Use Of Ultrasound Contrast Agents Research Articles

Bioactive Nanotherapeutic Ultrasound Contrast Agent for Concurrent Breast Cancer Ultrasound Imaging and Treatment.

Contrast-enhanced ultrasound (CEUS) plays a crucial role in cancer diagnosis. The use of ultrasound contrast agents (UCAs) is inevitable in CEUS. However, current applications of UCAs primarily focus on enhancing imaging quality of ultrasound contrast rather than serving as integrated platforms for both diagnosis and treatment in clinical settings. In this study, a novel UCA, termed NPs-DPPA(C3F8), is innovatively prepared using a combination of nanoprecipitation and ultrasound vibration methods. The DPPA lipid possesses inherent antiangiogenic and antitumor activities, and when combined with C3F8, it functions as a theranostic agent. Notably, the preparation of NPs-DPPA(C3F8) is straightforward, requiring only one hour from raw materials to the final product due to the use of a single material, DPPA. NPs-DPPA(C3F8) exhibits inherent antiangiogenic and biotherapeutic activities, effectively inhibiting triple-negative breast cancer (TNBC) angiogenesis and reducing VEGFA expression both in vitro and in vivo. Clinically, NPs-DPPA(C3F8) enables simultaneous real-time imaging, tumor assessment, and antitumor activity. Additionally, through ultrasound cavitation, NPs-DPPA(C3F8) can overcome the dense vascular walls to increase accumulation at the tumor site and facilitate internalization by tumor cells. The successful preparation of NPs-DPPA(C3F8) offers a novel approach for integrating clinical diagnosis and treatment of TNBC.

Usefulness of contrast echocardiography for detection of left ventricular thrombus in a real-world population with acute anterior myocardial infarction

Abstract Funding Acknowledgements Type of funding sources: None. Background/Introduction The treatment of ST-elevation myocardial infarction (STEMI) has considerably changed in recent years, with early, mainly transcatheter reperfusion therapy improving survival. However, left ventricular thrombus (LVT) is still reported as a relatively common complication especially in anterior STEMI. Two-dimensional transthoracic echocardiography (TTE) is the most commonly used diagnostic modality in this setting due to its wide availability and low cost but can lead to misdiagnoses. The use of ultrasound contrast agents has dramatically improved the visualization of cardiac chambers and thus detection of LVT. Purpose The purpose of this study was to assess the value of contrast echocardiography (CE) for the detection of apical LVT in a real-world population of patients with acute anterior myocardial infarction (MI) in the modern era. Methods The population of this prospective study consisted of consecutive patients presenting within a year with acute anterior MI in a tertiary hospital with capability of primary percutaneous coronary intervention (PCI). Patients with confirmed COVID-19 infection and/or current use of anticoagulant medication were excluded from the study. All patients underwent TTE without and with contrast within 7 days post-MI by an experienced cardiologist. CE was considered the reference standard. Results A total of 102 patients (mean age 61±13 years, 19% female) with anterior STEMI were prospectively recruited in our study. Ninety-eight patients underwent primary PCI, 3 patients underwent rescue PCI after unsuccessful thrombolysis, 1 patient underwent surgical revascularization. Two patients did not receive contrast agent (1 due to known hypersensitivity to contrast agent and 1 due to cardiogenic shock). Mean ejection fraction (EF) was 46% ± 10% in total population and was significantly lower in patients with LVT (42% ± 7% vs 47% ± 10%, p = 0.025). The incidence of confirmed LVT by CE was 28% (28/100) within 7 days post-MI. In total, 8 out of 28 LVT cases (28.5%) would have been missed using TTE without contrast within 7 days post-MI (sensitivity 71%, specificity 100%, positive predictive value 100% and negative predictive value 90%). Example of missed LVT on TTE without and with contrast (left and right panel respectively) is shown in Figure 1. Conclusions LVT is not uncommon after anterior STEMI in the modern era of primary PCI. LVT would have been missed in a significant proportion of patients with anterior STEMI if CE was not used, depriving these patients from the option of early anticoagulation treatment.

Renal haemodynamics changes in different course of type 2 diabetes mellitus on the Contrast Enhanced Ultrasound evidences

Introduction. The currently used ionizing or invasive instrumental methods are considered to be unsuitable for haemodymanics monitoring. Contrast Enhanced ultrasound (CEUS) can provide better images of renal blood flow. Objective. To assess the renal haemodynamics changes in patients with different course of type 2 diabetes on the CEUS evidences. Materials and methods. From 2019 to 2022 118 patients 62 women (52.5 %), 56 men (47.5 %), average age 64±5.2) were examined. The control group was (n=48). The same study design used for all patients included case history, physical examination, SR-36 and DEBQ questionnaires, laboratory examination, multiparametric examination, CEUS. Results. When assessing BMI the 41.02 %, 52.27 % and 42.85 % of patients were found to be overweighted in the 1, 2 and 3 groups, respectively. By the ROC analysis the quantitative parameters of the CUI were obtained: on day 1 AUC=0.6544, after 6 months AUC=0.6492, after 12 months AUC=0.7418, after 24 months AUC=0.7515, after 36 months AUC=0.7529. For ΔPI according to the data, the optimal threshold for cutting off the transition of diabetic kidney disease to CKD is 76.3 dB. Conclusions. 1. The use of ultrasound contrast agents in the diagnosis of CKD enhances the importance of the ultrasound method. 2. qualitative and quantitative parameters of the CUSI allow to assess the renal haemodynamics changes in patients with different course of type 2 diabetes. 3. ΔPI corresponds to a high quality of prognostic model for the CKD dynamics (AUC=0.7418) with an optimal threshold for cutting off the transition of diabetic disease kidneys in CKD 76.3 dB.

Organization and Activity of Italian Echocardiographic Laboratories: A Survey of the Italian Society of Echocardiography and Cardiovascular Imaging.

The Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand better how different echocardiographic modalities are used and accessed in Italy. We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved via an electronic survey based on a structured questionnaire, uploaded on the SIECVI website. Data were obtained from 228 echocardiographic laboratories: 112 centers (49%) in the northern, 43 centers (19%) in the central, and 73 (32%) in the southern regions. During the month of observation, we collected 101,050 transthoracic echocardiography (TTE) examinations performed in all centers. As concern other modalities there were performed 5497 transesophageal echocardiography (TEE) examinations in 161/228 centers (71%); 4057 stress echocardiography (SE) examinations in 179/228 centers (79%); and examinations with ultrasound contrast agents (UCAs) in 151/228 centers (66%). We did not find significant regional variations between the different modalities. The usage of picture archiving and communication system (PACS) was significantly higher in the northern (84%) versus central (49%) and southern (45%) centers (P < 0.001). Lung ultrasound (LUS) was performed in 154 centers (66%), without difference between cardiology and noncardiology centers. The evaluation of left ventricular (LV) ejection fraction was evaluated mainly using the qualitative method in 223 centers (94%), occasionally with the Simpson method in 193 centers (85%), and with selective use of the three-dimensional (3D) method in only 23 centers (10%). 3D TTE was present in 137 centers (70%), and 3D TEE in all centers where TEE was done (71%). The assessment of LV diastolic function was done routinely in 80% of the centers. Right ventricular function was evaluated using tricuspid annular plane systolic excursion in all centers, using tricuspid valve annular systolic velocity by tissue Doppler imaging in 53% of the centers, and using fractional area change in 33% of the centers. When we divided into cardiology (179, 78%) and noncardiology (49, 22%) centers, we found significant differences in the SE (93% vs. 26%, P < 0.001), TEE (85% vs. 18%), UCA (67% vs. 43%, P < 0001), and STE (87% vs. 20%, P < 0.001). The incidence of LUS evaluation was similar between the cardiology and noncardiology centers (69% vs. 61%, P = NS). This nationwide survey demonstrated that digital infrastructures and advanced echocardiography modalities, such as 3D and STE, are widely available in Italy with a notable diffuse uptake of LUS in the core TTE examination, a suboptimal diffusion of PACS recording, and conservative use of UCA, 3D, and strain. There are significant differences between northern and central-southern regions and echocardiographic laboratories that pertain to the cardiac unit. This inhomogeneous distribution of technology represents one of the main issues that must be solved to standardize the practice of echocardiography.

Adjunct Methods for the Detection of Patent Foramen Ovale: The Contribution of Transcranial Doppler and the Valsalva Manoeuvre.

A patent foramen ovale (PFO) is present in 25% of the population. In some patients, especially those without traditional stroke risk factors and with no immediately apparent cause, a cryptogenic stroke may be caused by an embolus passing through the PFO to the systemic circulation. The identification, or indeed exclusion, of a PFO is sought in these patients, most commonly using contrast-enhanced transthoracic or transoesophageal echocardiography. Another method for detecting a PFO is transcranial Doppler, which allows the detection of PFO possibly without the need for an echo laboratory, and with arguably improved sensitivity. This review will focus on transcranial Doppler detection of PFO, with a brief summary of echocardiographic techniques and the use of ultrasound contrast agents, and the role of provocations to increase diagnostic accuracy, specifically the Valsalva manoeuvre. We discuss the phases alongside the direct and indirect signs of an adequate Valsalva manoeuvre.

High-order singular value decomposition of contrast pulsing sequences for improved clutter suppression

Contrast-enhanced ultrasound is a diagnostic tool used to visualize blood flow in the cardiovascular system. The use of ultrasound contrast agent (microbubbles) in combination with contrast pulsing scheme (CPS) improves the sensitivity and specificity of ultrasound flow imaging by enhancing the signal in the blood compartment. The commonly used CPS are pulse inversion (PI), amplitude modulation (AM), and amplitude-modulated pulse inversion (AMPI). Using differences in phase or amplitude of multiple pulses, the linear tissue clutter signal can be suppressed. However, this process can be degraded by motion or non-linear propagation of the ultrasound wave. These effects cause the cancellation of linear clutter signal to be ineffective We propose using higher-order singular value decomposition (HOSVD) with spatial, temporal, and pulsing dimensions as the input to improve clutter suppression under the conditions of motion and non-linear propagation. We performed systematic in-vitro- experiment emulating these conditions, as well as in-vivo cardiac measurements. The results showed that HOSVD increases the clutter suppression of all the 3 CPS compared to the conventional linear processing. The improvement of clutter reduction could be beneficial to various cardiac evaluation like myocardial perfusion or intra ventricular flow assessment.

SonoVue® vs. Sonazoid™ vs. Optison™: Which Bubble Is Best for Low-Intensity Sonoporation of Pancreatic Ductal Adenocarcinoma?

The use of ultrasound and microbubbles to enhance therapeutic efficacy (sonoporation) has shown great promise in cancer therapy from in vitro to ongoing clinical studies. The fastest bench-to-bedside translation involves the use of ultrasound contrast agents (microbubbles) and clinical diagnostic scanners. Despite substantial research in this field, it is currently not known which of these microbubbles result in the greatest enhancement of therapy within the applied conditions. Three microbubble formulations—SonoVue®, Sonazoid™, and Optison™—were physiochemically and acoustically characterized. The microbubble response to the ultrasound pulses used in vivo was simulated via a Rayleigh–Plesset type equation. The three formulations were compared in vitro for permeabilization efficacy in three different pancreatic cancer cell lines, and in vivo, using an orthotopic pancreatic cancer (PDAC) murine model. The mice were treated using one of the three formulations exposed to ultrasound from a GE Logiq E9 and C1-5 ultrasound transducer. Characterisation of the microbubbles showed a rapid degradation in concentration, shape, and/or size for both SonoVue® and Optison™ within 30 min of reconstitution/opening. Sonazoid™ showed no degradation after 1 h. Attenuation measurements indicated that SonoVue® was the softest bubble followed by Sonazoid™ then Optison™. Sonazoid™ emitted nonlinear ultrasound at the lowest MIs followed by Optison™, then SonoVue®. Simulations indicated that SonoVue® would be the most effective bubble using the evaluated ultrasound conditions. This was verified in the pre-clinical PDAC model demonstrated by improved survival and largest tumor growth inhibition. In vitro results indicated that the best microbubble formulation depends on the ultrasound parameters and concentration used, with SonoVue® being best at lower intensities and Sonazoid™ at higher intensities.

Contrast-enhanced ultrasound: a comprehensive review of safety in children.

Contrast-enhanced ultrasound (CEUS) has been increasingly used in pediatric radiology practice worldwide. For nearly two decades, CEUS applications have been performed with the off-label use of gas-containing second-generation ultrasound contrast agents (UCAs). Since 2016, the United States Food and Drug Administration (FDA) has approved the UCA Lumason for three pediatric indications: the evaluation of focal liver lesions and echocardiography via intravenous administration and the assessment of vesicoureteral reflux via intravesical application (contrast-enhanced voiding urosonography, ceVUS). Prior to the FDA approval of Lumason, numerous studies with the use of second-generation UCAs had been conducted in adults and children. Comprehensive protocols for clinical safety evaluations have demonstrated the highly favorable safety profile of UCA for intravenous, intravesical and other intracavitary uses. The safety data on CEUS continue to accumulate as this imaging modality is increasingly utilized in clinical settings worldwide. As of August 2021, 57 pediatric-only original research studies encompassing a total of 4,518 children with 4,906 intravenous CEUS examinations had been published. As in adults, there were a few adverse events; the majority of these were non-serious, although very rarely serious anaphylactic reactions were reported. In the published pediatric-only intravenous CEUS studies included in our analysis, the overall incidence rate of serious adverse events was 0.22% (10/4,518) of children and 0.20% (10/4,906) of all CEUS examinations. Non-serious adverse events from the intravenous CEUS were observed in 1.20% (54/4,518) of children and 1.10% (54/4,906) of CEUS examinations. During the same time period, 31 studies with the intravesical use of UCA were conducted in 12,362 children. A few non-serious adverse events were encountered (0.31%; 38/12,362), but these were most likely attributable to the bladder catheterization rather than the UCA. Other developing clinical applications of UCA in children, including intracavitary and intralymphatic, are ongoing. To date, no serious adverse events have been reported with these applications. This article reviews the existing pediatric CEUS literature and provides an overview of safety-related information reported from UCA uses in children.

Diagnostyka zmian ogniskowych wątroby z zastosowaniem ultrasonograficznych środków kontrastujących – strategia badania

The aim of the paper is to present the technique and strategy of ultrasound examination with the use of ultrasound contrast agents in the diagnosis of focal liver lesions depending on the indications and clinical situation.

Impact of ultrasound contrast agent during transoesophageal echocardiography on the sizing of the left atrial appendage

IntroductionInterventional closure of the left atrial appendage closure (LAAC) has been established as an alternative treatment in patients with atrial fibrillation (AF) and an increased risk of stroke. So far...

EFSUMB 2020 Proposal for a Contrast-Enhanced Ultrasound-Adapted Bosniak Cyst Categorization - Position Statement.

The 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.

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.

The 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.

Contrast-Enhanced Ultrasound-Guided Interventions-The New Sheriff in Town?: A Case-Based Review of Problem Solving With Ultrasound Contrast.

Ultrasound (US)-guided intervention is a well-established medical procedure and offers advantages such as real-time guidance, portability, reduced cost, shortened procedure time compared with computed tomography, and lack of ionizing radiation. Ultrasound contrast agents (UCAs) are a useful adjunct to US-guided procedures. The addition of microbubble UCAs during US-guided interventions can assist with biopsy planning and lesion selection, aid in identification of target lesions, and direct the biopsy toward viable tissue. Ultrasound contrast agents have been in use outside of the United States for many years and have been used off label at select institutions across the United States before the Food and Drug Administration approval of Lumason (Bracco Diagnostics) for liver lesion evaluation in April 2016. After Food and Drug Administration approval, the use of UCAs has expanded rapidly, and UCAs are being used for a variety of clinical applications. Ultrasound contrast agents have been shown to be safe, and there is no renal toxicity. In this article, we will discuss the indications and techniques for using contrast-enhanced ultrasound during US-guided interventions, and we will present case examples where contrast-enhanced ultrasound added value.

Indications for abdominal imaging: When and what to choose?

Imaging has a very important role in evaluating abdominal pathology. A good knowledge of indications is of crucial importance in the management of the patient with abdominal pathology. Ultrasound, which on its own can lead to an accurate diagnosis, plays a pivotal role in the management of abdominal pathology. The use of ultrasound contrast agents has significantly improved ultrasound diagnostic capacities in both hepatic and non-hepatic pathology. The use of computed tomography should be limited due to the potential harmful side effects of ionizing radiation, but it has established roles in evaluating severe abdominal traumatic and non-traumatic emergencies as well as in staging oncologic patients. Magnetic resonance imaging has very limited utility in abdominal emergencies due to difficulty of accessing the scanner and the long duration of the examination compared to computed tomography or ultrasound. However, magnetic resonance imaging has well-established clinical roles particularly for evaluating diffuse or focal hepatic pathology, benign and malignant bile duct pathology, pancreatic tumors, inflammatory bowel disease and rectal tumors. The aims of the following paper are to familiarize the clinician with the indications for imaging in abdominal pathology, to guide the clinician and radiologist in choosing the correct technique for a particular clinical situation, to prevent the overuse of imaging techniques and to prevent misdiagnosis of disease and incorrect therapy resulting from inappropriate imaging.

The AFSUMB Consensus Statements and Recommendations for the Clinical Practice of Contrast-Enhanced Ultrasound using Sonazoid.

The first edition of the guidelines for the use of ultrasound contrast agents was published in 2004, dealing with liver applications. The second edition of the guidelines in 2008 reflected changes in the available contrast agents and updated the guidelines for the liver, as well as implementing some nonliver applications. The third edition of the contrast-enhanced ultrasound (CEUS) guidelines was the joint World Federation for Ultrasound in Medicine and Biology-European Federation of Societies for Ultrasound in Medicine and Biology (WFUMB-EFSUMB) venture in conjunction with other regional US societies such as Asian Federation of Societies for Ultrasound in Medicine and Biology, resulting in a simultaneous duplicate on liver CEUS in the official journals of both WFUMB and EFSUMB in 2013. However, no guidelines were described mainly for Sonazoid due to limited clinical experience only in Japan and Korea. The new proposed consensus statements and recommendations provide general advice on the use of Sonazoid and are intended to create standard protocols for the use and administration of Sonazoid in hepatic and pancreatobiliary applications in Asian patients and to improve patient management.

Impact of ultrasound contrast agent on the detection of thrombi during transoesophageal echocardiography

BackgroundAtrial fibrillation (AF) carries the risk of thrombus formation in the left atrium and especially in the left atrial appendage (LAA). A transoesophageal echocardiography (TOE) is routinely performed in these...

Rabbit lung hemorrhage induced by acoustic radiation force impulse in clinical settings

Background Acoustic radiation force impulse (ARFI) has recently become widespread in clinical practice as ultrasound elastography. However, the safety of the modality is yet to be confirmed. Although we have already reported the alveolar hemorrhage induced by ARFI on rabbit lung tissue, these experiments were conducted with much longer pulse duration (PD) compared with that in clinical use. Therefore, we introduced a new ARFI exposure system that can confirm a targeting focal spot on a B mode image and adjust a focal depth with a good alignment precision. This time, we conducted a series of animal experiments with the setup which is equivalent to the clinical condition. Methods 10 rabbits were anesthetized and placed in spine position. Tracheal intubation was performed to control ventilation. A focused 5.2 MHz linear probe that transmitted ARFI was placed in precordial and subcostal regions bilaterally and determined appropriate locations for exposure of the lung through two paths (transhepatic and transthoracic) respectively. Exposure settings were varied in the cases and included: mechanical index (MI) 0.6∼1.4, PD 0.3 or 1.0ms, pulse repetition time (PRT) 3s, exposure time 90s. One case was conducted with ultrasound contrast agent. After exposure, the lungs were removed for macrophotography and histopathologic study. Results A red spot was observed on the surface of the lung corresponding to the area of exposure in each animal (17 at transhepatic and 19 at transthoracic path out of 20 and 19 exposures respectively). The size of red spots varied from 2 mm to 22 mm. The damage was not aggravated with use of ultrasound contrast agent. Microscopic findings confirmed alveolar hemorrhage in each red spot. Discussion Ultrasound exposure has been known to induce lung injury in animal experiments. In this study, ARFI induced lung injury under the acoustic output regulation value of MI ( Conclusion Lung hemorrhage was induced under regulation value of MI and with shorter PD of 0.3ms equivalent to that in clinical use of ARFI. These results identify a potential risk of lung injury associated with the elastography when the lung is unintentionally exposed to ultrasound from the probe, especially for liver or breast imaging.

Invited commentary

Kapetanios and colleagues have comprehensively reviewed the published literature on the use of contrast-enhanced ultrasound (CEUS) for detection of endoleaks after endovascular aneurysm repair (EVAR). Unfortunately, the methodology used may only amplify biases present in the reviewed publications. Thus, analyses in the current review do not provide substantial new insights. Skepticism about comparative studies is warranted as double-blind ultrasound examinations cannot be done. Unbiased data are not available. We cannot know the thoroughness of the conventional imaging, which might have been abbreviated if CEUS was already planned. Direct comparisons are not practical. Significantly, the authors observed that the sensitivity of both conventional ultrasound and CEUS improved over time. This would be the expected finding as imagining technology evolves and sonographer training and protocols improve. Our vascular laboratory at UC Davis never made CEUS a required part of post-EVAR imaging; but for several years, we used CEUS routinely. Although CEUS is now rarely performed, we do use contrast material occasionally. We have a very good vascular laboratory. The ultrasound systems are up to date. The technologists are all well trained and perform only vascular ultrasound studies. We have a detailed protocol for post-EVAR studies and allow up to 2 hours for the examination and documentation. The use of contrast material made the examinations substantially more complex. Examinations needed to be scheduled with a nurse available to establish intravenous access and to administer the contrast agent. We did not track the additional costs associated with the contrast material, required supplies, and personnel time. The primary reason that we stopped using contrast material, however, was neither inconvenience nor cost. We stopped doing CEUS because we never found endoleaks that were undetected with conventional ultrasound techniques. Furthermore, ultrasound routinely identified endoleaks found with computed tomography scanning. This paper should not be a call to arms for routine use of ultrasound contrast agents in post-EVAR examinations. There are other factors in post-EVAR surveillance that are recognized as important. Rather than encouraging routine use of contrast material, existing best practices should be emphasized: imaging in an accredited vascular laboratory; post-EVAR imaging using appropriate protocols, with sufficient time allocated for thorough studies; imaging by appropriately trained and credentialed vascular technologists (RVT or equivalent); and interpretation of the studies by knowledgeable and qualified physicians (RPVI credential or equivalent). CEUS is not the standard for post-EVAR imaging in most vascular laboratories. There is potential for harm if the authors' conclusions about the superiority of CEUS are accepted at face value. This paper might lead some to believe that CEUS is necessary for post-EVAR surveillance. If the cost and complexity disadvantages of CEUS were to dissuade surgeons from using ultrasound for routine surveillance, computed tomography scanning might be unnecessarily overused or compliance with surveillance schedules might decrease. Evidence supporting a recommendation for routine use of ultrasound contrast agents for post-EVAR examinations is weak. CEUS may have value in selected circumstances, but high-quality conventional color duplex ultrasound remains an excellent tool for post-EVAR surveillance, and its routine use is recommended in two recent Society for Vascular Surgery guidelines.1Zierler R.E. Jordan W.D. Lal B.K. Mussa F. Leers S. Fulton J. et al.The Society for Vascular Surgery practice guidelines on follow-up after vascular surgery arterial procedures.J Vasc Surg. 2018; 68: 256-284Abstract Full Text Full Text PDF PubMed Scopus (67) Google Scholar, 2Chaikof E.L. Dalman R.L. Eskandari M.K. Jackson B.M. Lee W.A. Mansour M.A. et al.The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm.J Vasc Surg. 2018; 67: 2-77.e2Abstract Full Text Full Text PDF PubMed Scopus (1133) Google Scholar Meta-analysis of the accuracy of contrast-enhanced ultrasound for the detection of endoleak after endovascular aneurysm repairJournal of Vascular SurgeryVol. 69Issue 1PreviewThe purpose of this systematic review and meta-analysis was to investigate the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) for detection of endoleak after endovascular aneurysm repair (EVAR). Full-Text PDF Open Archive

How to perform Contrast-Enhanced Ultrasound (CEUS).

“How to perform contrast-enhanced ultrasound (CEUS)” provides general advice on the use of ultrasound contrast agents (UCAs) for clinical decision-making and reviews technical parameters for optimal CEUS performance. CEUS techniques vary between centers, therefore, experts from EFSUMB, WFUMB and from the CEUS LI-RADS working group created a discussion forum to standardize the CEUS examination technique according to published evidence and best personal experience. The goal is to standardise the use and administration of UCAs to facilitate correct diagnoses and ultimately to improve the management and outcomes of patients.

Which Factors May Predict Use of Ultrasound Contrast Agents During Transthoracic Echocardiography?

Background: Transthoracic echocardiography (TTE) is the commonest imaging modality used in the assessment of cardiac structure and function. However, up to 25% of unenhanced TTE (UE-TTE) may be non-diagnostic, due to sub-optimal image quality. Common factors that may limit TTE image quality include obesity, lung disease, and poor acoustic windows. The use of ultrasound contrast agents (UCA) can improve endocardial definition and help to minimise these non-diagnostic TTE. The aim of this analysis was to assess factors that may predict the use of UCA in a large cohort of patients.