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Details for Patent: 6,231,834

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Details for Patent: 6,231,834

Title: Methods for ultrasound imaging involving the use of a contrast agent and multiple images and processing of same
Abstract:Improved methods for providing an image of an internal region of a patient. Embodiments of the invention involve the administration to the patient of a contrast agent which comprises, in an aqueous carrier, a lipid, protein, polymer or surfactant, and a gas. The patient is scanned using ultrasound imaging to obtain a visible image of the region. In embodiments of the invention, the scanning step may comprise applying a first quantity of ultrasound energy to the patient to provide a first image, followed by the application substantially immediately thereafter of a second quantity of ultrasound energy to provide a second image. The first and second images are then processed. The methods are particularly useful for obtaining on-line images of the cardiovascular region which may be employed, for example, to diagnose the presence of diseased tissue in the cardiovascular region of a patient.
Inventor(s): Unger; Evan C. (Tucson, AZ), Fritz; Thomas A. (Tucson, AZ), Gertz; Edward W. (Paradise Valley, AZ)
Assignee: ImaRx Pharmaceutical Corp. (Tucson, AZ)
Filing Date:Dec 02, 1997
Application Number:08/982,829
Claims:1. A method for providing an image of an internal region of a patient comprising (a) administering to the patient a contrast agent which comprises, in an aqueous carrier, a lipid, protein or polymer, and a gas, and (b) scanning the patient using ultrasound imaging to obtain a visible image of the region, wherein said scanning step comprises:

(i) applying a first quantity of ultrasound energy to the patient to provide a first image;

(ii) applying within about 100 milliseconds thereafter a second quantity of ultrasound energy to the patient to provide a second image; and

(iii) processing said first and second images,

wherein said processing step (iii) comprises subtracting said second image from said first image.

2. A method according to claim 1 wherein said contrast agent comprises a lipid.

3. A method according to claim 2 wherein said lipid comprises a phospholipid.

4. A method according to claim 3 wherein said phospholipid is selected from the group consisting of phosphatidylcholine, phosphatidylethanolamine and phosphatidic acid.

5. A method according to claim 4 wherein said phosphatidylcholine is selected from the group consisting of dioleoylphosphatidylcholine, dimyristoylphosphatidylcholine, dipalmitoylphosphatidylcholine and distearoylphosphatidylcholine.

6. A method according to claim 5 wherein said phosphatidylcholine comprises dipalmitoylphosphatidylcholine.

7. A method according to claim 6 wherein said phosphatidylethanolamine is selected from the group consisting of dipalmitoylphosphatidylethanolamine, dioleoylphosphatidylethanolamine, N-succinyldioleoylphosphatidylethanolamine and 1-hexadecyl-2-palmitoylglycerophosphoethanolamine.

8. A method according to claim 7 wherein said phosphatidylethanolamine comprises dipalmitoylphosphatidylethanolamine.

9. A method according to claim 4 wherein said phosphatidic acid comprises dipalmitoylphosphatidic acid.

10. A method according to claim 2 wherein said lipid further comprises a polymer.

11. A method according to claim 10 wherein said polymer comprises a hydrophilic polymer.

12. A method according to claim 11 wherein said polymer comprises polyethylene glycol.

13. A method according to claim 1 wherein said contrast agent comprises a protein.

14. A method according to claim 13 wherein said protein comprises albumin.

15. A method according to claim 1 wherein said contrast agent comprises a polymer.

16. A method according to claim 15 wherein said polymer comprises synthetic polymers or copolymers which are prepared from monomers selected from the group consisting of acrylic acid, methacrylic acid, ethyleneimine, crotonic acid, acrylamide, ethyl acrylate, methyl methacrylate, 2-hydroxyethyl methacrylate, lactic acid, glycolic acid, .epsilon.-caprolactone, acrolein, cyanoacrylate, bisphenol A, epichlorhydrin, hydroxyalkylacrylates, siloxane, dimethylsiloxane, ethylene oxide, propylene oxide, ethylene glycol, hydroxyalkylmethacrylates, N-substituted acrylamides, N-substituted methacrylamides, N-vinyl-2-pyrrolidone, 2,4-pentadiene-1-ol, vinyl acetate, acrylonitrile, styrene, p-amino-styrene, p-aminobenzylstyrene, sodium styrene sulfonate, sodium 2-sulfoxyethyl-methacrylate, vinyl pyridine, aminoethyl methacrylates and 2-methacryloyloxytrimethyl-ammonium chloride.

17. A method according to claim 15 wherein said polymer comprises synthetic polymers or copolymers selected from the group consisting of polyacrylic acid, polyethyleneimine, polymethacrylic acid, polymethylmethacrylate, polysiloxane, polydimethylsiloxane, polylactic acid, poly(.epsilon.-caprolactone), epoxy resin, poly(ethylene oxide), poly(propylene oxide), poly(ethylene glycol), polyamide, polyvinylidene-polyacrylonitrile, polyvinylidene-polyacrylonitrile-polymethylmethacrylate and polystyrene-polyacrylonitrile.

18. A method according to claim 17 wherein said polymer comprises polyvinylidene-polyacrylonitrile copolymer.

19. A method according to claim 1 wherein said gas comprises a fluorinated gas.

20. A method according to claim 19 wherein said fluorinated gas is selected from the group consisting of a perfluorocarbon, sulfur hexafluoride and heptafluoropropane.

21. A method according to claim 20 wherein said fluorinated gas comprises a perfluorocarbon.

22. A method according to claim 21 wherein said perfluorocarbon gas is selected from the group consisting of perfluoromethane, perfluoroethane, perfluoropropane, perfluorobutane and perfluorocyclobutane.

23. A method according to claim 1 wherein said gas is derived, at least in part, from a gaseous precursor.

24. A method according to claim 23 wherein said gaseous precursor has a boiling point of greater than about 37.degree. C.

25. A method according to claim 23 wherein said gaseous precursor comprises a fluorinated compound.

26. A method according to claim 25 wherein said fluorinated compound comprises a perfluorocarbon.

27. A method according to claim 26 wherein said perfluorocarbon is selected from the group consisting of perfluoropentane and perfluorohexane.

28. A method according to claim 1 wherein said contrast agent comprises vesicles.

29. A method according to claim 28 wherein said vesicles are selected from the group consisting of micelles and liposomes.

30. A method according to claim 2 wherein said lipid is selected from the group consisting of unilamellar lipids, oligolamellar lipids and multilamellar lipids.

31. A method according to claim 30 wherein said lipids comprise unilamellar lipids.

32. A method according to claim 31 wherein said lipid comprises one monolayer.

33. A method according to claim 32 wherein said lipid is a phospholipid and said gas is sulfur hexafluoride.

34. A method according to claim 32 wherein said lipid is a phospholipid and said gas is perfluoropropane.

35. A method according to claim 32 wherein said lipid is a phospholipid and said gas is perfluorobutane.

36. A method according to claim 32 wherein said gas is derived, at least in part, from a gaseous precursor.

37. A method according to claim 36 wherein said lipid is a phospholipid and said gas or gaseous precursor is perfluoropentane.

38. A method according to claim 31 wherein said lipid comprises one bilayer.

39. A method according to claim 38 wherein said lipid is a phospholipid and said gas is sulfur hexafluoride.

40. A method according to claim 38 wherein said lipid is a phospholipid and said gas is perfluoropropane.

41. A method according to claim 38 wherein said lipid is a phospholipid and said gas is perfluorobutane.

42. A method according to claim 38 wherein said gas is derived, at least in part, from a gaseous precursor.

43. A method according to claim 42 wherein said lipid is a phospholipid and said gaseous precursor is perfluoropentane.

44. A method according to claim 30 wherein said lipids are selected from the group consisting of oligolamellar lipids and multilamellar lipids.

45. A method according to claim 44 wherein said lipids comprise one monolayer.

46. A method according to claim 45 wherein said lipid is a phospholipid and said gas is sulfur hexafluoride.

47. A method according to claim 45 wherein said lipid is a phospholipid and said gas is perfluoropropane.

48. A method according to claim 45 wherein said lipid is a phospholipid and said gas is perfluorobutane.

49. A method according to claim 45 wherein said gas is derived, at least in part, from a gaseous precursor.

50. A method according to claim 49 wherein said lipid is a phospholipid and said gaseous precursor is perfluoropentane.

51. A method according to claim 44 wherein said lipids comprise one bilayer.

52. A method according to claim 51 wherein said lipid is a phospholipid and said gas is sulfur hexafluoride.

53. A method according to claim 51 wherein said lipid is a phospholipid and said gas is perfluoropropane.

54. A method according to claim 51 wherein said lipid is a phospholipid and said gas is perfluorobutane.

55. A method according to claim 51 wherein said gas is derived, at least in part, from a gaseous precursor.

56. A method according to claim 55 wherein said lipid is a phospholipid and said gaseous precursor is perfluoropentane.

57. A method according to claim 2 wherein said lipid is a polymerized lipid.

58. A method according to claim 2 wherein said contrast agent further comprises polyethyleneglycol.

59. A method according to claim 28 wherein said vesicles comprise lipid vesicles.

60. A method according to claim 59 wherein said vesicles are selected from the group consisting of unilamellar vesicles, oligolamellar vesicles and multilamellar vesicles.

61. A method according to claim 60 wherein said vesicles comprise unilamellar vesicles.

62. A method according to claim 61 wherein said vesicles comprise one monolayer.

63. A method according to claim 62 wherein said lipid is a phospholipid and said gas is sulfur hexafluoride.

64. A method according to claim 62 wherein said lipid is a phospholipid and said gas is perfluoropropane.

65. A method according to claim 63 wherein said lipid is a phospholipid and said gas is perfluorobutane.

66. A method according to claim 62 wherein said gas is derived, at least in part, from a gaseous precursor.

67. A method according to claim 66 wherein said lipid is a phospholipid and said gas or gaseous precursor is perfluoropentane.

68. A method according to claim 62 wherein said lipid is a polymerized lipid.

69. A method according to claim 61 wherein said vesicles comprise a bilayer.

70. A method according to claim 69 wherein said lipid is a phospholipid and said gas is sulfur hexafluoride.

71. A method according to claim 69 wherein said lipid is a phospholipid and said gas is perfluoropropane.

72. A method according to claim 69 wherein said lipid is a phospholipid and said gas is perfluorobutane.

73. A method according to claim 69 wherein said gas is derived, at least in part, from a gaseous precursor.

74. A method according to claim 73 wherein said lipid is a phospholipid and said gaseous precursor is perfluoropentane.

75. A method according to claim 69 wherein said lipid comprises a polymerized lipid.

76. A method according to claim 60 wherein said vesicles are selected from the group consisting of oligolamellar vesicles and multilamellar vesicles.

77. A method according to claim 76 wherein said vesicles comprise one monolayer.

78. A method according to claim 77 wherein said lipid is a phospholipid and said gas is sulfur hexafluoride.

79. A method according to claim 77 wherein said lipid is a phospholipid and said gas is perfluoropropane.

80. A method according to claim 77 wherein said lipid is a phospholipid and said gas is perfluorobutane.

81. A method according to claim 77 wherein said gas is derived, at least in part, from a gaseous precursor.

82. A method according to claim 81 wherein said lipid is a phospholipid and said gaseous precursor is perfluoropentane.

83. A method according to claim 77 wherein said lipid is a polymerized lipid.

84. A method according to claim 76 wherein said vesicles comprise a bilayer.

85. A method according to claim 84 wherein said lipid is a phospholipid and said gas is sulfur hexafluoride.

86. A method according to claim 84 wherein said lipid is a phospholipid and said gas is perfluoropropane.

87. A method according to claim 84 wherein said lipid is a phospholipid and said gas is perfluorobutane.

88. A method according to claim 84 wherein said gas is derived, at least in part, from a gaseous precursor.

89. A method according to claim 88 wherein said lipid is a phospholipid and said gas or gaseous precursor is perfluoropentane.

90. A method according to claim 13 wherein said gas comprises a perfluorocarbon.

91. A method according to claim 90 wherein said perfluorocarbon is selected from the group consisting of perfluoromethane, perfluoroethane, perfluoropropane, perfluorobutane, perfluorocyclobutane, perfluoropentane, perfluorohexane, perfluoroheptane, perfluorooctane and perfluorononane.

92. A method according to claim 91 wherein said perfluorocarbon is perfluoropropane.

93. A method according to claim 13 wherein said protein is crosslinked.

94. A method according to claim 91 wherein said protein is crosslinked.

95. A method according to claim 1 wherein said region comprises the myocardial region.

96. A method according to claim 95 wherein said region comprises the left atrium.

97. A method according to claim 1 wherein said contrast agent is administered to the patient at a rate which substantially eliminates diagnostic artifacts in the image.

98. A method according to claim 1 wherein each of said first and second quantities of ultrasound energy comprises a pulse of ultrasound energy.

99. A method according to claim 98 wherein said first and second images are obtained during the same cardiac cycle.

100. A method according to claim 99 wherein said first pulse of ultrasound energy is applied at end systole or end diastole.

101. A method according to claim 100 wherein said first pulse of ultrasound energy is applied at end systole.

102. A method according to claim 100 wherein said first pulse of ultrasound energy is applied at end diastole.

103. A method according to claim 99 wherein said second pulse of ultrasound energy is applied from about 5 to less than about 100 milliseconds.

104. A method according to claim 103 wherein said second pulse of ultrasound energy is applied from about 10 to about 80 milliseconds after said application of said first pulse of ultrasound energy.

105. A method according to claim 104 wherein said second pulse of ultrasound energy is applied from about 20 to about 60 milliseconds after said application of said first pulse of ultrasound energy.

106. A method according to claim 105 wherein said second pulse of ultrasound energy is applied from about 30 to about 40 milliseconds after said application of said first pulse of ultrasound energy.

107. A method according to claim 106 wherein said second pulse of ultrasound energy is applied about 40 milliseconds after said application of said first pulse of ultrasound energy.

108. A method according to claim 99 wherein said first quantity of energy is applied at a time which corresponds to about the end of the T-wave in the patient's ECG.

109. A method according to claim 99 wherein said first quantity of energy is applied at a time which corresponds to about the end of the R-wave in the patient's ECG.

110. A method according to claim 1 wherein said processed images are displayed in gray scale or color format.

111. A method according to claim 1 which comprises administering said contrast agent to the patient at a rate of constant infusion.

112. A method according to claim 111 comprising administering said contrast agent using a constant infusion device.

113. A method according to claim 1 wherein said region comprises the myocardial region.

114. A method according to claim 113 wherein said region comprises the left atrium.

115. A method for diagnosing the presence of diseased tissue in a patient comprising (a) administering to the patient a contrast agent which comprises, in an aqueous carrier, a lipid, protein or polymer, and a gas, and (b) scanning the patient using ultrasound imaging to obtain a visible image of any diseased tissue in the patient, wherein said scanning step comprises:

(i) applying a first quantity of ultrasound energy to the patient to provide a first image;

(ii) applying within about 100 milliseconds thereafter a second quantity of ultrasound energy to the patient to provide a second image; and

(iii) processing said first and second images,

wherein said processing step (iii) comprises subtracting said second image from said first image.
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