Harmonic Gray Scale Research Articles

The role of contrast-enhanced sonography for radiofrequency ablation of liver tumors.

To assess the feasibility and usefulness of contrast-enhanced sonography for tumor detection and guidance of liver VX2 tumor ablation and to evaluate post radiofrequency ablation effectiveness. VX2 tumors were implanted into the livers of 6 rabbits. Both conventional and harmonic gray scale and power Doppler imaging were performed with a commercially available scanner to evaluate the liver tumors before and after intravenous injection of a sonographic contrast agent before and after radiofrequency ablation. Contrast-enhanced imaging was used to detect the tumors before ablation, to guide needle insertion, and to measure the ablation sites after radiofrequency ablation. Pathologic examination was performed for comparison. Three tumors were seen without contrast enhancement, whereas 10 tumors (<1 cm) were detected with contrast enhancement. Intentionally, 2 tumors were completely ablated and 5 tumors were partially ablated. In 3 cases, incompletely ablated tumors could only be identified on contrast-enhanced Doppler imaging by enhancing the detection of residual tumor vascularity. There was excellent concordance between sonographic imaging and gross pathologic findings. Contrast-enhanced sonographic imaging appears useful for detection of liver tumors and for guiding and monitoring tumor ablation therapies.

Contrast-enhanced, wide-band harmonic gray scale imaging of hepatocellular carcinoma: correlation with helical computed tomographic findings.

We evaluated the usefulness of contrast-enhanced, wide-band harmonic gray scale imaging for the diagnosis of hepatocellular carcinoma and compared it with helical computed tomography. Forty-eight patients with 61 hepatocellular carcinoma lesions were scanned by contrast-enhanced, wide-band harmonic gray scale imaging after an intravenous bolus injection of the contrast agent Levovist. Fifty-seven of the 61 hepatocellular carcinoma lesions showed hypervascular enhancement, and intratumoral vessels could be observed in 40 of the 57 lesions. Helical computed tomography revealed a high-attenuation area in 54 of the 61 lesions, whereas the other lesions showed an equivocal-attenuation area. Contrast-enhanced, wide-band harmonic gray scale imaging is a useful method for diagnosing the vascularity of hepatocellular carcinoma.

Hepatic vasculature flow monitoring through the ultrasonic interruption of contrast agents

A technique has been developed to assess differential liver perfusion due to hepatic artery versus portal vein. This technique uses a continuous intravenous infusion of contrast agent and transcutaneous ultrasound to control the flow of contrast agent in selected vessels. A 1-in diameter transducer controlled the flow of perfluorocarbon-filled contrast agent in the abdominal aorta. It has been previously shown that acoustic amplitudes required to manipulate contrast agent are well within FDA limits. Pulsed ultrasound 10-cycle tonebursts at 2.25 MHz and 2.7% duty cycle were applied to the abdominal aorta for 30 sec to clear contrast agent from the hepatic artery, portal vein and liver parenchyma. The interruption transducer was then turned off, creating a sharp leading edge of contrast agent, with risetimes of approximately 0.1 sec measured in the hepatic artery. Harmonic grayscale and spectral Doppler images were obtained on a Toshiba Powervision 8000. The sharp contrast agent leading edge allows differential measurements of hepatic artery and portal vein arrival times. This time differential was measured at approximately 10 sec. These results indicate that image-guided insonification of the abdominal aorta may substantially improve discrimination of the hepatic arterial and portal venous supply in hepatic imaging.

Gray scale second harmonic imaging of acoustic emission signals improves detection of liver tumors in rabbits.

This study evaluates a new reticuloendothelium specific sonographic contrast agent NC100100 (Sonazoid) for detection of liver VX-2 tumors in rabbits. Gray scale imaging of five groups of three rabbits, with hepatic VX-2 tumors implanted 7, 10, 12, 14, and 18 days previously, was performed prior to injection of Sonazoid (dosages, 0.01-0.5 ml/kg). Sonazoid produces induced acoustic emission after uptake in the liver. Therefore, harmonic gray scale images were obtained immediately after injection as well as delayed (by up to 2(1/2) h). Five rabbits (one from each group) also had angiography performed, while all animals were evaluated by pathologic examination. Non-contrast enhanced sonography detected 17 of 61 tumors (29%), as well as three false-positives, while the addition of Sonazoid detected 57 tumors (93%) and one false-positive (P<0.001). Acoustic emission made 2 x 2 mm tumors (invisible in conventional B-mode sonography) clearly perceivable in harmonic gray scale. In the subgroup that received angiography, 12 of 36 tumors (33%) were detected with conventional sonography compared to 22 tumors (61%) seen with angiography (P = 0.002). After injection of Sonazoid the ultrasonographic detection rate increased to 97% (35 of 36 tumors), which was a significant improvement over angiography (P = 0.00024). Improved detection of hepatic VX-2 tumors with second harmonic gray scale imaging of Sonazoid is possible because of this agent's acoustic emission capabilities.

Harmonic grey scale imaging of the human brain.

Harmonic imaging increases the signal-to-noise ratio in grey-scale imaging. With the use of ultrasound contrast agents (UCA), imaging of brain perfusion seems possible. The authors used an ultrasound system in connection with a 1.8/3.6-MHz harmonic sector transducer and an acoustic densitometry unit for quantification of ultrasound intensity in the thalamus (THAL), the temporoparietal white matter (TPWM), and the lateral fissure (LF). Ten milliliters of BY963, a spherosome-air-based UCA, was injected intravenously in 12 healthy volunteers. Time-intensity curves were calculated. Mean increase of intensity (standard deviation [SD]), mean area under the time-intensity curve (AUC) from baseline (SD), and mean transit time (MTT) (SD) in the region of LF, THAL, and TPWM were 2.2 +/- 1.7, 1.1 +/- 0.6, 0.9 +/- 0.9 dB and 16.7 +/- 22.7, 4.7 +/- 4.7, 3.7 +/- 6.3 as well as 11.1 +/- 3.5, 9.7 +/- 3.1, and 11.9 +/- 8.0, respectively. There was a statistically significant difference for mean AUC (p = 0.02) but none comparing mean intensity increase (p = 0.07) and MTT (p = 0.9). The authors' study indicates that different regions of the human brain show different time-intensity curves. These results suggest that it is possible to measure parameters closely related to perfusion in various regions of the adult human brain.

On the feasibility of real-time, in vivo harmonic imaging with proteinaceous microspheres.

Harmonic imaging is a new contrast-specific imaging modality, which utilizes the nonlinear properties of microbubble-based sonographic contrast agents by transmitting at the fundamental frequency but receiving at the second harmonic frequency. The feasibility of improving the detection of slow, small-volume blood flow using real-time harmonic imaging has been investigated in vivo. Proteinaceous microspheres (FS069) were administrated to four dogs, two woodchucks (with multiple hepatomas), and one rabbit. Three different scanners were used to obtain real-time images of kidneys and liver (including vessels) in harmonic and conventional gray scale and color flow modes. The duration of contrast enhancement lasted significantly longer in harmonic than in conventional modes (on average 87 s; P = 0.008). Harmonic images were less susceptible to artifacts, such as acoustic shadowing, and a clear increase in the (flow) signal-to-noise ratio was observed. These preliminary in vivo results demonstrate the feasibility of performing real-time, contrast-enhanced harmonic imaging, but further studies are required to establish clinical efficacy.