Medical & Biological Engineering & Computing

, Volume 47, Issue 8, pp 813–826 | Cite as

Clinical uses of microbubbles in diagnosis and treatment

  • David Cosgrove
  • Chris Harvey
Special Issue - Review


The development of microbubbles as ultrasound contrast agents (USCA) has opened the way for new and extended applications of ultrasound in clinical practise as well as offering rich new research opportunities. Some of the experimentally developed applications have been accepted into clinical practise and the European Federation has published guidelines on their use, particularly in the liver [18]. Many new applications are being explored and the field is unusual in imaging because its proper exploration depends on parallel development by the pharmaceutical and ultrasound equipment manufacturers. Microbubbles are unique amongst contrast agents for imaging in that the imaging process changes the agent and even destroys it. They contain gases that respond to the pressure changes of the ultrasound by changing size and this forms the basis for their selective imaging. In addition, when the volume changes reach a threshold, the oscillations become sufficiently violent that the...


Focal Nodular Hyperplasia Focal Liver Lesion High Intensity Focus Ultrasound Endocardial Border Contrast Myocardial Echocardiography 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Alonso A, Della Martina A, Stroick M et al (2007) Molecular imaging of human thrombus with novel abciximab immunobubbles and ultrasound. Stroke 38:1508–1514. doi: 10.1161/STROKEAHA.106.471391 CrossRefGoogle Scholar
  2. 2.
    Alter J, Lou F, Rabinowitz A et al (2006) Systemic delivery of morpholino oligonucleotide restores dystrophin expression bodywide and improves dystrophic pathology. Nat Med 12:175–177. doi: 10.1038/nm1345 CrossRefGoogle Scholar
  3. 3.
    Armstrong WF, Ryan T (2008) Stress echocardiography from 1979 to present. J Am Soc Echocardiogr 21:22–28. doi: 10.1016/j.echo.2007.11.005 CrossRefGoogle Scholar
  4. 4.
    Ascenti G, Gaeta M, Magno C et al (2004) Contrast-enhanced second-harmonic sonography in the detection of pseudocapsule in renal cell carcinoma. AJR Am J Roentgenol 182:1525–1530Google Scholar
  5. 5.
    Barnett SB, Duck F, Ziskin M (2007) WFUMB symposium on safety of ultrasound in medicine: conclusions and recommendations on biological effects and safety of ultrasound contrast agents, 2006. Ultrasound Med Biol 33:233–234. doi: 10.1016/j.ultrasmedbio.2006.07.004 CrossRefGoogle Scholar
  6. 6.
    Becher H, Schlief R (1989) Improved sensitivity of color Doppler by SH U 454. Am J Cardiol 64:374–377. doi: 10.1016/0002-9149(89)90538-9 CrossRefGoogle Scholar
  7. 7.
    Becker H, Burns P (2000) Handbook of contrast echocardiography. Springer, BerlinGoogle Scholar
  8. 8.
    Behm C, Lindner J (2006) Cellular and molecular imaging with targeted contrast ultrasound. Ultrasound Q 22:67–72Google Scholar
  9. 9.
    Berry J, Sidhu P (2004) Microbubble contrast-enhanced ultrasound in liver transplantation. Eur Radiol 14:96–103. doi: 10.1007/s10406-004-0082-5 CrossRefGoogle Scholar
  10. 10.
    Bhatia VK, Senior R (2008) Contrast echocardiography: evidence for clinical use. J Am Soc Echocardiogr 21:409–416. doi: 10.1016/j.echo.2008.01.018 CrossRefGoogle Scholar
  11. 11.
    Cassano E, Rizzo S, Bozzini A et al (2006) Contrast enhanced ultrasound of breast cancer. Cancer Imaging 6:4–6. doi: 10.1102/1470-7330.2006.0001 CrossRefGoogle Scholar
  12. 12.
    Catalano O, Sandomenico F, Matarazzo I et al (2005) Contrast-enhanced sonography of the spleen. AJR Am J Roentgenol 184:1150–1156Google Scholar
  13. 13.
    Celli N, Gaiani S, Piscaglia F et al (2007) Characterization of liver lesions by real-time contrast-enhanced ultrasonography. Eur J Gastroenterol Hepatol 19:3–14. doi: 10.1097/01.meg.0000250585.53608.3c CrossRefGoogle Scholar
  14. 14.
    Chen M, Yang W, Yan K et al (2007) The role of contrast-enhanced ultrasound in planning treatment protocols for hepatocellular carcinoma before radiofrequency ablation. Clin Radiol 62:752–760. doi: 10.1016/j.crad.2006.12.013 CrossRefGoogle Scholar
  15. 15.
    Choi BI, Kim TK, Han JK et al (2000) Vascularity of hepatocellular carcinoma: assessment with contrast-enhanced second-harmonic versus conventional power Doppler US. Radiology 214:381–386Google Scholar
  16. 16.
    Choi D, Lim HK, Lee WJ et al (2003) Early assessment of the therapeutic response to radio frequency ablation for hepatocellular carcinoma: utility of gray scale harmonic ultrasonography with a microbubble contrast agent. J Ultrasound Med 22:1163–1172Google Scholar
  17. 17.
    Claudon M, Plouin PF, Baxter GM et al (2000) Renal arteries in patients at risk of renal arterial stenosis: multicenter evaluation of the echo-enhancer SH U 508A at color and spectral Doppler US. Levovist Renal Artery Stenosis Study Group. Radiology 214:739–746Google Scholar
  18. 18.
    Claudon M, Cosgrove D, Albrecht T et al (2008) Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS)—update 2008. Ultraschall Med 29:28–44. doi: 10.1055/s-2007-963785 CrossRefGoogle Scholar
  19. 19.
    Cosgrove D (1995) TRUS with contrast agents in carcinoma of the prostate. In: Murphy G, Khoury S, Chatelain C, Dennis L (eds) Fourth international symposium on recent advances in urological cancer. Scientific Communications International, Jersey, pp 131–140Google Scholar
  20. 20.
    Cosgrove D (2004) Future prospects for SonoVue and CPS. Eur Radiol 14:116–124. doi: 10.1007/s10406-004-0084-3 CrossRefGoogle Scholar
  21. 21.
    Cosgrove D (2006) Ultrasound contrast agents: an overview. Eur J Radiol 60:324–330. doi: 10.1016/j.ejrad.2006.06.022 CrossRefGoogle Scholar
  22. 22.
    D’Arcy TJ, Jayaram V, Lynch M et al (2004) Ovarian cancer detected non-invasively by contrast-enhanced power Doppler ultrasound. BJOG 111:619–622. doi: 10.1111/j.1471-0528.2004.00157.x CrossRefGoogle Scholar
  23. 23.
    D’Onofrio M, Zamboni G, Faccioli N et al (2007) Ultrasonography of the pancreas. 4. Contrast-enhanced imaging. Abdom Imaging 32:171–181. doi: 10.1007/s00261-006-9010-6 CrossRefGoogle Scholar
  24. 24.
    Darge K, Troeger J, Duetting T et al (1999) Reflux in young patients: comparison of voiding US of the bladder and retrovesical space with echo enhancement versus voiding cystourethrography for diagnosis. Radiology 210:201–207Google Scholar
  25. 25.
    Dayton PA, Rychak JJ (2007) Molecular ultrasound imaging using microbubble contrast agents. Front Biosci 12:5124–5142. doi: 10.2741/2553 CrossRefGoogle Scholar
  26. 26.
    DeMaria AN, Narula J, Mahmud E et al (2006) Imaging vulnerable plaque by ultrasound. J Am Coll Cardiol 47:C32–C39. doi: 10.1016/j.jacc.2005.11.047 CrossRefGoogle Scholar
  27. 27.
    Dietrich CF, Schuessler G, Trojan J et al (2005) Differentiation of focal nodular hyperplasia and hepatocellular adenoma by contrast-enhanced ultrasound. Br J Radiol 78:704–707. doi: 10.1259/bjr/88181612 CrossRefGoogle Scholar
  28. 28.
    Dijkmans P, Visser C, Kamp O (2005) Adverse reactions to ultrasound contrast agents: is the risk worth the benefit? Eur J Echocardiogr 6:363–366. doi: 10.1016/j.euje.2005.02.003 CrossRefGoogle Scholar
  29. 29.
    Dill-Macky J (2006) Aortic endografts: detecting endoleaks using contrast-enhanced ultrasound. Ultrasound Q 22:49–52Google Scholar
  30. 30.
    Dill-Macky MJ, Wilson SR, Sternbach Y et al (2007) Detecting endoleaks in aortic endografts using contrast-enhanced sonography. AJR Am J Roentgenol 188:W262–W268. doi: 10.2214/AJR.05.0532 CrossRefGoogle Scholar
  31. 31.
    Drighil A, El Mosalami H, Elbadaoui N et al (2007) Patent foramen ovale: a new disease? Int J Cardiol 122:1–9. doi: 10.1016/j.ijcard.2006.12.028 CrossRefGoogle Scholar
  32. 32.
    Eggers J (2008) Transcranial Doppler ultrasound enhances the efficacy of intravenous thrombolysis in patients with middle cerebral artery occlusion. StrokeGoogle Scholar
  33. 33.
    European Agency for the Evaluation of Medicinal Products (2004) Public statement on SonoVue: new contraindication in patients with heart diseaseGoogle Scholar
  34. 34.
    FDA (2007) Information for healthcare professionalsGoogle Scholar
  35. 35.
    Feinstein S, Heidenreich P, Dick C et al (1988) Albunex: a new intravascular ultrasound contrast agent: preliminary safety and efficacy results. Circulation 78(Suppl II):565Google Scholar
  36. 36.
    Ferrara K, Pollard R, Borden M (2007) Ultrasound microbubble contrast agents: fundamentals and application to gene and drug delivery. Annu Rev Biomed Eng 9:415–447. doi: 10.1146/annurev.bioeng.8.061505.095852 CrossRefGoogle Scholar
  37. 37.
    Fienstein S (2007) Letter to the FDA: black box warning on Definity and OptisonGoogle Scholar
  38. 38.
    Folkman J (1995) Angiogenesis in cancer, vascular, rheumatoid and other disease. Nat Med 1:27–31CrossRefGoogle Scholar
  39. 39.
    Gramiak R, Shah P (1968) Echocardiography of the aortic root. Invest Radiol 3:356–366. doi: 10.1097/00004424-196809000-00011 CrossRefGoogle Scholar
  40. 40.
    Halpern EJ (2006) Contrast-enhanced ultrasound imaging of prostate cancer. Rev Urol 8(Suppl 1):S29–S37Google Scholar
  41. 41.
    Harvey CJ, Albrecht T (2001) Ultrasound of focal liver lesions. Eur Radiol 11:1578–1593. doi: 10.1007/s003300101002 CrossRefGoogle Scholar
  42. 42.
    Harvey CJ, Blomley MJ, Eckersley RJ et al (2001) Developments in ultrasound contrast media. Eur Radiol 11:675–689. doi: 10.1007/s003300000624 CrossRefGoogle Scholar
  43. 43.
    Huang P, Wang Z, Huang F et al (2009) Analysis of Neovascularization within carotid plaques in patients with cerebral infarction using contrast-enhanced ultrasound. J Am Coll Cardiol (in press)Google Scholar
  44. 44.
    Ikonomidis I, Holmes E, Nihoyannopoulos P (1998) Assessment of left ventricular wall motion after intravenous injection of Albunex during dobutamine stress echocardiography. Coron Artery Dis 9:567–576CrossRefGoogle Scholar
  45. 45.
    Kaneko Y, Maruyama T, Takegami K et al (2005) Use of a microbubble agent to increase the effects of high intensity focused ultrasound on liver tissue. Eur Radiol 15:1415–1420. doi: 10.1007/s00330-005-2663-7 CrossRefGoogle Scholar
  46. 46.
    Kaufmann BA, Wei K, Lindner JR (2007) Contrast echocardiography. Curr Probl Cardiol 32:51–96. doi: 10.1016/j.cpcardiol.2006.10.004 CrossRefGoogle Scholar
  47. 47.
    Klibanov AL (2007) Ultrasound molecular imaging with targeted microbubble contrast agents. J Nucl Cardiol 14:876–884. doi: 10.1016/j.nuclcard.2007.09.008 CrossRefGoogle Scholar
  48. 48.
    Klibanov AL, Hughes MS, Villanueva FS et al (1999) Targeting and ultrasound imaging of microbubble-based contrast agents. MAGMA 8:177–184. doi: 10.1007/BF02594596 CrossRefGoogle Scholar
  49. 49.
    Konopke R, Bunk A, Kersting S (2007) The role of contrast-enhanced ultrasound for focal liver lesion detection: an overview. Ultrasound Med Biol 33:1515–1526. doi: 10.1016/j.ultrasmedbio.2007.04.009 CrossRefGoogle Scholar
  50. 50.
    Krenning BJ, Kirschbaum SW, Soliman OI et al (2007) Comparison of contrast agent-enhanced versus non-contrast agent-enhanced real-time three-dimensional echocardiography for analysis of left ventricular systolic function. Am J Cardiol 100:1485–1489. doi: 10.1016/j.amjcard.2007.06.042 CrossRefGoogle Scholar
  51. 51.
    Krix M (2005) Quantification of enhancement in contrast ultrasound: a tool for monitoring of therapies in liver metastases. Eur Radiol Suppl 15:104–108. doi: 10.1007/s10406-005-0172-z CrossRefGoogle Scholar
  52. 52.
    Kusnetzky L, Khalid A, Khumri T et al (2008) Acute mortality in hospitalized patients undergoing echocardiography with and without an ultrasound contrast agent: results in 18, 671 consecutive studies. J Am Coll Cardiol 51:1704–1706. doi: 10.1016/j.jacc.2008.03.006 CrossRefGoogle Scholar
  53. 53.
    Lamuraglia M, Escudier B, Chami L et al (2006) To predict progression-free survival and overall survival in metastatic renal cancer treated with sorafenib: pilot study using dynamic contrast-enhanced Doppler ultrasound. Eur J Cancer 42:2472–2479. doi: 10.1016/j.ejca.2006.04.023 CrossRefGoogle Scholar
  54. 54.
    Lassau N, Roche A (2007) Imaging and angiogenesis: DCE-US (dynamic contrast enhanced-ultrasonography). Bull Cancer 94(Spec No):S247–S253Google Scholar
  55. 55.
    Lassau N, Lamuraglia M, Chami L et al (2006) Gastro-intestinal stromal tumours treated with Imatinib: monitoring response with contrast enhanced ultrasound. AJR Am J Roentgenol 187:1267–1273. doi: 10.2214/AJR.05.1192 CrossRefGoogle Scholar
  56. 56.
    Lechat P, Mas JL, Lascault G et al (1988) Prevalence of patent foramen ovale in patients with stroke. N Engl J Med 318:1148–1152Google Scholar
  57. 57.
    Leen E, Ceccotti P, Kalogeropoulou C et al (2006) Prospective multicenter trial evaluating a novel method of characterizing focal liver lesions using contrast-enhanced sonography. AJR Am J Roentgenol 186:1551–1559. doi: 10.2214/AJR.05.0138 CrossRefGoogle Scholar
  58. 58.
    Li T, Tachibana K, Kuroki M (2003) Gene transfer with echo-enhanced contrast agents: comparison between Albunex, Optison, and Levovist in mice—initial results. Radiology 229:423–428. doi: 10.1148/radiol.2292020500 CrossRefGoogle Scholar
  59. 59.
    Liang HD, Lu QL, Xue SA et al (2004) Optimisation of ultrasound-mediated gene transfer (sonoporation) in skeletal muscle cells. Ultrasound Med Biol 30:1523–1529. doi: 10.1016/j.ultrasmedbio.2004.08.021 CrossRefGoogle Scholar
  60. 60.
    Main ML, Goldman JH, Grayburn PA (2007) Thinking outside the “box”-the ultrasound contrast controversy. J Am Coll Cardiol 50:2434–2437. doi: 10.1016/j.jacc.2007.11.006 CrossRefGoogle Scholar
  61. 61.
    Malm S, Frigstad S, Sagberg E et al (2004) Accurate and reproducible measurement of left ventricular volume and ejection fraction by contrast echocardiography: a comparison with magnetic resonance imaging. J Am Coll Cardiol 44:1030–1035CrossRefGoogle Scholar
  62. 62.
    McKinlay AE (ed) (2007) Effects of ultrasound and infrasound relevant to human health. Prog Biophys Mol Biol 93:1–420. doi: 10.1016/j.pbiomolbio.2006.07.002
  63. 63.
    Meloni MF, Livraghi T, Filice C et al (2006) Radiofrequency ablation of liver tumors: the role of microbubble ultrasound contrast agents. Ultrasound Q 22:41–47Google Scholar
  64. 64.
    Miller DL, Averkiou MA, Brayman AA et al (2008) Bioeffects considerations for diagnostic ultrasound contrast agents. J Ultrasound Med 27:611–632Google Scholar
  65. 65.
    Moir S, Marwick TH (2004) Combination of contrast with stress echocardiography: a practical guide to methods and interpretation. Cardiovasc Ultrasound 2:15–25. doi: 10.1186/1476-7120-2-15 CrossRefGoogle Scholar
  66. 66.
    Moir S, Shaw L, Haluska B et al (2007) Left ventricular opacification for the diagnosis of coronary artery disease with stress echocardiography: an angiographic study of incremental benefit and cost-effectiveness. Am Heart J 154:510–518. doi: 10.1016/j.ahj.2007.04.046 CrossRefGoogle Scholar
  67. 67.
    Moran C, Watson R, Fox A et al (2002) In vitro acoustic characterisation of four intravenous ultrasonic contrast agents at 30 MHz. Ultrasound Med Biol 28:785–791. doi: 10.1016/S0301-5629(02)00520-3 CrossRefGoogle Scholar
  68. 68.
    Nemes A, Geleijnse ML, Krenning BJ et al (2007) Usefulness of ultrasound contrast agent to improve image quality during real-time three-dimensional stress echocardiography. Am J Cardiol 99:275–278. doi: 10.1016/j.amjcard.2006.08.023 CrossRefGoogle Scholar
  69. 69.
    Ng K, Liu Y (2002) Therapeutic ultrasound: its application in drug delivery. Med Res Rev 22:204–223. doi: 10.1002/med.10004 CrossRefGoogle Scholar
  70. 70.
    Nicolau C, Vilana R, Bru E (2004) The use of contrast-enhanced ultrasound in the management of the cirrhotic patient and for detection of HCC. Eur Radiol 14:63–72. doi: 10.1007/s00330-004-2298-0 CrossRefGoogle Scholar
  71. 71.
    Nishioka T, Luo H, Fishbein MC et al (1997) Dissolution of thrombotic arterial occlusion by high intensity, low frequency ultrasound and dodecafluoropentane emulsion: an in vitro and in vivo study. J Am Coll Cardiol 30:561–568. doi: 10.1016/S0735-1097(97)00182-4 CrossRefGoogle Scholar
  72. 72.
    Padhani AR, Ollivier L (2001) The RECIST (response evaluation criteria in solid tumors) criteria: implications for diagnostic radiologists. Br J Radiol 74:983–986Google Scholar
  73. 73.
    Piscaglia F, Bolondi L (2006) The safety of Sonovue in abdominal applications: retrospective analysis of 23188 investigations. Ultrasound Med Biol 32:1369–1375. doi: 10.1016/j.ultrasmedbio.2006.05.031 CrossRefGoogle Scholar
  74. 74.
    Piscaglia F, Corradi F, Mancini M et al (2007) Real time contrast enhanced ultrasonography (CEUS) in detection of liver metastases from gastrointestinal cancer. BMC Cancer 7:171–184. doi: 10.1186/1471-2407-7-171 CrossRefGoogle Scholar
  75. 75.
    Quaia E, Degobbis F, Tona G et al (2004) Differential patterns of contrast enhancement in different focal liver lesions after injection of the microbubble US contrast agent SonoVue. Radiol Med (Torino) 107:155–165Google Scholar
  76. 76.
    Quaia E, Palumbo A, Rossi S et al (2006) Characterization of liver tumors insonated at low transmit power after microbubble contrast agent injection: comparison of visual and quantitative analysis in diagnostic performance. AJR Am J Roentgenol 186:1560–1570. doi: 10.2214/AJR.05.0527 CrossRefGoogle Scholar
  77. 77.
    Quaia E, D’Onofrio M, Palumbo A et al (2006) Comparison of contrast-enhanced ultrasonography versus baseline ultrasound and contrast-enhanced computed tomography in metastatic disease of the liver: diagnostic performance and confidence. Eur Radiol 16:1599–1609. doi: 10.1007/s00330-006-0192-7 CrossRefGoogle Scholar
  78. 78.
    Robotti D, Cammarota T, Debani P et al (2004) Activity of Crohn disease: value of Color-Power-Doppler and contrast-enhanced ultrasonography. Abdom Imaging 29:652–678. doi: 10.1007/s00261-003-0157-0 CrossRefGoogle Scholar
  79. 79.
    Schneider M (2008) Molecular imaging and ultrasound-assisted drug delivery. J Endourol 22:795–802. doi: 10.1089/end.2007.9821 CrossRefGoogle Scholar
  80. 80.
    Schumann PA, Christiansen JP, Quigley RM et al (2002) Targeted-microbubble binding selectively to GPIIb IIIa receptors of platelet thrombi. Invest Radiol 37:587–593. doi: 10.1097/00004424-200211000-00001 CrossRefGoogle Scholar
  81. 81.
    Schwenger V, Hinkel UP, Nahm AM et al (2006) Real-time contrast-enhanced sonography in renal transplant recipients. Clin Transplant 20(Suppl 17):51–54. doi: 10.1111/j.1399-0012.2006.00600.x CrossRefGoogle Scholar
  82. 82.
    Senior R, Becher H, Monaghan M et al (2009) Contrast echocardiography: evidence and guidelines for clinical use. Eur J Echocardiogr (in press)Google Scholar
  83. 83.
    Shimoni S, Frangogiannis NG, Aggeli CJ et al (2003) Identification of hibernating myocardium with quantitative intravenous myocardial contrast echocardiography: comparison with dobutamine echocardiography and thallium-201 scintigraphy. Circulation 107:538–544. doi: 10.1161/01.CIR.0000047211.53448.12 CrossRefGoogle Scholar
  84. 84.
    Solbiati L, Ierace T, Tonolini M et al (2004) Guidance and monitoring of radiofrequency liver tumor ablation with contrast-enhanced ultrasound. Eur J Radiol 51(Suppl):S19–S23. doi: 10.1016/j.ejrad.2004.03.035 CrossRefGoogle Scholar
  85. 85.
    Soliman OI, Geleijnse ML, Meijboom FJ et al (2007) The use of contrast echocardiography for the detection of cardiac shunts. Eur J Echocardiogr 8:S2–S12. doi: 10.1016/j.euje.2007.03.006 CrossRefGoogle Scholar
  86. 86.
    Soman P, Lahiri A, Senior R (2000) Safety of an intravenous second generation contrast agent in patients with severe left ventricular dysfunction. Heart Vessels 84:634–635Google Scholar
  87. 87.
    Strunk H, Stuckmann G, Frohlich E et al (1998) Native and signal-enhanced power Doppler sonography for characterization of liver lesions. Rontgenstr Fortschr 168:344–351. doi: 10.1055/s-2007-1015140 CrossRefGoogle Scholar
  88. 88.
    Tachibana K, Tachibana S (1995) Albumin microbubble echo-contrast material as an enhancer for ultrasound accelerated thrombolysis. Circulation 92:1148–1150Google Scholar
  89. 89.
    Tatlidede AD, Oflazoglu B, Celik SE et al (2007) Prevalence of patent foramen ovale in patients with migraine. Agri 19:39–42Google Scholar
  90. 90.
    Thorelius L (2004) Contrast enhanced ultrasound in trauma. Eur Radiol 14:43–52. doi: 10.1007/s10406-004-0078-1 CrossRefGoogle Scholar
  91. 91.
    Torzilli G (2004) Contrast-enhanced intraoperative ultrasonography in surgery for liver tumors. Eur J Radiol 51(Suppl):S25–S29. doi: 10.1016/j.ejrad.2004.03.025 CrossRefGoogle Scholar
  92. 92.
    Torzilli G, Del Fabbro D, Palmisano A et al (2007) Contrast-enhanced intraoperative ultrasonography: a valuable and not any more monocentric diagnostic technique performed in different ways. Ann Surg 245:152–153 (author reply 152–153). doi: 10.1097/01.sla.0000250940.21627.57 Google Scholar
  93. 93.
    Tousek P, Penicka M, Tintera J et al (2007) Identification of hibernating myocardium with myocardial contrast echocardiography: Comparison with late gadolinium-enhanced magnetic resonance. Int J Cardiol 128:117–120. doi: 10.1016/j.ijcard.2007.05.113 CrossRefGoogle Scholar
  94. 94.
    van Wamel A, Kooiman K, Harteveld M et al (2006) Vibrating microbubbles poking individual cells: drug transfer into cells via sonoporation. J Control Release 112:149–155. doi: 10.1016/j.jconrel.2006.02.007 CrossRefGoogle Scholar
  95. 95.
    Villanueva FS, Lu E, Bowry S et al (2007) Myocardial ischemic memory imaging with molecular echocardiography. Circulation 115:345–352. doi: 10.1161/CIRCULATIONAHA.106.633917 CrossRefGoogle Scholar
  96. 96.
    von Bibra H, Sutherland G, Becher H et al (1995) Clinical usefulness of left heart Doppler contrast enhancement by saccharide-based transpulmonary contrast agent. The Levovist Cardiac Working Group. J Am Coll Cardiol 25:500–508. doi: 10.1016/0735-1097(94)00404-E CrossRefGoogle Scholar
  97. 97.
    von Herbay A, Haeussinger D, Gregor M et al (2007) Characterization and detection of hepatocellular carcinoma (HCC): comparison of the ultrasound contrast agents SonoVue (BR 1) and Levovist (SH U 508A). Ultraschall Med 28:168–175. doi: 10.1055/s-2007-963070 CrossRefGoogle Scholar
  98. 98.
    Ward M, Wu J, Chiu JF (1999) Ultrasound-induced cell lysis and sonoporation enhanced by contrast agents. J Acoust Soc Am 105:2951–2957. doi: 10.1121/1.426908 CrossRefGoogle Scholar
  99. 99.
    Watanabe A, Otake R, Nozaki T et al (2008) Effects of microbubbles on ultrasound-mediated gene transfer in human prostate cancer PC3 cells: comparison among Levovist, YM454, and MRX-815H. Cancer Lett 265:107–112CrossRefGoogle Scholar
  100. 100.
    Wiesmann M, Bergmann-Käster C, Kreft B et al (2004) Renal perfusion imaging using contrast-enhanced phase-inversion ultrasound. Clin Nephrol 62:423–431Google Scholar
  101. 101.
    Wilson SR, Burns PN (2006) An algorithm for the diagnosis of focal liver masses using microbubble contrast-enhanced pulse-inversion sonography. AJR Am J Roentgenol 186:1401–1412. doi: 10.2214/AJR.04.1920 CrossRefGoogle Scholar
  102. 102.
    Xu HX, Lu MD, Liu GJ et al (2006) Imaging of peripheral cholangiocarcinoma with low-mechanical index contrast-enhanced sonography and SonoVue: initial experience. J Ultrasound Med 25:23–33Google Scholar
  103. 103.
    Xu H, Xie X, Lu M et al (2008) Unusual benign focal liver lesions: findings on real-time contrast-enhanced sonography. J Ultrasound Med 27:243–254Google Scholar
  104. 104.
    Yanagisawa K, Moriyasu F, Miyahara T et al (2007) Phagocytosis of ultrasound contrast agent microbubbles by Kupffer cells. Ultrasound Med Biol 33:318–325. doi: 10.1016/j.ultrasmedbio.2006.08.008 CrossRefGoogle Scholar

Copyright information

© International Federation for Medical and Biological Engineering 2009

Authors and Affiliations

  1. 1.Imperial College, Hammersmith HospitalLondonUK

Personalised recommendations