EFSUMB Guidelines 2011: Comments and Illustrations

C. F. Dietrich; X. W. Cui; D. G. Schreiber-Dietrich; A. Ignee

doi:10.1055/s-0032-1312890

Ultraschall in der Medizin - European Journal of Ultrasound, Table of Contents

Ultraschall Med 2012; 33(S 01): S11-S21
DOI: 10.1055/s-0032-1312890

Supplement

EFSUMB Guidelines 2011: Comments and Illustrations

EFSUMB-Leitlinien 2011: Kommentare und Illustrationen

Authors

C. F. Dietrich
X. W. Cui
D. G. Schreiber-Dietrich
A. Ignee

Abstract

The European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) introduced the first guidelines on the use of contrast-enhanced ultrasound (CEUS) in 2004. This EFSUMB document focused mainly on liver applications. However, new applications extending beyond the liver were subsequently developed. Therefore, in the update of the clinical recommendations on the use of CEUS by the EFSUMB, applications in other organs were also described and published in 2008. Increased interest in recent years in the CEUS technique and in the application of CEUS in novel fields has resulted in CEUS indications and applications for nearly all organ systems. As a result, the EFSUMB initiated a new update of the guidelines in 2011 to include this additional knowledge. Some of the indications are established, whereas others are preliminary. The latter indications are categorized as emergent CEUS applications since the available evidence is insufficient for general recommendation. This article focuses on comments, illustrations and examples of the application of CEUS in the pancreas, spleen, gastrointestinal tract, kidney, adrenals, lymph nodes, perineum, and hepatobiliary system. The potential for endoscopic ultrasound to highlight the importance of CEUS in the daily routine is also addressed.

Zusammenfassung

Leitlinien zum kontrastverstärkten Ultraschall (CEUS) wurden erstmalig von der EFSUMB (“European Federation of Societies for Ultrasound in Medicine and Biology”) 2004 publiziert. Dieses Manuskript erläuterte die Möglichkeiten der kontrastverstärkten Lebersonografie. Weitere Anwendungsmöglichkeiten haben sich in den folgenden Jahren etabliert, sodass ein Update 2008 notwendig wurde, das auch andere Organsysteme beinhaltete. In den Folgejahren beschleunigte sich die rasante Entwicklung und es gibt aktuell kaum ein Organsystem, das nicht mittels CEUS untersucht worden ist. Unterschieden werden etablierte Indikationen von möglichen Indikationen, die sich erst im routinemäßigen Alltag bewähren müssen. Die EFSUM hat somit 2011 aktuelle Leitlinien publiziert, die sich mit nicht hepatischen Indikationen beschäftigen und die in diesem Manuskript kommentiert und illustriert werden.

Key words

diagnosis - characterisation - metastases - hepatocellular carcinoma - guidelines - hemangioma - microbubble contrast agent

Full Text

References

References
1 Piscaglia F, Nolsoe C, Dietrich CF et al. The EFSUMB Guidelines and Recommendations on the Clinical Practice of Contrast-enhanced Ultrasound (CEUS): Update 2011 on non-hepatic applications. Ultraschall in Med 2011;
2 Albrecht T, Blomley M, Bolondi L et al. Guidelines for the use of contrast agents in ultrasound. January 2004. Ultraschall in Med 2004; 25: 249-256
3 Claudon M, Cosgrove D, Albrecht T et al. Guidelines and good clinical practice recommendations for contrast-enhanced ultrasound (CEUS) – update 2008. Ultraschall in Med 2008; 29: 28-44
4 Dietrich CF. Comments and illustrations regarding the guidelines and good clinical practice recommendations for contrast-enhanced ultrasound (CEUS) – update 2008. Ultraschall in Med 2008; 29: S188-S202
5 Piscaglia F, Bolondi L. The safety of Sonovue in abdominal applications: retrospective analysis of 23188 investigations. Ultrasound Med Biol 2006; 32: 1369-1375
6 Main ML, Ryan AC, Davis TE et al. Acute mortality in hospitalized patients undergoing echocardiography with and without an ultrasound contrast agent (multicenter registry results in 4,300,966 consecutive patients). Am J Cardiol 2008; 102: 1742-1746
7 Gilja OH. Report Education and Professional Standard Committee. In EFSUMB Newsletter. Ultraschall in Med 2009; 30: 86-87
8 Dietrich CF, Ignee A, Hocke M et al. Pitfalls and artefacts using contrast-enhanced ultrasound. Z Gastroenterol 2011; 49: 350-356
9 Ignee A, Baum U, Schuessler G et al. Contrast-enhanced ultrasound-guided percutaneous cholangiography and cholangiodrainage (CEUS-PTCD). Endoscopy 2009; 41: 725-726
10 Nolsoe C, Piscaglia F, Dietrich C et al. Primum non nocere? Why Can’t We Use Second Generation Ultrasound Contrast Agents for the Examination of Children?. Ultraschall in Med 2011; 32: 83-86
11 Dietrich CF, Mertens JC, Braden B et al. Contrast-enhanced ultrasound of histologically proven liver hemangiomas. Hepatology 2007; 45: 1139-1145
12 Dietrich CF, Braden B, Hocke M et al. Improved characterisation of solitary solid pancreatic tumours using contrast-enhanced transabdominal ultrasound. J Cancer Res Clin Oncol 2008; 134: 635-643
13 Dietrich CF, Ignee A, Braden B et al. Improved differentiation of pancreatic tumors using contrast-enhanced endoscopic ultrasound. Clin Gastroenterol Hepatol 2008; 6: 590-597
14 D’Onofrio M, Barbi E, Dietrich CF et al. Pancreatic multicenter ultrasound study (PAMUS). Eur J Radiol 2011;
15 D’Onofrio M, Zamboni G, Tognolini A et al. Mass-forming pancreatitis: value of contrast-enhanced ultrasonography. World J Gastroenterol 2006; 12: 4181-4184
16 Kersting S, Konopke R, Kersting F et al. Quantitative perfusion analysis of transabdominal contrast-enhanced ultrasonography of pancreatic masses and carcinomas. Gastroenterology 2009; 137: 1903-1911
17 Ryschich E, Schmidt J, Loeffler T et al. Different radiogenic effects on microcirculation in healthy pancreas and in pancreatic carcinoma of the rat. Ann Surg 2003; 237: 515-521
18 Ryschich E, Schmidt E, Maksan SM et al. Expansion of endothelial surface by an increase of vessel diameter during tumor angiogenesis in experimental and hepatocellular and pancreatic cancer. World J Gastroenterol 2004; 10: 3171-3174
19 Schmidt J, Ryschich E, Daniel V et al. Vascular structure and microcirculation of experimental pancreatic carcinoma in rats. Eur J Surg 2000; 166: 328-335
20 Makinen K, Loimas S, Nuutinen P et al. The growth pattern and microvasculature of pancreatic tumours induced with cultured carcinoma cells. Br J Cancer 2000; 82: 900-904
21 D’Onofrio M, Mansueto G, Falconi M et al. Neuroendocrine pancreatic tumor: value of contrast-enhanced ultrasonography. Abdom Imaging 2004; 29: 246-258
22 Malago R, D’Onofrio M, Zamboni GA et al. Contrast-enhanced sonography of nonfunctioning pancreatic neuroendocrine tumors. Am J Roentgenol 2009; 192: 424-430
23 Mork H, Ignee A, Schuessler G et al. Analysis of neuroendocrine tumour metastases in the liver using contrast-enhanced ultrasonography. Scand J Gastroenterol 2007; 42: 652-662
24 Dietrich CF, Hocke M, Gallotti A et al. Ultrasonography of the Pancreas. Italia: Springer-Verlag; 2012: 95-112
25 D’Onofrio M, Megibow AJ, Faccioli N et al. Comparison of contrast-enhanced sonography and MRI in displaying anatomic features of cystic pancreatic masses. Am J Roentgenol 2007; 189: 1435-1442
26 Beyer-Enke SA, Hocke M, Ignee A et al. Contrast-enhanced transabdominal ultrasound in the characterisation of pancreatic lesions with cystic appearance. JOP 2010; 11: 427-433
27 Ripolles T, Martinez MJ, Lopez E et al. Contrast-enhanced ultrasound in the staging of acute pancreatitis. Eur Radiol 2010; 20: 2518-2523
28 Hocke M, Ignee A, Dietrich CF. Contrast-enhanced endoscopic ultrasound in the diagnosis of autoimmune pancreatitis. Endoscopy 2011; 43: 163-165
29 Dietrich CF, Ignee A, Frey H. Contrast-enhanced endoscopic ultrasound with low mechanical index: a new technique. Z Gastroenterol 2005; 43: 1219-1223
30 Becker D, Strobel D, Bernatik T et al. Echo-enhanced color- and power-Doppler EUS for the discrimination between focal pancreatitis and pancreatic carcinoma. Gastrointest Endosc 2001; 53: 784-789
31 Bhutani MS, Hoffman BJ, van Velse A et al. Contrast-enhanced endoscopic ultrasonography with galactose microparticles: SHU508 A (Levovist). Endoscopy 1997; 29: 635-639
32 Kitano M, Sakamoto H, Matsui U et al. A novel perfusion imaging technique of the pancreas: contrast-enhanced harmonic EUS (with video). Gastrointest Endosc 2008; 67: 141-150
33 Hocke M, Schulze E, Gottschalk P et al. Contrast-enhanced endoscopic ultrasound in discrimination between focal pancreatitis and pancreatic cancer. World J Gastroenterol 2006; 12: 246-250
34 Saftoiu A, Iordache SA, Gheonea DI et al. Combined contrast-enhanced power Doppler and real-time sonoelastography performed during EUS, used in the differential diagnosis of focal pancreatic masses (with videos). Gastrointest Endosc 2010; 72: 739-747
35 D’Onofrio M, Malago R, Zamboni G et al. Contrast-enhanced ultrasonography better identifies pancreatic tumor vascularization than helical CT. Pancreatology 2005; 5: 398-402
36 Faccioli N, D’Onofrio M, Malago R et al. Resectable pancreatic adenocarcinoma: depiction of tumoral margins at contrast-enhanced ultrasonography. Pancreas 2008; 37: 265-268
37 Numata K, Ozawa Y, Kobayashi N et al. Contrast-enhanced sonography of pancreatic carcinoma: correlations with pathological findings. J Gastroenterol 2005; 40: 631-640
38 Serra C, Menozzi G, Labate AMM et al. Ultrasound assessment of vascularization of the thickened terminal ileum wall in Crohn’s disease patients using a low-mechanical index real-time scanning technique with a second generation ultrasound contrast agent. Eur J Radiology 2007; 62: 114-121
39 Dietrich CF, Jenssen C. Evidenzbasierte Einsatzmöglichkeiten der Endosonografie (Evidence based endoscopic ultrasound. Z Gastoenterol 2011; 49: 599-621
40 Dietrich CF, Jenssen C, Hocke M et al. Imaging of gastrointestinal stromal tumours with modern ultrasound techniques – A pictorial essay. Z Gastroenterol 2012; 50: 457-467
41 Dietrich CF, Jedrzejczyk M, Ignee A. Sonographic assessment of splanchnic arteries and the bowel wall. Eur J Radiol 2007; 64: 202-212
42 Gorg C, Faoro C, Bert T et al. Contrast-enhanced ultrasound of splenic lymphoma involvement. Eur J Radiol 2011; 80: 169-174
43 Catalano O, Sandomenico F, Matarazzo I et al. Contrast-enhanced sonography of the spleen. Am J Roentgenol 2005; 184: 1150-1156
44 Gorg C, Bert T. Second-generation sonographic contrast agent for differential diagnosis of perisplenic lesions. Am J Roentgenol 2006; 186: 621-626
45 von Herbay A, Barreiros AP, Ignee A et al. Contrast-enhanced ultrasonography with SonoVue: differentiation between benign and malignant lesions of the spleen. J Ultrasound Med 2009; 28: 421-434
46 Chiavaroli R, Grima P, Tundo P. Characterization of nontraumatic focal splenic lesions using contrast-enhanced sonography. J Clin Ultrasound 2011; 39: 310-315
47 Catalano O, Lobianco R, Sandomenico F et al. Splenic trauma: evaluation with contrast-specific sonography and a second-generation contrast medium: preliminary experience. J Ultrasound Med 2003; 22: 467-477
48 Valentino M, Serra C, Zironi G et al. Blunt abdominal trauma: emergency contrast-enhanced sonography for detection of solid organ injuries. Am J Roentgenol 2006; 186: 1361-1367
49 Catalano O, Aiani L, Barozzi L et al. CEUS in abdominal trauma: multi-center study. Abdom Imaging 2009; 34: 225-234
50 Correas JM, Claudon M, Tranquart F et al. The kidney: imaging with microbubble contrast agents. Ultrasound Q 2006; 22: 53-66
51 Ignee A, Straub B, Schuessler G et al. Contrast-enhanced ultrasound of renal masses. World J Radiol 2010; 2: 15-31
52 Ignee A, Straub B, Brix D et al. The value of contrast-enhanced ultrasound (CEUS) in the characterisation of patients with renal masses. Clin Hemorheol Microcirc 2010; 46: 275-290
53 Quaia E, Bertolotto M, Cioffi V et al. Comparison of contrast-enhanced sonography with unenhanced sonography and contrast-enhanced CT in the diagnosis of malignancy in complex cystic renal masses. Am J Roentgenol 2008; 191: 1239-1249
54 Clevert DA, Minaifar N, Weckbach S et al. Multislice computed tomography versus contrast-enhanced ultrasound in evaluation of complex cystic renal masses using the Bosniak classification system. Clin Hemorheol Microcirc 2008; 39: 171-178
55 Park BK, Kim B, Kim SH et al. Assessment of cystic renal masses based on Bosniak classification: comparison of CT and contrast-enhanced US. Eur J Radiol 2007; 61: 310-314
56 Mazziotti S, Zimbaro F, Pandolfo A et al. Usefulness of contrast-enhanced ultrasonography in the diagnosis of renal pseudotumors. Abdom Imaging 2010; 35: 241-245
57 Bertolotto M, Martegani A, Aiani L et al. Value of contrast-enhanced ultrasonography for detecting renal infarcts proven by contrast-enhanced CT. A feasibility study. Eur Radiol 2008; 18: 376-383
58 Dietrich CF, Ignee A, Barreiros AP et al. Contrast-enhanced ultrasound for imaging of adrenal masses. Ultraschall in Med 2010; 31: 163-168
59 Friedrich-Rust M, Glasemann T, Polta A et al. Differentiation between benign and malignant adrenal mass using contrast-enhanced ultrasound. Ultraschall in Med 2011; 32: 460-471
60 Trojan J, Schwarz W, Sarrazin C et al. Role of ultrasonography in the detection of small adrenal masses. Ultraschall in Med 2002; 23: 96-100
61 Schmid-Wendtner MH, Partscht K, Korting HC et al. Improved differentiation of benign and malignant lymphadenopathy in patients with cutaneous melanoma by contrast-enhanced color Doppler sonography. Arch Dermatol 2002; 138: 491-497
62 Nakase K, Yamamoto K, Hiasa A et al. Contrast-enhanced ultrasound examination of lymph nodes in different types of lymphoma. Cancer Detect Prev 2006; 30: 188-191
63 Hocke M, Menges M, Topalidis T et al. Contrast-enhanced endoscopic ultrasound in discrimination between benign and malignant mediastinal and abdominal lymph nodes. J Cancer Res Clin Oncol 2008; 134: 473-480
64 Jenssen C, Dietrich CF. Endoscopic ultrasound-guided fine-needle aspiration biopsy and trucut biopsy in gastroenterology – An overview. Best Pract Res Clin Gastroenterol 2009; 23: 743-759
65 Cui XW, Ignee A, Braden B et al. Billiary papillomatosis and new ultrasound imaging modalities. Z Gastroenterol 2012; 50 (2) 50: 226-231