CEUS in the study of bladder, method, administration and evaluation, a technical note

Abstract

Purpose Contrast-enhanced ultrasound (CEUS) is the application of ultrasound contrast agents (UCAs) to traditional medical sonography. The development of UCAs allowed to overcome some of the limitations of conventional B-mode and Doppler ultrasound techniques and enabled the display of the parenchymal microvasculature. Purpose of this paper is to delineate the elements of a solid and science-based technique in the execution of urinary bladder CEUS. Methods We describe the technical execution of urinary bladder CEUS and the use of perfusion softwares to perform contrast enhancement quantitative analysis with generation of time-intensity curves from regions of interest. Results During CEUS, normal bladder wall shows a wash-in time of 13 s, a time to peak (TTP) [40 s, a signal intensity (SI) \45 % and a wash-out time [80 s; Lowgrade urothelial cell carcinoma (UCC) shows a wash-in time of 13 s, a time to peak TTP [28 s, a SI \45 % and a wash-out time of 40 s; High-grade UCC shows a wash-in time of 13 s, a TTP[28 s, a SI[50 % and a wash-out time of 58 s. Conclusions CEUS is a useful tool for an accurate characterization of bladder UCC although it has some drawbacks. To avoid misunderstandings, a widely accepted classification and a standardized terminology about the most significant parameters of this application should be adopted in the immediate future.

Contrast enhanced ultrasound in urothelial carcinoma of urinary bladder: An underutilized staging and grading modality

“…If Ta and T1 lesions were combined as NMIBC, then the sensitivity of the test improved but specificity declined. Our results are in concordance with previously published studies [9, 10, 11]. …”

“…The software that is used for the quantitative analysis a CEUS recording is different with different manufacturers [10, 11]. There are many types of propriety software available.…”

“…There are many types of propriety software available. The TIC values recorded will vary with the machine, probe, signal gain settings and the software being used [10, 11]. We also noticed that the amount of contrast used and the dilution used also had an effect on the TIC values.…”

Contrast‐Enhanced Ultrasound Differentiation Between Low‐ and High‐ Grade Bladder Urothelial Carcinoma and Correlation With Tumor Microvessel Density

“…The recent rapid development of contrast‐enhanced ultrasound (CEUS) has increased the clinical value of ultrasound in oncology by providing quantification of tumor blood perfusion parameters . It has already been suggested that CEUS has the potential for differentiating low‐grade bladder urothelial carcinoma from high grade . Contrast‐enhanced ultrasound is a diagnostic method that enables the assessment of tumor microvasculature via blood pool imaging, and has been used for studying angiogenesis in solid pancreatic lesions and liver tumors .…”

“…12 It has already been suggested that CEUS has the potential for differentiating low-grade bladder urothelial carcinoma from high grade. 13,14 Contrast-enhanced ultrasound is a diagnostic method that enables the assessment of tumor microvasculature via blood pool imaging, and has been used for studying angiogenesis in solid pancreatic lesions and liver tumors. 15,16 Thus, CEUS may be suitable for the evaluation of bladder urothelial carcinoma angiogenesis.…”