scholarly journals Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) in the Liver – Update 2020 – WFUMB in Cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS

2020 ◽  
Vol 41 (05) ◽  
pp. 562-585 ◽  
Author(s):  
Christoph F. Dietrich ◽  
Christian Pállson Nolsøe ◽  
Richard G. Barr ◽  
Annalisa Berzigotti ◽  
Peter N Burns ◽  
...  
Keyword(s):  
Contrast Agents ◽  
Good Clinical Practice ◽  
The United States ◽  
International Perspective ◽  
Ultrasound Contrast Agents ◽  
European Federation ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
United States Food ◽  
Recent Developments

AbstractThe present, updated document describes the fourth iteration of recommendations for the hepatic use of contrast enhanced ultrasound (CEUS), first initiated in 2004 by the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB). The previous updated editions of the guidelines reflected changes in the available contrast agents and updated the guidelines not only for hepatic but also for non-hepatic applications.The 2012 guideline requires updating as previously the differences of the contrast agents were not precisely described and the differences in contrast phases as well as handling were not clearly indicated. In addition, more evidence has been published for all contrast agents. The update also reflects the most recent developments in contrast agents, including the United States Food and Drug Administration (FDA) approval as well as the extensive Asian experience, to produce a truly international perspective.These guidelines and recommendations provide general advice on the use of ultrasound contrast agents (UCA) and are intended to create standard protocols for the use and administration of UCA in liver applications on an international basis to improve the management of patients.

scholarly journals Recent Experiences and Advances in Contrast-Enhanced Subharmonic Ultrasound

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
John R. Eisenbrey ◽  
Anush Sridharan ◽  
Ji-Bin Liu ◽  
Flemming Forsberg
Keyword(s):  
Contrast Agents ◽  
Tumor Imaging ◽  
Three Dimensional ◽  
Ultrasound Contrast Agents ◽  
Surrounding Tissue ◽  
Contrast Enhanced Ultrasound ◽  
Ultrasound Contrast ◽  
Contrast Enhanced ◽  
Subharmonic Response

Nonlinear contrast-enhanced ultrasound imaging schemes strive to suppress tissue signals in order to better visualize nonlinear signals from blood-pooling ultrasound contrast agents. Because tissue does not generate a subharmonic response (i.e., signal at half the transmit frequency), subharmonic imaging has been proposed as a method for isolating ultrasound microbubble signals while suppressing surrounding tissue signals. In this paper, we summarize recent advances in the use of subharmonic imagingin vivo. These advances include the implementation of subharmonic imaging on linear and curvilinear arrays, intravascular probes, and three-dimensional probes for breast, renal, liver, plaque, and tumor imaging.

scholarly journals Window-Modulated Compounding Nakagami Parameter Ratio Approach for Assessing Muscle Perfusion with Contrast-Enhanced Ultrasound Imaging

Sensors ◽  
2020 ◽  
Vol 20 (12) ◽  
pp. 3584
Author(s):  
Huang-Chen Lin ◽  
Shyh-Hau Wang
Keyword(s):  
Contrast Agents ◽  
Ultrasound Imaging ◽  
Ultrasound Contrast Agents ◽  
Muscle Disease ◽  
Contrast Enhanced Ultrasound ◽  
Time Intensity Curve ◽  
Muscle Perfusion ◽  
Ultrasound Contrast ◽  
Parameter Ratio ◽  
Contrast Enhanced

The assessment of microvascular perfusion is essential for the diagnosis of a specific muscle disease. In comparison with the current available medical modalities, the contrast-enhanced ultrasound imaging is the simplest and fastest means for probing the tissue perfusion. Specifically, the perfusion parameters estimated from the ultrasound time-intensity curve (TIC) and statistics-based time–Nakagami parameter curve (TNC) approaches were found able to quantify the perfusion. However, due to insufficient tolerance on tissue clutters and subresolvable effects, these approaches remain short of reproducibility and robustness. Consequently, the window-modulated compounding (WMC) Nakagami parameter ratio imaging was proposed to alleviate these effects, by taking the ratio of WMC Nakagami parameters corresponding to the incidence of two different acoustic pressures from an employed transducer. The time–Nakagami parameter ratio curve (TNRC) approach was also developed to estimate perfusion parameters. Measurements for the assessment of muscle perfusion were performed from the flow phantom and animal subjects administrated with a bolus of ultrasound contrast agents. The TNRC approach demonstrated better sensitivity and tolerance of tissue clutters than those of TIC and TNC. The fusion image with the WMC Nakagami parameter ratio and B-mode images indicated that both the tissue structures and perfusion properties of ultrasound contrast agents may be better discerned.

An EFSUMB Introduction into Dynamic Contrast-Enhanced Ultrasound (DCE-US) for Quantification of Tumour Perfusion

2012 ◽  
Vol 33 (04) ◽  
pp. 344-351 ◽  
Author(s):  
C. Dietrich ◽  
M. Averkiou ◽  
J.-M. Correas ◽  
N. Lassau ◽  
E. Leen ◽  
...  
Keyword(s):  
Contrast Agents ◽  
Image Interpretation ◽  
Ultrasound Contrast Agents ◽  
Ultrasound Images ◽  
Contrast Enhanced Ultrasound ◽  
Dynamic Contrast Enhanced ◽  
Technical Requirements ◽  
Contrast Enhanced ◽  
Microbubble Contrast Agents ◽  
Safety Considerations

AbstractDynamic Contrast Enhanced Ultrasound (DCE-US) is an imaging technique that utilizes microbubble contrast agents in diagnostic ultrasound. The EFSUMB guidelines published in 2004, updated in 2008 and 2011 focused on the use of DCE-US, including essential technical requirements, training, investigational procedures and steps, guidance on image interpretation, established and recommended clinical indications and safety considerations. However the quantification of images acquired with ultrasound contrast agents (UCAs) is not discussed in the guidelines. The purpose of this EFSUMB document is to provide some recommendations and descriptions of the quantification of ultrasound images, technical requirements for analysis of time-intensity curves (TICs), methodology for data analysis, and interpretation of the results.

Pediatric contrast-enhanced ultrasound: shedding light on the pursuit of approval in the United States

2021 ◽  
Author(s):  
Kassa Darge ◽  
Susan J. Back ◽  
Dorothy I. Bulas ◽  
Steven B. Feinstein ◽  
Aikaterini Ntoulia ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced

21st Century Citizen Pharma: The FDA & Patient-Focused Product Development

2018 ◽  
Vol 44 (2-3) ◽  
pp. 309-327 ◽  
Author(s):  
Jordan Paradise
Keyword(s):  
Product Development ◽  
Health And Safety ◽  
The United States ◽  
The Public ◽  
United States Food ◽  
Recent Developments ◽  
States Food ◽  
And Control ◽  
Patient Advocacy Groups

Perpetual debate regarding the delicate balance between access and innovation and the protection of the public health and safety dominate discussions of the United States Food and Drug Administration (“FDA”). Established chiefly as a command and control federal administrative agency, iterative changes in legislation have shaped the FDA's activity in drug, biologic, and medical device regulation over the course of the last one hundred plus years. The most recent fundamental reframing of the agency's authority and directive presented itself in the 21st Century Cures Act, reflecting an important role for patient perspectives in the regulatory process. This Article explores recent developments in patient-focused product development efforts at the FDA and offers modest insights on the increasing role of patients, and patient advocacy groups, in agency decision-making. The Article terms this era “21st century citizen pharma.”

Incidental nonfunctioning pancreatic neuroendocrine tumors: Contrast enhanced ultrasound features in diagnosis

2021 ◽  
pp. 1-10
Author(s):  
Daohui Yang ◽  
Dansong Wang ◽  
Yijie Qiu ◽  
Xiaofan Tian ◽  
Dan Zuo ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Clinical Decision Making ◽  
Ultrasound Contrast Agents ◽  
Arterial Phase ◽  
Control Group ◽  
Pancreatic Neuroendocrine Tumors ◽  
Contrast Enhanced Ultrasound ◽  
Color Flow ◽  
Color Flow Imaging ◽  
Contrast Enhanced

AIM: Preoperative suspicion of malignancy in nonfunctioning pancreatic neuroendocrine tumors (pNETs) is mostly based on tumor size. We retrospectively analyzed the contrast enhanced ultrasound (CEUS) features of a series of histopathologically proved nonfunctioning pNETs. METHODS: In this retrospective study, 37 surgery and histologically proved nonfunctioning pNETs were included. All pNETs lesions were incidentally detected by transabdominal ultrasound. B mode ultrasound (BMUS) and CEUS features were reviewed and analyzed. 52 histopathologically proved pancreatic ductal adenocarcinoma (PDACs) lesions were included as a control group. RESULTS: All nonfunctioning pNETs patients showed no typical clinical symptoms. No significant differences were observed in size, echogenicity or internal color flow imaging signal between pNETs and PDAC patients (P >  0.05). Most of nonfunctioning pNETs showed a well-defined tumor margin. The presence of pancreatic duct dilatation was less frequently observed in nonfunctioning pNETs patients (P <  0.05). After injection of ultrasound contrast agents, homogeneous enhancement was more commonly observed in nonfunctioning pNETs group (P <  0.05). During arterial phase of CEUS, most of nonfunctioning pNETs were hyper- or isoenhanced (32/37, 86.5%), whereas most of PDACs were hypoenhanced (34/52, 65.4%) (P <  0.05). Nonenhanced necrosis area was more commonly detected in PDACs (P = 0.012). CONCLUSIONS: CEUS features are helpful for preoperative non-invasive differential diagnosis of nonfunctioning pNETs, assisting further clinical decision-making process.

scholarly journals EFSUMB 2020 Proposal for a Contrast-Enhanced Ultrasound-Adapted Bosniak Cyst Categorization – Position Statement

2020 ◽  
Author(s):  
Vito Cantisani ◽  
Michele Bertolotto ◽  
Dirk-André Clevert ◽  
Jean-Michel Correas ◽  
Francesco Maria Drudi ◽  
...  
Keyword(s):  
Contrast Agents ◽  
Task Force ◽  
Position Statement ◽  
Ultrasound Contrast Agents ◽  
Renal Lesions ◽  
Ultrasound Contrast ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography ◽  
Cystic Renal Lesions

AbstractThe well-established Bosniak renal cyst classification is based on contrast-enhanced computed tomography determining the malignant potential of cystic renal lesions. Ultrasound has not been incorporated into this pathway. However, the development of ultrasound contrast agents coupled with the superior resolution of ultrasound makes it possible to redefine the imaging of cystic renal lesions. In this position statement, an EFSUMB Expert Task Force reviews, analyzes, and describes the accumulated knowledge and limitations and presents the current position on the use of ultrasound contrast agents in the evaluation of cystic renal lesions.

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