SIR 2024
Imaging
Krishna Kinariwala, MD
Interventional Radiology Resident
Temple University Hospital
Financial relationships: Full list of relationships is listed on the CME information page.
Jeffrey Cruz, MD
Clinical Assistant Professor, Interventional Radiology
Temple University Hospital
Disclosure information not submitted.
Joseph Panaro, MD
Clinical Associate Professor, Interventional Radiology
Temple University Hospital
Disclosure information not submitted.
Emily Cuthbertson, MD
Clinical Associate Professor, Interventional Radiology
Temple University Hospital
Disclosure information not submitted.
Shane Lee, MD
Interventional Radiology Attending
Temple University Health System
Disclosure information not submitted.
Perry Gerard, MD, FACR, MBA
Professor of Radiology
New York Medical College- Westchester Medical Center
Disclosure information not submitted.
Jared Meshekow, MD MPH
Clinical Assistant Professor, Vascular and Interventional Radiology
Temple University Hospital
Disclosure information not submitted.
· Explore the utility of contrast-enhanced ultrasound (CEUS) in ablation and embolization procedures.
· Review techniques and best practices for employing CEUS in pre-procedural planning, intra-procedural guidance, and post-procedural assessment.
· Explore clinical findings and procedure details showcasing the utility of CEUS in improving procedural outcomes.
· Review recommendations and lessons learned from CEUS applications in ablation and embolization.
Background:
Contrast-enhanced ultrasound (CEUS) is a highly effective and valuable imaging modality in interventional radiology due to its ability to provide real-time, radiation-free visualization of vascular structures and tissue perfusion. In the context of ablation and embolization procedures, having appropriate guidance is crucial for ensuring optimal clinical outcomes and patient care. This resource is designed to offer detailed information and recommendations on CEUS techniques, best practices, clinical findings, and key examples - thereby enabling healthcare professionals to provide safe and effective care for their patients.
Clinical Findings/Procedure Details:
CEUS in Pre-procedural Planning:
· CEUS aids in better-characterizing lesions and distinguishing between benign and malignant entities.
· CUES enables the assessment of tumor vascularity, helping in pre-procedural planning for embolization.
· CEUS helps evaluate the proximity of critical structures to the target lesion, reducing procedural complications.
CEUS in Intra-procedural Guidance:
· CEUS allows continuous visualization of the target lesion during the procedure, ensuring precise ablation or embolization.
· CUES ensures accurate needle placement, decreasing the risk of incomplete treatment.
· CEUS provides immediate feedback on treatment success and the need for additional intervention.
CEUS in Post-procedural
Assessment:
· CEUS aids in assessing treatment efficacy and detecting perfusion which may indicate residual tumor or incomplete embolization of a vascular structure.
· CEUS can identify post-procedural complications such as bleeding or infarction of healthy tissue.
· CEUS is useful for post-procedural surveillance to monitor treatment response and recurrence.
Conclusion and/or Teaching Points:
Contrast-enhanced ultrasound is a powerful tool that may improve the outcomes of ablation and embolization procedures. Its ability to provide real-time, dynamic imaging during all phases of the intervention enhances safety and efficacy.