ICUS Weekly News Monitor 5-19-17

ICUS Weekly News Monitor

19 May 2017 - 9 am Eastern

  1. 1.ICUS, May 19, 2017, Professor David Cosgrove, MD, FRCR, FRCP, 1938 - 2017
  2. 2.BMUS, May 19, 2017, 4th International Paediatric CEUS Course - 19 to 20 June 2017


Professor David Cosgrove, MD, FRCR, FRCP, 1938 - 2017

May 19, 2017

David Cosgrove

It is with enormous sorrow that the ICUS Board announces the passing of its dear friend and colleague, David Cosgrove.

David was one of the original founders of ICUS in 2008 and was a member of the Board since its inception. As Professor of Clinical Ultrasound at Imperial College, London, he was a tireless advocate for CEUS and more recently facilitated a role for ICUS in China, where ICUS now has active representation and growing relationships. His passing is a huge loss for the entire ICUS family, and he will be missed enormously as a colleague and a friend, a kind, warm, decent human being with whom it was always a pleasure to spend time. David passed away peacefully at a hospice near his home in south London.

To honor David's memory, the Board has instated a lecture series, to be known as The David Cosgrove Memorial Lecture, that will be given at the Advances in Contrast Ultrasound 'Bubble' Conference each year by an invitee chosen by the Board.


BMUS - The British Medical Ultrasound Society

4th International Paediatric CEUS Course - 19 to 20 June 2017

May 19, 2017


The course will take place at theWindsor Walk Lecture Theatre, Fetal Medicine Research Institute, King’s College Hospital, London.Directions are available here.

This is the 4th occasion that this course has been organised and it has now grown to a full two day course.

The course is recognised as a EUROSON School, with full endorsement of the European Federation of Societies of Ultrasound in Medicine and Biology (EFSUMB) and is endorsed by the British Medical Ultrasound Society (BMUS), with continuing medical education credits provided by the Royal College of Radiologists, United Kingdom.

Registration fees (Fee includes all beverages, lunch on 2 days and course dinner)

  • EFSUMB/BMUS/AIUM member £320.00 (with letter of proof)
  • Medical or Radiology Trainee £320.00 (with letter of proof)
  • Sonographer or Ultrasound Technician £320.00
  • Non Affiliated Physician £400

Further details can be obtained from Emma in the BMUS office.

View the programme.

To register, please visit this website.

ICUS Weekly News Monitor 5-8-17

  1. ICUS,  CEUS: Basic Training for Novices - June 17th 2017,  Hosted by Dr. Stephanie Wilson,   Register Now!
  2. Uro Today, Apr 21, 2017, Feasibility of Contrast-Enhanced Intraoperative Ultrasound for Detection and Characterization of Renal Mass Undergoing Open Partial Nephrectomy       Authors: Le Ott, et al

CEUS: Basic Training for Novices

Hosted by Dr. Stephanie Wilson, Department of Radiology, University of Calgary

June 17, 2017

Register Now

Course Overview:

  • CEUS: What, why and when?
  • Microbubble Contrast Agents: Safety, uses, cost effectiveness and handling.
  • Introduction to CEUS:  Liver, kidney, other organ systems. 
  • Getting started: From set-up to optimizing performance.  
  • Hands-on demonstrations– live patient demonstrations featuring contrast agents and equipment of our sponsors
  • Knobology– Break out rooms with personalized opportunities to "touch and feel" all of the featured ultrasound systems and contrast agents, examine settings, etc.

Course Objectives

  • Understand the fundamentals of CEUS performed with microbubble contrast agents and low MI US techniques.
  • Realize the requirements for initiation of a CEUS facility.
  • Appreciate the protocol for successful performance of CEUS examinations of the liver
  • Recognize the features of common enhancement patterns for benign and malignant liver tumors.

Who Should Attend:

Radiologists, physicians performing contrast enhanced ultrasound, sonographers, technologists, residents, trainees, and other allied health care professionals.


$125.00 Canadian dollars plus GST. Fee includes all meals and course materials food and the closing reception on Saturday Night.


University of Calgary
Training Research and Wellness Center
3280 Hospital Drive NW
Calgary AB


ALOFT Calgary
Rate: 129.00 per night.

Conference Secretariat:

Heather Baylis
+1 403 519 4171
Email:   This email address is being protected from spambots. You need JavaScript enabled to view it.


Uro Today

Feasibility of Contrast-Enhanced Intraoperative Ultrasound for Detection and Characterization of Renal Mass Undergoing Open Partial Nephrectomy

Apr 21, 2017

Authors: Le Ott, Christopher Wood, Raghunandan Vikram, Madhavi Patnana, Priya Bhosale, Roland Bassett, Deepak Bedi

Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA., Department of Urology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA., University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

To determine the feasibility of obtaining intraoperative contrast-enhanced ultrasound (CEUS) imaging in patients undergoing open partial nephrectomy for renal cancer. We hypothesize that the study was feasible and the addition of CEUS would improve lesion identification and characterization.

The study population consisted of 10 patients with known renal mass scheduled for intraoperative ultrasound-guided open partial nephrectomy. After dissection and exposure of the kidney by the surgeon, an intraoperative pre- and post-CEUS was performed by the radiologist. Feasibility was defined as successful imaging in 8 of 10 patients with intraoperative CEUS. Image quality, lesion conspicuity/contrast, lesion vascularity, morphology, and size were assessed and graded with pre- and post-contrast images.

Intraoperative ultrasound was successfully acquired in 10 of 11 patients for renal mass detection and characterization. One study was canceled intraoperatively as a result of clinical complications related to a difficult surgery. Tumor size ranged from 1.3 to 4.2 cm. All lesions were solid. No additional lesions were found on CEUS compared with baseline imaging. Image quality post-contrast ranged from acceptable to excellent. There were no adverse events recorded for all 10 patients.

In our feasibility study consisting of 10 patients, CEUS for detection and characterization of renal mass undergoing open partial nephrectomy was feasible and safe. Because intraoperative ultrasound during open partial nephrectomy can affect the extent of surgery, CEUS can be used to help detect and characterize renal mass for surgical planning/resection intraoperatively.

ICUS Weekly News Monitor 4-10-2017

  1. 1.Circulation: Cardiovascular Imaging,April 4, 2017, Advances in Cardiovascular Imaging; Safety With Echocardiographic Contrast Agents

Authors: Preetham R. Muskula, MD, Michael L. Main, MD

  1. 2.Ultrasound International Open, April 2017, Clinical Applications of Contrast-Enhanced Ultrasound in the Pediatric Work-Up of Focal Liver Lesions and Blunt Abdominal Trauma: A Systematic Review

Authors: Nicolaj Grønbæk Laugesen, Christian Pallson Nolsoe, Jacob Rosenberg

  1. 3.Science Daily,April 4, 2017, Ultrasound and microbubbles flag malignant cancer in humans, says study

Source: Stanford University Medical Center


Circulation: Cardiovascular Imaging

 http://circimaging.ahajournals.orgDOI: 10.1161/CIRCIMAGING.116.005459

Advances in Cardiovascular Imaging

Safety With Echocardiographic Contrast Agents

April 4, 2017

Authors: Preetham R. Muskula, MD; Michael L. Main, MD

From Saint Luke’s Mid America Heart Institute, Kansas City, MO Correspondence to Michael L. Main, MD, Saint Luke’s Mid America Heart Institute, 4330 Wornall Rd, Suite 2000, Kansas City, MO 64111. E-mail  This email address is being protected from spambots. You need JavaScript enabled to view it.


In October 2007, the Food and Drug Administration mandated significant revisions to product labeling for the commercially available echocardiographic contrast agents (ECA) Definity and Optison after spontaneous healthcare provider reports of 4 patient deaths and ≈190 severe cardiopulmonary reactions occurring in close temporal relationship to ECA administration. Since then, multiple large ECA safety studies have been published and have included outpatients, hospitalized patients (including the critically ill), patients undergoing stress echocardiography, and patients with pulmonary hypertension. In addition, the Food and Drug Administration has convened 2 Advisory Committee meetings and the product labels for Optison and Definity have been substantially revised with a softening of safety restrictions.

In this review, we will address the safety of ECA use in patients with serious cardiopulmonary conditions, patients with intracardiac shunts, and special patient populations including pulmonary hypertension, pediatrics, and pregnancy. In addition, we will discuss the confounding role of pseudocomplication in attribution of adverse events during diagnostic testing, the current status of the ECA Black Box Warning, and recommended safety precautions during ECA administration.



Ultrasound International Open

Ultrasound Int Open 2017; 03(01): E2-E7 DOI: 10.1055/s-0042-124502

Clinical Applications of Contrast-Enhanced Ultrasound in the Pediatric Work-Up of Focal Liver Lesions and Blunt Abdominal Trauma: A Systematic Review

April 2017

Authors: Nicolaj Grønbæk Laugesen1, Christian Pallson Nolsoe2, Jacob Rosenberg3

Affiliations: 1 Neurological, Herlev Hospital, Herlev, Denmark; 2 Ultrasound Section, Department of Gastroenterology, Departmentof Surgery, Herlev Hospital, Herlev, Denmark; 3 Department of Surgery, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark


In pediatrics ultrasound has long been viewed more favorably than imaging that exposes patients to radiation and iodinated contrast or requires improved sedation. It is child-friendly and diagnostic capabilities have been with the advent of contrast-enhanced ultrasound (CEUS). The application of CEUS is indeed promising. However, no ultrasound contrast agent manufactured today is registered for pediatric use in Europe. The contrast agent SonoVue® has recently been approved by the FDA under the name of Lumason® to be used in hepatic investigations in adults and children. This article reviews the literature with respect to 2specific applications of CEUS in children: 1) identification of parenchymal injuries following blunt abdominal trauma, and 2) classification of focal liver lesions. Applications were chosen through the CEUS guidelines published by the European Federation of Societies for Ultrasound in Medicine and Biology and World Federation for Ultrasound in Medicine and Biology. Literature was obtained by searching Medline and Pubmed Central (using Pubmed), Scopus database and Embase. CEUS proved to be an effective investigation in the hemodynamically stable child for identifying parenchymal injuries and for the characterization of focal liver lesions. CEUS showed comparable performance to CT and MRI with a specificity of 98 % for identifying benign lesions and a negative predictive value of 100 %. For the applications reviewed here, CEUS holds promising perspectives and can help reduce radiation exposure and use of iodinated contrast agents in pediatrics, thereby potentially reducing complications in routine imaging.

Science Daily

Ultrasound and microbubbles flag malignant cancer in humans, says study

April 4, 2017

Source: Stanford University Medical Center

Jürgen Willmann, MD, a professor of radiology at Stanford, is lead author, and Sanjiv "Sam" Gambhir, MD, PhD, professor and chair of radiology, is the senior author of the study.

Originally published online March 14 in theJournal of Clinical Oncology.

A Stanford-led team of researchers has developed tiny bubbles that bind to malignant tumors, making them visible to ultrasound imaging.

A team led by researchers from the Stanford University School of Medicine has demonstrated a way to diagnose cancer without resorting to surgery, raising the possibility of far fewer biopsies.

For this first-in-humans clinical trial, women with either breast or ovarian tumors were injected intravenously with microbubbles capable of binding to and identifying cancer.

For the study, 24 women with ovarian tumors and 21 women with breast tumors were intravenously injected with the microbubbles. Clinicians used ordinary ultrasound to image the tumors for about a half-hour after injection. The high-tech bubbles clustered in the blood vessels of tumors that were malignant, but not in those that were benign.

The ultrasound imaging of patients’ bubble-labeled tumors was followed up with biopsies and pathology studies that confirmed the accuracy of the diagnostic microbubbles

Medical microbubbles are spheres of phospholipids, the same material that makes up the membranes of living cells. The bubbles are 1 to 4 microns in diameter, a little smaller than a red blood cell, and filled with a harmless mixture of perfluorobutane and nitrogen gas.

Ordinary microbubbles have been approved by the Food and Drug Administration and in clinical use for several years now. But such microbubbles, a kind of ultrasound "contrast agent," have only been used to image organs like the liver by displaying the bubbles as they pass through blood vessels. Up to now, the bubbles couldn’t latch onto blood vessels of cancer in patients.

The microbubbles used in this study were designed to bind to a receptor called KDR found on the tumor blood vessels of cancer but not in healthy tissue. Noncancerous cells don’t have such a receptor. Under ultrasound imaging, the labeled microbubbles, called MBKDR, show up clearly when they cluster in a tumor. And since benign breast and ovarian tumors usually lack KDR, the labeled microbubbles mostly passed them by.

In this small, preliminary safety trial, the technique appeared to be both safe and very sensitive, said Willmann, who is chief of the Division of Body Imaging at Stanford. And it also works with ordinary ultrasound equipment. "So, there’s no new ultrasound equipment that needs to be built for that," he said. "You can just use your regular ultrasound and turn on the contrast mode — which all modern ultrasound equipment has."

Willmann said now that the phase-1 trial has shown that the MBKDR contrast agent is safe for patients, his team is moving forward in a larger phase-2 trial. In that trial, the team will measure how well the combination of MBKDRand ultrasound differentiate cancer from noncancer in breast and in ovarian tumors. The team will also try to find out how small a tumor can be imaged using KDR microbubbles. Because the diagnostic approach can, in principle, be used with any kind of cancer that expresses KDR, they plan to image pancreatic cancer tumors as well.

One of the advantages of MBKDR, Willmann said, is that the bubbles remain attached to the tumors for several minutes and as long as half an hour — the longest time tested in the trial. That should give clinicians time to image both breasts or ovaries without having to start over with a new injection of contrast agent.

If all goes as hoped, the KDR microbubbles could improve diagnoses and reduce unnecessary surgeries in women suspected of having breast or ovarian cancer.

"The difficulty with ultrasound right now," Willmann said, "is that it detects a lot of lesions in the breast, but most of them are benign. And that leads to many unnecessary biopsies and surgeries."

The work is an example of Stanford Medicine’s focus on precision health, the goal of which is to anticipate and prevent disease in the healthy and precisely diagnose and treat disease in the ill.Distinguishing benign from malignant tumors with harmless ultrasound imaging could save millions of patients from biopsies they don’t need, Willman said. "To decrease those unnecessary biopsies and surgeries would be a huge leap forward," he said. "We could make ultrasound a highly accurate screening technology that is relatively low cost, highly available and with no radiation." And since ultrasound technology is accessible almost everywhere, he said, the technology could potentially help patients all over the world.


Other Stanford-affiliated co-authors of the study are assistant professor of radiology Amelie Lutz, MD, and research assistant Keerthi Valluru.

Gambhir is director of the Canary Center for Cancer Early Detection at Stanford, director of the Molecular Imaging Program at Stanford and a member of Stanford Bio-X, the Stanford Cancer Institute, the Stanford Cardiovascular Institute and Stanford ChEM-H. Willmann is a member of Stanford Bio-X, the Molecular Imaging Program and the Canary Center. Lutz is a member of Stanford Bio-X.

Researchers from the Gemelli University Hospital in Rome are also co-authors of the study.

The research was supported by the National Institutes of Health (grants R01CA155289, CCNE-TU54CA151459 and CCNE-TRU54CA119367), the Bracco Group and the Canary Foundation.

ICUS Sponsors

ICUS gratefully acknowledges its 2017 sponsors:






Contact ICUS

  • Address:  International Contrast Ultrasound Society
    c/o Dentons
    233 S. Wacker Drive, Suite 5900 Chicago, IL 60606-6361
  • Telephone: 202-408-6199

About ICUS

ICUS is the world’s only professional society exclusively devoted to contrast-enhanced ultrasound (CEUS) medical imaging technology.

Learn more...

You are here: Home ICUS Weekly News