SonoVue® vs. Sonazoid™ vs. Optison™: Which Bubble Is Best for Low-Intensity Sonoporation of Pancreatic Ductal Adenocarcinoma?

The use of ultrasound and microbubbles to enhance therapeutic efficacy (sonoporation) has shown great promise in cancer therapy from in vitro to ongoing clinical studies. The fastest bench-to-bedside translation involves the use of ultrasound contrast agents (microbubbles) and clinical diagnostic scanners. Despite substantial research in this field, it is currently not known which of these microbubbles result in the greatest enhancement of therapy within the applied conditions. Three microbubble formulations—SonoVue®, Sonazoid™, and Optison™—were physiochemically and acoustically characterized. The microbubble response to the ultrasound pulses used in vivo was simulated via a Rayleigh–Plesset type equation. The three formulations were compared in vitro for permeabilization efficacy in three different pancreatic cancer cell lines, and in vivo, using an orthotopic pancreatic cancer (PDAC) murine model. The mice were treated using one of the three formulations exposed to ultrasound from a GE Logiq E9 and C1-5 ultrasound transducer. Characterisation of the microbubbles showed a rapid degradation in concentration, shape, and/or size for both SonoVue® and Optison™ within 30 min of reconstitution/opening. Sonazoid™ showed no degradation after 1 h. Attenuation measurements indicated that SonoVue® was the softest bubble followed by Sonazoid™ then Optison™. Sonazoid™ emitted nonlinear ultrasound at the lowest MIs followed by Optison™, then SonoVue®. Simulations indicated that SonoVue® would be the most effective bubble using the evaluated ultrasound conditions. This was verified in the pre-clinical PDAC model demonstrated by improved survival and largest tumor growth inhibition. In vitro results indicated that the best microbubble formulation depends on the ultrasound parameters and concentration used, with SonoVue® being best at lower intensities and Sonazoid™ at higher intensities.

Effect of Manufacturing and Absorption Promotion of Lidocaine Hydrogel Using Ultrasonic Waves during Cosmetic Procedures

Purpose: In this study, we study to more effectively use anesthesia products used in beauty procedures following the popularization of anti-aging. Hydrogel, which contains lidocaine, is believed to be more effective in relieving pain if used in cosmetic procedures with ultrasonic waves.Methods: The availability of manufactured hydrogels and commercial gels for ultrasonic treatment was compared, and the effect on skin penetration and skin penetration due to ultrasonic limitations was evaluated based on their applicability. Usability and optimal ultrasound parameters were identified during ultrasound treatment.Results: Viscosity measurement, gelation rate, swelling, skin permeability experiment, and HPLC analysis of manufactured hydrogels all revealed properties, with skin permeability being highest at frequency 1 MHz, cycle low 200, and high 50.Conclusions: Finally, hydrogels containing lidocaine increased skin permeability during ultrasound treatment, allowing for faster targeted transdermal transmission that was more effective depending on the ultrasound parameters. As a result, it is determined that it can be used in cosmetic procedures.

Diagnostic Value of Prenatal Ultrasound Parameters and Esophageal Signs in Pouch and Lower Thoracic Segment in Fetuses with Esophageal Atresia

In order to investigate the diagnostic value of prenatal ultrasound parameters and signs of pouch and lower thoracic esophagus in the fetus with esophageal atresia (EA), the prenatal ultrasound data of 35 EA fetuses (observation group) confirmed by autopsy after induced labor or postnatal surgery and imaging examination in our hospital from May 2019 to May 2021 were retrospectively analyzed and compared with 35 normal postnatal fetuses (control group). General information and prenatal ultrasound parameters of the two groups, including head circumference (HC), abdominal circumference (AC), double parietal diameter (BPD), fetal body weight (EFW), and signs (small or unmanifested gastric vesicles, amniotic fluid, neck or upper chest pouch, lower chest esophagus not visible), were analyzed using logistic regression. The logistic multifactor regression model for EA diagnosis was established, and the diagnostic value for EA was analyzed. As a result, the HC, AC, and EFW of the observation group were lower than those of the control group, the gastric bubbles were small or not displayed, the amniotic fluid was more, and the signs of neck or upper chest pouch and lower chest esophagus were not visible in the observation group ( P < 0.05 ). Logistic regression analysis showed that decreased ultrasound parameters HC, AC, EFW, small or no gastric bubble, amniotic fluid, neck or upper chest pouch, and no visible signs of lower chest esophagus were all risk factors for EA ( P < 0.05 ). And in the prenatal ultrasound diagnostic model of EA was established, logistic P = − 19.851 + HC × 0.384 + AC × 0.682 + EFW × 0.695 + small or no gastric vesicle × 3.747 + amniotic fluid × 3.607 + cervical or upper chest sac × 4.104 + invisible lower thoracic esophagus × 4.623 .When logistic P > 0.468 , AUC was 0.891, χ 2 was 7.764, diagnostic sensitivity was 91.24%, and specificity was 79.22%. To draw a conclusion, prenatal ultrasound parameters and signs are of great value in the diagnosis of EA. Independent influencing factors of EA include small or no HC, AC, EFW and gastric vesicles, polyhydramnios, neck or upper chest pouch, and invisible lower thoracic esophagus. Logistic multifactor regression model has a high coincidence rate for the prenatal diagnosis of EA, providing a basis for clinical decision-making.

Effective drug release from safe ultrasound-triggered nanocarriers

Selective delivery of medication into specified tissue targets would realize the promise ofpersonalized medicine with minimal side effects. Such an approach could be particularlytransformative for patients with brain disorders, in whom drugs could be released in the impairedbrain circuits at high concentration while sparing other brain regions and organs. Focusedultrasound provides noninvasive and practical means to release drugs from nanocarriers selectivelyat its target. However, which nanoparticle formulations provide safe and effective release andunder which ultrasound parameters has been unclear. To expedite regulatory approval, wetested release effectiveness from nanocarriers filled with perfluorocarbon cores of relatively highboiling points (up to 142◦C). We confirmed the safety of these nanocarriers in non-humanprimates. Crucially, we found that these safe, high-boiling-point nanocarriers can be used foreffective release so long as they are activated by ultrasound of frequencies lower than thoseused previously (300 kHz). This study informs the formulation and release parameters for safeand effective drug delivery in specific parts of the body or brain regions.

A COMBINED ULTRASOUND AND CLINICAL SCORING MODEL FOR THE PREDICTION OF PERIPARTUM COMPLICATIONS IN PREGNANCIES COMPLICATED BY PLACENTA PREVIA

Introduction: Patients with placenta previa are at an increased risk of uncontrolled hemorrhage. Various clinical and ultrasound parameters can predict the risk of bleeding in these patients. Hence, the objective of our study is to develop a combined ultrasound and clinical scoring model for the prediction of peripartum complications in pregnancies complicated by placenta previa. Methods: Fifty singleton pregnant women with placenta previa who underwent cesarean delivery in our hospital were included in the study. We collected clinical and ultrasound data prospectively, and the score was given to each parameter, and total score correlated with the occurrence of peripartum complications. Clinical parameters included age, parity, history of dilatation and evacuation, previous cesarean delivery, history of placenta previa, antepartum hemorrhage, and ultrasound parameters included type of previa, no. of lacunae in placenta, uteroplacental hypervascularity. The peripartum complications noted were the need for blood transfusion, uterine artery ligation, and cesarean hysterectomy. Results: According to the composite scoring done, uterine artery ligation was needed in more than 50% of patients at a score of 9–10. It increased to 100% as the score increased to ≥11. At a score of ≥12, hysterectomy was needed in around 75% of patients, and 100% of patients needed a blood transfusion. Univariate analysis using the Pearson Chi-square test was also done to know whether individual parameters and peripartum complications were significantly related that is p<0.05 with one another. Conclusion: The scoring system may serve to predict peripartum complications in pregnancies complicated by placenta previa.

Peri-operative diaphragm ultrasound as a new method of recognizing post-operative residual curarization

Background This study sought to evaluate the diagnostic accuracy of peri-operative diaphragm ultrasound in assessing post-operative residual curarization (PORC). Methods Patients undergoing non-thoracic and non-abdominal surgery under general anaesthesia were enrolled from July 2019 to October 2019 at Peking Union Medical College Hospital. A train-of-four ratio (TOFr) lower than 0.9 was considered as the gold standard for PORC. Diaphragm ultrasound parameters included diaphragmatic excursion (DE) and diaphragm thickening fraction (DTF) during quiet breathing (QB) and deep breathing (DB). The diaphragm excursion fraction (DEF) was calculated as the DE-QB divided by the DE-DB. The diaphragm excursion difference (DED) was defined as DE-DB minus DE-QB. Receiver operating characteristic curve analysis was used to determine the cut-off values of ultrasound parameters for the prediction of PORC. Results In total, 75 patients were included, with a PORC incidence of 54.6%. The DE-DB and DED were positively correlated with the TOFr, while the DEF was negatively correlated with the TOFr. The DE-DB cut-off value for predicting PORC was 3.88 cm, with a sensitivity of 85.4% (95% confidence interval [CI]: 70.1–93.9%), specificity of 64.7% (95% CI: 46.4–79.7%), positive likelihood ratio of 2.42 (95% CI 1.5–3.9), and negative likelihood ratio of 0.23 (95% CI: 0.1–0.5). The DED cut-off value was 1.5 cm, with a specificity of 94.2% (95% CI: 80.3–99.3%), sensitivity of 63.4% (95% CI: 46.9–77.9%), positive likelihood ratio of 10.78 (95% CI: 2.8–42.2), and negative likelihood ratio of 0.39 (95% CI: 0.3–0.6). Conclusions Peri-operative diaphragm ultrasound may be an additional method aiding the recognition of PORC, with DED having high specificity.