Lymphangiogenesis, the formation of new lymphatic vessels, has become a new research frontier. There is a crucial need for noninvasive methods to evaluate lymphangiogenesis in situ. However, to the best of our knowledge, lymphosonography about the tumour lymphangiogenesis with percutaneous hepatic injection of ultrasound contrast material was not reported before.
A research article to be published on 28 June 2008, in the World Journal of Gastroenterology addresses this question. The research team led by Prof. Liu from the department of ultrasound, Qilu Hospital, Shandong University used PTL and contrast-enhanced ultrasonographic imaging with small volumes of SonVue microbubble to study the tumour angiogenesis and lymphangiogenesis. As various researches indicated contrast-enhanced ultrasonographic imaging enable noninvasive measurements of microvascular perfusion in heart, brain, kidney, skeletal muscle, skin grafts, and solid tumors and provide noninvasive, functionally relevant images of angiogenesis in animals and humans. At the same time, lymphosonography after interstitial injection of microbubble-based contrast agents indicated the ability of trace the lymphatic channels from the injection site up to the draining sentinel lymph node(s). The article further evaluate the feasibility and efficacy of PTL with small volumes of SonoVue(R) as a novel method for the detection of tumour lymphangiogenesis of rabbits hepatic VX2 and to evaluate the combination of PTL and contrast-enhanced ultrasonographic imaging for the improvement of the diagnostic ability of liver cancer.
When SonoVue(R) microbubbles delivered into the liver by the traditional percutaneous hepatic injection method and guide under ultrasound imaging. Hepatic lymph vessels were opacified with SonoVue(R) immediately after injection of contrast medium, whereas, liver parenchyma was not enhanced by SonoVue(R). At the same time the boundaries of VX2 tumors was hyperechoic relative to liver parenchyma and the tumors. The hyperechoic boundaries clearly delineate the peritumoral lympathatic vessels of the VX2 tumors. Comparing with the hyperechoic boundaries of VX2 tumors, the videodensity in the tumor parenchyma was no signal enhancement after injection compared with the baseline. The morphological features of the lymphatic vessels during PTL may be important predictive markers for evaluating lymphatic metastasis and prognosis of tumors. In this study, the typical enhancement pattern of VX2 tumors of routinely contrast-enhanced ultrasonographic imaging was hyperechoic relative to liver parenchyma during the early phase and hypoechoic during the later phase, which is helpful for assessment of tumor vascularity, revealed the microvascular perfusion and function.
PTL with small volumes of SonVue microbubble can be a novel method for for the detection of tumour lymphangiogenesis of rabbits hepatic VX2, the combination of PTL and contrast-enhanced ultrasonographic imaging can improve the diagnostic ability of liver cancer. Additional research is needed to determine the potential advantages of PTL and to determine if PTL can be used in clinical applications.