Efficacy Of Contrast-enhanced Ultrasonography Research Articles

CEUS examination of the outcome of radiofrequency ablation of canine prostate lesions

Purpose To determine the feasibility of using contrast-enhanced ultrasonography (CEUS) to dynamically examine the scope and development of radiofrequency ablation (RFA) lesions in the canine prostate. Material and methods Ten male canines were divided into two groups of five canines each: the 1 week after the RFA group and the 1 month after the RFA group. RFA was performed on one side of the prostate in each canine. For the 1 month after the RFA group, the other side of the prostate underwent RFA prior to euthanasia, and the RFA lesion on this side was included as the immediate RFA group. The RFA lesion volume was measured by CEUS. The evaluation efficacy of CEUS for prostate RFA lesions was determined and compared with the pathological measurements. Results In the immediately after RFA group, 1 week after RFA group, and 1 month after RFA group, the RFA lesion volumes were 0.77 ± 0.34, 1.11 ± 0.61, and 0.19 ± 0.09 cm3, as measured by CEUS; the volumes measured by pathology at the corresponding time points were 0.85 ± 0.28, 0.96 ± 0.31, and 0.20 ± 0.06 cm3, respectively. CEUS accurately assessed the RFA lesions at all the time points, and the measurement results were not significantly different from those of the pathological results (p > .05). Conclusions CEUS reflects the extent of prostate RFA lesions and dynamically shows their changes in blood flow perfusion.

Testing the Efficacy of Contrast-Enhanced Ultrasound in Detecting Transplant Rejection Using a Murine Model of Heart Transplantation.

One of the key unmet needs to improve long-term outcomes of heart transplantation is to develop accurate, noninvasive, and practical diagnostic tools to detect transplant rejection. Early intragraft inflammation and endothelial cell injuries occur prior to advanced transplant rejection. We developed a novel diagnostic imaging platform to detect early declines in microvascular perfusion (MP) of cardiac transplants using contrast-enhanced ultrasonography (CEUS). The efficacy of CEUS in detecting transplant rejection was tested in a murine model of heart transplants, a standard preclinical model of solid organ transplant. As compared to the syngeneic groups, a progressive decline in MP was demonstrated in the allografts undergoing acute transplant rejection (40%, 64%, and 92% on days 4, 6, and 8 posttransplantation, respectively) and chronic rejection (33%, 33%, and 92% on days 5, 14, and 30 posttransplantation, respectively). Our perfusion studies showed restoration of MP following antirejection therapy, highlighting its potential to help monitor efficacy of antirejection therapy. Our data suggest that early endothelial cell injury and platelet aggregation contributed to the early MP decline observed in the allografts. High-resolution MP mapping may allow for noninvasive detection of heart transplant rejection. The data presented have the potential to help in the development of next-generation imaging approaches to diagnose transplant rejection.

Efficacy of contrast-enhanced ultrasonography in detecting graft rupture sites after abdominal aortic aneurysm repair

Non-anastomotic graft rupture is a rare but critical complication after abdominal aortic aneurysm (AAA) repair. Therefore, identifying the rupture sites is important to perform endovascular stent grafting. A 78-year old man who had undergone Y-grafting for infrarenal AAA before 17 years was referred to our hospital with the complaints of abdominal pain. Computed tomography revealed acute pancreatitis and an enlargement around the grafted abdominal aorta. Contrast-enhanced ultrasonography revealed an extravazation from the graft body 1.5 cm distal to the proximal anastomosis, and endovascular stent grafting was successfully performed. Contrast-enhanced ultrasonography might be useful in detecting the graft rupture.

Efficacy of Contrast-Enhanced Ultrasonography in Radiofrequency Ablation for Hepatocellular Carcinoma

Local recurrence after radiofrequency ablation (RFA) is a major problem that needs to resolved to increase the survival rate of hepatocellular carcinoma (HCC). CE-US with Sonazoid(®), the second-generation contrast media, can detect smaller HCC lesions and the detection rate of ultrasonically unrecognized hypervascular HCC was improved by CE-US. The aim of the present study was to evaluate the role of CE-US with Sonazoid(®) in improving radicality and reducing local recurrence after RFA for HCC. A total of 102 nodules treated by RFA at our hospital from January 2006 to October 2009 were enrolled: 31 nodules were treated without CE-US, since CE-US was not yet available (Group A), and 71 nodules were treated with a combination of RFA and CE-US with Sonazoid(®) (Group B). The clinical characteristics (sex, virus marker, Child-Pugh grade, with or without transcatheter arterial infusion chemotherapy with lipiodol, and T factor) did not differ significantly between group A and group B. Mean age was significantly older and tumor size was significantly larger in group B. Group B had significantly better radicality compared with group A. The non-local recurrence rate was significantly higher in group B as compared with group A. CE-US with Sonazoid(®) greatly helps to improve RFA efficacy in HCC treatment. We suggest that the ability of CE-US with Sonazoid(®) to detect an accurate area of HCC before RFA and to immediately detect a residual tumor during RFA might contribute to an increase of the radicality and reduction of local recurrence after RFA.

The detection of pCR after PST by contrast-enhanced ultrasonography for breast cancer

Primary systemic therapy (PST; such as chemotherapy) has been approved as the standard therapy. Breast-conserving surgery is involved in 60-70% of breast cancer operations, and cancer can spread in the period between the initial treatment and preoperative chemotherapy. To reduce the residual tumor in persistent disease of breast tissue, determining the margin including normal tissue when removing the tumor is very difficult. With the development of the color Doppler method, contrast-enhanced ultrasonography (CEUS) allows visualization of the tumor bloodstream. The availability and efficacy of CEUS for setting the resection margin in breast-conserving surgery were examined and compared with MRI imaging as tools for making decisions for breast-conserving surgery. One hundred seventy patients underwent breast cancer operations: 59 were PST(+) and 111 PST(-). Imaging studies, ultrasonography and MRI, to measure the size of the tumor were performed twice, before and after chemotherapy, for PST patients. This was carried out not only to measure the residual tumor size after PST, but also to detect whether pathologically complete response (pCR) had been achieved or not. Fifty-nine patients received CEUS after PST, and we determined the precision of CEUS and conventional US. The sensitivity of CEUS for pCR was 80.0% (95% CI 0.571-0.88), specificity 98.0% (95% CI 0.933-0.996), positive predictive value 88.9% (95% CI 0.635-0.978) and negative predictive value 96.0% (95% CI 0.914-0.976). The difference between the pathological examination and ultrasonography, conventional ultrasonography and CEUS was -4.455 ± 2.02 and 2.582 ± 2.298 cm (95% CI -13.11 to -0.96, p = 0.0235); CEUS was near the diameter of the actual pathological examination. Contrast-enhanced ultrasonography is suitable for the preoperative examination, especially after PST, to determine the resection margin before breast-conserving surgery and detects pCR, which can help to avoid surgical procedures in the future.

Efficacy of Contrast-enhanced US and Magnetic Microbubbles Targeted to Vascular Cell Adhesion Molecule–1 for Molecular Imaging of Atherosclerosis

To evaluate whether microbubbles targeted to vascular cell adhesion molecule-1 (VCAM-1) (CD106) coupled with a magnetic guidance system could improve the efficacy of contrast-enhanced molecular ultrasonography (US) of atherosclerosis in the aorta. The animal research committee at Southern Medical University approved all experiments. Adherence of magnetic VCAM-1-targeted microbubbles, control inactive magnetic microbubbles, and nonmagnetic VCAM-1-targeted microbubbles to VCAM-1-Fc was determined in vitro by using a flow chamber at variable shear stress (1-24 dyne/cm(2)) under magnetic field guidance. Attachment of microbubbles under magnetic field guidance was determined in vivo with fluorescent microscopy and contrast-enhanced US of the abdominal aorta in wild-type (C57BL/6) or apolipoprotein E (APOE)-deficient mice on a regular or hypercholesterolemic diet. General factorial analysis of variance was used to compare the targeted effect of the microbubbles among different animal groups to identify significant differences. Attachment was noted for magnetic and nonmagnetic microbubbles but not for inactive magnetic microbubbles; firm attachment at high shear stress (16-20 dyne/cm(2)) was achieved only with magnetic microbubbles. Fluorescence intensity and video intensity were significantly higher in magnetic microbubbles with magnetic field guidance than in inactive magnetic microbubbles and nonmagnetic microbubbles (P < .05). Video intensity from retained magnetic microbubbles in APOE-deficient mice was significantly greater than that in wild-type mice (mean video intensity for APOE-deficient mice: 28.25 [interquartile range, or IQR, 26.55-29.20] with a hypercholesterolemic diet and 16.10 [IQR, 14.15-18.75] with a regular diet; mean video intensity for wild-type mice: 9.55 [IQR, 8.85-10.5] with a hypercholesterolemic diet and 2.90 [IQR, 1.25-3.85] with a regular diet; P < .001). Use of a magnetic targeted microbubble system results in greater attachment to endothelial VCAM-1 in atherosclerotic aortas in conditions of high shear stress and improved detection of early inflammatory changes of atherosclerosis.

S1906 The Efficacy of Contrast-Enhanced Ultrasonography in Evaluating the Therapeutic Responses to Radiofrequency Ablation of Hepatocellular Carcinoma

S1906 The Efficacy of Contrast-Enhanced Ultrasonography in Evaluating the Therapeutic Responses to Radiofrequency Ablation of Hepatocellular Carcinoma

To evaluate the effect using contrast-enhanced ultrasound in repeated cooled percutaneous radio frequency ablation for HCC

Objective To evaluate the efficacy of CEUS(contrast enhanced ultrasonography)in accessing the repeated curative effects of cooled radiofrequency therapy for hepacellular carcinoma(HCC).Methods 58 cases of residual lesion of HCC which had been treated with CRFA once received repeated CRFA treatment by the guidence of CEUS 10 minutes,every 2 weeks to 1 month after first CRFA.All these patients recruited for CECT and CEUS and residual lesions were verified.Results 58 cases received 245 CRFA treatment.mean of repeated CRFA(3±1.78)times.In group 1,there were 11 eases with 18 lesions,the diameter of lesion 5 cm.The cases of group 1 were treated with CRFA only,while the other groups were treated with combined therapies,ie:CRFA +TACE or PEIT.The appearance of multiple lesions and portal venous carcinomous emblia increased as time went by which correlated with the size of primary lesions,P<0.05.The 1,2,3 year-survival rates of group 1 differed significant from the other two groups,P<0.001.Conclusion CEUS Can dynamically show the characteristics of microcirculation,the contours of residual lesions,the portal venous emblia which can play an important role in selecting modalities of therapy to treat. Key words: Contrast-enhanced ultrasound(CEUS); Repeated cooled radio frequency ablation(repeated CRFA); Residual lesion; HCC