Gas body contrast agents bring a demonstrable risk of bioeffects to diagnostic ultrasound for the first time. Our research (and others throughout the world) has established the occurrence of micro-scale damage from contrast aided diagnostic ultrasound. Our laboratory has developed sensitive animal models and specific new tests for microscale bioeffects in heart and kidney. USFDA approved contrast agents and common diagnostic ultrasound scanners are used with carefully calibrated exposure methods to replicate not only the recommended doses and methods of administration of commercially available gas body contrast agents but also the attenuation and extended path lengths encountered in human exposures. It is therefore virtually certain that clinicians worldwide unknowingly cause similar microscale damage while obtaining diagnostic images with these methods. In our preliminary research on rat kidney, contrast gas bodies activated by diagnostic ultrasound ruptured the high pressure glomerular capillaries, and the resulting blood loss into the Bowman's capsule blocked entire nephrons and destroyed the resorptive epithelium of the proximal tubules. Our four specific aims will (1) examine the fundamental biophysics of the bioeffects at the microscopic level, (2) develop new dosimetric parameters and indices to aid clinicians in understanding and avoiding these bioeffects, (3) test common patient situations in which contrast ultrasound bioeffects potentially could result in medically significant injury, and (4) demonstrate ultrasound imaging methods which minimize bioeffects potential. Contrast aided diagnostic ultrasound appears to be a breakthrough for diagnosis but unfortunately progress has been stalled by the bioeffects problem, which is arguably the most pressing research need in medical ultrasound today. In this proposed research, experienced independent researchers will examine comprehensively this problem and resolve it. The establishment of principles and imaging procedures to insure safe use of contrast aided diagnostic ultrasound is urgently needed and achievable. Lay language: Contrast media have been invented to enhance ultrasound images by injecting small gas bubbles into the blood. After approval, research in animals has revealed microscopic damage in heart and kidney caused by the interaction of diagnostic ultrasound with the bubbles. This project will examine bioeffects in cells and tissues and show how to safely use ultrasound contrast agents in diagnostic imaging. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
Type
Research Project (R01)
Project #
2R01EB000338-23A1
Application #
7206704
Study Section
Medical Imaging Study Section (MEDI)
Program Officer
Lopez, Hector
Project Start
1987-01-01
Project End
2010-07-30
Budget Start
2006-09-22
Budget End
2007-07-31
Support Year
23
Fiscal Year
2006
Total Cost
$409,206
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Miller, Douglas L; Dou, Chunyan (2011) The influence of octyl ýý-D-glucopyranoside on cell lysis induced by ultrasonic cavitation. J Acoust Soc Am 130:3482-8
Miller, Douglas L; Dou, Chunyan; Sorenson, Dorothy et al. (2011) Histological observation of islet hemorrhage induced by diagnostic ultrasound with contrast agent in rat pancreas. PLoS One 6:e21617
Miller, Douglas L; Dou, Chunyan; Lucchesi, Benedict R (2011) Are ECG premature complexes induced by ultrasonic cavitation electrophysiological responses to irreversible cardiomyocyte injury? Ultrasound Med Biol 37:312-20
Miller, Douglas L; Dou, Chunyan; Wiggins, Roger C (2010) Contrast-enhanced diagnostic ultrasound causes renal tissue damage in a porcine model. J Ultrasound Med 29:1391-401
Miller, Douglas L; Dou, Chunyan; Wiggins, Roger C (2010) In vivo gas body efficacy for glomerular capillary hemorrhage induced by diagnostic ultrasound in rats. IEEE Trans Biomed Eng 57:167-74
Samuel, Stanley; Cooper, Michol A; Bull, Joseph L et al. (2009) An ex vivo study of the correlation between acoustic emission and microvascular damage. Ultrasound Med Biol 35:1574-86
Miller, Douglas L; Dou, Chunyan; Lucchesi, Benedict R (2009) Cardiac arrhythmia and injury induced in rats by burst and pulsed mode ultrasound with a gas body contrast agent. J Ultrasound Med 28:1519-26
Miller, Douglas L; Dou, Chunyan; Wiggins, Roger C (2009) Glomerular capillary hemorrhage induced in rats by diagnostic ultrasound with gas-body contrast agent produces intratubular obstruction. Ultrasound Med Biol 35:869-77
Samuel, Stanley; Fowlkes, J Brian; Miller, Douglas L (2009) An in vitro study of the correlation between bubble distribution, acoustic emission, and cell damage by contrast ultrasound. IEEE Trans Ultrason Ferroelectr Freq Control 56:589-99
Miller, Douglas L; Dou, Chunyan (2009) Induction of apoptosis in sonoporation and ultrasonic gene transfer. Ultrasound Med Biol 35:144-54

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