Ultraschall Med 2015; 36(05): 460-463
DOI: 10.1055/s-0035-1553462
© Georg Thieme Verlag KG Stuttgart · New York

An Introduction to the EFSUMB Guidelines on Interventional Ultrasound (INVUS)

Einführung in die EFSUMB Leitlinien zur Interventionellen Sonographie (INVUS)
C. F. Dietrich
1  Department of Internal Medicine 2, Caritas Krankenhaus, Bad Mergentheim, Germany
7  Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
T. Lorentzen
2  Department of Gastroenterology, Surgical Section, Herlev Hospital, University of Copenhagen, Herlev, Denmark
P. S. Sidhu
3  Department of Radiology, King’s College Hospital, London, UK
C. Jenssen
4  Department of Internal Medicine, Krankenhaus Märkisch Oderland, Strausberg/Wriezen, Germany
O. H. Gilja
5  National Centre for Ultrasound in Gastroenterology, Department of Medicine, Haukeland University Hospital, Bergen, Norway and Department of Clinical Medicine, University of Bergen, Norway
F. Piscaglia
6  Unit of Internal Medicine, Dept of Medical and Surgical Sciences, University of Bologna Hospital S.Orsola Malpighi, Bologna, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
15 October 2015 (online)


In 1972, the delegates of 13 European ultrasound societies met in Basel, Switzerland for the formal foundation of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB). Today the federation comprises 29 national societies with almost 20 000 members. EFSUMB is the largest society within the World Federation for Ultrasound in Medicine and Biology (WFUMB). The European federation's purpose has always been to promote the exchange of scientific knowledge in the field of ultrasound [1].

EFSUMB guidelines

Over the last decade EFSUMB has produced a series of guidelines and recommendations [2] [3] [4] [5] [6] [7] [8].


The introduction of any new diagnostic or treatment tool into clinical practice has always resulted in debate in the medical literature, both by clinicians and health care managers. This generally follows a pattern. The first phase is characterized by enthusiasm and optimism driven by the authors performing and promoting the new technique often reporting convincing outcomes, suggesting significant improvement over previous techniques in the same field. This author optimism is frequently counteracted by the skepticism of clinicians not directly involved in the technique. The second phase, often occurring many years later, is characterized by a more equilibrate evaluation prompting learned scientific societies to produce appropriate clinical guidelines, in which a consensus general agreement on the advantages and limitations of the technique and its diagnostic accuracy has been reached [9] [10].



Contrast-enhanced ultrasound (CEUS) guidelines were first introduced by EFSUMB in 2004 [2]. The CEUS liver guidelines were updated in 2008 [3] and 2012 [5] [11]. The current version was a successful joint WFUMB/EFSUMB venture simultaneously published in Ultraschall in der Medizin/European Journal of Ultrasound (EJU) [5] and Ultrasound in Medicine and Biology (UMB) [11]. The EFSUMB CEUS non-liver guidelines were also recently published and expand the clinical indications for CEUS to almost 30 applications [4]. 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 clinical applications on an international basis and improve the management of patients worldwide.



In addition, the first elastography guidelines worldwide were introduced and published by EFSUMB in 2013 [7] [8]. All EFSUMB guidelines and good clinical practice recommendations are freely available to download from the EFSUMB website (www.efsumb.org).



An image is worth a thousand words, and an image supplemented by an appropriate number of words is the most effective source of information. For this reason, EFSUMB has begun setting up an atlas of images to illustrate the various published clinical recommendations and guidelines, which includes a variety of contrast-enhanced ultrasound and elastographic applications. The published recommendations have printed page restrictions preventing the inclusion of enough clinical images. In the EFSUMB Atlas you can find pictures and video clips illustrating the typical patterns of most of the ultrasound findings described in the guidelines, with the display indexed according to the structure of the guidelines, to allow easy and rapid access directly to your topic of interest. We are confident that visiting these web pages will be fruitful for your professional activity regardless of your particular field of ultrasound application. We also refer to the current published textbook on interventional ultrasound which was also a motivation for more evidence-based recommendations [12] [13].


Impact factor

The successful EFSUMB guidelines published in our official journal “Ultraschall in der Medizin/European Journal of Ultrasound” have gained widespread attention. The impact factor (IF) of our journal has climbed to an impressive 4.9, which is the highest IF of an interdisciplinary ultrasound journal worldwide.