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DOI:10.2214/AJR.09.2553
AJR 2009; 193:55-60
© American Roentgen Ray Society

Review

Contrast-Enhanced Ultrasound: What Is the Evidence and What Are the Obstacles?

Stephanie R. Wilson1, Lennard D. Greenbaum2 and Barry B. Goldberg3

1 Department of Diagnostic Imaging, Foothills Medical Centre, 1403 29 St., NW, Calgary, AB T2N 2T9, Canada.
2 The Hughes Center for Fetal Diagnostics, Winnie Palmer Hospital for Women & Babies, Orlando, FL.
3 Division of Ultrasound, Thomas Jefferson University Hospital, Philadelphia, PA.

OBJECTIVE. Although ultrasound contrast agents (UCAs) are popular and widely used in Europe and Asia, the U.S. Food and Drug Administration (FDA) has not approved a microbubble agent for radiology imaging in the United States. Herein, we discuss the evidence for and the obstacles to using UCAs for contrast-enhanced ultrasound (CEUS).

CONCLUSION. Despite the obstacles to the use of UCAs for CEUS including regulatory and practice patterns, the evidence indicates that radiologists and patients will be missing an effectual imaging option if we do not encourage the use of CEUS and strongly support the approval of UCAs by the FDA. The evidence outweighs the obstacles: CEUS is cost-effective; can be performed at the bedside; uses no ionizing radiation; has no nephrotoxicity; and, most importantly, can provide accurate diagnostic information comparable to CT and MRI.

Keywords: contrast-enhanced ultrasound • contrast media • FDA approval • radiology practice guidelines • ultrasound contrast agents


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