Safety of Intravenous Application of Second-Generation Ultrasound Contrast Agent in Children: Prospective Analysis

Piskunowicz, Maciej; Kosiak, Wojciech; Batko, Tomasz; Piankowski, Arkadiusz; Połczyńska, Katarzyna; Adamkiewicz-Drożyńska, Elżbieta

doi:10.1016/j.ultrasmedbio.2014.11.003

Cited by 62 publications

(43 citation statements)

References 15 publications

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“…22 In the paediatric population, limited studies evaluated the safety profile of ultrasonography contrast agents. [23][24][25][26][27][28] The largest series involved 167 CEUS examinations using SonoVue™ in 137 children, which documented 1 (0.6%) severe allergic reaction. However, no other haemodynamic and oxygenation status changes were documented in this study, and no other subjective complaints were recorded following the CEUS examination.…”

Section: Safetymentioning

confidence: 99%

“…However, no other haemodynamic and oxygenation status changes were documented in this study, and no other subjective complaints were recorded following the CEUS examination. 26 In a retrospective questionnaire-based survey among paediatric radiologists in Europe, only six minor adverse reactions were recorded after the i.v. administration of the ultrasonography contrast.…”

Section: Safetymentioning

confidence: 99%

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Enhancing the role of paediatric ultrasound with microbubbles: a review of intravenous applications

Rafailidis¹,

Deganello²,

Watson³

et al. 2017

BJR

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Contrast-enhanced ultrasound (CEUS) represents a complementary technique to greyscale and colour Doppler ultrasonography which allows for real-time visualization and characterization of tissue perfusion. Its inherent advantages in the child makes ultrasonography an ideal imaging modality; repeatability and good tolerance along with the avoidance of CT, a source of ionizing radiation, renders ultrasonography imaging desirable. Although currently paediatric CEUS is principally used in an "off-label" manner, ultrasonography contrast agents have received regulatory approval for assessment of paediatric focal liver lesions (FLL) in the USA. The safety of ultrasound contrast-agents is well documented in adults, as safe as or even surpassing the safety profile of CT and MR contrast agents. Except for the established intracavitary use of CEUS in voiding urosonography, i.v. paediatric applications have been introduced with promising results in the abdominal trauma initial diagnosis and follow-up, characterization and differential diagnosis of FLL and characterization of lung, pleura, renal and splenic pathology. CEUS has also been used to detect complications after paediatric transplantation, evaluate inflammatory bowel disease activity and assess tumour response to antiangiogenic therapy. The purpose of this review was to present these novel i.v. paediatric applications of CEUS and discuss their value.

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Section: Safetymentioning

confidence: 99%

Section: Safetymentioning

confidence: 99%

Enhancing the role of paediatric ultrasound with microbubbles: a review of intravenous applications

Rafailidis¹,

Deganello²,

Watson³

et al. 2017

BJR

View full text Add to dashboard Cite

show abstract

“…In addition, UCA is considered the safest contrast agent with the lowest rate of adverse effects. 5-7 …”

Section: Dynamic Contrast-enhanced Ultrasound Of the Bowel Wall With mentioning

confidence: 99%

Dynamic contrast-enhanced ultrasound of the bowel wall with quantitative assessment of Crohn’s disease activity in childhood

Ključevšek

Vidmar

Urlep

et al. 2016

Radiology and Oncology

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BackgroundContrast-enhanced ultrasound (CEUS) has become an established non-invasive, patient-friendly imaging technique which improves the characterization of lesions. In addition, dynamic contrast-enhanced ultrasound (DCE-US) provides valuable information concerning perfusion of examined organs. This review addresses current applications of CEUS in children, focused on DCE-US of the bowel wall in patients with Crohn disease, which enables realtime assessment of the bowel wall vascularity with semi-quantitative and quantitative assessment of disease activity and response to medical treatment.ConclusionsCrohn’s disease is a chronic inflammatory relapsing disease. Frequent imaging re-evaluation is necessary. Therefore, imaging should be as little invasive as possible, children friendly with high diagnostic accuracy. US with wide varieties of techniques, including CEUS/DCE-US, can provide an important contribution for diagnosing and monitoring a disease activity. Even if the use of US contrast agent is off-label in children, it is welcome and widely accepted for intravesical use, and a little less for intravenous use, manly in evaluation of parenchymal lesions. To our knowledge this is the first time that the use of DCE-US in the evaluation of activity of small bowel Crohn disease with quantitative assessment of kinetic parameters is being described in children. Even if the results of the value and accuracy of different quantitative kinetic parameters in published studies in adult population often contradict one another there is a great potential of DCE-US to become a part of the entire sonographic evaluation not only in adults, but also in children. Further control studies should be performed.

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“…The safety of UCAs, either intravenous or intravesical, has been evaluated in several studies, also in the pediatric populations. Recently a meta-analysis of adverse effects after intravenous application of second-generation UCAs was performed by Piskunowicz et al (12). Only one severe anaphylactoid reaction in a child following the intravenous administration of UCA was described.…”

Section: Safety Issues Of Ultrasound Contrast Agentsmentioning

confidence: 99%

Contrast-enhanced ultrasonography in children

Ključevšek

2016

Pedaiatr Today

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Development of ultrasound contrast agents (UCAs) opened the possibility of a new radiation-free diagnostic technique called contrast-enhanced ultrasonography (CEUS) in pediatric imaging. First, the safety profile of CEUS is discussed, followed by the description of common clinical applications. UCAs are not registered for individuals younger than 18 years and their current use is off-label. The published studies concerning UCA safety have shown the high safety profile of UCAs. Following intravenous application of UCAs, only one severe anaphylactic reaction has been reported in children, along with some mild adverse reactions, while during intravesical application no adverse effect related to UCAs has been reported. The main indication in the pediatric population for UCA application is voiding urosonography (VUS). The generally accepted standard VUS procedure is described together with its role in the urodiagnostic algorithm. The intravenous application of UCA is less widespread, but it is slowly gaining popularity among pediatric radiologists as a problem solving method. Unfortunately, there has been no standardization of the procedure and there are no official recommendations regarding the dose of UCAs, which should be appropriately adjusted according to the patient's weight or age, and to the probe. The review of the published literature concerning intravenous CEUS is presented. A step forward towards functional imaging is dynamic CEUS, which enables quantification of enhancement. In addition, the role of the EFSUMB Paediatric Registry Data Base is presented. Conclusion -CEUS examinations have opened new prospects in ultrasound and have become promising non-invasive radiation-free method in children,

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Safety of Intravenous Application of Second-Generation Ultrasound Contrast Agent in Children: Prospective Analysis

Cited by 62 publications

References 15 publications

Enhancing the role of paediatric ultrasound with microbubbles: a review of intravenous applications

Enhancing the role of paediatric ultrasound with microbubbles: a review of intravenous applications

Dynamic contrast-enhanced ultrasound of the bowel wall with quantitative assessment of Crohn’s disease activity in childhood

Contrast-enhanced ultrasonography in children

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