Comments on the WFUMB EFSUMB 2012 liver guidelines

Contrast Enhanced Ultrasound (CEUS) is a well established diagnostic imaging technique for a variety of indications and applications. One of the most important applications is in the liver where it is frequently a first-line technique for the detection and diagnosis (characterization) of focal liver lesions (FLL). In this setting the accurate differentiation of benign from malignant lesions is critical to ensure the patient undergoes the appropriate therapeutic option.

Initially, a set of guidelines for the use of ultrasound contrast agents was published in 2004 dealing only with liver applications. A second edition of the guidelines in 2008 reflected changes in the available contrast agents and updated the guidelines for the liver, as well as implementing some non-liver applications [1]. Time has moved on, and the need for international guidelines on the use of CEUS in the liver [2,3] and non-liver [4] has become apparent. A joint WFUMB-EFSUMB initiative has implicated experts from major leading ultrasound societies worldwide. These liver CEUS guidelines are simultaneously published in the official journals of both organizing federations (i.e., Ultrasound in Medicine and Biology for WFUMB and Ultraschall in der Medizin/European Journal of Ultrasound for EFSUMB). These guidelines and recommendations provide general advice on the use of all currently clinically available ultrasound contrast agents (UCA). They are intended to create standard protocols for the use and administration of UCA in liver applications on an international basis and improve the management of patients worldwide.

In this Poster the role of CEUS in the characterization of FLL is described in the light of the recently published guidelines.

References:

[1] Piscaglia F, Nolsoe C, Dietrich CF, et al. (2012) The EFSUMB Guidelines and Recommendations on the Clinical Practice of Contrast Enhanced Ultrasound (CEUS): update 2011 on non-hepatic applications. Ultraschall in der Medizin, 33:33 – 59

[2] Claudon M, Dietrich CF, Choi BI, Cosgrove DO, Kudo M, Nolsoe CP et al. Guidelines and Good Clinical Practice Recommendations for Contrast Enhanced Ultrasound (CEUS) in the Liver – Update 2012. Ultraschall Med 2012.

[3] Dietrich CF, Maddalena ME, Cui XW, Schreiber-Dietrich D, Ignee A. Liver tumor characterization – review of the literature. Ultraschall (Suppl) 2012;33:S3-S10.

[4] Dietrich CF. Liver tumor characterization – comments and illustrations regarding guidelines. Ultraschall (Suppl) 2012; 33:S22-S30.

[5] Barreiros AP, Piscaglia F, Dietrich CF. Contrast enhanced ultrasound for the diagnosis of hepatocellular carcinoma (HCC): Comments on AASLD guidelines. J Hepatol 2012;57(4):930 – 932.