In the past two decades, research has underlined the potential of ultrasound and microbubbles to enhance drug delivery. However, there is less consensus on the biophysical and biological mechanisms leading to this enhanced delivery. Sonoporation, i.e. the formation of temporary pores in the cell membrane, as well as enhanced endocytosis is reported. Because of the variety of ultrasound settings used -and corresponding microbubble behavior, a clear overview is missing. Therefore, in this review, the mechanisms contributing to sonoporation are categorized according to three ultrasound settings: i) low intensity ultrasound leading to stable cavitation of microbubbles, ii) high intensity ultrasound leading to inertial cavitation with microbubble collapse, and iii) ultrasound application in the absence of microbubbles. Using low intensity ultrasound, the endocytotic uptake of several drugs could be stimulated, while short but intense ultrasound pulses can be applied to induce pore formation and the direct cytoplasmic uptake of drugs. Ultrasound intensities may be adapted to create pore sizes correlating with drug size. Small molecules are able to diffuse passively through small pores created by low intensity ultrasound treatment. However, delivery of larger drugs such as nanoparticles and gene complexes, will require higher ultrasound intensities in order to allow direct cytoplasmic entry.2

No abstract

A fast calculation method for the magnetic field distribution due to (dynamic) changes in susceptibility may allow real-time interventional applications. Here it is shown that a direct relationship can be obtained between the magnetic field perturbation and the susceptibility distribution inside the MR magnet using a first order perturbation approach to Maxwell's magneto-static equations, combined with the Fourier transformation technique to solve partial derivative equations. The mathematical formalism does not involve any limitation with respect to shape or homogeneity of the susceptibility field. A first order approximation is sufficient if the susceptibility range does not exceed 10 Ϫ4 (or 100 ppm). The formalism allows fast numerical calculations using 3D matrices. A few seconds computation time on a PC is sufficient for a 128 ϫ 128 ϫ 128 matrix size. Predicted phase maps fitted both analytical and experimental data within 1% precision.

The occlusion of the middle cerebral artery was used as an experimental acute stroke model in 30 cats. The diffusion of water was followed by diffusion-sensitized MRI between 1 and 15 h after induction of stroke. It is demonstrated that images representing the trace of the diffusion tensor provide a much more accurate delineation of affected area than images representing the diffusion in one direction only. The reason is that the strong contrast caused by the anisotropy and orientation of myelin fibers is completely removed in the trace of the diffusion tensor. The trace images show a small contrast between white and gray matter. The diffusion coefficient of white matter is decreased in acute stroke to approximately the same extent as gray matter. It is further shown that the average lifetime of water in extra and intracellular space is shorter than 20 ms both for healthy and ischemic tissue indicating that myelin fibers are permeable to water. The anisotropy contrast did not change before or after induction of stroke, nor after sacrifice. Together, these observations are consistent with the view that the changes in water diffusion during acute stroke are directly related to cytotoxic oedema, i.e., to the change in relative volume of intra- and extracellular spaces. Changes in membrane permeability do not appear to contribute significantly to the changes in diffusion.

The authors developed a hydrogen-1 proton magnetic resonance (MR) imaging method in which metabolic information is acquired by obtaining multiple sections through the brain. A spin-echo sequence is used for section selection, an octangular outer volume saturation pulse for lipid suppression, and a chemical-shift-selective saturation pulse for water suppression. High-quality maps of choline, creatine, and N-acetylaspartate were obtained in six studies performed in four volunteers. Water and lipid signal from the skull area was well suppressed by the pulse sequence used.

A volumetric sonication method is proposed that produces volume ablations by steering the focal point along a predetermined trajectory consisting of multiple concentric outward-moving circles. This method was tested in vivo on pig thigh muscle (32 ablations in nine animals). Trajectory diameters were 4, 12, and 16 mm with sonication duration depending on the trajectory size and ranging from 20 to 73 s. Despite the larger trajectories requiring more energy to reach necrosis within the desired volume, the ablated volume per unit applied energy increased with trajectory size, indicating improved treatment efficiency for larger trajectories. The higher amounts of energy required for the larger trajectories also increased the risk of off-focus heating, especially along the beam axis in the near field. To avoid related adverse effects, rapid volumetric multiplane MR thermometry was introduced for simultaneous monitoring of the temperature and thermal dose evolution along the beam axis and in the near field, as well as in the target region with a total coverage of six slices acquired every 3 s. An excellent correlation was observed between the thermal dose and both the nonperfused (R=0.929 for the diameter and R=0.964 for the length) and oedematous (R=0.913 for the diameter and R=0.939 for the length) volumes as seen in contrast-enhanced T1-weighted difference images and T2-weighted postsonication images, respectively. Histology confirmed the presence of a homogeneous necrosis inside the heated volumes. These results show that volumetric high-intensity focused ultrasound (HIFU) sonication allows for efficiently creating large thermal lesions while reducing treatment duration and also that the rapid multiplane MR thermometry improves the safety of the therapeutic procedure by monitoring temperature evolution both inside as well as outside the targeted volume.

Functional magnetic resonance imaging (jMRI) is

Purpose:To investigate the possibility of using combined blood oxygen level-dependent (BOLD) imaging and diffusion-weighted imaging (DWI) to detect pathological and physiological changes in renal tissue damage of the kidney induced by chronic renal hyperfiltration. Materials and Methods:The apparent diffusion coefficient (ADC) and the T 2 * value within the inner compartments of the kidneys of 17 rats with diabetes mellitus were compared with the results obtained from a control group (N ϭ 16). The influence of dynamic changes of the renal function on the blood-oxygen saturation was evaluated by comparing the T 2 * values before and after the active reduction of tubular transport by furosemide injection.Results: All compartments of the diabetic kidney showed significantly (P Ͻ 0.05) lower T 2 *-values compared to the control group. In particular, the very low values in the outer stripe (OS) of the outer medulla (OM) (T 2 *-normal: 69.4 Ϯ 10.9 msec; T 2 *-diabetic: 51.4 Ϯ 13.9 msec) indicated either hypoxia due to hyperfiltration, or renal blood volume changes. Diffusion imaging of the same area showed significantly lower ADC values (ADC-normal: 1.45 Ϯ 0.26; ADCedema: 1.19 Ϯ 0.25 [10 -9 m 2 /s]) that correlated with pathological findings on histopathology. The injection of furosemide significantly (P Ͻ 0.05) increased T 2 * in all compartments of both populations while the ADC remained unchanged.Conclusion: BOLD-contrast imaging appears to be able to depict tissue at risk from ischemia by revealing information about the balance between tubular workload and delivery of oxygen, and thus may reflect a measure of the reserve capacity. The diffusion measurements apparently reveal complementary information. Although ADC imaging is not sensitive to the current energy metabolism, it appears toreflect the pathological changes within the tissue. Therefore, ADC measurements may be a sensitive indicator of the severity of ischemic lesions.