Acoustic characterization of a new trisacryl contrast agent. Part I: In vitro study

The objective of the study was to acoustically characterize trisacryl polymeric microparticles (TMP), which are derived from biocompatible embolic agents.With significant acoustic properties, these polymeric particles could be potentially used as targeted ultrasound contrast agents, directed towards a specific site, with ligands conjugation on the polymeric network surface. In the in vitro study, a pulser/receiver (PRF of 1 kHz), associated to different transducers (5, 10 and 15 MHz), was used to measure the acoustic properties of the TMP inserted in a Couette flow device. Acoustic characterization according to TMP concentration (0.12-15.63 mg/ml), frequency (4.5-17 MHz, defined by each transducer bandwidth), ultrasound pressure (137-378 kPa) and exposure time (0-30 min) was conducted. Particle attenuation was also evaluated according to TMP concentration and emission frequency. Backscattering increased non linearly with concentration and maximum enhancement was of 16.4 dB ± 0.89 dB above 7.8 mg/ml. This parameter was found non-linear with increasing applied pressure and no harmonic oscillation could be noticed. Attenuation reached approximately 1.4 dB/cm at 15 MHz and for the 15.6 mg/ml suspension.The TMP have revealed in vitro ultrasound properties comparable to those observed with known contrast agents, studied in similar in vitro systems. However, such set-ups combined with a rather aqueous suspending medium, have some limitations and further investigations need now to be conducted to approach in vivo conditions in terms of flow and blood environment.     

Subharmonic imaging of contrast agents

Ultrasound contrast agents promise to improve the sensitivity and specificity of diagnostic ultrasound imaging. It is of great importance to adapt ultrasound equipment for optimal use with contrast agents e.g., by exploiting the nonlinear properties of the contrast microbubbles. Harmonic imaging is one technique that has been extensively studied and is commercially available. However, harmonic imaging is associated with problems, due to second harmonic generation and accumulation within the tissue itself. Given the lack of subharmonic generation in tissue, one alternative is the creation of subharmonic images by transmitting at the fundamental frequency (fo) and receiving at the subharmonic (fo/2). Subharmonic imaging should have a much better lateral resolution and may be suitable for scanning deep-lying structures owing to the higher transmit frequency and the much smaller attenuation of scattered subharmonic signals. In this paper, we will review different aspects of subharmonic imaging including implementation, in-vitro gray-scale imaging and subharmonic aided pressure estimation.     

Feasibility of using ultrasound contrast agents to increase the size of thermal lesions induced by non-focused transducers: in vitro demonstration in tissue mimicking phantom

Miniature flat ultrasound transducers have shown to be effective for a large variety of thermal therapies, but the associated superficial heating implicates developing original strategies in order to extend therapeutic depth. The goal of the present paper is to use ultrasound contrast agents (UCA) to increase remote attenuation and heating. Theoretical simulations demonstrated that increasing attenuation from 0.27 to 0.8 Np/cm at 10 MHz beyond a distance of 18 mm from the transducer should result in longer thermal damages due to protein coagulation in a tissue mimicking phantom. Contrast agents (BR14, Bracco, Plan-les-Ouates, Switzerland) were embedded in thermo-sensitive gel and attenuations ranging from 0.27 to 1.33 Np/cm were measured at 10 MHz for concentrations of BR14 between 0 and 4.8%. Thermal damages were then induced in several gels, which had different layering configurations. Thermal damages, 12.8 mm in length, were obtained in homogeneous gels. When mixing contrast agents at a concentration of 3.2% beyond a first 18 mm-thick layer of homogeneous gel, the thermal damages reached 21.5 mm in length. This work demonstrated that contrast agents can be used for increasing attenuation remotely and extending therapeutic depth induced by a non-focused transducer. Additional work must be done in vivo in order to verify the remote-only distribution of bubbles and associated increase in attenuation.     

Formulation and characterisation of drug-loaded antibubbles for image-guided and ultrasound-triggered drug delivery

The aim of this study was to develop high load-capacity antibubbles that can be visualized using diagnostic ultrasound and the encapsulated drug can be released and delivered using clinically translatable ultrasound.The antibubbles were developed by optimising a silica nanoparticle stabilised double emulsion template.We produced an emulsion with a mean size diameter of 4.23 ± 1.63 µm where 38.9 ± 3.1% of the droplets contained a one or more cores. Following conversion to antibubbles, the mean size decreased to 2.96 ± 1.94 µm where 99% of antibubbles were <10 µm. The antibubbles had a peak attenuation of 4.8 dB/cm at 3.0 MHz at a concentration of 200 × 10³ particles/mL and showed distinct attenuation spikes at frequencies between 5.5 and 13.5 MHz. No increase in subharmonic response was observed for the antibubbles in contrast to SonoVue®. High-speed imaging revealed that antibubbles can release their cores at MIs of 0.6. In vivo imaging indicated that the antibubbles have a long half-life of 68.49 s vs. 40.02 s for SonoVue®. The antibubbles could be visualised using diagnostic ultrasound and could be disrupted at MIs of ≥0.6. The in vitro drug delivery results showed that antibubbles can significantly improve drug delivery (p < 0.0001) and deliver the drug within the antibubbles. In conclusion antibubbles are a viable concept for ultrasound guided drug delivery.     

Acoustic properties of organic powders as ultrasonic contrast agents

The results of experiments on measuring attenuation and the effective acoustic nonlinear parameter of the second order are given for a suspension of cocoa-powder in water at different concentrations of the suspension. In the process of evaluating the value of the nonlinear parameter the attenuation in the suspension and generation of the second harmonic not only in the suspension but also in water are taken into account. The obtained results are evidence of the possibility of using a suspension of cocoa-powder in water as a technical substitute for ultrasonic contrast agents. The values of attenuation (up to 60 m⁻¹ at the concentration of 1 g of the powder per 1 l of water) and the nonlinear parameter (up to 120 m⁻¹ at the same concentration) mean that the suspension of cocoa-powder in water has smaller attenuation and the nonlinear parameter than ultrasonic contrast agents at the same concentration. However, these values for the suspension differ considerably from corresponding values for water or blood and, therefore, a suspension of cocoa-powder in water is a promising “substitute” for ultrasonic contrast agents in the case of technical testing of systems for nonlinear tomography of a blood flow, but cannot replace them in medical studies.     

有黏条件气泡声散射特性和衰减谱数值研究*

通过研究有黏条件下的气泡散射模型,数值分析水中单气泡声散射特性,进一步结合Beer-Lambert定律将其扩展到多气泡体系的声衰减预测。数值结果表明,随着谐波阶数递增,散射强度分布数值结果趋于稳定且前向散射增强。同时发现,无因次尺寸参量ka=0.1为过渡区与纯散射区的分界线,且在共振区间具有明显的吸收效应。对多气泡体系的声衰减预测也表明,ka 0.1时,该文气泡散射模型声衰减计算与经典ECAH模型结果吻合,在低浓度条件下声衰减谱随着剪切黏度的增加呈增宽趋势,且与体积浓度成正比例递增。模型预测的声衰减随粒径、声波频率、体积浓度分布数值特征能够为颗粒两相体系粒径及浓度表征提供理论依据。     

Improved contrast to tissue ratio at higher harmonics

The challenge in ultrasound contrast imaging is a better discrimination between the perfused tissue and the contrast bubbles, which is usually expressed by contrast to tissue ratio (CTR). Imaging based on the second harmonic frequency showed a higher CTR than imaging at the fundamental frequency. However, because of nonlinear propagation of ultrasound waves, harmonic frequencies are generated. These harmonic frequencies will be linearly reflected by the tissue and therefore limit the CTR at the second harmonic frequency. In order to reduce the scattering of tissue at harmonic frequencies and by that increase the CTR, nonlinear distortion has to be reduced. We demonstrate in this study that the CTR increases with the harmonic number. The increase is substantial when transmitting at lower frequencies. To take advantage of the higher harmonics (third, fourth, fifth and the ultraharmonics and termed here super harmonics), we have developed a new phased array transducer with a wide frequency band. In-vitro measurements using the new probe show an increase of 40 dB of the CTR for super harmonic components over the conventional second harmonic system. The increase in CTR is in agreement with the calculations using existing models for the response of encapsulated bubbles and known theory of nonlinear propagation.     

Optimal dosage of ultrasound contrast agent for ultrasound surgery: Thermal effect of linear plane wave

The optimal dosage of ultrasound contrast agent model for ultrasound surgery was explored. A specific ultrasound contrast agent Albunex^® was chosen for simulation. The model was developed based on a dilute bubbly liquid model proposed by Ye and Ding [Z. Ye, L. Ding, Acoustic dispersion and attenuation relations in bubbly mixture, J. Acoust. Soc. Am. 98 (3) (1995) 1629–1636]. The numerical simulation suggests that 2 MHz is more efficient than 1 MHz to thermally treat cancer in deep tissue with the optimal dosage of 3 ml. On the other hand, the simulation also suggests 3 MHz center frequency with the optimal dosage of 1.6 ml is adequate for prostate cancer treatment with transrectal equipment. The simulation is expected to valid up to 2 MPa incident pressure due to the limitation of the linearized UCA model. Even though it is developed from a single ultrasound contrast agent, this model is expected to be useful for any ultrasound contrast agent as long as the necessary parameters are provided.     

A comparative analysis of multi-pulse techniques in contrast-enhanced ultrasound medical imaging

One of the important issues in the field of ultrasound medical imaging using contrast agents is the development of techniques able to separate the response of the contrast media from that of the biological tissues. In the literature, one can find various solutions involving the use of multiple transmitted signals and the combination of related echoes. However, the quality of these techniques may be reduced due to some undesired effects that are seldom considered, despite the fact that they are always present in real systems. These effects are the signal distortions introduced by the hardware equipment, the thermal noise in the electronic circuitry, and body motion between successive pulses. In this paper we propose a simulation tool that will allow the calculation of the backscattered echo from a population of contrast agents immersed in a biological tissue, considering all the mentioned effects. With this tool, an assessment of the comparative robustness of three well-known multi-pulse techniques has been carried out under realistic working conditions and the performance of the three techniques has been evaluated in terms of contrast-to-tissue ratio and signal-to-noise ratio. The results show that the undesired effects have a strong impact on these techniques and that there are notable differences in their robustness. Finally, some suggestions on the choice of the particular technique to be applied are provided on the basis of the specific work conditions.     

Temperature impact on mechanically induced long-period fiber gratings

The spectral response of mechanically induced long-period fiber gratings (MLPFG) to the ambient temperature variation was experimentally study. In the MLPFG setting, a pressure rig with aluminum grooved plates on standard telecommunication fiber was used. We found that a relatively low change in temperature can produce a severe impact on the characteristic parameters of the attenuation bands, such as a critical decrease in the contrast and fast shift saturation. When the temperature increases from −10 to 70 °C, all the bands are shifted toward longer wavelengths with a mean sensitivity of approximately 180 pm/°C from 0 to 40 °C in the near-linear region, then they present a flattened zone beyond this temperature. Meanwhile, the contrast of the attenuation bands rapidly decreases from the maximum value to 0 dB with a quasi-cosinoidal behavior. These results are important and have to be considered when MLPFG are applied in a medium with ambient temperature variation. Furthermore, we show that MLPFG can be used as low cost ambient temperature sensors through intensity based measurements.     

Feasibility of 3D harmonic contrast imaging

Improved endocardial border delineation with the application of contrast agents should allow for less complex and faster tracing algorithms for left ventricular volume analysis. We developed a fast rotating phased array transducer for 3D imaging of the heart with harmonic capabilities making it suitable for contrast imaging. In this study the feasibility of 3D harmonic contrast imaging is evaluated in vitro. A commercially available tissue mimicking flow phantom was used in combination with Sonovue. Backscatter power spectra from a tissue and contrast region of interest were calculated from recorded radio frequency data. The spectra and the extracted contrast to tissue ratio from these spectra were used to optimize the excitation frequency, the pulse length and the receive filter settings of the transducer. Frequencies ranging from 1.66 to 2.35 MHz and pulse lengths of 1.5, 2 and 2.5 cycles were explored. An increase of more than 15 dB in the contrast to tissue ratio was found around the second harmonic compared with the fundamental level at an optimal excitation frequency of 1.74 MHz and a pulse length of 2.5 cycles. Using the optimal settings for 3D harmonic contrast recordings volume measurements of a left ventricular shaped agar phantom were performed. Without contrast the extracted volume data resulted in a volume error of 1.5%, with contrast an accuracy of 3.8% was achieved. The results show the feasibility of accurate volume measurements from 3D harmonic contrast images. Further investigations will include the clinical evaluation of the presented technique for improved assessment of the heart.     

Excitation of polymer-shelled contrast agents with high-frequency ultrasound

Few experimental and complementary theoretical studies have investigated high-frequency (>20 MHz) nonlinear responses from polymer-shelled ultrasound contrast agents. Three polymer agents with different shell properties were examined for their single-bubble backscatter when excited with a 40 MHz tone burst. Higher-order harmonic responses were observed for the three agents; however, their occurrence was at least partly due to nonlinear propagation. Only one of the agents (1.1 microm mean diameter) showed a subharmonic response for longer excitations (approximately 10-15 cycles) and midlevel pressure excitations ( 2.5 MPa). Theoretical calculations of the backscattered spectrum revealed behavior similar to the experimental results in specific parameter regimes.     

Scaling of the viscoelastic shell properties of phospholipid encapsulated microbubbles with ultrasound frequency

Phospholipid encapsulated microbubbles are widely employed as clinical diagnostic ultrasound contrast agents in the 1–5 MHz range, and are increasingly employed at higher ultrasound transmit frequencies. The stiffness and viscosity of the encapsulating “shells” have been shown to play a central role in determining both the linear and nonlinear response of microbubbles to ultrasound. At lower frequencies, recent studies have suggested that shell properties can be frequency dependent. At present, there is only limited knowledge of how the viscoelastic properties of phospholipid shells scale at higher frequencies. In this study, four batches of in-house phospholipid encapsulated microbubbles were fabricated with decreasing volume-weighted mean diameters of 3.20, 2.07, 1.82 and 1.61 μm. Attenuation experiments were conducted in order to assess the frequency-dependent response of each batch, resulting in resonant peaks in response at 4.2, 8.9, 12.6 and 19.5 MHz, respectively. With knowledge of the size measurements, the attenuation spectra were then fitted with a standard linearized bubble model in order to estimate the microbubble shell stiffness S_p and shell viscosity S_f, resulting in a slight increase in S_p (1.53–1.76 N/m) and a substantial decrease in S_f (0.29 × 10⁻⁶–0.08 × 10⁻⁶ kg/s) with increasing frequency. These results performed on a single phospholipid agent show that frequency dependent shell properties persist at high frequencies (up to 19.5 MHz).     

Numerical modeling of microbubble backscatter to optimize ultrasound particle image velocimetry imaging: initial studies

We have developed a promising non-invasive ultrasound-based method for performing particle image velocimetry (PIV) in vivo. This method, termed echo PIV, provides multi-component blood velocity data with good (2 ms) temporal resolution. The method takes advantage of the non-linear ultrasound backscatter characteristics of small gas-filled microbubbles (ultrasound contrast) that are seeded into the blood stream. In this study, we use a numerical model to explore potential areas to focus future work in echo PIV.

Ultrasound backscatter from encapsulated microbubbles was modeled using a modified Rayleigh–Plesset equation (Church model, 1995), taking into account the protein/lipid shell layer as a thick, mass-conserving incompressible fluid surrounded by incompressible blood-like fluid. The equation of motion was solved numerically to characterize the fundamental and second harmonic components of the backscattered pressure. Results show a significant advantage in using the second harmonic component for echo PIV, especially for small bubble sizes less than 3 μm in diameter at 2.2 MHz frequency. The effect of the shell thickness ranging from 10 to 500 nm on the vibration amplitude of the bubble was examined and it is shown that the presence of the shell requires mechanical index (MI)>0.2 of incident pressure amplitude to improve bubble detectability. Analysis of the effect of pulse length shows a tradeoff between axial resolution (short pulse length) and bubble detectability (longer pulse length) will most likely be required. The effect of varying MI between 0.1 and 0.6 was also studied at a center frequency of 2.2 MHz and the results indicate that the resonance of the second harmonic is maximized for bubbles with diameter of approximately 2.75 μm. Bubble non-linearities at MI>0.2 induced a resonant frequency shift away from the integer multiple of the incident frequency in the second harmonic backscatter. For a given bubble size, there is a combination of optimal incident frequency and mechanical index range that maximizes the ratio of the second harmonic compared to the fundamental. This resonant frequency decreases with increasing bubble radius. Further, a narrow bandwidth pulse is shown to increase signal strength. Both of these effects may cause conflict with factors governing spatial resolution. Optimization of the incident frequency, microbubble size and mechanical index to enhance bubble detectability will depend on the particular clinical application. These theoretical predictions provide further understanding of the physics behind our echo PIV technique, and should be useful for guiding the design of echo PIV systems.     

Difference-frequency ultrasound generation from microbubbles under dual-frequency excitation

The difference-frequency (DF) ultrasound generated by using parametric effect promises to improve detection depth owing to its low attenuation, which is beneficial for deep tissue imaging. With ultrasound contrast agents infusion, the harmonic components scattered from the microbubbles, including DF, can be generated due to the nonlinear vibration. A theoretical study on the DF generation from microbubbles under the dual-frequency excitation is proposed in formula based on the solution of the RPNNP equation. The optimisation of the DF generation is discussed associated with the applied acoustic pressure, frequency, and the microbubble size. Experiments are performed to validate the theoretical predictions by using a dual-frequency signal to excite microbubbles. Both the numerical and experimental results demonstrate that the optimised DF ultrasound can be achieved as the difference frequency is close to the resonance frequency of the microbubble and improve the contrast-to-tissue ratio in imaging.     

In vitro measurement of attenuation and nonlinear scattering from echogenic liposomes

Echogenic liposomes (ELIP) are an excellent candidate for concurrent imaging and drug delivery applications. They combine the advantages of liposomes-biocompatibility and ability to encapsulate both hydrophobic and hydrophilic drugs-with strong reflections of ultrasound. The objective of this study is to perform a detailed in vitro acoustic characterization - including nonlinear scattering that has not been studied before - along with an investigation of the primary mechanism of echogenicity. Both components are critical for developing viable clinical applications of ELIP. Mannitol, a cryoprotectant, added during the preparation of ELIP is commonly believed to be critical in making them echogenic. Accordingly, here ELIP prepared with varying amount of mannitol concentration are investigated for their pressure dependent linear and non-linear scattered responses. The average diameter of these liposomes is measured to be 125-185 nm. But they have a broad size distribution including liposomes with diameters over a micro-meter as observed by TEM and AFM. These larger liposomes are critical for the overall echogenicity. Attenuation through liposomal solution is measured with four different transducers (central frequencies 2.25, 3.5, 5, 10 MHz). Measured attenuation increases linearly with liposome concentration indicating absence of acoustic interactions between liposomes. Due to the broad size distribution, the attenuation shows a flat response without a distinct peak in the range of frequencies (1-12 MHz) investigated. A 15-20 dB enhancement with 1.67 μg/ml of lipids is observed both for the scattered fundamental and the second harmonic responses at 3.5 MHz excitation frequency and 50-800 kPa amplitude. It demonstrates the efficacy of ELIP for fundamental as well as harmonic ultrasound imaging. The scattered response however does not show any distinct subharmonic peak for the acoustic excitation parameters studied. Small amount of mannitol proves critical for echogenicity. However, mannitol concentration above 100 mM shows no effect.     

Superhydrophobic silica nanoparticles as ultrasound contrast agents

Microbubbles have been widely studied as ultrasound contrast agents for diagnosis and as drug/gene carriers for therapy. However, their size and stability (lifetime of 5–12 min) limited their applications. The development of stable nanoscale ultrasound contrast agents would therefore benefit both. Generating bubbles persistently in situ would be one of the promising solutions to the problem of short lifetime. We hypothesized that bubbles could be generated in situ by providing stable air nuclei since it has been found that the interfacial nanobubbles on a hydrophobic surface have a much longer lifetime (orders of days). Mesoporous silica nanoparticles (MSNs) with large surface areas and different levels of hydrophobicity were prepared to test our hypothesis. It is clear that the superhydrophobic and porous nanoparticles exhibited a significant and strong contrast intensity compared with other nanoparticles. The bubbles generated from superhydrophobic nanoparticles sustained for at least 30 min at a MI of 1.0, while lipid microbubble lasted for about 5 min at the same settings. In summary MSNs have been transformed into reliable bubble precursors by making simple superhydrophobic modification, and made into a promising contrast agent with the potentials to serve as theranostic agents that are sensitive to ultrasound stimulation.     

Tissue harmonic ultrasonic imaging

Harmonic imaging was originally developed for microbubble contrast agents in the early 90s under the assumption that tissue is linear and all harmonic echoes are generated by the bubbles. In fact, tissue, like bubbles, is a nonlinear medium. Whereas the harmonic echoes from bubbles have their origins in nonlinear scattering, those from tissue are a result of nonlinear propagation. The clinical benefits of tissue harmonic imaging are reduced reverberation noise and overall clutter level, improved border delineation, increased contrast resolution, and reduced phase aberration artifacts. To a large extent these benefits are explained by the properties of nonlinear propagation of the transmitted ultrasonic pulses in the tissue.     

Estimate of the attenuation coefficient using a clinical array transducer for the detection of cervical ripening in human pregnancy

Premature delivery is the leading cause of infant mortality in the United States. Currently, premature delivery cannot be prevented and new treatments are difficult to develop due to the inability to diagnose symptoms prior to uterine contractions. Cervical ripening is a long period that precedes the active phase of uterine contractions and cervical dilation. The changes in the microstructure of the cervix during cervical ripening suggest that the ultrasonic attenuation should decrease. The objective of this study is to use the reference phantom algorithm to estimate the ultrasonic attenuation in the cervix of pregnant human patients. Prior to applying the algorithm to in vivo human data, two homogeneous phantoms with known attenuation coefficients were used to validate the algorithm and to find the length and the width of the region of interest (ROI) that achieves the smallest error in the attenuation coefficient estimates. In the phantom data, we found that the errors in the attenuation coefficients estimates are less than 12% for ROIs that contain 40 wavelengths or more axially and 30 echo lines or more laterally. The reference phantom algorithm was then used to obtain attenuation maps of the echoes from two human pregnant cervices at different gestational ages. It was observed that the mean of the attenuation coefficient estimates in the cervix of the patient at a more advanced gestational age is smaller than the mean of the attenuation coefficient estimates in the cervix of the patient at an earlier gestational age which suggests that ultrasonic attenuation decreases with increasing gestational age. We also observed a large variance between the attenuation coefficient estimates in the different regions of the cervix due to the natural variation in tissue micro-structures across the cervix. The preliminary results indicate that the algorithm could potentially provide an important diagnostic tool for diagnosing the risk of premature delivery.     

A preliminary in vitro assessment of polymer-shelled microbubbles in contrast-enhanced ultrasound imaging

This paper focuses on the use of poly (vinyl alcohol)-shelled microbubbles as a contrast agent in ultrasound medical imaging. The objective was an in vitro assessment of the different working conditions and signal processing methods for the visual detection (especially in small vessels) of such microbubbles, while avoiding their destruction. Polymer-shelled microbubbles have recently been proposed as ultrasound contrast agents with some important advantages. The major drawback is a shell that is less elastic than that of the traditional lipidic microbubbles. Weaker echoes are expected, and their detection at low concentrations may be critical. In vitro experiments were performed with a commercial ultrasound scanner equipped with a dedicated acquisition board. A concentration of 100 bubbles/mm³, excitation pressure amplitudes from 120 kPa to 320 kPa, and a central frequency of 3 MHz or 4.5 MHz were used. Three multi-pulse techniques (i.e., pulse inversion, contrast pulse sequence based on three transmitted signals, and contrast pulse sequence in combination with the chirp pulse) were compared. The results confirmed that these microbubbles produce a weaker ultrasound response than lipidic bubbles with a reduced second-order nonlinear component. Nevertheless, these microbubbles can be detected by the contrast pulse sequence technique, especially when the chirp pulse is adopted. The best value of the contrast-to-tissue ratio was obtained at an excitation pressure amplitude of 230 kPa: although this pressure amplitude is higher than what is typically used for lipidic microbubbles, it does not cause the rupture of the polymeric contrast agent.