Ipshita Gupta1, Jonathan M Fenkel2, John R Eisenbrey3, Priscilla Machado4, Maria Stanczak5, Corinne E Wessner6, Colette M Shaw3, Cynthia Miller7, Michael C Soulen8, Kirk Wallace9, Flemming Forsberg10. 1. Post-doctoral research fellow, Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107, USA; School of Biomedical Engineering, Sciences and Health Systems, Drexel University, Philadelphia, PA 19104, USA. 2. Associate Professor, Department of Medicine, Division of Gastroenterology and Hepatology, Thomas Jefferson University, Philadelphia, PA 19107, USA. 3. Associate Professor, Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107, USA. 4. Project manager, Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107, USA. 5. Vascular Sonography Clinical Coordinator, Thomas Jefferson University, Philadelphia, PA 19107, USA. 6. Research sonographer, Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107, USA. 7. Clinical Trials Manager, Thomas Jefferson University, Philadelphia, PA 19107, USA. 8. Professor, Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA. 9. Senior Scientist, GE Global Research, Niskayuna, NY 12309, USA. 10. Professor, Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107, USA. Electronic address: flemming.forsberg@jefferson.edu.
Abstract
RATIONALE AND OBJECTIVE: Subharmonic aided pressure estimation (SHAPE) is based on the inverse relationship between the subharmonic amplitude of ultrasound contrast microbubbles and ambient pressure. The aim of this study was to verify if SHAPE can accurately monitor disease progression in patients identified with portal hypertension. MATERIALS & METHODS: A modified Logiq 9 scanner with a 4C curvi-linear probe (GE, Waukesha, WI) was used to acquire SHAPE data (transmitting and receiving at 2.5 and 1.25 MHz, respectively) using Sonazoid (GE Healthcare, Oslo, Norway; FDA IND 124,465). Twenty-one (median age 59 years; 12 Males) of the 178 patients enrolled in this institutional review board approved study (14F.113) were identified as having clinically significant portal hypertension based on their hepatic venous pressure gradient results ≥ 10 mmHg. Repeat SHAPE examinations were done every 6.2 months. Liver function tests and clinical indicators were used to establish treatment response. RESULTS: Of the 21 portal hypertensive subjects, 11 had successful follow up scans with an average follow up time of 6.2 months. There was a significantly larger SHAPE signal reduction in the group who were classified as treatment responders (n = 10; -4.01±3.61 dB) compared to the single nonresponder (2.33 dB; p < 0.001). Results for responders matched the corresponding clinical outcomes of improved model for end stage liver disease (MELD) scores, improvement in underlying cause of portal hypertension, improved liver function tests and reduced ascites. CONCLUSION: SHAPE can potentially monitor disease progression in portal hypertensive patients and hence, may help clinicians in patient management. A larger study would further validate this claim.
RATIONALE AND OBJECTIVE: Subharmonic aided pressure estimation (SHAPE) is based on the inverse relationship between the subharmonic amplitude of ultrasound contrast microbubbles and ambient pressure. The aim of this study was to verify if SHAPE can accurately monitor disease progression in patients identified with portal hypertension. MATERIALS & METHODS: A modified Logiq 9 scanner with a 4C curvi-linear probe (GE, Waukesha, WI) was used to acquire SHAPE data (transmitting and receiving at 2.5 and 1.25 MHz, respectively) using Sonazoid (GE Healthcare, Oslo, Norway; FDA IND 124,465). Twenty-one (median age 59 years; 12 Males) of the 178 patients enrolled in this institutional review board approved study (14F.113) were identified as having clinically significant portal hypertension based on their hepatic venous pressure gradient results ≥ 10 mmHg. Repeat SHAPE examinations were done every 6.2 months. Liver function tests and clinical indicators were used to establish treatment response. RESULTS: Of the 21 portal hypertensive subjects, 11 had successful follow up scans with an average follow up time of 6.2 months. There was a significantly larger SHAPE signal reduction in the group who were classified as treatment responders (n = 10; -4.01±3.61 dB) compared to the single nonresponder (2.33 dB; p < 0.001). Results for responders matched the corresponding clinical outcomes of improved model for end stage liver disease (MELD) scores, improvement in underlying cause of portal hypertension, improved liver function tests and reduced ascites. CONCLUSION: SHAPE can potentially monitor disease progression in portal hypertensivepatients and hence, may help clinicians in patient management. A larger study would further validate this claim.
Authors: Jaydev K Dave; Valgerdur G Halldorsdottir; John R Eisenbrey; Joel S Raichlen; Ji-Bin Liu; Maureen E McDonald; Kris Dickie; Shumin Wang; Corina Leung; Flemming Forsberg Journal: Am J Physiol Heart Circ Physiol Date: 2012-05-04 Impact factor: 4.733
Authors: George Kalambokis; Pinelopi Manousou; Shusang Vibhakorn; Laura Marelli; Evangelos Cholongitas; Marco Senzolo; David Patch; Andrew K Burroughs Journal: J Hepatol Date: 2007-05-24 Impact factor: 25.083
Authors: J R Eisenbrey; J K Dave; V G Halldorsdottir; D A Merton; P Machado; J B Liu; C Miller; J M Gonzalez; S Park; S Dianis; C L Chalek; K E Thomenius; D B Brown; V Navarro; F Forsberg Journal: Ultrasonics Date: 2011-05-10 Impact factor: 2.890
Authors: Jaydev K Dave; Valgerdur G Halldorsdottir; John R Eisenbrey; Joel S Raichlen; Ji-Bin Liu; Maureen E McDonald; Kris Dickie; Shumin Wang; Corina Leung; Flemming Forsberg Journal: JACC Cardiovasc Imaging Date: 2012-01