Guidelines and Good Clinical Practice Recommendations for Contrast-Enhanced Ultrasound (CEUS) in the Liver-Update 2020 WFUMB in Cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS

Ultrasound Med Biol. 2020 Oct;46(10):2579-2604. doi: 10.1016/j.ultrasmedbio.2020.04.030. Epub 2020 Jul 24.


The present, updated document describes the fourth iteration of recommendations for the hepatic use of contrast-enhanced ultrasound, first initiated in 2004 by the European Federation of Societies for Ultrasound in Medicine and Biology. The previous updated editions of the guidelines reflected changes in the available contrast agents and updated the guidelines not only for hepatic but also for non-hepatic applications. The 2012 guideline requires updating as, previously, the differences in the contrast agents were not precisely described and the differences in contrast phases as well as handling were not clearly indicated. In addition, more evidence has been published for all contrast agents. The update also reflects the most recent developments in contrast agents, including U.S. Food and Drug Administration approval and the extensive Asian experience, to produce a truly international perspective. These guidelines and recommendations provide general advice on the use of ultrasound contrast agents (UCAs) and are intended to create standard protocols for the use and administration of UCAs in liver applications on an international basis to improve the management of patients.

Keywords: Contrast-enhanced ultrasound; Guideline; Liver; World Federation for Ultrasound in Medicine and Biology.

Publication types

  • Practice Guideline
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Contrast Media*
  • Humans
  • Liver / diagnostic imaging*
  • Liver Diseases / diagnostic imaging*
  • Liver Diseases / therapy
  • Liver Neoplasms / diagnostic imaging*
  • Liver Neoplasms / therapy
  • Ultrasonography / methods
  • Ultrasonography / standards*
  • Ultrasonography, Interventional


  • Contrast Media