Liver dysplasia: US molecular imaging with targeted contrast agent enables early assessment

Radiology. 2013 May;267(2):487-95. doi: 10.1148/radiol.13120220. Epub 2013 Jan 29.

Abstract

Purpose: To investigate the ability of vascular endothelial growth factor receptor type 2 (VEGFR2)-targeted ultrasonographic (US) microbubbles for the assessment of liver dysplasia in transgenic mice.

Materials and methods: Animal experiments were approved by the governmental review committee. Nuclear factor-κB essential modulator knock-out mice with liver dysplasia and wild-type mice underwent liver imaging by using a clinical US system. Two types of contrast agents were investigated: nontargeted, commercially available, second-generation microbubbles (SonoVue) and clinically translatable PEGylated VEGFR2-targeted microbubbles (BR55). Microbubble kinetics was investigated over the course of 4 minutes. Targeted contrast material-enhanced US signal was quantified 5 minutes after injection. Competitive in vivo binding experiments with BR55 were performed in knock-out mice. Immunohistochemical and hematoxylin-eosin staining of liver sections was performed to validate the in vivo US results. Groups were compared by using the Mann-Whitney test.

Results: Peak enhancement after injection of SonoVue and BR55 did not differ in healthy and dysplastic livers (SonoVue, P = .46; BR55, P = .43). Accordingly, immunohistochemical findings revealed comparable vessel densities in both groups. The specificity of BR55 to VEGFR2 was proved by in vivo competition (P = .0262). While the SonoVue signal decreased similarly in healthy and dysplastic livers during the 4 minutes, there was an accumulation of BR55 in dysplastic livers compared with healthy ones. Furthermore, targeted contrast-enhanced US signal indicated a significantly higher site-specific binding of BR55 in dysplastic than healthy livers (P = .005). Quantitative immunohistologic findings confirmed significantly higher VEGFR2 levels in dysplastic livers (P = .02).

Conclusion: BR55 enables the distinction of early stages of liver dysplasia from normal liver.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Contrast Media
  • Liver / diagnostic imaging*
  • Liver / metabolism
  • Liver / pathology
  • Mice
  • Mice, Transgenic
  • Molecular Imaging
  • Phospholipids
  • Sensitivity and Specificity
  • Statistics, Nonparametric
  • Sulfur Hexafluoride
  • Ultrasonography
  • Vascular Endothelial Growth Factor Receptor-2 / metabolism

Substances

  • Contrast Media
  • Phospholipids
  • contrast agent BR1
  • Vascular Endothelial Growth Factor Receptor-2
  • Sulfur Hexafluoride