- Department of Ultrasound, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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Azami RH, Forsberg F, Eisenbrey JR, Sarkar K. Acoustic response and ambient pressure sensitivity characterization of SonoVue for noninvasive pressure estimation. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2024; 155:2636-2645. [PMID: 38629883 PMCID: PMC11026112 DOI: 10.1121/10.0025690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/21/2024] [Accepted: 03/27/2024] [Indexed: 04/20/2024]
Abstract
Subharmonic aided pressure estimation (SHAPE) is a noninvasive pressure measurement technique based on the pressure dependent subharmonic signal from contrast microbubbles. Here, SonoVue microbubble with a sulfur hexafluoride (SF6) core, was investigated for use in SHAPE. The study uses excitations of 25-700 kPa peak negative pressure (PNP) and 3 MHz frequency over eight pressurization cycles between atmospheric pressure and overpressures, ranging from 0 to 25 kPa (0 to 186 mm Hg). The SonoVue subharmonic response was characterized into two types. Unlike other microbubbles, SonoVue showed significant subharmonic signals at low excitations (PNPs, 25-400 kPa), denoted here as type I subharmonic. It linearly decreased with increasing overpressure (-0.52 dB/kPa at 100 kPa PNP). However, over multiple pressurization-depressurization cycles, type I subharmonic changed; its value at atmospheric pressure decreased over multiple cycles, and at later cycles, it recorded an increase in amplitude with overpressure (highest, +13 dB at 50 kPa PNP and 10 kPa overpressure). The subharmonic at higher excitations (PNP > 400 kPa), denoted here as type II subharmonic, showed a consistent decrease with the ambient pressure increase with strongest sensitivity of -0.4 dB/kPa at 500 kPa PNP.
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Affiliation(s)
- Roozbeh H Azami
- Department of Mechanical and Aerospace Engineering, The George Washington University, Washington, DC 20052, USA
| | - Flemming Forsberg
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA
| | - John R Eisenbrey
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA
| | - Kausik Sarkar
- Department of Mechanical and Aerospace Engineering, The George Washington University, Washington, DC 20052, USA
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McGrath S, Shen YJ, Aragaki M, Motooka Y, Koga T, Gregor A, Bernards N, Cherin E, Demore CEM, Yasufuku K, Matsuura N. Imaging Microbubbles With Contrast-Enhanced Endobronchial Ultrasound. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:28-38. [PMID: 37813701 DOI: 10.1016/j.ultrasmedbio.2023.08.020] [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: 03/28/2023] [Revised: 08/02/2023] [Accepted: 08/28/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVE Endobronchial ultrasound (EBUS) is commonly used to guide transbronchial needle biopsies for the staging of lymph nodes in non-small cell lung cancer patients. Although contrast-enhanced ultrasound (CEUS) and microbubbles (MBs) can improve the diagnostic accuracy in tumors, the ability of contrast-enhanced EBUS (CE-EBUS) to image MBs has not yet been comprehensively evaluated. In this study, we assessed the ability of a CE-EBUS system (Olympus EU-ME2 PREMIER and BF-UC180F bronchoscope) to detect laboratory-synthesized MBs in comparison to clinical (Toshiba Aplio SSA-790A) and pre-clinical (VisualSonics Vevo 2100) CEUS systems in vitro and in vivo, respectively. METHODS Agar flow phantoms and reference tissue were used to assess CE-EBUS MB imaging in vitro, and A549 tumor-bearing athymic nude and AE17-OVA tumor-bearing C57BL/6 mice were used to assess MB detectability and perfusion in vivo, respectively. RESULTS Results revealed that despite the lower sensitivity of CE-EBUS to MB concentration in comparison to clinical CEUS, CE-EBUS yielded a similar contrast-to-tissue ratio (CTR) in vitro of 28.9 ± 4.5 dB for CE-EBUS, compared with 29.7 ± 2.6 dB for clinical CEUS (p < 0.05). In vivo, CE-EBUS generated a perfusion curve highly correlated with that obtained with the pre-clinical CEUS system (Pearson correlation coefficient = 0.927, p < 0.05). Moreover, CE-EBUS yielded a CTR 2.7 times higher than that obtained with the pre-clinical ultrasound system. CONCLUSION These findings together suggest that CE-EBUS can perform contrast imaging comparable to that produced by commercial pre-clinical and clinical ultrasound systems, with potential for clinical characterization of mediastinal lymph nodes in lung cancer patients.
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Affiliation(s)
- Sean McGrath
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Yu-Jack Shen
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Masato Aragaki
- Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Yamato Motooka
- Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Takamasa Koga
- Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Alexander Gregor
- Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Nicholas Bernards
- Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Emmanuel Cherin
- Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Christine E M Demore
- Physical Sciences, Sunnybrook Research Institute, Toronto, ON, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Kazuhiro Yasufuku
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada; Division of Thoracic Surgery, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Naomi Matsuura
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada; Department of Materials Science & Engineering, University of Toronto, Toronto, ON, Canada; Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
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Zhou C, Zhu X, Li J, Luo Y, Zhou Y. Dynamic assessment of brain perfusion in a middle cerebral artery occlusion rat model by contrast-enhanced ultrasound imaging: a pilot study. Acta Radiol 2023; 64:3042-3051. [PMID: 37872652 DOI: 10.1177/02841851231205163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
BACKGROUND The middle cerebral artery occlusion model (MCAo) is a commonly used animal model for cerebral ischemia studies but lacks accessible imaging techniques for the assessment of hemodynamic changes of the model. PURPOSE The study aims to explore the value of contrast-enhanced ultrasound (CEUS) in evaluating brain perfusion in the early stages after MCAo surgery. MATERIAL AND METHODS In total, 18 adult male Sprague-Dawley rats were subjected to right MCAo using an intraluminal filament model, and CEUS was performed at the three following timepoints: before (T0), immediately after (T1), and 6 h after permanent MCAo (T2). Twelve rats successfully completed the study, and their brains were removed and stained using 2, 3, 5-triphenyltetrazolium chloride (TTC). CEUS video images were visualized offline, and the time-intensity curves (TICs) were analyzed. Different cerebrovascular patterns and manifestations of the contrast enhancement in rat ischemic hemispheres were observed. Semi-quantitative parameters of TICs in ischemic areas (ROIi) and the surrounding normal- or hypo-perfused areas (ROIn) were calculated and compared between T0, T1, and T2, and also between ROIi and ROIn. RESULTS A significant correlation was found between the lesion volume (%) determined by TTC and CEUS parameters (r = -0.691, P = 0.013 for peak intensity; r = -0.742, P = 0.006 for area under the curve) at T2. After the same occlusion, there were differences in contrast perfusion in each group. CONCLUSION This study suggests that CEUS could be an effective imaging tool for studying cerebral ischemia and perfusion in small animals as long as the transcranial acoustic window allows it.
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Affiliation(s)
- Chenyun Zhou
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
| | - Xiaoxia Zhu
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
| | - Jin Li
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
| | - Yan Luo
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
| | - Yuqing Zhou
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
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Shin J, Hwang JH, Park SB, Kim SH. Prediction of renal recovery following sepsis-associated acute kidney injury requiring renal replacement therapy using contrast-enhanced ultrasonography. Kidney Res Clin Pract 2023; 42:473-486. [PMID: 37551127 PMCID: PMC10407630 DOI: 10.23876/j.krcp.22.086] [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: 04/22/2022] [Revised: 08/04/2022] [Accepted: 09/08/2022] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Microcirculatory dysfunction plays a critical role in sepsis-associated acute kidney injury (S-AKI) development; however, its impact on renal recovery remains uncertain. We investigated the association between cortical microcirculatory function assessed using contrast-enhanced ultrasonography (CEUS) and renal recovery after S-AKI needing renal replacement therapy (RRT). METHODS This retrospective study included 23 patients who underwent CEUS among those who underwent acute RRT for S-AKI. In addition, we acquired data from 17 healthy individuals and 18 patients with chronic kidney disease. Renal recovery was defined as sustained independence from RRT for at least 14 days. RESULTS Of the CEUS-derived parameters, rise time, time to peak, and fall time were longer in patients with S-AKI than in healthy individuals (p = 0.045, 0.01, and 0.096, respectively). Fourteen patients (60.9%) with S-AKI receiving RRT experienced renal recovery; and these patients had higher values of peak enhancement, wash-in area under the curve (AUC), wash-in perfusion index, and washout AUC than those without recovery (p = 0.03, 0.01, 0.03, and 0.046, respectively). We evaluated the receiver operating characteristic curve and found that the peak enhancement, wash-in AUC, wash-in perfusion index, and wash-out AUC of CEUS derivatives estimated the probability of renal recovery after S-AKI requiring RRT (p = 0.03, 0.01, 0.03, and 0.04, respectively). CONCLUSION CEUS-assessed cortical microvascular perfusion may predict renal recovery following S-AKI that requires RRT. Further studies are essential to validate the clinical utility of microcirculatory parameters obtained from CEUS to estimate renal outcomes in various etiologies and severities of kidney disease.
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Affiliation(s)
- Jungho Shin
- Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Jin Ho Hwang
- Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Sung Bin Park
- Department of Radiology, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Su Hyun Kim
- Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Republic of Korea
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Moody CT, Durham PG, Dayton PA, Brudno Y. Loading Intracranial Drug-Eluting Reservoirs Across the Blood-Brain Barrier With Focused Ultrasound. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:1679-1685. [PMID: 37120330 PMCID: PMC10192093 DOI: 10.1016/j.ultrasmedbio.2023.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 03/12/2023] [Accepted: 03/14/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Efficient, sustained and long-term delivery of therapeutics to the brain remains an important challenge to treatment of diseases such as brain cancer, stroke and neurodegenerative disease. Focused ultrasound can assist movement of drugs into the brain, but frequent and long-term use has remained impractical. Single-use intracranial drug-eluting depots show promise but are limited for the treatment of chronic diseases as they cannot be refilled non-invasively. Refillable drug-eluting depots could serve as a long-term solution, but refilling is hindered by the blood-brain barrier (BBB), which prevents drug refills from accessing the brain. In this article, we describe how focused ultrasound enables non-invasive loading of intracranial drug depots in mice. METHODS Female CD-1 mice (n = 6) were intracranially injected with click-reactive and fluorescent molecules that are capable of anchoring in the brain. After healing, animals were treated with high-intensity focused ultrasound and microbubbles to temporarily increase the permeability of the blood-brain barrier and deliver dibenzocyclooctyne (DBCO)-Cy7. The mice were perfused, and the brains were imaged via ex vivo fluorescence imaging. RESULTS Fluorescence imaging indicated small molecule refills are captured by intracranial depots as long as 4 wk after administration and are retained for up to 4 wk based on fluorescence imaging. Efficient loading was dependent on both focused ultrasound and the presence of refillable depots in the brain as absence of either prevented intracranial loading. CONCLUSION The ability to target and retain small molecules at predetermined intracranial sites with pinpoint accuracy provides opportunities to continuously deliver drugs to the brain over weeks and months without excessive BBB opening and with minimal off-target side effects.
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Affiliation(s)
- Christopher T. Moody
- Joint Department of Biomedical Engineering. University of North Carolina – Chapel Hill and North Carolina State University – Raleigh. 1840 Entrepreneur Drive. Raleigh, NC 27695, USA
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC USA
| | - Phillip G Durham
- Joint Department of Biomedical Engineering. University of North Carolina – Chapel Hill and North Carolina State University – Raleigh. 1840 Entrepreneur Drive. Raleigh, NC 27695, USA
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Paul A Dayton
- Joint Department of Biomedical Engineering. University of North Carolina – Chapel Hill and North Carolina State University – Raleigh. 1840 Entrepreneur Drive. Raleigh, NC 27695, USA
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Yevgeny Brudno
- Joint Department of Biomedical Engineering. University of North Carolina – Chapel Hill and North Carolina State University – Raleigh. 1840 Entrepreneur Drive. Raleigh, NC 27695, USA
- Comparative Medicine Institute, North Carolina State University, Raleigh, NC USA
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Khan AH, Jiang X, Kaushik A, Nair HS, Edirisinghe M, Mercado-Shekhar KP, Shekhar H, Dalvi SV. Combining Ultrasound and Capillary-Embedded T-Junction Microfluidic Devices to Scale Up the Production of Narrow-Sized Microbubbles through Acoustic Fragmentation. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2022; 38:10288-10304. [PMID: 35943351 DOI: 10.1021/acs.langmuir.2c01676] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Microbubbles are tiny gas-filled bubbles that have a variety of applications in ultrasound imaging and therapeutic drug delivery. Microbubbles can be synthesized using a number of techniques including sonication, amalgamation, and saline shaking. These approaches can produce highly concentrated microbubble suspensions but offer minimal control over the size and polydispersity of the microbubbles. One of the simplest and effective methods for producing monodisperse microbubbles is capillary-embedded T-junction microfluidic devices, which offer great control over the microbubble size. However, lower production rates (∼200 bubbles/s) and large microbubble sizes (∼300 μm) limit the applicability of such devices for biomedical applications. To overcome the limitations of these technologies, we demonstrate in this work an alternative approach to combine a capillary-embedded T-junction device with ultrasound to enhance the generation of narrow-sized microbubbles in aqueous suspensions. Two T-junction microfluidic devices were connected in parallel and combined with an ultrasonic horn to produce lipid-coated SF6 core microbubbles in the size range of 1-8 μm. The rate of microbubble production was found to increase from 180 microbubbles/s in the absence of ultrasound to (6.5 ± 1.2) × 106 bubble/s in the presence of ultrasound (100% ultrasound amplitude). When stored in a closed environment, the microbubbles were observed to be stable for up to 30 days, with the concentration of the microbubble suspension decreasing from ∼2.81 × 109/mL to ∼2.3 × 106/mL and the size changing from 1.73 ± 0.2 to 1.45 ± 0.3 μm at the end of 30 days. The acoustic response of these microbubbles was examined using broadband attenuation spectroscopy, and flow phantom imaging was performed to determine the ability of these microbubble suspensions to enhance the contrast relative to the surrounding tissue. Overall, this approach of coupling ultrasound with microfluidic parallelization enabled the continuous production of stable microbubbles at high production rates and low polydispersity using simple T-junction devices.
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Affiliation(s)
- Aaqib H Khan
- Chemical Engineering, Indian Institute of Technology Gandhinagar, Palaj, Gandhinagar 382355, Gujarat, India
| | - Xinyue Jiang
- Department of Mechanical Engineering, University College London (UCL), London WC1E 7JE, U.K
| | - Anuj Kaushik
- Electrical Engineering, Indian Institute of Technology Gandhinagar, Palaj, Gandhinagar 382355, Gujarat, India
| | - Hari S Nair
- Biological Engineering, Indian Institute of Technology Gandhinagar, Palaj, Gandhinagar 382355, Gujarat, India
| | - Mohan Edirisinghe
- Department of Mechanical Engineering, University College London (UCL), London WC1E 7JE, U.K
| | - Karla P Mercado-Shekhar
- Biological Engineering, Indian Institute of Technology Gandhinagar, Palaj, Gandhinagar 382355, Gujarat, India
| | - Himanshu Shekhar
- Electrical Engineering, Indian Institute of Technology Gandhinagar, Palaj, Gandhinagar 382355, Gujarat, India
| | - Sameer V Dalvi
- Chemical Engineering, Indian Institute of Technology Gandhinagar, Palaj, Gandhinagar 382355, Gujarat, India
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Safety considerations related to intravenous contrast agents in pediatric imaging. Pediatr Radiol 2022:10.1007/s00247-022-05470-z. [PMID: 35941280 DOI: 10.1007/s00247-022-05470-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/25/2022] [Accepted: 07/22/2022] [Indexed: 10/15/2022]
Abstract
Intravenous contrast media are used in MRI, CT and US studies for anatomical evaluation and lesion characterization. Safety is always of paramount importance when administering any contrast media to children, and it is important for radiologists and ordering providers to be knowledgeable of the safety profiles and potential adverse events that can occur. This manuscript reviews the frequency and types of adverse events associated with intravenous contrast agents reported in the pediatric literature. Overall, intravenous contrast agents are very safe to use in children. However, familiarity with how to treat and prevent these uncommon events is crucial in preventing poor outcomes. In addition, an understanding of gadolinium deposition in tissues can help facilitate conversations with concerned physicians and parents. This review provides a concise yet comprehensive reference for radiologists and ordering providers on intravenous contrast safety considerations in the pediatric patient.
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He H, Zhang X, Du L, Ye M, Lu Y, Xue J, Wu J, Shuai X. Molecular imaging nanoprobes for theranostic applications. Adv Drug Deliv Rev 2022; 186:114320. [PMID: 35526664 DOI: 10.1016/j.addr.2022.114320] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/11/2022] [Accepted: 04/30/2022] [Indexed: 12/13/2022]
Abstract
As a non-invasive imaging monitoring method, molecular imaging can provide the location and expression level of disease signature biomolecules in vivo, leading to early diagnosis of relevant diseases, improved treatment strategies, and accurate assessment of treating efficacy. In recent years, a variety of nanosized imaging probes have been developed and intensively investigated in fundamental/translational research and clinical practice. Meanwhile, as an interdisciplinary discipline, this field combines many subjects of chemistry, medicine, biology, radiology, and material science, etc. The successful molecular imaging not only requires advanced imaging equipment, but also the synthesis of efficient imaging probes. However, limited summary has been reported for recent advances of nanoprobes. In this paper, we summarized the recent progress of three common and main types of nanosized molecular imaging probes, including ultrasound (US) imaging nanoprobes, magnetic resonance imaging (MRI) nanoprobes, and computed tomography (CT) imaging nanoprobes. The applications of molecular imaging nanoprobes were discussed in details. Finally, we provided an outlook on the development of next generation molecular imaging nanoprobes.
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Affiliation(s)
- Haozhe He
- Nanomedicine Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China; Department of Pediatrics, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China
| | - Xindan Zhang
- Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing 100029, China
| | - Lihua Du
- PCFM Lab of Ministry of Education, School of Materials Science and Engineering, Sun Yat-Sen University, Guangzhou 510260, China
| | - Minwen Ye
- Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing 100029, China
| | - Yonglai Lu
- Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing 100029, China
| | - Jiajia Xue
- Beijing Laboratory of Biomedical Materials, Beijing University of Chemical Technology, Beijing 100029, China.
| | - Jun Wu
- PCFM Lab of Ministry of Education, School of Biomedical Engineering, Sun Yat-sen University, Shenzhen 518107, China.
| | - Xintao Shuai
- Nanomedicine Research Center, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China; PCFM Lab of Ministry of Education, School of Materials Science and Engineering, Sun Yat-Sen University, Guangzhou 510260, China.
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Abstract
Ultrasound imaging is a key investigatory step in the evaluation of chronic kidney disease and kidney transplantation. It uses nonionizing radiation, is noninvasive, and generates real-time images, making it the ideal initial radiographic test for patients with abnormal kidney function. Ultrasound enables the assessment of both structural (form and size) and functional (perfusion and patency) aspects of kidneys, both of which are especially important as the disease progresses. Ultrasound and its derivatives have been studied for their diagnostic and prognostic significance in chronic kidney disease and kidney transplantation. Ultrasound is rapidly growing more widely accessible and is now available even in handheld formats that allow for bedside ultrasound examinations. Given the trend toward ubiquity, the current use of kidney ultrasound demands a full understanding of its breadth as it and its variants become available. We described the current applications and future directions of ultrasound imaging and its variants in the context of chronic kidney disease and transplantation in this review.
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Affiliation(s)
- Rohit K. Singla
- MD and PhD Program, University of British Columbia, Vancouver, Canada
- School of Biomedical Engineering, University of British Columbia, Vancouver, Canada
- Address for Correspondence: Rohit Singla, MASc, The University of British Columbia, 2332 Main Mall, Vancouver, BC, Canada, V6T 1Z4.
| | - Matthew Kadatz
- Department of Nephrology, University of British Columbia, Vancouver, Canada
| | - Robert Rohling
- School of Biomedical Engineering, University of British Columbia, Vancouver, Canada
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, Canada
| | - Christopher Nguan
- Department of Urologic Sciences, University of British Columbia, Vancouver, Canada
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Li P, Sun D. Advanced diagnostic imaging of sentinel lymph node in early stage breast cancer. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:415-421. [PMID: 35092313 PMCID: PMC9303781 DOI: 10.1002/jcu.23151] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 01/07/2022] [Accepted: 01/08/2022] [Indexed: 06/14/2023]
Abstract
Sentinel lymph node biopsy has been regarded as the standard procedure for early staging breast cancer. One of the key steps is to locate the sentinel lymph node (SLN). The recommended method is the joint use of blue dye and radioisotope. However, due to radionuclide radiation and high cost, it is urgent to develop more convenient and sensitive imaging methods to accurately locate SLN. This article discusses the advancement of accurately locating SLN by isotope tracer imaging, magnetic tracer method, computed tomographic lymphography, and trans-lymphatic contrast-enhanced ultrasound, as well as proposing new propose for clinical diagnosis.
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Affiliation(s)
- Ping Li
- Weifang Medical UniversityWeifangShandongChina
- Department of UltrasonographyPeking University Shenzhen HospitalShenzhenGuangdongChina
| | - Desheng Sun
- Department of UltrasonographyPeking University Shenzhen HospitalShenzhenGuangdongChina
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12
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Wang Y, Zhao P, Li N, Dong Z, Lin L, Liu J, Liang S, Wang Q, Tang J, Luo Y. A Study on Correlation between Contrast-Enhanced Ultrasound Parameters and Pathological Features of Diabetic Nephropathy. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:228-236. [PMID: 34789402 DOI: 10.1016/j.ultrasmedbio.2021.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/12/2021] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
The objective of this study was to evaluate the correlation between contrast-enhanced ultrasound (CEUS) parameters and histopathological features in patients with diabetic nephropathy (DN). Sixty-two patients with DN (44 men, mean age: 52.61 ± 10.63 y) were enrolled. They underwent renal biopsy for DN at the Department of Ultrasound, PLA Hospital, between May 2017 and February 2020. Renal tissue was obtained by ultrasound-guided percutaneous needle biopsy. CEUS was performed, and time-intensity curves (TICs) and renal perfusion parameters were analyzed. Differences in CEUS parameters were analyzed according to the glomerular classification and interstitial fibrosis-tubular atrophy (IFTA) score. Continuous variables were evaluated using the analysis of variance or Mann-Whitney U-test. Discontinuous variables were compared with the χ2-test. Spearman correlation analyses evaluated associations among quantitative ultrasound perfusion parameters and histopathological characteristics. Peak enhancement (PE), wash-in rate (WiR), wash-in perfusion index (WiPI) and wash-out rate (WoR) of the cortex, and their cortex/medulla ratios, decreased with increasing glomerular classification grade (p < 0.05). The fall time (FT) of the cortex, and their cortex/medulla ratios, increased with increasing glomerular classification grade (p < 0.05). There were no significant differences in the CEUS parameters for different IFTA scores. The perfusion volume-relevant parameters (such as PE, WiR and WiPI) had a negative correlation (p < 0.05), while the perfusion time-relevant parameters (such as RT and FT) had a positive correlation (p < 0.05), with the severity of glomerular lesions, glomerulosclerosis rate and number of Kimmelstiel-Wilson lesions. The CEUS parameters of the cortex could reflect pathological characteristics, especially changes in glomerular lesions.
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Affiliation(s)
- Yiru Wang
- Department of Ultrasound, First Medical Center, Chinese PLA General Hospital, Beijing, China; Medical School of Chinese PLA, Beijing, China
| | - Ping Zhao
- Department of Ultrasound, First Medical Center, Chinese PLA General Hospital, Beijing, China; Medical School of Chinese PLA, Beijing, China
| | - Nan Li
- Department of Ultrasound, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Zheyi Dong
- Department of Nephrology, First Medical Center, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, Beijing Key Laboratory of Kidney Diseases, Beijing, China; State Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, Beijing, China
| | - Lin Lin
- Department of Ultrasound, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jiaona Liu
- Department of Nephrology, First Medical Center, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, Beijing Key Laboratory of Kidney Diseases, Beijing, China; State Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, Beijing, China
| | - Shiyuan Liang
- Department of Ultrasound, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Qian Wang
- Department of Nephrology, First Medical Center, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, Beijing Key Laboratory of Kidney Diseases, Beijing, China; State Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, Beijing, China
| | - Jie Tang
- Department of Ultrasound, First Medical Center, Chinese PLA General Hospital, Beijing, China; Medical School of Chinese PLA, Beijing, China
| | - Yukun Luo
- Department of Ultrasound, First Medical Center, Chinese PLA General Hospital, Beijing, China; Medical School of Chinese PLA, Beijing, China; State Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, Beijing, China.
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13
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Wang J, Zhao R, Cheng J. Diagnostic accuracy of contrast-enhanced ultrasound to differentiate benign and malignant breast lesions: A systematic review and meta-analysis. Eur J Radiol 2022; 149:110219. [DOI: 10.1016/j.ejrad.2022.110219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/28/2022] [Accepted: 02/10/2022] [Indexed: 12/24/2022]
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14
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Wang H, Feng Q, Li C, Zhang H, Peng Y. Ultrasonographic study of hemodynamics and CEUS in the rhesus monkey kidney. Exp Anim 2021; 71:116-122. [PMID: 34803125 PMCID: PMC9130040 DOI: 10.1538/expanim.20-0194] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Nonhuman primates share many developmental similarities with humans. As the world has recognized the rhesus monkey as a standard experimental monkey, studies of rhesus monkey are very
important and essential. The purpose of this study was to use gray-scale ultrasound, color Doppler flow imaging (CDFI), and contrast-enhanced ultrasound (CEUS) to study the ultrasound
appearance of adult healthy rhesus monkey kidneys and to investigate the relationship between renal ultrasound manifestations and body weight, gender, and the left and right kidneys. Thirty
adult healthy rhesus monkeys were studied in the experiments. The size of the kidney and the length and diameter of the renal artery were measured. The peak systolic velocity (PSV), end
diastolic velocity (EDV), and resistance index (RI) of the renal artery and intrarenal arteries were measured by CDFI. In CEUS, the time-intensity curve (TIC) was used to obtain
microvascular perfusion parameters. There were significant differences in renal size, diameter and length of the renal artery, and hemodynamics of the renal arteries between the different
weight groups. In CEUS, there were significant differences in area under curve (AUC), time from peak to one half (THP), intensity peak (PI), time to peak (TTP), mean transit time (MTT), and
wash-in-slope (WIS) between the different weight groups. There were no statistical differences between genders or the left and right kidneys. Our study provides valuable reference data for
the studies of the kidney and indicates that CEUS can be used to evaluate renal perfusion in rhesus monkeys.
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Affiliation(s)
- Hong Wang
- Department of Ultrasound, West China Hospital of Sichuan University
| | - Qipu Feng
- Regenerative Medicine Research Center, West China Hospital, Sichuan University
| | - Chao Li
- Oncology of Department, General Hospital of Western Theater Command PLA
| | - Huan Zhang
- Department of Ultrasound, West China Hospital of Sichuan University
| | - Yulan Peng
- Department of Ultrasound, West China Hospital of Sichuan University
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15
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Radzina M, Ratniece M, Putrins DS, Saule L, Cantisani V. Performance of Contrast-Enhanced Ultrasound in Thyroid Nodules: Review of Current State and Future Perspectives. Cancers (Basel) 2021; 13:5469. [PMID: 34771632 PMCID: PMC8582579 DOI: 10.3390/cancers13215469] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/20/2021] [Accepted: 10/27/2021] [Indexed: 12/12/2022] Open
Abstract
Ultrasound has been established as a baseline imaging technique for thyroid nodules. The main advantage of adding CEUS is the ability to assess the sequence and intensity of vascular perfusion and hemodynamics in the thyroid nodule, thus providing real-time characterization of nodule features, considered a valuable new approach in the determination of benign vs. malignant nodules. Original studies, reviews and six meta-analyses were included in this article. A total of 624 studies were retrieved, and 107 were included in the study. As recognized for thyroid nodule malignancy risk stratification by US, for acceptable accuracy in malignancy a combination of several CEUS parameters should be applied: hypo-enhancement, heterogeneous, peripheral irregular enhancement in combination with internal enhancement patterns, and slow wash-in and wash-out curve lower than in normal thyroid tissue. In contrast, homogeneous, intense enhancement with smooth rim enhancement and "fast-in and slow-out" are indicative of the benignity of the thyroid nodule. Even though overlapping features require standardization, with further research, CEUS may achieve reliable performance in detecting or excluding thyroid cancer. It can also play an operative role in guiding ablation procedures of benign and malignant thyroid nodules and metastatic lymph nodes, and providing accurate follow-up imaging to assess treatment efficacy.
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Affiliation(s)
- Maija Radzina
- Radiology Research Laboratory, Riga Stradins University, LV-1007 Riga, Latvia; (M.R.); (L.S.)
- Medical Faculty, University of Latvia, LV-1004 Riga, Latvia;
- Diagnostic Radiology Institute, Paula Stradina Clinical University Hospital, LV-1002 Riga, Latvia
| | - Madara Ratniece
- Radiology Research Laboratory, Riga Stradins University, LV-1007 Riga, Latvia; (M.R.); (L.S.)
| | - Davis Simanis Putrins
- Medical Faculty, University of Latvia, LV-1004 Riga, Latvia;
- Diagnostic Radiology Institute, Paula Stradina Clinical University Hospital, LV-1002 Riga, Latvia
| | - Laura Saule
- Radiology Research Laboratory, Riga Stradins University, LV-1007 Riga, Latvia; (M.R.); (L.S.)
- Diagnostic Radiology Institute, Paula Stradina Clinical University Hospital, LV-1002 Riga, Latvia
| | - Vito Cantisani
- Department of Radiological, Anatomopathological and Oncological Sciences, Sapienza University of Rome, 00100 Rome, Italy;
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16
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Brusic A, Oo J, Stella DL, Simkin PM, Loveday BP. Giant haemorrhagic hepatic cyst with flame-like morphology in a patient with polycystic kidney and liver disease. ULTRASOUND : JOURNAL OF THE BRITISH MEDICAL ULTRASOUND SOCIETY 2021; 29:187-192. [PMID: 34567231 DOI: 10.1177/1742271x20987263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/07/2020] [Indexed: 11/16/2022]
Abstract
Introduction Intracystic haemorrhage is a rare complication of hepatic cysts, and is often mistaken for a malignant lesion. Case Report A 55-year-old female with a history of polycystic kidney and liver disease presented with a six-month history of abdominal distension, abdominal pain, early satiety, shortness of breath and 5 kg of weight loss. Imaging revealed a 20 cm mixed solid-cystic hepatic lesion containing peripheral avascular mobile echogenic material with a flame-like morphology. After experiencing symptomatic relief from ultrasound-guided aspiration, the patient underwent cyst fenestration for more definitive treatment. Discussion Haemorrhagic hepatic cysts are uncommon and may present on imaging as having lace-like retractile clot, internal layering or shading of separating blood products or avascular mobile flame-like excrescences. The presence of avascular mobile flame-like excrescences appears to be a unique feature of haemorrhagic hepatic cysts. Conclusion While haemorrhagic hepatic cysts are rare and commonly mistaken for biliary cystadenomas or adenocarcinomas, the identification of particular features on high-resolution magnetic resonance imaging and contrast-enhanced ultrasound can lead to the correct diagnosis.
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Affiliation(s)
- Ana Brusic
- Department of Radiology, Royal Melbourne Hospital, Parkville, Australia
| | - June Oo
- Surgical Oncology, Peter MacCallum Cancer Centre, Parkville, Australia
| | - Damien L Stella
- Department of Radiology, Royal Melbourne Hospital, Parkville, Australia.,Department of Radiology, University of Melbourne, Parkville, Australia
| | - Paul M Simkin
- Department of Radiology, Royal Melbourne Hospital, Parkville, Australia.,Department of Radiology, University of Melbourne, Parkville, Australia
| | - Benjamin Pt Loveday
- Surgical Oncology, Peter MacCallum Cancer Centre, Parkville, Australia.,Department of Surgery, Royal Melbourne Hospital, Parkville, Australia.,Department of Surgery, University of Auckland, Auckland, New Zealand
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17
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Dong YC, Bouché M, Uman S, Burdick JA, Cormode DP. Detecting and Monitoring Hydrogels with Medical Imaging. ACS Biomater Sci Eng 2021; 7:4027-4047. [PMID: 33979137 PMCID: PMC8440385 DOI: 10.1021/acsbiomaterials.0c01547] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Hydrogels, water-swollen polymer networks, are being applied to numerous biomedical applications, such as drug delivery and tissue engineering, due to their potential tunable rheologic properties, injectability into tissues, and encapsulation and release of therapeutics. Despite their promise, it is challenging to assess their properties in vivo and crucial information such as hydrogel retention at the site of administration and in situ degradation kinetics are often lacking. To address this, technologies to evaluate and track hydrogels in vivo with various imaging techniques have been developed in recent years, including hydrogels functionalized with contrast generating material that can be imaged with methods such as X-ray computed tomography (CT), magnetic resonance imaging (MRI), optical imaging, and nuclear imaging systems. In this review, we will discuss emerging approaches to label hydrogels for imaging, review the advantages and limitations of these imaging techniques, and highlight examples where such techniques have been implemented in biomedical applications.
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Affiliation(s)
- Yuxi C Dong
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Mathilde Bouché
- Université de Lorraine, CNRS, L2CM UMR 7053, F-54000 Nancy, France
| | - Selen Uman
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Jason A Burdick
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - David P Cormode
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
- Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
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18
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Gassert F, Schnitzer M, Kim SH, Kunz WG, Ernst BP, Clevert DA, Nörenberg D, Rübenthaler J, Froelich MF. Comparison of Magnetic Resonance Imaging and Contrast-Enhanced Ultrasound as Diagnostic Options for Unclear Cystic Renal Lesions: A Cost-Effectiveness Analysis. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2021; 42:411-417. [PMID: 32052386 DOI: 10.1055/a-1110-7172] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE Correct differentiation between malignant and benign incidentally found cystic renal lesions has critical implications for patient management. In several studies contrast-enhanced ultrasound (CEUS) showed higher sensitivity with respect to the accurate characterization of these lesions compared to MRI, but the cost-effectiveness of CEUS has yet to be investigated. The aim of this study was to analyze the cost-effectiveness of CEUS as an alternative imaging method to MRI for the characterization of incidentally found cystic renal lesions. MATERIALS AND METHODS A decision model including the diagnostic modalities MRI and CEUS was created based on Markov simulations estimating lifetime costs and quality-adjusted life years (QALYs). The recent literature was reviewed to obtain model input parameters. The deterministic sensitivity of diagnostic parameters and costs was determined and probabilistic sensitivity analysis using Monte-Carlo Modelling was applied. Willingness-to-pay (WTP) was assumed to be $ 100 000/QALY. RESULTS In the base-case scenario, the total costs for CEUS were $9654.43, whereas the total costs for MRI were $9675.03. CEUS resulted in an expected effectiveness of 8.06 QALYs versus 8.06 QALYs for MRI. Therefore, from an economic point of view, CEUS was identified as an adequate diagnostic alternative to MRI. Sensitivity analysis showed that results may vary if CEUS costs increase or those of MRI decrease. CONCLUSION Based on the results of the analysis, the use of CEUS was identified as a cost-effective diagnostic strategy for the characterization of incidentally found cystic renal lesions.
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Affiliation(s)
- Felix Gassert
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Germany
| | - Moritz Schnitzer
- Department of Clinical Radiology, Ludwig-Maximilians-University of Munich-Großhadern Campus, Munich, Germany
| | - Su Hwan Kim
- Department of Radiology, Interdisciplinary ultrasound center, University Hospital LMU Munich, Germany
| | - Wolfgang G Kunz
- Department of Radiology, Interdisciplinary ultrasound center, University Hospital LMU Munich, Germany
| | | | - Dirk-André Clevert
- Department of Clinical Radiology, University of Munich-Großhadern Campus, Munich, Germany
| | - Dominik Nörenberg
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Germany
| | - Johannes Rübenthaler
- Department of Clinical Radiology, Ludwig-Maximilians-University of Munich-Großhadern Campus, Munich, Germany
| | - Matthias Frank Froelich
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Germany
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19
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Singh R, Jo J, Riegel M, Forrest ML, Yang X. The feasibility of ultrasound-assisted endovascular laser thrombolysis in an acute rabbit thrombosis model. Med Phys 2021; 48:4128-4138. [PMID: 34214203 DOI: 10.1002/mp.15068] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/27/2021] [Accepted: 06/21/2021] [Indexed: 12/31/2022] Open
Abstract
PURPOSE This study aimed to test the feasibility of combined ultrasound and laser technique, namely, ultrasound-assisted endovascular laser thrombolysis (USELT), for thrombolysis by conducting in vivo tests in a rabbit thrombosis model. MATERIALS AND METHODS An acute thrombus was created in the right jugular vein of rabbit and then was treated with ultrasound only, laser only, and USELT to dissolve the blood clot. A total of 20 rabbits were used. Out of which, the first three rabbits were used to titrate the laser and ultrasound parameters. Then, five rabbits were treated with ultrasound only, five rabbits were treated with laser only, and seven rabbits were treated with USELT. During USELT, 532-nm laser pulses were delivered endovascularly directly to the clot through a fiber optic, and 0.5 MHz ultrasound pulses were applied noninvasively to the same region. A laser fluence of 4 to 12 mJ/cm2 and ultrasound amplitude of 1 to 2 MPa were used. Recanalization of the jugular vein was assessed by performing ultrasound Doppler imaging immediately after the treatment. The maximum blood flow speed after the treatment as compared to its value before the treatment was used to calculate the blood flow recovery in vessel. RESULTS The blood flow was fully recovered (100%) in three rabbits, partially recovered in two rabbits (more than 50% and less than 100%) with mean percentage recovery of 69.73% and poorly recovered in two rabbits (<50%) with mean percentage recovery of 6.2% in the USELT group. In contrast, the treatment group with ultrasound or laser alone did not show recanalization of vein in any case, all the five rabbits were poorly/not recovered with a mean percentage recovery of 0%. CONCLUSIONS The USELT technology was shown to effectively dissolve the blood clots in an acute rabbit jugular vein thrombosis model.
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Affiliation(s)
- Rohit Singh
- Institute for Bioengineering Research and Department of Mechanical Engineering, University of Kansas, Lawrence, Kansas, USA
| | - Janggun Jo
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA.,Vesarex LLC, Lawrence, Kansas, USA
| | - Matthew Riegel
- Animal Care Unit, University of Kansas, Lawrence, Kansas, USA
| | - M Laird Forrest
- Department of Pharmaceutical Chemistry, University of Kansas, Lawrence, Kansas, 66045, USA
| | - Xinmai Yang
- Institute for Bioengineering Research and Department of Mechanical Engineering, University of Kansas, Lawrence, Kansas, USA
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20
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Daniels SP, Mankowski Gettle L, Blankenbaker DG, Lee KS, Ross AB. Contrast-enhanced ultrasound-guided musculoskeletal biopsies: our experience and technique. Skeletal Radiol 2021; 50:673-681. [PMID: 32935196 DOI: 10.1007/s00256-020-03604-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To present our experience with contrast-enhanced ultrasound (CEUS)-guided musculoskeletal soft tissue biopsies in a busy interventional clinic. MATERIALS AND METHODS After IRB approval was obtained and informed consent was waived, we retrospectively reviewed all CEUS-guided musculoskeletal biopsies performed from December 1, 2018 to March 2, 2020. Relevant pre-procedure imaging was reviewed. Number of samples, suspected necrosis on pre-procedure imaging, specimen adequacy for pathologic analysis, correlation with pathologic diagnosis of surgical resection specimens, and procedural complications were recorded. RESULTS Thirty-six CEUS-guided musculoskeletal biopsies were performed in 32 patients (mean age 57, range 26-88; 22 males, 10 females). All procedures were performed using 16-gauge biopsy needles, and all procedures provided adequate samples for pathologic analysis as per the final pathology report. Between two and seven core specimens were obtained (mean 3.7). In 30/36 cases (83%), a contrast-enhanced MRI was obtained prior to biopsy, and 10/30 (33%) of these cases showed imaging features suspicious for necrosis. In 15/36 cases, surgical resection was performed, and the core biopsy and surgical resection specimens were concordant in 14/15 cases (93%). One patient noted transient leg discomfort at the time of microbubble bursting. Otherwise, no adverse reactions or procedural complications were observed. CONCLUSION CEUS is an accurate way to safely target representative areas of soft tissue lesions for biopsy and can be implemented in a busy interventional clinic. Our early experience has shown this to be a promising technique, especially in targeting representative areas of heterogeneous lesions and lesions with areas of suspected necrosis on prior imaging.
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Affiliation(s)
- Steven P Daniels
- Department of Radiology, NYU Langone Heath, 660 First Avenue, New York, NY, 10016, USA.
| | - Lori Mankowski Gettle
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 E. Highland Avenue, Madison, WI, 53792, USA
| | - Donna G Blankenbaker
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 E. Highland Avenue, Madison, WI, 53792, USA
| | - Kenneth S Lee
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 E. Highland Avenue, Madison, WI, 53792, USA
| | - Andrew B Ross
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 E. Highland Avenue, Madison, WI, 53792, USA
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21
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Jo J, Forrest ML, Yang X. Ultrasound-assisted laser thrombolysis with endovascular laser and high-intensity focused ultrasound. Med Phys 2020; 48:579-586. [PMID: 33280145 DOI: 10.1002/mp.14636] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/15/2020] [Accepted: 11/29/2020] [Indexed: 12/20/2022] Open
Abstract
PURPOSE The combination of laser and ultrasound can significantly improve the efficiency of thrombolysis through an enhanced cavitation effect. We developed a fiber optics-based laser-ultrasound thrombolysis device and tested the feasibility and efficiency of this technology for restoring blood flow in an in vitro blood clot model. METHODS An in vitro blood flow-clot model was setup, and then an endovascular laser thrombolysis system was combined with high-intensity focused ultrasound to remove the clot. The laser and ultrasound pulses were synchronized and delivered to the blood clot concurrently. The laser pulses of 532 nm were delivered to the blood clot endovascularly through an optical fiber, whereas the ultrasound pulses of 0.5 MHz were applied noninvasively to the same region. Effectiveness of thrombolysis was evaluated by the ability to restore blood flow, which was monitored by ultrasound Doppler. RESULTS As laser powers increased, the ultrasound threshold pressures for effective thrombolysis decreased. For laser fluence levels of 0, 2, and 4 mJ/cm2 , the average negative ultrasound threshold pressures were 1.26 ± 0.114, 1.05 ± 0.181, and 0.59 ± 0.074 MPa, respectively. The periods of time needed to achieve effective thrombolysis were measured at 0.8, 2, and 4 mJ/cm2 laser fluence levels and 0.42, 0.70, and 0.98 MPa negative ultrasound pressures. In general, thrombolysis could be achieved more rapidly with higher laser powers or ultrasound pressures. CONCLUSIONS Effective thrombolysis can be achieved by combining endovascular laser with noninvasive ultrasound at relatively low power and pressure levels, which can potentially improve both the treatment efficiency and safety.
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Affiliation(s)
- Janggun Jo
- Vesarex LLC, Lawrence, KS, 66047, USA.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, 48109, USA
| | - M Laird Forrest
- Department of Pharmaceutical Chemistry, the University of Kansas, Lawrence, Kansas, 66045, USA
| | - Xinmai Yang
- Institute for Bioengineering Research and Department of Mechanical Engineering, the University of Kansas, Lawrence, Kansas, 66045, USA
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22
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Crist RM, Dasa SSK, Liu CH, Clogston JD, Dobrovolskaia MA, Stern ST. Challenges in the development of nanoparticle-based imaging agents: Characterization and biology. WILEY INTERDISCIPLINARY REVIEWS-NANOMEDICINE AND NANOBIOTECHNOLOGY 2020; 13:e1665. [PMID: 32830448 DOI: 10.1002/wnan.1665] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 12/15/2022]
Abstract
Despite imaging agents being some of the earliest nanomedicines in clinical use, the vast majority of current research and translational activities in the nanomedicine field involves therapeutics, while imaging agents are severely underrepresented. The reasons for this lack of representation are several fold, including difficulties in synthesis and scale-up, biocompatibility issues, lack of suitable tissue/disease selective targeting ligands and receptors, and a high bar for regulatory approval. The recent focus on immunotherapies and personalized medicine, and development of nanoparticle constructs with better tissue distribution and selectivity, provide new opportunities for nanomedicine imaging agent development. This manuscript will provide an overview of trends in imaging nanomedicine characterization and biocompatibility, and new horizons for future development. This article is categorized under: Diagnostic Tools > in vivo Nanodiagnostics and Imaging Toxicology and Regulatory Issues in Nanomedicine > Toxicology of Nanomaterials Toxicology and Regulatory Issues in Nanomedicine > Regulatory and Policy Issues in Nanomedicine.
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Affiliation(s)
- Rachael M Crist
- Nanotechnology Characterization Laboratory, Cancer Research Technology Program, Frederick National Laboratory for Cancer Research sponsored by the National Cancer Institute, Frederick, Maryland, USA
| | - Siva Sai Krishna Dasa
- Nanotechnology Characterization Laboratory, Cancer Research Technology Program, Frederick National Laboratory for Cancer Research sponsored by the National Cancer Institute, Frederick, Maryland, USA
| | - Christina H Liu
- Nanodelivery Systems and Devices Branch, Cancer Imaging Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, Rockville, Maryland, USA
| | - Jeffrey D Clogston
- Nanotechnology Characterization Laboratory, Cancer Research Technology Program, Frederick National Laboratory for Cancer Research sponsored by the National Cancer Institute, Frederick, Maryland, USA
| | - Marina A Dobrovolskaia
- Nanotechnology Characterization Laboratory, Cancer Research Technology Program, Frederick National Laboratory for Cancer Research sponsored by the National Cancer Institute, Frederick, Maryland, USA
| | - Stephan T Stern
- Nanotechnology Characterization Laboratory, Cancer Research Technology Program, Frederick National Laboratory for Cancer Research sponsored by the National Cancer Institute, Frederick, Maryland, USA
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23
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Cai J, Nash WT, Okusa MD. Ultrasound for the treatment of acute kidney injury and other inflammatory conditions: a promising path toward noninvasive neuroimmune regulation. Am J Physiol Renal Physiol 2020; 319:F125-F138. [PMID: 32508112 PMCID: PMC7468827 DOI: 10.1152/ajprenal.00145.2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/25/2020] [Accepted: 06/01/2020] [Indexed: 02/08/2023] Open
Abstract
Acute kidney injury (AKI) is an important clinical disorder with high prevalence, serious consequences, and limited therapeutic options. Modulation of neuroimmune interaction by nonpharmacological methods is emerging as a novel strategy for treating inflammatory diseases, including AKI. Recently, pulsed ultrasound (US) treatment was shown to protect from AKI by stimulating the cholinergic anti-inflammatory pathway. Because of the relatively simple, portable, and noninvasive nature of US procedures, US stimulation may be a valuable therapeutic option for treating inflammatory conditions. This review discusses potential impacts of US bioeffects on the nervous system and how this may generate feedback onto the immune system. We also discuss recent evidence supporting the use of US as a means to treat AKI and other inflammatory diseases.
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Affiliation(s)
- Jieru Cai
- Division of Nephrology and Center for Immunity, Inflammation, and Regenerative Medicine, University of Virginia, Charlottesville, Virgnia
| | - William T Nash
- Division of Nephrology and Center for Immunity, Inflammation, and Regenerative Medicine, University of Virginia, Charlottesville, Virgnia
| | - Mark D Okusa
- Division of Nephrology and Center for Immunity, Inflammation, and Regenerative Medicine, University of Virginia, Charlottesville, Virgnia
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24
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Abstract
An introduction to the expanding modality of contrast-enhanced ultrasound is provided, along with basics on contrast agents and technique. The contrast ultrasound findings of multiple renal tumors are reviewed with examples, including clear cell renal cell carcinoma, papillary renal cell carcinoma, chromophobe renal cell carcinoma, other rare renal cell carcinoma subtypes, oncocytoma, upper tract urothelial carcinoma, lymphoma, and angiomyolipoma, followed also by brief discussions of renal infections and pseudolesions.
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Affiliation(s)
- Kevin G King
- Keck School of Medicine, University of Southern California, Norris Cancer Center, 1500 San Pablo Street, 2nd Floor Imaging, Los Angeles, CA 90033, USA.
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25
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Wang Y, Jiang C, Huang H, Liu N, Wang Y, Chen Z, Liang S, Wu M, Jiang Y, Wang X, Zhou T, Chen H, Zhang L, Li H. Correlation of Cerebral White Matter Lesions with Carotid Intraplaque Neovascularization assessed by Contrast-enhanced Ultrasound. J Stroke Cerebrovasc Dis 2020; 29:104928. [PMID: 32689582 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104928] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Carotid atherosclerotic plaque is closely associated with cerebral white matter lesions (WMLs), while intraplaque neovascularization (IPN) contributes significantly to arterial remodeling and plaque vulnerability. In this study, we aim to evaluate the correlation of carotid IPN with cerebral WMLs. METHODS The presence of IPN and WMLs were assessed by contrast-enhanced ultrasound (CEUS) and MRI respectively. IPN was evaluated utilizing semi-quantification visual grading scale and WMLs was divided according to Fazekas grading scale. We investigated the baseline data, Fazekas grades, and IPN grades among 269 participants. We explored the influences of each variable on Fazekas grades using ordinal logistic regression and evaluated the relationship between IPN grades and WMLs Fazekas grades. RESULTS Increased age (OR: 1.06, P<0.001), hypertension (OR: 2.17, P=0.002), cerebral infarction (OR: 1.74, P=0.046), and elevated carotid IPN grading were significantly associated with aggravated Fazekas grades (grade 2 or 3). To be specific, people having grade 3, 2, and 1 carotid IPN were 25.84 (P<0.001), 10.64 (P<0.001), and 5.96 (P=0.010) times as likely to have elevated Fazekas grades compared with those who having grade 0 carotid IPN. CONCLUSION Increased carotid IPN is independently correlated with aggravated cerebral WMLs.
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Affiliation(s)
- Yuxuan Wang
- Department of Neurology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; First Clinical Medical School, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China.
| | - Chao Jiang
- Department of Public Health, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Hui Huang
- Department of Ultrasound, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Niu Liu
- Department of Ultrasound, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Yi Wang
- Department of Neurosurgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Zhaoyao Chen
- Department of Neurology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Sen Liang
- Department of Neurology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Minghua Wu
- Department of Neurology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Yajun Jiang
- Department of Neurology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Xiaoxiao Wang
- GCP Center, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Tingting Zhou
- Department of Neurology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; First Clinical Medical School, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Hu Chen
- Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Lin Zhang
- Department of Neurology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; First Clinical Medical School, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
| | - Hui Li
- Department of Neurology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; First Clinical Medical School, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
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Frinking P, Segers T, Luan Y, Tranquart F. Three Decades of Ultrasound Contrast Agents: A Review of the Past, Present and Future Improvements. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:892-908. [PMID: 31941587 DOI: 10.1016/j.ultrasmedbio.2019.12.008] [Citation(s) in RCA: 131] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 12/05/2019] [Accepted: 12/06/2019] [Indexed: 06/10/2023]
Abstract
Initial reports from the 1960s describing the observations of ultrasound contrast enhancement by tiny gaseous bubbles during echocardiographic examinations prompted the development of the first ultrasound contrast agent in the 1980s. Current commercial contrast agents for echography, such as Definity, Optison, Sonazoid and SonoVue, have proven to be successful in a variety of on- and off-label clinical indications. Whereas contrast-specific technology has seen dramatic progress after the introduction of the first approved agents in the 1990s, successful clinical translation of new developments has been limited during the same period, while understanding of microbubble physical, chemical and biologic behavior has improved substantially. It is expected that for a successful development of future opportunities, such as ultrasound molecular imaging and therapeutic applications using microbubbles, new creative developments in microbubble engineering and production dedicated to further optimizing microbubble performance are required, and that they cannot rely on bubble technology developed more than 3 decades ago.
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Affiliation(s)
- Peter Frinking
- Tide Microfluidics, Capitool 41, Enschede, The Netherlands.
| | - Tim Segers
- Physics of Fluids group, University of Twente, Enschede, The Netherlands
| | - Ying Luan
- R&D Pharmaceutical Diagnostics, General Electric Healthcare, Amersham, UK
| | - François Tranquart
- R&D Pharmaceutical Diagnostics, General Electric Healthcare, Amersham, UK
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Abstract
Ultrasound and magneto-responsive nanosized drug delivery systems have been designed as novel carriers for controlled release. Colloidal bubbles (CBs) could be designed to incorporate different materials, such as protein, lipid, polymer, surfactants, and even nanoparticles in their shell, which makes them suitable for a wide range of drug delivery applications. The interior of CBs may be filled with different gases, which is essential for conferring the characteristics of an ultrasounds contrasting agent. Manipulating the core of CBs enhances features such as stability and duration of the echogenic effect. Thus CBs derivatized with nanoparticles combine functional properties of CBs and NPs to yield a versatile theranostics platform technology.
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Abstract
PURPOSE OF REVIEW In recent years, there has been renewed interest in the use of contrast-enhanced ultrasound (CEUS) in abdominal imaging and intervention. The goal of this article is to review the practical applications of CEUS in the kidney, including renal mass characterization, treatment monitoring during and after percutaneous ablation, and biopsy guidance. RECENT FINDINGS Current evidence suggests that CEUS allows accurate differentiation of solid and cystic renal masses and is an acceptable alternative to either computed tomography (CT) or magnetic resonance imaging (MRI) for characterization of indeterminate renal masses. CEUS is sensitive and specific for diagnosing residual or recurrent renal cell carcinoma (RCC) following percutaneous ablation. Furthermore, given its excellent spatial and temporal resolution, CEUS is well suited to demonstrate tumoral microvascularity associated with malignant renal masses and is an effective complement to conventional grayscale ultrasound (US) for percutaneous biopsy guidance. Currently underutilized, CEUS is an important problem-solving tool in renal imaging and intervention whose role will continue to expand in coming years.
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Bertolotto M, Bucci S, Valentino M, Currò F, Sachs C, Cova MA. Contrast-enhanced ultrasound for characterizing renal masses. Eur J Radiol 2018; 105:41-48. [PMID: 30017297 DOI: 10.1016/j.ejrad.2018.05.015] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 04/28/2018] [Accepted: 05/14/2018] [Indexed: 12/20/2022]
Abstract
On cross-sectional imaging studies performed for other indications, incidental discovery of renal lesions is not uncommon. In daily use, grey-scale ultrasonography (US) and conventional Doppler modes are often the modality of choice for the initial assessment. While simple cysts are fully characterized with US, other lesions require further characterization, which is traditionally obtained by multiphase imaging, such as contrast-enhanced CT and MRI. Contrast-enhanced ultrasound (CEUS) has become a powerful additional tool for imaging renal lesions. With its lack of nephrotoxicity, the absence of ionizing radiation, and the ability to evaluate the enhancement pattern of renal lesions quickly and in real- time, CEUS has unique advantages over traditional modes. Established applications are differentiation between solid tumours, pseudolesions, and complex cysts; characterization of complex cysts with different malignant potential, and evaluation of tumor ablation. Microbubble contrast agents are safe. Adverse reactions are rare. This article provides an overview of the current clinical applications of CEUS in characterizing renal masses, discussing advantages and limitations. The aim is to provide the framework for sonologists to make informed decisions regarding this emerging imaging test in appropriate circumstances.
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Affiliation(s)
- Michele Bertolotto
- Department of Radiology, University of Trieste, Ospedale di Cattinara, Strada di Fiume 447, 34149 Trieste, TS, Italy.
| | - Stefano Bucci
- Department of Urology, University of Trieste, Ospedale di Cattinara, Strada di Fiume 447, 34149 Trieste, TS, Italy
| | - Massimo Valentino
- Department of Radiology, Ospedale Sant'Antonio Abate, Via Giobatta Morgagni 18, 33028 Tolmezzo, UD, Italy
| | - Francesca Currò
- Department of Radiology, University of Trieste, Ospedale di Cattinara, Strada di Fiume 447, 34149 Trieste, TS, Italy
| | - Camilla Sachs
- Department of Radiology, University of Trieste, Ospedale di Cattinara, Strada di Fiume 447, 34149 Trieste, TS, Italy
| | - Maria Assunta Cova
- Department of Radiology, University of Trieste, Ospedale di Cattinara, Strada di Fiume 447, 34149 Trieste, TS, Italy
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