Dynamic contrast enhanced ultrasound assessment of the vascular effects of novel therapeutics in early stage trials

Abstract

Imaging is key in the accurate monitoring of response to cancer therapies targeting tumour vascularity to inhibit its growth and dissemination. Dynamic contrast enhanced ultrasound (DCE ultrasound) is a quantitative method with the advantage of being non-invasive, widely available, portable, cost effective, highly sensitive and reproducible using agents that are truly intravascular. Under the auspices of the initiative of the Experimental Cancer Medicine Centre Imaging Network, bringing together experts from the UK, Europe and North America for a 2-day workshop in May 2010, this consensus paper aims to provide guidance on the use of DCE ultrasound in the measurement of tumour vascular support in clinical trials. Key Points • DCE ultrasound can quantify and extract specific blood flow parameters, such as flow velocity, relative vascular volume and relative blood flow rate. • DCE ultrasound can be performed repeatedly and is therefore ideally suited for pharmacokinetic and pharmacodynamic studies evaluating vascular-targeted drugs. • DCE ultrasound provides a reproducible method of assessing the vascular effects of therapy in pre-clinical and early clinical trials, which is easily translatable into routine clinical practice.

Comparison of contrast-enhanced ultrasound and contrast-enhanced computed tomography in evaluating the treatment response to transcatheter arterial chemoembolization of hepatocellular carcinoma using modified RECIST

“…CEUS is an operator-dependent imaging technology [25]. It has some other limitations, such as being affected by the tumour location and acoustic window [26,27].…”

Improvement of the accuracy of liver lesion DCEUS quantification with the use of automatic respiratory gating

“…Indicator dilution theory can be used to model lesion haemodynamics and extract blood flow parameters [5]. The DCEUS quantification parameters relating to lesion perfusion may provide for an early detection of patient response to treatment [6,7]. Various factors can affect the image intensity in DCEUS loops such as signal saturation, acoustic shadowing, nonlinear propagation of ultrasound, beam non-uniformity, ultrasound probe motion and system settings [8][9][10].…”

Evaluation of the Accuracy of Liver Lesion DCEUS Quantification With Respiratory Gating

“…These studies use modeling of the tumor perfusion to extract quantification parameters in order to make the evaluation of the response to treatment more objective than visual assessment and provide an early detection of response [13], [14]. Ideally these quantification parameters would be affected only by the blood flow and volume which in turn are related to the concentration of the microbubbles in the lesion under investigation.…”