Infusion agent: innovative contrast will replace CT with ultrasound

Russian scientists are developing the first domestic contrast agent for ultrasound diagnostics. They have successfully tested its capabilities in an experiment, obtaining a high-quality image of a rat's heart. The invention exceeds the characteristics of foreign analogs. This in the future will allow to use it for ultrasound diagnostics in a number of cases, where previously used MRI and CT studies. Thus, it is possible to avoid the harmful effects of toxic drugs in the study with contrast and radiation in CT. In addition, not every hospital has the necessary equipment, unlike the more common ultrasound.

The first Russian contrast agent

Skoltech specialists are working on the creation of the first domestic contrast agent for ultrasound diagnostics. They have already created a prototype and successfully tested its capabilities on rats. During the experiment, a clear image of the animal's heart was obtained. Thanks to the use of components new for such materials, scientists were able to increase the contrast of ultrasound images and noticeably extend the time of action of the agent.

- The task of developing the contrast was set by the doctors themselves, as this drug has not been produced in Russia, and the existing contrasts in the world are not supplied to our country. The drug is relevant and necessary for diagnostics of a wide range of diseases. When developing the prototype, we took protein and polymer as a basis, obtained a complex of these components and a material - microbubbles based on them, thus combining the advantages of both substances. As a result, we achieved brighter and more uniform contrasting and increased the stability of microbubbles," said Polina Rudakovskaya, a researcher at the Skolkovo Institute of Science and Technology.

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Ultrasound examination is an inexpensive and harmless for the body method of medical diagnostics. Equipment for it is available in almost every clinic. Theoretically, in some cases, the method can become an alternative to magnetic resonance or computer tomography, which gives up to 600 times more radiation exposure to the patient than a conventional medical X-ray. CT and MRI scans with contrast are toxic because of the substances administered intravenously.

In cases where CT and MRI are contraindicated or there is no possibility to do them, ultrasound could replace these types of research of internal organs: liver, kidneys, heart and blood vessels, female reproductive system. This would be easier, cheaper and would allow screening of a larger number of patients, and if necessary, to do several studies of one patient, without exposing him to numerous harmful effects. But this requires high-quality contrast agents. The substances produced abroad are harmless, but expensive, and their importation has stopped, besides, they have a number of disadvantages.

- Of course, we cannot completely replace other diagnostic methods. But partially more toxic methods can be replaced by ultrasound. For example, to study infertility now use CT with contrast. It's toxic. The patient comes to the doctor with the desire to get pregnant, and because of the diagnosis she should not do it for some time, because the body is poisoned. Yes, and for patients with other diagnoses, additional intoxication is harmful. In addition, ultrasound can be done in any remote region where there is no CT or MRI. For example, our contrast can be used to detect a heart attack. We plan to show the difference between a sick and healthy heart. More clearly identified area of the lesion allows to prescribe more effective therapy, - said Polina Rudakovskaya.

What contrast for ultrasound works longer

Contrasts for ultrasound consist of microbubbles. In the world in clinical practice are used only three preparations: two with a shell based on lipids and one based on proteins. Polymer-based agents are also possible, but they have not yet reached the clinic. Proteins have the advantage of better visualization quality, while polymers have the advantage of stable microbubbles and a higher circulation time in the patient's blood, meaning extra minutes per diagnosis.

Scientists from Skoltech combined polymers and albumin protein in their material. They obtained a substance that has the advantages of both components, but eliminates their disadvantages. More than 100 variants of contrast for ultrasound were obtained. Albumin was tried to be combined with different polymers in terms of composition and molecular weight. For each combination, 10 different protein to polymer ratios were considered, ranging from 50% to just over 98% protein. From these, they selected the most effective one and tested it on rats. In this way they obtained an effective visualization of the beating heart of the animal.

The result in comparison: without contrast almost nothing could be seen, with the existing protein contrast only the left ventricle of the heart could be seen. And with the new microbubbles based on the hybrid complex "protein - polymer" all four chambers of the heart can be seen. And it is visible for more than five minutes, while the protein preparation acts for about one minute.

Opinions of practicing physicians regarding the prospects of creating the first Russian contrast agent are divided.

- If it will not be possible to purchase imported drugs, then a Russian one is necessary. However, my experience with many medicines shows that when a domestic analog is created, it is always an order of magnitude inferior to imported ones in terms of side effects, because this area was not developed in the country and little attention was paid to it. Increasing the time of action of the agent for just a few minutes will not play a special role, as well as increasing the contrast, as the method error of 2-3 mm is considered normal, - said specialist in ultrasound diagnostics medical center "Doctor Leader" Alla Nadezhdina.

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However, according to Irina Filatova, chief physician and ultrasound diagnostic specialist at Hartman Clinic, any improvement in the quality of the drugs used leads to better medical results.

- This development is very necessary because we have to switch to domestic drugs. In the past, we worked only with our own materials and yet we operated remarkably well. Due to the fact that there are problems with the supply of foreign drugs, both patients and doctors suffer. And increasing the time of action of contrast and improving image quality are very important, because in diagnostics, the better the reagents, the better the result," she said.

As the scientists noted, the combined protein-polymer preparation has features that can make it a more advantageous option for ultrasound of brain vessels, but this direction requires additional research.