Including Peak Intensity Research Articles

Quantitative Perfusion-Weighted Magnetic Resonance Imaging in Uveal Melanoma.

Perfusion-weighted imaging (PWI; magnetic resonance imaging [MRI]) has been shown to provide valuable biological tumor information in uveal melanoma (UM). Clinically used semiquantitative methods do not account for tumor pigmentation and eye movement. We hypothesize that a quantitative PWI method that incorporates these, provides a more accurate description of tumor perfusion than the current clinical method. The aim of this study was to test this in patients with UM before and after radiotherapy. Perfusion-weighted 3T MRIs were retrospectively analyzed in 47 patients with UM before and after radiotherapy. Tofts pharmacokinetic modeling was performed to determine vascular permeability (Ktrans), extracellular extravascular space (ve), and reflux rate (kep). These were compared with semiquantitative clinical parameters including peak intensity and outflow percentage. The effect of tumor pigmentation on peak intensity and outflow percentage was statistically significant (P < 0.01) and relative peak intensity was significantly different between melanotic and amelanotic tumors (1.5 vs. 1.9, P < 0.01). Before radiotherapy, median tumor Ktrans was 0.63 min-1 (range = 0.06-1.42 min-1), median ve was 0.23 (range = 0.09-0.63), and median kep was 2.3 min-1 (range = 0.6-5.0 min-1). After radiotherapy, 85% showed a decrease in Ktrans and kep (P < 0.01). Changes in tumor pigmentation before and after radiotherapy were small and not significant (median increase in T1 of 33 ms, P = 0.55). Quantitative PWI parameters decreased significantly after radiotherapy and can therefore can serve as an early biomarker for treatment response assessment. However, due to the nonsignificant changes in tumor pigmentation before and after radiotherapy, the current semiquantitative method appears to be sufficiently sensitive for detection of changes in tumor perfusion.

FREE: Enhanced Feature Representation for Isotopic Envelope Evaluation in Top-Down Mass Spectra Deconvolution.

The aim of deconvolution of top-down mass spectra is to recognize monoisotopic peaks from the experimental envelopes in raw mass spectra. So accurate assessment of similarity between theoretical and experimental envelopes is a critical step in mass spectra data deconvolution. Existing evaluation methods primarily rely on intensity differences and m/z similarity, potentially lacking a comprehensive assessment. To overcome this constraint and facilitate a comprehensive and refined assessment of the similarity between theoretical and experimental envelopes, there exists an imperative to systematically explore and identify increasingly efficacious features for assessing this correspondence. We present enhanced feature representation for isotopic envelope evaluation (FREE) that derives diverse feature representations, encapsulating fundamental physical attributes of envelopes, including peak intensity and envelope shape. We trained FREE and evaluated its performance on both the ovarian tumor (OT) (human OT cells) data set and zebrafish (ZF) (brain in mature female ZF) data set. Specifically, comparing the state-of-art method, FREE demonstrates higher performance in multiple evaluation metrics across both the OT and ZF data sets, with a particular emphasis on precision, and it demonstrates accurate predictions of a greater number of positive envelopes among the top-ranked envelopes based on their scores. Moreover, within a cross-species data set of ZF, FREE identified a higher number of proteoform-spectrum matches (PrSMs), increasing the count from 50,795 to 52,927 compared to EnvCNN, the amalgamation of FREE with TopFD also exhibits a commendable capacity to discern 117,883 fragment ions, thus surpassing the 97,554 fragment ions identified through the application of EnvCNN in conjunction with TopFD. To further validate the performance of FREE, we have tested 10 a cross-species top-down proteomes containing 36 subdata set from ProteomeXchange. The results reveal that, after deconvolution with TopFD + FREE, TopPIC identifies more PrSMs across these 10 data sets in both the first and second rounds of experiments. These findings underscore the robustness and generalization capabilities of the FREE approach in diverse proteomes.

Current possibilities of ultrasonography in diagnosing local spread of endometrial cancer

Background. The incidence of oncologic pathology in the female reproductive system is continually rising, highlighting the importance of finding new methods for early and precise diagnosis. This study aimed to determine the invasion depth of endometrial cancer through contrast-enhanced ultrasonography.&#x0D; Materials and methods. The study included 38 patients who were confirmed to have endometrial cancer. All patients underwent complex ultrasound examinations in real-time and grayscale mode. The qualitative assessment of vascularization in color and energy Doppler mapping modes was performed using contrast enhancement with the assessment of qualitative and quantitative parameters of contrast.&#x0D; Results. The results were compared with histological examination results from postoperative materials. The study identified contrasting qualitative parameters that are most indicative of endometrial cancer and quantitative parameters that are statistically significant and reliably distinguished the myometrium affected by the tumor from the unaffected myometrium (including peak intensity, time to peak intensity, and contrast half-life).&#x0D; Conclusions. Contrast enhancement increases the effectiveness of comprehensive ultrasonography in determining the invasion depth of endometrial cancer.

Clinical Practice Guidelines for the Use of Transcranial Direct Current Stimulation in Psychiatry.

Clinical Practice Guidelines for the Use of Transcranial Direct Current Stimulation in Psychiatry.

New application of multimodal ultrasound imaging for identification of myofascial trigger points in the trapezius muscle.

The study aimed to quantify the characteristics of trapezius myofascial trigger points (MTrPs) using shear wave elastography (SWE) and contrast-enhanced ultrasound (CEUS) and explore the application value of the new ultrasound techniques in identifying MTrPs. Forty patients participated in this study. MTrPs in the trapezius muscle were determined by palpation, and SWE and CEUS were used to quantify the focal and adjacent areas. The elastic modulus values and CEUS parameters between the focal area of MTrPs and adjacent areas were evaluated and compared. Pathological biopsy was performed according to the above two methods, and the pathological tissues were observed by Masson staining, immunohistochemistry and electron microscope. The elastic modulus values were significantly higher for the focal area of MTrPs compared to those for adjacent areas (P<0.05). There were statistically significant differences in MTrP parameters, including peak intensity, mean transit time, and area between the focal and adjacent areas (P<0.05). Masson staining showed that there were inflammatory cell infiltration dominated by lymphocytes in the vascular wall. Electron microscopy showed a large number of fibroblast proliferation, lamellar collagen proliferation and lysosomal deposition; immunohistochemical results: the expression of CD3+, CD4+, CD8+, CD68+, mhc-1+, dys+, CD8 was more than that of CD20 (F=4.385, P=0.036). Combined use of SWE and CEUS provides a new detection approach for quantitative identification of MTrPs in the trapezius muscle, which has high application value and is a method worthy of wider use in clinical practice.

Contrast-Enhanced Ultrasound in the Differential Diagnosis of Primary Thyroid Lymphoma and Nodular Hashimoto's Thyroiditis in a Background of Heterogeneous Parenchyma.

ObjectiveTo investigate the diagnostic performance of contrast-enhanced ultrasound (CEUS) in the differentiation of primary thyroid lymphoma (PTL) and nodular Hashimoto’s thyroiditis (NHT) in patients with background of heterogeneous diffuse Hashimoto’s thyroiditis (HT).MethodsSixty HT patients with 64 thyroid nodules (31 PTL and 33 NHT) who had undergone CEUS examination were included in this study. With histopathological results as the reference, we evaluated the imaging features of each nodule on both conventional ultrasonography (US) and CEUS. Quantitative CEUS parameters including peak intensity (PI), time to peak (TTP), and area under the time–intensity curve (AUC) were gathered in the nodule and background parenchyma. The ratio indexes of theses parameters were calculated by the ratio of the lesion and the corresponding thyroid parenchyma. Logistic regression and receiver operating characteristic (ROC) curves analyses of valuable US indicators were further preformed to evaluate the diagnostic capability of CEUS in discrimination of PTL and NHT.ResultsAmong all the observed US imaging features and CEUS parameters, 10 indicators showed significant differences between PTL and NHT (all P < 0.05). All the significant indicators were ranked according to the odds ratios (ORs). Eight of them were CEUS associated including imaging features of enhancement pattern, degree, homogeneity, and quantification parameters of PI, AUC, ratios of PI, AUC, and TTP, while indicators on conventional US, including vascularity and size ranked the last two with ORs less than 3. The five single CEUS parameters showed good diagnostic performance in diagnosis of PTL with areas under ROC curves of 0.72–0.83 and accuracies of 70.3–75.0%. The combination of CEUS imaging features and the ratios of PI, AUC, and TTP demonstrated excellent diagnostic efficiency and achieved area under ROC curve of 0.92, which was significantly higher than any of the five single parameters (all P < 0.05), with a sensitivity of 83.9%, specificity of 87.9%, and accuracy of 85.9%.ConclusionsCEUS is an efficient diagnostic tool in the differential diagnosis of PTL and NHT for patients with diffuse HT. Conjoint analysis of CEUS imaging features and quantification parameters could improve the diagnostic values.

Urban pluvial flooding prediction by machine learning approaches – a case study of Shenzhen city, China

Urban pluvial flooding is a threatening natural hazard in urban areas all over the world, especially in recent years given its increasing frequency of occurrence. In order to prevent flood occurrence and mitigate the subsequent aftermath, urban water managers aim to predict precipitation characteristics, including peak intensity, arrival time and duration, so that they can further warn inhabitants in risky areas and take emergency actions when forecasting a pluvial flood. Previous studies that dealt with the prediction of urban pluvial flooding are mainly based on hydrological or hydraulic models, requiring a large volume of data for simulation accuracy. These methods are computationally expensive. Using a rainfall threshold to predict flooding based on a data-driven approach can decrease the computational complexity to a great extent. In order to prepare cities for frequent pluvial flood events – especially in the future climate – this paper uses a rainfall threshold for classifying flood vs. non-flood events, based on machine learning (ML) approaches, applied to a case study of Shenzhen city in China. In doing so, ML models can determine several rainfall threshold lines projected in a plane spanned by two principal components, which provides a binary result (flood or no flood). Compared to the conventional critical rainfall curve, the proposed models, especially the subspace discriminant analysis, can classify flooding and non-flooding by different combinations of multiple-resolution rainfall intensities, greatly raising the accuracy to 96.5% and lowering the false alert rate to 25%. Compared to the conventional model, the critical indices of accuracy and true positive rate (TPR) were 5%-15% higher in ML models. Such models are applicable to other urban catchments as well. The results are expected to be used to assist early warning systems and provide rational information for contingency and emergency planning.

Contrast-enhanced Ultrasonography and Color Doppler Ultrasonography for Dynamic Assessment of Intracranial Changes in Early MCAO Rats Models

To assess the value of contrast-enhanced ultrasound (CEUS) and color Doppler ultrasound (DUS) on hemodynamic changes and cerebral perfusion quantitative analyses in Sprague-Dawley (SD) rats with focal permanent ischemic stroke. Sixteen SD rats with thin skulls were subjected to establish middle cerebral artery occlusion (MCAO) model. CEUS images were performed before modeling (T 0), immediately after modeling (5-15 min after modeling, T 1), 3 h after modeling (T 2), followed by the measurement of bilateral middle cerebral artery (MCA), anterior cerebral artery (ACA), posterior cerebral artery (PCA) using DUS. The peak systolic velocity (PSV), end-diastolic velocity (EDV) and mean velocity (MV) of these arteries were obtained. The brain time-intensity curve was taken as interest region of the whole right brain, and the quantitative parameters of CEUS were obtained, including peak intensity (PI), area under the curve ( AUC), wash in slope (WIS), time to peak (TTP), rise time (RT) and time from peak to one half (TPH). The modified neurological deficit score (mNSS) of the rats was performed 3 h after the modeling, and the data of the rats with a score of 9-11 were statistically analyzed. A total of 12 rats were successfully modeled and completed with mNSS score 9-11. No blood flow signals were observed on the right MCA and ACA in the 12 rats at T 1 and T 2. From T 0 to T 1, PI, AUC and WIS of the right hemisphere decreased sharply with TTP and RT significantly prolonged, and the differences were statistically significant. However, there was no significant difference in hemodynamic parameters at that period of time. From T 1 to T 2, there were no significant changes in CEUS quantitative parameters (except AUCand TPH), while PSV, EDV, MV of LMCA and bilateral PCA showed significant acceleration, and the differences were statistically significant. CEUS and DUS can reveal the intracranial hemodynamics and brain tissue perfusion trends of MCAO rats, which could be new methods in assessment of ischemic stroke model at multiple time points.

Contrast-Enhanced Ultrasound Evaluation of Renal Blood Perfusion Changes After Percutaneous Transluminal Renal Angioplasty and Stenting for Severe Atherosclerotic Renal Artery Stenosis

This study used contrast-enhanced ultrasound (CEUS) to evaluate changes in renal cortical blood perfusion after percutaneous transluminal renal angioplasty and stenting (PTRAS) for severe renal artery stenosis (RAS) (≥70%). CEUS was performed in 21 patients with 24 severe RASs that underwent PTRAS. Renal cortical perfusion was quantitatively evaluated by comparing time intensity curve (TIC) parameters for SonoVue (Bracco, Milan, Italy) contrast enhancement, including peak intensity (PI), time to peak (TTP), mean transmit time (MTT), curve ascending slope (S), area under the curve (AUC), AUC-wash-in and AUC-wash-out. The parameters PI, TTP, MTT and S differed significantly between the pre-intervention and post-intervention TIC analysis (p < 0.05). Of the 24 pre-intervention curve appearances, 58.3% (14/24) improved after operation. The PI difference correlated positively with the estimated glomerular filtration rate difference (r = 0.433, p < 0.05). In conclusion, changes in some ultrasound perfusion parameters on CEUS and the shape of the TIC can be used to quantitatively and intuitively evaluate renal cortical blood perfusion change after PTRAS.

Assessment of angiogenesis in rabbit orthotropic liver tumors using three-dimensional dynamic contrast-enhanced ultrasound compared with two-dimensional DCE-US

To evaluate quantitative three-dimensional (3D) dynamic contrast-enhanced ultrasound (DCE-US) in the assessment of tumor angiogenesis using an orthotropic liver tumor model. Nine New Zealand white rabbits with liver orthotropic VX2 tumors were established and imaged by two-dimensional (2D) and 3D DCE-US after SonoVue® bolus injections. The intraclass correlation coefficients of perfusion parameters, including peak intensity (PI), mean transit time, time to peak, and area under the curve, were calculated based on time-intensity curve. The percentage area of microvascular (PAMV) and the expression of vascular endothelial growth factor (VEGF) were both evaluated by immunohistochemical analysis and weighted by the tumor activity area ratio. Correlations between quantitative and histologic parameters were analyzed. The reproducibility of 3D DCE-US quantitative parameters was excellent (ICC 0.91-0.99); but only PI showed high reproducibility (ICC 0.97) in 2D. None of the parameters of quantitative 2D DCE-US were significantly correlated with weighted PAMV or VEGF. For 3D DCE-US, there was a positive correlation between PI and weighted PAMV (r = 0.74, P = 0.04) as well as VEGF (r = 0.79, P = 0.02). Quantitative parameters of 3D DCE-US show feasibility, higher reproducibility and accuracy for the assessment of tumor angiogenesis using an orthotropic liver tumor model compared with 2D DCE-US.

Six-Transmembrane Epithelial Antigen of the Prostate-1 (STEAP-1)-Targeted Ultrasound Imaging Microbubble Improves Detection of Prostate Cancer In Vivo.

To investigate the feasibility of the 6-transmembrane epithelial antigen of the prostate-1 (STEAP-1)-targeted microbubbles for enhancing ultrasound imaging of prostate tumors in the nude mouse xenograft models. Contrast agents were established by conjugating biotinylated STEAP-1 monoclonal antibodies with streptavidin coated SonoVue microbubbles. Then, ordinary SonoVue (Bracco, Milan, Italy) microbubble and STEAP-1-targeted SonoVue microbubble were used, respectively, for contrast-enhanced sonography to detect prostate tumors in the nude mouse xenograft models. The characteristics, including peak intensity, time to peak, area under the curve, and mean transit time, were measured. The biological characteristics of STEAP-1-targeted SonoVue microbubbles were stable. STEAP-1-targeted SonoVue microbubbles can successfully conjugate to prostate cancer cell lines in vitro. Enhancement of ultrasound signal intensity was determined after injection of STEAP-1-targeted SonoVue microbubble, compared with ordinary SonoVue microbubble. Higher intensities of ultrasound signals in xenograft tumor of prostate cancer were associated with increased levels of STEAP-1 expression. Our results suggest that SonoVue microbubble carrying STEAP-1 monoclonal antibody could improve the ultrasound visualization of prostate cancer and identify the tumor more effectively in vivo. A prospective study is required to validate our finding in patients with prostate cancer.

Comparison of 2-dimensional and 3-dimensional contrast-enhanced ultrasound for quantitative analysis in liver neoplasms

Objective To evaluate the correlation and consistency of dynamic three-dimensional contrast-enhanced ultrasonography (3D-CEUS) and two-dimensional contrast-enhanced ultrasonography (2D-CEUS) in the time-intensity curve (TIC) parameters of quantitative analysis in liver neoplasms. Methods Thirty patients were examined with 2D-CEUS and dynamic 3D-CEUS.The dynamic raw data were analyzed by quantitative analysis software. The regions of interest were manually selected around the entire lesion; TIC curves were generated and fitted respectively. Quality of fit (QOF) was used to evaluate the degree of fit between the fitted curve and the initial curve. The corresponding 2D-CEUS and 3D-CEUS quantitative parameters of the same lesion were compared, including peak intensity (PI), slope (S), area under curve (AUC), time to peak (TTP) and mean transit time (MTT). The correlation of the intensity-related quantitative parameters and the consistency of the time-related quantitative parameters were analyzed between the two kinds of CEUS. Results The consistency of time related quantitative parameters, including MTT and TTP, were 0.97 and 0.96, and the correlation were 0.94 and 0.93. The correlation coefficients of S, PI and AUC were 0.92, 0.72 and 0.65, respectively. Conclusions The quantitative results of 3D-CEUS are stable and reliable, and have fair concordance with 2D-CEUS. Dynamic 3D-CEUS can be used for clinical evaluation of the blood perfusion of liver neoplasms. Key words: Contrast-enhanced ultrasonography; Liver neoplasms; Quantitative analysis

Quantitative Evaluation of Hepatic Microvascular Perfusion after Ischemia–Reperfusion Injury in Rabbits by Contrast-Enhanced Ultrasound Perfusion Imaging

The aim of this study was to evaluate microvascular perfusion after liver ischemia–reperfusion injury (IRI) in rabbits using the “flash-replenishment” method of contrast-enhanced ultrasound (CEUS) perfusion imaging. Twenty-eight rabbits underwent either 30, 60 or 90 min of ischemia and 120 min of reperfusion. CEUS perfusion imaging was performed using the “flash-replenishment” model, and hepatic microvascular perfusion parameters, including peak intensity (PI), area under the curve (AUC), and hepatic artery-to-vein transit time (HA-HVTT), were calculated. Prolonged ischemia upregulated intracellular adhesion molecule-1 (ICAM-1), alanine transaminase (ALT) and aspartate transaminase (AST) levels. Longer ischemia decreased PI and AUC, but increased HA-HVTT. The perfusion parameters were significantly correlated with Suzuki's pathology scores and ALT and AST levels. The “flash-replenishment” method of CEUS perfusion imaging is an accurate and non-invasive method for evaluating hepatic microvascular perfusion and provides a valuable experimental basis for early prediction of liver IRI damage after liver transplantation or liver resection.

Contrast-enhanced ultrasound evaluation of pancreatic cancer xenografts in nude mice after irradiation with sub-threshold focused ultrasound for tumor ablation.

We evaluated the efficacy of contrast-enhanced ultrasound for assessing tumors after irradiation with sub-threshold focused ultrasound (FUS) ablation in pancreatic cancer xenografts in nude mice. Thirty tumor-bearing nude mice were divided into three groups: Group A received sham irradiation, Group B received a moderate-acoustic energy dose (sub-threshold), and Group C received a high-acoustic energy dose. In Group B, B-mode ultrasound (US), color Doppler US, and dynamic contrast-enhanced ultrasound (DCE-US) studies were conducted before and after irradiation. After irradiation, tumor growth was inhibited in Group B, and the tumors shrank in Group C. In Group A, the tumor sizes were unchanged. In Group B, contrast-enhanced ultrasound (CEUS) images showed a rapid rush of contrast agent into and out of tumors before irradiation. After irradiation, CEUS revealed contrast agent perfusion only at the tumor periphery and irregular, un-perfused volumes of contrast agent within the tumors. DCE-US perfusion parameters, including peak intensity (PI) and area under the curve (AUC), had decreased 24 hours after irradiation. PI and AUC were increased 48 hours and 2weeks after irradiation. Time to peak (TP) and sharpness were increased 24 hours after irradiation. TP decreased at 48 hours and 2 weeks after irradiation. CEUS is thus an effective method for early evaluation after irradiation with sub-threshold FUS.

Effects of quinestrol on the vocal behavior of mice during courtship interactions

Vocalizations are a crucial part of courtship and mating in a wide variety of species. Mating behavior, including courtship calls, is modulated by sex steroid hormones. Male mice produce courtship ultrasonic vocalizations to attract females during heterosexual encounters. However, rare is the knowledge on whether vocal behavior of mice changes under sterilant treatment which will affect gonadal hormone levels. In the present study, we treat male mice with quinestrol, which interferes with the release of the gonadotropin-releasing hormone (GnRH) and has a significant anti-fertility effect in rodents. We compared the differences in the syllable structures (including peak intensity, peak frequency, duration, and bandwidth), total number of calls, and harmonic syllable proportions between quinestrol treated and control male mice. Male mice treated with quinestrol produced more courtship calls and more harmonic syllables than control mice, whereas the parameters of call syllables showed no significant change between the two groups. The results indicate that normal male vocal behavior during sexual interactions could be retained or even reinforced after quinestrol treatment. In addition, female mice approached male mice treated with quinestrol more than control mice, suggesting that the treated male mice were more attractive to the female mice than the controls. Thus, competitive reproductive interference is enhanced. Further, findings provided behavior mechanism in vocal context of the fertility control in mice.

Evaluation of gastric blood supply in diabetic patients with gastroparesis by contrast-enhanced ultrasound.

Improvement in regional blood flow has been shown to ameliorate diabetic gastroparesis. We compared the gastric blood supply in patients with diabetes with gastroparesis with that in healthy subjects, by using contrast-enhanced ultrasound (CEUS). 30 healthy subjects and 40 patients with diabetic gastroparesis were enrolled. The CEUS parameters of greater curvatures of the antrum (GCOA) and lesser curvatures of the antrum (LCOA), including peak intensity (PI) and the area under the curve (AUC), were compared between the two groups. Intraclass correlation coefficient (ICC) for PI in healthy subjects measured on CEUS were 0.831-0.857 and 0.803-0.823, respectively. Intra-ICC and inter-ICC values for AUC were 0.805-0.823 and 0.813-0.815, respectively. In both groups, no significant difference was observed in PI and AUC values of GCOA and LCOA (p > 0.05). The PI and AUC of GCOA and LCOA in the diabetes group were less than those in the normal group (p < 0.05). CEUS can assess stomach wall vascularity with a high reproducibility. Microcirculation in the antrum of patients with diabetic gastroparesis is poorer than that of normal group, which is consistent with the mechanisms of diabetic neuropathy. CEUS can be used for evaluation of microvascular perfusion in patients with stomach wall disease. Advances in knowledge: This was the first study to use CEUS for assessment of blood supply of the gastric wall and to compare microvascular perfusion between healthy individuals and patients with diabetes with gastroparesis.

Nonlinear hierarchical modeling of experimental infection data

In this paper, we propose a nonlinear hierarchical model (NLHM) for analyzing longitudinal experimental infection (EI) data. The NLHM offers several improvements over commonly used alternatives such as repeated measures analysis of variance (RM-ANOVA) and the linear mixed model (LMM). It enables comparison of relevant biological properties of the course of infection including peak intensity, duration and time to peak, rather than simply comparing mean responses at each observation time. We illustrate the practical benefits of this model and the insights it yields using data from experimental infection studies on equine arteritis virus. Finally, we demonstrate via simulation studies that the NLHM substantially reduces bias and improves the power to detect differences in relevant features of the infection response between two populations. For example, to detect a 20% difference in response duration between two groups (n=15) in which the peak time and peak intensity were identical, the RM-ANOVA test had a power of just 11%, and LMM a power of just 12%. By comparison, the nonlinear model we propose had a power of 58% in the same scenario, while controlling the Type I error rate better than the other two methods.

Feasibility of Using Volumetric Contrast-Enhanced Ultrasound with a 3-D Transducer to Evaluate Therapeutic Response after Targeted Therapy in Rabbit Hepatic VX2 Carcinoma

The aim of this study was to assess the feasibility of using dynamic contrast-enhanced ultrasound (DCE-US) with a 3-D transducer to evaluate therapeutic responses to targeted therapy. Rabbits with hepatic VX2 carcinomas, divided into a treatment group (n = 22, 30 mg/kg/d sorafenib) and a control group (n = 13), were evaluated with DCE-US using 2-D and 3-D transducers and computed tomography (CT) perfusion imaging at baseline and 1 d after the first treatment. Perfusion parameters were collected, and correlations between parameters were analyzed. In the treatment group, both volumetric and 2-D DCE-US perfusion parameters, including peak intensity (33.2 ± 19.9 vs. 16.6 ± 10.7, 63.7 ± 20.0 vs. 30.1 ± 19.8), slope (15.3 ± 12.4 vs. 5.7 ± 4.5, 37.3 ± 20.4 vs. 15.7 ± 13.0) and area under the curve (AUC; 1004.1 ± 560.3 vs. 611.4 ± 421.1, 1332.2 ± 708.3 vs. 670.4 ± 388.3), had significantly decreased 1 d after the first treatment (p = 0.00). In the control group, 2-D DCE-US revealed that peak intensity, time to peak and slope had significantly changed (p < 0.05); however, volumetric DCE-US revealed that peak intensity, time–intensity AUC, AUC during wash-in and AUC during wash-out had significantly changed (p = 0.00). CT perfusion imaging parameters, including blood flow, blood volume and permeability of the capillary vessel surface, had significantly decreased in the treatment group (p = 0.00); however, in the control group, peak intensity and blood volume had significantly increased (p = 0.00). It is feasible to use DCE-US with a 3-D transducer to predict early therapeutic response after targeted therapy because perfusion parameters, including peak intensity, slope and AUC, significantly decreased, which is similar to the trend observed for 2-D DCE-US and CT perfusion imaging parameters.

Experimental study on contrast-enhanced ultrasound to evaluate testicular microvascular injury

Objective To explore the way of contrast-enhanced ultrasound(CEUS) and quantitative analysis technology to assess testicular microvascular ischemia-reperfusion injury. Methods Twenty-four healthy adult rabbits were randomly divided into the control group and the microvascular mild, moderate, serve ischemic injury group (group Ⅰ, including group Ⅰ1, Ⅰ2, Ⅰ3). The spermatic cord of the control group were threaded but not ligated. The group Ⅰ1, Ⅰ2, Ⅰ3 were reperfused 2 h after 2 h, 4 h, 6 h complete testicular ischemia respectively. The ultrasound contrast angiographic parameters of each group were analyzed by the quantitative analysis techniques, including peak intensity(PI), time to peak(TP), slope, mean transmit time(MTT), DT/2 and area. The levels of plasma vWF, NO and ET-1 were tested after the CEUS. The pathological changes of the ipsilateral testicular were observed by the HE and immunohistochemical staining. Statistical analysis was performed by SPSS13.0 software. Results Preoperativeiy, each parameter of the experimental group and the control group showed no statistical significance (P>0.05). Postoperatively, the PI, slope, area of the group Ⅰ1 increased significantly, while the TP, MTT were prolonged(P<0.05). Contrast time-intensity curve was significantly higher peak and retrusion. The group Ⅰ2′s PI, slope, area increased further, DT/2 was significantly prolonged, but TP significantly reduced(P<0.05). The contrast curve significantly increased, forward and decreased slowly. The contrast curves of the group Ⅰ3 was approximate a straight line. The vWF, NO, ET-1 levels of each experimental group were significantly higher than those in control group (P<0.05), among them, the levels of group Ⅰ2 were the highest(P<0.05). With the aggravation of ischemia, the testicular capillaries expansion, erythrocyte sedimentation, leakage, infiltration of inflammatory cells, MMP-9 expression in vascular basement membrane gradually increased. Conclusions The CEUS and quantitative analysis techniques can effectively evaluate testicular microvascular injury. Key words: Ultrasonography; Microbubbles; Testis; Ischemia; Reperfusion injury

Dynamic contrast-enhanced ultrasonographic (DCE-US) assessment of the early response after combined gemcitabine and HIFU with low-power treatment for the mouse xenograft model of human pancreatic cancer.

To assess therapeutic efficacy of gemcitabine and HIFU for a mouse model of pancreatic cancer, and the role of DCE-US for predicting early treatment response compared with pathology. In 48 PANC-1- nude mice (G1, HIFU_higher power [n = 14]; G2, gemcitabine [n = 12]; G3, combined gemcitabine and HIFU_low power [n = 12]; and G4, control [n = 10]), pulsed HIFU or gemcitabine therapy was used. DCE-US was performed 1 day before and after first treatment. Seven DCE-US perfusion parameters were obtained. Therapeutic efficacy was estimated using necrotic fraction and apoptosis. Correlation between tumour size and US perfusion parameters was analysed. Pathology results showed that combined gemcitabine and HIFU using low-power treatment had a more effective response than other treatments, including in the control group, i.e. necrotic fraction: 40.5 ± 4.9 vs. 16.9 ± 8.0, p = 0.000 and apoptosis: 44.3 ± 29.4 vs. 7.9 ± 4.9, p = 0.002. In this group, US perfusion parameters, including peak intensity (22.6 ± 22.6 vs. 9.6 ± 6.3, p = 0.002), AUC (961.8 ± 96.9 vs. 884.4 ± 91.4, p = 0.000), and AUCout (799.9 ± 75.6 vs. 747.1 ± 77.9, p = 0.000), had significantly decreased 1 day following first treatment (p < 0.05). In addition, peak intensity, AUC, and AUCout showed a tendency to decrease in treated groups. Alternatively, peak intensity, AUC, and AUCout showed a tendency to increase in control group. Gemcitabine and HIFU were more effective and safer than other treatments. US perfusion parameters were useful for predicting early therapeutic response 1 day following treatment. Recently, treatment of pancreatic cancer has changed based on a multidisciplinary approach. Combined gemcitabine_HIFU demonstrated more effective therapeutic response than other treatments. DCE-US is useful for predicting early therapeutic response 1 day after treatment. In the combined group, PI, AUC, and AUC (out) decreased 1 day after treatment.