1
|
English K. Echo contrast medium: How the use of contrast echocardiography (ultrasound contrast agents) can improve patient care. World J Methodol 2025; 15. [DOI: 10.5662/wjm.v15.i3.100490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2024] [Revised: 12/14/2024] [Accepted: 12/20/2024] [Indexed: 03/06/2025] Open
Abstract
Conventional echocardiography can sometimes pose a challenge to diagnosis due to sub-optimal images. Ultrasound contrast agents (UCAs) have been shown to drastically enhance imaging quality, particularly depicting the left ventricular endocardial borders. Their use during echocardiography has become a valuable tool in non-invasive diagnostics. UCAs provide higher-quality images that may ultimately reduce the length of hospital stays and improve patient care. The higher cost associated with UCAs in many situations has been an impediment to frequent use. However, when used as an initial diagnostic test, UCA during rest echocardiogram is more cost-effective than the traditional diagnostic approach, which frequently includes multiple tests and imaging studies to make an accurate diagnosis. They can be easily performed across multiple patient settings and provide optimal images that allow clinicians to make sound medical decisions. This consequently allows for better diagnostic accuracies and improvement in patient care.
Collapse
Affiliation(s)
- Kevan English
- Department of Internal Medicine, University of Nebraska Medical Center College of Medicine, Omaha, NE 68198, United States
| |
Collapse
|
2
|
Pérez-Liva M, Alonso de Leciñana M, Gutiérrez-Fernández M, Camacho Sosa Dias J, F Cruza J, Rodríguez-Pardo J, García-Suárez I, Laso-García F, Herraiz JL, Elvira Segura L. Dual photoacoustic/ultrasound technologies for preclinical research: current status and future trends. Phys Med Biol 2025; 70:07TR01. [PMID: 39914003 DOI: 10.1088/1361-6560/adb368] [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] [Received: 09/02/2024] [Accepted: 02/06/2025] [Indexed: 02/12/2025]
Abstract
Photoacoustic (PA) imaging, by integrating optical and ultrasound (US) modalities, combines high spatial resolution with deep tissue penetration, making it a transformative tool in biomedical research. This review presents a comprehensive analysis of the current status of dual PA/US imaging technologies, emphasising their applications in preclinical research. It details advancements in light excitation strategies, including tomographic and microscopic modalities, innovations in pulsed laser and alternative light sources, and US instrumentation. The review further explores preclinical methodologies, encompassing dedicated instrumentation, signal processing, and data analysis techniques essential for PA/US systems. Key applications discussed include the visualisation of blood vessels, micro-circulation, and tissue perfusion; diagnosis and monitoring of inflammation; evaluation of infections, atherosclerosis, burn injuries, healing, and scar formation; assessment of liver and renal diseases; monitoring of epilepsy and neurodegenerative conditions; studies on brain disorders and preeclampsia; cell therapy monitoring; and tumour detection, staging, and recurrence monitoring. Challenges related to imaging depth, resolution, cost, and the translation of contrast agents to clinical practice are analysed, alongside advancements in high-speed acquisition, artificial intelligence-driven reconstruction, and innovative light-delivery methods. While clinical translation remains complex, this review underscores the crucial role of preclinical studies in unravelling fundamental biomedical questions and assessing novel imaging strategies. Ultimately, this review delves into the future trends of dual PA/US imaging, highlighting its potential to bridge preclinical discoveries with clinical applications and drive advances in diagnostics, therapeutic monitoring, and personalised medicine.
Collapse
Affiliation(s)
- Mailyn Pérez-Liva
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, Pl. de las Ciencias, 1, Moncloa-Aravaca, Madrid 28040, Spain
- Health Research Institute of the Hospital Clínico San Carlos, IdISSC, C/ Profesor Martín Lagos s/n, Madrid 28040, Spain
| | - María Alonso de Leciñana
- Department of Neurology and Stroke Centre, Neurological Sciences and Cerebrovascular Research Laboratory, Neurology and Cerebrovascular Disease Group, Neuroscience Area Hospital La Paz Institute for Health Research-IdiPAZ (La Paz University Hospital, Universidad Autónoma de Madrid), Madrid, Spain
| | - María Gutiérrez-Fernández
- Department of Neurology and Stroke Centre, Neurological Sciences and Cerebrovascular Research Laboratory, Neurology and Cerebrovascular Disease Group, Neuroscience Area Hospital La Paz Institute for Health Research-IdiPAZ (La Paz University Hospital, Universidad Autónoma de Madrid), Madrid, Spain
| | - Jorge Camacho Sosa Dias
- Instituto de Tecnologías Físicas y de la Información (ITEFI, CSIC), Serrano 144, Madrid 28006, Spain
| | - Jorge F Cruza
- Instituto de Tecnologías Físicas y de la Información (ITEFI, CSIC), Serrano 144, Madrid 28006, Spain
| | - Jorge Rodríguez-Pardo
- Department of Neurology and Stroke Centre, Neurological Sciences and Cerebrovascular Research Laboratory, Neurology and Cerebrovascular Disease Group, Neuroscience Area Hospital La Paz Institute for Health Research-IdiPAZ (La Paz University Hospital, Universidad Autónoma de Madrid), Madrid, Spain
| | - Iván García-Suárez
- Department of Neurology and Stroke Centre, Neurological Sciences and Cerebrovascular Research Laboratory, Neurology and Cerebrovascular Disease Group, Neuroscience Area Hospital La Paz Institute for Health Research-IdiPAZ (La Paz University Hospital, Universidad Autónoma de Madrid), Madrid, Spain
- Department of Emergency Service, San Agustín University Hospital, Asturias, Spain
| | - Fernando Laso-García
- Department of Neurology and Stroke Centre, Neurological Sciences and Cerebrovascular Research Laboratory, Neurology and Cerebrovascular Disease Group, Neuroscience Area Hospital La Paz Institute for Health Research-IdiPAZ (La Paz University Hospital, Universidad Autónoma de Madrid), Madrid, Spain
| | - Joaquin L Herraiz
- IPARCOS Institute and EMFTEL Department, Universidad Complutense de Madrid, Pl. de las Ciencias, 1, Moncloa-Aravaca, Madrid 28040, Spain
- Health Research Institute of the Hospital Clínico San Carlos, IdISSC, C/ Profesor Martín Lagos s/n, Madrid 28040, Spain
| | - Luis Elvira Segura
- Instituto de Tecnologías Físicas y de la Información (ITEFI, CSIC), Serrano 144, Madrid 28006, Spain
| |
Collapse
|
3
|
Oliveira IM, da Silva WPR, Borges NC. B-mode and contrast-enhanced ultrasonography for intestinal assessment in dogs: A review. Open Vet J 2025; 15:1066-1077. [PMID: 40276201 PMCID: PMC12017737 DOI: 10.5455/ovj.2025.v15.i3.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2024] [Accepted: 02/08/2025] [Indexed: 04/26/2025] Open
Abstract
Ultrasound (USG) is a valuable diagnostic tool for evaluating the gastrointestinal tract of small animals, providing noninvasive and dynamic information. This review discusses intestinal evaluation in dogs using B-mode ultrasound and advanced contrast-enhanced ultrasound (CEUS) with microbubbles. B-mode USG allows the examination of the thickness and stratification of the intestinal wall, motility, and adjacent structures, such as lymph nodes and peritoneum to be examined. Reference values for intestinal wall thickness in dogs are based on body weight. The duodenum, jejunum, and ileum can be differentiated sonographically by location wall stratification, and relationship to other intestinal segments. Intestinal motility is assessed by counting peristaltic waves, and abnormalities indicate various diseases. CEUS uses microbubble-based contrast agents, such as sulfur hexafluoride, which remain stable in the vascular system and are eliminated by the lungs. This technique improves the perception of ultrasound echoes, making it possible to quantify tissue perfusion using parameters such as entry time, peak enhancement, and exit time. In human medicine, CEUS is used to assess intestinal perfusion in conditions such as Crohn's disease and ischemia. In veterinary medicine, this technique has been used to assess duodenal perfusion in healthy dogs and those with chronic enteropathies or alimentary lymphoma. Although CEUS shows potential in differentiating dogs with chronic enteropathies from healthy controls, more research is needed to standardize the methodology, establish reference values, and define clinical applications in various canine intestinal diseases. The combination of B-mode USG and CEUS provides a noninvasive assessment of intestinal morphology and function, contributing to the understanding of the pathophysiology of enteropathies in dogs.
Collapse
Affiliation(s)
- Iago Martins Oliveira
- Pontifícia Universidade Católica de Goiás, Escola de Ciências Médicas e da Vida, Goiânia, Goiás, Brazil
| | | | - Naida Cristina Borges
- Departamento de Medicina Veterinária, Escola de Veterinária e Zootecnia, Universidade Federal de Goiás, Goiânia, Brazil
| |
Collapse
|
4
|
Ćwiklińska A, Przewodowska D, Koziorowski D, Szlufik S. Innovative Approaches to Brain Cancer: The Use of Magnetic Resonance-guided Focused Ultrasound in Glioma Therapy. Cancers (Basel) 2024; 16:4235. [PMID: 39766134 PMCID: PMC11674718 DOI: 10.3390/cancers16244235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2024] [Revised: 12/15/2024] [Accepted: 12/17/2024] [Indexed: 01/11/2025] Open
Abstract
Gliomas are a wide group of common brain tumors, with the most aggressive type being glioblastoma multiforme (GBM), with a 5-year survival rate of less than 5% and a median survival time of approximately 12-14 months. The standard treatment of GBM includes surgical excision, radiotherapy, and chemotherapy with temozolomide (TMZ). However, tumor recurrence and progression are common. Therefore, more effective treatment for GBM should be found. One of the main obstacles to the treatment of GBM and other gliomas is the blood-brain barrier (BBB), which impedes the penetration of antitumor chemotherapeutic agents into glioblastoma cells. Nowadays, one of the most promising novel methods for glioma treatment is Magnetic Resonance-guided Focused Ultrasound (MRgFUS). Low-intensity FUS causes the BBB to open transiently, which allows better drug delivery to the brain tissue. Under magnetic resonance guidance, ultrasound waves can be precisely directed to the tumor area to prevent side effects in healthy tissues. Through the open BBB, we can deliver targeted chemotherapeutics, anti-tumor agents, immunotherapy, and gene therapy directly to gliomas. Other strategies for MRgFUS include radiosensitization, sonodynamic therapy, histotripsy, and thermal ablation. FUS can also be used to monitor the treatment and progression of gliomas using blood-based liquid biopsy. All these methods are still under preclinical or clinical trials and are described in this review to summarize current knowledge and ongoing trials.
Collapse
Affiliation(s)
| | | | | | - Stanisław Szlufik
- Department of Neurology, Faculty of Health Sciences, Medical University of Warsaw, 03-242 Warsaw, Poland
| |
Collapse
|
5
|
Babington EA, Amedu C, Anyasor E, Reeve R. Non-contrast ultrasound assessment of blood flow in clinical practice. J Ultrason 2024; 24:1-9. [PMID: 39619263 PMCID: PMC11608067 DOI: 10.15557/jou.2024.0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/26/2024] [Indexed: 01/04/2025] Open
Abstract
Since the first clinical use of ultrasound in the 1940s, significant advancements have been made in its applications. Color Doppler imaging and power Doppler imaging are considered the first and second generations of flow ultrasound assessment tools, respectively. Subsequently, the introduction of contrastenhanced ultrasound has significantly improved the assessment of arterial and venous vascular patterns in lesions and vessels. 'Blood flow brightness-mode imaging' or 'B-flow', a non-Doppler ultrasound flow assessment mode introduced more recently, provides even more information for ultrasound users in flow assessment. Microvascular imaging, introduced about a decade ago, is the third generation of Doppler non-contrast ultrasound flow modes, and is growing in popularity. Using a special wall filter, microvascular imaging overcomes the limitations of color Doppler imaging and power Doppler imaging in the detection of slow flowing signals. Advanced dynamic flow is a third-generation non-contrast Doppler flow technology that has so far gained popularity in obstetric ultrasound, commonly used to evaluate fetal umbilical vessels and heart chambers. This review article presents some recent updates on the various non-contrast ultrasound flow modalities available in clinical practice. It focuses on the design principles of individual flow modalities, discussing their strengths, limitations, and clinical applications, along with a review of the relevant literature.
Collapse
Affiliation(s)
| | - Cletus Amedu
- Department of Midwifery and Radiography, School of Health & Psychological Sciences, City University of London, London, United Kingdom
| | - Ebuka Anyasor
- Department of Radiology, University Hospital Kerry, Tralee, Ireland
| | - Ruth Reeve
- Department of Radiology, Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom
| |
Collapse
|
6
|
Kim H, Kim JH, Lee JM. A Comparative Study of SonoVue and Sonazoid for Contrast-Enhanced Ultrasound CT/MRI Fusion Guidance During Radiofrequency Ablation of Poorly Visualized Hepatic Malignancies: A Prospective Intra-Individual Analysis. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:1879-1884. [PMID: 39306481 DOI: 10.1016/j.ultrasmedbio.2024.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 07/31/2024] [Accepted: 08/17/2024] [Indexed: 10/21/2024]
Abstract
PURPOSE This study aimed to evaluate the effectiveness of two contrast agents, SonoVue (SV) and Sonazoid (SZ), by comparing them intra-individually in contrast-enhanced ultrasound (CEUS)-CT/MRI fusion imaging (FI) to improve the visibility of inconspicuous liver malignancies on B-mode sonography for guiding percutaneous radiofrequency ablation (RFA). Additionally, the radiologists' preference between SonoVue- CT/MRI FI (SV-FI) and Sonazoid-CT/MRI FI (SZ-FI) was determined. METHODS This prospective study enrolled 23 patients with inconspicuous hepatic malignancies (≤ 3 cm) on B-mode US who underwent both SV-FI and SZ-FI for RFA guidance. The patients underwent real-time CEUS FI with CT/MRI on the same day, utilizing both SV and SZ with at least 15-min intervals. Tumor visibility and radiologists' preferences were assessed and graded using a 4-point scale during the dynamic phases of both SV-FI and SZ-FI and the Kupffer phase of SZ-FI. RESULTS The tumor visibility scores obtained from CEUS-CT/MRI FI were significantly better than those obtained from US-FI. Indeed, SV-FI and SZ-FI demonstrated comparable visibility scores when corresponding phases were compared (p > 0.05). However, the Kupffer phase images of SZ-FI displayed superior visibility scores (3.70 ± 0.56 vs. 2.96 ± 0.88; p = 0.002) than the late vascular phase images of SV-FI. The radiologists favored SZ-FI in many cases, exhibiting moderate inter-observer agreement (Kappa value = 0.587; 95% CI, 0.403-0.772). CONCLUSION Although CEUS-CT/MRI FI with either SV or SZ substantially improved the visibility of inconspicuous tumors on US-CT/MRI FI, radiologists preferred SZ to SV to guide the RFA procedure.
Collapse
Affiliation(s)
- HeeSoo Kim
- Department of Radiology, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea
| | - Jae Hyun Kim
- Department of Radiology, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea; Department of Radiology, Seoul National University College of Medicine, Jongno-gu, Seoul, Republic of Korea
| | - Jeong Min Lee
- Department of Radiology, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea; Department of Radiology, Seoul National University College of Medicine, Jongno-gu, Seoul, Republic of Korea; Institute of Radiation Medicine, Seoul National University Medical Research Center, Jongno-gu, Seoul, Republic of Korea.
| |
Collapse
|
7
|
Kroenig J, Görg C, Prosch H, Von Schumann L, Westhoff CC, Alhyari A, Koenig FRM, Findeisen H, Safai Zadeh E. Perfusion Patterns of Peripheral Pulmonary Metastasis Using Contrast-Enhanced Ultrasound (CEUS) and Their Correlation with Immunohistochemically Detected Vascularization Pattern. Cancers (Basel) 2024; 16:3365. [PMID: 39409985 PMCID: PMC11475622 DOI: 10.3390/cancers16193365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2024] [Revised: 09/23/2024] [Accepted: 09/27/2024] [Indexed: 10/20/2024] Open
Abstract
PURPOSE Description of the perfusion of pulmonary metastasis by contrast-enhanced ultrasound (CEUS) and their correlation with vascularization patterns represented by immunohistochemical CD34 endothelial staining. PATIENTS AND METHODS The data of 54 patients with histologic proven peripheral pulmonary metastasis, investigated between 2004 and 2023 by CEUS. These CEUS parameters were evaluated: time to enhancement (TE), categorized as early pulmonary-arterial (PA) or delayed bronchial-arterial (BA) patterns; extent of enhancement (EE), either marked or reduced; homogeneity of enhancement (HE), homogeneous or inhomogeneous; and decrease of enhancement (DE), rapid washout (<120 s) or late washout (≥120 s). Additionally, tissue samples in 45 cases (83.3%) were stained with CD34 antibody for immunohistochemical analysis. RESULTS In total, 4 lesions (7.4 %) exhibited PA enhancement, and 50 lesions (92.6%) demonstrated BA enhancement. Furthermore, 37 lesions (68.5%) showed marked enhancement, while 17 lesions (31.5%) exhibited reduced enhancement. The enhancement was homogeneous in 28 lesions (51.86%) and inhomogeneous in 26 lesions (48.14%). Additionally, 53 lesions (98.1%) displayed a rapid washout. A chaotic vascular pattern indicative of a bronchial arterial blood supply was identified in all cases (45/45, 100%), including all 4 lesions with PA enhancement. CONCLUSION Pulmonary metastases in CEUS predominantly reveal bronchial arterial enhancement and a rapid washout. Regarding EE and HE, pulmonary metastases show heterogeneous perfusion patterns. A PA enhancement in CEUS does not exclude BA neoangiogenesis.
Collapse
Affiliation(s)
- Johannes Kroenig
- Lung Center Mainz, Clinic for Pneumology, Center for Thoracic Diseases, University Medical Center Mainz, 55131 Mainz, Germany;
- Interdisciplinary Center of Ultrasound Diagnostics, Gastroenterology, Endocrinology, Metabolism and Clinical Infectiology, University Hospital Giessen and Marburg, Philipp University of Marburg, Baldingerstraße, 35033 Marburg, Germany (A.A.)
| | - Christian Görg
- Interdisciplinary Center of Ultrasound Diagnostics, Gastroenterology, Endocrinology, Metabolism and Clinical Infectiology, University Hospital Giessen and Marburg, Philipp University of Marburg, Baldingerstraße, 35033 Marburg, Germany (A.A.)
| | - Helmut Prosch
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Wien, Austria; (H.P.); (F.R.M.K.)
| | - Lara Von Schumann
- Interdisciplinary Center of Ultrasound Diagnostics, Gastroenterology, Endocrinology, Metabolism and Clinical Infectiology, University Hospital Giessen and Marburg, Philipp University of Marburg, Baldingerstraße, 35033 Marburg, Germany (A.A.)
| | - Christina C. Westhoff
- Institute of Pathology, University Hospital Giessen and Marburg, Philipps University Marburg, Baldingerstraße, 35043 Marburg, Germany
| | - Amjad Alhyari
- Interdisciplinary Center of Ultrasound Diagnostics, Gastroenterology, Endocrinology, Metabolism and Clinical Infectiology, University Hospital Giessen and Marburg, Philipp University of Marburg, Baldingerstraße, 35033 Marburg, Germany (A.A.)
| | - Felix R. M. Koenig
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Wien, Austria; (H.P.); (F.R.M.K.)
| | - Hajo Findeisen
- Department for Internal Medicine, Red Cross Hospital Bremen, 28209 Bremen, Germany
| | - Ehsan Safai Zadeh
- Interdisciplinary Center of Ultrasound Diagnostics, Gastroenterology, Endocrinology, Metabolism and Clinical Infectiology, University Hospital Giessen and Marburg, Philipp University of Marburg, Baldingerstraße, 35033 Marburg, Germany (A.A.)
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Wien, Austria; (H.P.); (F.R.M.K.)
| |
Collapse
|
8
|
Ratajczak F, Jameel B, Bielas R, Józefczak A. Ultrasound Control of Pickering Emulsion-Based Capsule Preparation. SENSORS (BASEL, SWITZERLAND) 2024; 24:5710. [PMID: 39275621 PMCID: PMC11398209 DOI: 10.3390/s24175710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 08/23/2024] [Accepted: 08/29/2024] [Indexed: 09/16/2024]
Abstract
Capsules with microparticle shells became of great interest due to their potential in many fields. Those capsules can be fabricated at high temperatures from particle-stabilized emulsions (Pickering emulsions) by sintering together particles that cover droplets. One of the problems with such an approach is accurately controlling whether particles are already sintered and creating the rigid capsule shell of a capsule. Here, we propose using a non-destructive ultrasound method for monitoring Pickering emulsion-based capsules prepared using heating under an alternating magnetic field. The polyethylene microparticles that were responsive to temperatures higher than 112 °C were used as droplet stabilizers together with iron oxide nanoparticles. During the coalescence of the droplets, facilitated by an external electric field, the ultrasonic attenuation increased, giving evidence that the ultrasound method detects structural changes in Pickering emulsions. The main change was the difference in the droplets' size, which was also observed via optical microscopy. The attenuation of ultrasound increased even more when measured after magnetic heating for the same concentration of particle stabilizers. Simultaneously, the values of ultrasonic velocity did not exhibit similar variety. The results show that the values of the attenuation coefficient can be used for a quantitative evaluation of the capsule formation process.
Collapse
Affiliation(s)
- Filip Ratajczak
- Faculty of Physics, Adam Mickiewicz University in Poznań, Uniwersytetu Poznańskiego 2, 61-614 Poznań, Poland
| | - Bassam Jameel
- Faculty of Physics, Adam Mickiewicz University in Poznań, Uniwersytetu Poznańskiego 2, 61-614 Poznań, Poland
| | - Rafał Bielas
- Faculty of Physics, Adam Mickiewicz University in Poznań, Uniwersytetu Poznańskiego 2, 61-614 Poznań, Poland
| | - Arkadiusz Józefczak
- Faculty of Physics, Adam Mickiewicz University in Poznań, Uniwersytetu Poznańskiego 2, 61-614 Poznań, Poland
| |
Collapse
|
9
|
Atanasova EG, Pentchev CP, Nolsøe CP. Intracavitary Applications for CEUS in PTCD. Diagnostics (Basel) 2024; 14:1400. [PMID: 39001290 PMCID: PMC11241276 DOI: 10.3390/diagnostics14131400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 06/22/2024] [Accepted: 06/28/2024] [Indexed: 07/16/2024] Open
Abstract
Intracavitary contrast-enhanced ultrasound is widely accepted as a highly informative, safe, and easily reproducible technique for the diagnosis, treatment, and follow-up of different pathologies of the biliary tree. This review article describes the diverse applications for CEUS in intracavitary biliary scenarios, supported by a literature review of the utilization of the method in indications like biliary obstruction by various etiologies, including postoperative strictures, evaluation of the biliary tree of liver donors, and evaluation of the localization of a drainage catheter. We also provide pictorial examples of the authors' personal experience with the use of intracavitary CEUS in cases of PTCD as a palliative intervention. Intracavitary CEUS brings all the positive features of US together with the virtues of contrast-enhanced imaging, providing comparable accuracy to the standard techniques for diagnosing biliary tree diseases.
Collapse
Affiliation(s)
- Evelina G Atanasova
- Faculty of Medicine, Medical University of Sofia, 1431 Sofia, Bulgaria
- Clinic of Gastroenterology, "St. Ivan Rilski" University Hospital, 1431 Sofia, Bulgaria
| | - Christo P Pentchev
- Faculty of Medicine, Medical University of Sofia, 1431 Sofia, Bulgaria
- Clinic of Gastroenterology, "St. Ivan Rilski" University Hospital, 1431 Sofia, Bulgaria
| | - Christian P Nolsøe
- Centre for Surgical Ultrasound, Department of Surgery, Zealand University Hospital, 4600 Køge, Denmark
- Institute for Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
| |
Collapse
|
10
|
Oglat AA. A review of ultrasound contrast media. F1000Res 2024; 12:1444. [PMID: 38817410 PMCID: PMC11137482 DOI: 10.12688/f1000research.140131.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/03/2024] [Indexed: 06/01/2024] Open
Abstract
Efforts have been made over the last five decades to create effective ultrasonic contrast media (UCM) for cardiac and noncardiac applications. The initial UCM was established in the 1980s, following publications from the 1960s that detailed the discovery of ultrasonic contrast enhancement using small gaseous bubbles in echocardiographic examinations. An optimal contrast agent for echography should possess the following characteristics: non-toxicity, suitability for intravenous injection, ability to traverse pulmonary, cardiac, and capillary circulations, and stability for recirculation. Definity, Optison, Sonazoid, and SonoVue are examples of current commercial contrast media. These contrast media have shown potential for various clinical reasons, both on-label and off-label. Several possible UCMs have been developed or are in progress. Advancements in comprehending the physical, chemical, and biological characteristics of microbubbles have significantly improved the visualization of tumor blood vessels, the identification of areas with reduced blood supply, and the enhanced detection of narrowed blood vessels. Innovative advances are expected to enhance future applications such as ultrasonic molecular imaging and therapeutic utilization of microbubbles.
Collapse
Affiliation(s)
- Ammar A. Oglat
- Department of Medical Imaging, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa, 13133, Jordan., The Hashemite University, Az-Zarqa, Zarqa Governorate, 13133, Jordan
| |
Collapse
|
11
|
Riggs BJ, Martinez-Correa S, Stern J, Tierradentro-Garcia LO, Haddad S, Anupindi S, Back SJ, Darge K, Hwang M. Intravenous administration of ultrasound contrast to critically ill pediatric patients. Pediatr Radiol 2024; 54:820-830. [PMID: 38506945 PMCID: PMC11562664 DOI: 10.1007/s00247-024-05898-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND The off-label use of contrast-enhanced ultrasound has been increasingly used for pediatric patients. OBJECTIVE The purpose of this retrospective study is to report any observed clinical changes associated with the intravenous (IV) administration of ultrasound contrast to critically ill neonates, infants, children, and adolescents. MATERIALS AND METHODS All critically ill patients who had 1 or more contrast-enhanced ultrasound scans while being closely monitored in the neonatal, pediatric, or pediatric cardiac intensive care units were identified. Subjective and objective data concerning cardiopulmonary, neurological, and hemodynamic monitoring were extracted from the patient's electronic medical records. Vital signs and laboratory values before, during, and after administration of ultrasound contrast were obtained. Statistical analyses were performed using JMP Pro, version 15. Results were accepted as statistically significant for P-value<0.05. RESULTS Forty-seven contrast-enhanced ultrasound scans were performed on 38 critically ill patients, 2 days to 17 years old, 19 of which were female (50%), and 19 had history of prematurity (50%). At the time of the contrast-enhanced ultrasound scans, 15 patients had cardiac shunts or a patent ductus arteriosus, 25 had respiratory failure requiring invasive mechanical oxygenation and ventilation, 19 were hemodynamically unstable requiring continual vasoactive infusions, and 8 were receiving inhaled nitric oxide. In all cases, no significant respiratory, neurologic, cardiac, perfusion, or vital sign changes associated with IV ultrasound contrast were identified. CONCLUSION This study did not retrospectively identify any adverse clinical effects associated with the IV administration of ultrasound contrast to critically ill neonates, infants, children, and adolescents.
Collapse
Affiliation(s)
- Becky J Riggs
- Division of Pediatric Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Santiago Martinez-Correa
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, 3NW24, Philadelphia, PA, 19104, USA
| | - Joseph Stern
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, 3NW24, Philadelphia, PA, 19104, USA
| | - Luis Octavio Tierradentro-Garcia
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, 3NW24, Philadelphia, PA, 19104, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Sophie Haddad
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, 3NW24, Philadelphia, PA, 19104, USA
| | - Sudha Anupindi
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, 3NW24, Philadelphia, PA, 19104, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Susan J Back
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, 3NW24, Philadelphia, PA, 19104, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Kassa Darge
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, 3NW24, Philadelphia, PA, 19104, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Misun Hwang
- Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 3401 Civic Center Boulevard, 3NW24, Philadelphia, PA, 19104, USA.
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA.
| |
Collapse
|
12
|
Liu J, Wang C, Qiu S, Sun W, Yang G, Yuan L. Toward Ultrasound Molecular Imaging of Endothelial Dysfunction in Diabetes: Targets, Strategies, and Challenges. ACS APPLIED BIO MATERIALS 2024; 7:1416-1428. [PMID: 38391247 DOI: 10.1021/acsabm.4c00053] [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: 02/24/2024]
Abstract
Diabetes vasculopathy is a significant complication of diabetes mellitus (DM), and early identification and timely intervention can effectively slow the progression. Accumulating studies have shown that diabetes causes vascular complications directly or indirectly through a variety of mechanisms. Direct imaging of the endothelial molecular changes not only identifies the early stage of diabetes vasculopathy but also sheds light on the precise treatment. Targeted ultrasound contrast agent (UCA)-based ultrasound molecular imaging (UMI) can noninvasively detect the expression status of molecular biomarkers overexpressed in the vasculature, thereby being a potential strategy for the diagnosis and treatment response evaluation of DM. Amounts of efforts have been focused on identification of the molecular targets expressed in the vasculature, manufacturing strategies of the targeted UCA, and the clinical translation for the diagnosis and evaluation of therapeutic efficacy in both micro- and macrovasculopathy in DM. This review summarizes the latest research progress on endothelium-targeted UCA and discusses their promising future and challenges in diabetes vasculopathy theranostics.
Collapse
Affiliation(s)
- Jiahan Liu
- Department of Ultrasound Medicine, Tangdu Hospital, Fourth Military Medical University, Shaanxi 710038, China
| | - Chen Wang
- Department of Ultrasound Medicine, Tangdu Hospital, Fourth Military Medical University, Shaanxi 710038, China
| | - Shuo Qiu
- Department of Ultrasound Medicine, Tangdu Hospital, Fourth Military Medical University, Shaanxi 710038, China
| | - Wenqi Sun
- Department of Ultrasound Medicine, Tangdu Hospital, Fourth Military Medical University, Shaanxi 710038, China
| | - Guodong Yang
- State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers, Department of Biochemistry and Molecular Biology, Fourth Military Medical University Xi'an, Shaanxi 710032, China
| | - Lijun Yuan
- Department of Ultrasound Medicine, Tangdu Hospital, Fourth Military Medical University, Shaanxi 710038, China
| |
Collapse
|
13
|
Howells AR, Welch PJ, Kim J, Forest CR, Shi C, Lian XL. A drug-selectable acoustic reporter gene system for human cell ultrasound imaging. Bioeng Transl Med 2024; 9:e10584. [PMID: 38435822 PMCID: PMC10905554 DOI: 10.1002/btm2.10584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 06/23/2023] [Accepted: 07/10/2023] [Indexed: 03/05/2024] Open
Abstract
A promising new field of genetically encoded ultrasound contrast agents in the form of gas vesicles has recently emerged, which could extend the specificity of medical ultrasound imaging. However, given the delicate genetic nature of how these genes are integrated and expressed, current methods of producing gas vesicle-expressing mammalian cell lines requires significant cell processing time to establish a clonal/polyclonal line that robustly expresses the gas vesicles sufficiently enough for ultrasound contrast. Here, we describe an inducible and drug-selectable acoustic reporter gene system that can enable gas vesicle expression in mammalian cell lines, which we demonstrate using HEK293T cells. Our drug-selectable construct design increases the stability and proportion of cells that successfully integrate all plasmids into their genome, thus reducing the amount of cell processing time required. Additionally, we demonstrate that our drug-selectable strategy forgoes the need for single-cell cloning and fluorescence-activated cell sorting, and that a drug-selected mixed population is sufficient to generate robust ultrasound contrast. Successful gas vesicle expression was optically and ultrasonically verified, with cells expressing gas vesicles exhibiting an 80% greater signal-to-noise ratio compared to negative controls and a 500% greater signal-to-noise ratio compared to wild-type HEK293T cells. This technology presents a new reporter gene paradigm by which ultrasound can be harnessed to visualize specific cell types for applications including cellular reporting and cell therapies.
Collapse
Affiliation(s)
| | - Phoebe J. Welch
- George W. Woodruff School of Mechanical EngineeringGeorgia Institute of TechnologyAtlantaGeorgiaUSA
| | - John Kim
- George W. Woodruff School of Mechanical EngineeringGeorgia Institute of TechnologyAtlantaGeorgiaUSA
| | - Craig R. Forest
- George W. Woodruff School of Mechanical EngineeringGeorgia Institute of TechnologyAtlantaGeorgiaUSA
- Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of TechnologyAtlantaGeorgiaUSA
| | - Chengzhi Shi
- George W. Woodruff School of Mechanical EngineeringGeorgia Institute of TechnologyAtlantaGeorgiaUSA
- Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of TechnologyAtlantaGeorgiaUSA
| | - Xiaojun Lance Lian
- Department of Biomedical EngineeringPennsylvania State UniversityPennsylvaniaUSA
- Huck Institutes of the Life Sciences, Pennsylvania State UniversityPennsylvaniaUSA
- Department of BiologyPennsylvania State UniversityPennsylvaniaUSA
| |
Collapse
|
14
|
Rosselló JM, Izak Ghasemian S, Ohl CD. High-speed ultrasound imaging of bubbly flows and shear waves in soft matter. SOFT MATTER 2024; 20:823-836. [PMID: 38167938 DOI: 10.1039/d3sm01546g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
In this methods paper, we explore the capabilities of high-speed ultrasound imaging (USI) to study fast varying and complex multi-phase structures in liquids and soft materials. Specifically, we assess the advantages and the limitations of this imaging technique through three distinct experiments involving rapid dynamics: the underwater flow induced by an external jet, the dissolution of sub-micron bubbles in water, and the propagation of shear waves in a soft elastic material. The phenomena were simultaneously characterized using optical microscopy and USI. In water, we use compounded USI for tracking a multi-phase flow produced by a jetting bubble diving into a liquid pool at speeds around 20 m s-1. These types of jets are produced by focusing a single laser pulse below the liquid surface. Upon breakup, they create a bubbly flow that exhibits high reflectivity to the ultrasound signal, enabling the visualization of the subsequent turbulent flow. In a second experiment, we demonstrate the potential of USI for recording the diffusive shrinkage of micro- and nanobubbles in water that could not be optically resolved. Puncturing an elastic material with a liquid jet creates shear waves that can be utilized for elastography measurements. We analysed the shape and speed of shear waves produced by different types of jetting bubbles in industrial gelatin. The wave characteristics were simultaneously determined by implementing particle velocimetry in optical and ultrasound measurements. For the latter, we employed a novel method to create homogeneously distributed micro- and nanobubbles in gelatin by illuminating it with a collimated laser beam.
Collapse
Affiliation(s)
- Juan Manuel Rosselló
- Faculty of Mechanical Engineering, University of Ljubljana, Aškerčeva 6, 1000 Ljubljana, Slovenia.
- Otto von Guericke University Magdeburg, Institute of Physics, Universitätsplatz 2, 39106 Magdeburg, Germany
| | - Saber Izak Ghasemian
- Otto von Guericke University Magdeburg, Institute of Physics, Universitätsplatz 2, 39106 Magdeburg, Germany
| | - Claus-Dieter Ohl
- Otto von Guericke University Magdeburg, Institute of Physics, Universitätsplatz 2, 39106 Magdeburg, Germany
| |
Collapse
|
15
|
Kim G, Won J, Kim CW, Park JR, Park D. Fabrication and Evaluation of Ultrasound-Responsive Emulsion Loading Paclitaxel for Targeted Chemotherapy. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2024; 40:91-99. [PMID: 38146661 DOI: 10.1021/acs.langmuir.3c02005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
Chemotherapy is the most widely used cancer treatment, but it has several drawbacks such as adverse side effects and low bioavailability. To address these limitations, various drug delivery systems have been investigated, including liposomes, micelles, and emulsions. These drug delivery technologies have been improving the efficacy and safety of conventional chemotherapy. This study presents an emerging drug delivery technology for targeted chemotherapy using drug-loaded ultrasound-responsive emulsion (URE) as a drug carrier and ultrasound technology for external activation. URE was designed to be responsive to ultrasound energy and fabricated by using an emulsification technique. To investigate this technology, paclitaxel, as a model drug, was used and encapsulated into URE. The size distribution, morphology, and drug release behavior of paclitaxel-loaded URE (PTX-URE) were characterized, and the echogenicity of PTX-URE was assessed by using ultrasound imaging equipment. The cellular uptake and cytotoxicity of PTX-URE with ultrasound were evaluated in breast cancer cells (MDA-MB-231). Our in vitro results indicate that the combination of PTX-URE and ultrasound significantly enhanced cellular uptake by 10.6-fold and improved cytotoxicity by 24.1% compared to PTX alone. These findings suggest that the URE platform combined with ultrasound is a promising technology to improve the drug delivery efficiency for chemotherapy.
Collapse
Affiliation(s)
- Gayoung Kim
- Bioinfra Life Science Inc., Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul 03080, South Korea
| | - Jongho Won
- Bioinfra Life Science Inc., Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul 03080, South Korea
| | - Chul-Woo Kim
- Bioinfra Life Science Inc., Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul 03080, South Korea
| | - Jong-Ryul Park
- Bioinfra Life Science Inc., Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul 03080, South Korea
| | - Donghee Park
- Bioinfra Life Science Inc., Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-Ro, Jongno-Gu, Seoul 03080, South Korea
| |
Collapse
|
16
|
Yamashita Y, Shimokawa T, Ashida R, Hirooka Y, Iwashita T, Kato H, Kin T, Masamune A, Miwa H, Ohno E, Shiomi H, Sofuni A, Takenaka M, Kitano M. Protocol for a Multi-Center Confirmatory Trial to Evaluate the Differential Diagnostic Performance of Contrast-Enhanced Ultrasonography Using Perflubutane in Patients with a Pancreatic Mass: A Multicenter Prospective Study. Diagnostics (Basel) 2024; 14:130. [PMID: 38248007 PMCID: PMC10814130 DOI: 10.3390/diagnostics14020130] [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: 11/14/2023] [Revised: 12/09/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
For pancreatic masses, an evaluation of their vascularity using contrast-enhanced ultrasonography can help improve their characterization. This study was designed to evaluate the utility and safety of contrast-enhanced transabdominal ultrasonography (CE-TUS) and endoscopic ultrasonography (CE-EUS) in the diagnosis of pancreatic masses including solid or cystic masses. This multi-center comparative open-label superiority study is designed to compare Plain (P)-TUS/EUS alone with P-TUS/P-EUS plus CE-TUS/CE-EUS. Three hundred and one patients with a total of 232 solid pancreatic masses and 69 cystic masses were prospectively enrolled. The primary endpoints are to compare the diagnostic accuracy between P-TUS/P-EUS alone and P-TUS/P-EUS plus CE-TUS/CE-EUS for both the TUS and EUS of solid pancreatic masses, and to compare the diagnostic accuracy between P-EUS alone and P-EUS plus CE-EUS in cystic pancreatic masses. The secondary endpoints are to compare the diagnostic sensitivity and specificity of P-TUS/P-EUS alone and P-TUS/P-EUS plus CE-TUS/CE-EUS for pancreatic solid/cystic masses, and the accuracy of P-TUS alone and P-TUS plus CE-TUS for pancreatic cystic masses. Other secondary endpoints included comparing the diagnostic sensitivity, specificity, and accuracy of CE-TUS, CE-EUS and CE-computed tomography (CT) for solid/cystic pancreatic masses. The safety, degree of effective enhancement, and diagnostic confidence obtained with CE-TUS/CE-EUS will also be assessed.
Collapse
Affiliation(s)
- Yasunobu Yamashita
- Second Department of Internal Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-0012, Japan
| | - Toshio Shimokawa
- Clinical Study Support Center, Wakayama Medical University Hospital, Wakayama 641-0012, Japan
| | - Reiko Ashida
- Second Department of Internal Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-0012, Japan
| | - Yoshiki Hirooka
- Department of Gastroenterology and Gastroenterological Oncology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan
| | - Takuji Iwashita
- First Department of Internal Medicine, Gifu University Hospital, Gifu 501-1194, Japan
| | - Hironari Kato
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Okayama 700-8558, Japan
| | - Toshifumi Kin
- Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo 006-8555, Japan
| | - Atsushi Masamune
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Toyoake 980-8574, Japan
| | - Haruo Miwa
- Gastroenterological Center, Yokohama City University Medical Center, Yokohama 232-0024, Japan
| | - Eizaburo Ohno
- Department of Gastroenterology and Hepatology, University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Hideyuki Shiomi
- Division of Gastroenterology and Hepatobiliary and Pancreatic Diseases, Department of Internal Medicine, Hyogo Medical University, Nishinomiya 663-8501, Japan
| | - Atsushi Sofuni
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo 160-0023, Japan
| | - Mamoru Takenaka
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka 589-8511, Japan
| | - Masayuki Kitano
- Second Department of Internal Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-0012, Japan
| |
Collapse
|
17
|
Gómez FM, Van der Reijd DJ, Panfilov IA, Baetens T, Wiese K, Haverkamp-Begemann N, Lam SW, Runge JH, Rice SL, Klompenhouwer EG, Maas M, Helmberger T, Beets-Tan RG. Imaging in interventional oncology, the better you see, the better you treat. J Med Imaging Radiat Oncol 2023; 67:895-902. [PMID: 38062853 DOI: 10.1111/1754-9485.13610] [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] [Received: 04/06/2023] [Accepted: 11/22/2023] [Indexed: 01/14/2024]
Abstract
Imaging and image processing is the fundamental pillar of interventional oncology in which diagnostic, procedure planning, treatment and follow-up are sustained. Knowing all the possibilities that the different image modalities can offer is capital to select the most appropriate and accurate guidance for interventional procedures. Despite there is a wide variability in physicians preferences and availability of the different image modalities to guide interventional procedures, it is important to recognize the advantages and limitations for each of them. In this review, we aim to provide an overview of the most frequently used image guidance modalities for interventional procedures and its typical and future applications including angiography, computed tomography (CT) and spectral CT, magnetic resonance imaging, Ultrasound and the use of hybrid systems. Finally, we resume the possible role of artificial intelligence related to image in patient selection, treatment and follow-up.
Collapse
Affiliation(s)
- Fernando M Gómez
- Grupo de Investigación Biomédica en Imagen, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
- Área Clínica de Imagen Médica, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Ilia A Panfilov
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Tarik Baetens
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Kevin Wiese
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Siu W Lam
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jurgen H Runge
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Samuel L Rice
- Radiology, Interventional Radiology Section, UT Southwestern Medical Center, Dallas, TX, USA
| | | | - Monique Maas
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Thomas Helmberger
- Institut für Radiologie, Neuroradiologie und Minimal-Invasive Therapie, München Klinik Bogenhausen, Munich, Germany
| | - Regina Gh Beets-Tan
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- GROW School for Oncology and Developmental Biology, University of Maastricht, Maastricht, The Netherlands
| |
Collapse
|
18
|
Savsani E, Shaw CM, Forsberg F, Wessner CE, Lyshchik A, O'Kane P, Liu JB, Balasubramanya R, Roth CG, Naringrekar H, Keith SW, Tan A, Anton K, Bradigan K, Civan J, Schultz S, Shamimi-Noori S, Hunt S, Soulen MC, Mattrey RF, Kono Y, Eisenbrey JR. Contrast-enhanced US Evaluation of Hepatocellular Carcinoma Response to Chemoembolization: A Prospective Multicenter Trial. Radiology 2023; 309:e230727. [PMID: 37847138 PMCID: PMC10623205 DOI: 10.1148/radiol.230727] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 09/04/2023] [Accepted: 09/13/2023] [Indexed: 10/18/2023]
Abstract
Background Contrast-enhanced (CE) US has been studied for use in the detection of residual viable hepatocellular carcinoma (HCC) after locoregional therapy, but multicenter data are lacking. Purpose To compare two-dimensional (2D) and three-dimensional (3D) CE US diagnostic performance with that of CE MRI or CT, the current clinical standard, in the detection of residual viable HCC after transarterial chemoembolization (TACE) in a prospective multicenter trial. Materials and Methods Participants aged at least 21 years with US-visible HCC scheduled for TACE were consecutively enrolled at one of three participating academic medical centers from May 2016 to March 2022. Each underwent baseline 2D and 3D CE US before TACE, 2D and 3D CE US 1-2 weeks and/or 4-6 weeks after TACE, and CE MRI or CT 4-6 weeks after TACE. CE US and CE MRI or CT were evaluated by three fellowship-trained radiologists for the presence or absence of viable tumors and were compared with reference standards of pathology (18%), angiography on re-treatment after identification of residual disease at 1-2-month follow-up imaging (31%), 4-8-month CE MRI or CT (42%), or short-term (approximately 1-2 months) CE MRI or CT if clinically decompensated and estimated viability was greater than 50% at imaging (9%). Diagnostic performance criteria, including sensitivity and specificity, were obtained for each modality and time point with generalized estimating equation analysis. Results A total of 132 participants were included (mean age, 64 years ± 7 [SD], 87 male). Sensitivity of 2D CE US 4-6 weeks after TACE was 91% (95% CI: 84, 95), which was higher than that of CE MRI or CT (68%; 95% CI: 58, 76; P < .001). Sensitivity of 3D CE US 4-6 weeks after TACE was 89% (95% CI: 81, 94), which was higher than that of CE MRI or CT (P < .001), with no evidence of a difference from 2D CE US (P = .22). CE MRI or CT had 85% (95% CI: 76, 91) specificity, higher than that of 4-6-week 2D and 3D CE US (70% [95% CI: 56, 80] and 67% [95% CI: 53, 78], respectively; P = .046 and P = .023, respectively). No evidence of differences in any diagnostic criteria were observed between 1-2-week and 4-6-week 2D CE US (P > .21). Conclusion The 2D and 3D CE US examinations 4-6 weeks after TACE revealed higher sensitivity in the detection of residual HCC than CE MRI or CT, albeit with lower specificity. Importantly, CE US performance was independent of follow-up time. Clinical trial registration no. NCT02764801 © RSNA, 2023 Supplemental material is available for this article.
Collapse
Affiliation(s)
- Esika Savsani
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Colette M. Shaw
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Flemming Forsberg
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Corinne E. Wessner
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Andrej Lyshchik
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Patrick O'Kane
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Ji-Bin Liu
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Rashmi Balasubramanya
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Christopher G. Roth
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Haresh Naringrekar
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Scott W. Keith
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Allison Tan
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Kevin Anton
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Kristen Bradigan
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Jesse Civan
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Susan Schultz
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Susan Shamimi-Noori
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Stephen Hunt
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Michael C. Soulen
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Robert F. Mattrey
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - Yuko Kono
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| | - John R. Eisenbrey
- From the Department of Radiology (E.S., C.M.S., F.F., C.E.W., A.L.,
P.O., J.B.L., R.B., C.G.R., H.N., A.T., K.A., K.B., J.R.E.), Sidney Kimmel
Medical College (E.S.), Division of Biostatistics, Department of Pharmacology,
Physiology, and Cancer Biology (S.W.K.), and Department of Medicine (J.C.),
Thomas Jefferson University, 132 S 10th St, 796 E Main Building, Philadelphia,
PA 19107; Department of Radiology, Abramson Cancer Center, University of
Pennsylvania, Philadelphia, Pa (S.S., S.S.N., S.H., M.C.S.); Department of
Radiology, University of Texas Southwestern Medical Center, Dallas, Tex
(R.F.M.); Cancer Prevention and Research Institute of Texas, Austin, Tex
(R.F.M.); and Departments of Medicine and Radiology, University of California,
San Diego, La Jolla, Calif (Y.K.)
| |
Collapse
|
19
|
Ruiter NV, Kripfgans OD. Medical ultrasound: Time-honored method or emerging research frontier? Z Med Phys 2023; 33:251-254. [PMID: 37302938 PMCID: PMC10517395 DOI: 10.1016/j.zemedi.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
|
20
|
Uchihara Y, Saito K, Motoyama R, Ishibashi-Ueda H, Yamaguchi E, Hatakeyama K, Tanaka A, Kataoka H, Iihara K, Sugie K, Koga M, Toyoda K, Nagatsuka K, Ihara M. Neovascularization From the Carotid Artery Lumen Into the Carotid Plaque Confirmed by Contrast-Enhanced Ultrasound and Histology. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:1798-1803. [PMID: 37202244 DOI: 10.1016/j.ultrasmedbio.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/30/2023] [Accepted: 04/09/2023] [Indexed: 05/20/2023]
Abstract
OBJECTIVE This study was aimed at assessing intraplaque neovessels, focusing on neovascularization from the vascular luminal side using contrast-enhanced ultrasound (CEUS) and determining that this contrast effect indicates that the neovessel is connected to the vessel lumen histopathologically. Whether plaque vulnerability can be assessed more accurately was also investigated. METHODS We enrolled consecutive patients with internal carotid artery stenosis who underwent carotid endarterectomy (CEA) and pre-operative CEUS with perflubutane of the carotid arteries. We graded the contrast effect semi-quantitatively from the vascular luminal and adventitial sides. We compared the contrast effect with the pathological findings, especially the neovascularization of the CEA specimens. RESULTS In total, 68 carotid arterial atheromatous plaques (47 symptomatic) were analyzed. Symptomatic plaques were significantly correlated with stronger contrast effects from the luminal side than from the adventitial side (p = 0.0095). Microbubbles from the luminal side appeared to flow mainly into the plaque shoulder. The contrast effect value for the plaque shoulder and neovessel density were significantly correlated (ρ = 0.35, p = 0.031). Neovessel density was significantly higher in symptomatic than in asymptomatic plaques (56.2 ± 43.7/mm2 and 18.1 ± 15.2/mm2, respectively, p < 0.0001). Serial histological sections of CEA specimens in a symptomatic plaque with a strong contrast effect from the luminal side revealed multiple neovessels fenestrated to the vessel lumen with endothelial cells, consistent with the CEUS findings. CONCLUSION Contrast-enhanced ultrasound can be used to evaluate neovessels originating from the luminal side, histopathologically confirmed in serial sections. Symptomatic vulnerable plaque is correlated more significantly with intraplaque neovascularization from the luminal side than with neovascularization from the adventitia.
Collapse
Affiliation(s)
- Yuto Uchihara
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan; Department of Neurology, Nara Medical University, Nara, Japan.
| | - Kozue Saito
- Department of Neurology, Nara Medical University, Nara, Japan; Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Rie Motoyama
- Department of Neurology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | | | - Eriko Yamaguchi
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kinta Hatakeyama
- Department of Pathology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Akito Tanaka
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan; Department of Neurology, Nara Medical University, Nara, Japan
| | - Hiroharu Kataoka
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Koji Iihara
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kazuma Sugie
- Department of Neurology, Nara Medical University, Nara, Japan
| | - Masatoshi Koga
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kazunori Toyoda
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kazuyuki Nagatsuka
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| |
Collapse
|
21
|
Mee-Inta O, Hsieh CF, Chen DQ, Fan CH, Chiang YY, Liu CC, Sze CI, Gean PW, Wu PC, Yang MS, Huang PS, Chieh Wu P, Kuo YM, Huang CC. High-frequency ultrasound imaging for monitoring the function of meningeal lymphatic system in mice. ULTRASONICS 2023; 131:106949. [PMID: 36773481 DOI: 10.1016/j.ultras.2023.106949] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/30/2022] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
The meningeal lymphatic system drains the cerebrospinal fluid from the subarachnoid space to the cervical lymphatic system, primarily to the deep cervical lymph nodes. Perturbations of the meningeal lymphatic system have been linked to various neurologic disorders. A method to specifically monitor the flow of meningeal lymphatic system in real time is unavailable. In the present study, we adopted the high-frequency ultrasound (HFUS) with 1,1'diocatadecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate (DiI)-loaded microbubble and FePt@PLGA nanoparticle contrast agents to evaluate the flow of the meningeal lymphatic system in 2-month-old mice. Statistical analysis was performed to identify changes of HFUS signals among the microbubbles, FePt@PLGA nanoparticles, and saline control groups. Approximately 15 min from the start of intracerebroventricular injection of contrast agents, their signals were evident at the deep cervical lymph nodes and lasted for at least 60 min. These signals were validated on the basis of the presence of DiI and Fe signals in the deep cervical lymph nodes. Ligation of afferent lymphatic vessels to the deep cervical lymph nodes eliminated the HFUS signals. Moreover, ablation of lymphatic vessels near the confluence of sinuses decreased the HFUS signals in the deep cervical lymph nodes. Glioma-bearing mice that exhibited reduced lymphatic vessel immunostaining signals near the confluence of sinuses had lowered HFUS signals in the deep cervical lymph nodes within 60 min. The proposed method provides a minimally invasive approach to monitor the qualities of the meningeal lymphatic system in real time as well as the progression of the meningeal lymphatic system in various brain disease animal models.
Collapse
Affiliation(s)
- Onanong Mee-Inta
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chin-Fang Hsieh
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - De-Quan Chen
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Ching-Hsiang Fan
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Yi Chiang
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Chan-Chuan Liu
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan
| | - Chun-I Sze
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Cell Biology and Anatomy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Wu Gean
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Pharmacology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ping-Ching Wu
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan; Institute of Oral Medicine and Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University Tainan, Taiwan; Center of Applied Nanomedicine, National Cheng Kung University, Tainan, Taiwan
| | - Mon-Shieh Yang
- College of Science, National Cheng Kung University, Tainan, Taiwan
| | - Po-Sheng Huang
- Department of Photonics, National Cheng Kung University, Tainan, Taiwan
| | - Pin Chieh Wu
- Department of Photonics, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Min Kuo
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Cell Biology and Anatomy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Chih-Chung Huang
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan.
| |
Collapse
|
22
|
Zeng W, Yue X, Dai Z. Ultrasound contrast agents from microbubbles to biogenic gas vesicles. MEDICAL REVIEW (2021) 2023; 3:31-48. [PMID: 37724107 PMCID: PMC10471104 DOI: 10.1515/mr-2022-0020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/11/2022] [Indexed: 09/20/2023]
Abstract
Microbubbles have been the earliest and most widely used ultrasound contrast agents by virtue of their unique features: such as non-toxicity, intravenous injectability, ability to cross the pulmonary capillary bed, and significant enhancement of echo signals for the duration of the examination, resulting in essential preclinical and clinical applications. The use of microbubbles functionalized with targeting ligands to bind to specific targets in the bloodstream has further enabled ultrasound molecular imaging. Nevertheless, it is very challenging to utilize targeted microbubbles for molecular imaging of extravascular targets due to their size. A series of acoustic nanomaterials have been developed for breaking free from this constraint. Especially, biogenic gas vesicles, gas-filled protein nanostructures from microorganisms, were engineered as the first biomolecular ultrasound contrast agents, opening the door for more direct visualization of cellular and molecular function by ultrasound imaging. The ordered protein shell structure and unique gas filling mechanism of biogenic gas vesicles endow them with excellent stability and attractive acoustic responses. What's more, their genetic encodability enables them to act as acoustic reporter genes. This article reviews the upgrading progresses of ultrasound contrast agents from microbubbles to biogenic gas vesicles, and the opportunities and challenges for the commercial and clinical translation of the nascent field of biomolecular ultrasound.
Collapse
Affiliation(s)
- Wenlong Zeng
- Department of Biomedical Engineering, College of Future Technology, Peking University, Beijing, China
| | - Xiuli Yue
- School of Environment, Harbin Institute of Technology, Harbin, China
| | - Zhifei Dai
- Department of Biomedical Engineering, College of Future Technology, Peking University, Beijing, China
| |
Collapse
|
23
|
Muacevic A, Adler JR. A Review of Tubal Factors Affecting Fertility and its Management. Cureus 2022; 14:e30990. [PMID: 36475176 PMCID: PMC9717713 DOI: 10.7759/cureus.30990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/01/2022] [Indexed: 01/25/2023] Open
Abstract
Infertility is a problem that affects both developed and developing countries today. Many couples choose to have financial stability before conception, irrespective of age. Tubal blockage accounts for 30%-40% of a woman's fertility. Congenital abnormalities, acute and persistent inflammatory diseases, endometriosis, and different pathologies are associated with infertility and cause partial or complete obstruction of the fallopian tubes. Approximately 30% of women experience infertility due to fallopian tube illness, with 10%-25% of these women experiencing proximal fallopian tube obstruction. The fallopian tube is an integral part of the union of sperm, and its normal function is a prerequisite for natural conception. Tubal obstruction is a common cause of infertility. These patients are keen to unblock their blocked fallopian tubes and restore reproductive function. Accurate diagnosis and optimal treatment options are essential for treating infertility.
Collapse
|
24
|
Pane S, Zhang M, Iacovacci V, Zhang L, Menciassi A. Contrast-enhanced ultrasound tracking of helical propellers with acoustic phase analysis and comparison with color Doppler. APL Bioeng 2022; 6:036102. [PMID: 35935094 PMCID: PMC9348897 DOI: 10.1063/5.0097145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/05/2022] [Indexed: 11/14/2022] Open
Abstract
Medical microrobots (MRs) hold the potential to radically transform several interventional procedures. However, to guarantee therapy success when operating in hard-to-reach body districts, a precise and robust imaging strategy is required for monitoring and controlling MRs in real-time. Ultrasound (US) may represent a powerful technology, but MRs' visibility with US needs to be improved, especially when targeting echogenic tissues. In this context, motions of MRs have been exploited to enhance their contrast, e.g., by Doppler imaging. To exploit a more selective contrast-enhancement mechanism, in this study, we analyze in detail the characteristic motions of one of the most widely adopted MR concepts, i.e., the helical propeller, with a particular focus on its interactions with the backscattered US waves. We combine a kinematic analysis of the propeller 3D motion with an US acoustic phase analysis (APA) performed on the raw radio frequency US data in order to improve imaging and tracking in bio-mimicking environments. We validated our US-APA approach in diverse scenarios, aimed at simulating realistic in vivo conditions, and compared the results to those obtained with standard US Doppler. Overall, our technique provided a precise and stable feedback to visualize and track helical propellers in echogenic tissues (chicken breast), tissue-mimicking phantoms with bifurcated lumina, and in the presence of different motion disturbances (e.g., physiological flows and tissue motions), where standard Doppler showed poor performance. Furthermore, the proposed US-APA technique allowed for real-time estimation of MR velocity, where standard Doppler failed.
Collapse
Affiliation(s)
| | - M Zhang
- Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - L Zhang
- Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Hong Kong SAR, China
| | | |
Collapse
|
25
|
Dietrich CF, Shi L, Koch J, Löwe A, Dong Y, Cui X, Worni M, Jenssen C. Early detection of pancreatic tumors by advanced EUS imaging. Minerva Gastroenterol (Torino) 2022; 68:133-143. [PMID: 33337117 DOI: 10.23736/s2724-5985.20.02789-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
The early detection of pancreatic ductal adenocarcinoma (PDAC) dramatically improves outcome. All available state-of-the-art imaging methods allow early detection with EUS being the best technique for exclusion of PDAC and detection of very early PDAC. Etiological differentiation of small SPL is important to guide individually tailored patients' management including radical surgery in resectable PDAC, medical (neoadjuvant or palliative intended) treatment in patients with non-resectable malignancy, pancreatic parenchyma saving strategies in some non-PDAC, and follow-up in particular in low-grade PanNEN or other small benign lesions. Multimodality EUS imaging including B-Mode assessment, elastography, contrast-enhancement and EUS-guided sampling is the most appropriate technique for diagnosis and risk assessment of small SPL. We present a review discussing modern (endoscopic) ultrasound imaging techniques including contrast enhanced ultrasound and elastography for the early detection and characterization of solid pancreatic lesions.
Collapse
Affiliation(s)
- Christoph F Dietrich
- Department Allgemeine Innere Medizin, Beau Site Clinic, Salem-Spital, Kliniken Hirslanden, Bern, Switzerland -
| | - Long Shi
- Department of Ultrasound, Jingmen N.2 People's Hospital, Jingmen, China
| | - Jonas Koch
- Department Allgemeine Innere Medizin, Beau Site Clinic, Salem-Spital, Kliniken Hirslanden, Bern, Switzerland
| | - Axel Löwe
- Department Allgemeine Innere Medizin, Beau Site Clinic, Salem-Spital, Kliniken Hirslanden, Bern, Switzerland
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xinwu Cui
- Department of Medical Ultrasound, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Mathias Worni
- Department of Visceral Surgery, Clarunis, St. Clara Hospital and University Hospital, University Center for Gastrointestinal and Liver Diseases, Basel, Switzerland
- Campus SLB, Swiss Institute for Translational and Entrepreneurial Medicine, Stiftung Lindenhof, Bern, Switzerland
- Department of Surgery, Beau Site Clinic, Bern, Switzerland
| | - Christian Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch Oderland, Strausberg, Germany
- Brandenburg Institute for Clinical Ultrasound, Medical University Brandenburg, Neuruppin, Germany
| |
Collapse
|
26
|
Riaz R, Abbas SR, Iqbal M. Synthesis, rheological characterization, and proposed application of pre‐polyglycerol sebacate as ultrasound contrast agent based on theoretical estimation. J Appl Polym Sci 2022. [DOI: 10.1002/app.51963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Ramish Riaz
- Department of Industrial Biotechnology Atta ur Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST) Islamabad Pakistan
| | - Shah Rukh Abbas
- Department of Industrial Biotechnology Atta ur Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology (NUST) Islamabad Pakistan
| | | |
Collapse
|
27
|
Contrast-enhanced ultrasound of the kidneys: principles and potential applications. Abdom Radiol (NY) 2022; 47:1369-1384. [PMID: 35150315 DOI: 10.1007/s00261-022-03438-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 02/07/2023]
Abstract
Contrast-enhanced ultrasound (CEUS) is an extension and an enhanced form of ultrasound that allows real-time evaluation of the various structures in different vascular phases. The last decade has witnessed a widespread expansion of CEUS applications beyond the liver. It has shown fair potential in kidneys and its diagnostic efficacy is comparable to CT and MRI. Ultrasound is the well-accepted screening modality for renal pathologies, however, it underperforms in the characterization of the renal masses. CEUS can be beneficial in such cases as it can help in the characterization of such incidental masses in the same sitting. It has an excellent safety profile with no risk of radiation or contract-related nephropathy. It can aid in the correct categorization of renal cysts into one of the Bosniak classes and has proven its worth especially in complex cysts or indeterminate renal masses (especially Bosniak Category IIF and III). Few studies also describe its potential role in solid masses and in differentiating benign from malignant masses. Other areas of interest include infections, infarctions, trauma, follow-up of local ablative procedures, and VUR. Through this review, the readers shall get an insight into the various applications of CEUS in kidneys, with imaging examples.
Collapse
|
28
|
Hersant J, Ramondou P, Douillet D, Abrard S, Vandeputte P, Lapébie FX, Abraham P, Henni S. Comparison between conventional duplex ultrasonography and the dual-gate Doppler mode for hemodynamic measurements of the carotid arteries. Ultrasonography 2022; 41:373-381. [PMID: 34974673 PMCID: PMC8942739 DOI: 10.14366/usg.21175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/09/2021] [Indexed: 12/24/2022] Open
Abstract
Purpose This study investigated the correlations of hemodynamic parameters measured to quantify stenosis between the gold-standard duplex ultrasonography and the dual-gate Doppler mode. Methods Patients examined due to suspicion of carotid artery stenosis or for surveillance of known stenosis were invited to participate in this prospective single-center study. Upon acceptance, the hemodynamic characteristics of the carotid arteries were determined successively in standard duplex and dual-gate Doppler modes. The correlations between the two modes were analyzed by computing Pearson coefficients (r2) and Lin concordance coefficients (ρc). The degree of agreement between the two methods was visualized using Bland-Altman graphical representations. Results The correlation between internal carotid artery peak systolic velocity measured by standard duplex ultrasonography and dual-gate Doppler mode was good (r2=0.642). The same high level of correlation was observed for the carotid ratio (r2=0.544). However, the Bland-Altman graphical representation and the Lin concordance coefficients (ρc=0.75 and ρc=0.74 for the internal carotid artery peak systolic velocity and carotid ratio, respectively) showed that a lack of precision generated some discrepancies between the two measurement methods. Conclusion Although some discrepancies were observed, the hemodynamic measurements were closely correlated between the two ultrasonography modes. Therefore, the dual-gate Doppler mode may have obvious advantages over conventional ultrasonography, offering interesting development possibilities.
Collapse
Affiliation(s)
- Jeanne Hersant
- Vascular Medicine, University Hospital Center, Angers, France
| | - Pierre Ramondou
- Vascular Medicine, University Hospital Center, Angers, France
| | | | | | | | | | - Pierre Abraham
- Sports Medicine, University Hospital Center, Angers, France.,MitoVasc Institute UMR CNRS 6015/INSERM 1083, Faculty of Medicine, Angers University, Angers, France
| | - Samir Henni
- Vascular Medicine, University Hospital Center, Angers, France.,MitoVasc Institute UMR CNRS 6015/INSERM 1083, Faculty of Medicine, Angers University, Angers, France
| |
Collapse
|
29
|
Yi HM, Lowerison MR, Song PF, Zhang W. A Review of Clinical Applications for Super-resolution Ultrasound Localization Microscopy. Curr Med Sci 2022; 42:1-16. [PMID: 35167000 DOI: 10.1007/s11596-021-2459-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 03/11/2021] [Indexed: 12/21/2022]
Abstract
Microvascular structure and hemodynamics are important indicators for the diagnosis and assessment of many diseases and pathologies. The structural and functional imaging of tissue microvasculature in vivo is a clinically significant objective for the development of many imaging modalities. Contrast-enhanced ultrasound (CEUS) is a popular clinical tool for characterizing tissue microvasculature, due to the moderate cost, wide accessibility, and absence of ionizing radiation of ultrasound. However, in practice, it remains challenging to demonstrate microvasculature using CEUS, due to the resolution limit of conventional ultrasound imaging. In addition, the quantification of tissue perfusion by CEUS remains hindered by high operator-dependency and poor reproducibility. Inspired by super-resolution optical microscopy, super-resolution ultrasound localization microscopy (ULM) was recently developed. ULM uses the same ultrasound contrast agent (i.e. microbubbles) in CEUS. However, different from CEUS, ULM uses the location of the microbubbles to construct images, instead of using the backscattering intensity of microbubbles. Hence, ULM overcomes the classic compromise between imaging resolution and penetration, allowing for the visualization of capillary-scale microvasculature deep within tissues. To date, many in vivo ULM results have been reported, including both animal (kidney, brain, spinal cord, xenografted tumor, and ear) and human studies (prostate, tibialis anterior muscle, and breast cancer tumors). Furthermore, a variety of useful biomarkers have been derived from using ULM for different preclinical and clinical applications. Due to the high spatial resolution and accurate blood flow speed estimation (approximately 1 mm/s to several cm/s), ULM presents as an enticing alternative to CEUS for characterizing tissue microvasculature in vivo. This review summarizes the principles and present applications of CEUS and ULM, and discusses areas where ULM can potentially provide a better alternative to CEUS in clinical practice and areas where ULM may not be a better alternative. The objective of the study is to provide clinicians with an up-to-date review of ULM technology, and a practical guide for implementing ULM in clinical research and practice.
Collapse
Affiliation(s)
- Hui-Ming Yi
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.,Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, 61801, USA.,Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, 61801, USA
| | - Matthew R Lowerison
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, 61801, USA.,Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, 61801, USA
| | - Peng-Fei Song
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, 61801, USA.,Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, 61801, USA
| | - Wei Zhang
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. .,Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, 61801, USA. .,Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, 61801, USA.
| |
Collapse
|
30
|
Kikuchi Y, Kanagawa T, Ayukai T. Physico-mathematical model for multiple ultrasound-contrast-agent microbubbles encapsulated by a visco-elastic shell: Effect of shell compressibility on ultrasound attenuation. Chem Eng Sci 2022. [DOI: 10.1016/j.ces.2022.117541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
31
|
Farooq A, Sabah S, Dhou S, Alsawaftah N, Husseini G. Exogenous Contrast Agents in Photoacoustic Imaging: An In Vivo Review for Tumor Imaging. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:393. [PMID: 35159738 PMCID: PMC8840344 DOI: 10.3390/nano12030393] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/10/2022] [Accepted: 01/18/2022] [Indexed: 11/16/2022]
Abstract
The field of cancer theranostics has grown rapidly in the past decade and innovative 'biosmart' theranostic materials are being synthesized and studied to combat the fast growth of cancer metastases. While current state-of-the-art oncology imaging techniques have decreased mortality rates, patients still face a diminished quality of life due to treatment. Therefore, improved diagnostics are needed to define in vivo tumor growths on a molecular level to achieve image-guided therapies and tailored dosage needs. This review summarizes in vivo studies that utilize contrast agents within the field of photoacoustic imaging-a relatively new imaging modality-for tumor detection, with a special focus on imaging and transducer parameters. This paper also details the different types of contrast agents used in this novel diagnostic field, i.e., organic-based, metal/inorganic-based, and dye-based contrast agents. We conclude this review by discussing the challenges and future direction of photoacoustic imaging.
Collapse
Affiliation(s)
- Afifa Farooq
- Biomedical Engineering Graduate Program, American University of Sharjah, Sharjah 26666, United Arab Emirates; (A.F.); (S.S.); (N.A.)
| | - Shafiya Sabah
- Biomedical Engineering Graduate Program, American University of Sharjah, Sharjah 26666, United Arab Emirates; (A.F.); (S.S.); (N.A.)
| | - Salam Dhou
- Biomedical Engineering Graduate Program, American University of Sharjah, Sharjah 26666, United Arab Emirates; (A.F.); (S.S.); (N.A.)
- Department of Computer Science and Engineering, American University of Sharjah, Sharjah 26666, United Arab Emirates
| | - Nour Alsawaftah
- Biomedical Engineering Graduate Program, American University of Sharjah, Sharjah 26666, United Arab Emirates; (A.F.); (S.S.); (N.A.)
| | - Ghaleb Husseini
- Biomedical Engineering Graduate Program, American University of Sharjah, Sharjah 26666, United Arab Emirates; (A.F.); (S.S.); (N.A.)
- Department of Chemical Engineering, American University of Sharjah, Sharjah 26666, United Arab Emirates
| |
Collapse
|
32
|
Zeng F, Du M, Chen Z. Nanosized Contrast Agents in Ultrasound Molecular Imaging. Front Bioeng Biotechnol 2021; 9:758084. [PMID: 34912789 PMCID: PMC8666542 DOI: 10.3389/fbioe.2021.758084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/08/2021] [Indexed: 11/13/2022] Open
Abstract
Applying nanosized ultrasound contrast agents (nUCAs) in molecular imaging has received considerable attention. nUCAs have been instrumental in ultrasound molecular imaging to enhance sensitivity, identification, and quantification. nUCAs can achieve high performance in molecular imaging, which was influenced by synthetic formulations and size. This review presents an overview of nUCAs from different synthetic formulations with a discussion on imaging and detection technology. Then we also review the progress of nUCAs in preclinical application and highlight the recent challenges of nUCAs.
Collapse
Affiliation(s)
- Fengyi Zeng
- The First Affiliated Hospital, Medical Imaging Centre, Hengyang Medical School, University of South China, Hengyang, China.,Institute of Medical Imaging, Hengyang Medical School, University of South China, Hengyang, China.,Laboratory of Ultrasound Molecular Imaging, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Meng Du
- The First Affiliated Hospital, Medical Imaging Centre, Hengyang Medical School, University of South China, Hengyang, China.,Institute of Medical Imaging, Hengyang Medical School, University of South China, Hengyang, China
| | - Zhiyi Chen
- The First Affiliated Hospital, Medical Imaging Centre, Hengyang Medical School, University of South China, Hengyang, China.,Institute of Medical Imaging, Hengyang Medical School, University of South China, Hengyang, China
| |
Collapse
|
33
|
Sbeit W, Kadah A, Mahamid M, Mari A, Khoury T. A state-of-the-art comprehensive review summarizing the emerging data on endoscopic ultrasound-guided liver diseases management. Eur J Gastroenterol Hepatol 2021; 33:e13-e20. [PMID: 32804852 DOI: 10.1097/meg.0000000000001893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Liver diseases are among the most common diseases worldwide accounting for substantial morbidity and mortality. Most liver diseases necessitate radiological evaluation or accurate diagnosis and recently for management as well. In the last decade, the application of therapeutic endoscopic ultrasound (EUS) procedure has been increasingly utilized for the management of various liver diseases. In this comprehensive narrative review article, we provide systematic overview on EUS-guided therapeutic interventions in various liver diseases summarizing most updated data regarding technical success, outcomes and safety profiles. Overall, 35 articles have reported on the use of EUS in the treatment of liver diseases with excellent technical success, favorable radiological response and high safety profiles for EUS-guided treatment of solid and cystic liver lesion and for EUS-guided angiotherapy for gastric varices, except for EUS-guided cyanoacrylate glue injection which was associated with life-threatening fatal systemic embolization adverse events. This suggests that EUS-guided intervention is a new promising therapeutic intervention for the treatment of various liver diseases with durable effect and a limited potential for adverse events.
Collapse
Affiliation(s)
- Wisam Sbeit
- Department of Gastroenterology, Galilee Medical Center, Nahariya
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed
| | - Anas Kadah
- Department of Gastroenterology, Galilee Medical Center, Nahariya
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed
| | - Mahmud Mahamid
- Gastroenterology Department, Sharee Zedek Medical Center, Jerusalem
| | - Amir Mari
- Gastroenterology and Endoscopy Units, The Nazareth Hospital, EMMS, Nazareth
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | - Tawfik Khoury
- Department of Gastroenterology, Galilee Medical Center, Nahariya
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed
| |
Collapse
|
34
|
Chingo Aimacaña CM, Pila KO, Quinchiguango Perez DA, Debut A, Attia MF, Santos-Oliveira R, Whitehead DC, Reinoso C, Alexis F, Dahoumane SA. Bimodal Ultrasound and X-ray Bioimaging Properties of Particulate Calcium Fluoride Biomaterial. Molecules 2021; 26:5447. [PMID: 34576919 PMCID: PMC8472579 DOI: 10.3390/molecules26185447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/31/2021] [Accepted: 09/03/2021] [Indexed: 11/30/2022] Open
Abstract
Ultrasound (US) and X-ray imaging are diagnostic methods that are commonly used to image internal body structures. Several organic and inorganic imaging contrast agents are commercially available. However, their synthesis and purification remain challenging, in addition to posing safety issues. Here, we report on the promise of widespread, safe, and easy-to-produce particulate calcium fluoride (part-CaF2) as a bimodal US and X-ray contrast agent. Pure and highly crystalline part-CaF2 is obtained using a cheap commercial product. Scanning electron microscopy (SEM) depicts the morphology of these particles, while energy-dispersive X-ray spectroscopy (EDS) confirms their chemical composition. Diffuse reflectance ultraviolet-visible spectroscopy highlights their insulating behavior. The X-ray diffraction (XRD) pattern reveals that part-CaF2 crystallizes in the face-centered cubic cell lattice. Further analyses regarding peak broadening are performed using the Scherrer and Williamson-Hall (W-H) methods, which pinpoint the small crystallite size and the presence of lattice strain. X-ray photoelectron spectroscopy (XPS) solely exhibits specific peaks related to CaF2, confirming the absence of any contamination. Additionally, in vitro cytotoxicity and in vivo maximum tolerated dose (MTD) tests prove the biocompatibility of part-CaF2. Finally, the results of the US and X-ray imaging tests strongly signal that part-CaF2 could be exploited in bimodal bioimaging applications. These findings may shed a new light on calcium fluoride and the opportunities it offers in biomedical engineering.
Collapse
Affiliation(s)
| | - Kevin O. Pila
- School of Biological Sciences and Engineering, Yachay Tech University, Urcuquí 100650, Ecuador; (K.O.P.); (D.A.Q.P.)
| | - Dilan A. Quinchiguango Perez
- School of Biological Sciences and Engineering, Yachay Tech University, Urcuquí 100650, Ecuador; (K.O.P.); (D.A.Q.P.)
| | - Alexis Debut
- Center of Nanoscience and Nanotechnology, Universidad de las Fuerzas Armadas ESPE, Sangolquí 170501, Ecuador;
| | - Mohamed F. Attia
- Center for Nanotechnology in Drug Delivery and Division of Pharmaco-engineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
| | - Ralph Santos-Oliveira
- Laboratory of Nanoradiopharmacy and Synthesis of Novel Radiopharmaceuticals, Nuclear Engineering Institute, Brazilian Nuclear Energy Commission, Rio de Janeiro 21941-906, Brazil;
- Laboratory of Radiopharmacy and Nanoradiopharmaceuticals, Zona Oeste State University, Rio de Janeiro 23070-200, Brazil
| | | | - Carlos Reinoso
- School of Physical Sciences and Nanotechnology, Yachay Tech University, Urcuquí 100650, Ecuador; (C.M.C.A.); (C.R.)
| | - Frank Alexis
- School of Biological Sciences and Engineering, Yachay Tech University, Urcuquí 100650, Ecuador; (K.O.P.); (D.A.Q.P.)
| | - Si Amar Dahoumane
- School of Biological Sciences and Engineering, Yachay Tech University, Urcuquí 100650, Ecuador; (K.O.P.); (D.A.Q.P.)
- Department of Chemical Engineering, Polytechnique Montreal, Montreal, QC H3C 3A7, Canada
| |
Collapse
|
35
|
Ho YJ, Huang CC, Fan CH, Liu HL, Yeh CK. Ultrasonic technologies in imaging and drug delivery. Cell Mol Life Sci 2021; 78:6119-6141. [PMID: 34297166 PMCID: PMC11072106 DOI: 10.1007/s00018-021-03904-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/13/2021] [Accepted: 07/19/2021] [Indexed: 12/14/2022]
Abstract
Ultrasonic technologies show great promise for diagnostic imaging and drug delivery in theranostic applications. The development of functional and molecular ultrasound imaging is based on the technical breakthrough of high frame-rate ultrasound. The evolution of shear wave elastography, high-frequency ultrasound imaging, ultrasound contrast imaging, and super-resolution blood flow imaging are described in this review. Recently, the therapeutic potential of the interaction of ultrasound with microbubble cavitation or droplet vaporization has become recognized. Microbubbles and phase-change droplets not only provide effective contrast media, but also show great therapeutic potential. Interaction with ultrasound induces unique and distinguishable biophysical features in microbubbles and droplets that promote drug loading and delivery. In particular, this approach demonstrates potential for central nervous system applications. Here, we systemically review the technological developments of theranostic ultrasound including novel ultrasound imaging techniques, the synergetic use of ultrasound with microbubbles and droplets, and microbubble/droplet drug-loading strategies for anticancer applications and disease modulation. These advancements have transformed ultrasound from a purely diagnostic utility into a promising theranostic tool.
Collapse
Affiliation(s)
- Yi-Ju Ho
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan
| | - Chih-Chung Huang
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
- Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan
| | - Ching-Hsiang Fan
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
- Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan
| | - Hao-Li Liu
- Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan.
| | - Chih-Kuang Yeh
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan.
| |
Collapse
|
36
|
Takahashi MS, Yamanari MGI, Suzuki L, Pedrosa ÉFNC, Lopes RI, Chammas MC. Use of contrast-enhanced ultrasound in pediatrics. Radiol Bras 2021; 54:321-328. [PMID: 34602668 PMCID: PMC8475167 DOI: 10.1590/0100-3984.2020.0167] [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: 11/19/2020] [Accepted: 02/11/2021] [Indexed: 12/03/2022] Open
Abstract
Although contrast-enhanced ultrasound has been shown to provide considerable benefits, particularly in pediatric patients, it is still used relatively rarely in Brazil. It has proven to be a safe technique, and adverse effects are rare. In this review, we address the technique and main applications of contrast-enhanced ultrasound in the pediatric population, including the evaluation of focal liver lesions, abdominal trauma, kidney grafts, liver grafts, bowel loops, and vesicoureteral reflux. It is important for pediatric radiologists to be acquainted with this promising tool, understanding its applications and limitations.
Collapse
Affiliation(s)
- Marcelo Straus Takahashi
- Instituto de Radiologiado Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/HC-FMUSP), São Paulo, SP, Brazil
- Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (ICr/HC-FMUSP), São Paulo, SP, Brazil
| | - Mauricio Gustavo Ieri Yamanari
- Instituto de Radiologiado Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/HC-FMUSP), São Paulo, SP, Brazil
- Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (ICr/HC-FMUSP), São Paulo, SP, Brazil
| | - Lisa Suzuki
- Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (ICr/HC-FMUSP), São Paulo, SP, Brazil
| | | | - Roberto Iglesias Lopes
- Pediatric Urology Sector, Department of Urology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP, Brazil
| | - Maria Cristina Chammas
- Instituto de Radiologiado Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InRad/HC-FMUSP), São Paulo, SP, Brazil
| |
Collapse
|
37
|
A 10-Year Retrospective Review of Prenatal Applications, Current Challenges and Future Prospects of Three-Dimensional Sonoangiography. Diagnostics (Basel) 2021; 11:diagnostics11081511. [PMID: 34441444 PMCID: PMC8394388 DOI: 10.3390/diagnostics11081511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/14/2021] [Accepted: 08/18/2021] [Indexed: 12/12/2022] Open
Abstract
Realistic reconstruction of angioarchitecture within the morphological landmark with three-dimensional sonoangiography (three-dimensional power Doppler; 3D PD) may augment standard prenatal ultrasound and Doppler assessments. This study aimed to (a) present a technical overview, (b) determine additional advantages, (c) identify current challenges, and (d) predict trajectories of 3D PD for prenatal assessments. PubMed and Scopus databases for the last decade were searched. Although 307 publications addressed our objectives, their heterogeneity was too broad for statistical analyses. Important findings are therefore presented in descriptive format and supplemented with the authors’ 3D PD images. Acquisition, analysis, and display techniques need to be personalized to improve the quality of flow-volume data. While 3D PD indices of the first-trimester placenta may improve the prediction of preeclampsia, research is needed to standardize the measurement protocol. In highly experienced hands, the unique 3D PD findings improve the diagnostic accuracy of placenta accreta spectrum. A lack of quality assurance is the central challenge to incorporating 3D PD in prenatal care. Machine learning may broaden clinical translations of prenatal 3D PD. Due to its operator dependency, 3D PD has low reproducibility. Until standardization and quality assurance protocols are established, its use as a stand-alone clinical or research tool cannot be recommended.
Collapse
|
38
|
Gessner I. Optimizing nanoparticle design and surface modification toward clinical translation. MRS BULLETIN 2021; 46:643-649. [PMID: 34305307 PMCID: PMC8279028 DOI: 10.1557/s43577-021-00132-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/02/2021] [Indexed: 05/14/2023]
Abstract
The field of nanomedicine is a rapidly evolving field driven by the need for safer and more efficient therapies as well as ultrasensitive and fast diagnostics. Although the advantages of nanoparticles for diagnostic and therapeutic applications are unambiguous, in vivo requirements, including low toxicity, long blood circulation time, proper clearance, sufficient stability, and reproducible synthesis have, in most cases, bedeviled their clinical translation. Nevertheless, researchers have the opportunity to have a decisive influence on the future of nanomedicine by developing new multifunctional molecules and adapting the material design to the requirements. Ultimately, the goal is to find the right level of functionality without adding unnecessary complexity to the system. This article aims to emphasize the potential and current challenges of nanoparticle-based medical agents and highlights how smart and functional material design considerations can help to overcome many of the current limitations and increase the clinical value of nanoparticles.
Collapse
Affiliation(s)
- Isabel Gessner
- Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| |
Collapse
|
39
|
Musielak M, Potoczny J, Boś-Liedke A, Kozak M. The Combination of Liposomes and Metallic Nanoparticles as Multifunctional Nanostructures in the Therapy and Medical Imaging-A Review. Int J Mol Sci 2021; 22:6229. [PMID: 34207682 PMCID: PMC8229649 DOI: 10.3390/ijms22126229] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/05/2021] [Accepted: 06/06/2021] [Indexed: 12/24/2022] Open
Abstract
Nanotechnology has introduced a new quality and has definitely developed the possibilities of treating and diagnosing various diseases. One of the scientists' interests is liposomes and metallic nanoparticles (LipoMNPs)-the combination of which has introduced new properties and applications. However, the field of creating hybrid nanostructures consisting of liposomes and metallic nanoparticles is relatively little understood. The purpose of this review was to compile the latest reports in the field of treatment and medical imaging using of LipoMNPs. The authors focused on presenting this issue in the direction of improving the used conventional treatment and imaging methods. Most of all, the nature of bio-interactions between nanostructures and cells is not sufficiently taken into account. As a result, overcoming the existing limitations in the implementation of such solutions in the clinic is difficult. We concluded that hybrid nanostructures are used in a very wide range, especially in the treatment of cancer and magnetic resonance imaging. There were also solutions that combine treatments with simultaneous imaging, creating a theragnostic approach. In the future, researchers should focus on the description of the biological interactions and the long-term effects of the nanostructures to use LipoMNPs in the treatment of patients.
Collapse
Affiliation(s)
- Marika Musielak
- Department of Electroradiology, Poznan University of Medical Sciences, 61-701 Poznań, Poland
- Radiobiology Laboratory, Department of Medical Physics, Greater Poland Cancer Centre, 61-866 Poznań, Poland
- Department of Macromolecular Physics, Faculty of Physics, Adam Mickiewicz University, 61-614 Poznań, Poland; (A.B.-L.); (M.K.)
| | - Jakub Potoczny
- Heliodor Swiecicki Clinical Hospital in Poznan, 60-355 Poznań, Poland;
| | - Agnieszka Boś-Liedke
- Department of Macromolecular Physics, Faculty of Physics, Adam Mickiewicz University, 61-614 Poznań, Poland; (A.B.-L.); (M.K.)
| | - Maciej Kozak
- Department of Macromolecular Physics, Faculty of Physics, Adam Mickiewicz University, 61-614 Poznań, Poland; (A.B.-L.); (M.K.)
| |
Collapse
|
40
|
Chingo Aimacaña CM, Quinchiguango Perez DA, Rocha Pinto S, Debut A, Attia MF, Santos-Oliveira R, Whitehead DC, Terencio T, Alexis F, Dahoumane SA. Polytetrafluoroethylene-like Nanoparticles as a Promising Contrast Agent for Dual Modal Ultrasound and X-ray Bioimaging. ACS Biomater Sci Eng 2021; 7:1181-1191. [PMID: 33590748 DOI: 10.1021/acsbiomaterials.0c01635] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Various noninvasive imaging techniques are used to produce deep-tissue and high-resolution images for biomedical research and clinical purposes. Organic and inorganic bioimaging agents have been developed to enhance the resolution and contrast intensity. This paper describes the synthesis of polytetrafluoroethylene-like nanoparticles (PTFE≈ NPs), their characterization, biological activity, and bioimaging properties. Transmission electron microscopy (TEM) images showed the shape and the size of the as-obtained small and ultrasmall PTFE≈ NPs. Fourier transform infrared spectroscopy (FTIR) confirmed the PTFE-like character of the samples. X-ray diffraction (XRD) enabled the determination of the crystallization system, cell lattice, and index of crystallinity of the material in addition to the presence of titania (TiO2) as the contamination. These findings were corroborated by X-ray photoelectron spectroscopy (XPS) that identifies the chemical states of the elements present in the samples along with their atomic percentages allowing the determination of both the purity index of the sample and the nature of the impurities. Additionally, diffuse reflectance ultraviolet-visible spectroscopy (UV-vis) was used to further assess the optical properties of the materials. Importantly, PTFE≈ NPs showed significant in vitro and in vivo biocompatibility. Lastly, PTFE≈ NPs were tested for their ultrasound and X-ray contrast properties. Our encouraging preliminary results open new avenues for PTFE-like nanomaterials as a suitable multifunctional contrast agent for biomedical imaging applications. Combined with suitable surface chemistry and morphology design, these findings shed light to new opportunities offered by PTFE nanoparticles in the ever-booming biomedical field.
Collapse
Affiliation(s)
| | | | - Suyene Rocha Pinto
- Brazilian Nuclear Energy Commission, Nuclear Engineering Institute, Laboratory of Nanoradiopharmacy and Synthesis of Novel Radiopharmaceuticals, 21941906 Rio de Janeiro, Brazil.,Zona Oeste State University, Laboratory of Radiopharmacy and Nanoradiopharmaceuticals, 23070200 Rio de Janeiro, Brazil
| | - Alexis Debut
- Center of Nanoscience and Nanotechnology, Universidad de las Fuerzas Armadas ESPE, Sangolquí 170501, Ecuador
| | - Mohamed F Attia
- Department of Chemistry, Clemson University, Clemson, South Carolina 29634, United States
| | - Ralph Santos-Oliveira
- Brazilian Nuclear Energy Commission, Nuclear Engineering Institute, Laboratory of Nanoradiopharmacy and Synthesis of Novel Radiopharmaceuticals, 21941906 Rio de Janeiro, Brazil.,Zona Oeste State University, Laboratory of Radiopharmacy and Nanoradiopharmaceuticals, 23070200 Rio de Janeiro, Brazil
| | - Daniel C Whitehead
- Department of Chemistry, Clemson University, Clemson, South Carolina 29634, United States
| | - Thibault Terencio
- School of Chemical Sciences and Engineering, Yachay Tech University, 100650 Urcuquí, Ecuador
| | - Frank Alexis
- School of Biological Sciences and Engineering, Yachay Tech University, 100650 Urcuquí, Ecuador
| | - Si Amar Dahoumane
- School of Biological Sciences and Engineering, Yachay Tech University, 100650 Urcuquí, Ecuador
| |
Collapse
|
41
|
Jung YJ, Moon SH, Kim MH. Role of Endoscopic Procedures in the Diagnosis of IgG4-Related Pancreatobiliary Disease. Chonnam Med J 2021; 57:44-50. [PMID: 33537218 PMCID: PMC7840337 DOI: 10.4068/cmj.2021.57.1.44] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/20/2020] [Accepted: 12/21/2020] [Indexed: 12/16/2022] Open
Abstract
The emergence of the disease entity of glucocorticoid-responsive systemic immunoglobulin G4 (IgG4)-related pancreatobiliary disease has generated substantial attention among the international gastroenterology society. IgG4-related pancreatobiliary disease includes type 1 autoimmune pancreatitis (AIP) and IgG4-related sclerosing cholangitis (IgG4-SC). The typical manifestations of IgG4-related pancreatobiliary disease are cholestatic liver dysfunction, obstructive jaundice, and weight loss, although it may present with no clinical symptoms. Since it mimics tumors on imaging, AIP/IgG4-SC may often be misdiagnosed as pancreatic or biliary cancer. The endoscopic armamentarium for the diagnosis of IgG4-related pancreatobiliary disease includes endoscopic ultrasonography, intraductal ultrasonography, endoscopic retrograde cholangiopancreatography, and cholangioscopy. The role of endoscopic tissue acquisition is two-fold in the diagnosis of IgG4-related pancreatobiliary disease: exclusion of cancer and procurement of histopathological proof for diagnosis of AIP/IgG4-SC, which can also be achieved by adding the immunohistochemistry for IgG4. Our review article addresses the role of various endoscopic examinations in diagnosing IgG4-related pancreatobiliary disease, focusing on the differentiation of this condition from pancreatobiliary malingnancies.
Collapse
Affiliation(s)
- Ye-Ji Jung
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Sung-Hoon Moon
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.,Institute for Liver and Digestive Diseases, Hallym University, Chuncheon, Korea
| | - Myung-Hwan Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
42
|
Beckmann S, Simanowski JH. Update in Contrast-Enhanced Ultrasound. Visc Med 2020; 36:476-486. [PMID: 33447604 PMCID: PMC7768106 DOI: 10.1159/000511352] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 09/03/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The aim of modern medicine is to safely classify diseases for successful therapy without invasive measures. Sonography, computed tomography (CT), and magnetic resonance imaging (MRI) are potent imaging techniques. However, without contrast medium, the informative value of the 3 native methods is limited. The advantages of sonography are: no radiation exposure or previously known physically harmful interactions with tissue, proportionate disappearance of a contrast agent risk, no (probably irreversible) contrast agent deposits, and no risk of renal insufficiency. But, is that enough to compete with of even exceed CT and MRI? SUMMARY In this review, the state of the art of contrast-enhanced ultrasound (CEUS) in the abdominal cavity is presented. The remarkable diagnostic possibilities can unfortunately only be demonstrated here in a small number of impressive, typical case studies underpinned by the literature, so that, from one's own perspective, the full spectrum of CEUS can be used by oneself or initiated. Within the limits of physics, the real-time dynamics of CEUS enable conclusions to be drawn, so that with the current technology, sonography, including expansion by contrast, can be considered superior to other imaging methods. It is not uncommon for CEUS to have the value of a control and reference method. KEY MESSAGES Sonography very often enables reliable diagnostics. The introduction of a contrast agent in sonography has led to a quantum leap similar to that of other imaging techniques. Already natively, the real-time representation of dynamic events leads to a certain superiority, i.e., complete observation of the inflow and outflow phases of the contrast medium and the resulting diagnostic; tissue-specific differentiation options provide a unique selling point. Further advantages of the first-choice imaging diagnostic method are: a lack of radiation exposure, repeatability of the examination at any time, local independence, a negligible allergy rate compared to the contrast agents of other methods, and a lack of kidney and thyroid exposure or excluded deposits.
Collapse
Affiliation(s)
| | - Jörg H. Simanowski
- Clinic for General, Visceral, Vascular and Obesity Surgery and Interdisciplinary Emergency Center of the Nordstadt Clinic of the Hannover Region Clinic, Hannover, Germany
| |
Collapse
|
43
|
Singh A, Nyankima AG, Anthony Phipps M, Chaplin V, Dayton PA, Caskey C. Improving the heating efficiency of high intensity focused ultrasound ablation through the use of phase change nanodroplets and multifocus sonication. Phys Med Biol 2020; 65:205004. [PMID: 32438353 DOI: 10.1088/1361-6560/ab9559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Thermal ablation by ultrasound is being explored as a local therapy for cancers of soft tissue, such as the liver or breast. One challenge for these treatments are off-target effects, including heating outside of the intended region or skin burns. Improvements in heating efficiency can mitigate these undesired outcomes, and here, we describe methods for using phase-shift nanodroplets (PSNDs) with multi-focus sonications to enhance volumetric ablation and ablation efficiency at constant powers while increasing the pre-focal temperature by less than 6 [Formula: see text]C. Multi-focus ablation with 4 foci performed the best and achieved a mean ablation volume of 120.2 ± 22.4 mm3 and ablation efficiency of 0.04 mm3 J-1 versus an ablation volume of 61.2 ± 21.16 mm3 and ablation efficiency of 0.02 mm3 J-1 in single focus case. The combined use of PSNDs with multi-focal ultrasound presented here is a new approach to increasing ablation efficiency while reducing off-target effects and could be generally applied in various focused ultrasound thermal ablation treatments.
Collapse
Affiliation(s)
- Aparna Singh
- Department of Biomedical Engineering, Vanderbilt University, Nashville Tennessee 37212, United States of America
| | | | | | | | | | | |
Collapse
|
44
|
Sbeit W, Kadah A, Mari A, Mahamid M, Khoury T. A Comprehensive Narrative Review on the Evolving Role of Endoscopic Ultrasound in Focal Solid Liver Lesions Diagnosis and Management. Diagnostics (Basel) 2020; 10:688. [PMID: 32932960 PMCID: PMC7554970 DOI: 10.3390/diagnostics10090688] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/05/2020] [Accepted: 09/10/2020] [Indexed: 12/11/2022] Open
Abstract
The implications of endoscopic ultrasound (EUS) have expanded considerably in recent years to cover more fields in invasive gastroenterology practice, as both an investigative and therapeutic modality. The utility of EUS in the diagnosis and management of focal liver lesions has gained a special attractiveness recently. The EUS probe proximity to the liver and its excellent spatial resolution enables real-time images coupled with several enhancement techniques, such as contrast-enhanced (CE) EUS. Aside from its notable capability to execute targeted biopsies and therapeutic interventions, EUS has developed into a hopeful therapeutic tool for the management of solid liver lesions. Herein, we provide a comprehensive state-of-the-art review on the efficacy and safety of EUS in the diagnosis and management of focal solid liver lesions. Medline/PubMed and Embase database searches were conducted by two separate authors (T.K. and W.S.), all relevant studies were assessed, and relevant data was extracted and fully reported. EUS-guided diagnosis of focal liver lesions by sonographic morphologic appearance and cytological and histopathological finding of biopsies obtained via fine needle aspiration/biopsy have been shown to significantly improve the diagnosis of solid liver lesions compared with traditional imaging tools. Similarly, EUS-guided treatment has been shown to consistently have excellent technical success, high efficacy, and minor adverse events. The evolving valuable evidences of EUS utility might satisfy the unmet need of optimizing management of focal solid liver lesions.
Collapse
Affiliation(s)
- Wisam Sbeit
- Department of Gastroenterology, Galilee Medical Center, Nahariya 22100, Israel; (W.S.); (A.K.)
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 1311502, Israel;
| | - Anas Kadah
- Department of Gastroenterology, Galilee Medical Center, Nahariya 22100, Israel; (W.S.); (A.K.)
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 1311502, Israel;
| | - Amir Mari
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 1311502, Israel;
- Gastroenterology and Endoscopy Units, The Nazareth Hospital, EMMS, Nazareth 16100, Israel
| | - Mahmud Mahamid
- Department of Gastroenterology and Liver Diseases, Shaare Zedek Medical Center, Jerusalem 9103102, Israel;
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel
| | - Tawfik Khoury
- Department of Gastroenterology, Galilee Medical Center, Nahariya 22100, Israel; (W.S.); (A.K.)
- Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 1311502, Israel;
| |
Collapse
|
45
|
Snehota M, Vachutka J, Ter Haar G, Dolezal L, Kolarova H. Therapeutic ultrasound experiments in vitro: Review of factors influencing outcomes and reproducibility. ULTRASONICS 2020; 107:106167. [PMID: 32402858 DOI: 10.1016/j.ultras.2020.106167] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 04/16/2020] [Accepted: 04/23/2020] [Indexed: 05/07/2023]
Abstract
Current in vitro sonication experiments show immense variability in experimental set-ups and methods used. As a result, there is uncertainty in the ultrasound field parameters experienced by sonicated samples, poor reproducibility of these experiments and thus reduced scientific value of the results obtained. The scope of this narrative review is to briefly describe mechanisms of action of ultrasound, list the most frequently used experimental set-ups and focus on a description of factors influencing the outcomes and reproducibility of these experiments. The factors assessed include: proper reporting of ultrasound exposure parameters, experimental geometry, coupling medium quality, influence of culture vessels, formation of standing waves, motion/rotation of the sonicated sample and the characteristics of the sample itself. In the discussion we describe pros and cons of particular exposure geometries and factors, and make a few recommendations as to how to increase the reproducibility and validity of the experiments performed.
Collapse
Affiliation(s)
- Martin Snehota
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, Olomouc 775 15, Czech Republic; Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 5, Olomouc 779 00, Czech Republic
| | - Jaromir Vachutka
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, Olomouc 775 15, Czech Republic.
| | - Gail Ter Haar
- Joint Department of Physics and Cancer Research UK Cancer Imaging Centre, Division of Radiotherapy and Imaging, The Institute of Cancer Research, London and The Royal Marsden NHS Foundation Trust, Sutton, London SM2 5PT, United Kingdom
| | - Ladislav Dolezal
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, Olomouc 775 15, Czech Republic
| | - Hana Kolarova
- Department of Medical Biophysics, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, Olomouc 775 15, Czech Republic; Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 5, Olomouc 779 00, Czech Republic
| |
Collapse
|
46
|
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: 4.0] [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.
Collapse
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
| |
Collapse
|
47
|
Wang JY, Feng SY, Xu JW, Li J, Chu L, Cui XW, Dietrich CF. Usefulness of the Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System in Diagnosing Focal Liver Lesions by Inexperienced Radiologists. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2020; 39:1537-1546. [PMID: 32078173 DOI: 10.1002/jum.15242] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/10/2020] [Accepted: 01/27/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To evaluate the usefulness of the contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) in diagnosing focal liver lesions (FLLs) by inexperienced radiologists. METHODS Images and clinical data from 258 patients at risk for hepatocellular carcinoma who underwent CEUS were collected retrospectively. Two trained inexperienced radiologists and 2 experienced radiologists reviewed all CEUS clips. Each inexperienced radiologist assigned a CEUS LI-RADS category for each observation and labeled it benign or malignant independently. Each experienced radiologist labeled each lesion malignant or benign independently using a conventional diagnostic method. Interobserver agreement of CEUS LI-RADS was analyzed by the κ test. The overall diagnostic accuracy of the LI-RADS category and conventional diagnosis was described by the sensitivity, specificity, positive predictive value, and negative predictive value. All test results were considered significant at P < .05. RESULTS A κ value of 0.774 indicated that the CEUS LI-RADS algorithm resulted in substantial consistency between the inexperienced radiologists. For the diagnosis of hepatocellular carcinoma, the sensitivity, specificity, positive predictive value, and negative predictive value were improved significantly in inexperienced radiologists using the CEUS LI-RADS compared to conventional methods. The overall diagnostic accuracy of the experienced radiologists was almost equal to that of CEUS LI-RADS categories assigned by the inexperienced radiologists. CONCLUSIONS The CEUS LI-RADS algorithm can not only obtain substantial consistency among inexperienced radiologists but also have excellent diagnostic efficacy in the differentiation of benign from malignant FLLs compared to conventional methods. As a comprehensive algorithm, the CEUS LI-RADS can act as a guide for trainees in learning how to diagnose FLLs.
Collapse
Affiliation(s)
- Jia-Yu Wang
- Sino-German Tongji-Caritas Research Center of Ultrasound in Medicine, Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shao-Yang Feng
- Department of Ultrasound, Sixth People's Hospital of Zhengzhou, Zhengzhou, China
| | - Jian-Wei Xu
- Department of Ultrasound, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jun Li
- Department of Ultrasound, First Affiliated Hospital, School of Medicine, Shihezi University, Xinjiang, China
| | - Liang Chu
- Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xin-Wu Cui
- Sino-German Tongji-Caritas Research Center of Ultrasound in Medicine, Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Christoph F Dietrich
- Department of Internal Medicine, Hirslanden Clinic, Schänzlihalde 11, Bern, Switzerland
| |
Collapse
|
48
|
Dietrich CF, Dong Y, Kono Y, Caraiani C, Sirlin CB, Cui XW, Tang A. LI-RADS ancillary features on contrast-enhanced ultrasonography. Ultrasonography 2020; 39:221-228. [PMID: 32475089 PMCID: PMC7315297 DOI: 10.14366/usg.19052] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 04/02/2020] [Accepted: 05/09/2020] [Indexed: 12/11/2022] Open
Abstract
The Liver Imaging Reporting and Data System (LI-RADS) was created to standardize liver imaging in patients at high risk for hepatocellular carcinoma (HCC), and it uses a diagnostic algorithm to assign categories that reflect the relative probability of HCC, non-HCC malignancies, or benign focal liver lesions. In addition to major imaging features, ancillary features (AFs) are used by radiologists to refine the categorization of liver nodules. In the present document, we discuss and explain the application of AFs currently defined within the LI-RADS guidelines. We also explore possible additional AFs visible on contrast-enhanced ultrasonography (CEUS). Finally, we summarize the management of CEUS LI-RADS features, including the role of current and potential future AFs.
Collapse
Affiliation(s)
- Christoph F. Dietrich
- Department Allgemeine Innere Medizin (DAIM), Kliniken Beau Site, Salem und Permanence, Hirslanden, Bern, Switzerland
- Ultrasound Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yi Dong
- Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuko Kono
- Department of Medicine and Radiology, University of California, San Diego, CA, USA
| | - Cosmin Caraiani
- Department of Medical Imaging, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Claude B. Sirlin
- Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Xin-Wu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - An Tang
- Department of Radiology, Université de Montréal, Montreal, Canada
| |
Collapse
|
49
|
Dietrich CF, Jenssen C. Modern ultrasound imaging of pancreatic tumors. Ultrasonography 2020; 39:105-113. [PMID: 31962384 PMCID: PMC7065990 DOI: 10.14366/usg.19039] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 08/25/2019] [Accepted: 08/27/2019] [Indexed: 12/11/2022] Open
Abstract
In patients with solid pancreatic lesions (SPLs), the differential diagnosis must be evaluated to determine whether radical surgery, pancreatic parenchyma-saving strategies, or follow-up is indicated. Contrast-enhanced (endoscopic) ultrasonography and elastography facilitate the further characterization of SPLs. The majority of cases of pancreatic ductal adenocarcinoma exhibit hypoenhancement with contrast-enhanced ultrasonography. Elastographically soft SPLs are benign with very few exceptions, whereas stiffer SPLs can be malignant or benign. This article reviews the current use of modern ultrasound imaging techniques, including contrast-enhanced ultrasonography and elastography, for the detection and characterization of SPLs. In particular, the unexcelled diagnostic potential of multiparametric endoscopic ultrasonography to detect and characterize small SPLs is highlighted.
Collapse
Affiliation(s)
- Christoph F. Dietrich
- Medical Department, Caritas-Krankenhaus, Bad Mergentheim, Germany
- Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Christian Jenssen
- Department of Internal Medicine, Krankenhaus Märkisch Oderland, Strausberg/Wriezen and Brandenburg Institute for Clinical Ultrasound, Neuruppin, Germany
| |
Collapse
|
50
|
Abstract
Contrast-enhanced ultrasound (CEUS) imaging is a valuable tool for preclinical and clinical diagnostics. The most frequently used ultrasound contrast agents are microbubbles. Besides them, novel nano-sized materials are under investigation, which are briefly discussed in this chapter. For molecular CEUS, the ultrasound contrast agents are modified to actively target disease-associated molecular markers with a site-specific ligand. The most common markers for tumor imaging are related to neoangiogenesis, like the vascular endothelial growth factor receptor-2 (VEGFR2) and αvβ3 integrin. In this chapter, applications of molecular ultrasound to longitudinally monitor receptor expression during tumor growth, to detect neovascularization, and to evaluate therapy responses are described. Furthermore, we report on first clinical trials of molecular CEUS with VEGFR2-targeted phospholipid microbubbles showing promising results regarding patient safety and its ability to detect tumors of prostate, breast, and ovary. The chapter closes with an outlook on ultrasound theranostics, where (targeted) ultrasound contrast agents are used to increase the permeability of tumor tissues and to support drug delivery.
Collapse
Affiliation(s)
- Jasmin Baier
- Institute for Experimental Molecular Imaging Organization University Clinics, RWTH Aachen University, Forckenbeckstrasse 55, 52074 Aachen, Germany
| | - Anne Rix
- Institute for Experimental Molecular Imaging Organization University Clinics, RWTH Aachen University, Forckenbeckstrasse 55, 52074 Aachen, Germany
| | - Fabian Kiessling
- Institute for Experimental Molecular Imaging Organization University Clinics, RWTH Aachen University, Forckenbeckstrasse 55, 52074 Aachen, Germany.
| |
Collapse
|