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Article: Contrast-Enhanced Ultrasound Tumor Therapy With Abdominal Imaging Transducer.

Morrison, Ryan G / Karmacharya, Mrigendra B / Sehgal, Chandra M

Journal of medical devices

2022 Volume 16, Issue 4, Page(s) 41010

Abstract: A diagnostic ultrasound machine add-on module (AOM) was created to enable an off-the-shelf abdominal imaging transducer to perform contrast-enhanced therapeutic ultrasound. The AOM creates plane-wave ultrasound through an abdominal imaging transducer ... ...

Abstract	A diagnostic ultrasound machine add-on module (AOM) was created to enable an off-the-shelf abdominal imaging transducer to perform contrast-enhanced therapeutic ultrasound. The AOM creates plane-wave ultrasound through an abdominal imaging transducer targeting intravascular microbubbles within tumors. This therapeutic antivascular ultrasound (AVUS) causes heating and cavitation effects that destroy tumor vasculature and starves it of nutrients. The AOM can switch between therapeutic and imaging modes for monitoring AVUS treatment. The therapeutic capability of the AOM was validated in murine hepatocellular carcinomas (HCC) grown in adult mice. Contrast-enhanced ultrasound imaging performed before and after the therapeutic treatment evaluated the AVUS response to the treatment. The peak enhancement (PE), perfusion index (PI), and area under the curve (AUC) were measured for the control and AOM treatment groups. The AOM group showed a substantial decrease in these parameters compared to the control group. The difference between the pre- and post-therapy was significant, (
Language	English
Publishing date	2022-09-01
Publishing country	United States
Document type	Journal Article
ISSN	1932-6181
ISSN	1932-6181
DOI	10.1115/1.4055112
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: A Review of Early Experience in Lung Ultrasound in the Diagnosis and Management of COVID-19.

Sultan, Laith R / Sehgal, Chandra M

Ultrasound in medicine & biology

2020 Volume 46, Issue 9, Page(s) 2530–2545

Abstract: A novel coronavirus (2019-nCoV) was identified as the cause of a cluster of pneumonia in Wuhan, China, at the end of 2019. Since then more than eight million confirmed cases of coronavirus disease 2019 (COVID-19) have been reported around the globe. The ... ...

Abstract	A novel coronavirus (2019-nCoV) was identified as the cause of a cluster of pneumonia in Wuhan, China, at the end of 2019. Since then more than eight million confirmed cases of coronavirus disease 2019 (COVID-19) have been reported around the globe. The current gold standard for etiologic diagnosis is reverse transcription-polymerase chain reaction analysis of respiratory-tract specimens, but the test has a high false-negative rate owing to both nasopharyngeal swab sampling error and viral burden. Hence diagnostic imaging has emerged as a fundamental component of current management of COVID-19. Currently, high-resolution computed tomography is the main imaging tool for primary diagnosis and evaluation of disease severity in patients. Lung ultrasound (LUS) imaging has become a safe bedside imaging alternative that does not expose the patient to radiation and minimizes the risk of contamination. Although the number of studies to date is limited, LUS findings have demonstrated high diagnostic sensitivity and accuracy, comparable with those of chest computed tomography scans. In this note we review the current state of the art of LUS in evaluating pulmonary changes induced by COVID-19. The goal is to identify characteristic sonographic findings most suited for the diagnosis of COVID-19 pneumonia infections.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Clinical Protocols ; Coronavirus Infections/diagnostic imaging ; Coronavirus Infections/therapy ; Humans ; Lung/diagnostic imaging ; Pandemics ; Pneumonia, Viral/diagnostic imaging ; Pneumonia, Viral/therapy ; SARS-CoV-2 ; Ultrasonography/methods
Keywords	covid19
Language	English
Publishing date	2020-05-25
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	186150-5
ISSN	1879-291X ; 0301-5629
ISSN (online)	1879-291X
ISSN	0301-5629
DOI	10.1016/j.ultrasmedbio.2020.05.012
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ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Photoacoustic monitoring of oxygenation changes induced by therapeutic ultrasound in murine hepatocellular carcinoma.

Karmacharya, Mrigendra B / Sultan, Laith R / Sehgal, Chandra M

Scientific reports

2021 Volume 11, Issue 1, Page(s) 4100

Abstract: Hepatocellular carcinoma (HCC) is a highly vascular solid tumor. We have previously shown that ultrasound (US) therapy significantly reduces tumor vascularity. This study monitors US-induced changes in tumor oxygenation on murine HCC by photoacoustic ... ...

Abstract	Hepatocellular carcinoma (HCC) is a highly vascular solid tumor. We have previously shown that ultrasound (US) therapy significantly reduces tumor vascularity. This study monitors US-induced changes in tumor oxygenation on murine HCC by photoacoustic imaging (PAI). Oxygen saturation and total hemoglobin were assessed by PAI before and after US treatments performed at different intensities of continuous wave (CW) bursts and pulsed wave (PW) bursts US. PAI revealed significant reduction both in HCC oxygen saturation and in total hemoglobin, proportional to the US intensity. Both CW bursts US (1.6 W/cm
MeSH term(s)	Animals ; Carcinoma, Hepatocellular/blood supply ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/therapy ; Liver/blood supply ; Liver/pathology ; Liver Neoplasms, Experimental/blood supply ; Liver Neoplasms, Experimental/pathology ; Liver Neoplasms, Experimental/therapy ; Male ; Mice ; Mice, Nude ; Neoplasm Transplantation ; Oxygen Saturation ; Photoacoustic Techniques/methods ; Ultrasonic Therapy/adverse effects ; Ultrasonic Therapy/methods
Language	English
Publishing date	2021-02-18
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-83439-y
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Article: Sonothrombolysis: State-of-the-Art and Potential Applications in Children.

Ward, Rebecca E / Martinez-Correa, Santiago / Tierradentro-García, Luis Octavio / Hwang, Misun / Sehgal, Chandra M

Children (Basel, Switzerland)

2023 Volume 11, Issue 1

Abstract: In recent years, advances in ultrasound therapeutics have been implemented into treatment algorithms for the adult population; however, the use of therapeutic ultrasound in the pediatric population still needs to be further elucidated. In order to better ...

Abstract	In recent years, advances in ultrasound therapeutics have been implemented into treatment algorithms for the adult population; however, the use of therapeutic ultrasound in the pediatric population still needs to be further elucidated. In order to better characterize the utilization and practicality of sonothrombolysis in the juvenile population, the authors conducted a literature review of current pediatric research in therapeutic ultrasound. The PubMed database was used to search for all clinical and preclinical studies detailing the use and applications of sonothrombolysis, with a focus on the pediatric population. As illustrated by various review articles, case studies, and original research, sonothrombolysis demonstrates efficacy and safety in clot dissolution in vitro and in animal studies, particularly when combined with microbubbles, with potential applications in conditions such as deep venous thrombosis, peripheral vascular disease, ischemic stroke, myocardial infarction, and pulmonary embolism. Although there is limited literature on the use of therapeutic ultrasound in children, mainly due to the lower prevalence of thrombotic events, sonothrombolysis shows potential as a noninvasive thrombolytic treatment. However, more pediatric sonothrombolysis research needs to be conducted to quantify the safety and ethical considerations specific to this vulnerable population.
Language	English
Publishing date	2023-12-31
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2732685-8
ISSN	2227-9067
ISSN	2227-9067
DOI	10.3390/children11010057
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Article ; Online: Hydralazine-augmented contrast ultrasound imaging improves the detection of hepatocellular carcinoma.

Sultan, Laith R / Karmacharya, Mrigendra B / Al-Hasani, Maryam / Cary, Theodore W / Sehgal, Chandra M

Medical physics

2023 Volume 50, Issue 3, Page(s) 1728–1735

Abstract: Background: Hepatocellular carcinoma (HCC) detection with B-mode and contrast-enhanced ultrasound (CUS) imaging often varies between subjects, especially in patients with background cirrhosis. Various factors contribute to this variability, including ... ...

Abstract	Background: Hepatocellular carcinoma (HCC) detection with B-mode and contrast-enhanced ultrasound (CUS) imaging often varies between subjects, especially in patients with background cirrhosis. Various factors contribute to this variability, including the tumor blood flow, tumor size, internal echoes, and its location in livers with diffuse fibro-cirrhotic changes. Objective: Towards improving lesion detection, this study evaluates a vasodilator, hydralazine, to enhance the visibility of HCC by reducing its blood flow relative to the surrounding liver tissue. Methods: HCC were analyzed for tumor visibility measured for B-mode, CUS, and hydralazine-augmented-contrast ultrasound (HyCUS) in an autochthonous HCC rat model. 21 tumors from 12 rats were studied. B-mode and CUS images were acquired before hydralazine injection. Rats received an intravenous hydralazine injection of 5 mg/kg, then images were acquired 20 min later. Four rats were used as controls. The difference in echo intensity of the lesion and the surrounding tissue was used to determine the visibility index (VI). Results: The visibility index for HCC was found to be significantly improved with the use of HyCUS imaging compared to traditional B-mode and CUS imaging. The visibility index for HCC was 16.5 ± 2.8 for HyCUS, compared to 5.3 ± 4.8 for B-mode and 4.1 ± 3.8 for CUS. The differences between HyCUS and the other imaging modalities were statistically significant, with p-values of 0.001 and 0.02, respectively. Additionally, when compared to control cases, HyCUS showed higher discrimination of HCC (VI = 6.4 ± 1.2) with a p-value of 0.003, while B-mode (VI = 6.7 ± 1.4, p = 0.5) and CUS (VI = 6.4 ± 1.2, p = 0.3) showed lower discrimination. Conclusion: Vascular blood flow modulation by hydralazine enhances the visibility of HCC. HyCUS offers a potential problem-solving method for detecting HCC when B-mode and CUS are unsuccessful, especially with background fibro-cirrhotic liver disease. Future evaluation of the approach in humans will determine its translatability for clinical applications.
MeSH term(s)	Humans ; Rats ; Animals ; Carcinoma, Hepatocellular/diagnostic imaging ; Carcinoma, Hepatocellular/pathology ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/pathology ; Contrast Media ; Ultrasonography ; Liver Cirrhosis ; Hydralazine/pharmacology
Chemical Substances	Contrast Media ; Hydralazine (26NAK24LS8)
Language	English
Publishing date	2023-01-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	188780-4
ISSN	2473-4209 ; 0094-2405
ISSN (online)	2473-4209
ISSN	0094-2405
DOI	10.1002/mp.16232
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Zs.A 1210: Show issues

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bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
Jg. 1995 - 2021: Lesesall (1.OG)
ab Jg. 2022: Lesesaal (EG)

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Article ; Online: A review of early experience in lung ultrasound (LUS) in the diagnosis and management of COVID-19

Sultan, Laith R / Sehgal, Chandra M

Ultrasound Med Biol

Abstract: Abstract A novel coronavirus (2019-nCoV) was identified as the cause of a cluster of pneumonia in Wuhan, China at the end of 2019. Since then more than four million confirmed cases of coronavirus disease 2019 (COVID-19) have been reported around the ... ...

Abstract	Abstract A novel coronavirus (2019-nCoV) was identified as the cause of a cluster of pneumonia in Wuhan, China at the end of 2019. Since then more than four million confirmed cases of coronavirus disease 2019 (COVID-19) have been reported around the globe. The current gold standard for etiological diagnosis is reverse transcription polymerase chain reaction (rRT-PCR) analysis of respiratory tract specimens, but the test has a high false-negative rate due to both nasopharyngeal swab sampling error and viral burden. Hence diagnostic imaging has emerged as a fundamental component of current management of COVID-19 patients. Currently, high-resolution computed tomography (CT) is the main imaging tool for primary diagnosis and evaluation of disease severity in patients. Lung ultrasound (LUS) imaging has become a safe bedside imaging alternative that does no expose the patient to radiation, and minimizes the risk of contamination. Although the number of studies to date are limited, LUS findings have demonstrated high diagnostic sensitivity and accuracy, comparable to those of chest CT scans. In this article we review the current state of art of LUS in evaluating pulmonary changes induced by COVID-19. The goal is to identify characteristic sonographic findings most suited for the diagnosis of COVID-19 pneumonia infections.
Keywords	covid19
Publisher	Elsevier; PMC; WHO
Document type	Article ; Online
Note	WHO #Covidence: #361182
DOI	10.1016/j.ultrasmedbio.2020.05.012
Database	COVID19

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Article: A Review of Early Experience in Lung Ultrasound in the Diagnosis and Management of COVID-19

Sultan, Laith R / Sehgal, Chandra M

Ultrasound med. biol

Abstract	A novel coronavirus (2019-nCoV) was identified as the cause of a cluster of pneumonia in Wuhan, China, at the end of 2019. Since then more than eight million confirmed cases of coronavirus disease 2019 (COVID-19) have been reported around the globe. The current gold standard for etiologic diagnosis is reverse transcription-polymerase chain reaction analysis of respiratory-tract specimens, but the test has a high false-negative rate owing to both nasopharyngeal swab sampling error and viral burden. Hence diagnostic imaging has emerged as a fundamental component of current management of COVID-19. Currently, high-resolution computed tomography is the main imaging tool for primary diagnosis and evaluation of disease severity in patients. Lung ultrasound (LUS) imaging has become a safe bedside imaging alternative that does not expose the patient to radiation and minimizes the risk of contamination. Although the number of studies to date is limited, LUS findings have demonstrated high diagnostic sensitivity and accuracy, comparable with those of chest computed tomography scans. In this note we review the current state of the art of LUS in evaluating pulmonary changes induced by COVID-19. The goal is to identify characteristic sonographic findings most suited for the diagnosis of COVID-19 pneumonia infections.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #32591166
Database	COVID19

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Article ; Online: A Review of Early Experience in Lung Ultrasound in the Diagnosis and Management of COVID-19

Sultan, Laith R. / Sehgal, Chandra M.

Ultrasound in Medicine & Biology

2020 Volume 46, Issue 9, Page(s) 2530–2545

Keywords	Biophysics ; Acoustics and Ultrasonics ; Radiological and Ultrasound Technology ; Radiology Nuclear Medicine and imaging ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ZDB-ID	186150-5
ISSN	1879-291X ; 0301-5629
ISSN (online)	1879-291X
ISSN	0301-5629
DOI	10.1016/j.ultrasmedbio.2020.05.012
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Hydralazine augmented ultrasound hyperthermia for the treatment of hepatocellular carcinoma.

Karmacharya, Mrigendra B / Sultan, Laith R / Hunt, Stephen J / Sehgal, Chandra M

Scientific reports

2021 Volume 11, Issue 1, Page(s) 15553

Abstract: This study investigates the use of hydralazine to enhance ultrasound hyperthermia for the treatment of hepatocellular carcinoma (HCC) by minimizing flow-mediated heat loss from the tumor. Murine HCC tumors were treated with a continuous mode ultrasound ... ...

Abstract	This study investigates the use of hydralazine to enhance ultrasound hyperthermia for the treatment of hepatocellular carcinoma (HCC) by minimizing flow-mediated heat loss from the tumor. Murine HCC tumors were treated with a continuous mode ultrasound with or without an intravenous administration of hydralazine (5 mg/kg). Tumor blood flow and blood vessels were evaluated by contrast-enhanced ultrasound (CEUS) imaging and histology, respectively. Hydralazine markedly enhanced ultrasound hyperthermia through the disruption of tumor blood flow in HCC. Ultrasound treatment with hydralazine significantly reduced peak enhancement (PE), perfusion index (PI), and area under the curve (AUC) of the CEUS time-intensity curves by 91.9 ± 0.9%, 95.7 ± 0.7%, and 96.6 ± 0.5%, compared to 71.4 ± 1.9%, 84.7 ± 1.1%, and 85.6 ± 0.7% respectively without hydralazine. Tumor temperature measurements showed that the cumulative thermal dose delivered by ultrasound treatment with hydralazine (170.8 ± 11.8 min) was significantly higher than that without hydralazine (137.7 ± 10.7 min). Histological assessment of the ultrasound-treated tumors showed that hydralazine injection formed larger hemorrhagic pools and increased tumor vessel dilation consistent with CEUS observations illustrating the augmentation of hyperthermic effects by hydralazine. In conclusion, we demonstrated that ultrasound hyperthermia can be enhanced significantly by hydralazine in murine HCC tumors by modulating tumor blood flow. Future studies demonstrating the safety of the combined use of ultrasound and hydralazine would enable the clinical translation of the proposed technique.
MeSH term(s)	Animals ; Carcinoma, Hepatocellular/drug therapy ; Cell Line, Tumor ; Contrast Media ; Hydralazine/therapeutic use ; Hyperthermia, Induced ; Liver Neoplasms/drug therapy ; Mice ; Temperature
Chemical Substances	Contrast Media ; Hydralazine (26NAK24LS8)
Language	English
Publishing date	2021-07-30
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-94323-0
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Multivariable Dependence of Acoustic Contrast of Fluorocarbon and Xenon Microbubbles under Flow.

Chattaraj, Rajarshi / Hammer, Daniel A / Lee, Daeyeon / Sehgal, Chandra M

Ultrasound in medicine & biology

2021 Volume 47, Issue 9, Page(s) 2676–2691

Abstract: Microbubbles (MBs) are 1 to 10 µm gas particles stabilized by an amphiphilic shell capable of responding to biomedical ultrasound with strong acoustic signals, allowing them to be commonly used in ultrasound imaging and therapy. The composition of both ... ...

Abstract	Microbubbles (MBs) are 1 to 10 µm gas particles stabilized by an amphiphilic shell capable of responding to biomedical ultrasound with strong acoustic signals, allowing them to be commonly used in ultrasound imaging and therapy. The composition of both the shell and the core determines their stability and acoustic properties. While there has been extensive characterization of the dissolution, oscillation, cavitation, collapse and therefore, ultrasound contrast of MBs under static conditions, few reports have examined such behavior under hydrodynamic flow. In this study, we evaluate the interplay of ultrasound parameters (five different mechanical indices [MIs]), MB shell parameter (shell stiffness), type of gas (perfluorocarbon for diagnostic imaging and xenon as a therapeutic gas), and a flow parameter (flow rate) on the ultrasound signal of phospholipid-stabilized MBs flowing through a latex tube embedded in a tissue-mimicking phantom. We find that the contrast gradient (CG), a metric of the rate of decay of contrast along the length of the tube, and the contrast peak (CP), the location where the maximum contrast is reached, depend on the conditions of flow, imaging, and MB material. For instance, while the contrast near the flow inlet of the field of view is highest for a softer shell (dipalmitoylphosphatidylcholine [DPPC], C16) than for stiffer shells (distearoylphosphatidylcholine [DSPC], C18, and dibehenoylphosphatidylcholine [DBPC], C22), the contrast decay is also faster; stiffer shells provide more resistance and hence lead to slower MB dissolution/destruction. At higher flow rates, the CG is low for a fixed length of time because each MB is exposed to ultrasound for a shorter period. The CG becomes high for low flow rates, especially at high incident pressures (high MI), causing more MB destruction closer to the inlet of the field of view. Also, the CP shifts toward the inlet at low flow rates, high MIs, and low shell stiffness. We also report the first demonstration of sustained ultrasound flow imaging of a water-soluble, therapeutic gas MB (xenon). We find that an increased MB concentration is necessary for obtaining the same signal magnitude for xenon MBs. In summary, this study builds a framework depicting how multiple variables simultaneously affect the evolution of MB ultrasound contrast under flow. Depending on the MB composition, imaging conditions, transducer positioning, and image processing, building on such a framework could potentially allow for extraction of additional diagnostic information than is commonly analyzed for physiological flow.
MeSH term(s)	Acoustics ; Contrast Media ; Fluorocarbons ; Microbubbles ; Xenon
Chemical Substances	Contrast Media ; Fluorocarbons ; Xenon (3H3U766W84)
Language	English
Publishing date	2021-06-08
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	186150-5
ISSN	1879-291X ; 0301-5629
ISSN (online)	1879-291X
ISSN	0301-5629
DOI	10.1016/j.ultrasmedbio.2021.04.025
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