EFSUMB Newsletter
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EFSUMB Newsletter European Federation of Societies for Ultrasound in Medicine and Biology
EUROSON 2013
Young Investigator Award Winner David Maresca Award Winner David Maresca
David Maresca was born in Paris on June 16, 1983. He followed his secondary education at the Lycée Claude Monet from 1994 to 2001. In 2003, he started his university education in Physics at the University Paris Diderot. In the frame of his studies, he completed various assignments at the interface of physics and other disciplines such as astronomy (Hα kinematics of isolated galaxies), journalism (brief news items for Sciences et Avenir magazine), philosophy (epistemology, evolutionary theories), art (pigment analysis of the Mona Lisa with near infrared spectroscopy) and medicine (transcranial hyperthermia with ultrasound). He received a Master of Science in Ultrasound Physics in 2007 after the completion of his master’s thesis, entitled “Single element ultrasonic imaging based on a variable refractive structure”, at Philips High Tech Campus, Eindhoven, the Netherlands. Subsequently, he was appointed for a year as research scientist in experimental echocardiography at Philips Research and co-authored a patent on an acoustic fluid lens for ultrasound imaging. In October 2008, he joined the Thorax Centre Department of Biomedical Engineering of Erasmus University Medical Centre, Rotterdam, the Netherlands, to carry out a PhD in harmonic intravascular ultrasound imaging under the supervision of Nico de Jong and Antonius F. W. van der Steen. In August 2013 he started a postdoctoral fellowship in ultrafast echocardiography at the Institut Langevin, Paris, France.
Abstract - Imaging Microvasculature with Contrast Enhanced Ultraharmonic Ultrasound ▼▼ David Maresca1, Ilya Skachkov1, Guillaume Renaud1, Krista Jansen1,2, Gijs van Soest1, Nico de Jong1,2,3, Antonius F. W. van der Steen1,2,3 1
Thorax Centre Department of Biomedical Engineering, Erasmus University Medical Centre, Rotterdam, the Netherlands
2
Interuniversity Cardiology Institute of the Netherlands, Utrecht, the Netherlands
3
Imaging Science and Technology Department, Delft University of Technology, Delft, the Netherlands
Atherosclerotic plaque neovascularization was shown to be one of the strongest predictors of future cardiovascular events [1]. Yet, the clinical tools for coronary wall microvasculature detection in vivo are lacking. Here we report a contrast-enhanced ultrasound pulse sequence capable of detecting microvasculature invisible in conventional intracoronary imaging. Our approach consisted in imaging contrast microbubbles using first order ultraharmonics that arise at 1.5 times the transmit frequency. These signals are specific to the ultrasound contrast agent, preventing non-linear propagation artefacts, and can be captured with a transducer frequency bandwidth of 40%. The ultrasound pulse sequence consisted in pairs of phase inverted chirp excitations (26 MHz center frequency). The ultraharmonic content was extracted by summing A-lines acquired in response to the pairs of inverted excitations. Subsequently, the residual data was digitally filtered in the ultraharmonic band (centered at 39 MHz). We imple-
Dates ▶▶16 June 1983 Birth in Paris, France. ▶▶2001 Baccalauréat Scientifique, Lycée Claude Monet, Paris, France. ▶▶2001-2003 Classes préparatoires Physique, Chimie, Sciences de l’Ingénieur, Lycée Pierre-Gilles de Gennes – ENCPB, Paris, France. ▶▶2003 Entered the Magistère de Physique program of the University Paris Diderot, Paris, France. ▶▶2004 Exchange program at the University of New South Wales, Sydney, Australia. ▶▶2007 Master of Science in Ultrasound Physics of the University Paris Diderot. ▶▶Magistère de Physique of the University Paris Diderot. ▶▶2007-2008 Research Scientist in Experimental Echocardiography at Philips Research, Eindhoven High Tech Campus, the Netherlands. ▶▶2008-2012 PhD in Experimental Echocardiography at the Thorax Centre Department of Biomedical Engineering, Erasmus University Medical Centre, Rotterdam, the Netherlands. ▶▶October 2013 Young Investigator Award of the 25th EUROSON Congress, Stuttgart, Germany mented the pulse sequence on an intravascular ultrasound probe (transducer bandwidth < 60%), and acquired images of the respiratory microvasculature of a 6 days old chicken embryo. Microvessels exhibited cross sections of the order of human atherosclerotic plaque neovascularization (diameters < 200 μm). In conventional intravascular ultrasound (IVUS) images, we could not disentangle
EFSUMB Lynne Rudd 28 Portland Place, London W1B 1LY, United Kingdom Tel: +44 (0) 20 7099 7140 Email: efsumb@efsumb.org
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EFSUMB Newsletter microvessels from the connective tissue. On the contrary, ultraharmonic IVUS images successfully captured the ultrasound contrast agent spreading in the microvasculature. We confirmed experimentally the presence of an ultraharmonic frequency peak generated by the ultrasound contrast agent. Quantitatively, the contrast to tissue ratio between a microvessel and adjacent connective tissue was up to doubled (12.5 dB in ultraharmonic IVUS as opposed to 6 dB in conventional IVUS). For reference, a photograph of the microvasculature insonified with IVUS was acquired. It matched the ultraharmonic IVUS image with a strong agreement. Contrast-enhanced ultraharmonic ultrasound revealed microvasculature invisible in conventional IVUS, clearing way towards a translation of the method to co-
ronary plaque noevascularization detection in humans. [1] W. E. Hellings, W. Peeters, F. L. Moll, S. R. D. Piers, J. van Setten, P. J. Van der Spek, J. de Vries, K. A. Seldenrijk, P. C. De Bruin,
Report on EFSUMB 2013 activities from EFSUMB President Christoph F. Dietrich It is my pleasure to report on the important activities of last year and welcome the new year of ultrasound 2014. The EUROSON congress took place in Stuttgart, Germany. This was a very successful event, joining the “Dreiländertreffen” of the German speaking countries with EUROSON, our multidisciplinary congress. We are very much looking forward to EUROSON 2014 in Tel Aviv, Israel. Please follow our invitation to this cosmopolitan city which never rests. The succesful EFSUMB/WFUMB CEUS liver guidelines were published in our official journal “Ultraschall in der Medizin / European Journal of Ultrasound”. This publication can be freely downloaded via our website www.efsumb.org (Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) in the Liver - Update 2012. Ultraschall Med 2013; 34(1):11-29). The guidelines were simultanously published
in the WFUMB journal (Ultrasound Med Biol) as a WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS (2013 Feb;39(2):187-210), to strengthen the joint efforts of the federations. The technological and clinical recommentations on the use of ultrasound elastography have been published as the first guidelines published by a multidisciplinary ultrasound society. The guidelines are part of EFSUMB’s forefront worldwide efforts to improve and distribute scientific knowledge of new ultrasound techniques according to our constitution. Part 1 of the guidelines deals with the basics of ultrasound elastography, aimed at clarifying the different modalities currently on the market, which produce different types of elastography, including strain elastography and various shearwave modalities. Part 2 presents the current recommended clinical applications. It should be mentioned that a position statement on safety
A. Vink, E. Velema, D. P. V. de Kleijn, G. Pasterkamp, Composition of Carotid Atherosclerotic Plaque Is Associated With Cardiovascular Outcome A Prognostic Study. Circulation 121, 1941-U1111 (2010).
of elastography has been released by the ECMUS (Safety) Committee. Guidelines on ultrasound guided interventions are in preparation. The EFSUMB website has been updated and enriched on a regular base. In preparation of my EFSUMB presidency we published an article on the use of the website (Dietrich CF, Rudd L. The EFSUMB website, a guide for better understanding. Med Ultrason 2013; 15(3):215-223) which can be downloaded via our website www.efsumb.org. The successful EFSUMB Course Book with ten thousands of hits was updated. The printed version with coloured images is still available and can be ordered at a very cheap price via our charming secretary Lynne Rudd (efsumb@efsumb.org). The whole book is alternatively freely available on our website. The chapters are continously updated. We encourage our readers to suggest further improvements. The EFSUMB Course Book Student Edition has been introduced with chapters on our website including videos on examination technique and anatomy. Please feel free to use and improve this material.
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EFSUMB Newsletter The Educational Portal also hosts two ePub books which can be downloaded for free: “Hepatic elastography using ultrasound waves”, edited by Prof Ioan Sporea and Dr Roxana Sirli and “The safe use of ultrasound in medical diagnosis”, edited by Dr Gail ter Haar. The EFSUMB Case of the Month (CoM) was initiated in 2008. Since this time the CoM is the most visited website page of EFSUMB. Due to the efforts of the current Editor Paul Sidhu, CoM has been translated in several languages. New cases from all EFSUMB members are welcome and can provide great visibility to the authors. The EFSUMB proposed term “Echoscopy” for bedside focused, clinically simple applications that can be carried out with pocket size scanners has been an inspiration for many actitivities. Also in the EFSUMB Course Book Student Edition (ECBSE) a chapter has been devoted to this important subject. Recommendations and Guidelines are planned. In 2013 the EFSUMB Education Committee (EPSC) approved eight Euroson Schools in as many countries, with a successful Elastography School held in Athens, Greece and the ever popular Hannover CEUS School. The EPSC endorsed eleven courses. All information about the educational actitvities can be found on our website.
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Education and Professional Standards Committee (EPSC) Program 2013 – 2015 “Education is the most powerful weapon which you can use to change the world” (Nelson Mandela) Technological progress opened new perspectives to ultrasound, new clinical applications are emerging therefore education and subsequently preparation and updating of the US knowledge is crucial. The EPSC has the aim to plan, initiate and monitor international co-operative studies on training in medical ultrasound; to propose and formulate scientific sessions on all aspects of ultrasound training and accreditation for inclusion in the EUROSON Congresses, Euroson Schools and Endorsed Courses; to arrange meetings, conference sessions and training courses as necessary to promote ultrasound education. The aim is to continue with the tasks already started such as: 1. The Integration of European sonographic courses; templates, rules and uniformity of quality of teaching has been revised and changed where necessary. 2. The improvement of e-learning. EFSUMB has an online educational portal
with cases and video presentations and an ATLAS of images to accompany the Elastography, CEUS Liver and non Liver Guidelines. It also offers a post-graduate web course and links to useful web pages. 3. To complete the phase of preparation of the common curriculum of European Ultrasound Learning Centres starting with the establishment of the first centres for initiating a promotional and experimental phase in order to disseminate them and to make them attractive to users. 4. To continue to better define and promote teaching of ultrasound at the university co-operating with the universities which have already implemented this. Vito Cantisani, EPSC Chairman and Committee - Dieter Nuernberg, Radu Badea, Eugenio Cerezo, Hilde Berner Hammer, Adnan Kabaalioglu, Helmut Prosch and Andreas Serra.
EFSUMB continuing medical education (CME) credits have been introduced to acknowledge participation in its educational activities. Recognition of these credits by a national agency is not guaranteed and should be specially verified. It has to be taken into account that an universal recognition is not possible on an European basis due to the different rules of local authorities which are not mutually recognized. I would like to cordially thank Lynne Rudd, our marvellous secretary, my friends and colleagues in the ExB, various EFSUMB committees and Board of Delegates. We look forward to working closely with our National Societies in 2014 in building the European Ultrasound Community. Christoph F. Dietrich EFSUMB President 2013-2015
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