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There is an enormous sense of excitement in the communities of
cancer research and cancer care as we move into the middle third of
the ?rst decade of the 21st century. For the ?rst time, there is a
true sense of c- ?dence that the tools provided by the human genome
project will enable cancer researchers to crack the code of genomic
abnormalities that allow tumor cells to live within the body and
provide highly speci?c, virtually non-toxic therapies for the
eradication, or at least ?rm control of human cancers. There is
also good reason to hope that these same lines of inquiry will
yield better tests for screening, early detection, and prev- tion
of progression beyond curability. While these developments provide
a legitimate basis for much op- mism, many patients will continue
to develop cancers and suffer from their debilitating effects, even
as research moves ahead. For these in- viduals, it is imperative
that the cancer ?eld make the best possible use of the tools
available to provide present day cancer patients with the best
chances for cure, effective palliation, or, at the very least,
relief from symptoms caused by acute intercurrent complications of
cancer. A modality that has emerged as a very useful approach to at
least some of these goals is tumor ablation by the use of physical
or physiochemical approache
The value of ultrasound contrast agents (USCA) in clinical practice
depends on the pharmacokinetics, the signal processing, and the
contrast-specific imaging modalities. USCA are exogenous non-toxic
substances smaller than red blood cells, which after intravenous
administration must be stable enough to pass through the pulmonary
capillary bed and enter the blood pool producing the necessary
contrast enhancement for the duration of the examination. Recently,
second-generation agents, such as SonoVue (Bracco Imaging SpA,
Milan, Italy), have been introduced into the market. These agents,
taking advantage of the stability of their microbubbles, withstand
the acoustic pressure of insonation much better than previous USCA,
resulting in an increased half-life of the agent and thus in a
prolonged diagnostic window. These agents are blood pool agents
that remain in the intravascular compartment and do not leak into
the organ tissue. Therefore, they are used to - crease the Doppler
signal amplitude during their dynamic vascular phase. Concomitant
with the improvement of contrast agents, d- ferent
contrast-specific imaging modalities have been developed which,
used in combination with USCA and a low mechanical - dex (MI),
allow continuous real-time grey-scale imaging. These - cent
technical improvements have opened new possibilities in the use of
USCA in a variety of indications, as shown in the contributions
contained in this book. In the following chapters, some of the most
distinguished users of second-generation USCA will share their
knowledge and experience. The first contributor is Dr. Thomas
Albrecht, Department of - diology, University Hospital of Be
There is an enormous sense of excitement in the communities of
cancer research and cancer care as we move into the middle third of
the ?rst decade of the 21st century. For the ?rst time, there is a
true sense of c- ?dence that the tools provided by the human genome
project will enable cancer researchers to crack the code of genomic
abnormalities that allow tumor cells to live within the body and
provide highly speci?c, virtually non-toxic therapies for the
eradication, or at least ?rm control of human cancers. There is
also good reason to hope that these same lines of inquiry will
yield better tests for screening, early detection, and prev- tion
of progression beyond curability. While these developments provide
a legitimate basis for much op- mism, many patients will continue
to develop cancers and suffer from their debilitating effects, even
as research moves ahead. For these in- viduals, it is imperative
that the cancer ?eld make the best possible use of the tools
available to provide present day cancer patients with the best
chances for cure, effective palliation, or, at the very least,
relief from symptoms caused by acute intercurrent complications of
cancer. A modality that has emerged as a very useful approach to at
least some of these goals is tumor ablation by the use of physical
or physiochemical approache
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