Read full paper at:
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=52823#.VKn3mcnQrzE
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=52823#.VKn3mcnQrzE
Author(s)
Objectives:
To demonstrate in vitro that changes
in ultrasound cavitation threshold might be used for non-invasively
distinguishing high viscosity mucinous fluid from low viscosity serous fluid in
cystic masses, based on the facts that cavitation threshold increases with
increasing viscosity and that cavitation microbubbles are observable with
diagnostic ultrasound. Methods: An in
vitro model of a cyst was designed using dilutions of ultrasonic gel, and the
cavitation threshold of this model was determined using focused and unfocused
ultrasound for bubble initiation and clinical ultrasound b-scan for detection.
Results: Viscosities of dilutions between 0% and 30% gel were had viscosities
measuring between 1.05 ± 0.08 cP and 6600 ± 875 cP. Inertial cavitation in the
latter was determined to require an order of magnitude greater intensity, at 1
MHz and 100% duty cycle, than the former (>2.2 W/cm2 vs. <0.19
W/cm2) using unfocused ultrasound. A four-fold increase in the peak
negative pressure was required to initiate significant bubble activity using
1.1 MHz and 50% duty cycle focused ultrasound in the 6600 cP fluid compared with
the 1 cP fluid. Based on these results, it was estimated that a threshold could
be defined that would result in no bubbles in 99.9% of mucinous cysts and just
22% of serous cysts. The remaining 78% of patients presenting with serous cysts
would be positively identified by detection of bubbles, and would be spared an
unnecessary biopsy. Conclusions: The cavitation threshold may be used
non-invasively to distinguish between high viscosity and low viscosity fluids
in cysts and reduce biopsies on serous cysts.
KEYWORDS
Cite this paper
O’Neill, B. , Chang, E. and Yu, N. (2014)
Potential Use of Ultrasonic Cavitation Threshold to Non-Invasively
Differentiate Cystic Masses. Open Journal of Radiology, 4, 329-338. doi: 10.4236/ojrad.2014.44043.
[1] |
Spence, R.A.J., Dasari, B.,
Love, M., Kelly, B. and Taylor, M. (2011) Overview of the Investigation
and Management of Cystic Neoplasms of the Pancreas. Digestive Surgery,
28, 386-397. http://dx.doi.org/10.1159/000334758 |
[2] |
Scoazec, J.Y., Vullierme, M.P.,
Barthet, M., Gonzalez, J.M. and Sauvanet, A. (2013) Cystic and Ductal
Tumors of the Pancreas: Diagnosis and Management. Journal of Visceral
Surgery, 150, 69-84. http://dx.doi.org/10.1016/j.jviscsurg.2013.02.003 |
[3] |
Kwon, R.S. (2012) Advances in
the Diagnosis of Cystic Neoplasms of the Pancreas. Current Opinions in
Gastroenterology, 28, 494-500. http://dx.doi.org/10.1097/MOG.0b013e3283567f3f |
[4] |
Eastham, R.D. (1954) The Serum
Viscosity and the Serum Proteins. Journal of Clinical Pathology, 7,
66-68. http://dx.doi.org/10.1136/jcp.7.1.66 |
[5] |
Rosenson, R.S., McCormick, A.
and Uretz, E.F. (1996) Distribution of Blood Viscosity Values and
Biochemical Correlates in Healthy Adults. Clinical Chemistry, 42,
1189-1195. http://www.clinchem.org/content/42/8/1189.long |
[6] |
Allen, J.S., Roy, R.A. and
Church, C.C. (1997) On the Role of Shear Viscosity in Mediating Inertial
Cavitation from Short-Pulse Megahertz-Frequency Ultrasound. IEEE
Transactions on Ultrasound, Ferroelectrics and Frequency Control. 44,
743-751. http://dx.doi.org/10.1109/58.655189 |
[7] |
Lai, S.K., Wang, Y.Y., Cone, R.,
Wirtz, D. and Hanes, J. (2009) Altering Mucus Rheology to “Solidify”
Human Mucus at the Nanoscale. PLoS One, 4, e4294. http://dx.doi.org/10.1371/journal.pone.0004294 |
[8] |
Lai, S.K., Wang, Y.Y., Wirtz, D.
and Hanes, J. (2009) Micro- and Macrorheology of Mucus. Advanced Drug
Delivery Reviews, 61, 86-100. http://dx.doi.org/10.1016/j.addr.2008.09.012 |
[9] |
Soo, M.S., Ghate, S.V., Baker,
J.A., Rosen, E.L., Walsh, R., Warwick, B.N., et al. (2006) Streaming
Detection for Evaluation of Indeterminate Sonographic Breast Masses: A
Pilot Study. American Journal of Roentgenology, 186, 1335-1341. http://dx.doi.org/10.2214/AJR.05.0005 |
[10] |
Clarke, L., Edwards, A. and
Graham, E. (2004) Acoustic Streaming: An in Vitro Study. Ultrasound in
Medicine and Biology, 30, 559-562. http://dx.doi.org/10.1016/j.ultrasmedbio.2004.01.007 |
[11] | Clarke, L., Edwards, A. and Pollard, K. (2005) Acoustic Streaming in Ovarian Cysts. Journal of Ultrasound in Medicine, 24, 617-621. |
[12] |
Van Holsbeke, C., Zhang, J., Van
Belle, V., Paladini, D., Guerriero, S., Czekierdowski, A., et al.
(2010) Acoustic Streaming Cannot Discriminate Reliably between
Endometriomas and Other Types of Adnexal Lesion: A Multicenter Study of
633 Adnexal Masses. Ultrasound in Obstetrics and Gynecology, 35,
349-353. http://dx.doi.org/10.1002/uog.7537 |
[13] |
Holland, C.K. and Apfel, R.E.
(1989) Improved Theory for the Prediction of Microcavitation Thresholds.
IEEE Transactions on Ultrasound, Ferroelectrics and Frequency Control,
36, 204-208. http://dx.doi.org/10.1109/58.19152 |
[14] |
Yang, X. and Church, C.C. (2005)
A Model for the Dynamics of Gas Bubbles in Soft Tissue. Journal of the
Acoustic Society of America, 118, 3595-3606. http://dx.doi.org/10.1121/1.2118307 |
[15] |
R Development Core Team (2010)
R: A Language and Environment for Statistical Computing. R Foundation
for Statistical Computing, Vienna. http://www.R-project.org |
[16] | Hyndman, R. and Fan, Y. (1996) Sample Quantiles in Statistical Packages. The American Statistician, 50, 361-365. |
[17] |
Lewandrowski, K.B., Southern,
J.F., Pins, M.R., Compton, C.C. and Warshaw, A.L. (1993) Cyst Fluid
Analysis in the Differential Diagnosis of Pancreatic Cysts. A Comparison
of Pseudocysts, Serous Cystadenomas, Mucinous Cystic Neoplasms, and
Mucinous Cystadenocarcinoma. Annals of Surgery, 217, 41-47. http://dx.doi.org/10.1097/00000658-199301000-00008 |
[18] |
Leung, K.K., Ross, W.A., Evans,
D., Fleming, J., Lin, E., Tamm, E.P., et al. (2009) Pancreatic Cystic
Neoplasm: The Role of Cyst Morphology, Cyst Fluid Analysis, and
Expectant Management. Annals of Surgical Oncology, 16, 2818-2824. http://dx.doi.org/10.1245/s10434-009-0502-9 |
[19] |
Sokka, S.D., King, R. and
Hynynen, K. (2003) MRI-Guided Gas Bubble Enhanced Ultrasound Heating in
in Vivo Rabbit Thigh. Physics in Medicine and Biology, 48, 223-241. http://dx.doi.org/10.1088/0031-9155/48/2/306 |
[20] |
Shankar, H. and Pagel, P.S.
(2011) Potential Adverse Ultrasound-Related Biological Effects: A
Critical Review. Anesthesiology, 115, 1109-1124. http://dx.doi.org/10.1097/ALN.0b013e31822fd1f1 |
[21] |
Duck, F.A. (2008) Hazards, Risks
and Safety of Diagnostic Ultrasound. Medical Engineering and Physics,
30, 1338-1348. http://dx.doi.org/10.1016/j.medengphy.2008.06.002 |
[22] |
O’Brien Jr., W.D. (2007)
Ultrasound-Biophysics Mechanisms. Progress in Biophysics and Molecular
Biology, 93, 212-255. http://dx.doi.org/10.1016/j.pbiomolbio.2006.07.010 |
[23] |
Abdelmoneim, S.S., Bernier, M.,
Scott, C.G., Dhoble, A., Ness, S.A.C., Hagen, M.E., et al. (2009) Safety
of Contrast Agent Use during Stress Echocardiography: A 4-Year
Experience from a Single-Center Cohort Study of 26, 774 Patients. JACC
Cardiovascular Imaging, 2, 1048-1056. http://dx.doi.org/10.1016/j.jcmg.2009.03.020 |
[24] |
McDannold, N., Tempany, C.M.,
Fennessy, F.M., So, M.J., Rybicki, F.J., Stewart, E.A., et al. (2006)
Uterine Leiomyomas: MR Imaging-Based Thermometry and Thermal Dosimetry
during Focused Ultrasound Thermal Ablation. Radiology, 240, 263-272. http://dx.doi.org/10.1148/radiol.2401050717 |
[25] |
Lipsman, N., Schwartz, M.L.,
Huang, Y., Lee, L., Sankar, T., Chapman, M., et al. (2013) MR-Guided
Focused Ultrasound Thalamotomy for Essential Tremor: A Proof-of-Concept
Study. Lancet Neurology, 12, 462-468. http://dx.doi.org/10.1016/S1474-4422(13)70048-6 eww150105lx |
评论
发表评论