On sizing and counting of microbubbles using optical microscopy.

Intra- and interobserver (n = 3) variability of sizing and counting microbubbles using optical microscopy (OM) was assessed. The system was calibrated using standardised mono-disperse and poly-disperse microspheres. Results of the calibration show intraobserver variations of number count (C) = 13.0% and arithmetic mean size (MS) = 0.2%, and interobserver variations of C = 18.4% and MS = 0.6%, for the mono-disperse microspheres. For the poly-disperse microspheres, intraobserver variations were: C = 6.9% and MS = 0.8%, and interobserver: C = 10.5% and MS = 0.3%. For SonoVue™ the intraobserver variations were: C = 23.3% and MS = 8.0%, and interobserver C = 6.8% and MS = 3.8%. The results suggest that the higher values of the intraobserver variation for SonoVue™ arise from the natural decay of microbubbles over time. This article presents a detailed protocol and outlines potential pitfalls in our approach. These results are in general agreement with those previously reported and compare well with known size distributions.