Abstract
The Asian Federation of Societies for Ultrasound in Medicine and Biology aimed to provide information on techniques and indications for contrast-enhanced harmonic endoscopic ultrasound (CH-EUS), and to create statements including the level of recommendation. These statements are based on current scientific evidence reviewed by a Consensus Panel of 15 internationally renowned experts. The reliability of clinical questions was measured by agreement rates after voting. Six statements were made on techniques, including suitable contrast agents for CH-EUS, differences between contrast agents, setting of mechanical index, dual imaging and duration and phases for observation. Thirteen statements were made on indications, including pancreatic solid masses, pancreatic cancer staging, pancreatic cystic lesions and mural nodules, detection of subtle pancreatic lesions, gallbladder sludge and polyps, hepatic lesions, lymph nodes, subepithelial lesions, visceral vascular diseases, guidance of fine needle aspiration and evaluation for local therapy. These international expert consensus guidelines will assist endosonographers in conducting CH-EUS according to evidence-based information.
Highlights
Endoscopic ultrasound (EUS) is a special ultrasound technique in which the tip of the digestive endoscope is Ultrasound in Medicine & BiologyVolume 47, Number 6, 2021 most solid lesions are depicted as hypo-echoic masses
clinical questions (CQs) 1: Which ultrasound contrast agents are suitable for contrastenhanced harmonic EUS (CH-EUS)?
Use of CH-EUS is recommended for detection of subtle pancreatic lesions when they are either small or difficult to detect
Summary
Ultrasound contrast agents have a good safety profile in all patients; severe adverse events are exceedingly rare (Moriyasu and Itoh 2009; Miyamoto et al 2014; Tang et al 2017; Chou et al 2019; Hu et al 2019). CHEUS is increasingly being used in the diagnosis of intraabdominal lesions, and its utility has been extensively reported. Indications and standardization of methods and settings for CH-EUS remain to be determined. The Asian Federation of Societies for Ultrasound in Medicine and Biology (AFSUMB) aimed to provide internationally applicable information based on current scientific evidence reviewed by a panel of internationally renowned experts on the aforementioned topics, to allow further utilization and research in the field of CH-EUS possibly throughout Asia and the rest of the world
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