shu-508 and Carcinoma

We quantified changes in prostate carcinoma vascularity treated with anti-androgens using color Doppler and power transrectal ultrasound in combination with microbubble contrast agent Levovist.. Thirty-six men with prostate carcinoma were studied at baseline and at intervals during treatment. At each attendance, Levovist((R)) (10 ml, 300 mg/ml) was given as an iv bolus. Using quantitative analysis, we calculated the pre-enhancement scores, arrival time, time to peak, peak value, and area under the time-enhancement curve (AUC). These were compared to pre-treatment values and serial PSA measurements.. The pre-enhancement, peak value, and AUC each showed a marked response with reductions within one week. The average AUC declined to 68% +/- 9% (mean +/- standard error) by week 1, 56% +/- 9% by week 3, and 20% +/- 4% by week 6. A strong correlation with changes in the mean PSA (r = 0.95, P < 0.001) was also measured. In four patients, Doppler indices did not fall with PSA: two patients with the most marked discrepancy relapsed at 6 months.. The vascular enhancement declined with therapy, similar to PSA. Microbubble enhanced ultrasound can show early response to treatment.

Topics: Androgen Antagonists; Carcinoma; Contrast Media; Humans; Male; Middle Aged; Neoplasm Staging; Polysaccharides; Prostate-Specific Antigen; Prostatic Neoplasms; Rectum; Sensitivity and Specificity; Treatment Outcome; Ultrasonography, Doppler, Color

Comparative study of contrast-enhanced ultrasonography (CE-US) and histopathology of surgically resected specimens in 13 patients with pancreatic carcinoma. A time intensity curve was used to determine the percentage brightness increase in cancerous and normal regions and the patients were divided into two groups, hyperperfusion, with a percentage brightness increase over 80% (n=6) and hypoperfusion, with an increase of less than 80% (n=7) on CE-US. The hyperperfusion group included well-differentiated tubular adenocarcinoma, adenosquamous cell carcinoma and acinar cell carcinoma, while all 7 patients in the hypoperfusion group had moderately differentiated tubular adenocarcinoma. Immunological staining (α-SMA and anti-CD34) of the resected specimens showed significantly higher microartery count (MAC) in the hyperperfusion group (p<0.005) than in the hypoperfusion group or normal pancreas. In the normal pancreas, the mean vessel diameter was significantly higher (over 100 μm) than in the hyperperfusion group (30 μm; p<0.005). It was concluded that a muscular arterial vessel density of less than 30 μm is an important factor in determining staining degree and carcinoma progression by CE-US in pancreatic carcinoma.

Topics: Actins; Adenocarcinoma; Aged; Antigens, CD34; Arteries; Biomarkers, Tumor; Carcinoma; Carcinoma, Acinar Cell; Carcinoma, Adenosquamous; Contrast Media; Female; Humans; Immunohistochemistry; Male; Middle Aged; Muscle, Smooth, Vascular; Pancreatic Neoplasms; Polysaccharides; Predictive Value of Tests; Staining and Labeling; Ultrasonography

We examined contrast-enhanced harmonic gray-scale sonographic findings of pancreatic carcinoma in relation to the pathological findings in resected specimens to evaluate correlations between observations made by this modality and the pathological findings.. The pathological findings of surgical specimens obtained from 16 patients were examined in relation to the contrast-enhanced harmonic gray-scale sonography findings. Lesion vascularity was examined by contrast-enhanced harmonic gray-scale sonography from 20 to 50 s after the injection of Levovist (Schering, Berlin, Germany) (early phase), and lesion enhancement was also monitored at approximately 90 s after injection (delayed phase).. Contrast-enhanced harmonic gray-scale sonography showed positive enhancement in 12 of the 16 lesions (peripheral tumor region alone, n = 9; entire tumor, n = 3), while the other 4 lesions showed no contrast enhancement in any region. Twelve enhanced regions (9 peripheral tumor region and 3 entire tumor regions) detected by contrast-enhanced harmonic gray-scale sonography showed: (1) mild fibrosis with inflammation, in 10 regions (83%); (2) the presence of both carcinoma cells and residual acinar cells in 8 (67%); and (3) presence of relatively large arteries in 2 (17%). In contrast, 13 non-enhanced regions (4 entire tumor regions and 9 central regions) showed: (1) severe fibrosis in 10 regions (77%); (2) necrosis in 7 (54%); and (3) mucin in 4 (31%).. Contrast-enhanced harmonic gray-scale sonographic findings of pancreatic carcinoma are influenced by interstitial histological features associated with tumor growth.

Topics: Aged; Carcinoma; Contrast Media; Female; Follow-Up Studies; Humans; Injections, Intravenous; Male; Middle Aged; Pancreatic Neoplasms; Polysaccharides; Retrospective Studies; Sensitivity and Specificity; Severity of Illness Index; Tomography, X-Ray Computed; Ultrasonography

This study was designed to evaluate digital subtraction imaging (DSI) with Levovist in the diagnosis of hepatocellular carcinoma (HCC), metastatic hepatocellular carcinoma, and hepatic hemangioma. The subjects in this study were 70 patients with 76 nodules of hepatic tumors (48 nodules in 46 cases of hepatocellular carcinoma, 20 nodules in 16 cases of metastatic hepatocellular carcinoma, and 8 nodules in 8 cases of hepatic hemangioma). Contrast enhancement of tumors acquired in the early, portal, and late phases with DSI were compared to classify the tumors. DSI of HCC showed contrast enhancement of 40 nodules (82.2%). High contrast enhancement in the early phase, which was maintained in the portal phase, changed to images with no contrast enhancement with partial persistence of contrast enhancement in the late phase. DSI of metastatic hepatic carcinomas demonstrated contrast enhancement of tumor of 18 nodules (90%) to a high degree in the early and portal phases, which changed to images with no contrast enhancement in the late phases. DSI of hepatic hemangioma maintained high contrast enhancement on tumor margins of 5 nodules (62.5%) and on the entire tumor of 3 nodules (37.5%) in the early, portal, and late phases. DSI of hepatic tumors (hepatocellular carcinoma, metastatic hepatocellular carcinoma, and hepatic hemangioma) provided characteristic findings of contrast enhancement in the early, portal, and late phases, and contribute to differential diagnosis.

Topics: Aged; Aged, 80 and over; Angiography; Carcinoma; Carcinoma, Hepatocellular; Contrast Media; Female; Hemangioma; Humans; Image Processing, Computer-Assisted; Leiomyosarcoma; Liver Neoplasms; Male; Middle Aged; Polysaccharides; Subtraction Technique; Tomography, X-Ray Computed; Ultrasonography

To investigate if the use of a contrast agent (Levovist) improves the specificity of US in the diagnosis of prostate carcinoma, having the results of prostate biopsy as the gold standard.. Thirty patients with physical findings suspicious for prostate carcinoma and PSA ranging 5 ng/mL to 15 ng/mL were examined with transrectal US (TRUS) integrated with the color Doppler mode and contrast agent administration (4 g injected at 4 mL/min: 300 mL concentration).. Based on bioptic and surgical results, 14 prostate carcinomas were found, all of them < 1.2 cm. Conventional US recognized the suspected nodule in 11 cases, with 78% sensitivity and 93% specificity. Color Doppler showed color signals in 8/14 cases, which were peripheral to the lesion or intranodular, but did not add any important finding to those of gray-scale US. In contrast, contrast enhanced studies showed 13/14 carcinomas, which improved sensitivity significantly (92%). Particularly, 11/14 lesions had a typical avascular pattern within the strongly enhanced peripheral gland, while 2 small lesions only exhibited intranodular vessels.. We compared our results with the Microscopic Angiogenesis Grading System (MAGS) index and found it exceeded 30 in the 11 avascular lesions value indicates microneoangiogenesis. In the other two cases a value < 30 was correlated with a different type of tumor vascularization typical of macroangiogenesis.

Topics: Aged; Aged, 80 and over; Biopsy; Carcinoma; Contrast Media; Humans; Male; Middle Aged; Neovascularization, Pathologic; Polysaccharides; Prostate; Prostatic Neoplasms; Ultrasonography, Doppler, Color; Ultrasonography, Interventional

To evaluate contrast agent-enhancement patterns in hepatic hemangiomas, hepatic metastases, and hepatocellular carcinomas (HCCs) at pulse-inversion harmonic ultrasonography (US) with a microbubble contrast agent.. Twenty hepatic hemangiomas in 20 patients and 41 malignant hepatic tumors in 23 patients (33 metastases and eight HCCs) were evaluated with pulse-inversion harmonic US. US images were obtained before injection and every 10-15 seconds after injection of a 4-g bolus (300 mg/mL) of SH U 508A (a microbubble contrast agent) for 5 minutes. The contrast-enhancement patterns of 61 hepatic lesions were assessed.. Of 20 hemangiomas, 19 revealed peripheral enhancement, which was globular in 14 (70%) and rimlike in five (25%), with centripetal fill-in; the remaining one (5%) showed homogeneous enhancement. In 33 metastases, the enhancement was rimlike in 16 (48%), homogeneous in seven (21%), and stippled in two (6%); in the remaining eight metastases (24%), no enhancement was seen. Of eight HCCs, four (50%) showed homogeneous enhancement and the remaining four (50%) showed heterogeneous enhancement. Centripetal fill-in of lesions with intratumoral enhancement was not seen in any malignancy.. Pulse-inversion harmonic US with a microbubble contrast agent is potentially useful for the specific diagnosis of hemangiomas that demonstrate characteristic enhancement features.

Topics: Adult; Aged; Carcinoma; Carcinoma, Hepatocellular; Carcinoma, Islet Cell; Contrast Media; Female; Follow-Up Studies; Hemangioma; Humans; Image Enhancement; Liver; Liver Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Polysaccharides; Tomography, X-Ray Computed; Ultrasonography

The authors investigated the effect of intermittent second-harmonic gray-scale (ISHGS) ultrasonography (US) with SH U 508A microbubbles on the conspicuity of focal liver lesions. Twenty-three patients were included in the study. Images were analyzed subjectively and quantitatively. Objective lesion conspicuity was increased. In 12 of the 15 patients with liver malignancy, gray-scale defects were seen in previously unsuspected areas. ISHGS US may improve the sensitivity of US for liver lesions.

Topics: Adult; Aged; Carcinoid Tumor; Carcinoma; Contrast Media; Female; Focal Nodular Hyperplasia; Humans; Image Enhancement; Image Processing, Computer-Assisted; Infusions, Intravenous; Liver; Liver Neoplasms; Male; Middle Aged; Observer Variation; Phantoms, Imaging; Polysaccharides; Sensitivity and Specificity; Ultrasonics; Ultrasonography; Videotape Recording

To report the results of a prospective study investigating the potentials of contrast-enhanced power Doppler in the diagnosis of expansive renal lesions.. From 1997 to October 30, 1999, we studied 59 expansive renal lesions (28 malignant, 31 benign) in 48 patients (mean age 55 years, range 10-79) with power Doppler US before and after the administration of an echo-enhancing agent (Levovist, Schering AG, Berlin, Germany). We identified 5 patterns of vascular architecture of the lesions, both before and after contrast agent administration, following the classification by Jinzaki e Coll.. Power Doppler US showed vascular structures in 34 patients. The administration of Levovist revealed vessels in 12/25 lesions which had none at baseline studies and in 6 cases vascularity was particularly evident. Color signals were enhanced in all the 34 vascularized lesions, which allowed better definition of vascular patterns. The characterization of vascular patterns with baseline power Doppler US helped improve diagnostic accuracy compared to gray-scale US (58% versus 32%) for hyperechoic lesions, complex cysts and pseudomasses. Independent of contrast agent administration, the integration of gray-scale and power Doppler modes increased diagnostic accuracy even further (76% correct diagnoses).. In our series, the US contrast agent did not increase the diagnostic accuracy of power Doppler in the differential diagnosis of hyperechoic renal lesions; conversely, Levovist can be advantageous for the characterization of suspected pseudomasses and complex cysts.

Topics: Adolescent; Adult; Aged; Angiolipoma; Carcinoma; Child; Contrast Media; Cysts; Female; Humans; Kidney Neoplasms; Male; Middle Aged; Polysaccharides; Prospective Studies; Ultrasonography, Doppler

Prospective comparison of plain and signal-enhanced frequency and amplitude-modulated colour Doppler ultrasound of intramammary tumours to evaluate new criteria for diagnostic analysis.. Frequency and amplitude-modulated colour Doppler examination with qualitative and quantitative analysis of 80 potentially malignant intramammary lesions were performed before and after application of d-galactose.. Signal-enhanced sonography revealed a typical vessel morphology of primary and recurrent breast cancer facilitating differential diagnosis. In 18 (frequency modulated US) or 16 (amplitude modulated US) of 51 carcinomas, the typical malignant vascularisation structure was sufficiently visible only after application of the signal enhancing agent. In 50% of the fibroadenomas, Doppler analysis of the vessels was possible only after application of d-galactose.. The application of d-galactose provides additional criteria for the differential diagnosis of breast lesions due to improved visualisation of the vascularisation structure.

Topics: Adult; Aged; Breast Neoplasms; Carcinoma; Contrast Media; Diagnosis, Differential; Evaluation Studies as Topic; Female; Fibroadenoma; Humans; Middle Aged; Polysaccharides; Prospective Studies; Ultrasonography, Doppler, Color