Targeted ultrasound contrast agents provide advantages compared with usual microbubble blood pool agents. The goal of targeted ultrasound contrast agents is to significantly and selectively enhance the detection of a targeted vascular site. Tissue-specific ultrasound contrast agents improve the image contrast resolution through differential uptake. Targeted drug delivery via contrast microbubbles is another contrast media concept and provides the potential for earlier detection and characterization of disease.
Targeted contrast imaging provides a higher sensitivity and specificity than obtained with a nontargeted contrast agent.
The detection of disease-indicative molecular signatures may allow early assessment of pathology on a molecular level.
Molecular imaging should be an efficient and less invasive technique to obtain three-dimensional localization of pathology.
Ultrasound agents typically remain within the vascular space, and therefore possible targets include molecular markers on thrombus, endothelial cells, and leukocytes. Targeted contrast agents permit noninvasive detection of thrombus, cancer, inflammation, or other sites where specific integrins or other adhesion molecules are expressed. Adhesion molecules such as monoclonal antibodies, peptides, asialoglycoproteins, or polysaccharides are incorporated into the shell of the microbubble or liposome. After injection into the bloodstream, the targeted agent accumulates via adhesion receptors at the affected site, enhancing detection with an ultrasound system.

See also Acoustically Active Lipospheres, and Tissue-Specific Ultrasound Contrast Agent.

(CEUS) Contrast agents increase the reflection of ultrasonic energy, improve the signal to noise ratio and caused by that the detection of abnormal microvascular and macrovascular disorders. Contrast enhanced ultrasound is used in abdominal ultrasound (liver sonography) as well as in cerebrovascular examinations e.g., for an accurate grading of carotid stenosis. The used contrast agents are safe and well tolerated.

The quality of the enhancement depends on:
The additional use of ultrasound contrast agents (USCAs) may overcome typical limitations like poor contrast of B-mode imaging or limited sensitivity of Doppler techniques. The development of new ultrasound applications (e.g., blood flow imaging, perfusion quantification) depends also from the development of pulse sequences for bubble specific imaging. In addition, contrast enhanced ultrasound improves the monitoring of ultrasound guided interventions like RF thermal ablation.

See also Contrast Enhanced Doppler Imaging, Contrast Harmonic Imaging, Contrast Imaging Techniques and Contrast Pulse Sequencing.

In June 2007 Tyco International Ltd. completed the separation of its healthcare business, which is named Covidien. Mallinckrodt, Inc. is now part of Covidien Ltd. The company makes and distributes products for respiratory care; bulk and dosage pharmaceuticals, primarily for pain relief and addiction therapy; and imaging agents for magnetic resonance, ultrasound, x-ray, and nuclear medicine applications. With worldwide manufacturing and distribution facilities and sales offices, Mallinckrodt, Inc. sells its products worldwide.
Albunex was one of the first marketed ultrasound contrast agents. Currently, Mallinckrodt discontinued the manufacturing and development of ultrasound contrast agents.

Ultrasound Contrast Agents:

The definition of imaging is the visual representation of an object. Medical imaging is a broad term that encompasses various imaging modalities and techniques used in the field of medicine to visualize and study the body's anatomy and physiology. It includes both diagnostic and non-diagnostic imaging procedures, where diagnostic imaging specifically refers to the subset of medical imaging techniques that are primarily focused on diagnosing diseases or conditions. Medical imaging techniques are employed to obtain images or visual representations of the internal organs, tissues, and structures, aiding in the diagnosis, treatment, and monitoring of medical conditions.
The field of medical imaging has significantly evolved since the discovery of X-rays by Konrad Roentgen in 1896. Initially, radiological imaging involved focusing X-rays on the body and capturing the images on a single piece of film within a specialized cassette. Subsequent advancements introduced the use of fluorescent screens and special glasses for real-time visualization of X-ray images.
A significant breakthrough came with the application of contrast agents, enhancing image contrast and improving organ visualization. In the 1950s, nuclear medicine studies utilizing gamma cameras demonstrated the uptake of low-level radioactive chemicals in organs, enabling the observation of biological processes in vivo. Currently, positron emission tomography (PET) and single photon emission computed tomography (SPECT) technologies play pivotal roles in clinical research and the diagnosis of biochemical and physiological processes. Additionally, the advent of the x-ray image intensifier in 1955 facilitated the capture and display of x-ray movies.
In the 1960s, diagnostic imaging incorporated the principles of sonar, using ultrasonic waves generated by a quartz crystal. These waves, reflecting at the interfaces between different tissues, were received by ultrasound machines and translated into images through computer algorithms and reconstruction software. Ultrasound (ultrasonography) has become an indispensable diagnostic tool across various medical specialties, with immense potential for further advancements such as targeted contrast imaging, real-time 3D or 4D ultrasound, and molecular imaging. The first use of ultrasound contrast agents (USCA) dates back to 1968.
Digital imaging techniques were introduced in the 1970s, revolutionizing conventional fluoroscopic image intensifiers. Godfrey Hounsfield's pioneering work led to the development of the first computed tomography (CT) scanner. Digital images are now electronic snapshots represented as grids of dots or pixels. X-ray CT brought about a breakthrough in medical imaging by providing cross-sectional images of the human body with high contrast between different types of soft tissue. These advancements were made possible by analog-to-digital converters and computers. The introduction of multislice spiral CT technology dramatically expanded the clinical applications of CT scans.
The first magnetic resonance imaging (MRI) devices were tested on clinical patients in 1980. With technological improvements, such as higher field strength, more open MRI magnets, faster gradient systems, and novel data-acquisition techniques, MRI has emerged as a real-time interactive imaging modality capable of providing detailed structural and functional information of the body.
Today, imaging in medicine offers a wide range of modalities, including:

These imaging modalities have become integral components of modern healthcare. With the rapid advancement of digital imaging, efficient management has become important, leading to the expansion of radiology information systems (RIS) and the adoption of Picture Archiving and Communication Systems (PACS) for digital image archiving. In telemedicine, real-time transmission of all medical image modalities from MRI to X-ray, CT and ultrasound has become the standard. The field of medical imaging continues to evolve, promising further innovations and advancements in the future, ultimately contributing to improved patient care and diagnostics.

See also History of Ultrasound Contrast Agents, and History of Ultrasound.

Tissue-specific ultrasound contrast agents improve the image contrast resolution through differential uptake. The concentration of microbubble contrast agents within the vasculature, reticulo-endothelial, or lymphatic systems produces an effective passive targeting of these areas. Other contrast media concepts include targeted drug delivery via contrast microbubbles.
Tissue-specific ultrasound contrast agents are injected intravenously and taken up by specific tissues or they adhere to specific targets such as venous thrombosis. These effects may require minutes to several hours to reach maximum effectiveness. By enhancing the acoustic differences between normal and diseased tissues, these tissue-specific agents improve the detectability of abnormalities.
Some microbubbles accumulate in normal hepatic tissue; some are phagocytosed by Kupffer cells in the reticuloendothelial system and others may stay in the sinusoids. Liver tumors without normal Kupffer cells can be identified by the lack of the typical mosaic color pattern of the induced acoustic emission. The hepatic parenchymal phase, which may last from less than an hour to several days, depending on the specific contrast medium used, may be imaged by bubble-specific modes such as stimulated acoustic emission (color Doppler using high MI) or pulse inversion imaging.