Contrast-enhanced ultrasound (CEUS) helps streamline hospital workflows, according to survey results presented September 10 at the International Contrast Ultrasound Society (ICUS) meeting in Chicago.
"Contrast-enhanced ultrasound gives patients a quick and very accurate diagnosis, and that helps hospitals deliver better and more cost-effective care while also moving patients through the system more efficiently," said Jordan Strom, MD, of Harvard Medical School in Boston. Strom is an officer of the ICUS.
CEUS uses microbubble ultrasound contrast agents that are infused intravenously during an ultrasound exam to enhance images, Strom and colleagues explained. These agents do not contain iodine or gadolinium -- and thus are not nephrotoxic -- and can provide a same-day diagnosis and mitigate delays and costs associated with MR and CT imaging.
The investigators conducted a survey of 104 CEUS practitioners, researchers, and ultrasound industry professionals. It was administered by the ICUS and by Inteleos, the governing and managing organization for three organizations: the American Registry for Diagnostic Medical Sonography (ARDMS), the Alliance for Physician Certification and Advancement (APCA), and the Point-of-Care Ultrasound (POCUS) Certification Academy.
Overall, the survey found that survey respondents described CEUS as helpful for "[improving workflow] efficiencies because it does not require sedation, anesthesia, or the need to transport patients to 'big scanners.'" It also found that 79% of clinician respondents believed that having an IV-trained sonographer available increases CEUS utilization.
In an ICUS statement, Stephanie Wilson, MD, of the University of Calgary in Canada, noted that CEUS "is recognized as the problem solver for all indeterminate CT and MR scans of the liver and kidney." Wilson is co-president of the ICUS.
"Our referring doctors love the immediate results that we can get from CEUS, and so do our patients, because if the results of the scan are good, the patients will have peace of mind, and if the results are concerning, their therapy will not be delayed while they wait for additional unnecessary testing," she said.
![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)
