CONTRAST-ENHANCED ENDOSCOPIC ULTRASONOGRAPHY WITH GALACTOSE MICROPARTICLES - SHU508-A (LEVOVIST)

Background and Study Aims: To evaluate the utility of a suspension of galactose microparticles available as SHU508A (Levovist) as a contrast agent during endoscopic ultrasonography (EUS). Materials and Methods: Three sets of experiments were performed on three 20-25 kg swine (Sus scrofa) under general anesthesia, Upper EUS was performed with an ech o endoscope with color Doppler capability (Pentax FG-32 UA), The celia c artery, superior mesenteric artery, aorta, portal vein, pancreas, an d gastrointestinal wall were imaged by EUS, Multiple intravenous bolus injections of 400 mg/ml of SHU508A were made, and their effect on col or Doppler and gray-scale imaging during EUS was studied. Results: Aft er contrast injection there was a significant, visually noticeable enh ancement of the color Doppler signals from the celiac artery, superior mesenteric artery, and portal vein, Vessels with weak to no color Dop pler signals before injection of SHU508 A for example, the celiac arte ry and superior mesenteric artery were observed to have strong color s ignals after injection, The effect of SHU508 A on color Doppler imagin g was easily appreciated subjectively without the need for complex qua ntitative measurements, No visually noticeable color Doppler enhanceme nt was seen in vessels such as the aorta that had a very pronounced co lor Doppler signal even prior to the injection of contrast, Movement o f particulate matter was seen in the portal vein on the gray scale. Co nclusion: Intravenous SHU508 A as a contrast agent significantly enhan ces color Doppler signals during EUS, Vascular contrast of this sort c ould potentially have a significant role in improving the accuracy of EUS in diagnosing malignant vascular invasion, the detection of occult pancreatic neoplasms, and the diagnosis of vascular thrombosis.