Copyright ©The Author(s) 2023.
World J Gastroenterol. Jul 7, 2023; 29(25): 4021-4035
Published online Jul 7, 2023. doi: 10.3748/wjg.v29.i25.4021
Table 1 Dynamic contrast-enhanced ultrasound parameters in time-intensity curve
ATArrival timeTime from administration of UCA to the beginning of the curves
AUC or WiWoAUCArea under the curve or wash-in and wash-out area under the curve

Total area under the curve

FTFall timeTime from PE to point where tangent of descending curve across x-axiss
IMAX or MIMaximum intensityMaximum intensity of the curveAIU
MTTMean transit timeMean time taken by contrast to pass through the ROIs
PEPeak enhancement Maximum intensity of the curveAIU
PIPeak intensity Maximum intensity of the curveAIU
PwSlope coefficient of wash-inCoefficient of the enhancement wash-in slopeAIU × s
RTRise timeTime from PE to point where tangent of ascending curve across x-axiss
TPI or TTP or TPTime to peakTime from the beginning of the curve to peaks
WiAUCWash-in area under the curveAUC from the beginning of the curve to PEAIU × s
WoAUCWash-out area under the curveAUC from the PE to the end of the curveAIU × s
WiRWash-in rateTangent at the ascending part of the curveAIU × s
WoRWash-out rateTangent at the descending part of the curveAIU × s
Table 2 Dynamic contrast-enhanced ultrasound and liver diseases
Study design/number of patients
Object of D-CEUS
Significant results (P < 0.05)
Wildner et al[31], 2022Prospective/17Melanoma liver metastasisPatients with melanoma liver metastasis treated with sorafenib/Responders’ vs non-responders Sequoia 512/SonoVue/QontrastIncrease of MTT and TTP is associated with response to treatment and prognosis
Gu et al[30], 2022Retrospective/97HCCPatients with HCC underwent thermal ablationAcuson Sequoia, Phillip EpiQ7/SonoVue/VueBoxWiAUC, WoAUC, and WiWoAUC ratios between HCC and surrounding parenchyma before ablation were predictors of survival
Huang et al[18], 2022 Prospective/120HCCPatients with HCC underwent biopsy/Low-Ki-67 vs high-Ki-67Logiq E9/Sonazoid/NovoUltrasound KitPE difference between HCC and distal liver parenchyma was different in the Kupffer phase
Li et al[22], 2022Retrospective/31HCCPatients with HCC underwent surgery/MVI-positive vs MVI-negativePhillip EpiQ7/Sonazoid/built-in auto contrast softwareNone of the D-CEUS parameters was related to MVI
Zocco et al[28], 2013 Prospective/46Liver parenchyma Cirrhotic patient underwent HVPG/clinically significant portal hypertension vs severe portal hypertensioniU22/SonoVue/QLABNegative correlation between PI, Pw and HVPG. Positive correlation with MTT. AUROC of 1.00 for PI < 23.3 AIU to predict clinically significant portal hypertension
Dong et al[21], 2021 Retrospective/16HCCPatients with HCC underwent surgery/MVI-positive vs MVI-negativeAcuson Oxana, Logiq E9, Siemens Acuson Sequoia/SonoVue, Lumason/VueBoxWiAUC and WoAUC were higher in MVI positive group
Schwarz et al[24], 2021Retrospective/139Focal liver lesionPatients with diagnosed focal liver lesion/malignant versus benignAcuson Sequoia, S2000 or S3000 and Phillip EpiQ7/SonoVue/VueBoxRT and late phase ratio were different between malignant and benign liver lesion
Xuan et al[19], 2021Retrospective/128HCCPatients with HCC underwent biopsy or surgery/highly-differentiated vs moderate-differentiated vs poorly-differentiated -/SonoVue/-RT and MTT increased from poorly- to moderate- to highly-differentiated. Enhancement rates decreased from poorly- to moderate- to highly-differentiated
Amadori et al[32], 2018Prospective/37CRC Liver metastasis Patients underwent chemotherapy/chemotherapy vs chemotherapy plus bevacizumabiU22 vision 2008/SonoVue/QLABReduction of PI and AUC and increase of TPI correlated with higher PFS in chemotherapy plus bevacizumab group
Wildner et al[25], 2019Prospective/148Focal liver lesionPatients with focal liver lesion and subsequent final diagnosis/HCC, CCC, PCA, CRC, BC, MM, FNHSequoia 512/SonoVue/VueBoxHigher PE and WiWoAUC in HCC than CRC. Lower Relative intensity signal for PCA and CRC compared to HCC at 30 and 120 s after PE
Mogensen et al[33], 2017Prospective/12CRC liver metastasisPatients underwent chemotherapy/chemotherapy vs chemotherapy plus bevacizumab Logiq E9/SonoVue/VueBoxEarly changes of PE correlate with tumor shrinkage at CT scan
Zocco et al[28], 2013Prospective/28HCCPatients treated with sorafenib/Responders’ vs non-respondersiU22/SonoVue/QLABPI, Pw and AUC 10% decrease correlate with response to therapy. AUC 10% decrease and increased/unchanged TPI and MTT are associated with longer survival. Decrease of Pw is associated with PFS
Zhan et al[20], 2019Prospective/35HCCPatients with HCC underwent microwaves ablationAcuson Sequia/Sonovue/SonoLiver Positive correlation between MVD, VEGF and IMAX; negative correlation between MVD and TTP. TTP was an independent predictor of OS
Wildner et al[26], 2014 Prospective/43HCC, ICCPatient with proven HCC and ICCAcuson Sequoia 512/SonoVue/VueBoxFT and MTT were lower in ICC than HCC. Relative signal intensity was lower in ICC than HCC in all time point after PE
Frampas et al[69], 2013 Prospective/19HCCPatients with HCC treated with sorafenib or sunitinib/RECIST progressor vs non-progressorAplio XV/SonoVue/Vascular Recognition Imaging” modeAUC decrease ≥ 40% correlated with RECIST non-progression
Lassau et al[29], 2011Prospective/42HCCPatients with HCC treated with BevacizumabAplio scanner/SonoVue/Contrast Harmonic Imaging-Quantification software AUC, WiAUC, WoAUC and TPI decrease correlate with tumor response. TPI decrese correlate with PFS. AUC and WoAC decrease correlate with OS
Table 3 Dynamic contrast-enhanced ultrasound and pancreatic diseases
Study design/number of patients
Object of D-CEUS
Significant results (P < 0.05)
Yang et al[47], 2023Retrospective/42pNETPatients with histopathologically proved pNET/G1, G2, G3, pNECAcuson Sequoia, Acuson Oxana2/SonoVue/VueBoxrPE, rMTT and rAUC were higher in pNETs G1/G2 than G3/pNECs
Zhang et al[45], 2020Prospective/11LAPCPatient with LAPC underwent chemoradiotherapyAcuson Oxana2/SonoVue/SonoLiverMI decreased after chemoradiotherapy
Vitali et al[43], 2015Prospective/20PC, focal AIPPatients with diagnosis of AIP vs histologically proved PCAcuson Sequoia 512, S200/SonoVue/VueBoxThe difference in PE (dPE) between lesion and surrounding parenchyma in AIP was lower compared to dPE in PC
D’Onofrio et al[40], 2014Prospective/10Suspected PDACPatients with suspected and then histologically proved PDAC Acuson S2000/SonoVue/VueBoxPE and ascending curve values were different between lesion and adjacent parenchyma
Kersting et al[42], 2009Prospective/60Undefined pancreatic lesion Patients with undefined pancreatic lesion underwent biopsy/PDAC vs CPSonoline Elegra/SonoVue/Axius ACQTTP and AT were longer in PDAC compared to focal masses in CP
Table 4 Dynamic contrast-enhanced ultrasound and inflammatory bowel diseases
Study design/number of patients
Object of D-CEUS
Significant results (P < 0.05)
Laterza et al[60], 2021 Prospective/44CDPatients with CD treated with anti-TNFα/responders vs non-respondersiU22/SonoVue/QLABCorrelation between decrease in PI, AUC, Pw, and MTT and response to therapy
Goertz et al[57], 2018Prospective/18CD and UCPatients with CD or UC treated with vedolizumab/responders vs non-respondersAcuson S2000/SonoVue/VueBoxWiR was lower in responders’ group after 14 wk
Wilkens et al[56], 2018Retrospective/104CDPatients with severe CD underwent CEUS/normal vs atypical intensity decline on CEUS iU22/Definity/QLAB AUC, wash-out time, and intensity at 60s and 120s were higher in atypical decline group and this correlated with bad outcomes
Quaia et al[53], 2017Prospective/65CDPatients with CD with terminal ileal loop stricture histologically characterized/inflammatory vs fibrostenotic diseaseiU22/SonoVue/VueBoxPE, WiR, WiPI, AUC, WiAUC and WoAUC were higher in inflammatory group compared to fibrostenotic gruoup. TTP was not different between the two groups
Medellin-Kowalewski et al[55], 2016Retrospective/127CDPatients with CD underwent US and CEUSiU22/Definity/QLAB PE correlate with wall thickness
Quaia et al[61], 2016Prospective/50CDPatient with CD underwent medical treatment/responders vs non-responders iU22/SonoVue/VueBoxChanges in PE, WiR, WoR, WiPI, AUC, WiAUC, and WoAUC from baseline to six weeks after therapy differed between responders and non-responses
Socaciu et al[58], 2015Prospective/38CD and UCPatients with CD or CU candidate for medical treatmentLogiq 7/SonoVue/SonoLiverLogarithm of AUC correlated with endoscopic improvement in both diseases
Saevik et al[59], 2014Prospective/14CDPatients with CD started medical treatment/remission vs treatment failureLogiq E9/SonoVue/VueBoxPE, WiR, WoR, and WiAUC were different between two groups at 1 mo of treatment
Romanini et al[50], 2014Prospective/33CDPatients with CD undergoing colonoscopy and biopsy Sequoia 512/SonoVue/QontrastCorrelation between high vascular density and Peak% and regional blood flow
Ripollés et al[51], 2013Prospective/25CDPatients with CD undergoing elective bowel resection/inflammatory vs fibrostenotic diseaseAplio 80/SonoVue/Software in Aplio 80 systemThe percentage of increase in contrast enhancement of the bowel wall in inflammatory lesions was greater than fibrotic lesions
Nylund et al[52], 2013Prospective/33CDPatient with CD underwent surgery or medical treatment/inflammatory vs fibrostenotic diseaseLogiq E9/SonoVue/Custom softwareBlood flow and blood volume were higher in the medical group compared to surgery group
Girlich et al[54], 2012Prospective/11UCPatients with UC undergoing endoscopyLogiq E9/SonoVue/QontrastNegative correlation between TTP/Peak% and histopathological score
Girlich et al[49], 2011Prospective/20CD

Patients with

planned bowel surgery due to CD

Logiq 9/SonoVue/QontrastNegative correlation between TTP and histopathological score. Positive correlation with single items of the score
Girlich et al[48], 2009Prospective/20CDPatients with active CD vs healthy volunteersLogiq 9/SonoVue/QontrastHigher PE and regional blood volume and shorter TTP in CD