Abstract
Heterogeneity within the tumor may cause large heterogeneity in quantitative perfusion parameters. Three-dimensional contrast-enhanced ultrasound (3D-CEUS) can show the spatial relationship of vascular structure after post-acquisition reconstruction and monodisperse bubbles can resonate the ultrasound pulse, resulting in the increase in sensitivity of CEUS imaging.To evaluate whether the combination of 3D-CEUS and monodisperse microbubbles could reduce the heterogeneity of quantitative CEUS.Three in vitro perfusion models with perfusion volume ratio of 1:2:4 were set up. Both quantitative 2D-CEUS and 3D-CEUS were used to acquire peak intensity (PI) with 2 kinds of ultrasound agents. One was a new kind of monodisperse bubbles produced in this study, named Octafluoropropane-loaded cerasomal microbubbles (OC-MBs), the other was SonoVue®. The coefficient of variation (CV) was calculated to evaluate the cross-sectional variability. Pearson's correlation analysis was used to assess the correlation between weighted PIs (average of PIs of 3 different planes) and perfusion ratios.The average CVs of quantitative 3D-CEUS was slightly lower than that of 2D-CEUS (0.41 ±0.17 compared to 0.55 ±0.26, p = 0.3592). As for quantitative 3D-CEUS, the PI of the OC-MBs has shown better stability than that of SonoVue®, but without a significant difference (average CVs: 0.32 ±0.19 compared to 0.50 ±0.10, p = 0.0711). In the 2D-CEUS condition, the average CVs of OC-MBs group and SonoVue® group were 0.68 ±0.15 and 0.41 ±0.17 (p = 0.2747). As for 3D-CEUS condition, using OC-MBs group and SonoVue®, the r-values of the weighted PI and perfusion ratio were 0.8685 and 0.5643, respectively, while that of 2D-CEUS condition were 0.7760 and 0.3513, respectively.Our in vitro experiments showed that OC-MBs have the potential in acquiring more stable quantitative CEUS value, as compared to the SonoVue® in 3D-CEUS condition. The combination of 3D-CEUS and OC-MBs can reflect perfusion volume more precisely and may be a potential way to reduce quantitative heterogeneity.
Highlights
Contrast-enhanced ultrasound (CEUS) is a noninvasive imaging method, using ultrasound contrast agent (UCA) and low mechanical index (MI) ultrasound for dynamic blood perfusion observation in the target tissue
The average coefficient of variation (CV) of quantitative 3D-CEUS was slightly lower than that of 2D-CEUS (0.41 ±0.17 compared to 0.55 ±0.26, p = 0.3592)
As for quantitative 3D-CEUS, the peak intensity (PI) of the Octafluoropropaneloaded cerasomal microbubbles (OC-MBs) has shown better stability than that of SonoVue®, but without a significant difference
Summary
Contrast-enhanced ultrasound (CEUS) is a noninvasive imaging method, using ultrasound contrast agent (UCA) and low mechanical index (MI) ultrasound for dynamic blood perfusion observation in the target tissue. It has been applied in the detection and differential diagnosis of solid tumors, the assessment of nonsurgical treatment and the evaluation of left ventricular function. In contrast with traditional CEUS, quantitative CEUS with dedicated software can detect lesions with abnormal perfusion more sensitively.[1] A multitude of quantitative parameters can be used as imaging biomarkers. Three-dimensional contrast-enhanced ultrasound (3D-CEUS) can show the spatial relationship of vascular structure after post-acquisition reconstruction and monodisperse bubbles can resonate the ultrasound pulse, resulting in the increase in sensitivity of CEUS imaging
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