ICUS Weekly News Monitor 8-18-17

ICUS

CEUS: Basic Training for Novices 

Hosts:

Stephanie Wilson, MD – ICUS Co-President and Basic Training Education Chair; University of Calgary

Andrej Lyshchik, MD, PhD – ICUS Member; Thomas Jefferson University Hospital

Event information:

September 9, 2017 Hotel Sofitel Philadelphia

8am to 4.30pm; 120 S. 17th Street Philadelphia, PA | Map

Program Description:

Expert lectures, case demonstrations and hands-on instruction for CEUS novices. Sessions will provide practical skills needed to implement a successful CEUS program – including how to determine optimal settings, inject contrast agents, and correctly interpret CEUS images.

Topics:

CEUS: What, why and when?

Microbubble Contrast Agents: Safety, uses, cost effectiveness and handling.

Introduction to CEUS: Liver, kidney, other organ systems.

Getting started: From set-up to optimizing performance.

Case demonstrations: Featuring equipment of each sponsor.

Knobology: Break out rooms with personalized opportunities to "touch and feel" all of the featured ultrasound systems and contrast agents, examine settings, etc.

Who Should Attend:

Physicians, technologists, sonographers, trainees and other allied health care professionals

Registration:

$125 (Includes breakfast and lunch)

To register, visit:  https://www.regonline.com/ceusbasictrainingfornovices

Accommodations: Hotel Sofitel – (215) 569-8300; ask for ICUS Event discount rate $239/night

Book by Aug 25 to get special rate!

Conference Secretariat:   This email address is being protected from spambots. You need JavaScript enabled to view it.

 

About ICUS:

ICUS is the only international professional society that exclusively focuses on advancing the safe and appropriate use of CEUS to improve patient care. ICUS membership is free; to join, simply visitwww.ICUS-SOCIETY.org. ICUS Basic Training is supported by our generous sponsors.

 

Meeting Program

8:00 AM – 8:05 AM. Opening Remarks.

Andrej Lyshchik, MD, PhD (TJUH)

8:05 AM – 8:35 AM. Microbubble contrast agents and their Imaging Techniques.

Andrej Lyshchik, MD, PhD (TJUH)

8:35 AM – 9:15 AM. Tips of the Trade: How to do excellent CEUS examinations.

Stephanie Wilson, MD (University of Calgary)

9:15 AM – 10:00 AM. CEUS of the Liver.

Stephanie Wilson, MD (University of Calgary)

10:00 AM – 10:15 AM. Liver Imaging Reporting and Data System (LI-RADS).

Yuko Kono, MD, PhD (UCSD)

10:15 AM – 10:45 AM. Break.

10:45 AM – 11:00 AM. Clinical integration of CEUS in liver patient management.

Yuko Kono, MD, PhD (UCSD)

11:00 AM – 11:30 AM. CEUS of the Kidneys.

Andrej Lyshchik, MD, PhD (TJUH)

11:30 AM – 12:00 PM. Pediatric applications of CEUS.

Judith Machnitz, MD (CHOP)

12:00 PM – 12:15 PM. Commonly Asked Questions

Yuko Kono, MD, PhD (UCSD)

12:15 PM – 2:00 PM. Lunch / MANUFACTURERS EXIBITS.

Participants have lunch and visit manufacturers in the exhibition room. Manufacturers will demonstrate their equipment used for contrast-enhanced ultrasound. No patient scanning will be permitted.

2:00 PM – 2:30 PM. Surgical, vascular and interventional applications of CEUS.

Andrej Lyshchik, MD, PhD (TJUH)

2:30 PM – 3:00 PM. Questions & Answers.

Faculty

3:00 PM – 4:15 PM. Case-Based Review: our best cases to show the scope of CEUS and to test your skills at basic interpretation.

Stephanie Wilson, MD (University of Calgary), Andrej Lyshchik, MD, PhD (TJUH)

4:15 PM – 4:30 PM. Wrap-Up

Faculty

ICUS Weekly News Monitor 8-11-17

Business Journal News Network

Crouse Health unveils new ultrasound-imaging test to detect liver, kidney cancer

Aug 4, 2017

Author:  Eric Reinhardt

SYRACUSE, N.Y. — Crouse Health has introduced a new imaging test to detect liver and kidney cancers that it says “up until now has only been available in larger markets such as Boston, New York City, and Philadelphia.”

It’s called contrast-enhanced ultrasound (CEUS).

The procedure uses contrast agents called “microbubbles,” Dr. Thomas Green, chief of radiology at Crouse Health, said in a news release.

Green recently took special training in CEUS at Thomas Jefferson University in Philadelphia, Crouse Health said.

The microbubbles are “dramatically improving” the precision of diagnostic sonograms and expanding the clinical scope of a widely used, imaging modality.

Once injected in the patient’s arm, the microbubbles go directly to the suspected area of the liver or kidney, improving visualization of blood flow, the cardiovascular system and the movement of blood into vital organs, particularly the liver and kidney.

“Liver and renal lesions are very common,” Green said. “Differentiating benign from malignant can be difficult and expensive. Traditionally, this has been done with enhanced CT scanning, enhanced MRI or sometimes nuclear medicine.”

CEUS has advantages over all three methods, according to Green.

For example, CEUS doesn’t involve radiation, as CT and nuclear medicine do. It also doesn’t generate concerns about renal function or iodine contrast allergy.

It also doesn’t result in “issues” with metallic implants, internal pacemakers or claustrophobia, as an MRI (magnetic resonance imaging) procedure would produce.

And, according to Green, the test is “significantly less expensive” than other options, which is “important, especially with today’s high-deductible insurance plans.”

Crouse is expecting the number of cases using the new ultrasound-imaging test will increase once providers learn of its availability, Green adds.

 
 
 
 
 
 

Dove Medical Press

Paclitaxel-loaded and A10-3.2 aptamer-targeted poly(lactide-co-glycolic acid) nanobubbles for ultrasound imaging and therapy of prostate cancer

Jul 26, 2017

Authors:   Meng Wu,1,2 Ying Wang,3 Yiru Wang,2 Mingbo Zhang,2 Yukun Luo,2 Jie Tang,2 Zhigang Wang,4 Dong Wang,5 Lan Hao,4 Zhibiao Wang6

1School of Medicine, Nankai University, Tianjin, 2Department of Ultrasound, Chinese PLA General Hospital, Beijing, 3Wuhan Textile University, Wuhan, 4Chongqing Key Laboratory of Ultrasound Molecular Imaging, The Second Affiliated Hospital of Chongqing Medical University, 5Department of Ultrasound, The First Affiliated Hospital of Chongqing Medical University, 6College of Biomedical Engineering, Chongqing Medical University, Chongqing, People’s Republic of China

Published 26 July 2017 Volume 2017:12 Pages 5313—5330

  1.  https://doi.org/10.2147/IJN.S136032

Abstract:

In the current study, we synthesized prostate cancer-targeting poly(lactide-co-glycolic acid) (PLGA) nanobubbles (NBs) modified using A10-3.2 aptamers targeted to prostate-specific membrane antigen (PSMA) and encapsulated paclitaxel (PTX). We also investigated their impact on ultrasound (US) imaging and therapy of prostate cancer. PTX-A10-3.2-PLGA NBs were developed using water-in-oil-in-water (water/oil/water) double emulsion and carbodiimide chemistry approaches. Fluorescence imaging together with flow cytometry verified that the PTX-A10-3.2-PLGA NBs were successfully fabricated and could specifically bond to PSMA-positive LNCaP cells. We speculated that, in vivo, the PTX-A10-3.2-PLGA NBs would travel for a long time, efficiently aim at prostate cancer cells, and sustainably release the loaded PTX due to the improved permeability together with the retention impact and US-triggered drug delivery. The results demonstrated that the combination of PTX-A10-3.2-PLGA NBs with low-frequency US achieved high drug release, a low 50% inhibition concentration, and significant cell apoptosis in vitro. For mouse prostate tumor xenografts, the use of PTX-A10-3.2-PLGA NBs along with low-frequency US achieved the highest tumor inhibition rate, prolonging the survival of tumor-bearing nude mice without obvious systemic toxicity. Moreover, LNCaP xenografts in mice were utilized to observe modifications in the parameters of PTX-A10-3.2-PLGA and PTX-PLGA NBs in the contrast mode and the allocation of fluorescence-labeled PTX-A10-3.2-PLGA and PTX-PLGA NBs in live small animals and laser confocal scanning microscopy fluorescence imaging. These results demonstrated that PTX-A10-3.2-PLGA NBs showed high gray-scale intensity and aggregation ability and showed a notable signal intensity in contrast mode as well as aggregation ability in fluorescence imaging. In conclusion, we successfully developed an A10-3.2 aptamer and loaded PTX-PLGA multifunctional theranostic agent for the purpose of obtaining US images of prostate cancer and providing low-frequency US-triggered therapy of prostate cancer that was likely to constitute a strategy for both prostate cancer imaging and chemotherapy.

ICUS Weekly News Monitor 7-11-17

Science Daily

Tiny bubbles offer sound solution for drug delivery

Noninvasive approach to drug delivery for next generation brain therapies uses ultrasound and bubbles

June 26, 2017

Source: Acoustical Society of America

Cavitation microstreaming generated by a SonoVue microbubble and marked by fluorescent beads. Under ultrasound exposure, microbubbles can produce streaming flows which may contribute to blood-brain barrier opening and will be investigated directly using our in vitro platform.

Credit: Miles M. Aron, courtesy of BUBBL, University of Oxford, England

Your brain is armored. It lives in a box made of bones with a security system of vessels. These vessels protect the brain and central nervous system from harmful chemicals circulating in the blood. Yet this protection system -- known as the blood-brain barrier -- also prevents delivery of drugs that could help treat patients with brain cancers and brain diseases such as Alzheimer's disease. The heavily guarded brain has long frustrated physicians tending patients in need of brain treatments without surgery.

With recent advances in technology, the blood-brain barrier can now be opened safely, noninvasively and in a targeted manner using ultrasound. One of the newest approaches aiming to advance this research will be presented during Acoustics '17 Boston, the third joint meeting of the Acoustical Society of America and the European Acoustics Association being held June 25-29, in Boston, Massachusetts.

Investigators at the University of Oxford in the United Kingdom, collaborating with colleagues at the University of Twente in the Netherlands, have produced a promising in vitro experimental platform to investigate relationships between the way the blood-brain barrier opens, how long it takes to recover, and the sounds emitted during blood-brain barrier opening. Think of it as a blood-brain barrier on-a-chip using cultured cells rather than animal or human models.

"The key advantage of our system is that it uses three modalities -- involving light, sound, and electrical fields -- to simultaneously monitor acoustic emissions, blood-brain barrier disruption and recovery, and the biological response of blood-brain barrier cells in real-time," said Miles M. Aron at the University of Oxford.

Researchers have tried to open the blood-brain barrier using ultrasound since the 1950s. The breakthrough for safely opening the blood-brain barrier was to use tiny bubbles that interact with the ultrasound field known as "cavitation agents." Several cavitation agents are already approved for enhancing contrast in ultrasound imaging by the U.S. Food and Drug Administration. Cavitation agents work by oscillating rapidly or "singing" when exposed to ultrasound.

"The treatment can be monitored externally by 'listening' to the re-radiated sound from the cavitation agents interacting with the ultrasound field. These acoustic emissions provide information regarding the energy of cavitation within the blood vessels and are already being used to adjust ultrasound parameters in real-time to reduce the likelihood of damaging healthy cells during treatment," Aron said.

The team monitors acoustic emissions and the integrity of the blood-brain barrier in real-time throughout the treatment, an improvement compared to other approaches that generally involve blood-brain barrier assessment only after the treatment is completed, Aron said.

In addition, the team uses fluorescent probes to monitor either changes in the cells during treatment, or mechanical and chemical effects from the cavitation agents as they are exposed to ultrasound in real-time.

"By analyzing multiple sources of data during ultrasound exposure and throughout BBB recovery, we aim to better understand this promising new treatment," Aron said. "With the Oxford Centre for Drug Delivery Devices, OxCD3, we are currently working on a non-invasive method to detect and treat brain metastases before they become deadly. Our in vitro system will play a critical role in the development of this and other next-generation approaches to ultrasound-mediated blood brain barrier opening."

 
 
 
 
 
 

Uro Today

Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. Contrast-Enhanced Ultrasound Differentiation Between Low and High-Grade Bladder Urothelial Carcinoma and Correlation With Tumor Microvessel Density.

May 27, 2017

By Suping Guo, Pan Xu, Aiyun Zhou, Gongxian Wang, Weimin Chen, Jinhong Mei, Fan Xiao, Juan Liu, Cheng Zhang

Department of Ultrasonography, First Affiliated Hospital of Nanchang University, Nanchang, China., Department of Urology Surgery, First Affiliated Hospital of Nanchang University, Nanchang, China., Department of Pathology, First Affiliated Hospital of Nanchang University, Nanchang, China.

  1. PubMed http://www.ncbi.nlm.nih.gov/pubmed/28556470

Time-intensity curves (TICs) of contrast-enhanced ultrasound (CEUS) were analyzed retrospectively to differentiate between low-grade and high-grade bladder urothelial carcinoma, and to investigate correlation with tumor microvessel density (MVD).

The data of 105 patients with pathologically confirmed bladder urothelial carcinoma (55 low-grade and 50 high-grade) were reviewed. Lesions were examined before surgery using conventional ultrasound and CEUS with TIC analysis. The TIC parameters time from peak to one-half the signal intensity (TPH) and the corresponding descending slope (DS) of the low-grade and high-grade groups were compared, and receiver operating characteristic curves constructed. The MVDs of the resectioned tissue specimens were quantified via immunohistochemistry for CD34.

Based on conventional ultrasound, the low-grade and high-grade groups were similar in tumor shape, number, topography, internal echo, height, width, and vascularity. The TPH of the high-grade group was significantly longer than that of the low-grade group, and the DS was lower. The cutoff points of TPH and DS for differentiating low-grade and high-grade bladder urothelial carcinoma were 48.06 seconds and 0.15 dB/seconds, respectively (area under the receiver operating characteristic curve = 0.79 for both). The mean MVDs per high-power field of the low-grade and high-grade groups were 41.39 16.65 and 51.03 20.16, respectively (P = .009). The TPH correlated linearly with MVD (P < .01), as did the DS (P < .01).

Contrast-enhanced ultrasound can be used to differentiate low from high-grade bladder urothelial carcinoma. The TIC parameters of CEUS reflect the MVD of bladder urothelial tumors and may be helpful for evaluating tumor angiogenesis, with implications for clinical diagnosis, treatment, and prognosis.

ICUS Sponsors

ICUS gratefully acknowledges its 2017 sponsors:

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Contact ICUS

  • Address: 1900 K Street, N.W.
    Washington, DC 20006-1102, USA
  • Telephone: 202-408-6199

About ICUS

ICUS is the world’s only professional society exclusively devoted to contrast-enhanced ultrasound (CEUS) medical imaging technology.

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