Ultrasound in Medicine and Biology

Masthead

2010-03-01

Editorial Advisory Board

2010-03-01

Three-Dimensional High-Frequency Characterization of Cancerous Lymph Nodes

2010-02-04

Abstract: High-frequency ultrasound (HFU) offers a means of investigating biologic tissue at the microscopic level. High-frequency, three-dimensional (3-D) quantitative-ultrasound (QUS) methods were developed to characterize freshly-dissected lymph nodes of cancer patients. Three-dimensional ultrasound data were acquired from lymph nodes using a 25.6-MHz center-frequency transducer. Each node was inked prior to tissue fixation to recover orientation after sectioning for 3-D histologic evaluation. Backscattered echo signals were processed using 3-D cylindrical regions-of-interest to yield four QUS estimates associated with tissue microstructure (i.e., effective scatterer size, acoustic concentration, intercept and slope). QUS estimates were computed following established methods using two scattering models. In this study, 46 lymph nodes acquired from 27 patients diagnosed with colon cancer were processed. Results revealed that fully-metastatic nodes could be perfectly differentiated from cancer-free nodes using slope or scatterer-size estimates. Specifically, results indicated that metastatic nodes had an average effective scatterer size (i.e., 37.1 ± 1.7 μm) significantly larger (p < 0.05) than that in cancer-free nodes (i.e., 26 ± 3.3 μm). Therefore, the 3-D QUS methods could provide a useful means of identifying small metastatic foci in dissected lymph nodes that might not be detectable using current standard pathology procedures. (E-mail: mamou@rrinyc.org)

The Validity of Ultrasonographic Assessment in Cubital Tunnel Syndrome: The Value of a Cubital-to-Humeral Nerve Area Ratio (CHR) Combined with Morphologic Features

Hannes Gruber, Bernhard Glodny, Siegfried Peer — 2010-02-04

Abstract: Diagnosis of a typical idiopathic cubital tunnel syndrome (CuTS) is straight forward but the work-up of mild forms is clinically challenging. The diagnostic value of high-resolution ultrasound (HRUS) relying solely on nerve measurements is doubtful. Additional textural analysis of the nerve may possibly overcome this drawback. Thirty-eight prospectively enrolled patients with idiopathic CuTS and 23 healthy volunteers underwent standardized HRUS. A cubital-to-humeral nerve area ratio (CHR) was calculated and the texture of the most swollen nerve segment assessed. CHR was significantly different among patients and volunteers (p<0.001) but with a marked overlap. Combination of at least partial inner fascicular masking plus a CHR>1.4 showed a positive linear coherence with idiopathic CuTS at a specificity>95% and a PPV>90%. Thus, the combined textural analysis and CHR calculation seems a powerful tool for the sonographic diagnosis of idiopathic CuTS. (E-mail: hannes.gruber@i-med.ac.at)

A New Visually Evoked Cerebral Blood Flow Response Analysis Using a Low-Frequency Estimation

Beatriz Rey, Valery Naranjo, Vera Parkhutik, José Tembl, Mariano Alcañiz — 2010-02-04

Abstract: Transcranial Doppler (TCD) has been widely used to monitor cerebral blood flow velocity (BFV) during the performance of cognitive tasks compared with repose periods. Although one of its main advantages is its high temporal resolution, only some of the previous functional TCD studies have focused on the analysis of the temporal evolution of the BFV signal and none of them has performed a spectral analysis of the signal. In this study, maximum BFV data in both posterior cerebral arteries was monitored during a visual perception task (10 cycles of alternating darkness and illumination) for 23 subjects. A peak was located in the low-frequency band of the spectrum of the maximum BFV of each subject both during visual stimulation and repose periods. The frequency of this peak was in the range between 0.037 and 0.098Hz, depending on the subject, the vessel and the experimental condition. The component of the signal at this frequency, which is associated with the slow variations caused by the visual stimuli, was estimated. That way, the variations in BFV caused by the experimental stimuli were isolated from the variations caused by other factors. This low-frequency estimation signal was used to obtain parameters about the temporal evolution and the magnitude variations of the BFV in a reliable way, thus, characterizing the neurovascular coupling of the participants. (E-mail: brey@labhuman.i3bh.es)

Longitudinal Reference Values for Ductus Venosus Doppler in Low-Risk Pregnancies

2010-02-04

Abstract: The aim of this study was to establish normal ranges of blood flow velocities and indices in the fetal ductus venosus (DV) during the second half of normal pregnancy. A Doppler study of 60 healthy pregnant women without fetal pathologies was performed during the second half of pregnancy. The peak systolic velocity (PSV), peak diastolic velocity (PDV), maximum velocity during atrial contraction (VAC), peak systolic velocity / maximum velocity during atrial contraction (S/A ratio), pulsatility index for the vein (PIV), preload index (PLI) and velocity index for the vein (VIV) were calculated from the DV at 4-week intervals. A significant increase in PSV, PDV and VAC was observed from the 20–236/7 to the 28–316/7 weeks, with stabilization of values until the end of the pregnancy. On the other hand, the study showed a significant decrease for the S/A ratio, PIV, PLI and VIV from the 20–236/7 to the 28–316/7 weeks and remaining stable from then until term. (E-mail: dralemar@uol.com.br)

Shock Waves in the Treatment of Post-Traumatic Myositis Ossificans

2010-02-04

Abstract: Myositis ossificans (MO) is a fairly common evolution in sports activity and can be due to direct trauma or to repeated micro-injuries. The traditional therapeutic approach relies on a variety of treatments, such as physical therapy but evidence of their proven clinical efficacy is lacking. The latest therapeutic option is surgical removal but this is a demolitive procedure and is frequently associated with a significant loss of functional integrity. There are few articles in literature about the treatment of post-traumatic MO, and none on extracorporeal shock wave therapy (ESWT). We illustrate a case series of 24 sportsmen treated with three sessions of electro-hydraulic shockwave therapy and an associated rehabilitation program. Only a partial reduction of the ossification was observed in the X-ray images but all the patients showed signs of functional improvement immediately after therapy. Two months after the therapy, a normal range of motion and no signs of weakness were observed. Three months after treatment, 87.5% of patients resumed regular sports activities. (E-mail: angelanotarnicola@yahoo.it)

An Analysis of the Origin of Differences between Measured and Simulated Fields Produced by A 15-Element Ultrasound Phased Array

Adam H. Aitkenhead, John A. Mills, Adrian J. Wilson — 2010-02-04

Abstract: Modeling provides an attractive approach for the design of phased array ultrasound transducers for hyperthermia. However, measurements on physical transducers reveal differences from the idealized field profiles predicted by simulation. In this paper we report a method of analyzing the origins of these differences. The measured performance of a 15-element sparse phased array is described and compared with simulated fields calculated using the point source method. It highlighted two notable differences: First, that the focal region was located closer to the surface of the physical transducer than in the simulated fields; and second, that numerous intensity maxima were present between the surface of the transducer and the focal zone in the experimental data, but not in the simulated fields. We identified six factors that could potentially affect the field but were not taken into account by the default simulations, and we performed a sensitivity analysis on these: (i) Variation in the amplitude of the output from each element, (ii) the presence of square-wave harmonics in the drive signals, (iii) nonpistonlike vibration of elements, (iv) quantization of the applied phases, (v) errors in the spatial positioning of each element; and (vi) interelement cross-coupling. Both the independent impact of each factor and the interactions between multiple factors were analyzed by using a full-factorial experimental design composed of 64 (26) simulations. The results indicated that nonpistonlike motion of elements is likely to be the primary cause of differences between the measured and modelled fields. Determination of the precise vibrational modes of elements in an array is complex and would require full finite element analysis. However, the simple vibrational mode considered within the present work, corresponding to the addition of a surface Rayleigh wave originating at the element center and propagating radially, produced simulation results that were in good agreement with the measured data. (E-mail: adam.aitkenhead@physics.cr.man.ac.uk)

Cavitation Properties of Block Copolymer Stabilized Phase-Shift Nanoemulsions Used as Drug Carriers

Natalya Rapoport, Douglas A. Christensen, Anne M. Kennedy, Kweon-Ho Nam — 2010-02-04

Abstract: Cavitation properties of block copolymer stabilized perfluoropentane nanoemulsions have been investigated. The nanoemulsions were stabilized by two biodegradable amphiphilic block copolymers differing in the structure of the hydrophobic block, poly(ethylene oxide)-co-poly(L-lactide) (PEG-PLLA) and poly(ethylene oxide)-co-polycaprolactone (PEG-PCL). Cavitation parameters were measured in liquid emulsions and gels as a function of ultrasound pressure for unfocused or focused 1-MHz ultrasound. Acoustic droplet vaporization preceded generation of acoustic cavitation in liquid matrices and gels. Both stable and inertial cavitation was observed for focused ultrasound while only stable cavitation was observed for unfocused ultrasound. (E-mail: Natasha.rapoport@utah.edu)

Sonoporation Mediated Immunogene Therapy of Solid Tumors

2010-02-04

Abstract: Development of gene-based therapies for the treatment of inherited and acquired diseases, including cancer, has seen renewed interest in the use of nonviral vectors coupled to physical delivery modalities. Low-frequency ultrasound (US), with a well-established record in a clinical setting, has the potential to deliver DNA efficiently, accurately and safely. Optimal in vivo parameters for US-mediated delivery of naked plasmid DNA were established using the firefly luciferase reporter gene construct. Optimized parameters were used to administer a therapeutic gene construct, coding for granulocyte-macrophage colony-stimulating factor (GM-CSF) and B7-1 costimulatory molecule, to growing murine fibrosarcoma tumors. Tumor progression and animal survival was monitored throughout the study and the efficacy of the US-mediated gene therapy determined and compared with an electroporation-based approach. Optimal parameters for US-mediated delivery of plasmid DNA to tumors were deduced to be 1.0 W/cm2 at 20% duty cycle for 5 min (60 J/cm2). In vivo US-mediated gene therapy resulted in a 55% cure rate in tumor-bearing animals. The immunological response invoked was cell mediated, conferring resistance against re-challenge and resistance to tumor challenge after transfer of splenocytes to naïve animals. US treatment was noninjurious to treated tissue, whereas therapeutic efficacy was comparable to an electroporation-based approach. US-mediated delivery of an immune-gene construct to growing tumors was therapeutically effective. Sonoporation has the potential to be a major factor in the development of nonviral gene delivery approaches. (E-mail: geraldc@iol.ie)

Dendritic Cells Loaded with Ultrasound-Ablated Tumour Induce in vivo Specific Antitumour Immune Responses

Jian Deng, Ying Zhang, Jun Feng, Feng Wu — 2010-03-01

Abstract: Previous studies have shown that high-intensity focused ultrasound (HIFU) ablation can induce a local inflammation with marked infiltration of dendritic cells (DCs). The purpose of this study was to investigate whether DCs could capture and present activating signals delivered by necrotic tumour cells that remain in situ after HIFU, thus initiating specific antitumour immunity. Tumour debris was derived from a mouse H22 tumour model after HIFU ablation. Bone marrow-derived DCs were loaded with HIFU-treated tumour, tumour lysate and mouse serum. Syngeneic naïve C57BL/6J mice were immunised with three loaded DCs followed by a subsequent H22 tumour challenge. Tumour size and survival were then recorded in each vaccinated mouse. The results showed that both HIFU-ablated tumour and tumour lysate could significantly increase the number of mature DCs and the secretion of IL-12 and IFN-γ (p<0.001). The proliferation of splenic lymphocytes co-incubated with the loaded-DCs was significantly higher in both HIFU-ablated tumour and tumour lysate groups (p<0.01). Cytotoxocity and TNF-α and IFN-γ secretion of cytotoxic T lymphocytes against H22 cells were significantly higher in HIFU-ablated tumour group than that in tumour lysate group (p<0.01). After the H22 tumour challenge, a significant decrease of tumour volume was observed in HIFU-ablated tumour group (p<0.01). However, there was no statistical difference of long-term survival rates among three groups (p>0.05). It is concluded that DCs can be activated by HIFU-ablated tumour debris and, thus, initiate host specific antitumour immune response after HIFU therapy. (E-mail: mfengwu@yahoo.com)

Ultrasonic Microbubble-Mediated Gene Delivery Causes Phenotypic Changes of Human Aortic Endothelial Cells

2010-02-04

Abstract: Ultrasound, in combination with microbubbles, serves as a feasible nonviral method in vascular gene delivery. However, the effects of ultrasonic microbubble transfection (UMT) on vascular endothelial cells remained unclear. We therefore investigated whether UMT itself causes phenotypic changes of the human aortic endothelial cells (HAEC) in vitro. HAEC were cultured with solution containing luciferase reporter gene and microbubbles followed by exposure to ultrasound of selected parameters. Thereafter, the proliferation and migration activities of HAEC were investigated. Real-time RT-PCR and/or western blotting were performed to assess expression profile of HAEC, including growth-related factors (vascular endothelial growth factor, fins-like tyrosine kinase-1 [Flt-1] and kinase insert domain-containing receptor [KDR]), coagulatory factor (von Willebrand factor), vasodilatory enzyme (endothelial nitric oxide synthase), gap junctional protein connexin43 and adhesion molecules (P-selectin, intercellular adhesion molecule 1 and vascular cell adhesion molecule 1). The results showed that in conditions where UMT lead to expression of luciferase, proliferation capacity is enhanced (p<0.001), partly attributable to the effect of ultrasound (p<0.05), after excluding the effect of contact inhibition. In addition, the expression of KDR and Flt-1 were found increased at either the mRNA level, protein level, or both (p<0.05). Other markers did not have significant changes (all p>0.2). Similarly, the migration capacity was minimally changed (p>0.3). In conclusion, UMT causes phenotypic changes of HAEC by enhancing proliferation and upregulating KDR and Flt-1, while possesses no obvious adverse effect on viable transfected cells. Further investigation is required to clarify the impact of these changes by UMT in vivo. (E-mail: hiyeh@ms1.mmh.org.tw)

Effects of Nonlinear Propagation in Ultrasound Contrast Agent Imaging

Meng-Xing Tang, Naohisa Kamiyama, Robert J. Eckersley — 2010-02-05

Abstract: This paper investigates two types of nonlinear propagation and their effects on image intensity and contrast-to-tissue ratio (CTR) in contrast ultrasound images. Previous studies have shown that nonlinear propagation can occur when ultrasound travels through tissue and microbubble clouds, making tissue farther down the acoustic path appear brighter in pulse inversion (PI) images, thus reducing CTR. In this study, the effect of nonlinear propagation through tissue or microbubbles on PI image intensity and CTR are compared at low mechanical index. A combination of simulation and experiment with SonoVue microbubbles were performed using a microbubble dynamics model, a laboratory ultrasound system and a clinical prototype scanner. The results show that, close to the bubble resonance frequency, nonlinear propagation through a bubble cloud of a few centimeter thickness with a modest concentration (1:10000 dilution of SonoVue microbubbles) is much more significant than through tissue-mimicking material. Consequently, CTR in regions distal to the imaging probe is greatly reduced for nonlinear propagation through the bubble cloud, with as much as a 12-dB reduction compared with nonlinear propagation through tissue-mimicking material. Both types of nonlinear propagation cause only a small change in bubble PI signals at the bubble resonance frequency. When the driving frequency increases beyond bubble resonance, nonlinear propagation through bubbles is greatly reduced in absolute values. However because of a greater reduction in nonlinear scattering from bubbles at higher frequencies, the corresponding CTR is much lower than that at bubble resonance frequency. (E-mail: mengxing.tang@imperial.ac.uk)

Automatic Localization of Intimal and Adventitial Carotid Artery Layers with Noninvasive Ultrasound: A Novel Algorithm Providing Scan Quality Control

Alessandro C. Rossi, Peter J. Brands, Arnold P.G. Hoeks — 2010-03-01

Abstract: Transcutaneous ultrasound measurements of common carotid artery (CCA) diameter and intima-media thickness (IMT) give insight on arterial dynamics and anatomy, both correlating well with atherosclerosis and risk of cardiovascular disease. We propose a novel automatic algorithm to estimate CCA diameter and IMT in ultrasound (US) images, based on separate analysis of anterior and posterior CCA walls and able to distinguish internal (intima-intima) and external (adventitia-adventitia) diameter. The method combines off-line signal- and image-processing techniques to accommodate echo images acquired at a frame rate of 30Hz and composed directly from RF data, circumventing digital video-grabbing. Segmentation consists of automatic CCA recognition, followed by adventitial delineation performed with a sustain-attack filter with exponentially decaying reference functions. Intimal delineation is then based on the multiscale anisotropic barycenter (MAB), which is an extension of a known delineation method involving the “first order absolute central moment” of the echo amplitude. An automatic measure of the quality of the US beam incidence for each wall is superimosed on the CCA contour overlays for visual feedback. Validation is carried out on 36 US CCA acquisitions from 12 healthy volunteers, as well as on synthetic US images. Results indicate good accuracy on synthetic US images (within 1.3% for diameter and 3% for IMT). The in vivo intra-recording beat-to-beat variations are on average lower than 50μm for external diameter and IMT, and lower than 100μm for internal diameter. A comparison with a commercial device (ART.LAB system) shows that the proposed algorithm performs better in terms of inter-recording precision. The beam incidence control significantly improves the repeatability of IMT estimates, and motivates sonographers actively to maintain a proper scan plane throughout the acquisition to minimize the incidence of confounding factors. The method is clinically viable, providing robust estimates of CCA internal and external diameter and IMT waveforms for both CCA walls, even at a low B-mode update rate of 30 Hz. (E-mail: peter.brands@esaote.nl)

New Adaptive Clutter Rejection for Ultrasound Color Doppler Imaging: In vivo Study

Yang Mo Yoo, Yongmin Kim — 2010-02-04

Abstract: Clutter rejection is essential for accurate flow estimation in ultrasound color Doppler imaging. In this article, we present a new adaptive clutter rejection (ACR) technique where an optimum filter is dynamically selected depending upon the underlying clutter characteristics (e.g., tissue acceleration and power). We compared the performance of the ACR method with other adaptive methods, i.e., down-mixing (DM) and adaptive clutter filtering (ACF), using in vivo data acquired from the kidney, liver and common carotid artery. With the kidney data, the ACR method provided an average improvement of 3.05 dB and 1.7 dB in flow signal-to-clutter ratio (SCR) compared with DM and ACF, respectively. With the liver data, SCR was improved by 2.75 dB and 1.8 dB over DM and ACF while no significant improvement with ACR was found in the common carotid artery data. Thus, the proposed adaptive method could provide more accurate flow estimation by improving clutter rejection in abdominal ultrasound color Doppler imaging pending validation. (E-mail: ykim@u.washington.edu)

An Automatic Angle Tracking Procedure for Feasible Vector Doppler Blood Velocity Measurements

2010-02-04

Abstract: Two-dimensional angle-independent blood velocity estimates typically combine the Doppler frequencies independently measured by two ultrasound beams with known interbeam angle. A different dual-beam approach was recently introduced in which one (reference) beam is used to identify the flow direction, and the second (measuring) beam directly estimates the true flow velocity at known beam-flow angle. In this paper, we present a procedure to automatically steer the two beams along optimal orientations so that the velocity magnitude can be measured. The operator only takes care of locating the Doppler sample volume in the region of interest and, through the extraction of appropriate parameters from the Doppler spectrum, the reference beam is automatically steered toward right orientation to the flow. The velocity magnitude is thus estimated by the measuring beam, which is automatically oriented with respect to the (known) flow direction at a suitable Doppler angle. The implementation of the new angle tracking method in the ULtrasound Advanced Open Platform (ULA-OP), connected to a linear array transducer, is reported. A series of experiments shows that the proposed method rapidly locks the flow direction and measures the velocity magnitude with low variability for a large range of initial probe orientations. In vitro tests conducted in both steady and pulsatile flow conditions produced coefficients of variability (CV) below 2.3% and 8.3%, respectively. The peak systolic velocities have also been measured in the common carotid arteries of 13 volunteers, with mean CV of 7%. (E-mail: piero.tortoli@unifi.it).

The E-Wave Delayed Relaxation Pattern to LV Pressure Contour Relation: Model-Based Prediction With in vivo Validation

Wei Zhang, Leonid Shmuylovich, Sándor J. Kovács — 2010-03-01

Abstract: The transmitral Doppler E-wave “delayed relaxation” (DR) pattern is an established sign of diastolic dysfunction (DD). Furthermore, chambers exhibiting a DR filling pattern are also expected to have a prolonged time-constant of isovolumic relaxation (τ). The simultaneous observation of a DR pattern and normal τ in the same heart is not uncommon, however. The simultaneous hemodynamic equivalent of the DR pattern has not been proposed. To determine the feature of the left ventricular (LV) pressure contour during the E-wave that is causally related to its DR pattern we applied kinematic and fluid mechanics based arguments to derive the pressure recovery ratio (PRR). The PRR is dimensionless and is defined by the left ventricular pressure difference between diastasis and minimum pressure, normalized to the pressure difference between a fiducial diastolic filling pressure and minimum pressure [PRR=(PDiastasis-PMin)/(PFiducial-PMin)]. We analyzed 354 cardiac cycles from 40 normal sinus rhythm (NSR) subjects and 113 beats from nine atrial fibrillation (AF) subjects from our database of simultaneous transmitral flow-micromanometric LV pressure recordings. The fiducial pressure is defined by the end diastolic pressure in NSR and by the pressure at dP/dtMIN in the setting of AF. Consistent with derivation, PRR was linearly related to a DR pattern related, model-based relaxation parameter (R2 = 0.77, 0.83 in NSR and AF, respectively). Furthermore, the PRR successfully differentiated subjects with a DR pattern from subjects with partial DR or normal E-wave pattern (p < 0.05). We conclude that the PRR may differentiate between subjects having a DR pattern and subjects with normal E-waves, even when τ cannot. (E-mail: sjk@wuphys.wustl.edu)

Quantitative Assessment of Articular Cartilage with Morphologic, Acoustic and Mechanical Properties Obtained Using High-Frequency Ultrasound

Shu-Zhe Wang, Yan-Ping Huang, Simo Saarakkala, Yong-Ping Zheng — 2010-03-01

Abstract: Osteoarthritis (OA) is one of the most common joint diseases among adults, and its early detection is still not possible. In this study, high-frequency ultrasound and ultrasound-assisted mechanical testing systems were used to quantitatively measure the morphologic, acoustic and mechanical properties of normal and enzymatically degraded bovine articular cartilages in vitro. A total of 40 osteochondral cartilage plugs were prepared from 20 bovine patellae (n=20×2) and divided into two groups for collagenase and trypsin digestions, respectively. A high-frequency ultrasound system (center frequency: 40MHz) was used to analyze the surface integrity (ultrasound roughness index, URI), thickness and acoustic properties of the articular cartilages before and after enzymatic degradations. Acoustic parameters included the integrated reflection coefficient (IRC) from the cartilage surface, reflection from the cartilage-bone interface (AIBbone), integrated attenuation (IA) and integrated backscatter (IBS) of the internal cartilage tissue. A newly developed ultrasound water jet indentation system was used to assess the mechanical properties of the cartilage samples. The results showed that the URI increased significantly (p<0.05) after collagenase digestion while no significant change (p>0.05) was found after trypsin digestion. With regard to acoustic parameters, the IRC decreased significantly (p<0.05) after collagenase digestion while no significant change (p>0.05) was found after trypsin digestion. The AIBbone demonstrated an insignificant change after collagenase digestion (p>0.05) but a significant decrease after trypsin digestion (p<0.05). Both enzymatic degradation groups showed insignificant differences (p>0.05) in the IA but a significant increase (p<0.05) in the IBS after both enzymatic degradations. The apparent stiffness measured by ultrasound water jet indentation suggested that articular cartilage from both groups became significantly softer (p<0.05) after the enzymatic degradations. A significant relationship was found to exist between the IRC and URI (p<0.05). This study showed that high-frequency ultrasound can be a comprehensive tool to quantitatively and systematically analyze the morphologic, acoustic and mechanical properties of articular cartilage in association with its degeneration. (E-mail: ypzheng@ieee.org)

Ultrasound in Medicine and Biology

Masthead

Editorial Advisory Board

Contents

Three-Dimensional High-Frequency Characterization of Cancerous Lymph Nodes

The Validity of Ultrasonographic Assessment in Cubital Tunnel Syndrome: The Value of a Cubital-to-Humeral Nerve Area Ratio (CHR) Combined with Morphologic Features

A New Visually Evoked Cerebral Blood Flow Response Analysis Using a Low-Frequency Estimation

Longitudinal Reference Values for Ductus Venosus Doppler in Low-Risk Pregnancies

Shock Waves in the Treatment of Post-Traumatic Myositis Ossificans

An Analysis of the Origin of Differences between Measured and Simulated Fields Produced by A 15-Element Ultrasound Phased Array

Cavitation Properties of Block Copolymer Stabilized Phase-Shift Nanoemulsions Used as Drug Carriers

Sonoporation Mediated Immunogene Therapy of Solid Tumors

Dendritic Cells Loaded with Ultrasound-Ablated Tumour Induce in vivo Specific Antitumour Immune Responses

Ultrasonic Microbubble-Mediated Gene Delivery Causes Phenotypic Changes of Human Aortic Endothelial Cells

Effects of Nonlinear Propagation in Ultrasound Contrast Agent Imaging

Automatic Localization of Intimal and Adventitial Carotid Artery Layers with Noninvasive Ultrasound: A Novel Algorithm Providing Scan Quality Control

New Adaptive Clutter Rejection for Ultrasound Color Doppler Imaging: In vivo Study

An Automatic Angle Tracking Procedure for Feasible Vector Doppler Blood Velocity Measurements

The E-Wave Delayed Relaxation Pattern to LV Pressure Contour Relation: Model-Based Prediction With in vivo Validation

Quantitative Assessment of Articular Cartilage with Morphologic, Acoustic and Mechanical Properties Obtained Using High-Frequency Ultrasound