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Wan M, Zhang Y, Li J, Qian Z, Gao F, Yang Y, Li W. Optical-resolution photoacoustic microelastography system for elasticity mapping: Phantom study and practical application. JOURNAL OF BIOPHOTONICS 2024; 17:e202400032. [PMID: 38894573 DOI: 10.1002/jbio.202400032] [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: 02/01/2024] [Revised: 04/26/2024] [Accepted: 05/16/2024] [Indexed: 06/21/2024]
Abstract
Elastography is a noninvasive technique for characterizing the mechanical properties of biological tissues. Conventional methods have limitations in resolution and sensitivity, hindering disease detection in clinical diagnostics. To address these issues, this study developed an optical-resolution photoacoustic microelastography (OR-PAME) system. Using an agar tissue phantom with varying agar concentrations and contrast agents, PAME evaluated elasticity distribution under compression in both lateral and axial dimensions. It indirectly measured elastic properties by correlating photoacoustic responses, temporal lags, and induced displacement. We also applied the system to the study of the distribution of elastic characteristics of the liver tissue after ablation, which confirmed the potential of OR-PAME in the study of elastic characteristics. Quantitative analysis showed greater lateral displacement in regions with reduced agar concentrations, indicating decreased stiffness. PAME also detected vertical displacement along the axial plane, validating its efficacy in elastographic imaging. By improving resolution and penetration, PAME provides superior visualization of elasticity distribution. Its methodology correlates microstructural alterations with tissue biomechanics, holding potential implications in medical diagnostics.
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Affiliation(s)
- Min Wan
- Department of Biomedical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, China
| | - Yameng Zhang
- Department of Biomedical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, China
- Department of Computer Engineering, Nanjing Institute of Technology, Nanjing, Jiangsu, China
| | - Jiani Li
- Department of Biomedical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, China
| | - Zhiyu Qian
- Department of Biomedical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, China
| | - Fan Gao
- Department of Biomedical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, China
| | - Yamin Yang
- Department of Biomedical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, China
| | - Weitao Li
- Department of Biomedical Engineering, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, China
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Zhong X, Zhang X, Cao Y, Zhou P. Interaction Between Microbubbles and Microwave Ablation: A Phantom and Rabbit Model. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:1143-1151. [PMID: 38469913 DOI: 10.1002/jum.16443] [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: 09/25/2023] [Revised: 02/24/2024] [Accepted: 02/24/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVES This study aimed to explore the interactions between microbubbles and microwave ablation (MWA). METHODS The study employed custom-made phantoms (in vitro) and white New Zealand rabbits (in vivo). MWA was performed with or without microbubbles in the phantoms (2 × 105 particles mL-1) and rabbit livers (intravenous injection of 0.05 mL/kg SonoVue). During the MWA, K-type thermocouple probes were used to monitor the MWA-induced temperature increase. Contrast-enhanced ultrasound imaging (CEUS) was used to monitor and analyze the microbubbles signal intensity. After MWA, the ablation-zone volumes were evaluated and compared between the groups with and without microbubbles. RESULTS In both the phantom models and rabbits, microbubbles showed no significant influence on MWA, including the ablation range and MWA-induced temperature increase. In phantoms and rabbit livers filled with microbubbles, MWA caused the formation of a gradually expanding microbubble-defect region over the ablation time. An increase in the temperature caused microbubble destruction. CONCLUSIONS Microbubbles had no significant influence on MWA. However, MWA induced the destruction of microbubbles in a temperature-dependent manner. Thus, the poor thermotolerance of microbubbles is a non-negligible barrier when using CEUS to monitor the ablation range during MWA in real-time.
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Affiliation(s)
- Xinyu Zhong
- Department of Ultrasound, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xinghao Zhang
- Department of Ultrasound, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Yuting Cao
- Institute of Ultrasound Imaging and Department of Ultrasound, Chongqing Key Laboratory of Ultrasound Molecular Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ping Zhou
- Department of Ultrasound, The Third Xiangya Hospital, Central South University, Changsha, China
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Zhang Y, Numata K, Du Y, Maeda S. Contrast Agents for Hepatocellular Carcinoma Imaging: Value and Progression. Front Oncol 2022; 12:921667. [PMID: 35720001 PMCID: PMC9200965 DOI: 10.3389/fonc.2022.921667] [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: 04/16/2022] [Accepted: 05/02/2022] [Indexed: 11/25/2022] Open
Abstract
Hepatocellular carcinoma (HCC) has the third-highest incidence in cancers and has become one of the leading threats to cancer death. With the research on the etiological reasons for cirrhosis and HCC, early diagnosis has been placed great hope to form a favorable prognosis. Non-invasive medical imaging, including the associated contrast media (CM)-based enhancement scan, is taking charge of early diagnosis as mainstream. Meanwhile, it is notable that various CM with different advantages are playing an important role in the different imaging modalities, or even combined modalities. For both physicians and radiologists, it is necessary to know more about the proper imaging approach, along with the characteristic CM, for HCC diagnosis and treatment. Therefore, a summarized navigating map of CM commonly used in the clinic, along with ongoing work of agent research and potential seeded agents in the future, could be a needed practicable aid for HCC diagnosis and prognosis.
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Affiliation(s)
- Ying Zhang
- Department of Medical Ultrasound, Ningbo Medical Centre Li Huili Hospital, Ningbo, China.,Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan.,Department of Gastroenterology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Kazushi Numata
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Yuewu Du
- Department of Medical Ultrasound, Ningbo Medical Centre Li Huili Hospital, Ningbo, China
| | - Shin Maeda
- Department of Gastroenterology, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
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Eisenbrey JR, Gabriel H, Savsani E, Lyshchik A. Contrast-enhanced ultrasound (CEUS) in HCC diagnosis and assessment of tumor response to locoregional therapies. Abdom Radiol (NY) 2021; 46:3579-3595. [PMID: 33825927 DOI: 10.1007/s00261-021-03059-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 02/06/2023]
Abstract
Hepatocellular carcinoma (HCC) is a global problem constituting the second leading cause of cancer deaths worldwide, thereby necessitating an accurate and cost-effective solution for managing care. Ultrasound is well poised to address this need due to its low cost, portability, safety, and excellent temporal resolution. The role of ultrasound for HCC screening has been well established and supported by multiple international guidelines. Similarly, contrast-enhanced ultrasound (CEUS) can be used for the characterization of focal liver lesions in high-risk populations, and standardized criteria for CEUS have been established by the American College of Radiology Liver Imaging Reporting & Data System (LI-RADS). Following HCC identification, CEUS can also be highly beneficial in treatment planning, delivery, and monitoring HCC response to locoregional therapies. Specific advantages of CEUS include providing real-time treatment guidance and improved diagnostic performance for the detection of residual tumor viability or recurrence, thereby identifying patients in need of retreatment substantially earlier than contrast-enhanced CT and MRI. This review provides a primer on ultrasound and CEUS for the screening and characterization of HCC, with an emphasis on assessing tumor response to locoregional therapies.
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Affiliation(s)
- John R Eisenbrey
- Department of Radiology, Thomas Jefferson University, 132 South 10th St, 796E Main Building, Philadelphia, PA, 19107, USA.
| | - Helena Gabriel
- Department of Radiology, Northwestern University, Chicago, IL, USA
| | - Esika Savsani
- Department of Radiology, Thomas Jefferson University, 132 South 10th St, 796E Main Building, Philadelphia, PA, 19107, USA
| | - Andrej Lyshchik
- Department of Radiology, Thomas Jefferson University, 132 South 10th St, 796E Main Building, Philadelphia, PA, 19107, USA
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Contrast-enhanced ultrasound imaging of the liver: a review of the clinical evidence for SonoVue and Sonazoid. Abdom Radiol (NY) 2020; 45:3779-3788. [PMID: 32424608 DOI: 10.1007/s00261-020-02573-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Contrast-enhanced ultrasound (CEUS) has become an established modality in various clinical indications for liver diseases. SonoVue®, a pure blood pure agent, and Sonazoid®, which exhibits an additional Kupffer phase, are contrast agents approved for liver imaging. This review discusses and compares the current clinical evidence for these two ultrasound contrast agents in the characterization and detection of focal liver lesions in the non-cirrhotic and cirrhotic liver, as well as for the use in interventional procedures such as liver biopsy guidance, and local ablation treatment monitoring. Reference is made to clinical studies which evaluated the accuracy of CEUS using a standard of reference, its safety, or to comparative studies of these two agents.
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Abbass MA, Ahmad SA, Mahalingam N, Krothapalli KS, Masterson JA, Rao MB, Barthe PG, Mast TD. In vivo ultrasound thermal ablation control using echo decorrelation imaging in rabbit liver and VX2 tumor. PLoS One 2019; 14:e0226001. [PMID: 31805129 PMCID: PMC6894854 DOI: 10.1371/journal.pone.0226001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 11/18/2019] [Indexed: 12/21/2022] Open
Abstract
The utility of echo decorrelation imaging feedback for real-time control of in vivo ultrasound thermal ablation was assessed in rabbit liver with VX2 tumor. High-intensity focused ultrasound (HIFU) and unfocused (bulk) ablation were performed using 5 MHz linear image-ablate arrays. Treatments comprised up to nine lower-power sonications, followed by up to nine higher-power sonications, ceasing when the average cumulative echo decorrelation within a control region of interest exceeded a predefined threshold (- 2.3, log10-scaled echo decorrelation per millisecond, corresponding to 90% specificity for tumor ablation prediction in previous in vivo experiments). This threshold was exceeded in all cases for both HIFU (N = 12) and bulk (N = 8) ablation. Controlled HIFU trials achieved a significantly higher average ablation rate compared to comparable ablation trials without image-based control, reported previously. Both controlled HIFU and bulk ablation trials required significantly less treatment time than these previous uncontrolled trials. Prediction of local liver and VX2 tumor ablation using echo decorrelation was tested using receiver operator characteristic curve analysis, showing prediction capability statistically equivalent to uncontrolled trials. Compared to uncontrolled trials, controlled trials resulted in smaller thermal ablation regions and higher contrast between echo decorrelation in treated vs. untreated regions. These results indicate that control using echo decorrelation imaging may reduce treatment duration and increase treatment reliability for in vivo thermal ablation.
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Affiliation(s)
- Mohamed A. Abbass
- Dept of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, United States of America
| | - Syed A. Ahmad
- Dept of Surgery, University of Cincinnati, Cincinnati, Ohio, United States of America
| | - Neeraja Mahalingam
- Dept of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, United States of America
| | - K. Sameer Krothapalli
- Dept of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, United States of America
| | - Jack A. Masterson
- Dept of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, United States of America
| | - Marepalli B. Rao
- Dept of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, United States of America
- Dept of Environmental Health, University of Cincinnati, Cincinnati, Ohio, United States of America
| | - Peter G. Barthe
- Guided Therapy Systems/Ardent Sound, Mesa, Arizona, United States of America
| | - T. Douglas Mast
- Dept of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, United States of America
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Abstract
BACKGROUND Numerous studies have reported that contrast ultrasound (CU) can be utilized for diagnosis in patients with liver cancer (LC) accurately. However, no systematic review has addressed to assess its diagnostic impact on patients with LC. Thus, this systematic review will investigate the accurate of CU diagnosis on LC. METHODS A comprehensive literature search for relevant studies will be performed in the Cochrane Library, EMBASE, MEDILINE, Web of Science, PSYCINFO, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure from inceptions to the March 10, 2019. All case-controlled studies investigating the impacts of CU diagnosis on LC will be included in this study. Two researchers will independently carry out study selection, quality assessment, and data extraction. The quality will be assessed by using Quality Assessment of Diagnostic Accuracy Studies tool. Statistical analysis will be conducted by RevMan V.5.3 (Cochrane Community, London, UK) and Stata V.12.0 software (Stata Corp, College Station). RESULTS This study will present the accuracy of CU diagnosis for patients with LC through the assessment of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of CU. CONCLUSION The findings of this study will summarize the current evidence for accuracy of CU diagnosis in patients with LC. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019127108.
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Affiliation(s)
- Hong-bin Guo
- Department of Ultrasound, Second Affiliated Hospital of Xi’an Medical College, Xi’an
| | - Jun-hu Wang
- Department of Ultrasound Diagnosis, Yan’an People's Hospital, Yan’an, China
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Abbass MA, Garbo AJ, Mahalingam N, Killin JK, Mast TD. Optimized Echo Decorrelation Imaging Feedback for Bulk Ultrasound Ablation Control. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2018; 65:1743-1755. [PMID: 29994657 PMCID: PMC6294441 DOI: 10.1109/tuffc.2018.2847599] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Feasibility of controlling bulk ultrasound (US) thermal ablation using echo decorrelation imaging was investigated in ex vivo bovine liver. The first of two ablation and control procedures used a sequence of constant-intensity sonication cycles, ceased when the minimum echo decorrelation within a control region of interest (ROI) exceeded a predetermined threshold. The second procedure used a variable-intensity sonication sequence, with spatially averaged decorrelation as the stopping criterion. US exposures and echo decorrelation imaging were performed by a linear image-ablate array. Based on preliminary experiments, control ROIs and thresholds for the minimum-decorrelation and average-decorrelation criteria were specified. Controlled trials for the minimum-decorrelation and average-decorrelation criteria were compared with uncontrolled trials employing 9 or 18 cycles of matching sonication sequences. Lesion dimensions, treatment times, ablation rates, and areas under receiver operating characteristic curves were statistically compared. Successfully controlled trials using both criteria required significantly shorter treatment times than corresponding 18-cycle treatments, with better ablation prediction performance than uncontrolled 9-cycle and 18-cycle treatments. Either control approach resulted in greater ablation rate than corresponding 9-cycle or 18-cycle uncontrolled approaches. A post hoc analysis studied the effect of exchanging control criteria between the two series of controlled experiments. For either group, the average time needed to exceed the alternative decorrelation threshold approximately matched the average duration of successfully controlled experimental trials. These results indicate that either approach, using minimum-decorrelation or average-decorrelation criteria, is feasible for control of bulk US ablation. In addition, use of a variable-intensity sonication sequence for bulk US thermal ablation can result in larger ablated regions compared to constant-intensity sonication sequences.
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