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Ultrasound contrast agents: microbubbles made simple for the pediatric radiologist

  • Contrast-enhanced ultrasound (CEUS) in children
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Abstract

The ability to provide prompt, real-time, easily accessible and radiation-free diagnostic assessments makes ultrasound (US) one of the most versatile imaging modalities. The introduction and development of stable microbubble-based ultrasound contrast agents (UCAs) in the early 1990s improved visualization of complex vascular structures, overcoming some of the limitations of B-mode and Doppler imaging. UCAs have been used extensively in the adult population to visualize vasculature and to evaluate perfusion and blood flow dynamics in organs and lesions. Since the first observations that air bubbles within a liquid can generate a strong echogenic effect, to the early makeshift approaches with agitated saline, and later to the development of industrially produced and federally approved UCAs, these agents have evolved to become both clinically and commercially viable. Perhaps the most exciting potential of UCAs is being uncovered by current research that explores the use of these agents for molecular imaging and therapeutic applications. As contrast-enhanced ultrasound (CEUS) becomes more widely available, it is important for pediatric radiologists to understand the physics of the interaction between the US signal and the microbubbles in order to properly utilize them for the highest level of diagnostic imaging and interventions. In this article we introduce the composition of UCAs and the physics of their behavior in US, and we offer a brief history of their development over the last decades.

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Authors and Affiliations

  1. Department of Radiology, Children’s Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA

    Anush Sridharan & Aikaterini Ntoulia

  2. Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA

    John R. Eisenbrey & Flemming Forsberg

  3. Children’s Hospital, Dresden Municipal Hospital, Teaching-Hospital of Technical University, Dresden, Germany

    Norbert Lorenz

  4. Trainings-Zentrum Ultraschall-Diagnostik LS GmbH, Mainleus, Germany

    Ludwig Steffgen

Authors
  1. Anush Sridharan
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  2. John R. Eisenbrey
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  3. Flemming Forsberg
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  4. Norbert Lorenz
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  5. Ludwig Steffgen
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  6. Aikaterini Ntoulia
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Correspondence to Anush Sridharan.

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Conflicts of interest

Dr. Eisenbrey has received grant support and speaker fees from Lantheus Medical Imaging, equipment support from Siemens, and grant and equipment support from GE Healthcare. Dr. Forsberg has received equipment support from GE Healthcare, Siemens, Canon and Butterfly; UCA support from Lantheus, GE Healthcare and Bracco; and is a consultant for Samumed and Exact Therapeutics.

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Sridharan, A., Eisenbrey, J.R., Forsberg, F. et al. Ultrasound contrast agents: microbubbles made simple for the pediatric radiologist. Pediatr Radiol 51, 2117–2127 (2021). https://doi.org/10.1007/s00247-021-05080-1

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  • DOI: https://doi.org/10.1007/s00247-021-05080-1

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