EFSUMB Technical Review – Update 2023: Dynamic Contrast-Enhanced Ultrasound (DCE-CEUS) for the Quantification of Tumor Perfusion

 

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Abstract

Dynamic contrast-enhanced ultrasound (DCE-US) is a technique to quantify tissue perfusion based on phase-specific enhancement after the injection of microbubble contrast agents for diagnostic ultrasound. The guidelines of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) published in 2004 and updated in 2008, 2011, and 2020 focused on the use of contrast-enhanced ultrasound (CEUS), including essential technical requirements, training, investigational procedures and steps, guidance regarding image interpretation, established and recommended clinical indications, and safety considerations. However, the quantification of phase-specific enhancement patterns acquired with ultrasound contrast agents (UCAs) is not discussed here. The purpose of this EFSUMB Technical Review is to further establish a basis for the standardization of DCE-US focusing on treatment monitoring in oncology. It provides some recommendations and descriptions as to how to quantify dynamic ultrasound contrast enhancement, and technical explanations for the analysis of time-intensity curves (TICs). This update of the 2012 EFSUMB introduction to DCE-US includes clinical aspects for data collection, analysis, and interpretation that have emerged from recent studies. The current study not only aims to support future work in this research field but also to facilitate a transition to clinical routine use of DCE-US.

Zusammenfassung

Der DCE-US (Dynamic contrast-enhanced ultrasound) ist eine Quantifizierungstechnik des kontrastverstärkten Ultraschalls. Die EFSUMB-Leitlinien von 2004, mit Updates aus den Jahren 2008, 2011, 2013 und 2020, erläutern die Grundlagen der Ultraschall-Kontrastmitteltechniken, geben aber keine detaillierten Informationen zu den Anwendungsmöglichkeiten, der Vorgehensweise und den Besonderheiten des DCE-US. Ziel dieses EFSUMB-Dokuments ist es nun, auf der Basis einer aktuellen Literaturrecherche Standardisierungsgrundlagen zur Methodik des DCE-US – insbesondere für das Therapiemonitoring bei onkologischen Erkrankungen – weiter zu vertiefen. Die notwendigen Grundlagen und technischen Voraussetzungen für die Analyse von Zeit-Intensitätskurven werden vorgestellt. Das vorliegende Update eines EFSUMB-Statements aus dem Jahr 2012 berücksichtigt klinische Aspekte aufgrund jüngster Studien für einen standardisierten Ablauf der Daten-Akquise und -Analyse sowie Empfehlungen zur Interpretation. Die aktuelle Arbeit zielt nicht nur darauf ab, künftige Arbeiten auf diesem Forschungsgebiet zu unterstützen, sondern auch den Übergang zur klinischen Routineanwendung des DCE-US zu erleichtern.

Publication History

Received: 04 April 2023

Accepted after revision: 15 August 2023

Article published online:
25 September 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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