Journal Review

June will be remembered as the month in which the American Institute of Ultrasound in Medicine renewed its crusade to have contrast agents approved for use beyond the heart. The Institute's Journal of Ultrasound in Medicine published several papers dedicated to this topic, including an editorial article by two leading sonologists and a white paper outlining the AIUM's strategy to get FDA approval. The JUM also included original research papers exploring microbubble contrast applications, mostly in the liver.

Commentary

Contrast-enhanced ultrasound: An idea whose time has come

J Ultrasound Med 26:703-704

This editorial from Thomas R. Nelson, Ph.D., and J Brian Fowlkes, Ph.D., voices the concern of U.S. sonologists and sonographers that the lack of ultrasound contrast availability limits imagers' ability to provide optimal diagnosis and hurts society as a whole. The authors endorse the AIUM white paper published in the same issue by Greenbaum et al and encourage researchers to work along with the FDA to get successful approval of ultrasound contrast agents.

Clinical practice

American Institute of Ultrasound in Medicine recommendations for contrast-enhanced liver ultrasound imaging clinical trials

J Ultrasound Med 26:705-716

This paper by Dr. Lennard Greenbaum and colleagues outlines five recommendations for researchers planning to perform contrast-enhanced ultrasound imaging clinical trials. Banking on abundant literature that deals with contrast-enhanced imaging of the liver, the authors have chosen to focus on this organ to speed up the approval process and, eventually, facilitate approval of further applications in other organ systems.

Liver imaging

Contrast-enhanced ultrasonography for assessment of tumor vascularity in hepatocellular carcinoma

J Ultrasound Med 26:757-762

Researchers in China evaluated the efficacy of contrast-enhanced sonography to assess angiogenesis in 50 patients with hepatocellular carcinomas. They used contrast pulse sequencing and quantitative software to analyze the peak intensity of lesions. They found the application of these techniques helped establish tumor vascularity, including microvessel density.

Differential diagnosis of gallbladder diseases with contrast-enhanced harmonic gray-scale ultrasonography

J Ultrasound Med 26:763-774

Researchers in Yokohama, Japan, evaluated the utility of contrast-enhanced sonography for the differential diagnosis of gallbladder tumors. The investigators reviewed contrast-enhanced harmonic gray-scale images from 33 patients with polypoid gallbladder lesions larger than 1 cm. They found that harmonic gray-scale images after contrast injection helped characterize gallbladder carcinoma from benign tumors.

Diagnosis of focal liver masses on ultrasonography: Comparison of unenhanced and contrast-enhanced scans

J Ultrasound Med 26: 75-787

In this study, researchers in Canada led by Dr. Stephanie R. Wilson at the University of Toronto compared the diagnostic accuracy and confidence level of contrast-enhanced and unenhanced ultrasonography imaging of focal liver masses. The investigators enrolled 167 patients. They found that contrast sonography improves diagnostic accuracy and confidence and has an impact on management by reducing the need of further imaging studies.