EFSUMB Young Investigator's Award 2007

Table of Contents

Each year, each member society of EFSUMB is invited to nominate a member of their society to present a paper in the Young Investigator's Award session of the EUROSON Congress. Applicants must be under 35 years of age at the opening date of the Congress, and must be a paid up member of the nominating society. The member society must agree to sponsor their candidate for the cost of their travel and accommodation expenses, and the organising committee of the conference offer the candidates free registration at the meeting. One or two prizes of € 1,000 are awarded to the candidates, judged by an ad-hoc committee to be best in terms of scientific content and quality of presentation. This year entries were received from 5 national societies (Germany, Italy, Norway, Poland, United Kingdom), and as always the quality of the presentations was excellent.

Two First Prizes were awarded on this occasion. Emma Chung, from Leicester, United Kingdom and Vito Cantisani from Rome, Italy. Their CVs and abstract are to be found here below. I would like to encourage all societies to consider nominating one of their outstanding young members for the 2007 competition to be held in Leipzig in October of this year. I would also commend attendance at the Young Investigators session to the membership in general; for me it is one of the highlights of the meeting.

CV Emma Chung

Emma Chung

Dr Emma Chung was born in Tasmania in 1975 and moved to the England in 1980. She received her Master of Physics (MPhys, 1st Class, Hons.) degree and Sims-Portex prize for best undergraduate research project from the University of Kent in 1998. Emma gained her PhD from the Superconductivity and Magnetism Group of the Department of Physics at the University of Warwick in 2002. Following her PhD, Emma continued her research while living in Germany and the USA. She performed neutron scattering experiments at the Institut Laue-Langevin in Grenoble (France), where she was the first to observe two-dimensional magnetic scattering using neutron Laue diffraction.

Since 2004, Emma has been working as a Medical Physicist at the University Hospitals of Leicester NHS Trust where she coordinates clinical and laboratory research aimed at improving Doppler ultrasound detection of cerebral emboli during carotid and cardiac surgery. She is currently Assistant Editor of 'Ultrasound'- the journal of the British Medical Ultrasound Society. In 2007 she was one of eight short-listed nominees for a L'Oreal UK Woman in Science Award. Emma also holds a Wellcome Trust Value in People (VIP) Award and a David Watkin Award for overseas study leave.

Emma has a talent for identifying novel applications of Physics to problems in the Cardiovascular Sciences. Her latest research pioneers targeted microbubbles for enhanced detection of thrombus (Stroke 2007; 38:10:2726-32), and 'virtual patient' computer simulations for an improved understanding of stroke (Phys. Med. Biol. 2007; 52:7153-66). Internet website: www.le.ac.uk/cv/research/Ultrasound/Emma/Emma_personal.html

Abstract

Title: Detection of small vessel occlusion using Doppler ultrasound; an in vitro study

Authors: Chung E.¹, Ramnarine K.V.¹, Long C.V.¹, Udommongkol C.², Chambers B.R.²

¹University Hospitals of Leicester NHS Trust, Medical Physics Group, Leicester, United Kingdom, ²Austin Hospital, Department of Neurology, Melbourne, Australia

Aims: 'Small vessel knock' is a recently reported Doppler ultrasound finding detected in patients with acute ischemic stroke. Knock signals are periodic, of short-duration (<100 ms), and localised within the head. Typically, signals have a unidirectional component in systole and a reflected component during diastole. Currently it is not known whether this signal arises due to occluded blood-flow, wall motion, or some other mechanism. The potential uses of Doppler ultrasound for location of small-vessel occlusion in stroke patients therefore remains controversial. The aim of this study was to determine the origins of knock-type signals by reproducing conditions for small-vessel occlusion in vitro.

Method: Synthetic bifurcations were moulded from latex and glass, artificially occluded, and placed in a closed-loop flow-rig mimicking physiologically realistic blood-flow conditions. Doppler signals associated with blood-flow and wall-motion were examined under controlled conditions using Doppler, B-mode and Colour Doppler Duplex imaging.

Results: Complete occlusion of the peripheral branch of the glass model revealed discrete knock-type signals caused by fluid flow in the occluded vessel. Imaging of the occluded vessel using Colour Doppler revealed forward and reflected components and two types of flow pattern. Wall motion was investigated using a latex model and found to produce periodic bidirectional signals typically =100 ms in duration occurring during systole.

Conclusions: Our in vitro experiments suggest that transcranial Doppler ultrasound is capable of detecting blood-flow within an occluded side vessel. However, as similar knock-type signals are also produced by wall motion, careful interpretation of data for detection and classification of knock signals is required.

Acknowledgement: this project was funded by the Australian Society for Ultrasound in Medicine (ASUM) and British Medical Ultrasound Society (BMUS) as part of a British-Australian exchange visit to the National Stroke Research Institute in Melbourne, Australia.

CV Vito Cantisani

Vito Cantisani

Department of Radiology, University "La Sapienza", Rome *Department of Radiology,University Campus Biomedico,Rome. Born on August 20, 1974 in Lagonegro, Italy. Graduated in Medicine at University La Sapienza of Rome in 1999 cum Laude.

• Visiting Fellow the Johns Hopkins Hospital in Baltimore and AFIP in Walter Reed in Washington. 2002 Fellowship in Abdominal Radiology at BWH, Boston, Medical University.

• Chief Resident and completed in 2004 the Residency in Radiology at University La Sapienza cum Laude.

• In 2002 and 2003 awarded at ECR with the EURORAD prizes.

• From 2004 employed in the Department of Radiology, II Chair, University La Sapienza, as Full-Time Staff Radiologist and Instructor in Radiology.

• From 2005 attending the PhD in Cardio-vascular and Thoracic Fisiopathology and Imaging and Surgery at University La Sapienza.

• From 2004 coordinator oF Color-Doppler sonography didactic Courses at the Department of Radiological Sciences at Policlinico Umberto I.

• From 2005 Professor at School of Residency in Diagnostic Radiology and at School for Radiological Technicians at University La Sapienza.

• Co-coordinator of the TEMPUS project "US School in Tirana".

• Research interest is mainly focused on US contrast media in abdominal and non-abdominal applications in correlation with multislice-CT and enhanced-MRI.

• 2007 nominated secretary of Contrast media Group of SIUMB and SIRM.

• Wrote as first author or co-author more than 40 papers published on Italian or International peer-reviewed Journals. Co-author of more than 10 chapters of International Books. He presented more 60 oral presentations, 10 scientific exhibits, 5 invited lectures and 2 chairmanships. He took part to the organization commettee of more than 10 Italian or international Meetings.

• Member of SIRM (Società Italiana di Radiologia Medica) from 2000, SIUMB (Società Italiana di Ultrasonografia in Medicina e Biologia) from 2004, ESR (European Society Radiology) from 2007, ESGAR (European Society of Gastointestinal Radiology) from 2007. Member of the Editorial Board of Journal Ultrasound from 2006.

Abstract

Title: Detection of hepatic metastases from colorectal tumours: prospective evaluation of US versus sonoVue low mechanical index (MI) real time-enhanced US as compared with 64 slice-CT or BOPTA-MRI

Authors: V Cantisani, P Ricci, E Pagliara, M Erturk, U D'Ambrosio, G Alfano, C Catalano, FM Drudi, R Passariello. Department of Radiological Sciences, Policlinico Umberto I, University La Sapienza, Rome, Italy

Purpose: To compare low-mechanical index(MI) contrast enhanced US, US and 64-slice CT for the detection of hepatic metastases from colorectal tumors assuming the combination of 6 months follow-up with 64 slice CT and/or BOPTA-MRI and/or intraoperative US (IOUS) as referring imaging modalit

Methods and Materials: From February to June 2006, 110 patients with colorectal tumors (55 males, 35 females; mean age 62 years; range 39-78) with suspected hepatic lesions were evaluated with US, CEUS and 64-slice-CT by two independent readers. Intraoperative ultrasonography (n=45) or a follow-up up for at least 6 months by using CT or BOPTA-enhanced MRI (n=50) was considered the gold standard. To compare the sensitivity and specificity of US, CEUS, and CT, McNemar test was employed.

Results: No side effects were observed. Reference standards revealed 430 metastases in 110 patients. At patient-by-patients analysis CEUS improved US sensitivity from 74% to 95% (p<0.05). At lesion-by-lesion analysis, CEUS improved the sensitivity of US for the detection of individual metastases, from 60.4% to 92.8%, respectively (p<.001). The specificity increased from 60% and to 84%, respectively; there were no significant differences between CEUS and CT. Contrast-enhanced US was significantly more accurate than baseline US, especially for small metastases (p<0.001) with an increase of sensitivity from 35% to 76.6% with no statistical difference if compared with 64-slice spiral CT (73.3%-75.8%).

Conclusions: CEUS is significantly more accurate than US and highly comparable with 64-slice spiral CT and BOPTA-MRI in the detection of liver metastases from colorectal cancer. Therefore, in the evaluation of patients with suspected hepatic metastases from colorectal tumour, US examination must be performed after contrast administration