Quantitative analysis of in-vivo microbubble distribution in the human brain

Abstract Microbubbles (MB) are widely used as contrast agents to perform contrast-enhanced ultrasound (CEUS) imaging and as acoustic amplifiers of mechanical bioeffects incited by therapeutic-level ultrasound. The distribution of MBs in the brain is not yet fully understood, thereby limiting intra-o...

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Autores principales:	Francesco Prada, Antonio G. Gennari, Ian M. Linville, Michael E. Mutersbaugh, Zhihang Chen, Natasha Sheybani, Francesco DiMeco, Frederic Padilla, John A. Hossack
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d4bfe53ddf554e02a480635dedb5da5e
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spelling	oai:doaj.org-article:d4bfe53ddf554e02a480635dedb5da5e2021-12-02T18:24:54ZQuantitative analysis of in-vivo microbubble distribution in the human brain10.1038/s41598-021-91252-w2045-2322https://doaj.org/article/d4bfe53ddf554e02a480635dedb5da5e2021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-91252-whttps://doaj.org/toc/2045-2322Abstract Microbubbles (MB) are widely used as contrast agents to perform contrast-enhanced ultrasound (CEUS) imaging and as acoustic amplifiers of mechanical bioeffects incited by therapeutic-level ultrasound. The distribution of MBs in the brain is not yet fully understood, thereby limiting intra-operative CEUS guidance or MB-based FUS treatments. In this paper we describe a robust platform for quantification of MB distribution in the human brain, allowing to quantitatively discriminate between tumoral and normal brain tissues and we provide new information regarding real-time cerebral MBs distribution. Intraoperative CEUS imaging was performed during surgical tumor resection using an ultrasound machine (MyLab Twice, Esaote, Italy) equipped with a multifrequency (3–11 MHz) linear array probe (LA332) and a specific low mechanical index (MI < 0.4) CEUS algorithm (CnTi, Esaote, Italy; section thickness, 0.245 cm) for non-destructive continuous MBs imaging. CEUS acquisition is started by enabling the CnTI PEN-M algorithm automatically setting the MI at 0.4 with a center frequency of 2.94 MHz–10 Hz frame rate at 80 mm—allowing for continuous non-destructive MBs imaging. 19 ultrasound image sets of adequate length were selected and retrospectively analyzed using a custom image processing software for quantitative analysis of echo power. Regions of interest (ROIs) were drawn on key structures (artery–tumor–white matter) by a blinded neurosurgeon, following which peak enhancement and time intensity curves (TICs) were quantified. CEUS images revealed clear qualitative differences in MB distribution: arteries showed the earliest and highest enhancement among all structures, followed by tumor and white matter regions, respectively. The custom software built for quantitative analysis effectively captured these differences. Quantified peak intensities showed regions containing artery, tumor or white matter structures having an average MB intensity of 0.584, 0.436 and 0.175 units, respectively. Moreover, the normalized area under TICs revealed the time of flight for MB to be significantly lower in brain tissue as compared with tumor tissue. Significant heterogeneities in TICs were also observed within different regions of the same brain lesion. In this study, we provide the most comprehensive strategy for accurate quantitative analysis of MBs distribution in the human brain by means of CEUS intraoperative imaging. Furthermore our results demonstrate that CEUS imaging quantitative analysis enables discernment between different types of brain tumors as well as regions and structures within the brain. Similar considerations will be important for the planning and implementation of MB-based imaging or treatments in the future.Francesco PradaAntonio G. GennariIan M. LinvilleMichael E. MutersbaughZhihang ChenNatasha SheybaniFrancesco DiMecoFrederic PadillaJohn A. HossackNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Francesco Prada Antonio G. Gennari Ian M. Linville Michael E. Mutersbaugh Zhihang Chen Natasha Sheybani Francesco DiMeco Frederic Padilla John A. Hossack Quantitative analysis of in-vivo microbubble distribution in the human brain
description	Abstract Microbubbles (MB) are widely used as contrast agents to perform contrast-enhanced ultrasound (CEUS) imaging and as acoustic amplifiers of mechanical bioeffects incited by therapeutic-level ultrasound. The distribution of MBs in the brain is not yet fully understood, thereby limiting intra-operative CEUS guidance or MB-based FUS treatments. In this paper we describe a robust platform for quantification of MB distribution in the human brain, allowing to quantitatively discriminate between tumoral and normal brain tissues and we provide new information regarding real-time cerebral MBs distribution. Intraoperative CEUS imaging was performed during surgical tumor resection using an ultrasound machine (MyLab Twice, Esaote, Italy) equipped with a multifrequency (3–11 MHz) linear array probe (LA332) and a specific low mechanical index (MI < 0.4) CEUS algorithm (CnTi, Esaote, Italy; section thickness, 0.245 cm) for non-destructive continuous MBs imaging. CEUS acquisition is started by enabling the CnTI PEN-M algorithm automatically setting the MI at 0.4 with a center frequency of 2.94 MHz–10 Hz frame rate at 80 mm—allowing for continuous non-destructive MBs imaging. 19 ultrasound image sets of adequate length were selected and retrospectively analyzed using a custom image processing software for quantitative analysis of echo power. Regions of interest (ROIs) were drawn on key structures (artery–tumor–white matter) by a blinded neurosurgeon, following which peak enhancement and time intensity curves (TICs) were quantified. CEUS images revealed clear qualitative differences in MB distribution: arteries showed the earliest and highest enhancement among all structures, followed by tumor and white matter regions, respectively. The custom software built for quantitative analysis effectively captured these differences. Quantified peak intensities showed regions containing artery, tumor or white matter structures having an average MB intensity of 0.584, 0.436 and 0.175 units, respectively. Moreover, the normalized area under TICs revealed the time of flight for MB to be significantly lower in brain tissue as compared with tumor tissue. Significant heterogeneities in TICs were also observed within different regions of the same brain lesion. In this study, we provide the most comprehensive strategy for accurate quantitative analysis of MBs distribution in the human brain by means of CEUS intraoperative imaging. Furthermore our results demonstrate that CEUS imaging quantitative analysis enables discernment between different types of brain tumors as well as regions and structures within the brain. Similar considerations will be important for the planning and implementation of MB-based imaging or treatments in the future.
format	article
author	Francesco Prada Antonio G. Gennari Ian M. Linville Michael E. Mutersbaugh Zhihang Chen Natasha Sheybani Francesco DiMeco Frederic Padilla John A. Hossack
author_facet	Francesco Prada Antonio G. Gennari Ian M. Linville Michael E. Mutersbaugh Zhihang Chen Natasha Sheybani Francesco DiMeco Frederic Padilla John A. Hossack
author_sort	Francesco Prada
title	Quantitative analysis of in-vivo microbubble distribution in the human brain
title_short	Quantitative analysis of in-vivo microbubble distribution in the human brain
title_full	Quantitative analysis of in-vivo microbubble distribution in the human brain
title_fullStr	Quantitative analysis of in-vivo microbubble distribution in the human brain
title_full_unstemmed	Quantitative analysis of in-vivo microbubble distribution in the human brain
title_sort	quantitative analysis of in-vivo microbubble distribution in the human brain
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/d4bfe53ddf554e02a480635dedb5da5e
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Quantitative analysis of in-vivo microbubble distribution in the human brain

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