Official Proceedings - AIUM

American Institute of Ultrasound in Medicine Proceedings J Ultrasound Med 32(suppl):S1–S134, 2013Hands-on How to Do the BiopsyModerator: Dean Nakamoto, MDAfter attending this session, participants will be able to describeprebiopsy preparations, use and have hands-on experience with the techniquesof doing biopsies of soft tissue masses, thyroid nodules, breastmasses, the liver, and kidneys, and recognize and manage complications.SPECIAL INTEREST SESSIONTUESDAY, APRIL 9, 2013, 11:00 AM–12:30 PMSPECIAL INTEREST SESSIONSTUESDAY, APRIL 9, 2013, 1:30 PM–3:30 PMBefore and After: Case Presentations, SurgicalFindings, and Clinical OutcomesModerator: James Shwayder, MD, JDAdnexal MassesJames Shwayder Obstetrics and Gynecology, University ofMississippi Medical Center, Jackson, Mississippi USAThis portion of the session will present clinical cases addressingthe options for diagnosing adnexal masses. Ultrasound findingscomprising morphology, vascular studies, and 3D will be reviewed.The presentations will focus on clinical history and ultrasound findingscorrelated with surgical outcomes.Hands-on Scanning: Peripheral Nerves of theUpper ExtremityModerator: Kenneth Lee, MDAfter attending this session, participants will have gained handsonexperience in scanning the peripheral nerves of the upper extremity.recognition of normal outflow tracts in different orientations will increasethe likelihood of identifying fetuses in which these connections are abnormal.Imaging the 3-vessel view can further help distinguish that theoutflow tracts are normal. Vessel size, alignment, arrangement, number, directionof flow, and turbulent flow at the level of the 3-vessel view provideadditional information about the normalcy of the outflow tracts. Given itshigh prevalence and significant infant morbidity and mortality, universalscreening for congenital heart disease is warranted. Early detection allowsfor an assessment for associated chromosomal, syndromic, or extracardiacabnormalities as well as consideration of pregnancy options and planningfor ongoing obstetric and neonatal care. A thorough evaluation of theoutflow tracts can improve the overall prenatal diagnosis of major fetalheart malformations.Microbubbles and Drug/Gene DeliveryModerators: Christy Holland, PhD, and Kai Thomenius, PhDImproving Sonoporation Delivery and Gene Transfection byControlling Ultrasound Excitation of MicrobubblesCheri Deng Biomedical Engineering, University of Michigan,Ann Arbor, Michigan USALive Fetal Cardiac Scanning by the ExpertsModerator: Lami Yeo, MDBasics of Fetal Cardiac Screening: How to Confirm Normal OutflowTractsLynn Simpson Obstetrics and Gynecology, ColumbiaUniversity Medical Center, New York, New York USAAlthough the majority of pregnant women undergo obstetricultrasound, only a third to one-half of all major congenital heart defects aredetected prior to birth. The 4-chamber view of the fetal heart can identify40% to 50% of major cardiac anomalies. The prenatal detection of heartmalformations can be increased to 60% to 80% when views of the rightand left ventricular outflow tracts are also assessed. It is now recommendedthat in addition to the 4-chamber view, views of the outflow tractsbe evaluated as part of the cardiac screening examination. This has thepotential to increase the identification of conotruncal anomalies that frequentlyare associated with a normal-appearing 4-chamber view. TheS57Microbubble-facilitated disruption of the cell membrane, orsonoporation, has been exploited for nonviral intracellular delivery of therapeuticagents. However, ultrasound-mediated microbubble activities andtheir impact on cells are difficult to control and optimize due to the complexcharacteristics of ultrasound interaction with microbubbles. Theseoften result in low delivery efficiency and variable delivery outcome. Todevelop sonoporation technique to achieve reproducible, robust deliveryoutcomes, we examined the detail characteristics of ultrasound interactionwith microbubbles. The goal of our study is to improve ultrasoundmediatedintracellular delivery and gene transfection by designingultrasound exposure conditions based on the detailed dynamic processesof ultrasound interaction with microbubbles in the context of their impactto cells. We performed experiments using both free microbubbles and targetedmicrobubbles that were attached to a cell membrane via receptor-ligandbinding. We identified 3 distinct regimes of ultrasound excitation oftargeted microbubbles characterized by the rate of microbubble collapseand translational movement (displacement): stable cavitation with minimaldisplacement, coalescence and translation, and rapid collapse (inertialcavitation) with minimal displacement. We quantified and correlated themicrobubble dynamics with the resulting membrane disruption, intracel-