quality:corruption
Contrast ultrasonography (ultrasound contrast imaging)

A contrast medium for medical ultrasonography is a formulation of encapsulated gaseous microbubbles to increase echogenicity of blood, discovered by Dr. Raymond Gramiak in 1968 and named contrast-enhanced ultrasound. This contrast medical imaging modality is used throughout the world, for echocardiography in particular in the United States and for ultrasound radiology in Europe and Asia.

Microbubbles-based contrast media is administered intravenously into the patient blood stream during the ultrasonography examination. Due to their size, the microbubbles remain confined in blood vessels without extravasating towards the interstitial fluid. An ultrasound contrast media is therefore purely intravascular, making it an ideal agent to image organ microvasculature for diagnostic purposes. A typical clinical use of contrast ultrasonography is detection of a hypervascular metastatic tumor, which exhibits a contrast uptake (kinetics of microbubbles concentration in blood circulation) faster than healthy biological tissue surrounding the tumor. Other clinical applications using contrast exist, as in echocardiography to improve delineation of left ventricle for visualizing contractibility of heart muscle after a myocardial infarction. Finally, applications in quantitative perfusion (relative measurement of blood flow) have emerged for identifying early patient response to anti-cancerous drug treatment (methodology and clinical study by Dr. Nathalie Lassau in 2011), enabling the best oncological therapeutic options to be determined.

In oncological practice of medical contrast ultrasonography, clinicians use 'parametric imaging of vascular signatures' invented by Dr. Nicolas Rognin in 2010. This method is conceived as a cancer aided diagnostic tool, facilitating characterization of a suspicious tumor (malignant versus benign) in an organ. This method is based on medical computational science to analyze a time sequence of ultrasound contrast images, a digital video recorded in real-time during patient examination. Two consecutive signal processing steps are applied to each pixel of the tumor:

Once signal processing in each pixel is completed, a color spatial map of the parameter is displayed on a computer monitor, summarizing all vascular information of the tumor in a single image called a parametric image (see last figure of press article as clinical examples). This parametric image is interpreted by clinicians based on predominant colorization of the tumor: red indicates a suspicion of malignancy (risk of cancer), green or yellow – a high probability of benignity. In the first case (suspicion of malignant tumor), the clinician typically prescribes a biopsy to confirm the diagnostic or a CT scan examination as a second opinion. In the second case (quasi-certain of benign tumor), only a follow-up is needed with a contrast ultrasonography examination a few months later. The main clinical benefits are to avoid a systemic biopsy (with inherent risks of invasive procedures) of benign tumors or a CT scan examination exposing the patient to X-ray radiation. The parametric imaging of vascular signatures method proved to be effective in humans for characterization of tumors in the liver. In a cancer screening context, this method might be potentially applicable to other organs such as breast or prostate.