CEUS cardiac exam protocols International Contrast Ultrasound Society (ICUS) recommendations

The present CEUS Cardiac Exam Protocols represent the first effort to promulgate a standard set of protocols for optimal administration of ultrasound enhancing agents (UEAs) in echocardiography, based on more than two decades of experience in the use of UEAs for cardiac imaging. The protocols reflect current clinical CEUS practice in many modern echocardiography laboratories throughout the world. Specific attention is given to preparation and dosing of three UEAs that have been approved by the United States Food and Drug Administration (FDA) and additional regulatory bodies in Europe, the Americas and Asia–Pacific. Consistent with professional society guidelines (J Am Soc Echocardiogr 31:241–274, 2018; J Am Soc Echocardiogr 27:797–810, 2014; Eur Heart J Cardiovasc Imaging 18:1205, 2017), these protocols cover unapproved “off-label” uses of UEAs—including stress echocardiography and myocardial perfusion imaging—in addition to approved uses. Accordingly, these protocols may differ from information provided in product labels, which are generally based on studies performed prior to product approval and may not always reflect state of the art clinical practice or guidelines.