超声对比剂的材料学特点及临床应用

背景：目前临床上应用的超声对比剂均是含有不同包膜材料和气体成分的微泡对比剂,微泡对比剂的出现使超声诊断技术得到了较大的发展。 目的：探讨超声对比剂的材料学研究特点,及超声对比剂在临床疾病治疗中的应用。 方法：超声对比剂是由气体微泡和外部包裹的膜物质组成,包膜材料主要分为白蛋白、大分子脂质体、多聚体和各种表面活性剂等。超声造影是通过增强背向散射信号来成像。超声对比剂研究的发展大致分为3个阶段,造影相关技术包括二次谐波、组织特异性显像、反相脉冲谐波成像、相干造影成像技术、对比脉冲序列、能量多普勒谐波成像、间歇谐波成像技术、编码谐波成像和超声造影三维成像。 结果与结论：超声对比剂形式的不同主要是通过改变微泡包膜和气体的性质和设计来实现的。微气泡能够实现超声对比剂的显影作用,还可在药物传输上发挥功能。新型的微泡超声对比剂不仅可以提供血流灌注学信息,还可以通过靶向作用于病变组织,分析病变的发生机制,使微泡对比剂的诊断更准确。随着微泡对比剂材料学研究以及制备工艺完善,使超声对比剂具有良好的生物相容性。不仅可以用于各种状态下的特异性超声造影,还可以利用空化效应携带药物或治疗基因向目标组织转移释放。微泡造影技术具有治疗、诊断和超声成像的功能,是一种安全、高效、无创的诊断和靶向传输治疗手段。     

In vivo ultrasound visualization of non-occlusive blood clots with thrombin-sensitive contrast agents

The use of microbubbles as ultrasound contrast agents is one of the primary methods to diagnose deep venous thrombosis. However, current microbubble imaging strategies require either a clot sufficiently large to produce a circulation filling defect or a clot with sufficient vascularization to allow for targeted accumulation of contrast agents. Previously, we reported the design of a microbubble formulation that modulated its ability to generate ultrasound contrast from interaction with thrombin through incorporation of aptamer-containing DNA crosslinks in the encapsulating shell, enabling the measurement of a local chemical environment by changes in acoustic activity. However, this contrast agent lacked sufficient stability and lifetime in blood to be used as a diagnostic tool. Here we describe a PEG-stabilized, thrombin-activated microbubble (PSTA-MB) with sufficient stability to be used in vivo in circulation with no change in biomarker sensitivity. In the presence of actively clotting blood, PSTA-MBs showed a 5-fold increase in acoustic activity. Specificity for the presence of thrombin and stability under constant shear flow were demonstrated in a home-built in vitro model. Finally, PSTA-MBs were able to detect the presence of an active clot within the vena cava of a rabbit sufficiently small as to not be visible by current non-specific contrast agents. By activating in non-occlusive environments, these contrast agents will be able to detect clots not diagnosable by current contrast agents.     

High Resolution Ultrasound Superharmonic Perfusion Imaging: <Emphasis Type="Italic">In Vivo</Emphasis> Feasibility and Quantification of Dynamic Contrast-Enhanced Acoustic Angiography

Mapping blood perfusion quantitatively allows localization of abnormal physiology and can improve understanding of disease progression. Dynamic contrast-enhanced ultrasound is a low-cost, real-time technique for imaging perfusion dynamics with microbubble contrast agents. Previously, we have demonstrated another contrast agent-specific ultrasound imaging technique, acoustic angiography, which forms static anatomical images of the superharmonic signal produced by microbubbles. In this work, we seek to determine whether acoustic angiography can be utilized for high resolution perfusion imaging in vivo by examining the effect of acquisition rate on superharmonic imaging at low flow rates and demonstrating the feasibility of dynamic contrast-enhanced superharmonic perfusion imaging for the first time. Results in the chorioallantoic membrane model indicate that frame rate and frame averaging do not affect the measured diameter of individual vessels observed, but that frame rate does influence the detection of vessels near and below the resolution limit. The highest number of resolvable vessels was observed at an intermediate frame rate of 3 Hz using a mechanically-steered prototype transducer. We also demonstrate the feasibility of quantitatively mapping perfusion rate in 2D in a mouse model with spatial resolution of ~100 μm. This type of imaging could provide non-invasive, high resolution quantification of microvascular function at penetration depths of several centimeters.     

Superparamagnetic iron oxide nanoparticle-embedded encapsulated microbubbles as dual contrast agents of magnetic resonance and ultrasound imaging

An encapsulated microbubble (EMB) of a novel construct is proposed to enhance the magnetic resonance imaging contrast by introducing superparamagnetic iron oxide (SPIO) nanoparticles (mean diameter is 12 nm) into the polymer shell of the microbubble. Such microbubble vesicle has nitrogen gas in the core and its mean diameter is 3.98 μm. An in vitro MR susceptibility experiment using a phantom consisting EMBs has shown that the relationship between the transverse relaxation rate R₂ and the Fe₃O₄ nanoparticle concentration in the shell (the volume fraction of EMBs is kept constant) can be fitted to a linear function and an exponentially growth function is observed between R₂ and the SPIO-inclusion microbubble concentration. The in vivo MRI experiments also show that the SPIO-inclusion microbubbles have longer contrast-enhancement duration time in rat liver than non-SPIO-inclusion microbubbles. An in vitro ultrasound imaging experiment of SPIO-inclusion microbubbles also shows that they can enhance the ultrasound contrast significantly. Additionally, the interaction between the SPIO-inclusion microbubbles and cells indicates that such microbubble construct can retain the acoustic property under the ultrasound exposure by controlling the SPIO concentration in the shell. Therefore, the proposed SPIO nanoparticle-embedded EMBs potentially can become effective MR susceptibility contrast agents while also can be good US contrast agents.     

Enhancement of subharmonic emission from encapsulated microbubbles by using a chirp excitation technique

Subharmonic contrast imaging promises to improve ultrasound-imaging quality by taking advantage of an increased contrast to tissue signal. However, acoustic pressures beyond the subharmonic generation threshold using common ultrasound pulses may induce significant contrast microbubble destruction. In this work, a chirp excitation technique is presented to enhance the subharmonic emission from encapsulated microbubbles. Chirp signals with a center frequency of 5 MHz, variable frequency range and duration time are employed to drive microbubbles in numerical simulation and experimental studies. We provide a theoretical evaluation of the chirp excitation pressure threshold and the acoustic pressure dependence of subharmonic based on Church's model and demonstrate that the amplitude and axial resolution of the subharmonic can be optimized by proper selection of the frequency range and time duration of the chirp signal. Measurements are qualitatively in agreement with the simulation. Moreover, we demonstrate that chirp excitation may be able to improve the amplitude of the subharmonic component up to 22 dB over the pulse excitation. The chirp excitation technique could potentially be used for improving the subharmonic contrast imaging quality.     

Understanding the limitations of ultrasonic backscatter measurements from microbubble populations

Despite over ten years of in vitro investigations of ultrasound contrast agents, the level of understanding of their behaviour in ultrasound fields is limited. Several problems associated with these investigations, particular to the nature of contrast agents, are discussed. Using a commercial scanner the RF normalized backscatter of two different contrast agents (Definity and Quantison) was measured at different suspension concentrations and acoustic pressures. Both contrast agents scattered ultrasound nonlinearly and the backscatter showed a dependence on acoustic pressure. In order to assess the average behaviour of the agents across the range of acoustic pressures and microbubble concentrations the experimental data were fitted to a theoretically acceptable model using nonlinear regression analysis. The analysis showed that both the backscatter and the attenuation of the Quantison suspensions displayed a higher order of dependence on acoustic pressure than the Definity suspensions. It was also discovered that Quantison microbubbles did not demonstrate uniform behaviour across the acoustic pressure range. At lower acoustic pressures the behaviour could not follow a model similar to that which predicted the behaviour at higher acoustic pressures, which was mainly due to the fact that free bubbles were released in a fashion dependent on acoustic pressure. The fact that two different populations of scatterers exist in the same suspensions makes the assessment of the behaviour of the particular agent impossible with the high concentrations that are commonly used. Very low concentration suspensions whereby single scattering events can be monitored should be more useful. In conclusion, the approach of using high microbubble concentrations in order to investigate the properties of ultrasonic contrast agents is limited in that the results of such studies cannot be used to understand the behaviour of single microbubbles.     

Novel preparation techniques for controlling microbubble uniformity: a comparison

In recent years, there has been increasing interest in the use of coated microbubbles as vehicles for ultrasound mediated targeted drug delivery. This application requires a high degree of control over the size and uniformity of microbubbles, in order to ensure accurate dosing of a given drug and to maximise delivery efficiency. Similarly, as more advanced imaging techniques are developed which exploit the complex nonlinear features of the microbubble signal and/or enable quantification of tissue perfusion, the ability to predetermine the acoustic response of a microbubble suspension is becoming increasingly important. Consequently, a number of new preparation technologies have been developed to meet the demand for improved control over microbubble characteristics. The aim of the work described in this paper was to compare a conventional microbubble preparation technique, sonication, with two more recent methods: coaxial electrohydrodynamic atomisation and microfluidic (T-junction) processing, in terms of their ability to produce bubbles which are sufficiently small and stable for in vivo use, microbubble uniformity, relative production rates and other practical and economic considerations.

Acoustic response of compliable microvessels containing ultrasound contrast agents

The existing models of the dynamics of ultrasound contrast agents (UCAs) have largely been focused on an UCA surrounded by an infinite liquid. Preliminary investigations of a microbubble's oscillation in a rigid tube have been performed using linear perturbation, under the assumption that the tube diameter is significantly larger than the UCA diameter. In the potential application of drug and gene delivery, it may be desirable to fragment the agent shell within small blood vessels and in some cases to rupture the vessel wall, releasing drugs and genes at the site. The effect of a compliant small blood vessel on the UCA's oscillation and the microvessel's acoustic response are unknown. The aim of this work is to propose a lumped-parameter model to study the interaction of a microbubble oscillation and compliable microvessels. Numerical results demonstrate that in the presence of UCAs, the transmural pressure through the blood vessel substantially increases and thus the vascular permeability is predicted to be enhanced. For a microbubble within an 8 to 40 microm vessel with a peak negative pressure of 0.1 MPa and a centre frequency of 1 MHz, small changes in the microbubble oscillation frequency and maximum diameter are observed. When the ultrasound pressure increases, strong nonlinear oscillation occurs, with an increased circumferential stress on the vessel. For a compliable vessel with a diameter equal to or greater than 8 microm, 0.2 MPa PNP at 1 MHz is predicted to be sufficient for microbubble fragmentation regardless of the vessel diameter; however, for a rigid vessel 0.5 MPa PNP at 1 MHz may not be sufficient to fragment the bubbles. For a centre frequency of 1 MHz, a peak negative pressure of 0.5 MPa is predicted to be sufficient to exceed the stress threshold for vascular rupture in a small (diameter less than 15 microm) compliant vessel. As the vessel or surrounding tissue becomes more rigid, the UCA oscillation and vessel dilation decrease; however the circumferential stress is predicted to increase. Decreasing the vessel size or the centre frequency increases the circumferential stress. For the two frequencies considered in this work, the circumferential stress does not scale as the inverse of the square root of the acoustic frequency va as in the mechanical index, but rather has a stronger frequency dependence, 1/va.     

Iron oxide nanoparticle-containing microbubble composites as contrast agents for MR and ultrasound dual-modality imaging

Magnetic resonance (MR) and ultrasound (US) imaging are widely used diagnostic modalities for various experimental and clinical applications. In this study, iron oxide nanoparticle-embedded polymeric microbubbles were designed as multi-modal contrast agents for hybrid MR-US imaging. These magnetic nano-in-micro imaging probes were prepared via a one-pot emulsion polymerization to form poly(butyl cyanoacrylate) microbubbles, along with the oil-in-water (O/W) encapsulation of iron oxide nanoparticles in the bubble shell. The nano-in-micro embedding strategy was validated using NMR and electron microscopy. These hybrid imaging agents exhibited strong contrast in US and an increased transversal relaxation rate in MR. Moreover, a significant increase in longitudinal and transversal relaxivities was observed after US-induced bubble destruction, which demonstrated triggerable MR imaging properties. Proof-of-principle in?vivo experiments confirmed that these nanoparticle-embedded microbubble composites are suitable contrast agents for both MR and US imaging. In summary, these magnetic nano-in-micro hybrid materials are highly interesting systems for bimodal MR-US imaging, and their enhanced relaxivities upon US-induced destruction recommend them as potential vehicles for MR-guided US-mediated drug and gene delivery.     

基质细胞衍生因子1靶向超声对比剂在体内可与血管内皮细胞紧密结合

背景：基质细胞衍生因子1是心肌梗死区域微环境中效力最强的趋化因子,在趋化干细胞修复梗死心肌以及在促进血管新生方面起到重要的作用。微泡和声学活性物质携带靶向配基,可制备成超声成像靶向对比剂并与活体细胞结合,用于分子成像,超声分子成像的关键是寻找“成像靶点”,并成功制备能与“成像靶点” 特异、高效结合的靶向超声对比剂。 目的：实验制备和评价携基质细胞衍生因子1单克隆抗体的靶向微泡超声对比剂。 方法：采用“生物素-亲和素”桥接法构建携基质细胞衍生因子1单克隆抗体的靶向微泡超声对比剂,并从外观、pH值、粒径测定、光镜及荧光显微镜下观、流式细胞仪检测等多个方面对靶向对比剂进行评价。4头中华小型猪均结扎左冠状动脉前降支第一对角支制备心肌梗死模型,2头开胸但不结扎左冠状动脉前降支第一对角支,均注入靶向超声对比剂,心肌组织冰冻切片后采用免疫荧光法检测靶向微泡的体内稳定性。 结果与结论：通过生物素-亲和素桥接法可将基质细胞衍生因子1抗体和超声微泡两者结合。体外实验中对比剂外观：表现为半透明的淡黄或绿色,静置后分层。非靶向对比剂pH值为7.02±0.12,靶向微泡对比剂的pH值为6.10±0.19。荧光显微镜下观察靶向微泡明亮且呈指环状绿色荧光环绕外壳周边,剧烈震荡后表面荧光无明显改变。靶向对比剂在携带基质细胞衍生因子1抗体之后微泡粒径大小为(2 422.62±238.82) nm。流式细胞仪检测显示,靶向对比剂在不同时间段的基质细胞衍生因子1携带率稳定,静置1 h后携带率稳定且剧烈震荡前后差异无显著性意义。在体内实验中可见靶向微泡在心梗部位血管内皮细胞处聚集。结果证实,经生物素-亲和素桥接法制备的携基质细胞衍生因子1单克隆抗体靶向微泡超声对比剂体内可与血管内皮细胞结合,在体外结合率高而且结合稳定。     

Acoustic scattering from a contrast agent microbubble near an elastic wall of finite thickness

Interest in the problem under consideration in this study is motivated by targeted ultrasound imaging where one has to deal with microbubble contrast agents pulsating near blood vessel walls. A modified Rayleigh–Plesset equation is derived that describes the oscillation of a contrast agent microbubble near an elastic wall of finite thickness. It is assumed that the medium behind the wall is a fluid but it is shown that the equation obtained is easily transformable to the case that the medium behind the wall is an elastic solid. In contrast to the model of a rigid wall, which predicts decreasing natural frequency of a bubble near the wall, the elastic wall model reveals that the bubble natural frequency can both decrease and increase, and in cases of interest for medical applications, the bubble natural frequency usually increases. It is found that the influence of an elastic wall on the acoustic response of a bubble is determined by the ratio between a cumulative parameter, which integrally characterizes the mechanical properties of the wall and has the dimension of density, and the density of the liquid surrounding the bubble. It is shown that the acoustic influence of the arterial wall on the bubble is weak and apparently cannot be used to recognize the moment when the bubble approaches the wall. However, in experiments where the behavior of bubbles near various plastic walls is observed, changes in the bubble response, such as increasing natural frequency and decreasing oscillation amplitude, are detectable.     

Unbinding of targeted ultrasound contrast agent microbubbles by secondary acoustic forces

Targeted molecular imaging with ultrasound contrast agent microbubbles is achieved by incorporating targeting ligands on the bubble coating and allows for specific imaging of tissues affected by diseases. Improved understanding of the interplay between the acoustic forces acting on the bubbles during insonation with ultrasound and other forces (e.g. shear due to blood flow, binding of targeting ligands to receptors on cell membranes) can help improve the efficacy of this technique. This work focuses on the effects of the secondary acoustic radiation force, which causes bubbles to attract each other and may affect the adhesion of targeted bubbles. First, we examine the translational dynamics of ultrasound contrast agent microbubbles in contact with (but not adherent to) a semi-rigid membrane due to the secondary acoustic radiation force. An equation of motion that effectively accounts for the proximity of the membrane is developed, and the predictions of the model are compared with experimental data extracted from optical recordings at 15 million frames per second. A time-averaged model is also proposed and validated. In the second part of the paper, initial results on the translation due to the secondary acoustic radiation force of targeted, adherent bubbles are presented. Adherent bubbles are also found to move due to secondary acoustic radiation force, and a restoring force is observed that brings them back to their initial positions. For increasing magnitude of the secondary acoustic radiation force, a threshold is reached above which the adhesion of targeted microbubbles is disrupted. This points to the fact that secondary acoustic radiation forces can cause adherent bubbles to detach and alter the spatial distribution of targeted contrast agents bound to tissues during activation with ultrasound. While the details of the rupture of intermolecular bonds remain elusive, this work motivates the use of the secondary acoustic radiation force to measure the strength of adhesion of targeted microbubbles.     

A new local multiscale Fourier analysis for medical imaging

The Stockwell transform (ST), recently developed for geophysics, combines features of the Fourier, Gabor and wavelet transforms; it reveals frequency variation over time or space. This valuable information is obtained by Fourier analysis of a small segment of a signal at a time. Localization of the Fourier spectrum is achieved by filtering the signal with frequency-dependent Gaussian scaling windows. This multi-scale time-frequency analysis provides information about which frequencies occur and more importantly when they occur. Furthermore, the Stockwell domain can be directly inferred from the Fourier domain and vice versa. These features make the ST a potentially effective tool to visualize, analyze, and process medical imaging data. The ST has proven useful in noise reduction and tissue texture analysis. Herein, we focus on the theory and effectiveness of the ST for medical imaging. Its effectiveness and comparison with other linear time-frequency transforms, such as the Gabor and wavelet transforms, are discussed and demonstrated using functional magnetic resonance imaging data.     

Theoretical predictions of harmonic generation from submicron ultrasound contrast agents for nonlinear biomedical ultrasound imaging

Submicron ultrasound contrast agents have aroused attention for their significant promise in ultrasonic contrast/molecular imaging, targeted therapy and echo particle imaging velocimetry. However, nonlinear acoustic properties of submicron encapsulated gas bubbles for ultrasonic applications are still not clearly understood. In this paper, nonlinear acoustic emission characteristics from submicron bubbles were examined using a numerical study. The modified RP equation incorporating viscosity, acoustic radiation, thermal effects and encapsulated shell was used to study single bubble dynamics. Further, a size integration method, shown previously to be useful in prediction of backscatter spectra from groups of bubbles, was applied to analyse response from a bubble population. We show that bubbles with radii (200-500 nm) produce significant subharmonic and ultraharmonic components of the backscatter spectrum, while smaller bubbles (<200 nm) provide substantial second harmonic components. Additionally, nanoscale bubbles (<100 nm) produce very low backscatter amplitudes and thus may not be useful with the use of current ultrasound technology. Analysing optimal ultrasound driving pressures and bubbles size ranges for maximal subharmonic and ultraharmonic signals showed that sub and ultraharmonic mode nonlinear imaging methods may be potentially competitive for larger size bubbles (>200 nm) in providing proper contrast-to-tissue signal ratios.     

Effect of self-demodulation on the subharmonic response of contrast agent microbubbles

Subharmonic (SH) emission from the ultrasound contrast agent (UCA) is of interest since it is produced only by the UCA and not by tissue, opposite to harmonic imaging modes where both tissue and microbubble show harmonics. In this work, the use of the self-demodulation (S-D) signal as a means of microbubble excitation at the SH frequency to enhance the SH emission of UCA is studied. The S-D wave is a low-frequency signal produced by the weak nonlinear propagation of an ultrasound wave. It is proportional to the second time derivative of the squared envelope of the transmitted signal. A diluted population of BR14 UCA (Bracco Research SA, Geneva, Switzerland) was insonified by a 10 MHz transducer focused at 76 mm firing bursts with different envelopes, durations and peak pressure amplitudes. The center frequency of the S-D signal changes from low frequencies (around 0.5 MHz) toward the transmitted frequency (10 MHz) by modifying the envelope function from gaussian to rectangular. For 6 and 20 transmitted cycles, the SH response is enhanced up to 25 and 22 dB, respectively, when using a rectangular envelope instead of a gaussian one. The experimental results are confirmed by the numerical simulation. The effects of the excitation duration and pressure amplitude are also studied. This study shows that a suitable design of the envelope of the transmit excitation to generate a S-D signal at the SH frequency can enhance the SH emission of UCA, and the SH imaging is feasible at high frequencies with a shorter transmit burst (six-cycle) and low acoustic pressure (～100 KPa).     

Photoacoustic/ultrasound dual-modality contrast agent and its application to thermotherapy

This study investigates a photoacoustic/ultrasound dual-modality contrast agent, including extending its applications from image-contrast enhancement to combined diagnosis and therapy with site-specific targeting. The contrast agent comprises albumin-shelled microbubbles with encapsulated gold nanorods (AuMBs). The gas-filled microbubbles, whose diameters range from submicrometer to several micrometers, are not only echogenic but also can serve as drug-delivery vehicles. The gold nanorods are used to enhance the generation of both photoacoustic and photothermal signals. The optical absorption peak of the gold nanorods is tuned to 760 nm and is invariant after microbubble encapsulation. Dual-modality contrast enhancement is first described here, and the applications to cellular targeting and laser-induced thermotherapy in a phantom are demonstrated. Photoacoustic imaging can be used to monitor temperature increases during the treatment. The targeting capability of AuMBs was verified, and the temperature increased by 26°C for a laser power of 980 mW, demonstrating the potential of combined diagnosis and therapy with the dual-modality agent. Targeted photo- or acoustic-mediated delivery is also possible.     

Magnetic resonance acoustic radiation force imaging

Acoustic radiation force impulse imaging is an elastography method developed for ultrasound imaging that maps displacements produced by focused ultrasound pulses systematically applied to different locations. The resulting images are "stiffness weighted" and yield information about local mechanical tissue properties. Here, the feasibility of magnetic resonance acoustic radiation force imaging (MR-ARFI) was tested. Quasistatic MR elastography was used to measure focal displacements using a one-dimensional MRI pulse sequence. A 1.63 or 1.5 MHz transducer supplied ultrasound pulses which were triggered by the magnetic resonance imaging hardware to occur before a displacement-encoding gradient. Displacements in and around the focus were mapped in a tissue-mimicking phantom and in an ex vivo bovine kidney. They were readily observed and increased linearly with acoustic power in the phantom (R2=0.99). At higher acoustic power levels, the displacement substantially increased and was associated with irreversible changes in the phantom. At these levels, transverse displacement components could also be detected. Displacements in the kidney were also observed and increased after thermal ablation. While the measurements need validation, the authors have demonstrated the feasibility of detecting small displacements induced by low-power ultrasound pulses using an efficient magnetic resonance imaging pulse sequence that is compatible with tracking of a dynamically steered ultrasound focal spot, and that the displacement increases with acoustic power. MR-ARFI has potential for elastography or to guide ultrasound therapies that use low-power pulsed ultrasound exposures, such as drug delivery.     

Subharmonic generation from ultrasonic contrast agents

Ultrasonic contrast agents are used to enhance backscatter from blood and thus aid in delineating blood from surrounding tissue. However, behaviour of contrast agents in an acoustic field is nonlinear and leads to harmonic components in the backscattered signal. Various research groups have investigated second-harmonic emissions. In this work, the subharmonic emission from contrast agents is investigated with a view towards potential use in imaging. It is shown that the microbubbles with various surface properties, such as contrast agents, generate significant subharmonics under various insonating conditions. Theoretical results as well as experimental results using Optison indicate the generation of strong subharmonics with burst insonation at twice the resonant frequency of the microbubble. It is suggested that subharmonic imaging may provide a better modality than second-harmonic imaging to delineate blood from tissue and will be of significant importance for imaging deep vessels, such as in echocardiography and vascular diseases, due to the high signal-to-clutter ratio of the subharmonic imaging.     

Deformation-compensated averaging for clutter reduction in epiphotoacoustic imaging in vivo

Photoacoustic imaging, based on ultrasound detected after laser irradiation, is an extension to diagnostic ultrasound for imaging the vasculature, blood oxygenation and the uptake of optical contrast media with promise for cancer diagnosis. For versatile scanning, the irradiation optics is preferably combined with the acoustic probe in an epi-style arrangement avoiding acoustically dense tissue in the acoustic propagation path from tissue irradiation to acoustic detection. Unfortunately epiphotoacoustic imaging suffers from strong clutter, arising from optical absorption in tissue outside the image plane, and from acoustic backscattering. This limits the imaging depth for useful photoacoustic image contrast to typically less than one centimeter. Deformation-compensated averaging (DCA), which takes advantage of clutter decorrelation induced by palpating the tissue with the imaging probe, has previously been proposed for clutter reduction. We demonstrate for the first time that DCA results in reduced clutter in real-time freehand clinical epiphotoacoustic imaging. For this purpose, combined photoacoustic and pulse-echo imaging at 10-Hz frame rate was implemented on a commercial scanner, allowing for ultrasound-based motion tracking inherently coregistered with photoacoustic frames. Results from the forearm and the neck confirm that contrast is improved and imaging depth increased by DCA.     

Acoustic droplet–hydrogel composites for spatial and temporal control of growth factor delivery and scaffold stiffness

Wound healing is regulated by temporally and spatially restricted patterns of growth factor signaling, but there are few delivery vehicles capable of the “on-demand” release necessary for recapitulating these patterns. Recently we described a perfluorocarbon double emulsion that selectively releases a protein payload upon exposure to ultrasound through a process known as acoustic droplet vaporization (ADV). In this study, we describe a delivery system composed of fibrin hydrogels doped with growth factor-loaded double emulsion for applications in tissue regeneration. Release of immunoreactive basic fibroblast growth factor (bFGF) from the composites increased up to 5-fold following ADV and delayed release was achieved by delaying exposure to ultrasound. Releasates of ultrasound-treated materials significantly increased the proliferation of endothelial cells compared to sham controls, indicating that the released bFGF was bioactive. ADV also triggered changes in the ultrastructure and mechanical properties of the fibrin as bubble formation and consolidation of the fibrin in ultrasound-treated composites were accompanied by up to a 22-fold increase in shear stiffness. ADV did not reduce the viability of cells suspended in composite scaffolds. These results demonstrate that an acoustic droplet–hydrogel composite could have broad utility in promoting wound healing through on-demand control of growth factor release and/or scaffold architecture.