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 echo endoscope with color Doppler capability (Pentax FG-32 UA), The celiac artery, superior mesenteric artery, aorta, portal vein, pancreas, and gastrointestinal wall were imaged by EUS, Multiple intravenous bolus injections of 400 mg/ml of SHU508A were made, and their effect on color Doppler and gray-scale imaging during EUS was studied. Results: After contrast injection there was a significant, visually noticeable enhancement of the color Doppler signals from the celiac artery, superior mesenteric artery, and portal vein, Vessels with weak to no color Doppler signals before injection of SHU508 A for example, the celiac artery and superior mesenteric artery were observed to have strong color signals after injection, The effect of SHU508 A on color Doppler imaging was easily appreciated subjectively without the need for complex quantitative measurements, No visually noticeable color Doppler enhancement was seen in vessels such as the aorta that had a very pronounced color Doppler signal even prior to the injection of contrast, Movement of particulate matter was seen in the portal vein on the gray scale. Conclusion: Intravenous SHU508 A as a contrast agent significantly enhances color Doppler signals during EUS, Vascular contrast of this sort could 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.