- Email: [email protected]
Broadband Attenuation and Size Measurements of Ultrasound Contrast Agents
S92
Ultrasound in Medicine and Biology
to prevent manifest renal damage and to postpone the onset of irreversible diabetic nephropathy.
TL.12.005 Ultrasonographic Evaluation of Transplanted Kidneys: Establishing a Protocol R. M. Mendonc¸a, I. X. C. R. Rebouc¸as, J. C. D. Oliveira, E. A. Q. Lisboa, M. A. Borba, A. A. L. Liguori, Z. J. Queiroz, J. B. Almeida Hospital Universit ario Onofre Lopes, Natal, Rio Grande Do Norte, Brasil Brief Description of the Purpose of the Study: Kidney transplantation is an important therapy in chronic kidney disease and anticipate the urological/vascular/functional complications is crucial in maintaining graft. The Doppler ultrasonography (USG-Dp) plays an important role in this follow-up, being requested to patients with clinical intercurrences. This study aims to define a protocol of USG-Dp routine, even for patients with adequate evolution, will show benefits, anticipating behaviors in patients with subclinical changes. Methods: Receptors patients underwent two tests routinely performed by the same sonographer in the 2nd and 7th postoperative day. Registered ultrasound findings, clinical outcome and was noted if the USG-Dp modified behavior. Main Results: Included 29 patients (mean age 43.14), 27 cadaver donor receivers. 75.8% (22) were classified as clinical expected, considering postoperative acute tubular necrosis related to ischemic time. Of the total, 24.1% (07) had significant ultrasound findings, altering therapy applied. Isolating only those patients with postoperative compatible course, which would not be assessed at this time, 18.2% (04) had the follow-up clinical modified/anticipated based on this USG-Dp, implemented as a routine. Importance of the Conclusions: Based on the results it is essential to establish protocol USG-Dp in transplant patients, even within the normal clinical course, providing basis for behavior change in 24.1% of cases, helping to prevent tragic outcomes.
13 - New Technologies in Ultrasound PD.13.001 WITHDRAWN
TL.13.012 Micro/Nano Silica Shell Particle for Ultrasound Imaging Z. Wu, A. Liberman, H. P. Martinez, Y. Kono, R. Mattrey, W. Trogler, A. Kummel University of California, San Diego CA, USA Brief Description of the Purpose of the Study: We develop a gas filled silica shell particle as a novel ultrasound contrast agent. There is an increased need for submicron ultrasound contrast agents with extended period of lifetime for various reasons. The micro/nano shells (M-NSs) can be injected via IV or subcutaneously and imaged up to 7 days post injection. The particle’s acoustic behavior is studied and in vivo imaging is demonstrated. Methods: We manufactured hollow silica particles in sizes ranging from 100 nm to 2000 nm and filled them with perfluoropentane vapor. The M-Ns are imaged with SEM and TEM for their morphology and size distribution. They are also observed by contrast specific (CPS mode) ultrasound and Doppler ultrasound in vitro. For in vitro studies, 100nm, 500nm, and 2um diameter particles are dispersed
Volume 39, Number 5S, 2013 in degassed water and placed in a thin wall plastic chamber. A Siemens Sequoia scanner was used to scan the sample at various Mechanical Indexes (MI). A minimum MI for each type of particles was determined by observing a minimally visible signal with the ultrasound imaging system. Main Results: SEM and TEM images for two different sizes of hollow microshells that have been prepared. The high degree of reproducibility of the gas-filled microshells in the bulk sample and their dispersal from one another were documented. In the in vitro study, under the CPS mode with a transmit frequency of 7MHz, a minimum MI is found to excite this particle to render visible signals. Strong ultrasound enhancement in the peritoneal cavity is observed when a rat is injected with 200ug of 500nm particles intrapertoneally and imaged at high MI up to 72hr post injection. Importance of the Conclusions: We have developed a novel submicron silica shell particle which lasts days in tissue with strong signals in CPS mode. This is the first demonstration of an ultrasound contrast agent which can persist for several days in tissue.
TL.13.015 New Computer Technology - Real-Time Virtual Sonography : First Experience of Combination of Ultrasound, CT and MRI A. Zubarev, A. Fedorova, N. Fedorova, S. Churkina President Medical Centre Brief Description of the Purpose of the Study: The objective of this study was to determine diagnostic capabilities and accuracy of virtual sonography in combination with CT and MRI data. Methods: Real-time virtual sonography (RVS) allows to receive simultaneous ultrasound image on the monitor to get a computer image on ultrasound device, corresponding CT or MRI slices. We gained the first clinical experience of RVS in difficult diagnostic cases, when it was necessary to interpret examination data based on different methods of diagnosis. We have examined more than 20 patients, for whom combined examination using CT, MRI and US of liver, kidneys and pelvis, was of a great interest. Main Results: Using technology RVS, we received key information in determining the nature of volume formations in large number of cases. Application of RVS provided additional information and significantly improved diagnostic accuracy. With the possibility of multiple repetition of diagnostic studies, we can combine ultrasound method and CT, performed only once. Thus, in some cases we were able to manage without use of contrast agents in CT and get an equivalent information by ultrasound. Importance of the Conclusions: Combination of different methods, using RVS technology, raises the level of objectivity of ultrasound to a new level, while ultrasound does not lose its main advantages.
TL.13.017 Broadband Attenuation and Size Measurements of Ultrasound Contrast Agents J. L. Raymond,1 K. J. Haworth,1 K. B. Bader,1 K. Radhakrishnan,1 S.-L. Huang,2 D. D. Mcpherson,2 C. K. Holland1 1 University of Cincinnati, Cincinnati, Ohio, USA, 2University of Texas Health Science Center At Houston, Houston, Texas, USA Brief Description of the Purpose of the Study: Echogenic liposomes (ELIP) are under development as an ultrasound contrast agent (UCA) for image-guided, targeted drug delivery. The aim of this study was to investigate the effect of the lipid formulation and type of encapsulated gas on the acoustic response of ELIP under physiologic conditions. The
Abstracts influence of temperature and diluent on the measured attenuation coefficients was investigated for ELIP as well as the commercial lipid-based UCA Definity. Methods: Broadband attenuation spectra were obtained for agents diluted either in whole blood or in saline solution containing 0.5% bovine serum albumin (BSA) at 25 C and 37 C. The spectra and particle size distributions obtained using a Coulter counter were compared with scattering theory to estimate the properties of the lipid shell stabilizing the microbubbles. Main Results: Dilution of ELIP or Definity in either whole blood or BSA solution did not affect the measured attenuation coefficients. However, the temperature and gas saturation of the diluent were found to impact the attenuation spectra significantly. Importance of the Conclusions: The attenuation spectra of UCAs are strongly impacted by temperature and gas saturation relative to physiologic values. Knowledge of the acoustic properties and size distribution of these agents under physiologic conditions will allow for their safe use in vivo.
14 - Ultrasound in Pediatrics TL.14.002 Renal Parenchymal Thickness as a Measure of Renal Growth in Low-Birth-Weight Infants Versus Normal Birth Weight Infants S. Brennan The Townsville Hospital, Townsville, Queensland, Australia Brief Description of the Purpose of the Study: Low birth weight (LBW; , 2500 g) infants have smaller kidneys, and therefore a reduced number of glomeruli and nephrons. Renal ultrasound remains the primary technique for assessing renal growth. We carried out a study to see if a new measurement, renal parenchymal thickness, can be used to detect any differences in renal growth between LBW and normal birth weight (NBW; 2500-4500 g) infants. Methods: This study was conducted over a 12-month period from August 2010 at The Townsville Hospital. Renal ultrasounds were performed on 38 full-term infants who had no underlying renal problems. Renal parenchymal thickness, length, transverse diameter and anteroposterior diameter were measured. Main Results: Thirty-eight infants were evaluated (11 LBW and 27 NBW). The mean kidney volume and mean renal parenchymal thickness in LBW infants are significantly lower than they are in NBW infants. Renal parenchymal thickness is found to be closely correlated with an increase in renal volume (r 5 0.76; p , 0.0001). Importance of the Conclusions: The mean renal parenchymal thickness in LBW infants is significantly lower than it is in NBW infants. Renal parenchymal thickness is a single, easily performed measurement that could potentially be a more useful and accurate approach to monitoring renal growth than renal volume.
15 - Ultrasound in Small Parts TL.15.001 Trans-Orbital Sonographic Measurement of Normal Optic Nerve Diameter at Aminu Kano Teaching Hospital, Kano, Nigeria A. Ismail Bayero University, Kano, Nigeria Brief Description of the Purpose of the Study: This study is aimed at determining the optic nerve diameter (OND) by ocular ultrasonography in normal Nigerian adults.
S93
Methods: This prospective study was conducted at Aminu Kano Teaching Hospital. The OND was measured at 3 mm posterior to the globe using a 7.5 MHz linear transducer on the closed eyelids of 400 healthy adults in supine position. Three repeated measurements were obtained on each optic nerve to reduce intra-observer variability. Main Results: The study subjects consisted of 192 males and 208 females. Their mean age was 36.94 6 16.63 years. The mean OND were 4.18 + 0.49 mm and 4.17 + 0.44 mm on the respective right and left sides. The mean OND of the right and left were 4.18 mm and 4.16 mm among males and 4.17 mm on each optic nerve among females. There was no statistically significant variation in OND between the right and left sides (p 5 0.12) and also between males and females (p 5 0.296 and 0.745 for the respective right and left OND). Importance of the Conclusions: In this study, transorbital sonographic measurements of the OND show no correlation with side (right and left), age and sex. The normogram of OND measurements is therefore presented as diagnostic aid in clinical settings.
TL.15.002 Ultrasound Technologies of Qualitative and Quantitative Stiffness Evaluation in Diagnosis of Thyroid Malignancies A. N. Sencha, Y. N. Patrunov, M. S. Mogutov, E. D. Sergeeva Yaroslavl Railway Clinic, Yaroslavl, Russian Federation Brief Description of the Purpose of the Study: To assess the value of ultrasound elastography and acoustic radiation force impulse (ARFI) technologies in diagnosis of thyroid carcinoma. Methods: Retrospective analysis of complex ultrasound examinations of 141 patients from 19 to 85 years of age operated for highly differentiated thyroid cancer (papillary - 75.2% and follicular - 24.8%) was performed with ultrasound scanner Siemens ‘‘Acuson S2000’’. Qualitative (elastography) and numeric parameters (ARFI) of the stiffness of thyroid carcinoma along with conventional ultrasound features were analyzed. Main Results: Malignant nodules demonstrated hard (blue) color pattern with elastography in 81.6% of cases and mixed (blue-greenred) pattern in 6.4%. The pattern was heterogeneous and irregular in 68.8% of lesions. Elastography failed to differentiate 12.8% of lesions, all smaller than 1 cm. Elastography supplied additional data to conventional ultrasound in 37.5% of cases. Its sensitivity in diagnosis of thyroid carcinoma was 87.5% with specificity of 75.0%. ARFI revealed the increased average share wave velocity within malignant thyroid lesions (3.7m/s; 2.9-4.3m/s), as compared with normal thyroid parenchyma (2.8m/s; 1.7-3.5m/s). The sensitivity of ARFI in diagnosis of thyroid carcinoma was 86.1% with specificity of 82.1%. Importance of the Conclusions: Malignant thyroid lesions often exhibit high grades of tissue strain with elastography and high share wave velocity with ARFI.
TL.15.005 TIRADS: An Effective Proposal for Classification and Stratification of Risk in Thyroid Nodules M. J. Francisco Neto, R. G. Garcia, A. Rahal Jr., J. P. B. Costa Lima, A. Maurano, F. A. C. Vieira, D. R. Nery, M. G. B. Funari Hospital Israelita Albert Einstein, S~ao Paulo, S~ao Paulo, Brasil Brief Description of the Purpose of the Study: Thyroid nodules are common sonographic findings, occurring in up to 70% of patients. In the literature, there is no consensus on standardizing sonographic nodule features to predict their malignancy risk. For this purpose, the TIRADS
Ultrasound in Medicine and Biology
to prevent manifest renal damage and to postpone the onset of irreversible diabetic nephropathy.
TL.12.005 Ultrasonographic Evaluation of Transplanted Kidneys: Establishing a Protocol R. M. Mendonc¸a, I. X. C. R. Rebouc¸as, J. C. D. Oliveira, E. A. Q. Lisboa, M. A. Borba, A. A. L. Liguori, Z. J. Queiroz, J. B. Almeida Hospital Universit ario Onofre Lopes, Natal, Rio Grande Do Norte, Brasil Brief Description of the Purpose of the Study: Kidney transplantation is an important therapy in chronic kidney disease and anticipate the urological/vascular/functional complications is crucial in maintaining graft. The Doppler ultrasonography (USG-Dp) plays an important role in this follow-up, being requested to patients with clinical intercurrences. This study aims to define a protocol of USG-Dp routine, even for patients with adequate evolution, will show benefits, anticipating behaviors in patients with subclinical changes. Methods: Receptors patients underwent two tests routinely performed by the same sonographer in the 2nd and 7th postoperative day. Registered ultrasound findings, clinical outcome and was noted if the USG-Dp modified behavior. Main Results: Included 29 patients (mean age 43.14), 27 cadaver donor receivers. 75.8% (22) were classified as clinical expected, considering postoperative acute tubular necrosis related to ischemic time. Of the total, 24.1% (07) had significant ultrasound findings, altering therapy applied. Isolating only those patients with postoperative compatible course, which would not be assessed at this time, 18.2% (04) had the follow-up clinical modified/anticipated based on this USG-Dp, implemented as a routine. Importance of the Conclusions: Based on the results it is essential to establish protocol USG-Dp in transplant patients, even within the normal clinical course, providing basis for behavior change in 24.1% of cases, helping to prevent tragic outcomes.
13 - New Technologies in Ultrasound PD.13.001 WITHDRAWN
TL.13.012 Micro/Nano Silica Shell Particle for Ultrasound Imaging Z. Wu, A. Liberman, H. P. Martinez, Y. Kono, R. Mattrey, W. Trogler, A. Kummel University of California, San Diego CA, USA Brief Description of the Purpose of the Study: We develop a gas filled silica shell particle as a novel ultrasound contrast agent. There is an increased need for submicron ultrasound contrast agents with extended period of lifetime for various reasons. The micro/nano shells (M-NSs) can be injected via IV or subcutaneously and imaged up to 7 days post injection. The particle’s acoustic behavior is studied and in vivo imaging is demonstrated. Methods: We manufactured hollow silica particles in sizes ranging from 100 nm to 2000 nm and filled them with perfluoropentane vapor. The M-Ns are imaged with SEM and TEM for their morphology and size distribution. They are also observed by contrast specific (CPS mode) ultrasound and Doppler ultrasound in vitro. For in vitro studies, 100nm, 500nm, and 2um diameter particles are dispersed
Volume 39, Number 5S, 2013 in degassed water and placed in a thin wall plastic chamber. A Siemens Sequoia scanner was used to scan the sample at various Mechanical Indexes (MI). A minimum MI for each type of particles was determined by observing a minimally visible signal with the ultrasound imaging system. Main Results: SEM and TEM images for two different sizes of hollow microshells that have been prepared. The high degree of reproducibility of the gas-filled microshells in the bulk sample and their dispersal from one another were documented. In the in vitro study, under the CPS mode with a transmit frequency of 7MHz, a minimum MI is found to excite this particle to render visible signals. Strong ultrasound enhancement in the peritoneal cavity is observed when a rat is injected with 200ug of 500nm particles intrapertoneally and imaged at high MI up to 72hr post injection. Importance of the Conclusions: We have developed a novel submicron silica shell particle which lasts days in tissue with strong signals in CPS mode. This is the first demonstration of an ultrasound contrast agent which can persist for several days in tissue.
TL.13.015 New Computer Technology - Real-Time Virtual Sonography : First Experience of Combination of Ultrasound, CT and MRI A. Zubarev, A. Fedorova, N. Fedorova, S. Churkina President Medical Centre Brief Description of the Purpose of the Study: The objective of this study was to determine diagnostic capabilities and accuracy of virtual sonography in combination with CT and MRI data. Methods: Real-time virtual sonography (RVS) allows to receive simultaneous ultrasound image on the monitor to get a computer image on ultrasound device, corresponding CT or MRI slices. We gained the first clinical experience of RVS in difficult diagnostic cases, when it was necessary to interpret examination data based on different methods of diagnosis. We have examined more than 20 patients, for whom combined examination using CT, MRI and US of liver, kidneys and pelvis, was of a great interest. Main Results: Using technology RVS, we received key information in determining the nature of volume formations in large number of cases. Application of RVS provided additional information and significantly improved diagnostic accuracy. With the possibility of multiple repetition of diagnostic studies, we can combine ultrasound method and CT, performed only once. Thus, in some cases we were able to manage without use of contrast agents in CT and get an equivalent information by ultrasound. Importance of the Conclusions: Combination of different methods, using RVS technology, raises the level of objectivity of ultrasound to a new level, while ultrasound does not lose its main advantages.
TL.13.017 Broadband Attenuation and Size Measurements of Ultrasound Contrast Agents J. L. Raymond,1 K. J. Haworth,1 K. B. Bader,1 K. Radhakrishnan,1 S.-L. Huang,2 D. D. Mcpherson,2 C. K. Holland1 1 University of Cincinnati, Cincinnati, Ohio, USA, 2University of Texas Health Science Center At Houston, Houston, Texas, USA Brief Description of the Purpose of the Study: Echogenic liposomes (ELIP) are under development as an ultrasound contrast agent (UCA) for image-guided, targeted drug delivery. The aim of this study was to investigate the effect of the lipid formulation and type of encapsulated gas on the acoustic response of ELIP under physiologic conditions. The
Abstracts influence of temperature and diluent on the measured attenuation coefficients was investigated for ELIP as well as the commercial lipid-based UCA Definity. Methods: Broadband attenuation spectra were obtained for agents diluted either in whole blood or in saline solution containing 0.5% bovine serum albumin (BSA) at 25 C and 37 C. The spectra and particle size distributions obtained using a Coulter counter were compared with scattering theory to estimate the properties of the lipid shell stabilizing the microbubbles. Main Results: Dilution of ELIP or Definity in either whole blood or BSA solution did not affect the measured attenuation coefficients. However, the temperature and gas saturation of the diluent were found to impact the attenuation spectra significantly. Importance of the Conclusions: The attenuation spectra of UCAs are strongly impacted by temperature and gas saturation relative to physiologic values. Knowledge of the acoustic properties and size distribution of these agents under physiologic conditions will allow for their safe use in vivo.
14 - Ultrasound in Pediatrics TL.14.002 Renal Parenchymal Thickness as a Measure of Renal Growth in Low-Birth-Weight Infants Versus Normal Birth Weight Infants S. Brennan The Townsville Hospital, Townsville, Queensland, Australia Brief Description of the Purpose of the Study: Low birth weight (LBW; , 2500 g) infants have smaller kidneys, and therefore a reduced number of glomeruli and nephrons. Renal ultrasound remains the primary technique for assessing renal growth. We carried out a study to see if a new measurement, renal parenchymal thickness, can be used to detect any differences in renal growth between LBW and normal birth weight (NBW; 2500-4500 g) infants. Methods: This study was conducted over a 12-month period from August 2010 at The Townsville Hospital. Renal ultrasounds were performed on 38 full-term infants who had no underlying renal problems. Renal parenchymal thickness, length, transverse diameter and anteroposterior diameter were measured. Main Results: Thirty-eight infants were evaluated (11 LBW and 27 NBW). The mean kidney volume and mean renal parenchymal thickness in LBW infants are significantly lower than they are in NBW infants. Renal parenchymal thickness is found to be closely correlated with an increase in renal volume (r 5 0.76; p , 0.0001). Importance of the Conclusions: The mean renal parenchymal thickness in LBW infants is significantly lower than it is in NBW infants. Renal parenchymal thickness is a single, easily performed measurement that could potentially be a more useful and accurate approach to monitoring renal growth than renal volume.
15 - Ultrasound in Small Parts TL.15.001 Trans-Orbital Sonographic Measurement of Normal Optic Nerve Diameter at Aminu Kano Teaching Hospital, Kano, Nigeria A. Ismail Bayero University, Kano, Nigeria Brief Description of the Purpose of the Study: This study is aimed at determining the optic nerve diameter (OND) by ocular ultrasonography in normal Nigerian adults.
S93
Methods: This prospective study was conducted at Aminu Kano Teaching Hospital. The OND was measured at 3 mm posterior to the globe using a 7.5 MHz linear transducer on the closed eyelids of 400 healthy adults in supine position. Three repeated measurements were obtained on each optic nerve to reduce intra-observer variability. Main Results: The study subjects consisted of 192 males and 208 females. Their mean age was 36.94 6 16.63 years. The mean OND were 4.18 + 0.49 mm and 4.17 + 0.44 mm on the respective right and left sides. The mean OND of the right and left were 4.18 mm and 4.16 mm among males and 4.17 mm on each optic nerve among females. There was no statistically significant variation in OND between the right and left sides (p 5 0.12) and also between males and females (p 5 0.296 and 0.745 for the respective right and left OND). Importance of the Conclusions: In this study, transorbital sonographic measurements of the OND show no correlation with side (right and left), age and sex. The normogram of OND measurements is therefore presented as diagnostic aid in clinical settings.
TL.15.002 Ultrasound Technologies of Qualitative and Quantitative Stiffness Evaluation in Diagnosis of Thyroid Malignancies A. N. Sencha, Y. N. Patrunov, M. S. Mogutov, E. D. Sergeeva Yaroslavl Railway Clinic, Yaroslavl, Russian Federation Brief Description of the Purpose of the Study: To assess the value of ultrasound elastography and acoustic radiation force impulse (ARFI) technologies in diagnosis of thyroid carcinoma. Methods: Retrospective analysis of complex ultrasound examinations of 141 patients from 19 to 85 years of age operated for highly differentiated thyroid cancer (papillary - 75.2% and follicular - 24.8%) was performed with ultrasound scanner Siemens ‘‘Acuson S2000’’. Qualitative (elastography) and numeric parameters (ARFI) of the stiffness of thyroid carcinoma along with conventional ultrasound features were analyzed. Main Results: Malignant nodules demonstrated hard (blue) color pattern with elastography in 81.6% of cases and mixed (blue-greenred) pattern in 6.4%. The pattern was heterogeneous and irregular in 68.8% of lesions. Elastography failed to differentiate 12.8% of lesions, all smaller than 1 cm. Elastography supplied additional data to conventional ultrasound in 37.5% of cases. Its sensitivity in diagnosis of thyroid carcinoma was 87.5% with specificity of 75.0%. ARFI revealed the increased average share wave velocity within malignant thyroid lesions (3.7m/s; 2.9-4.3m/s), as compared with normal thyroid parenchyma (2.8m/s; 1.7-3.5m/s). The sensitivity of ARFI in diagnosis of thyroid carcinoma was 86.1% with specificity of 82.1%. Importance of the Conclusions: Malignant thyroid lesions often exhibit high grades of tissue strain with elastography and high share wave velocity with ARFI.
TL.15.005 TIRADS: An Effective Proposal for Classification and Stratification of Risk in Thyroid Nodules M. J. Francisco Neto, R. G. Garcia, A. Rahal Jr., J. P. B. Costa Lima, A. Maurano, F. A. C. Vieira, D. R. Nery, M. G. B. Funari Hospital Israelita Albert Einstein, S~ao Paulo, S~ao Paulo, Brasil Brief Description of the Purpose of the Study: Thyroid nodules are common sonographic findings, occurring in up to 70% of patients. In the literature, there is no consensus on standardizing sonographic nodule features to predict their malignancy risk. For this purpose, the TIRADS