The Effects of Hydrostatic Pressure on the Subharmonic Response of SonoVue and Sonazoid

Gupta, Ipshita; Fuster, Daniel; Eckersley, Robert J.; Lamata, Pablo; Forsberg, Flemming; Nio, Amanda Q. X.; Faraci, Alessandro; Torkzaban, Mehnoosh; Christensen-Jeffries, Kirsten; Nam, Kibo; Raymond, Jason L.; Wallace, Kirk; Monaghan, Mark

doi:10.1109/ultsym.2019.8925812

Cited by 4 publications

(7 citation statements)

References 16 publications

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“…Subharmonic microbubble signals were acquired from the portal and hepatic vein in triplicate as 5 second segments with an average frame rate of 9 Hz. 41,[45][46][47] The SHAPE gradient (in dB) was calculated offline as the difference between the mean subharmonic amplitudes within the hepatic and portal veins using regions within the hepatic and portal veins selected on maximum intensity projection of B-mode images and were fixed throughout the 5 second acquisition (approximately 25-35 frames). The average RF signal over all the frames in a 0.5 MHz bandwidth around 1.25 MHz provided the mean subharmonic signal in each vessel.…”

Section: Methodsmentioning

confidence: 99%

“…Subharmonic data were acquired by the program for every acoustic output level and plotted as a function of acoustic output. A logistic curve was fitted to the data, with the inflection point (in the growth phase) being selected as the optimized power, as this has been shown to be the point of greatest SHAPE sensitivity 41,45–47 …”

Section: Methodsmentioning

confidence: 99%

“…Bandwidth and pulse duration were both fixed and kept constant by the scanner. Subharmonic microbubble signals were acquired from the portal and hepatic vein in triplicate as 5 second segments with an average frame rate of 9 Hz 41,45–47 …”

Section: Methodsmentioning

confidence: 99%

“…A logistic curve was fitted to the data, with the inflection point (in the growth phase) being selected as the optimized power, as this has been shown to be the point of greatest SHAPE sensitivity. 41,[45][46][47] Then the ROI was increased to encompass a hepatic vein and the portal vein located at a similar depth (Figure 2 the ROI is the entire area in "gold" seen in the images and that corresponds to the SHI signals). The subharmonic RF data were acquired at the optimal acoustic power setting in 5 seconds digital clips.…”

Section: Methodsmentioning

confidence: 99%

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Ultrasound Pressure Estimation for Diagnosing Portal Hypertension in Patients Undergoing Dialysis for Chronic Kidney Disease

Machado

Gupta

Fenkel

et al. 2021

J of Ultrasound Medicine

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Objectives-Hepatic venous pressure gradient (HVPG) is considered the standard in quantifying portal hypertension, but can be unreliable in dialysis patients. A noninvasive ultrasound technique, subharmonic-aided pressure estimation (SHAPE), may be a valuable surrogate of these pressure estimates. This study compared SHAPE and HVPG with pathology findings for fibrosis in dialysis patients.Methods-This was a subgroup study from an IRB-approved trial that included 20 patients on dialysis undergoing SHAPE examinations of portal and hepatic veins using a modified Logiq 9 scanner (GE, Waukesha, WI), during infusion of Sonazoid (GE Healthcare, Oslo, Norway). SHAPE was compared to HVPG and pathology findings using the Ludwig-Batts scoring system for fibrosis. Logistic regression, ROC analysis, and t-tests were used to compare HVPG and SHAPE with pathological findings of fibrosis.Results-Of 20 cases, 5 had HVPG values corresponding to subclinical and clinical portal hypertension (≥6 and ≥10 mmHg, respectively) while 15 had normal HVPG values (≤5 mmHg). SHAPE and HVPG correlated moderately (r = 0.45; P = .047). SHAPE showed a trend toward correlating with fibrosis (r = 0.42; P = .068), while HVPG did not (r = 0.18; P = .45). SHAPE could differentiate between mild (stage 0-1) and moderate to severe (stage 2-4) fibrosis (À10.4 AE 4.9 dB versus À5.4 AE 3.2 dB; P = .035), HVPG could not (3.0 AE 0.6 mmHg versus 4.8 AE 0.7 mmHg; P = .30). ROC curves showed a diagnostic accuracy for SHAPE of 80%, while HVPG reached 76%.Conclusion-Liver fibrosis staging in dialysis patients evaluated for portal hypertension appears to be more accurately predicted by SHAPE than by HVPG; albeit in a small sample size.Key Words-chronic kidney disease; contrast-enhanced ultrasound; dialysis; portal hypertension; subharmonic imaging; subharmonic pressure estimation L iver cirrhosis is the final common pathological pathway of liver damage arising from a wide variety of chronic liver diseases. [1][2][3][4][5][6][7][8][9] Histologically, it is characterized by diffuse nodular regeneration and dense fibrotic septa evolving to parenchymal extinction and collapse of liver structures. [1][2][3][4][5][6][7][8][9] Distortion of hepatic vascular architecture and increased resistance to portal blood flow leads to portal hypertension and hepatic synthetic dysfunction. [1][2][3][4][6][7][8][9][10]

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Ultrasound Pressure Estimation for Diagnosing Portal Hypertension in Patients Undergoing Dialysis for Chronic Kidney Disease

Machado

Gupta

Fenkel

et al. 2021

J of Ultrasound Medicine

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“…This may be due to microbubble destruction at higher mechanical indices and thus demonstrates the need for low mechanical index imaging in this new application of using SonoVue microbubbles to estimate hydrostatic pressure. A direct comparison of the subharmonic response of SonoVue with other microbubble ultrasound contrast agents will help verify this different behavior of SonoVue [31].…”

Section: B Subharmonic-pressure Response Of Sonovue Differs From Othmentioning

confidence: 98%

Optimal Control of SonoVue Microbubbles to Estimate Hydrostatic Pressure

Nio

Faraci

Christensen-Jeffries

et al. 2020

IEEE Trans. Ultrason., Ferroelect., Freq. Contr.

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The measurement of cardiac and aortic pressures enables diagnostic insight into cardiac contractility and stiffness. However, these pressures are currently assessed invasively using pressure catheters. It may be possible to estimate these pressures less invasively by applying microbubble ultrasound contrast agents as pressure sensors. The aim of this study was to investigate the subharmonic response of the microbubble ultrasound contrast agent SonoVue (Bracco Spa, Milan, Italy) at physiological pressures using a static pressure phantom. A commercially available cell culture cassette with Luer connections was used as a static pressure chamber. SonoVue was added to the phantom, and radio frequency data were recorded on the ULtrasound Advanced Open Platform (ULA-OP). The mean subharmonic amplitude over a 40% bandwidth was extracted at 0-200-mmHg hydrostatic pressures, across 1.7-7.0-MHz transmit frequencies and 3.5%-100% maximum scanner acoustic output. The Rayleigh-Plesset equation for single-bubble oscillations and additional hysteresis experiments were used to provide insight into the mechanisms underlying the subharmonic pressure response of SonoVue. The subharmonic amplitude of SonoVue increased with hydrostatic pressure up to 50 mmHg across all transmit frequencies and decreased thereafter. A decreasing microbubble surface tension may

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Hepatic Vein Contrast-Enhanced Ultrasound Subharmonic Imaging Signal as a Screening Test for Portal Hypertension

et al. 2021

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The Effects of Hydrostatic Pressure on the Subharmonic Response of SonoVue and Sonazoid

Cited by 4 publications

References 16 publications

Ultrasound Pressure Estimation for Diagnosing Portal Hypertension in Patients Undergoing Dialysis for Chronic Kidney Disease

Ultrasound Pressure Estimation for Diagnosing Portal Hypertension in Patients Undergoing Dialysis for Chronic Kidney Disease

Optimal Control of SonoVue Microbubbles to Estimate Hydrostatic Pressure

Hepatic Vein Contrast-Enhanced Ultrasound Subharmonic Imaging Signal as a Screening Test for Portal Hypertension

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