Contrast-Enhanced Ultrasound During Percutaneous Hepatosplenic Biopsy and Liver Ablation: Practical Applications, Pharmaceutical Principles, Administration Technique, and Complications

Ultrasound guidance during percutaneous biopsy or thermal ablation of hepatosplenic tumors provides distinct benefits over computed tomography guidance; however, not all lesions are well demarcated by ultrasound. Lesions that are isoechoic to the surrounding normal parenchyma can be occult and procedural outcome by ultrasound guidance may be compromised. Ultrasound contrast administration has been advanced as a method to improve lesion delineation in these cases. In addition, ultrasound contrast can be used to evaluate therapeutic effect after thermal ablation. This manuscript reviews the pharmaceutical principles, technical considerations, and potential complications of ultrasound contrast agents to ensure safe and effective administration during percutaneous hepatosplenic biopsy and liver ablation.