Ultraschall Med 2020; 41(05): 562-585
DOI: 10.1055/a-1177-0530
Guidelines & Recommendations

Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) in the Liver – Update 2020 – WFUMB in Cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS

Aktualisierte Leitlinien und Empfehlungen für die gute klinische Praxis für CEUS der Leber
Christoph F. Dietrich*
1  Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
2  Johann Wolfgang Goethe Universitätsklinik Frankfurt, Germany
Christian Pállson Nolsøe*
3  Center for Surgical Ultrasound, Dep of Surgery, Zealand University Hospital, Køge. Copenhagen Academy for Medical Education and Simulation (CAMES). University of Copenhagen, Denmark
Richard G. Barr
4  Department of Radiology, Northeastern Ohio Medical University, Rootstown, Ohio, USA and Southwoods Imaging, Youngstown, Ohio, USA
Annalisa Berzigotti
5  Hepatology, University Clinic for Visceral Surgery and Medicine, DBMR, Inselspital, University of Bern, Switzerland
Peter N Burns
6  Dept Medical Biophysics, University of Toronto, Imaging Research, Sunnybrook Research Institute, Toronto
Vito Cantisani
7  Uos Ecografia Internistico-chirurgica, Dipartimento di Scienze Radiologiche, Oncologiche, Anatomo-Patologiche, Policlinico Umberto I, Univ. Sapienza, Rome, Italy
Maria Cristina Chammas
8  Institute of Radiology, Hospital das Clínicas, School of Medicine, University of São Paulo, Brazil
Nitin Chaubal
9  Thane Ultrasound Centre, Jaslok Hospital and Research Centre, Mumbai, India
Byung Ihn Choi
10  Department of Radiology, Chung-Ang University Hospital, Seoul, Korea
Dirk-André Clevert
11  Interdisciplinary Ultrasound-Center, Department of Radiology, University of Munich-Grosshadern Campus, Munich, Germany
Xinwu Cui
12  Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan China
Yi Dong
13  Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai, China
Mirko D’Onofrio
14  Department of Radiology, G.B. Rossi University Hospital, University of Verona, Verona, Italy
J. Brian Fowlkes
15  Basic Radiological Sciences Division, Department of Radiology, University of Michigan Health System, Ann Arbor, MI, United States
Odd Helge Gilja
16  National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, and Department of Clinical Medicine, University of Bergen, Norway
Pintong Huang
17  Department of Ultrasound in Medicine, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
Andre Ignee
18  Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
Christian Jenssen
19  Krankenhaus Märkisch Oderland, Department of Internal Medicine, Strausberg/Wriezen, Germany
Yuko Kono
20  Departments of Medicine and Radiology, University of California, San Diego, USA
Masatoshi Kudo
21  Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
Nathalie Lassau
22  Imaging Department. Gustave Roussy and BIOMAPS. Université Paris-Saclay, Villejuif, France
Won Jae Lee
23  Department of Radiology and Center For Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. Departments of Health and Science and Technology and Medical Device Management and Research, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Korea
Jae Young Lee
24  Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
Ping Liang
25  Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
Adrian Lim
26  Department of Imaging, Imperial College London and Healthcare NHS Trust, Charing Cross Hospital Campus, London United Kingdom
Andrej Lyshchik
27  Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA, United States
Maria Franca Meloni
28  Radiology Dept, University of Pavia, Milano, Italy
Jean Michel Correas
29  Service de Radiologie Adultes, Hôpital Necker, Université Paris Descartes, Paris, France
Yasunori Minami
30  Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
Fuminori Moriyasu
31  Center for Cancer Ablation Therapy, Sanno Hospital, International University of Health and Welfare, Tokyo, Japan
Carlos Nicolau
32  Radiology Department, Hospital Clinic. University of Barcelona, Barcelona, Spain
Fabio Piscaglia
33  Unit of Internal Medicine, Dept of Medical and Surgical Sciences, University of Bologna S. Orsola-Malpighi Hospital, Bologna, Italy
Adrian Saftoiu
34  Research Center of Gastroenterology and Hepatology Craiova, University of Medicine and Pharmacy Craiova, Romania
Paul S. Sidhu
35  Department of Radiology, King’s College Hospital, King’s College London, London
Ioan Sporea
36  Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
Guido Torzilli
37  Department of Surgery, Division of Hepatobiliary & General Surgery, Humanitas University & Research Hospital, Rozzano, Milano, Italy
Xiaoyan Xie
38  Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
Rongqin Zheng
39  Department of Ultrasound, The 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
› Institutsangaben


The present, updated document describes the fourth iteration of recommendations for the hepatic use of contrast enhanced ultrasound (CEUS), first initiated in 2004 by the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB). The previous updated editions of the guidelines reflected changes in the available contrast agents and updated the guidelines not only for hepatic but also for non-hepatic applications.

The 2012 guideline requires updating as previously the differences of the contrast agents were not precisely described and the differences in contrast phases as well as handling were not clearly indicated. In addition, more evidence has been published for all contrast agents. The update also reflects the most recent developments in contrast agents, including the United States Food and Drug Administration (FDA) approval as well as the extensive Asian experience, to produce a truly international perspective.

These guidelines and recommendations provide general advice on the use of ultrasound contrast agents (UCA) and are intended to create standard protocols for the use and administration of UCA in liver applications on an international basis to improve the management of patients.

* Co-first authors.


Eingereicht: 30. April 2020

Angenommen: 12. Mai 2020

24. Juli 2020 (online)

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