Benefits of contrast-enhanced ultrasonography for interventional procedures

Abstract

For evaluating unclear tumorous lesions, CEUS is an important imaging modality besides contrast-enhanced computed tomography (CECT) and magnetic resonance imaging (MRI) and may provide valuable insights into the microvascularization of tumors by its dynamic examination. In interventional procedures, CEUS can make a valuable contribution in pre-, peri-and post-interventional settings, reduce radiation exposure and, under certain circumstances, the number of interventions for the patient.

Radiation Dose Reduction Opportunities in Vascular Imaging

“…Dynamic feedback, a feature unique to the ultrasound (and CEUS) modality, allows for real-time feedback that is particularly advantageous in targeted biopsies where examiners can distinguish between vascularized and non-vascularized tissue [ 47 ]. This type of feedback is useful when placing drains, enabling drain position verification and assessment at bedside, with rapid position confirmation when repositioning of the drain is required.…”

Ablation Difficulty Score: Proposal of a new tool to predict success rate of percutaneous ablation for hepatocarcinoma

“…Although HCC usually results hypoechoic or hyperechoic to the liver on grayscale ultrasonography, there are occasional cases of isoechoic appearance or ill-defined margins. In these cases the intraoperative visualization may result more difficult, with therefore a higher risk in achieving a complete necrosis [20]. This feature stresses the role of CEUS both in preoperative and intraoperative settings.…”

Contrast enhancement for ultrasound-guided interventions: when to use it and what to expect?

“…In contrast to SonoVue, Sonazoid is taken up by Kupffer cells in the post-vascular phase, leading to an additional postvascular phase, (Kupffer phase, 5 to 30 minutes after the injection), providing extremely stable images suitable for repeated scanning and interventions, and thus removing the time-constraint generated by a rapid contrast clearance. Moreover, the Sonazoid bubbles have a relatively narrow size distribution, are very robust, allowing for high mechanical index scanning (MI 0.2-0.3) and are not deterred by the use of higher US frequencies (5,12).…”

“…CEUS guidance might be used in the arterial phase for hypervascular lesions not seen in grayscale US, such as small hepatocellular carcinomas (HCCs) in patients with cirrhosis, or the late phase for liver metastases [ 13 ]. With the use of the new UCAs like Sonazoid, it became possible to target the liver lesions in the Kupffer phase (20-30 minutes after contrast injection), practically eliminating the time-constraint to perform the biopsy [ 12 ]. The use of CEUS before a biopsy may identify new lesions with an easier pathway for biopsy.…”