Use of paclitaxel-coated angioplasty balloons during percutaneous treatment of femoropopliteal disease is associated with significant reductions in late lumen loss and target-lesion revascularization. No significant benefit is seen with the use of a paclitaxel-containing contrast medium. (ClinicalTrials.gov number, NCT00156624 [ClinicalTrials.gov].).

These preliminary results suggest CE-IOUS is an essential tool prior to liver resection for metastases.

Detection of hepatic metastases is substantially improved by low MI real time contrast enhanced ultrasound with SonoVue compared to conventional B-mode sonography.

IntroductionThe liver has several features that make it a common site for metastases from malignancies of other organs. These are the dual blood supply via the portal vein and the hepatic artery, the high volume of blood flow (about a quarter of the cardiac output), the microscopic vascular anatomy which favours tumour cell trapping, and the major role that the liver plays in metabolism that provides an ideal environment for rapid growth [1]. Therefore, in 25-50% patients with a known malignancy, liver metastases are found at the time of diagnosis with decreasing frequency in colon, gastric, pancreatic, breast and lung cancer [2].Accurate and timely detection of hepatic metastases is very important because of the far-reaching therapeutic and prognostic implications. Especially after the recent improvements in liver resection and thermoablation of metastases from colorectal carcinoma, liver imaging has become more demanding. Accurate assessment of the number, size and segmental location of liver metastases is required for treatment planning and so as to identify patients that are suitable for surgical or interventional therapy.Besides metastases, there are a number of other, mainly benign, types of focal liver lesions which have to be differentiated from metastases. Benign liver lesions are very common: their prevalence has been reported to be more than 20% in non-selected autopsy series [3,4]. As a consequence of this, in patients with extrahepatic malignancy, about 50% of solid lesions smaller than 2 cm are benign [5,6]. The most common benign liver lesions are simple cysts, but they are usually easily recognised as such by imaging. More challenging is the characterisation of common solid lesions such as haemangiomas, focal nodular hyperplasia (FNH) and focal fatty change/sparing. Adenomas are much rarer and occur almost exclusively in patients on sex hormone medication. Other rare but relevant benign lesions include focal hepatic infections: pyogenic, parasitic or fungal abscesses. Furthermore, there is a worldwide increase in primary malignant liver lesions, namely hepatocellular carcinomas (HCC), of which 80% are associated with cirrhosis and/or chronic viral hepatitis [3], and this is an important differential diagnostic clue. Other primary malignant liver lesions such as cholangiocarcinoma are much rarer.The cross-sectional imaging methods used for liver imaging (computed tomography) (CT), magnetic resonance imaging (MRI) and grey-scale ultrasound (US) are based on assessment of lesion morphology. The use of contrast agents increases both sensitivity and specificity of lesion detection considerably and provides crucial additional information about the dynamic contrast behaviour for lesion characterisation. In contrast to CT and MRI, US is inexpensive and widely available with no radiation exposure and good patient acceptance. US is therefore often the first-line investigation for hepatic screening of cancer patients. However, mainly due to a lack of contrast agents, US used to be less sensitive and less spe...