Perfusion Quantification in Contrast-Enhanced Ultrasound (CEUS) – Ready for Research Projects and Routine Clinical Use

Abstract

With contrast-enhanced ultrasound (CEUS) now established as a valuable imaging modality for many applications, a more specific demand has recently emerged for quantifying perfusion and using measured parameters as objective indicators for various disease states. However, CEUS perfusion quantification remains challenging and is not well integrated in daily clinical practice. The development of VueBox™ alleviates existing limitations and enables quantification in a standardized way. VueBox™ operates as an off-line software application, after dynamic contrast-enhanced ultrasound (DCE-US) is performed. It enables linearization of DICOM clips, assessment of perfusion using patented curve-fitting models, and generation of parametric images by synthesizing perfusion information at the pixel level using color coding. VueBox™ is compatible with most of the available ultrasound platforms (nonlinear contrast-enabled), has the ability to process both bolus and disruption-replenishment kinetics loops, allows analysis results and their context to be saved, and generates analysis reports automatically. Specific features have been added to VueBox™, such as fully automatic in-plane motion compensation and an easy-to-use clip editor. Processing time has been reduced as a result of parallel programming optimized for multi-core processors. A long list of perfusion parameters is available for each of the two administration modes to address all possible demands currently reported in the literature for diagnosis or treatment monitoring. In conclusion, VueBox™ is a valid and robust quantification tool to be used for standardizing perfusion quantification and to improve the reproducibility of results across centers.

Ultrasound imaging in the diagnosis of large vessel vasculitis

“…Therefore, objective and reproducible quantification of contrast enhancement seems indispensable. Evaluation of modern CEUS perfusion quantifi cation methods, such as time-intensity curve analysis for this particular indication, is an important area for further research [96].…”

The utility of elastography and CEUS for the differentiation between benign and malignant cervical lymphadenopaty. Three cases report

“…The main problem of CEUS-the need for perfusion quantification and the use of these perfusion parameters as objective indicators for a specific disease-was largely studied. The development of specific software for quantification (VueBox, Bracco Suisse SA Switzerland or Qontrast, Esaote S.p.a, Florence, Italy) allows us now to have a better perspective for an objective evaluation by using CEUS [3] Our aim is to report three different clinical situations in which CEUS examination and perfusion quantification using Qontrast software (Esaote S.p.a, Florence, Italy) together with elastography had provided important data for a correct characterization of the cervical lymphadenopaty. All the cases were examined with GE Logiq S8 system, using grey scale ultrasonography (US), power Doppler, and elastography.…”

The role of contrast-enhanced endoscopic ultrasound in pancreatic adenocarcinoma

“…[19] Thus, a series of parameters can be estimated based on TIC analysis, such as peak enhancement (maximum intensity), rise time, wash-in and wash-out rate, and area under the curve. [2021] Both techniques (low and high MI) can easily be combined in the same examination using a sequential approach based on the long persistence of the enhancing effect of microbubbles [Figure 1a and b]. …”