shu-508 and Neoplasms

This paper reviews the potential of ultrasound for assessing the viability and biological behavior of tumors. Unlike color Doppler sonography, modern techniques for contrast-enhanced ultrasound permit the measurement of tissue perfusion irrespective of vessel size or flow velocity. Perfusion can also be assessed quantitatively, using replenishment kinetics or derivates thereof. The perfusion of tumors is a surrogate parameter of their viability and may mirror their response to therapy. Furthermore, the degree of vascularity in a tumor may express its aggressiveness and help to predict its response to treatment. In animal models, a decrease in blood flow has been shown to precede a shrinkage of tumors treated with anti-angiogenic compounds. In liver metastases, arterial and portal blood supply can be assessed separately, and a response to stereotactic radiotherapy was found to go along with a decrease in arterial perfusion. Moreover, a relatively high arterial perfusion of liver metastases may predict a response to chemotherapy. Contrast-enhanced ultrasound may be a potent tool for assessing the effects of anti-angiogenic treatment in patients.

Topics: Air; Animals; Contrast Media; Gases; Humans; Liver Neoplasms; Neoplasms; Neoplasms, Experimental; Phospholipids; Polysaccharides; Sulfur Hexafluoride; Ultrasonography, Doppler, Color

The early and functional evaluation of new treatments in oncology is a main goal. At present, technical advances in Doppler ultrasonography allow the detection of neovascularization for superficial and deep malignant tumours in order to evaluate the efficiency of new treatments such as antiangiogenic molecules. Contrast agents injection improves the efficiency of this technique and developments of perfusion softwares optimize this detection. Slow flows in tumour microvessels can be detected. Treatment response can be early predicted based on changes in the vascularization before volume modification. The availability of quantification softwares operating from the raw data before their compression for video display affords one and objective quantification of the contrast agent uptake.

Topics: Antineoplastic Agents; Benzamides; Contrast Media; Gastrointestinal Stromal Tumors; Humans; Imatinib Mesylate; Kidney Neoplasms; Microcirculation; Neoplasms; Neovascularization, Pathologic; Phospholipids; Piperazines; Polysaccharides; Pyrimidines; Sulfur Hexafluoride; Treatment Outcome; Ultrasonography

Fifty-one patients, with a range of underlying pathologic conditions, were studied prospectively to assess the diagnostic value of echo-enhanced color Doppler sonography in the pediatric and adolescent population Their diagnoses included various tumors, vascular disorders, cerebral bleeding, pathologic conditions of small parts, and focal lesions of parenchymal organs. All patients underwent color Doppler sonography before proceeding to echo-enhanced color Doppler sonography. Diagnoses were confirmed by additional imaging (computed tomography, magnetic resonance imaging, angiography, and scintigraphy) performed as appropriate, with or without histologic study. An additional 20 children did not proceed to echoenhanced color Doppler sonography as color Doppler sonography alone was found to be sufficiently diagnostic. Levovist (SHU 508A), a contrast agent based on galactose-encapsulated air microbubbles, is approved for pediatric applications in Austria and was used as the echo-enhancing agent. Echo-enhanced color Doppler sonography was performed a total of 63 times in 51 patients (mean age, 9.8 years). Compared to color Doppler sonography, echo-enhanced color Doppler sonography either detected or enhanced visualization of pathologic conditions in 55 investigations (87.3%), yielding an overall accuracy of 95.2% (sensitivity, 95%), versus 65.7% with color Doppler sonography. One spinal arteriovenous malformation, one cerebral cavernoma, and one liver lesion were missed. The contrast material was easy to administer; no adverse reactions were observed. We conclude that echoenhanced color Doppler sonography is beneficial in pediatric sonography. It enhances visualization of vessels and perfusion, thus offering a nonionizing imaging tool for detection and follow-up evaluation of pathologic conditions with disturbed vasculature in specific cases. In infants and in persons with superficial lesions it did not offer significant advantages over color Doppler sonography.

Topics: Adolescent; Adult; Age Factors; Arteriovenous Malformations; Child; Child, Preschool; Contrast Media; Female; Humans; Image Enhancement; Infant; Infant, Newborn; Kidney Diseases; Liver Diseases; Magnetic Resonance Imaging; Male; Neoplasms; Polysaccharides; Prospective Studies; Sensitivity and Specificity; Tomography, Emission-Computed; Tomography, X-Ray Computed; Ultrasonography, Doppler, Color; Urography; Vascular Diseases

Topics: Contrast Media; Humans; Image Enhancement; Neoplasms; Polysaccharides; Ultrasonography, Doppler, Color