Emerging roles for contrast-enhanced ultrasound.

The article considers new and potential uses for contrast-enhanced ultrasound (CEUS) in radiology. CEUS could become an early, sensitive and inexpensive tool for managing tumor ablation in patients in whom microvascular imaging adds diagnostic information, especially in inflammatory diseases. Its sensitivity in detecting focal liver lesions is comparable to that of other imaging modalities such as computed tomography or magnetic resonance imaging, and it provides a high accuracy in lesion characterization. The main indications in renal diseases are characterization of complicated cysts, arterial infarction and masses in the collecting system and renal vein. As local ablation therapy gains clinical acceptance in liver and recently in renal tumors, CEUS may play an important role in planning the procedure, needle navigation and the follow-up of these patients. In rheumatology, monitoring and optimizing the effectiveness of therapy may also become an important task for CEUS. In breast and prostate cancers, CEUS can add diagnostic value, especially in early detection of tumor recurrence. In lung disease, the technique has considerable potential for characterizing non-ventilated tissues and helping with interventional procedures. In vascular disease, CEUS is of value in arterial stenosis, but its greatest benefit may be in characterizing changes within the vessel wall. It also greatly increases the success rate of transcranial examinations. CEUS is expected to play a major role in detecting sentinel lymph nodes and estimating the tumor burden of involved lymphatic tissue. The possible indications and potential benefits of CEUS are numerous and have yet to be fully exploited.