Clinical relevance of pressure-dependent scattering at low acoustic pressures

Recent optical and acoustical studies have shown a threshold behaviour in the response of phospholipid-coated contrast agents, for a certain range of sizes. Below the acoustic pressure threshold, the microbubbles' scattering efficacy is significantly reduced compared to that above the threshold. Here we investigate the clinical relevance of the observed threshold behaviour. A cardiac ultrasound scanner system was used to analyse the pressure-dependence of the scatter intensity. The scattering of a native suspension of a phospholipid-coated contrast agent was compared to that of a suspension in which microbubbles with a size larger than 3.0 μm in diameter were extracted. A power modulation scheme at the fundamental frequency was applied. After linearly scaling and subtracting the B-mode images recorded at 70 and 200 kPa, the contrast-to-tissue ratio (CTR) of the native suspension was 3.2 dB, whereas the CTR of the filtered suspension was 20 dB. The 17 dB difference is attributed to the threshold behaviour. Well-established ultrasound imaging techniques such as fundamental power modulation imaging could benefit from the pressure-dependent scattering properties of this type of contrast microbubbles.