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

Abstract

The use of contrast enhancement in ultrasonography (CEUS) has become synonymous with high standard ultrasonography (US) in the recent past. From expanding the reach of US diagnostics to improving the precision of various invasive procedures, CEUS is rapidly becoming a standard in numerous niches. However, proficiency in CEUS comes with a cost, both from a learning curve and material standpoint, and as every growing field, lacks firm evidence and standardization.Therefore, in the current paper, we aim to provide an evidence-based review of available methods and to discuss the perks and pitfalls of CEUS in interventional procedures, trying to provide strong evidence whenever available, or at least an educated expert opinion if data is lacking.

Multimodality Imaging Assessment of Desmoid Tumors: The Great Mime in the Era of Multidisciplinary Teams

“…Ultrasound (US) is an inexpensive tool, widely available and safe since it does not use ionizing radiation so that the examination can be repeated several times, even in risk categories such as children and pregnant women [ 111 , 112 , 113 , 114 , 115 , 116 ]. US plays a limited role mainly in the delineation of mass and lesions involving the abdominal wall, chest wall, breast and extremities.…”

“…US plays a limited role mainly in the delineation of mass and lesions involving the abdominal wall, chest wall, breast and extremities. However, due to operator dependence and the poor performance of small intra-abdominal lesions, the necessity for patient collaboration reduces the sensitivity and specificity both in detection and characterization [ 111 , 112 , 113 , 114 , 115 , 116 ].…”

“…So, CT or MRI scans can not only help for diagnosis but also in determining the relationship between tumors and the surrounding organs to obtain proper pre-treatment planning. Otherwise, although US assessment is safe since it does not use ionizing radiation so that the examination can be repeated several times [ 111 , 112 , 113 , 114 , 115 , 116 ], it plays a limited role in the delineation of mass and lesions involving the abdominal wall, chest wall, breast and extremities. However, due to operator dependence and the poor performance of small intra-abdominal lesions, there is a necessity for patient collaboration to reduce the sensitivity and specificity both in the detection and characterization of these tumors.…”

“…Inexpensive; widely available; safe [111][112][113][114][115][116] Requires high spatial resolution to obtain sufficient anatomical detail for the detection of deep lesions and for targeting interventional procedures [80] Multiparametric approach; the exceptional contrast resolution; functional assessment [138][139][140][141][142][143]…”

“…Operator dependence; poor performance for small intra-abdominal lesions; patient's collaboration [111][112][113][114][115][116] Radiation exposure [97] Long examination and interpretation time; high costs [97]…”