Session 14
Diagnostic Improvement of Renal
Ultrasonography in Humans after
IV Injection of Perflenapent
Emulsion;
Jean-Michel Correas, MD, Lina Menassa, MD, Olivier H616non, MD
Arnaud M@jean, MD, Jean-Christophe Boyer, MD
Marie-France Mamzer, MD, Jean-Franqois Moreau, MD
The work in progress in US contrast media remains fo-
cused on the production of microbubbles injected intrave-
nously and trespassing the pulmonary barrier to reach the
systemic circulation, then producing preexisting signal en-
hancemem or even genuine self-created signals (1,2). Be-
sides the field of manufactured encapsulated micro-
bubbles, which has been the most open to varied experi-
ments until the '80s, the concept of phased-shift
introduced by Quay (3) is attractive because of the theo-
retic lack of preoperative management of the compound
available at the liquid phase. Perflenapent emulsion is the
first generation of preparation. The demonstration of the
USCA clinical utility using dodecafluoropentane (DDFP)
has not been reported in renal vascular and parenchymal
disorders. Our purpose was to evaluate Pertlenapent emul-
sion from the results of a phase IlI clinical trial including
19 patients using contrast-enhanced renal ultrasonography.
Nineteen patients (11 women, eight men) were enrolled
in this phase III study, carried out in accordance to the
Declaration of Helsinki. Mean age was 46.2 years +_ 17.7,
and mean weight was 64 kg _+ 12. Perflenapent emulsion
was administered at 0.05 mL/kg as a bolus injection fol-
lowing hypobaric activation in a 20-gange catheter in-
serted in an antecubital vein. The compound was flushed
with 10 mL of saline. All examinations were performed on
a Toshiba SSA-270 unit (Toshiba Medical Systems Europe,
Delft, The Netherlands) with a 3.75-MHz transducer and
recorded on an S-VHS PAL videotape. Color Doppler stud-
ies included velocity and power encoding. The pulse repeti-
tion frequency was adapted to the velocity expected within
the investigated vessels. The color gain was optimized dur-
ing baseline study and reduced in case of blooming artifact.
Pulsed Doppler was used to authenticate blood flow and to
assess blood velocity.
Patients were referred by their physicians for a contrast-
enhanced study after an inconclusive ultrasound and Dop-
pler examination. They were included only after an incon-
clusive baseline study according to two experienced radi-
ologists (J.M.C., O.H.), who evaluated each case separately.
All patients underwent a complete physical examination
with a review of their medical history. Vital signs (includ-
ing blood pressure, cardiac and respiratory rates) were
monitored prior to and after administration of the USCA.
Safety evaluation also included laboratory tests of glucose,
serum electrolytes, urea, creatinine, cholesterol, liver-en-
zyme plasma levels, and blood-cell count, before and after
the procedure. Definite diagnoses were obtained by multi-
modality imaging techniques, such as computed tomogra-
phy (CT), contrast-enhanced magnetic resonance imaging
(MRI), angiography, and/or surgery.
RESULTS
Acad Radio11998; 5(suppl 1):$185-$188
From the Departments of Radiology (J,M,C., L,M., O.H., J,C.B,,
J,F.M,), Urology (A.M.), and Renal Transplantation (JrF.M,), Necker
Hospital, 149 rue de S+vres, 75015 Paris, France, Supported by a grant
from Sonus Pharmaceuticals (European Phase III FDA approval), Ad-
dress reprint requests to J.M.C,
©AUR, 1998
Renal Masses (n = 9)
The study population encompassed nine renal masses,
including seven renal cell carcinomas, one cystic carci-
noma, and one complicated calyceal diverticulum. After
administration of Perflenapent emulsion, intratumoral color
Doppler signal intensity increased significantly in all cases
$185