News | Ultrasound Imaging | September 15, 2023

CEUS Underutilization May Pose Greater Risk Than Rare Side Effects Associated With Use, Say Experts

Contrast enhanced ultrasound (CEUS) is underutilized in the United States

Getty Images


September 15, 2023 — Contrast enhanced ultrasound (CEUS) is underutilized in the United States, and reduced access to this noninvasive diagnostic imaging tool may pose a greater risk to patients than rare side effects associated with use, according to doctors who spoke today at the 37th International Bubble Conference in Chicago. 

The conference drew CEUS experts from North America, Europe, China and Brazil, and focused on advances in the use of “microbubble” ultrasound enhancing agents (UEAs) used routinely worldwide to diagnose heart and vascular disease, identify and characterize tumors, monitor chronic gastro-intestinal diseases, evaluate other serious medical conditions and monitor therapy. UEAs do not contain dye, create no known risk of kidney damage or deposit of contrast media in the brain, and do not expose patients or hospital staff to ionizing radiation

“CEUS is among the safest of contrast media available,” according to Dr. Strom, an Assistant Professor of Medicine at Harvard Medical School and Director of the Echocardiography Laboratory at Beth Israel Deaconess Medical Center in Boston. He noted that UEAs present a rare risk of a severe allergic reaction in 1/15,000 patients. By comparison, iodinated contrast agents used for CT present a risk of life threatening reactions in 1/500 to 1/5,000 patients. In addition, cardiac angiography presents a risk of death in 1/1,000 patients, and SPECT or MUGA imaging presents a risk of fatal malignancies in 1/1,000-1/10,000 patients. 

To reduce UEA risk even further, Dr. Strom said “dilution of the agent is key.” He noted that vendors are not allowed to recommend UEA dilution because government regulations prohibit them from providing information that is not expressly contained in product labels approved by the FDA

Dr. Strom suggested that clinical applications specialists may, however, refer customers to new professional guidelines recently published in Echo Research and Practice: “CEUS cardiac exam protocols: International Contrast Ultrasound Society (ICUS) recommendations.” These guidelines address dilution and other evidence-based options for optimal UEAadministration. 

Dr. Strom also stressed the importance of preparedness for rare adverse events, and recommended staff training and assessment, detailed planning for a local response including who is responsible for specific tasks, having allergy kits available and stocked, tracking any issues and debriefing afterward. He also recommended posting a safety placard and having an emergency pager that is always covered. 

“Despite the rare risk of an adverse event associated with UEAs, patients face an even greater risk associated with non-use,” said Dr. Tom Porter, lead author of the ICUS guidelines. Dr. Porter is Chair of Cardiology and Professor of Internal Medicine at the University of Nebraska Medical Center in Omaha. 

Dr. Strom said that up to 40% of patients receiving echocardiograms at his medical center receive a UEA. This produces vital diagnostic information and in studies has been associated with reduced need for downstream imaging and cardiac catheterizations. He also said that CEUS use has even been associated with a reduced length of hospital stay in some patients. 

Research led by Dr. Strom also showed significant regional variation in use of UEAs and overall underutilization, resulting in varying standards of care across the country. According to Dr. Strom, the highest per capita use of UEAs is in Minnesota, whereas the lowest utilization is in Delaware. 

UEAs are manufactured and sold by Bracco, Lantheus and GE Healthcare. 

For more information: www.icus-society.org 


Related Content

News | Cardiac Imaging

June 10, 2024 — New expert consensus from the Society of Cardiovascular Computed Tomography (SCCT) reviews previously ...

Home June 10, 2024
Home
News | Cardiac Imaging

May 10, 2024 — According to the Summa Cum Laude Award-Winning Online Poster presented during the 124th ARRS Annual ...

Home May 10, 2024
Home
News | Cardiac Imaging

April 29, 2024 — FUJIFILM Healthcare Americas Corporation, a leading provider of diagnostic and enterprise imaging ...

Home April 29, 2024
Home
News | Cardiac Imaging

April 23, 2024 — CDL Nuclear Technologies, a pioneer in advanced diagnostic solutions, is proud to announce the launch ...

Home April 23, 2024
Home
Feature | Cardiac Imaging

Cardiac positron emission tomography (PET) is growing in popularity among cardiologists because it provides the ability ...

Home March 05, 2024
Home
News | Cardiac Imaging

PLEASE NOTE: This webinar has been postponed to a later date. A new date will be posted in the coming days. On March 25 ...

Home February 29, 2024
Home
News | Cardiac Imaging

February 28, 2024 — Royal Philips, a global leader in health technology, announced major enhancements to its Image ...

Home February 28, 2024
Home
News | Cardiac Imaging

February 12, 2024 — According to the American Journal of Roentgenology (AJR), free-breathing cine-deep learning (DL) may ...

Home February 12, 2024
Home
News | Cardiac Imaging

November 16, 2023 — Cardiovascular diseases rank among the top causes of death across the world, and cardiac ...

Home November 16, 2023
Home
News | Cardiac Imaging

September 21, 2023 — Declines in cardiovascular procedure volumes observed early in the COVID-19 pandemic greatly ...

Home September 21, 2023
Home
Subscribe Now