Contrast Enhanced Ultrasound In Clinical Practice

The value of ultrasound contrast agents (USCA) in everyday clinical practice depends on the pharmacokinetics, the signal processing, and the contrast-specific imaging modalities. Second-generation USCA, are blood pool agents that do not leak into the organ tissue to be examined but remain in the intravascular compartment increasing the Doppler signal amplitude during their dynamic vascular phase. Taking advantage of the stability of their microbubbles, they can withstand the acoustic pressure of insonation much better than first-generation contrast media, which results in an increased half-life of the agent and, consequently, in a prolonged diagnostic window. Concomitant with the improvement of contrast agents, different contrast-specific imaging modalities have been developed which, used in combination with USCA and a low mechanical index, allow continuous real-time grey-scale imaging. These recent technical improvements have opened new possibilities in the use of USCA in a variety of indications. Written by internationally renowned experts, the contributions gathered in this book give an overview of current and possible future new applications of USCA in routine and clinical practice.

This book provides a comprehensive analysis of the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of a wide variety of pathologies. Sonography reliably identifies a wide range of diseases, and the efficacy of modern ultrasound has dramatically improved with contrast enhancement. This book covers almost all aspects of CEUS starting from basic principles and ending with features of its application in individual organs. In particular, it explores the diseases of abdominal, retroperitoneal, and pelvic organs as well as superficial structures, highlighting the characteristic features of typical findings. Focal lesions are discussed in depth, with attention to their early detection and differential diagnosis. Besides, a practical approach to the stratification of the risk of malignancies is provided. The authors summarized their own experience with CEUS in oncology, hepatology, gynecology, urology, endocrinology, and other fields of medicine. The role of CEUS in differential diagnosis of various disorders of the female reproductive system is comprehensively discussed as well. The presentation is clear and concise, and richly illustrated. The book will be a helpful tool for both residents and practitioners approaching ultrasound diagnostics, as well for more experienced radiologists and other professionals.

This book is a comprehensive guide to the rapidly evolving field of contrast-enhanced ultrasound (CEUS) in the child. The uses and interpretation of CEUS are clearly explained with the aid of numerous illustrations. The coverage encompasses both established indications, such as focal liver lesions, abdominal solid organ injury, and vesicoureteral reflux, and a range of newer applications. Extensive information is also provided on microbubble agents and their use in the pediatric age group, as well as on practical aspects of setting up a CEUS service for children. CEUS is a safe imaging method that is ideal for the young patient and can be used for problem solving in a number of clinical situations. Ultrasound combined with microbubble contrast avoids the ionizing radiation of a CT examination, the use of iodinated contrast, the need for sedation or a general anesthetic, and the complexities of MR imaging. In bringing readers up to date with best practice and the latest innovations in CEUS, this book will be of value for pediatric radiologists, pediatric sonographers/technicians, and pediatricians.

This book aims to provide reader an overview of clinical applications of contrast-enhanced ultrasound in hepatic neoplasms diagnosis. Ultrasound images and pathological results of different hepatic neoplasms are introduced in the chapters, including benign liver tumors, malignant liver tumors, hepatic carcinoma, intrahepatic cholangiocarcinoma, rare liver benign and malignant neoplasms, regenerative nodules, inflammatory pseudotumor, parasite liver lesions, and hepatitis peliosis, etc. The combination of ultrasound findings with final histopathological results then discover the potential mechanical of contrast enhancement changes. With the development of ultrasound technology and widely application of ultrasound contrast agents (USCA) in recent decades, contrast-specific imaging modalities have been developed in combination with USCA and a low mechanical index (MI), allowing continuous real-time grey scale imaging. The updated contrast-specific software for liver diseases and hepatic tumors diagnosis has also been described described in detail. With high-resolution contrast ultrasound images during arterial phase, portal venous phase and late phase, author wants to show the whole dynamic wash-in and wash-out process of the different focal liver lesions.This book is an invaluable resource for radiologists, hepatologists and oncologists in their everyday clinical practice.

This volume takes into account the great impact of new technology on clinical practice for mass liver lesions. Its findings reflect a consensus meeting of experts assembled in order to develop guidelines for the use of ultrasound contrast agents in the diagnosis of liver diseases. These guidelines are presented in this book which provides an important starting point for clinical implementation of new diagnostic procedure.

This volume takes into account the great impact of new technology on clinical practice for mass liver lesions. Its findings reflect a consensus meeting of experts assembled in order to develop guidelines for the use of ultrasound contrast agents in the diagnosis of liver diseases. These guidelines are presented in this book which provides an important starting point for clinical implementation of new diagnostic procedure.

Accompanying DVD-ROM, in pocket at front of v. 1, contains ... "video clips referenced in the text."--DVD-ROM label.

Precision medicine is an approach that proposes customized medical care based on the individual characteristics of each patient. The rapidly emerging field not only holds great promise for diagnosis of disease and prediction of risk of developing diseases, but also offers the possibility of remarkably fine-tuned remedies to improve patient health while minimizing the risk of harmful side effects. Many technologies including genetics, informatics, and medical imaging, are rapidly expanding the scope of precision medicine. Among these technologies, imaging is poised to play a major role in the age of precision medicine. By characterizing anatomy, physiology and metabolism of the patient, medical imaging enables precise, personalized procedures and predictive, patient-specific therapy selection. In recent years, image-guided treatment procedures are becoming more and more common in hospitals, replacing conventional surgery or allowing faster recoveries with fewer post-procedure complications. As the most widely used modality, ultrasound is playing an increasingly important role towards moving precision medicine into clinical practice. It is a safe, inexpensive diagnostic tool and capable of producing real-time and non-invasive images without significant biological effects. To date, lots of ultrasound imaging technology, such as gray-scale, color Doppler flow imaging (CDFI), contrast enhanced ultrasound (CEUS), elastography have been developed, which have greatly improved disease diagnosis, treatment and prognosis. Thanks to these progress, ultrasound imaging has also been used in fields that were not previously involved, such as the lungs and musculoskeletal tissues. With the rapid development of ultrasound contrast agents, ultrasound molecular imaging is moving from animal study into clinical practice. First-in-human results of ultrasound molecular imaging with BR55 (a kinase insert domain receptor [KDR]–targeted contrast microbubble) in patients with breast and ovarian lesions have been reported in 2017. Taking advantage of microbubble cavitation effect, ultrasound-assisted drug delivery technology also makes great progress. The clinical trial of blood-brain barrier disruption for chemotherapy delivery in the brain had been conducted and confirmed its safety and well toleration in patients with recurrent glioblastoma (GBM). Moreover, ultrasound provides an advantageous tool for image-guided therapy due to its capability of real-time imaging for deep tissues, contributing to greatly improved localization and targeting of diseased tissues. More interestingly, by imaging these drug-loaded contrast agents, ultrasound-mediated drug delivery can be visualized. All of the above examples help demonstrate the promising potential of ultrasound in precision medicine, not only for disease diagnosis, but also for treatment selection and prognosis evaluation. The present Research Topic here in Frontiers in Pharmacology aims to bring a collection of research describing ultrasound used for precision medicine in diagnosis, drug delivery and image-guided therapy.