The growing utility of contrast-enhanced ultrasound (CEUS) will be a major theme at this year's RSNA meeting. Unfortunately, many U.S. ultrasound specialists may feel like they're on the outside looking in, as researchers from Europe, Asia, and the rest of the world present studies on ultrasound contrast products they've been using for years, but that are still not commercially available in the U.S.
What's to blame for the discrepancy? Most would point fingers at the U.S. Food and Drug Administration (FDA), which has displayed a reluctance to approve any new ultrasound contrast agents beyond the two already in use for echocardiography applications. Fortunately, contrast ultrasound advocates appear to be making progress in their efforts to convince the FDA that ultrasound contrast is a safe and efficacious technology that can help the modality achieve the diagnostic performance of more expensive imaging techniques, without the radiation dose.
For example, at least two presentations at this year's RSNA show will highlight how contrast-enhanced ultrasound can potentially be used in place of lymphoscintigraphy for determining if cancer has spread to the lymph nodes. In one study to be presented on Tuesday, December 1 (3:10 p.m.-3:20 p.m., SSJ02-02, Room E450A), U.K. researchers will describe their results in 69 patients with breast cancer, while in a second presentation on Monday, November 30 (3:50 p.m.-4:00 p.m., SSE13-06, Room S504CD), researchers from Thomas Jefferson University in Philadelphia will discuss their use of lymphosonography in an animal model for melanoma metastases.
Besides contrast studies, another important topic at this year's RSNA show will be breast ultrasound. The modality has solidified its role as an adjunct to mammography for characterizing suspicious lesions, and at this year's meeting, look for more advanced studies on techniques such as elastography and computer-aided detection (CAD) for volumetric breast ultrasound.
The dynamic nature of ultrasound can make for challenges when reporting studies, and several presentations will discuss ways to make the reporting process more efficient, such as through BI-RADS-based structured reporting (Tuesday, December 1, 3:40 p.m.-3:50 p.m., SSJ11-05, Room S102D) or practice optimization (Monday, November 30, 3:30 p.m.-3:40 p.m., SSE12-04, Room S102D).
Among the refresher courses, keep an eye out for RC515B (Wednesday, December 2, 8:30 a.m.-10:00 a.m., Room E451B) on the value of screening breast ultrasound, presented by Dr. Wendie Berg, Ph.D., lead investigator of the American College of Radiology Imaging Network (ACRIN) 6666 trial.
A Thursday afternoon course, RC715 (4:30 p.m.-6:30 p.m., Room N230), will review several areas of breast ultrasound technique, instrumentation, and reporting, along with a special track on elastography.
Below are highlights of the ultrasound-related research scheduled for presentation at this year's RSNA meeting. To view the RSNA's Web site listing abstracts for this year's scientific and educational programs, just click here.
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
