Contrast-enhanced ultrasound for the assessment of placental development and function

The use of contrast agents as signal enhancers during ultrasound improves visualization and the diagnostic utility of this technology in medical imaging. Although widely used in many disciplines, contrast ultrasound is not routinely implemented in obstetrics, largely due to safety concerns of administered agents for pregnant women and the limited number of studies that address this issue. Here the microbubble characteristics that make them beneficial for enhancement of the blood pool and the quantification of real-time imaging are reviewed. Literature from pregnant animal model studies and safety assessments are detailed, and the potential for contrast-enhanced ultrasound to provide clinically relevant data and benefit our understanding of early placental development and detection of placental dysfunction is discussed.

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Contrast-Enhanced Ultrasound (CEUS) for the Evaluation of Bosniak III Complex Renal Cystic Lesions—A 10-Year Specialized European Single-Center Experience with Histopathological Validation

Medicina ◽

10.3390/medicina56120692 ◽

2020 ◽

Vol 56 (12) ◽

pp. 692

Author(s):

Vincent Schwarze ◽

Johannes Rübenthaler ◽

Saša Čečatka ◽

Constantin Marschner ◽

Matthias Frank Froelich ◽

...

Keyword(s):

Imaging Modality ◽

Color Doppler ◽

Blood Pool ◽

Histopathological Analysis ◽

Cystic Lesions ◽

Contrast Enhanced Ultrasound ◽

Single Center ◽

Renal Lesions ◽

Experienced Radiologist ◽

Contrast Enhanced

Background and objectives: The aim of the present retrospective single-center study is to evaluate the diagnostic performance of contrast-enhanced ultrasound (CEUS) for assessing Bosniak III complex renal cystic lesions with histopathological validation. Materials and Methods: 49 patients with CEUS-categorized Bosniak III renal cystic lesions were included in this retrospective study. All patients underwent native B-mode, Color Doppler, contrast-enhanced ultrasound (CEUS) between 2010–2020. Eight and five patients underwent computed tomography (CT) and magnetic resonance imaging (MRI), respectively. Twenty-nine underwent (partial) nephrectomy allowing for histopathological analysis. The applied contrast agent for CEUS was a second-generation blood pool agent. Ultrasonography examinations were performed and interpreted by a single experienced radiologist with more than 15 years of experience (EFSUMB Level 3). Results: CEUS examinations were successfully performed in all included patients without registering any adverse effects. The malignancy rate of CEUS-categorized Bosniak III renal lesions accounted for 66%. Initially, cystic complexity was visualized in native B-mode. In none of the renal lesions hypervascularization was detected in Color Doppler. CEUS allowed for detection of contrast enhancement patterns in all included Bosniak III renal lesions. Delayed wash-out could be detected in 6/29 renal lesions. In two cases of histopathologically confirmed clear-cell RCC, appropriate up-grading from Bosniak IIF to III was achieved by CEUS. Conclusions: CEUS depicts a promising imaging modality for the precise diagnostic workup and stratification of renal cystic lesions according to the Bosniak classification system, thereby helping guidance of adequate clinical management in the future.

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Vascular recruitment in skeletal muscle during exercise and hyperinsulinemia assessed by contrast ultrasound

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00373.2001 ◽

2002 ◽

Vol 282 (3) ◽

pp. E714-E720 ◽

Cited By ~ 96

Author(s):

Dana Dawson ◽

Michelle A. Vincent ◽

Eugene J. Barrett ◽

Sanjiv Kaul ◽

Andrew Clark ◽

...

Keyword(s):

Skeletal Muscle ◽

Blood Flow ◽

Femoral Artery ◽

Artery Blood Flow ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced ◽

Adductor Muscles ◽

Femoral Artery Blood Flow ◽

Contrast Ultrasound

The purpose of this study was to noninvasively quantify the effects of insulin on capillary blood volume (capBV) and RBC velocity ( V RBC) in skeletal muscle in vivo with the use of contrast-enhanced ultrasound. We performed contrast ultrasound of the rat hindlimb adductor muscles at baseline and after 2-h infusions of either insulin (3 or 40 mU · kg−1 · min−1) or saline. Saline-treated animals were also studied during contractile exercise. V RBC and capBV were calculated from the relation between pulsing interval and video intensity. Femoral artery blood flow, measured by a flow probe, increased with both contractile exercise and insulin. Contractile exercise increased capBV more than twofold and V RBC fivefold. Insulin also increased capBV more than twofold in a dose-dependent fashion but did not significantly alter V RBC. Saline infusion did not significantly alter capBV, V RBC, or femoral artery blood flow. We conclude that physiological changes in skeletal muscle capillary perfusion can be assessed in vivo with the use of contrast-enhanced ultrasound. Exercise increases both V RBC and capBV, whereas hyperinsulinemia selectively increases only capBV, which may enhance skeletal muscle glucose uptake.

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Angiogenesis in the Placenta: The Role of Reactive Oxygen Species Signaling

BioMed Research International ◽

10.1155/2015/814543 ◽

2015 ◽

Vol 2015 ◽

pp. 1-12 ◽

Cited By ~ 63

Author(s):

Robyn D. Pereira ◽

Nicole E. De Long ◽

Ruijun C. Wang ◽

Fereshteh T. Yazdi ◽

Alison C. Holloway ◽

...

Keyword(s):

Oxidative Stress ◽

Transcription Factors ◽

Maternal Obesity ◽

Placental Development ◽

Placental Dysfunction ◽

Placental Angiogenesis ◽

Healthy Pregnancy ◽

Adverse Pregnancy ◽

And Function ◽

Reactive Oxygen Species Signaling

Proper placental development and function are central to the health of both the mother and the fetus during pregnancy. A critical component of healthy placental function is the proper development of its vascular network. Poor vascularization of the placenta can lead to fetal growth restriction, preeclampsia, and in some cases fetal death. Therefore, understanding the mechanisms by which uterine stressors influence the development of the placental vasculature and contribute to placental dysfunction is of central importance to ensuring a healthy pregnancy. In this review we discuss how oxidative stress observed in maternal smoking, maternal obesity, and preeclampsia has been associated with aberrant angiogenesis and placental dysfunction resulting in adverse pregnancy outcomes. We also highlight that oxidative stress can influence the expression of a number of transcription factors important in mediating angiogenesis. Therefore, understanding how oxidative stress affects redox-sensitive transcription factors within the placenta may elucidate potential therapeutic targets for correcting abnormal placental angiogenesis and function.

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The potential role of the ERRγ pathway in placental dysfunction

Reproduction ◽

10.1530/rep-20-0272 ◽

2020 ◽

Author(s):

Zhiyong Zou ◽

Karen Forbes ◽

Lynda K. Harris ◽

Alexander E P Heazell

Keyword(s):

Fetal Growth ◽

Therapeutic Interventions ◽

Placental Development ◽

Human Trophoblast ◽

Altered Expression ◽

Placental Dysfunction ◽

And Function ◽

Upstream Regulators ◽

Estrogen Related Receptor

Normal placental development and function is of key importance to fetal growth. Conversely aberrations of placental structure and function are evident in pregnancy complications including fetal growth restriction (FGR) and preeclampsia. Although trophoblast turnover and function is altered in these conditions, their underlying aetiologies and pathophysiology remains unclear, which hampers development of therapeutic interventions. Here we review evidence that supports a role for Estrogen Related Receptor-gamma (ERRγ) in the development of placental dysfunction in FGR and preeclampsia. This relationship deserves particular consideration because ERRγ is highly expressed in normal placenta, is reduced in FGR and preeclampsia and its expression is altered by hypoxia, which is thought to result from deficient placentation seen in FGR and preeclampsia. Several studies have also found microRNA or other potential upstream regulators of ERRγ negatively influence trophoblast function which could contribute to placental dysfunction seen in FGR and preeclampsia. Interestingly, microRNAs regulate ERRγ expression in human trophoblast. Thus, if ERRγ is pivotally associated with the abnormal trophoblast turnover and function it may be targeted by microRNAs or other possible upstream regulators in the placenta. This review explores altered expression of ERRγ and upstream regulation of ERRγ-mediated pathways resulting in the trophoblast turnover, placental vascularisation, and placental metabolism underlying placental dysfunctions. This demonstrates that the ERRγ pathway merits further investigation as a potential therapeutic target in FGR and preeclampsia.

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Safety of contrast-enhanced ultrasound in children for non-cardiac applications: a review by the Society for Pediatric Radiology (SPR) and the International Contrast Ultrasound Society (ICUS)

Pediatric Radiology ◽

10.1007/s00247-013-2746-6 ◽

2013 ◽

Vol 43 (9) ◽

pp. 1063-1073 ◽

Cited By ~ 71

Author(s):

Kassa Darge ◽

Frederica Papadopoulou ◽

Aikaterini Ntoulia ◽

Dorothy I. Bulas ◽

Brian D. Coley ◽

...

Keyword(s):

Pediatric Radiology ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced ◽

Contrast Ultrasound

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The Correlation between Targeted Contrast-Enhanced Ultrasound Imaging and Tumor Neovascularization of Ovarian Cancer Xenografts in Nude Mice

Journal of Healthcare Engineering ◽

10.1155/2021/5553649 ◽

2021 ◽

Vol 2021 ◽

pp. 1-13

Author(s):

Rong Hu ◽

Qianqian Zeng ◽

Xiaoling Su ◽

Wenxia Feng ◽

Hong Xiang

Keyword(s):

Ovarian Cancer ◽

Ultrasound Imaging ◽

Nude Mice ◽

Growth Time ◽

Contrast Enhanced Ultrasound ◽

Time To Peak ◽

Imaging Parameters ◽

Contrast Enhanced ◽

Tumor Neovascularization ◽

Contrast Ultrasound

In order to explore the correlation between targeted contrast-enhanced ultrasound imaging and tumor neovascularization of ovarian cancer xenografts in nude mice, a total of 49 nude mice were selected and randomly divided into 1-week group, 2-week group, 3-week group, 4-week group, 5-week group, 6-week group, and 7-week group according to their ovarian cancer xenografts’ growth time, with 7 ovarian cancer xenografts in each group. After preparing antibody-carrying targeted contrast agent, each group of xenografts performed normal and targeted contrast ultrasound examinations to obtain peak intensity, time to peak, and other imaging parameters; then, those ovarian cancer xenografts were sacrificed for pathological analysis: the neovascular density and antibody expression of the cancer xenografts at different stages were observed and counted, and the correlation between targeted contrast-enhanced ultrasound parameters and tumor neovascular densities of the ovarian cancer xenografts was analyzed. The results show that the peak intensities of targeted contrast ultrasound imaging are greater than that of ordinary ultrasound imaging in the 2-, 3-, 4-, and 5-week groups with statistically significant differences ( P < 0.05 ); the time to peak of targeted contrast ultrasound imaging is shorter than that of ordinary ultrasound imaging in the 2-, 3-, 4-, and 5-week groups with statistically significant differences ( P < 0.05 ); there is a positive correlation between the peak intensities of targeted contrast ultrasound imaging and tumor neovascular densities of the ovarian cancer xenografts in the 2-, 3-, and 4-week group (r2 = 0.645, r3 = 0.668, and r4 = 0.693, P < 0.05 ); there is a negative correlation between the time to peak of targeted contrast ultrasound imaging and tumor neovascular densities of the ovarian cancer xenografts in the 2-, 3-, and 4-week groups (r2 = −0.669, r3 = −0.692, and r4 = −0.704, P < 0.05 ). Therefore, the targeted contrast-enhanced ultrasound imaging parameters have a certain correlation with tumor neovascular density of ovarian cancer xenografts in nude mice and this correlation is more significant in the early stage of ovarian cancer; hence, targeted contrast-enhanced ultrasound imaging may provide a new method, new idea, and new basis for the diagnosis of early ovarian cancer.

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The 34th Annual Advances in Contrast Ultrasound International Bubble Conference, Chicago 2019: synopsis and take-home messages

Echo Research and Practice ◽

10.1530/erp-19-0055 ◽

2020 ◽

Vol 7 (1) ◽

pp. M1-M5

Author(s):

Stella Kyung ◽

Alan Goldberg ◽

Steven Feinstein ◽

Stephanie Wilson ◽

Sharon Mulvagh ◽

...

Keyword(s):

Clinical Trials ◽

Clinical Applications ◽

Expert Group ◽

Contrast Enhanced Ultrasound ◽

Government Officials ◽

Appropriate Use ◽

Contrast Enhanced ◽

New Directions ◽

Contrast Ultrasound ◽

Ultrasound Enhancement

The 34th annual Advances in Contrast Ultrasound (ACU) International Bubble Conference convened in Chicago, IL, USA, on September 5–6, 2019 to feature new directions of research, preclinical and first-in-man clinical trials, and novel clinical applications highlighting the diversity and utility of contrast enhanced ultrasound (CEUS). An expert group comprising clinicians, engineers, basic scientists, government officials, attorneys, and industry partners convened to collaborate on cutting-edge ultrasound enhancement technology. Utilizing this information, the International Contrast Ultrasound Society (ICUS) continues to have cause to advocate for the safe and appropriate use of CEUS with expanding indications and applications.

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