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1
Liang, Xing-xin, Fan Li, Feng Gao, et al. "The Value of the Model and Quantitative Parameters of Contrast-Enhanced Ultrasound in Judging the Severity of SHPT." BioMed Research International 2016 (2016): 1–5. http://dx.doi.org/10.1155/2016/6064526.
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Using the model and quantitative parameters of contrast-enhanced ultrasound (CEUS) to assess the severity of secondary hyperparathyroidism (SHPT) was proposed. 42 SHPT patients who underwent CEUS examination were divided into three groups, light, moderate, and heavy as per parathyroid hormone (PTH). The process of CEUS was divided into two phases, wash-in phase and wash-out phase. The three groups were analyzed with their enhancing model in the two phases. The quantitative parameters of CEUS such as Arrival Time (AT), Time to Peak (TTP), Mean Transit Time (MTT), and Maximum Intensity (IMAX) were measured by time-intensity curve (TIC) and compared among the three groups. The enhancing model of light SHPT, moderate SHPT, and heavy SHPT showed statistical significance in wash-in phase and wash-out phase (P<0.05). No difference was observed in AT and TTP among the three groups (P>0.05) while MTT and IMAX showed statistical significance (P<0.05). The CEUS of light SHPT was characterized by “slow-in, fast-out, and lower-enhancement” with short enhancement time; the CEUS of moderate SHPT was characterized by “fast-in, fast-out, and higher-enhancement” with slightly long enhancement time; the CEUS of heavy SHPT was characterized by “fast-in, slow-out, and higher-enhancement” with long enhancement time. Therefore, the model and quantitative parameters of CEUS can be benefit for the assessment of the severity of SHPT.
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Vavuranakis, Manolis, Fragiska Sigala, Dimitrios A. Vrachatis, et al. "Quantitative analysis of carotid plaque vasa vasorum by CEUS and correlation with histology after endarterectomy." Vasa 42, no. 3 (2013): 184–95. http://dx.doi.org/10.1024/0301-1526/a000267.
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Background: Intraplaque neovascularization and vasa vasorum (VV) proliferation contribute in the progression and rupture of atherosclerotic lesions. Contrast Enhanced Ultrasonography (CEUS) has been reported to attain data regarding intraplaque neovessels and VV. However, whether the detection of microbubbles by CEUS within atherosclerotic plaques truly represents microvessels is a point of concern. We aimed to evaluate stable and unstable carotid artery plaque (CAP) VV pattern by CEUS and its correlation with histology and immunochemistry. Patients and methods: Patients with CAP scheduled for plaque endarterectomy were enrolled. CAP was initially identified by conventional ultrasonography and subsequently CEUS (harmonic ultrasound imaging with simultaneous intravenous contrast agent injection) was performed. The recorded image loops were evaluated by a semi-automated method. Plaque specimens were excised and underwent histological and immunochemical (for CD34, Vascular Endothelial Growth Factor, CD68 and CD3 antibodies) analysis. Results: Fourteen patients (67.6 ± 10.2 years, 10 males) with a 86.9 ± 11.5 % degree of carotid artery stenosis were evaluated. Histology showed that half of the plaques were unstable. Enhancement of plaque brightness on CEUS was significant for both stable and unstable plaque subgroups (p = 0.018 for both). Immunochemistry showed that microvessels, as assessed by CD34 antibody, were more dense in unstable vs. stable plaques (36.6 ± 17.4 vs. 13.0 ± 7.2 respectively, p = 0.002). However, correlation between plaque brigthness enhancement on CEUS and microvessel density was significant only for stable (r = 0.800, p = 0.031) plaques. Conclusions: The identification of brightness enhacement during CEUS in carotid atherosclerotic plaques may not always reflect the presence of VV.
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Pavlovics, Sergejs, Maija Radzina, Rita Niciporuka, et al. "Contrast-Enhanced Ultrasound Qualitative and Quantitative Characteristics of Parathyroid Gland Lesions." Medicina 58, no. 1 (2021): 2. http://dx.doi.org/10.3390/medicina58010002.
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Background and Objectives: preoperative differentiation of enlarged parathyroid glands may be challenging in conventional B-mode ultrasound. The aim of our study was to analyse qualitative and quantitative characteristics of parathyroid gland lesions, using multiparametric ultrasound protocol—B-mode, Colour Doppler (CD), and contrast-enhanced ultrasound (CEUS)—and to evaluate correlation with morphology in patients with hyperparathyroidism (HPT). Materials and Methods: consecutive 75 patients with 88 parathyroid lesions and biochemically confirmed HPT prior to parathyroidectomy were enrolled in the prospective study. B-mode ultrasound, CD, and CEUS were performed with the subsequent qualitative and quantitative evaluation of acquired data. We used 1 mL or 2 mL of intravenous ultrasound contrast agent during the CEUS examination. Correlation with post-surgical morphology was evaluated. Results: seventy parathyroid adenomas were hypoechoic and well contoured with increased central echogenicity (44.3%), peripheral-central vascularization (47%), and polar feeding vessel (100%). Twelve hyperplasias presented with similar ultrasound appearance and were smaller in volume (p = 0.036). Hyperplasias had a tendency for homogenous, marked intense enhancement vs. peripherally enhanced adenomas with central wash-out in CEUS after quantitative analysis. No significant difference was observed in contrasting dynamics, regardless of contrast media volume use (1 mL vs. 2 mL). We achieved 90.9% sensitivity and 72.7% specificity, 93% positive predictive value (PPV), 87.3% negative predictive value (NPV), and 87.3% accuracy in the differentiation of parathyroid lesions prior to post-processing. In a quantitative lesion analysis, our sensitivity increased up to 98%, specificity 80%, PPV 98%, and NPV 80% with an accuracy of 96.4%. Conclusions: CEUS of parathyroid lesions shows potential in the differentiation of adenoma from hyperplasia, regardless of the amount of contrast media injected. The quantitative analysis improved the sensitivity and specificity of differentiation between parathyroid lesions. Hyperplasia was characterized by homogeneous enhancement, fast uptake, and homogeneous wash-out appearance; adenoma—by peripheral uptake, central wash-out, and reduced hemodynamics. The use of CEUS quantification methods are advised to improve the ultrasound diagnostic role in suspected parathyroid lesions.
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Hu, Zhipeng, Rong Xue, Zhixi Liu, Liang Liu, and Zheli Gong. "Role of contrast-enhanced ultrasound with time-intensity curve analysis about thyroid nodule and parenchyma for differentiating BRAF V600E mutation status." PeerJ 13 (February 25, 2025): e19006. https://doi.org/10.7717/peerj.19006.
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Background The BRAF V600E mutation was proven associated with papillary thyroid cancer (PTC) which has more aggressive behavior and could affect the outcome of PTC. The objective of this study was to observe more contrast-enhanced ultrasound (CEUS) time-intensity curve (TIC)—based quantitative parameters in nodules and surrounding parenchyma and analyze the association between the TIC-based quantitative parameters and BRAF V600E mutation status in patients with PTC. Methods A retrospective analysis of 447 PTC patients was conducted. Prior to thyroidectomy or fine needle aspiration (FNA), all patients had CEUS and had their BRAF V600E mutations examined. Based on their mutation status, the patients were split into two groups. The two groups were compared in terms of sex, age, quantitative CEUS characteristics, pathological findings, vascular invasion, capsular invasion, and cervical lymph node metastases. Results A total of 240 patients were in the mutation negative group and 207 patients were in the BRAF mutation positive group. The BRAF-positive group exhibited significantly higher arrival time (AT) and time to peak enhancement (TTP) of the nodules, among other direct quantitative characteristics. The BRAF-positive mutant nodules showed significantly higher arrival time change and time to peak change compared to the surrounding parenchyma for indirect quantitative metrics. Conclusion The time-dependent quantitative parameters of CEUS time intensity curve in nodules and surrounding parenchyma have clinical value in distinguishing BRAF V600E mutation positive nodules from gene mutation negative nodules. Quantitative CEUS characteristics may be beneficial in detecting the BRAF V600E mutation status and informing the subsequent clinical choice.
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Han, Dan, Ting Wang, Ruiqi Wang, Jingyu Chen, and Yi Tang. "Application of Quantitative Parameters of Contrast-Enhanced Ultrasound in Common Benign and Malignant Lesions in Pediatric Livers: A Preliminary Study." Diagnostics 13, no. 22 (2023): 3443. http://dx.doi.org/10.3390/diagnostics13223443.
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We aimed to investigate the diagnostic utility of quantitative parameters of contrast-enhanced ultrasound (CEUS) for benign and malignant liver lesions in pediatric patients. This was a single-center retrospective analysis of children with liver lesions who underwent CEUS at our hospital between July 2019 and February 2023. The CEUS perfusion patterns for all lesions were qualitatively analyzed using histopathology, contrast-enhanced magnetic resonance imaging, contrast-enhanced computed tomography, or long-term clinical follow-up as reference standards. The CEUS images were quantitatively analyzed using SonoLiver® software (TomTec Imaging Systems, Munich, Germany) to obtain data regarding quantitative parameters and dynamic vascular pattern (DVP) parametric images, including rise time (RT), time to peak (TTP), mean transit time (mTT), and maximum intensity (IMAX). Statistical analysis was carried out using Student’s t-test and receiver operating characteristic (ROC) curve analysis to evaluate the diagnostic value of quantitative parameters. A total of 53 pediatric cases were included in this study, and 88.57% (31/35) of malignant lesions exhibited hyper-enhancement with rapid washout patterns; the same proportion of DVP parametric images exhibited washout patterns. Conversely, 94.44% (17/18) of benign lesions showed hyper-enhancement with slow washout patterns, and the same proportion of DVP parametric images showed no-washout patterns. RT, TTP, and mTT were significantly shorter in the malignant group than in the benign group (p < 0.05), while IMAX showed no significant difference (p > 0.05). ROC analysis indicated that mTT < 113.34 had the highest diagnostic value, with an area under the curve of 0.82. CEUS quantitative analysis had an accuracy of 98.11%, while qualitative analysis had an accuracy of 92.45%, with no statistically significant difference (p > 0.05). Quantitative analysis of CEUS provides valuable assistance in differentiating benign and malignant liver lesions in children. Among all quantitative parameters, mTT holds promise as a potentially valuable tool for identifying liver tumors.
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Lu, Qin, Huihui Sun, Qian Yu, and Dongdong Tang. "Analysis of Contrast-Enhanced Ultrasound and Elastography in the Diagnosis of Benign and Malignant Apocrine Breast Tumors." Journal of Medical Imaging and Health Informatics 11, no. 7 (2021): 1807–16. http://dx.doi.org/10.1166/jmihi.2021.3531.
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In the past thirty years, breast cancer in women has continued to rise. The age of onset for women has become lower. Contrast-enhanced ultrasound (CEUS) can clearly show the blood perfusion and neovascularization of breast masses. Elastography provides information on the stiffness of tissues. The combination of them shows a good advantage in the various early diagnosis of breast cancer. The combined electrograph can distinguish benign and malignant apocrine breast tumors. The shear wave electrograph (SWE) combined with CEUS has the strongest consistency in the diagnosis and pathology of breast benign tumors. When they were diagnosed separately, it was found that SWE has higher diagnostic value than CEUS; the quantitative diagnosis of SWE is slightly higher than the qualitative diagnosis, and the qualitative diagnosis of CEUS is higher than the quantitative diagnosis. Both SWE and CEUS are valuable in the diagnosis of benign and malignant apocrine breast tumor when combined treatment is made.
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Goertz, Ruediger S., Daniel Klett, Dane Wildner, Raja Atreya, Markus F. Neurath, and Deike Strobel. "Quantitative contrast-enhanced ultrasound for monitoring vedolizumab therapy in inflammatory bowel disease patients: a pilot study." Acta Radiologica 59, no. 10 (2018): 1149–56. http://dx.doi.org/10.1177/0284185117752032.
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Background Microvascularization of the bowel wall can be visualized and quantified non-invasively by software-assisted analysis of derived time-intensity curves. Purpose To perform software-based quantification of bowel wall perfusion using quantitative contrast-enhanced ultrasound (CEUS) according to clinical response in patients with inflammatory bowel disease treated with vedolizumab. Material and Methods In a prospective study, in 18 out of 34 patients, high-frequency ultrasound of bowel wall thickness using color Doppler flow combined with CEUS was performed at baseline and after 14 weeks of treatment with vedolizumab. Clinical activity scores at week 14 were used to differentiate between responders and non-responders. CEUS parameters were calculated by software analysis of the video loops. Results Nine of 18 patients (11 with Crohn’s disease and seven with ulcerative colitis) showed response to treatment with vedolizumab. Overall, the responder group showed a significant decrease in the semi-quantitative color Doppler vascularization score. Amplitude-derived CEUS parameters of mural microvascularization such as peak enhancement or wash-in rate decreased in responders, in contrast with non-responders. Time-derived parameters remained stable or increased during treatment in all patients. Conclusion Analysis of bowel microvascularization by CEUS shows statistically significant changes in the wash-in-rate related to response of vedolizumab therapy.
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Kaltenbach, T. E. M., T. Graeter, R. A. Mason, et al. "Determination of vitality of liver lesions by alveolar echinococcosis." Nuklearmedizin 54, no. 01 (2015): 43–49. http://dx.doi.org/10.3413/nukmed-0670-14-05.
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SummaryObjective of our study is qualitative and quantitative comparison of contrast enhanced ultrasound (CEUS) and 18F-FDG PETCT in monitoring hepatic alveolar echinococcosis (HAE). Parasitic liver lesions were examined regarding number, size, morphology, vascularization and metabolic activity. Patients, methods: 36 patients with medicallytreated HAE were included in this prospective clinical study. Abdominal ultrasound and CEUS were carried out using ultrasound contrast amplifier SonoVue®. As part of monitoring, patients were examined by 18F-FDG-PET-CT. Quantitative analysis of CEUS was performed using the Software Vue- Box™ Quantification Toolbox. Maximum contrast enhancement in lesions peak enhancement (PE) was used as parameter. For quantification of 18F-FDG PET-CT, maximum Standardized Uptake Value (SUVmax) of lesions was specified and statistically compared with PE. Results: 18F-FDG uptake in parasitic liver lesions was diagnosed by 18F-FDG PET-CT in 32 of 36 patients. Vascularization of liver lesions was detected by CEUS in 22 of 32 FDG-positive patients with sensitivity of 69% and specificity of 100%. Mean maximum diameter of lesions was 69.5mm in CEUS and 63.7mm in B-scan ultrasound (p < 0.0001). No significant correlation was found between SUVmax and PE (p = 0.8879). Conclusion: In comparison to FDG PET-CT, the gold standard for detecting viable lesions by depicting metabolism, CEUS detects viable lesions with high specificity and moderate sensitivity by showing vascularization. CEUS must be regarded as an important tool in monitoring HAE. Dimensions of parasitic lesions are displayed more precisely through CEUS than in B-scan. With currently available methods, CEUS quantification has no benefit in monitoring HAE lesions in daily clinical practice.
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Wakonig, Katharina Margherita, Markus Herbert Lerchbaumer, Steffen Dommerich, et al. "Assessment of Parotid Gland Tumors by Means of Quantitative Multiparametric Ultrasound (mpUS)." Diagnostics 13, no. 1 (2022): 12. http://dx.doi.org/10.3390/diagnostics13010012.
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Objective: The preoperative diagnostical differentiation of parotid gland tumor (PGT) is not always simple due to several different entities. B-mode-ultrasound (US) remains the imaging modality of choice, while histopathology serves as the gold standard for finalizing the diagnosis. We aimed to evaluate the use of multiparametric US (mpUS) in the assessment of PGT. Methods: We included 97 PGTs from 96 patients. A standardized mpUS protocol using B-mode-US, shear-wave elastography (SWE), and standardized contrast-enhanced ultrasound (CEUS) was performed prior to surgical intervention. SWE was assessed by real-time measurement conducting a minimum of five measurements, while quantitative CEUS parameters were assessed with a post-processing perfusion software. Results: SWE allowed differentiation between benign PGT (Warthin’s Tumor (WT) paired with lymph nodes (LN) and pleomorphic adenoma (PA)), and WT and LN were softer compared to PA. WT showed lower velocities than squamous cell carcinoma (SCC): the most common malignant PGT. CEUS parameters showed significant group differences between WT and PA, WT and malignant lesions, WT and SCC, WT paired with LN versus PA, and WT paired with LN versus SCC. Conclusion: MpUS seems to be beneficial in the assessment of PGT characterization, with benign PGT appearing to be softer in SWE than tumors with malignant tendencies. The quantitative CEUS parameter shows higher perfusion in WT than in PA, and malignant PGTs are less vascularized than WTs.
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Wang, Ling, and Chandra Mohan. "Contrast-enhanced ultrasound: A promising method for renal microvascular perfusion evaluation." Journal of Translational Internal Medicine 4, no. 3 (2016): 104–8. http://dx.doi.org/10.1515/jtim-2016-0033.
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Abstract This article reviews the application of contrast-enhanced ultrasound (CEUS) in gauging renal microvascular perfusion in diverse renal diseases. The unique nature of the contrast agents used in CEUS provides real-time and quantitative imaging of the vasculature. In addition to the traditional use of CEUS for evaluation of kidney masses, it also emerges as a safe and effective imaging approach to assess microvascular perfusion in diffuse renal lesions, non-invasively. Although the precise CEUS parameters that may best predict disease still warrant systematic evaluation, animal models and limited clinical trials in humans raise hopes that CEUS could outcompete competing modalities as a first-line tool for assessing renal perfusion non-invasively, even in ailments such as acute kidney injury and chronic kidney disease.
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Banzato, Tommaso, Silvia Burti, Giuseppe Rubini, et al. "Contrast-enhanced ultrasonography features of hepatobiliary neoplasms in cats." Veterinary Record 186, no. 10 (2019): 320. http://dx.doi.org/10.1136/vr.105453.
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BackgroundContrast-enhanced ultrasonography (CEUS) features of primary hepatobiliary neoplasms have been reported in dogs but no information is available in cats.MethodsQualitative and quantitative features of bile duct adenomas (BDAs, n=20), bile duct carcinomas (BDCs, n=16), and hepatocellular carcinomas (HCCs, n=8) are described in 44 cats.ResultsThere was an overlap in CEUS qualitative features between different histotypes, both in wash-in and wash-out phases. Distinction between different neoplasms based only on the CEUS qualitative features was not possible. At peak of enhancement, the BDAs, BDCs and HCCs showed a large range of echogenicities, from hypoenhancement to hyperenhancement, in comparison to the liver parenchyma. Eight of 20 BDAs showed inhomogeneous hyperenhancement during wash-in, which is a feature reported as typical of malignant lesions in dogs. BDC had a significantly faster wash-in compared with both BDA and HCC but the diagnostic accuracy of all the included quantitative variables was only moderate. No significant differences in the wash-out quantitative features of BDA and BDC were evident.ConclusionThere is poor evidence that CEUS may be used to distinguish between different primary hepatobiliary neoplasms in cats.
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Wang, Lan, Ming Li, Tiantian Dong, Yuanyuan Li, Ci Yin, and Fang Nie. "Pancreatic Ductal Adenocarcinoma: The Characteristics of Contrast-Enhanced Ultrasound Are Correlated with the Hypoxic Microenvironment." Diagnostics 13, no. 20 (2023): 3270. http://dx.doi.org/10.3390/diagnostics13203270.
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A hypoxic microenvironment is associated with an increased risk of metastasis, treatment resistance and poor prognosis of pancreatic ductal adenocarcinoma (PDAC). This study aimed to identify contrast-enhanced ultrasound (CEUS) characteristics that could predict the hypoxic microenvironment of PDAC. A total of 102 patients with surgically resected PDAC who underwent CEUS were included. CEUS qualitative and quantitative characteristics were analyzed. The expression of hypoxia-inducible factor-1α (HIF-1) and glucose transporter-1 (GLUT1) were demonstrated by immunohistochemistry. The associations between CEUS characteristics and the HIF-1α and GLUT1 expression of PDACs were evaluated. We found that HIF-1α-high PDACs and GLUT1-high PDACs had a larger tumor size and were more prone to lymph node metastasis. There was a significant positive linear correlation between the expression of HIF-1α and GLUT1. CEUS qualitative characteristics including completeness of enhancement and peak enhancement degree (PED) were related to the expression of HIF-1α and GLUT1. A logistic regression analysis showed that tumor size, lymph node metastasis, incomplete enhancement and iso-enhancement of PED were independent predictors for HIF-1α-high PDACs and GLUT1-high PDACs. As for quantitative characteristics, HIF-1α-high PDACs and GLUT1-high PDACs showed higher peak enhancement (PE) and wash-in rate (WIR). CEUS can effectively reflect the hypoxia microenvironment of PDAC, which may become a noninvasive imaging biomarker for prognosis prediction and individualized treatment.
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Sun, Jun, Fengyu Na, Bo Ma, Li Wang, Hanbing Shi, and Yan Ding. "Quantitative Parameters of Contrast-Enhanced Ultrasound Combined with Lung Biopsy Were Used to Evaluate the Benign and Malignant Lesions around the Lungs." Journal of Sensors 2021 (November 27, 2021): 1–14. http://dx.doi.org/10.1155/2021/2259408.
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In recent years, due to the influence of living habits and smoking, the number of lung cancer patients worldwide has increased year by year, and it has gradually developed into one of the common diseases endangering human life. CEUS can observe the lesion and realize the rapid identification of the location of the active area of the lesion. CEUS is the abbreviation of contrast-enhanced ultrasound technology. Contrast-enhanced ultrasound technology is to inject ultrasound contrast agent through a peripheral vein to perform ultrasound exploration to observe the enhancement of the internal nodules. Compared with color ultrasound, it can diagnose more accurately and improve the inspection effect. At present, this technology is used for the diagnosis of many types of space-occupying lesions, but it is rarely used for the diagnosis of lung lesions. The purpose of this study is to explore the role of CEUS quantitative parameters combined with lung biopsy in the assessment of benign and malignant peripheral lung diseases. Based on the relevant theoretical basis of CEUS and lung biopsy, 158 patients with peripheral lung disease were selected as experimental subjects, and they were divided into experimental group and control group for comparative experiments. Experiments proved the effectiveness of CEUS quantitative parameters combined with lung biopsy methods. The experimental results showed that, compared with the benign group, the time-intensity curve, the rise time, and the peak time of the malignant lesions were significantly prolonged. In addition, CEUS combined with the quantitative parameters of lung biopsy can effectively distinguish the activity of lung lesions and the site of necrosis and promote the effective increase of the positive rate of lung biopsy.
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da Silva, Natascha, Matthias Hornung, Lukas Beyer, et al. "Intraoperative Shear Wave Elastography vs. Contrast-Enhanced Ultrasound for the Characterization and Differentiation of Focal Liver Lesions to Optimize Liver Tumor Surgery." Ultraschall in der Medizin - European Journal of Ultrasound 40, no. 02 (2018): 205–11. http://dx.doi.org/10.1055/a-0649-1000.
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Abstract Purpose Assessment of intraoperative quantitative shear wave elastography (SWE) and contrast-enhanced ultrasound (CEUS) for the characterization of focal liver lesions (FLLs) during liver surgery using postoperative histopathological results as the gold standard. Materials and Methods US data of 79 consecutive patients with 98 FLLs who underwent liver surgery between 08/2015 – 06/2017 were prospectively acquired and retrospectively analyzed. Multifrequency linear/T-shaped probes (6 – 9 MHz) were used to store cine loops of at least 5 s and images of B-mode, SWE and CEUS. The first CEUS loop was continuously documented over 1 min. in each case. Quantitative SWE analysis of FLLs was performed by placing 5 regions of interest to measure shear wave speed (m/s) and stiffness (kPa). CEUS was evaluated during the arterial, portal venous and late phase after i. v. bolus injections of 2.4 – 10 ml sulfur hexafluoride microbubbles. Postoperative histopathology after tumor resection or intraoperative biopsy was obtained to confirm findings of SWE and CEUS. Results Of 98 FLLs in 79 patients (mean age: 58 years sd ± 12y) 88 were malignant and 10 were benign ranging from 0.69 to 15.2 cm in size (mean: 2.8 cm, sd ± 2.25 cm). SWE characterized 73/88 FLLs correctly as malignant and 7/10 as benign using a cut-off value of 2.5 m/s/21.3 kPa (p < 0.0005). The sensitivity was 83 %, specificity 70 %, accuracy 82 %. CEUS could correctly identify 86/88 malignant and 8/10 benign FLLs. The sensitivity was 98 %, specificity 80 %, accuracy 96 %. SWE could correctly identify 2 malignant FLLs which CEUS falsely characterized as benign. Conclusion Intraoperative CEUS and SWE are excellent tools for the highly accurate visualization, characterization and malignancy assessment of hepatic tumors during liver surgery.
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Hillaert, Amber, Emmelie Stock, Sophie Favril, Luc Duchateau, Jimmy H. Saunders, and Katrien Vanderperren. "Intra- and Inter-Observer Variability of Quantitative Parameters Used in Contrast-Enhanced Ultrasound of Kidneys of Healthy Cats." Animals 12, no. 24 (2022): 3557. http://dx.doi.org/10.3390/ani12243557.
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Contrast-enhanced ultrasound (CEUS) is a non-invasive imaging technique which allows qualitative and quantitative assessment of tissue perfusion. Although CEUS offers numerous advantages, a major challenge remains the variability in tissue perfusion quantification. This study aimed to assess intra- and inter-observer variability for quantification of renal perfusion. Two observers with different levels of expertise performed a quantitative analysis of 36 renal CEUS studies, twice. The CEUS data were collected from 12 healthy cats at 3 different time points with a 7-day interval. The inter- and intra-observer agreement was assessed by the intraclass correlation coefficient. Within and between observers, a good agreement was demonstrated for intensity-related parameters in the cortex, medulla, and interlobular artery. For some parameters, ICCinter was considerably lower than ICCintra, mostly when the ROI encompassed the entire kidney or medulla. With the exception of time to peak (TTP) and mean transit time (mTTI), time-related and slope-related parameters showed poor agreement among observers. In conclusion, it may be advised against having the quantitative assessment of renal perfusion performed by different observers, especially if their experience levels differ. The cortical mTTI seemed to be the most appropriate parameter as it showed a favorable inter-observer agreement and inter-period agreement.
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Tantawi, Mohamed, Susan Shamimi-Noori, Colette M. Shaw, and John R. Eisenbrey. "State of the Art: Contrast Enhanced 4D Ultrasound to Monitor or Assess Locoregional Therapies." Digestive Disease Interventions 06, no. 01 (2022): 003–12. http://dx.doi.org/10.1055/s-0041-1741520.
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AbstractLocoregional therapies (LRTs) are an essential management tool in the treatment of primary liver cancers or metastatic liver disease. LRTs include curative and palliative modalities. Monitoring treatment response of LRTs is crucial for maximizing benefit and improving clinical outcomes. Clinical use of contrast-enhanced ultrasound (CEUS) was introduced more than two decades ago. Its portability, cost effectiveness, lack of contraindications and safety make it an ideal tool for treatment monitoring in numerous situations. Two-dimensional dynamic CEUS has been proved to be equivalent to the current imaging standard in the guidance of LRTs, assessment of their adequacy, and detection of early tumor recurrence. Recent technical advances in ultrasound transducers and image processing have made 3D CEUS scanning widely available on most commercial ultrasound systems. 3D scanning offers a broad multiplanar view of anatomic structures, overcoming many limitations of two-dimensional scanning. Furthermore, many ultrasound systems provide real-time dynamic 3D CEUS, also known as 4D CEUS. Volumetric CEUS has shown to perform better than 2D CEUS in the assessment and monitoring of some LRTs. CEUS presents a valid alternative to the current imaging standards with reduced cost and decreased risk of complications. Future efforts will be directed toward refining the utility of 4D CEUS through approaches such as multi-parametric quantitative analysis and machine learning algorithms.
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Macrì, Francesco, Vito Angileri, Teresa Russo, Maria Tomiko Russo, Marco Tabbì, and Simona Di Pietro. "Evaluation of Bone Healing Using Contrast-Enhanced Ultrasonography in Non-Operative Treatment of Tibial Fracture in a Puppy Dog." Animals 11, no. 2 (2021): 284. http://dx.doi.org/10.3390/ani11020284.
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A 10-month-old mixed-breed male dog was presented with an oblique tibial fracture. The dog was treated with a Robert Jones-like bandage as a conservative approach, and was subjected to X-ray, B-mode, Color Doppler and contrast-enhanced ultrasound (CEUS) examinations during the fracture healing, in order to assess bone hemodynamic changes. B-mode, Power Doppler and CEUS examinations of the fracture gap were performed at 7, 20, 35, and 50 days post-trauma. Quantitative analysis of CEUS and perfusion parameters were obtained. On CEUS, a steep incline in signal numbers was visible in fracture gap at 7 days with peaks at 35 days, after which the vascularization decreases gradually over the next days. In this study, CEUS provided important information on the early stages of the callus formation and on the healing of neighboring tissues, allowing recognition of a correct bone healing. Moreover, the number of vascular signals on CEUS was greater than that on Doppler images on the same day. This report showed the application of CEUS in controlling the fracture healing process. CEUS could be a method of monitoring the remedial processes, assessing the tibial fracture perfusion characterized by low-velocity, small-volume blood flows.
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Sharma, Anant, Shabnam Bhandari Grover, Chinta Mani, and Charanjeet Ahluwalia. "Contrast enhanced ultrasound quantitative parameters for assessing neoadjuvant chemotherapy response in patients with locally advanced breast cancer." British Journal of Radiology 94, no. 1121 (2021): 20201160. http://dx.doi.org/10.1259/bjr.20201160.
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Objectives: To evaluate the role of contrast-enhanced ultrasound (CEUS) quantitative parameters in predicting neoadjuvant chemotherapy (NACT) response in patients with locally advanced breast cancer (LABC). Methods: 30 patients with histologically proven LABC scheduled for NACT were recruited. CEUS was performed using a contrast bolus of 4.8 ml and time intensity curves (TICs) were obtained by contrast dynamics software. CEUS quantitative parameters assessed were peak enhancement (PE), time-to-peak (TTP), area under the curve (AUC) and mean transit time (MTT). The parameters were documented on four consecutive instances: before NACT and 3 weeks after each of the three cycles. The gold-standard was pathological response using Miller Payne Score obtained pre NACT and post-surgery. Results: A decrease in mean values of PE and an increase in mean values of TTP and MTT was observed with each cycle of NACT among responders. Post each cycle of NACT (compared with baseline pre-NACT), there was a statistically significant difference in % change of mean values of PE, TTP and MTT between good responders and poor responders (p-value < 0.05). The diagnostic accuracy of TTP post-third cycle was 87.2% (p = 0.03), and MTT post--second and third cycle was 76.7% (p = 0.004) and 86.7% (p = 0.006) respectively. Conclusion: In responders, a decrease in the tumor vascularity was reflected in the CEUS quantitative parameters as a reduction in PE, and a prolongation in TTP, MTT. Advances in knowledge: Prediction of NACT response by CEUS has the potential to serve as a diagnostic modality for modification of chemotherapy regimens during ongoing NACT among patients with LABC, thus affecting patient prognosis.
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Dong, Yi, Yijie Qiu, Daohui Yang, et al. "Potential application of dynamic contrast enhanced ultrasound in predicting microvascular invasion of hepatocellular carcinoma." Clinical Hemorheology and Microcirculation 77, no. 4 (2021): 461–69. http://dx.doi.org/10.3233/ch-201085.
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OBJECTIVE: To investigate the clinical value of dynamic contrast enhanced ultrasound (D-CEUS) in predicting the microvascular invasion (MVI) of hepatocellular carcinoma (HCC). PATIENTS AND METHODS: In this retrospective study, 16 patients with surgery and histopathologically proved HCC lesions were included. Patients were classified according to the presence of MVI: MVI positive group (n = 6) and MVI negative group (n = 10). Contrast enhanced ultrasound (CEUS) examinations were performed within a week before surgery. Dynamic analysis was performed by VueBox® software (Bracco, Italy). Three regions of interests (ROIs) were set in the center of HCC lesions, at the margin of HCC lesions and in the surrounding liver parenchyma accordingly. Time intensity curves (TICs) were generated and quantitative perfusion parameters including WiR (wash-in rate), WoR (wash-out rate), WiAUC (wash-in area under the curve), WoAUC (wash-out area under the curve) and WiPi (wash-in perfusion index) were obtained and analyzed. RESULTS: All of HCC lesions showed arterial hyperenhancement (100 %) and at the late phase as hypoenhancement (75%) in CEUS. Among all CEUS quantitative parameters, the WiAUC and WoAUC were higher in MVI positive group than in MVI negative group in the center HCC lesions (P < 0.05), WiAUC, WoAUC and WiPI were higher in MVI positive group than in MVI negative group at the margin of HCC lesions. WiR and WoR were significant higher in MVI positive group. CONCLUSIONS: D-CEUS with quantitative perfusion analysis has potential clinical value in predicting the existence of MVI in HCC lesions.
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Cantisani, Vito, Nicola Di Leo, Emanuele David, and Dirk-André Clevert. "Role of CEUS in Vascular Pathology." Ultraschall in der Medizin - European Journal of Ultrasound 42, no. 04 (2021): 348–66. http://dx.doi.org/10.1055/a-1403-2400.
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AbstractIn recent years, the implementation of contrast-enhanced ultrasound (CEUS) in clinical practice has opened new horizons in the arterial pathologies research field, since this technique is able to supply new sets of data that can be crucial in patient management. The main applications of CEUS in the arterial system are the detection, characterization, and follow-up of carotid plaques and endoleaks after EVAR. Other situations in which CEUS was demonstrated to be a useful tool are large vessel vasculitis, dissections, and untreated aneurysms. In carotid atherosclerosis CEUS is not only able to acquire quantitative data about stenosis but also to perform a qualitative assessment of the plaque. The most important plaque features that CEUS is able to depict are ulceration, neovascularization, and the presence of inflammatory infiltrates. All of these factors contribute to plaque vulnerability. Thus, CEUS is crucial in order to allow better risk stratification and management of patients. In follow-up after EVAR, CEUS shows sensitivity and specificity values similar to CTA while ensuring several advantages, such as lower cost and the absence of ionizing radiation and nephrotoxic agents. Moreover, CEUS is able to offer real-time evaluation of endoleaks and thus is a useful tool in cases that are ambiguous on CTA. Most limitations are patient-related and are the same as in all other ultrasound techniques, such as high BMI and meteorism.
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Haimerl, M., S. Poelsterl, L. P. Beyer, et al. "Chronic liver disease: Quantitative MRI vs CEUS-based microperfusion." Clinical Hemorheology and Microcirculation 64, no. 3 (2017): 435–46. http://dx.doi.org/10.3233/ch-168112.
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Hillaert, Amber, Emmelie Stock, Luc Duchateau, Hilde de Rooster, Nausikaa Devriendt, and Katrien Vanderperren. "B-Mode and Contrast-Enhanced Ultrasonography Aspects of Benign and Malignant Superficial Neoplasms in Dogs: A Preliminary Study." Animals 12, no. 20 (2022): 2765. http://dx.doi.org/10.3390/ani12202765.
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Contrast-enhanced ultrasonography (CEUS) is considered a promising technique for differentiation of benign and malignant tumors in humans. However, few studies have assessed superficial neoplasms in dogs by means of CEUS. The aim of this study was to identify ultrasonographic criteria evaluated by B-mode ultrasound (US) and CEUS that may be used to distinguish benign and malignant superficial neoplasms in dogs. A total of 63 superficial neoplasms from 59 dogs were evaluated using B-mode US and CEUS prior to histopathologic examination. Qualitative and quantitative parameters were compared between benign and malignant neoplasms by Fischer’s exact test or fixed effects model. With B-mode US, a significant difference was found for border definition, echogenicity and echotexture. With CEUS, a significant difference was found for the enhancement pattern at wash-in and the wash-out area under the curve at the center of the neoplasm. Malignant neoplasms had on average a lower regional blood volume during the wash-out phase compared to benign neoplasms. Despite these significant differences, there was a considerable overlap in B-mode and CEUS parameters between benign and malignant neoplasms. In conclusion, B-mode US and CEUS might contribute to malignancy prediction; however, based on individual ultrasonographic parameters, they seem unable to replace cytology or histopathology.
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Evdokimenko, A. N., A. O. Chechetkin, L. D. Druina, and M. M. Tanashyan. "Contrast-enhanced ultrasonography for assessing neovascularization of carotid atherosclerotic plaque." Exosomes, no. 4 (July 31, 2019): 24–31. http://dx.doi.org/10.24075/brsmu.2019.057.
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Neovascularization of a carotid atherosclerotic plaque (AP) is associated with an increased risk of stroke. Contrast-enhanced ultrasonography (CEUS) is a widely used method for imaging intraplaque neovascularization in vivo. Unfortunately, there are no standardized guidelines for CEUS interpretation. The aim of this study was to identify the most reliable method for CEUS-based assessment of AP neovascularization. Seventy-eight AP were removed during carotid endarterectomy in 73 patients, of whom 5 had AP on both sides, and examined morphologically. All patients underwent preoperative duplex scanning and CEUS; Sonovue was used as a contrast agent. AP neovascularization was assessed on a 4-grade visual scale and with 3 different quantitative methods using QLAB software. On the visual scale (method 1), poorly (37%) and moderately (51%) vascularized plaques were the most common. Quantitative analysis (data were presented as Me (Q1; Q3)) revealed that the number of blood vessels per 1 cm2 of the plaque (method 2) was 16 (10; 26), the ratio of the total vessel area to the plaque area (method 3) was 6% (3; 9), and AP ROI (method 4) was 2.6 dB (1.8; 4.1). Significant correlations were demonstrated between the results produced by method 2 and method 3 (р < 0.0001), method 3 and method 2 (p = 0.0006), and between pathomorphological findings and the results produced by methods 1–3, especially method 2 (p < 0.004). AP ROI brightness did not correlate with other results. The presence of hyperechoic components (calcifications) in AP dramatically reduced the reliability of US-based intraplaque neovascularization assessment. The most accurate CEUS-based quantitative method for assessing intraplaque neovascularization is estimation of blood vessel number per 1 cm2 of the plaque.
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Quartuccio, Marco, Luigi Liotta, Santo Cristarella, et al. "Contrast-Enhanced Ultrasound in Cystic Endometrial Hyperplasia–Pyometra Complex in the Bitch: A Preliminary Study." Animals 10, no. 8 (2020): 1368. http://dx.doi.org/10.3390/ani10081368.
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In cystic endometrial hyperplasia (CEH)–pyometra syndrome, toxic factors and endometrial remodeling culminate in changes characterized by exudative and degenerative inflammatory reaction. Recent studies on hemodynamic found an increased blood flow and lower vascular resistance in uterine arteries, suggesting color Doppler ultrasound as an adjunctive tool for quantitative assessment of endometrial vascularization during pyometra. The aim of this study was to assess, through contrast-enhanced ultrasound (CEUS) exam, the vascularization in endometrial microvessels in CEH-pyometra in order to evaluate the possibility of application in this syndrome. In twelve female dogs with clinical symptoms related to pyometra, B-mode, color Doppler and CEUS exams were performed. In CEH-pyometra uteri, histopathological examination revealed severe CEH and pyometra, immunohistochemical stain with CD 34 confirmed the presence of angiogenesis. CEUS exams revealed a widespread, intense and rapidly developing homogeneous enhancement of the hyperplastic endometrium, with absence of signal only in cystic areas. All parameters of the quantitative analysis were not significantly influenced by region of interest dimension and position. CEUS has the potential to improve clinical not invasive evaluations in the CEH-pyometra syndrome and virtually in CEH-mucometra.
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Petrasova, Hana, Radka Slaisova, Tomas Rohan, et al. "Contrast-Enhanced Ultrasonography for Differential Diagnosis of Benign and Malignant Thyroid Lesions: Single-Institutional Prospective Study of Qualitative and Quantitative CEUS Characteristics." Contrast Media & Molecular Imaging 2022 (April 23, 2022): 1–10. http://dx.doi.org/10.1155/2022/8229445.
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Objectives. To extend and revise the diagnostic value of contrast-enhanced ultrasonography (CEUS) for differentiation between malignant and benign thyroid nodules. Methods. This single-institution prospective study aims to compare CEUS qualitative and objective quantitative parameters in benign and malignant thyroid nodules. Consecutive cohort of 100 patients was examined by CEUS, 68 out of them were further analysed in detail. All included patients underwent cytological and/or histopathological verification of the diagnosis. Results. Fifty-five (81%) thyroid nodules were benign, and 13 (19%) were malignant. Ring enhancement pattern was strongly associated with a benign aetiology (positive predictive value 100%) and heterogeneous enhancement pattern with malignant aetiology (positive predictive value 72.7%). The shape of the TIC (time-intensity curve) was more often identical in the benign lesion (98.2%) than in malignant lesions (69.2%), p = 0.004 . Conclusions. This study indicates that CEUS enhancement patterns were significantly different in benign and malignant lesions. Ring enhancement was a very strong indicator of benign lesions, whereas heterogeneous enhancement was valuable to detect malignant lesions.
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Cicirelli, Vincenzo, Francesco Macrì, Simona Di Pietro, Raffaella Leoci, Giovanni Michele Lacalandra, and Giulio Guido Aiudi. "Use of Contrast-Enhanced Ultrasound of the Testes after Non-Surgical Sterilization of Male Dogs with CaCl2 in Alcohol." Animals 12, no. 5 (2022): 577. http://dx.doi.org/10.3390/ani12050577.
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Sterilization by intratesticular injection of chemical agents is a non-surgical alternative to neutering male companion animals. We used contrast-enhanced ultrasound (CEUS) to monitor vascular alterations to testes immediately after the intratesticular injection of CaCL2 in alcohol. We evaluated the CEUS features of normal and damaged testes in 20 dogs after the intratesticular injection of CaCl2. The CEUS evaluation was performed at the site of the chemical agent inoculation. In treated testes, qualitative CEUS showed a lower intensity enhancement of the parenchyma than pre-treatment normal testes with a predominantly anechoic pattern and only a few hyperechoic vascular focal spots. Quantitative CEUS showed significantly lower values of time-intensity curve (TIC) parameters, including signal intensity (Peak: 4.72 ± 2.1), regional blood volume (RBV: 134.3 ± 63.7), and regional blood flow (RBF: 4.36 ± 2.18) than normal testes (p < 0.001). Sonographic findings from CEUS showed hypovascularization of the canine testicular parenchyma caused by the hardening agent. This diagnostic technique helps clinicians define testicular vascular alterations achieved by chemical castration more efficiently. Nevertheless, more studies are required to apply this methodology to more subjects with a broader weight range and stray dogs.
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Maxeiner, Andreas, Thomas Fischer, Julia Schwabe, et al. "Contrast-Enhanced Ultrasound (CEUS) and Quantitative Perfusion Analysis in Patients with Suspicion for Prostate Cancer." Ultraschall in der Medizin - European Journal of Ultrasound 40, no. 03 (2018): 340–48. http://dx.doi.org/10.1055/a-0594-2093.
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Abstract Purpose The aim of this study was to investigate contrast-enhanced ultrasound (CEUS) parameters acquired by software during magnetic resonance imaging (MRI) US fusion-guided biopsy for prostate cancer (PCa) detection and discrimination. Materials and Methods From 2012 to 2015, 158 out of 165 men with suspicion for PCa and with at least 1 negative biopsy of the prostate were included and underwent a multi-parametric 3 Tesla MRI and an MRI/US fusion-guided biopsy, consecutively. CEUS was conducted during biopsy with intravenous bolus application of 2.4 mL of SonoVue® (Bracco, Milan, Italy). In the latter CEUS clips were investigated using quantitative perfusion analysis software (VueBox, Bracco). The area of strongest enhancement within the MRI pre-located region was investigated and all available parameters from the quantification tool box were collected and analyzed for PCa and its further differentiation was based on the histopathological results. Results The overall detection rate was 74 (47 %) PCa cases in 158 included patients. From these 74 PCa cases, 49 (66 %) were graded Gleason ≥ 3 + 4 = 7 (ISUP ≥ 2) PCa. The best results for cancer detection over all quantitative perfusion parameters were rise time (p = 0.026) and time to peak (p = 0.037). Within the subgroup analysis (> vs ≤ 3 + 4 = 7a (ISUP 2)), peak enhancement (p = 0.012), wash-in rate (p = 0.011), wash-out rate (p = 0.007) and wash-in perfusion index (p = 0.014) also showed statistical significance. Conclusion The quantification of CEUS parameters was able to discriminate PCa aggressiveness during MRI/US fusion-guided prostate biopsy.
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Schwarz, Sonja, Dirk-André Clevert, Michael Ingrisch, et al. "Quantitative Analysis of the Time–Intensity Curve of Contrast-Enhanced Ultrasound of the Liver: Differentiation of Benign and Malignant Liver Lesions." Diagnostics 11, no. 7 (2021): 1244. http://dx.doi.org/10.3390/diagnostics11071244.
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Background: To evaluate the diagnostic accuracy of quantitative perfusion parameters in contrast-enhanced ultrasound to differentiate malignant from benign liver lesions. Methods: In this retrospective study 134 patients with a total of 139 focal liver lesions were included who underwent contrast enhanced ultrasound (CEUS) between 2008 and 2018. All examinations were performed by a single radiologist with more than 15 years of experience using a second-generation blood pool contrast agent. The standard of reference was histopathology (n = 60), MRI or CT (n = 75) or long-term CEUS follow up (n = 4). For post processing regions of interests were drawn both inside of target lesions and the liver background. Time–intensity curves were fitted to the CEUS DICOM dataset and the rise time (RT) of contrast enhancement until peak enhancement, and a late-phase ratio (LPR) of signal intensities within the lesion and the background tissue, were calculated and compared between malignant and benign liver lesion using Student’s t-test. Quantitative parameters were evaluated with respect to their diagnostic accuracy using receiver operator characteristic curves. Both features were then combined in a logistic regression model and the cumulated accuracy was assessed. Results: RT of benign lesions (14.8 ± 13.8 s, p = 0.005), and in a subgroup analysis, particular hemangiomas (23.4 ± 16.2 s, p < 0.001) differed significantly to malignant lesions (9.3 ± 3.8 s). The LPR was significantly different between benign (1.59 ± 1.59, p < 0.001) and malignant lesions (0.38 ± 0.23). Logistic regression analysis with RT and LPR combined showed a high diagnostic accuracy of quantitative CEUS parameters with areas under the curve of 0.923 (benign vs. malignant) and 0.929 (hemangioma vs. malignant. Conclusions: Quantified CEUS parameters are helpful to differentiate malignant from benign liver lesions, in particular in case of atypical hemangiomas.
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Nedelmann, Max, Nouha Ritschel, Simone Doenges, et al. "Combined Contrast-Enhanced Ultrasound and rt-PA Treatment is Safe and Improves Impaired Microcirculation after Reperfusion of Middle Cerebral Artery Occlusion." Journal of Cerebral Blood Flow & Metabolism 30, no. 10 (2010): 1712–20. http://dx.doi.org/10.1038/jcbfm.2010.82.
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In monitoring of recanalization and in sonothrombolysis, contrast-enhanced ultrasound (CEUS) is applied in extended time protocols. As extended use may increase the probability of unwanted effects, careful safety evaluation is required. We investigated the safety profile and beneficial effects of CEUS in a reperfusion model. Wistar rats were subjected to filament occlusion of the right middle cerebral artery (MCA). Reperfusion was established after 90 minutes, followed by recombinant tissue-type plasminogen activator (rt-PA) treatment and randomization to additional CEUS (contrast agent: SonoVue; 60 minutes). Blinded outcome evaluation consisted of magnetic resonance imaging (MRI), neurologic assessment, and histology and, in separate experiments, quantitative 3D nano-computed tomography (CT) angiography (900 nm3 voxel size). Nano-CT revealed severely compromised microcirculation in untreated animals after MCA reperfusion. The rt-PA partially improved hemispheric perfusion. Impairment was completely reversed in animals receiving rt-PA and CEUS. This combination was more effective than treatment with either CEUS without rt-PA or rt-PA and ultrasound or ultrasound alone. In MRI experiments, CEUS and rt-PA treatment resulted in a significantly reduced ischemic lesion volume and edema formation. No unwanted effects were detected on MRI, histology, and intracranial temperature assessment. This study shows that CEUS and rt-PA is safe in the situation of reperfusion and displays beneficial effects on the level of the microvasculature.
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Lerchbaumer, Markus H., Katharina Margherita Wakonig, Philipp Arens, Steffen Dommerich, and Thomas Fischer. "Quantitative Multiparametric Ultrasound (mpUS) in the Assessment of Inconclusive Cervical Lymph Nodes." Cancers 14, no. 7 (2022): 1597. http://dx.doi.org/10.3390/cancers14071597.
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Background: Enlarged cervical lymph nodes (CLN) are preferably examined by ultrasound (US) by using criteria such as size and echogenicity to assess benign and suspicious CLN, which should be histologically evaluated. This study aims to assess the differentiation of malign and benign CLN by using multiparametric US applications (mpUS). Methods: 101 patients received a standardized US protocol prior to surgical intervention using B-mode–US, shear-wave elastography (SWE) and contrast-enhanced ultrasound (CEUS). SWE was assessed by 2D real-time SWE conducting a minimum of five measurements, CEUS parameters were assessed with post-processing perfusion software. Histopathological confirmation served as the gold standard. Results: B-mode–US and SWE analysis of 104 CLN (36 benign, 68 malignant) showed a significant difference between benign and malignant lesions, presenting a larger long axis and higher tissue stiffness (both p < 0.001). Moreover, tissue stiffness assessed by SWE was significantly higher in CLN with regular B-mode–US criteria (Solbiati Index > 2 and short-axis < 1 cm, p < 0.001). No perfusion parameter on CEUS showed a significant differentiation between benign and malignant CLN. Discussion: As the only multiparametric parameter, SWE showed higher tissue stiffness in malignant CLN, also in subgroups with regular B-mode criteria. This fast and easy application may be a promising noninvasive tool to US examination to ameliorate the sonographic differentiation of inconclusive CLN.
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Tikhankova, A. V., A. V. Borsukov, A. O. Buyeverov, V. V. Ivanov, and Yu V. Ivanov. "Improved methods of the contrast-enhanced ultrasound in patient with chronic viral hepatitis." Journal of Clinical Practice 10, no. 1 (2019): 4–9. http://dx.doi.org/10.17816/clinpract1014-9.
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Rationale. The article presents the data obtained by an improved method of contrast-enhanced ultrasound (CEUS) in patients with chronic viral hepatitis.
 Methods. We compared the quantitative and qualitative CEUS parameters in 2 groups of patients: the 1st group was administered 2.5 ml of the contrast agent, and the 2nd group was administered 1.0 ml of the contrast agent.
 Results. The results showed that the quantitative parameters had no statistical differences in the arterial and portal phases.
 Conclusion. The parameters of the late venous phase were not clinically significant, since the study objective included the assessment of diffuse liver disease, not focal liver lesions.
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Li, Hongbo, Hui Huang, Yun Luan, Niu Liu, Hui Gao, and Huijuan Sun. "Contrast-Enhanced Ultrasonography Characteristics in the Evaluation of Different Nature of Carotid Artery Plaques." Journal of Medical Imaging and Health Informatics 10, no. 3 (2020): 688–92. http://dx.doi.org/10.1166/jmihi.2020.2919.
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To investigate the value of contrast-enhanced ultrasonography (CEUS) in the evaluation of neovascular density in plaques with different carotid atherosclerosis. 97 patients with carotid plaques were observed by conventional ultrasound from January 2016 to December 2018. The CEUS test was used to grade and quantify the new blood vessels in the plaque. The results showed of the 97 patients with 101 plaques, 49 were soft plaques, 45 were mixed plaques, and 7 were hard plaques. CEUS clearly showed the continuity of plaque fibrous caps and found plaque ulcers that were easily missed by conventional ultrasound. The lower the echo of the plaque, the more obvious contrast enhancement in the plaques. Quantitative analysis of CEUS showed the peak time of soft plaques was shorter and the peak intensity of soft plaques was higher compared with mixed plaques. The difference was statistically significant (P <0.01). The results displayed that carotid CEUS is a convenient and intuitive new technology that can better help analyze plaque morphology and determine and quantify the extent of neovascularization in plaque. It can be used for clinical evaluation of potential cerebrovascular risk and also provides an accurate and reproducible detection method for clinical efficacy evaluation.
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Rogalska, Marta, Lukasz Antkowiak, Anna Kasperczuk, and Wojciech Scierski. "Contrast-Enhanced Ultrasound in the Differentiation between the Most Common Benign Parotid Gland Tumors: A Systematic Review and Meta-Analysis." Journal of Clinical Medicine 11, no. 24 (2022): 7360. http://dx.doi.org/10.3390/jcm11247360.
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Recently, contrast-enhanced ultrasound (CEUS) has become a promising tool in distinguishing benign from malignant parotid gland tumors. However, its usefulness in differentiating various benign parotid tumors has not been determined so far. This study aimed to systematically review the literature to determine the utility of CEUS in the preoperative differentiation between pleomorphic adenomas (PAs) and Warthin’s tumors (WTs) of the parotid gland. PubMed, Embase, and Cochrane were searched for English-language articles published until 21 July 2022. Fifteen studies were included. On CEUS examination, a significantly greater percentage of PAs displayed heterogeneous enhancement texture compared to WTs. Contrarily, the enhanced lesion size, the enhancement margin, and the presence of the enhancement rim did not differ significantly between the entities. Significantly longer normalized mean transit time (nMTT) and time to peak (TTP) were observed in PAs. Contrarily, the mean values of area under the curve (AUC) and time from peak to one half (TPH) were significantly higher for WTs. Due to the considerable overlap among the qualitative CEUS characteristics of PAs and WTs, the reproducible, investigator-independent quantitative CEUS measurements have a greater potential to distinguish PAs from WTs, which might influence the selection of an appropriate management strategy.
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Marticorena Garcia, S., J. Schwabe, E. Jung, and T. Fischer. "Quantitative Perfusionsanalyse mittels Kontrastmittelsonografie (CEUS) zur Differenzierung eines aggressiven Prostatakarzinoms." RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren 189, S 01 (2017): S1—S124. http://dx.doi.org/10.1055/s-0037-1600496.
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Weber, Marc-André, Martin Krix, and Stefan Delorme. "Quantitative evaluation of muscle perfusion with CEUS and with MR." European Radiology 17, no. 10 (2007): 2663–74. http://dx.doi.org/10.1007/s00330-007-0641-y.
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Ma, Jiuyi, Ying Fu, Xiangmei Chen, et al. "Utilizing the Postvascular Phase of Contrast-Enhanced Ultrasound to Predict Breast Cancer Lymph Node Metastasis." Medicina 60, no. 11 (2024): 1780. http://dx.doi.org/10.3390/medicina60111780.
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Background and Objectives: To evaluate the value of the postvascular phase of contrast-enhanced ultrasound (CEUS) in differentiating between benign and metastatic lymph nodes (LNs) in patients with breast cancer (BC). Materials and Methods: This study retrospectively analyzed 96 suspicious LNs in the lymphatic drainage area of the breast from 90 patients with BC. All LNs were assessed by conventional ultrasound (US) and CEUS following intravenous Sonazoid injection. All LNs underwent puncture biopsy, and pathological results were obtained. The correlations between US and CEUS indicators of LNs and LN metastasis (LNM) were analyzed. Results: Of the 96 LNs, 66 were metastatic. Overall, 80.00% (24/30) of the benign LNs exhibited relative hyper-enhancement in the postvascular phase, whereas 96.97% (64/66) of the metastatic LNs exhibited relative hypo-enhancement (p < 0.001). This CEUS finding was highly predictive of metastasis, with a sensitivity of 96.97%, specificity of 80.00%, positive predictive value of 91.43%, negative predictive value of 92.31%, and accuracy of 91.67%. The mean postvascular phase intensity (MPI) was significantly lower for malignant (median MPI, 12 dB) than for benign (median MPI, 75 dB) LNs. The postvascular phase was more sensitive, specific, and accurate than conventional US or the vascular phase of CEUS for the diagnosis of LNM, with an area under the curve of 0.95 (95% confidence interval: 0.89–0.99). Conclusions: Qualitative and quantitative indicators of the postvascular phase of CEUS provide a reliable diagnostic approach to differentiate benign and metastatic LNs in patients with BC.
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Han, Seul Ki, Soon Koo Baik, and Moon Young Kim. "New Applications of Contrast-Enhanced Ultrasound for Hepatic Fibrosis and Portal Hypertension." Clinical Ultrasound 8, no. 2 (2023): 66–71. http://dx.doi.org/10.18525/cu.2023.8.2.66.
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Liver biopsy and measurement of hepatic venous pressure gradient in patients with cirrhosis are the gold standards for estimation of hepatic fibrosis, and they have diagnostic and prognostic value. However, both approaches are invasive and cannot be used repeatedly in clinical practice. Ultrasonography (US) is safe, easy to perform, inexpensive, and yields numerical and accurate results. Contrast-enhanced US (CEUS) using second-generation microbubble ultrasonography agents (USA) is able to show the vascular structure and enhancement pattern of lesions and can be used in the diagnosis of hepatocellular carcinoma (HCC) due to its characteristic neovascularization. Beyond the diagnosis of HCC, functional US indices based on CEUS have been suggested as promising markers for fibrosis and portal hypertension (PH). Although investigations of the reproducibility and long-term prognostic value are needed, CEUS-based indices are promising quantitative non-invasive tests to estimate the severity of hepatic fibrosis and PH. Therefore, in this study, we describe the characteristics of second-generation microbubble USA and the usefulness of CEUS-based indices for hepatic fibrosis and PH.
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Tufano, Antonio, Francesco Maria Drudi, Flavia Angelini, et al. "Contrast-Enhanced Ultrasound (CEUS) in the Evaluation of Renal Masses with Histopathological Validation—Results from a Prospective Single-Center Study." Diagnostics 12, no. 5 (2022): 1209. http://dx.doi.org/10.3390/diagnostics12051209.
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Background: To evaluate the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) in characterizing between malignant and benign renal lesions confirmed by histological examination. Methods: Overall, 110 patients, for a total of 118 renal masses previously identified at CT and MRI underwent CEUS. An expert radiologist evaluated morphological, qualitative and quantitative parameters. Acquired data were analyzed to assess the value of each parameter to differentiate between malignant and benign lesions. Results: Histological results of 118 renal masses showed 88 (75%) malignant lesions and 30 (25%) benign lesions. Among morphological features, inhomogeneous echogenicity was the best predictor of malignancy depicting a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 76%, 76%, 88% and 57%, respectively. Among qualitative parameters, the most reliable parameter was the presence of pseudo-capsule. Here, sensitivity, specificity, positive PPV and NPV were 85%, 86%, 94% and 71%, respectively. Among quantitative parameters, the most reliable parameters were peak intensity (PI) and the area under the (AUC) with sensitivity, specificity, PPV and NPV values of 94%, 92%, 96% and 87% and 99%, 92%, 97% and 97%, respectively. Finally, the most reliable parameters were combined to distinguish between benign and malignant lesions. The best combination obtained was restricted to CEUS parameters (PI and AUC). Here, sensitivity, specificity, PPV, NPV and accuracy rate were 93%, 100%, 100%, 83% and 93%, respectively. Conclusions: CEUS increases the US accuracy to discriminate between benign and malignant renal lesions.
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Simeoni, Francesco, Rossella Terragni, Giuseppe Rubini, et al. "B-Mode and Contrast Enhanced Ultrasonography Features of Gastric Inflammatory and Neoplastic Diseases in Cats." Animals 10, no. 8 (2020): 1444. http://dx.doi.org/10.3390/ani10081444.
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Alimentary lymphoma (AL) is the most common malignancy of the feline gastrointestinal tract and may cause variable mild to severe alteration of the gastric wall on ultrasonography (US) that can be very similar to those caused by inflammation (INF). The aim of this prospective study is to establish the value of B-mode and contrast-enhanced US (CEUS) in describing specific features of normal, inflammatory, and neoplastic gastric diseases in feline species. B-mode US and CEUS of the stomach were performed in anesthetized cats with or without gastric disorders. Gastric wall qualitative and quantitative parameters were evaluated on B-mode US and CEUS examination. A total of 29 cats were included: six healthy (HEA) cats as the control group; nine INF; three low-grade lymphoma (LGAL); 10 high-grade lymphoma (HGAL). On B-mode US, there were significant differences in thickness, the wall’s layer definition and echogenicity between HGAL and all the other groups (<0.001). For CEUS, statistical differences between groups were found in the following: HGAL vs. HEA, HGAL vs. INF; HGAL vs. LGAL; INF vs. HEA. Diagnostic accuracy (AUC) and cut-off value were calculated and found to be significant for thickness (3.8 mm) for INF vs. LGAL (AUC > 0.70) and “benign” vs. “malignant” (AUC > 0.90) as well as peak enhancement (34.87 dB) for “benign” vs. “malignant” (AUC > 0.70). INF and LGAL showed an overlap of qualitative and quantitative parameters both on B-mode and CEUS, while HGAL usually appears as a severe wall thickening with absent layer definition, high-contrast uptake, a specific enhancement pattern, regional lymphadenopathy and local steatitis. Thickness and peak enhancement can be useful parameters in the characterization of gastric infiltrates in cats.
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Yi, Huiming, Baohuan Cai, Xi Ai, Kaiyan Li, Pengfei Song, and Wei Zhang. "Early Identification of Residual Tumors following Microwave Ablation Using Contrast-Enhanced Ultrasonography in a Rabbit VX2 Liver Cancer Model." BioMed Research International 2020 (September 27, 2020): 1–9. http://dx.doi.org/10.1155/2020/2462058.
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Objective. It is difficult to evaluate the ablation effect immediately after thermal ablation of liver cancer by clinical imaging methods, due to the immediate formation of an annular inflammatory reaction band (IRB). This study is aimed at exploring the early identification indicators of the IRB and residual tumor postmicrowave ablation (MVA) using contrast-enhanced ultrasonography (CEUS). Methods. MVA was used to inactivate part of the tumor nodules in rabbit VX2 liver cancer models, leading to the coexistence of the IRB with residual tumors. Quantitative analysis of the perfusion parameters of the tumor and ablation zone was performed using CEUS, followed by liver biopsy and VEGFR-2 immunohistochemical staining. Results. All rabbits successfully tolerated VX2 tumor inoculation and MVA operation. No statistically significant difference existed between the IRB vs. residual tumors, the IRB vs. junctional areas, and residual tumors postablation vs. VX2 tumors before ablation in regional blood volume, blood velocity, and blood flow estimated by parameters A, k, and A∗k of CEUS quantitative analysis. There was a statistically significant difference between the IRB and normal liver parenchyma in regional blood velocity and blood flow (p=0.005 and p=0.023, respectively). Normal liver parenchyma showed nonspecific VEGFR-2 staining, while VX2 tumor before ablation and residual tumor after ablation both showed positive VEGFR-2 staining; the necrosis zone showed negative staining by VEGFR-2 immunohistochemical staining. Conclusion. MVA had no significant effect on the residual tumor hemodynamics. The blood flow in the IRB increased significantly as compared to normal liver parenchyma, resembling tumor hemodynamic patterns. CEUS can detect residual tumors immediately postablation only when they protrude from the annular-shaped IRB. In addition, VEGFR-2 targeted CEUS may have a great potential for detecting residual tumor after thermal ablation of hepatocellular carcinoma.
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Sun, Di, Qijie Lu, Cong Wei, Yi Li, Yuanyi Zheng, and Bing Hu. "Differential diagnosis of <3 cm renal tumors by ultrasonography: a rapid, quantitative, elastography self-corrected contrast-enhanced ultrasound imaging mode beyond screening." British Journal of Radiology 93, no. 1112 (2020): 20190974. http://dx.doi.org/10.1259/bjr.20190974.
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Objectives: To assess the combined diagnostic strategy of contrast-enhanced ultrasound (CEUS) and acoustic radiation force impulse (ARFI) in the precise differential diagnosis of clear cell renal cell carcinoma (CCRCC) and urothelium carcinoma of the renal pelvis (UCRP) with other small renal tumors (SRTs) ＜3 cm in size. Methods: The elastography self-corrected CEUS (ESC) mode was established to perform the quantitative differential diagnosis of SRTs (<3 cm). The kidney shear wave velocity (SWV) value recorded by ARFI showed substantial variability in patients with CCRCC (high elasticity value) and UCRP (low elasticity value) compared with other renal masses, thus providing critical self-correction information for the ultrasound differential diagnosis of SRTs. Results: In this work, the ESC observations and the corresponding ESC criteria show a remarkable 94.6% accuracy in reference to the gold standards, thus allowing the quantitative, early triple distinction of CCRCC with UCRP and other SRTs in patients with suspicious SRTs. Conclusions: This ARFI self-corrected CEUS diagnostic strategy is far beyond a screening method and may have the potential to identify a window of therapeutic opportunity in which emerging therapies might be applied to patients with CCRCC and UCRP, reducing overtreatment and medical costs. Advances in knowledge: In our study, a new rapid and non-invasive elastography self-corrected CEUS (ESC) ultrasound imaging mode was developed, which was useful in the triple distinction of CCRCC, UCRP, and other SRTs with 94.6% accuracy. ESC is a promising method in the differential diagnosis of SRTs with accuracy and practicability far beyond a single screening model.
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Kaiser, Ulrich, Ursula Vehling-Kaiser, Fabian Kück, Mia Gilanschah, Friedrich Jung, and Ernst Michael Jung. "Super-Resolution Contrast-Enhanced Ultrasound Examination Down to the Microvasculature Enables Quantitative Analysis of Liver Lesions: First Results." Life 15, no. 7 (2025): 991. https://doi.org/10.3390/life15070991.
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This article investigates the first use of dynamic microvascularization of liver lesions in clinical evaluation using real-time super-resolution contrast-enhanced ultrasound (SR CEUS). A retrospective analysis of SR CEUS examinations of liver lesions was performed. All examinations were conducted using an SC7-1U convex probe after the bolus injection of the ultrasound contrast agent. Digital cine loops were stored for independent evaluation. The evaluation was performed with respect to parallel measuring lines (the diameter corresponded to the capillary density) in the area of the reference lesion, liver tissue, and liver capsule using statistical analysis. In total, 65 patients (female n = 28; male n = 37; average age 57.8 ± 17.2 years) were evaluated. The examined liver lesions were mostly benign masses (n = 46). Mild liver fibrosis (stage F1) was present in most cases (n = 35). The lesions examined were located at an average tissue depth of 6.07 ± 2.47 cm. The highest number of lesion measurements was observed in the malignant lesion group. Significant differences in the measurements were found when comparing benign lesions with the capillary region (p < 0.001) and normal liver tissue (p < 0.01). The use of SR CEUS opens up new possibilities for the quantification of neovascularization, assessment of microvascular changes, and evaluation of the follow-up of intrahepatic interventions.
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Bueverov, Аlexey O., Аlexey V. Borsukov, and Anna V. Tikhankova. "Assessment of the vascular structure of the liver in viral hepatitis by contrast-enhanced ultrasound." Terapevticheskii arkhiv 96, no. 2 (2024): 91–96. http://dx.doi.org/10.26442/00403660.2024.02.202580.
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Aim. To determine the diagnostic and prognostic value of contrast-enhanced ultrasound (CEUS) in assessment of the vascular structure of the liver in patients with chronic viral hepatitis.
 Materials and methods. Based on Clinical hospital №1 in Smolensk from 2018 to 2019 120 people with chronic viral hepatitis and 35 people with unchanged liver parenchyma as a control group were included in the study. All patients were examined by CEUS with 1,0 ml of contrast agent with subsequent evaluation of qualitative and quantitative parameters.
 Results. In statistical data processing it was found that the differences in quantitative parameters in the proximal and distal areas, contrast agent transit time from the arterial vascular bed to the venous one, as well as changes in the quality parameters have the most predictive value in the diagnosis of liver parenchyma lesion.
 Conclusion. CEUS is a non-invasive method for early diagnosis of changes in the vascular structure of the liver, including viral hepatitis, allowing to estimate the degree of parenchyma damage and on this basis to predict the further course of the disease in the format of a complex clinical-laboratory study.
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Freitas, M., V. Macedo Silva, C. Arieira, et al. "P134 Ultrasonographic scores for Crohn’s disease activity assessment – still lag behind CEUS." Journal of Crohn's and Colitis 15, Supplement_1 (2021): S222—S223. http://dx.doi.org/10.1093/ecco-jcc/jjab076.261.
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Abstract Background Intestinal ultrasound (IUS) is an increasingly used non-invasive tool to monitor Crohn‘s disease (CD) activity. Currently, there is no widely accepted, reproducible IUS activity index to evaluate inflammatory activity. In 2020, two new scores emerged: the Simple Ultrasound Activity Score for CD (SUS-CD) and International Bowel Ultrasound Segmental Activity Score (IBUS-SAS). We aimed to compare the accuracy of SUS-CD, IBUS-SAS and contrast ultrasound (CEUS) in predicting inflammatory activity in the terminal ileum in ileocolonoscopy. Methods Retrospective study including all IBD patients submitted to conventional IUS and CEUS with contrast SonoVue® directed to the terminal ileum performed by a single operator between April 2016 and March 2020. Examinations were performed using an ultrasound Hitachi HI VISION Avius®. Qualitative and quantitative parameters from the conventional IUS analysis including wall thickness, stratification, colour Doppler and inflammatory fat were evaluated, and segmental SUS-CD and IBUS-SAS were calculated. A quantitative measurement of contrast bowel wall enhancement, peak intensity, was evaluated using CEUS. The CD activity was assessed with ileocolonoscopy by Simple Endoscopic Score for CD (SES-CD). Disease activity was graded as inactive (SES-CD&lt;7) or active (SES-CD≥7). Results Fifty patients were included, 54.0% female, with mean age of 33±12years. Patients had a mean SUS-CD of 3.4±1.0, IBUS-SAS of 58.9±25.9 and CEUS peak intensity of 12.6±12.2. SUS-CD and IBUS-SAS were not different between patients with active or inactive disease (p=0.15; 0.57, respectively) with a poor capability to predict endoscopic activity (AUC 0.62, 95% CI 0.45–0.78; 0.55, 95% CI 0.38–0.72, respectively). Peak intensity in CEUS was significantly different in patients with active or inactive disease (p=0.004) with a good capability to predict endoscopic activity (AUC 0.80; 95% CI 0.64–0.92). A peak intensity optimal cut-off to predict active disease was 8.2 with a sensitivity of 71.4% and a specificity of 78.9%. Conclusion SUS-CD and IBUS-SAS were not able to predict with good accuracy endoscopic activity in terminal ileum in CD. On the other hand, CEUS with peak intensity assessment showed a good diagnostic accuracy for active inflammation in CD. Therefore, CEUS is a non-invasive emerging method, that should be routinely integrated in the ultrasonographic evaluation in CD.
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Simeoni, Francesco, Francesca Del Signore, Giovanni Aste, et al. "B-Mode and Contrast Enhanced Ultrasonography Features of Gastric Inflammatory and Neoplastic Diseases in Dogs." Animals 11, no. 3 (2021): 670. http://dx.doi.org/10.3390/ani11030670.
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Canine gastric disorders are common in veterinary clinical practice and among these neoplasms require rapid identification and characterization. Standard ultrasound (US) is the imaging modality of choice for gastric wall assessment. The aim of this prospective study is to describe the specific B-mode and contrast enhanced US (CEUS) features of normal, inflammatory, and neoplastic gastric wall in dogs. B-mode US and CEUS of the stomach were performed in anesthetized dogs with or without gastric disorders. Gastric wall qualitative and quantitative parameters were evaluated on B-mode US and CEUS examination. A total of 41 dogs were included: 6 healthy (HEA) as the control group; 9 gastritis (INF); 8 adenocarcinoma (AC); 8 alimentary lymphoma (AL); 4 leiomyosarcoma (LEIS); 2 gastrointestinal stromal tumor (GIST); 2 leiomyoma; 1 undifferentiated sarcoma; 1 metastatic gastric hemangiosarcoma. Gastric tumors appear as a marked wall thickness with absent layers definition and possible regional lymphadenopathy (AC and AL) and steatitis (AC) while gastritis generally shows no/mild thickening and no other alterations on B-mode US. On CEUS, neoplasm shows a higher and faster wash in if compared to that of gastritis. B-mode and CEUS assessment may be useful in the evaluation of canine gastric disorders in the distinction between gastritis and gastric neoplasms, even if there are no specific features able to discriminate between the different tumor histotypes.
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Wu, Hailan, Jiayu Shi, Long Gao, et al. "Qualitative and quantitative analysis of solid renal tumors by high-frame-rate contrast-enhanced ultrasound." Cancer Imaging 24, no. 1 (2024). http://dx.doi.org/10.1186/s40644-024-00788-3.
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Abstract Objective To analyze the characteristics of high-frame-rate contrast-enhanced ultrasound (H-CEUS) in solid renal tumors using qualitative and quantitative methods. Methods Seventy-five patients who underwent preoperative conventional ultrasound (US), conventional contrast-enhanced ultrasound (C-CEUS), and H-CEUS examination of renal tumors were retrospectively analyzed, with a total of 89 renal masses. The masses were divided into the benign (30 masses) and malignant groups (59 masses) based on the results of enhanced computer tomography and pathology. The location, diameter, shape, border, calcification, and color doppler blood flow imaging (CDFI) of the lesions were observed by US, and the characteristics of the C-CEUS and H-CEUS images were qualitatively and quantitatively analyzed. The χ² test or Fisher’s exact probability method was used to compare the US image characteristics between the benign and malignant groups, and the image characteristics of C-CEUS and H-CEUS between the benign and malignant groups. Moreover, the nonparametric Mann-Whitney test was used to compare the differences in C-CEUS and H-CEUS time-intensity curve (TIC) parameters. Results Significant differences in gender, surgical approach, echogenicity, and CDFI were observed between the malignant and benign groups (p = 0.003, < 0.001, < 0.001, = 0003). Qualitative analysis also revealed significant differences in the mode of wash-out and fill-in direction between C-CEUS and H-CEUS in the malignant group (p = 0.041, 0.002). In addition, the homogeneity of enhancement showed significant differences between the two contrast models in the benign group (p = 0.009). Quantitative analysis indicated that the TIC parameters peak intensity (PI), deceleration time (DT) /2, area under the curve (AUC), and mean transition time (MTT) were significantly lower in the H-CEUS model compared to the C-CEUS model in both the benign and malignant groups. (all p < 0.001). In contrast, ascending slope of rise curve (AS) was significantly higher in the H-CEUS model compared to the C-CEUS model in the malignant group (p = 0.048). Conclusions In renal tumors, H-CEUS shows clearer internal enhancement of the mass and the changes in the wash-out period. The quantitative TIC parameters PI, DT/2, AUC, and MTT were lower in H-CEUS compared to C-CEUS. Both the quantitative and qualitative analyses indicated that H-CEUS better displays the characteristics of solid renal masses compared with C-CEUS.
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Cao, Jiaying, Yi Dong, Peili Fan, et al. "Early evaluation of treatment response to transarterial chemoembolization in patients with advanced hepatocellular carcinoma: The role of dynamic three-dimensional contrast-enhanced ultrasound." Clinical Hemorheology and Microcirculation, March 5, 2021, 1–13. http://dx.doi.org/10.3233/ch-201086.
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BACKGROUND: Dynamic three-dimensional contrast-enhanced ultrasound (3D-CEUS) with quantitative analysis is available in recent years. It can reduce the quantitative sampling error caused by the inconsistency of different sections in order to evaluate local treatment response of hepatocellular carcinoma (HCC) accurately. OBJECTIVE: To investigate the value of dynamic 3D-CEUS in evaluating the early response to transarterial chemoembolization (TACE) treatment in patients with advanced HCC lesions. METHODS: In this prospective study, both two-dimensional (2D) CEUS and dynamic 3D-CEUS were performed on 40 HCC patients who scheduled for TACE at baseline (T0) and 1–3 days (T1) after treatment. Tumor microvascular perfusion changes were assessed by CEUS time-intensity curve (TIC) and quantitative parameters. According to contrast-enhanced computed tomography (CT) and magnetic resonance (MR) imaging 1 month after treatment results, patients were divided into responders and non-responders groups. The changes of perfusion parameters of both 2D-CEUS and 3D-CEUS were compared between responders and non-responders groups before and after TACE treatment. RESULTS: Before and after TACE treatment, no significant difference in maximum diameter of HCC lesions between the two groups could be found. There were more significant differences and ratios of perfusion parameters in 3D-CEUS quantitative analysis than in 2D-CEUS. The mutual significant differences and ratios of 2D-CEUS and 3D-CEUS included peak intensity (PI) difference, PI ratio, ratio of area under the curve (A), ratio of area under the wash-out part (AWO) and slope (S) difference. The former 4 corresponding parameters were better on 3D-CEUS than on 2D-CEUS. CONCLUSION: Dynamic 3D-CEUS can be used as a potential imaging method to evaluate early treatment response to TACE in advanced HCC patients.
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Li, Jiajia, Yunfeng Wu, Zhaoyu Tian, Linfeng Shu, Siru Wu, and Zuohui Wu. "Application Value of Ultrasound Elastography Combined With Contrast-Enhanced Ultrasound (CEUS) Quantitative Analysis in Differentiation of Nodular Fibrocystic Changes of the Breast From Invasive Ductal Carcinoma." Ultrasonic Imaging, December 14, 2023. http://dx.doi.org/10.1177/01617346231217087.
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This study aimed to compare the value of ultrasound elastography combined with contrast-enhanced ultrasound (CEUS) quantitative analysis in the differentiation of nodular fibrocystic breast change (FBC) from breast invasive ductal carcinoma (BIDC). We selected 50 patients each with nodular FBC and BIDC, who were admitted to the Affiliated Hospital of Zunyi Medical University from January 2018 to December 2021. Their ultrasonic elastic images and CEUS videos were collected, their ultrasound elastography scores and the ratio of strain rate (SR) of the lesions were determined, and the exported DICOM format videos of CEUS were quantitatively analyzed using VueBox software to obtain quantitative perfusion parameters. The differences between the ultrasound elastography score and SR while comparing nodular FBC and BIDC cases were statistically significant ( p < .05). The sensitivity, specificity, and accuracy of ultrasound elastography scores in the differential diagnoses of nodular FBC and BIDC were 74%, 88%, and 81%, respectively. Additionally, the sensitivity, specificity, and accuracy of SR in the differential diagnosis of nodular FBC and BIDC were 94%, 78%, and 86%, respectively. Statistically significant differences were observed in the CEUS quantitative perfusion parameters PE, AUC (WiAUC, WoAUC, WiWoAUC), and WiPI in both nodular FBC and BIDC according to the VueBox software ( p < .05). The sensitivity, specificity, and accuracy of CEUS quantitative analysis in the differential diagnoses of nodular FBC and BIDC were 66%, 82%, and 74%, respectively. Using the pathological findings as the gold standard, ROC curves were established, and the area under the curve (AUC) of the CEUS quantitative analysis, elasticity score, SR, and ultrasound elastography combined with CEUS quantitative analysis were 0.731, 0.838, and 0.892, as well as 0.945, respectively. Ultrasound elasticity scoring, SR and CEUS quantitative analysis have certain application value for differentiating nodular FBC cases from BIDC; however, ultrasound elasticity imaging combined with CEUS quantitative analysis can help in improving the differential diagnostic efficacy of nodular FBC cases from BIDC.
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Dillman, Jonathan R., Adam F. Prasanphanich, Katherine N. Epstein, Alexander J. Towbin, and Andrew T. Trout. "Contrast-enhanced ultrasound of Crohn’s disease in children and young adults: quantitative metric correlations and MRI disease severity associations." Pediatric Radiology, March 13, 2025. https://doi.org/10.1007/s00247-025-06203-8.
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Abstract Background There is a paucity of data comparing contrast-enhanced ultrasound (CEUS) to MR enterography in children and young adults with Crohn’s disease. Objective To measure correlations across CEUS quantitative metrics in children and young adults with Crohn’s disease, and to evaluate if these metrics are associated with MRI features of disease activity. Materials and methods Patients <21 years old with Crohn’s disease affecting the terminal ileum who underwent clinically-indicated MR enterography were recruited between 2021 and 2024. Research CEUS of the terminal ileum was performed using sulfur hexafluoride lipid-type A microspheres, and images were analyzed using VueBox (Bracco Group). MRI exams were independently reviewed by three radiologists to document features of disease activity. Pearson’s correlation (r) was used to measure associations across nine CEUS quantitative metrics and between CEUS metrics and mean or consensus MRI features. Results Twenty-five participants, 13 (52%) male, with a mean age of 16.5 years (range, 13-20 years) were included. The mean terminal ileal maximum bowel wall thickness at MRI was 7.5 mm±1.8 mm. The mean sMaRIA score was 3.4±0.8, consistent with severely active disease. CEUS quantitative measurements were highly variable across participants. The mean rise time was 7.0±2.7 s, while the mean peak enhancement was 3,282±3,754 a.u. Twelve of 36 (36%) CEUS quantitative metric bivariate comparisons were highly collinear with r>0.8 (P<0.0001). There were significant positive correlations between CEUS rise time and MRI maximum bowel wall thickness (r=0.40; P=0.046), visual analog scale assessment of overall inflammation (r=0.43; P=0.032), and postcontrast enhancement ratio (r=0.47; P=0.018); there were no other significant correlations between CEUS metrics and MRI measures of inflammation. Conclusion CEUS quantitative measurements are highly variable across patients with Crohn’s disease, with multiple metrics being highly correlated with one another. CEUS rise time correlates with MRI features of disease activity. Graphical Abstract
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Badiu, Simona Maria, Elena Codruța Gheorghe, Carmen Nicolau, and Adrian Săftoiu. "Quantitative time intensity curve analysis of contrast-enhanced ultrasound (CEUS) examinations for the assessment of focal liver lesions." Medical Ultrasonography, November 6, 2023. http://dx.doi.org/10.11152/mu-4108.
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Contrast enhanced ultrasound (CEUS) is well-established for the characterization of focal liver lesions (FLLs). By using intravenous ultrasound contrast agents, followed by specific low mechanical index examinations, CEUS enables a high spatial and temporal resolution as well as a dynamic assessment of macro- and microvascularization down to the capillaries. Nevertheless, CEUS has the disadvantage of being examiner-dependent, so quantitative analysis of time-intensity curves in dynamic CEUS (D-CEUS) could provide further information. The aim of this article is to provide a general review of the current literature regarding the usefulness of D-CEUS in the assessment of FLLs.