Developments in ultrasound contrast media

Harvey, Chris J.; Blomley, Martin; Eckersley, Robert J.; Cosgrove, David O.

doi:10.1007/s003300000624

Cited by 149 publications

(88 citation statements)

References 30 publications

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“…First, our [1,[17][18][19][20][21]. Second, the efficacy of CE sonography might be underestimated because of the limitations of our study, wherein the histologic results of biopsy were considered to be the reference standard and histologic examination of the entire prostate gland was not performed.…”

Section: Discussionmentioning

confidence: 94%

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Contrast-Enhanced Sonography for Prostate Cancer Detection in Patients with Indeterminate Clinical Findings

Kim

et al. 2006

American Journal of Roentgenology

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G e n i t o u r i n a r y I m a g i n g • O r i g i n a l R e s e a r c h Contrast-EnhancedOBJECTIVE. The purpose of our study was to evaluate the usefulness of contrast-enhanced sonography for prostate cancer detection in patients with an indeterminate prostate-specific antigen (PSA) level (4-10 ng/mL) and negative findings on digital rectal examination.SUBJECTS AND METHODS. Forty-eight patients underwent gray-scale, color Doppler, and contrast-enhanced sonography examinations and then sonographically guided biopsy. Contrast-enhanced sonography was performed using Levovist at a mechanical index of 1.1-1.4. The performances of the three methods for cancer detection were compared according to biopsy site and patient.RESULTS. Sensitivity by biopsy site was greater on contrast-enhanced sonography (68%) than on gray-scale (39%) and color Doppler (41%) sonography (p ≤ 0.05), whereas the specificity and overall accuracy by biopsy site (82% and 77% for gray-scale sonography, 84% and 79% for color Doppler sonography, and 83% and 81% for contrast-enhanced sonography, respectively) were not different for the three methods (p > 0.05). The concordance score for sonography and biopsy results by patient was not different for gray-scale (6.4 ± 1.8), color Doppler (6.3 ± 0.6), and contrast-enhanced sonography (6.5 ± 0.7) (p = 0.281).CONCLUSION. Contrast-enhanced sonography could improve only the sensitivity for cancer detection in analysis by biopsy site but did not improve the overall performance of sonography in patients with an indeterminate PSA level and negative digital rectal examination. rostate cancer is a common malignant neoplasm in men. Its incidence has been increasing because of improvements in diagnostic testing, increasing life expectancy, and the presence of environmental carcinogens [1,2]. Although sonography has wisely been used for evaluating the prostate, many reports have shown the limitations of sonography for cancer detection based on its unsatisfactory sensitivity and variable accuracy [3][4][5][6][7][8].Over the past few years, microbubble contrast-enhanced sonography has been introduced as a promising tool that can improve prostate cancer detection. Halpern et al. [1], in an early large study, showed significant improvement of the sensitivity from 38% on gray-scale and color or power Doppler sonography to 65% with contrast-enhanced (CE) sonography. Thereafter, several studies also reported an increased sensitivity of up to 86% [9][10][11][12]. However, the actual merit of sonographic contrast material may be in question because the performance of CE sonography varied in those studies. The variable degree of cancer risk in the study populations of previous studies may be largely responsible for the variable results of those studies; patients with a high PSA level and positive digital rectal examination may have a greater chance of having positive sonographic findings than those with an indeterminate risk of prostate cancer [9][10][11][12][13][14]. Therefore, if CE sonography were shown to have improved ...

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Section: Discussionmentioning

confidence: 94%

“…The use of a high mechanical index can generate more intense signal than a low mechanical index because of the destruction of a greater amount of contrast material [20,21]. Therefore, Levovist can clearly show hypervascular lesions such as prostate cancer.…”

Section: B Cmentioning

confidence: 99%

Contrast-Enhanced Sonography for Prostate Cancer Detection in Patients with Indeterminate Clinical Findings

Kim

et al. 2006

American Journal of Roentgenology

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“…At that time, they were not able not to pass the lung capillaries and thus were used mainly for assessment of (intracardiac or intrapulmonary) shunts [30][31][32]. Technical developments then created smaller micro-bubble carriers that enabled smaller and more stable US-CAs to pass the capillary bed, with a better signal response and constantly increasing contrast enhancement duration [30,32,33].…”

Section: Discussionmentioning

confidence: 99%

Application of a second-generation US contrast agent in infants and children—a European questionnaire-based survey

Riccabona

2012

Pediatr Radiol

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Background No US contrast agent (US-CA) is currently licensed for use in children.Objective To survey the off-label use in children of a second-generation US-CA. Materials and methods Questionnaires were e-mailed to European paediatric radiologists, who were asked about their experience with the second-generation US-CA Sonovue® (Bracco, Milan, Italy). Number of examinations per indication and adverse effects were recorded. Examinations were categorised by intravenous or intracavitary use of US-CA. Results Out of 146 respondents, 88 stated that they did not perform contrast-enhanced US in children, but 36 of these (44%) would appreciate paediatric approval. Fortyfive centres reported 5,079 examinations in children (age mean: 2.9 years; range: birth-18 years, M/F: 1/ 2.8). The majority (4,131 [81%] in 29 centres) were intravesical applications. The minority (948 [19%] in 30 centres) were intravenous applications. No adverse effects had been recorded from intravesical use. Six minor adverse effects (skin reaction, unusual taste, hyperventilation) had been recorded after five intravenous studies (0.52%). Conclusion Responses suggest a favourable safety profile of this second-generation US-CA in children. It also demonstrates a demand for such US-CA from paediatric radiologists.

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“…Recently, the use of ultrasound with echocontrast agents, including Optison, has resulted in improved gene delivery with minimal cytotoxicity (31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42). Ultrasound itself is harmless to the body and is widely used clinically for many purposes such as physical therapy, diagnosis, guidance for deep organ biopsy, and local drug and genetic material delivery (31,36 -39).…”

Section: Discussionmentioning

confidence: 99%

Inhibition of Renal Fibrosis by Gene Transfer of Inducible Smad7 Using Ultrasound-Microbubble System in Rat UUO Model

Lan

Mu²,

Tomita³

et al. 2003

Journal of the American Society of Nephrology

324

286

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ABSTRACT. TGF-β is a key mediator in renal fibrosis. Kidney-targeted gene therapy with anti–TGF-β strategies is expected to have therapeutic potential, but this has been hampered by concerns over the safety and practicability of viral vectors and the inefficiency of nonviral transfection techniques. The present study explored the potential role of TGF-β/Smad signaling in renal fibrosis in vivo and developed a safe and effective gene therapy to specifically block TGF-β signaling and renal fibrosis in a rat unilateral ureteral obstruction (UUO) model by transferring a doxycycline-regulated Smad7 gene or control empty vectors using an ultrasound-microbubble (Optison)-mediated system. The Smad7 transgene expression was tightly controlled by addition of doxycycline in the daily drinking water. Groups of six rats were sacrificed at day 7, and the transfection rate, Smad7 transgene expression, and tubulointerstitial fibrosis including α-smooth muscle actin and collagen matrix mRNA and protein expression were determined. Compared with the non-ultrasound treatment, the combination of ultrasound with Optison largely increased the transfection rate of FITC-ODN and Smad7 transgene expression up to a 1000-fold, and this was found in all kidney tissues. Compared with normal rats, Smad7 expression within the UUO kidney was significantly reduced, and this was associated with up to a sixfold increase in Smad2 and Smad3 activation and severe tubulointerstitial fibrosis. In contrast, treatment with inducible Smad7 resulted in a fivefold increase in Smad7 expression with complete inhibition of Smad2 and Smad3 activation and tubulointerstitial fibrosis in terms of tubulointerstitial myofibroblast accumulation (85%↓) and collagen I and III mRNA and protein expression (60 to 70%↓). In conclusion, the ultrasound-mediated inducible Smad7 gene transfer is a safe, effective, and controllable gene therapy. TGF-β–mediated renal fibrosis is regulated positively by Smad2/3, but negatively by Smad7. Target blockade of TGF-β/Smad signaling by expression of Smad7 may provide a new therapeutic potential for renal fibrosis. E-mail: hlan@bcm.tmc.edu

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Developments in ultrasound contrast media

Cited by 149 publications

References 30 publications

Contrast-Enhanced Sonography for Prostate Cancer Detection in Patients with Indeterminate Clinical Findings

Contrast-Enhanced Sonography for Prostate Cancer Detection in Patients with Indeterminate Clinical Findings

Application of a second-generation US contrast agent in infants and children—a European questionnaire-based survey

Inhibition of Renal Fibrosis by Gene Transfer of Inducible Smad7 Using Ultrasound-Microbubble System in Rat UUO Model

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