An Introduction to the EFSUMB Guidelines on Interventional Ultrasound (INVUS)

Introduction

In 1972, the delegates of 13 European ultrasound societies met in Basel, Switzerland for the formal foundation of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB). Today the federation comprises 29 national societies with almost 20 000 members. EFSUMB is the largest society within the World Federation for Ultrasound in Medicine and Biology (WFUMB). The European federation's purpose has always been to promote the exchange of scientific knowledge in the field of ultrasound [1].

EFSUMB guidelines

Over the last decade EFSUMB has produced a series of guidelines and recommendations [2] [3] [4] [5] [6] [7] [8].

General

The introduction of any new diagnostic or treatment tool into clinical practice has always resulted in debate in the medical literature, both by clinicians and health care managers. This generally follows a pattern. The first phase is characterized by enthusiasm and optimism driven by the authors performing and promoting the new technique often reporting convincing outcomes, suggesting significant improvement over previous techniques in the same field. This author optimism is frequently counteracted by the skepticism of clinicians not directly involved in the technique. The second phase, often occurring many years later, is characterized by a more equilibrate evaluation prompting learned scientific societies to produce appropriate clinical guidelines, in which a consensus general agreement on the advantages and limitations of the technique and its diagnostic accuracy has been reached [9] [10].

CEUS

Contrast-enhanced ultrasound (CEUS) guidelines were first introduced by EFSUMB in 2004 [2]. The CEUS liver guidelines were updated in 2008 [3] and 2012 [5] [11]. The current version was a successful joint WFUMB/EFSUMB venture simultaneously published in Ultraschall in der Medizin/European Journal of Ultrasound (EJU) [5] and Ultrasound in Medicine and Biology (UMB) [11]. The EFSUMB CEUS non-liver guidelines were also recently published and expand the clinical indications for CEUS to almost 30 applications [4]. These guidelines and recommendations provide general advice on the use of all currently clinically available ultrasound contrast agents (UCA). They are intended to create standard protocols for the use and administration of UCA in clinical applications on an international basis and improve the management of patients worldwide.

Elastography

In addition, the first elastography guidelines worldwide were introduced and published by EFSUMB in 2013 [7] [8]. All EFSUMB guidelines and good clinical practice recommendations are freely available to download from the EFSUMB website (www.efsumb.org).

Atlas

An image is worth a thousand words, and an image supplemented by an appropriate number of words is the most effective source of information. For this reason, EFSUMB has begun setting up an atlas of images to illustrate the various published clinical recommendations and guidelines, which includes a variety of contrast-enhanced ultrasound and elastographic applications. The published recommendations have printed page restrictions preventing the inclusion of enough clinical images. In the EFSUMB Atlas you can find pictures and video clips illustrating the typical patterns of most of the ultrasound findings described in the guidelines, with the display indexed according to the structure of the guidelines, to allow easy and rapid access directly to your topic of interest. We are confident that visiting these web pages will be fruitful for your professional activity regardless of your particular field of ultrasound application. We also refer to the current published textbook on interventional ultrasound which was also a motivation for more evidence-based recommendations [12] [13].

Impact factor

The successful EFSUMB guidelines published in our official journal “Ultraschall in der Medizin/European Journal of Ultrasound” have gained widespread attention. The impact factor (IF) of our journal has climbed to an impressive 4.9, which is the highest IF of an interdisciplinary ultrasound journal worldwide.

• References

• 1 Dietrich CF, Rudd L. The EFSUMB website, a guide for better understanding. Med Ultrason 2013; 15 (3) 215-223
• 2 Albrecht T, Blomley M, Bolondi L et al. Guidelines for the use of contrast agents in ultrasound. Ultraschall in Med 2004; 25 (4) 249-256
• 3 Claudon M, Cosgrove D, Albrecht T et al. Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) – update 2008. Ultraschall in Med 2008; 29 (1) 28-44
• 4 Piscaglia F, Nolsoe C, Dietrich CF et al. The EFSUMB Guidelines and Recommendations on the Clinical Practice of Contrast Enhanced Ultrasound (CEUS): update 2011 on non-hepatic applications. Ultraschall in Med 2012; 33 (1) 33-59
• 5 Claudon M, Dietrich CF, Choi BI et al. Guidelines and good clinical practice recommendations for Contrast Enhanced Ultrasound (CEUS) in the liver – update 2012: A WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultraschall in Med 2013; 34 (1) 11-29
• 6 Dietrich CF, Averkiou MA, Correas JM et al. An EFSUMB introduction into Dynamic Contrast-Enhanced Ultrasound (DCE-US) for quantification of tumour perfusion. Ultraschall in Med 2012; 33 (4) 344-351
• 7 Bamber J, Cosgrove D, Dietrich CF et al. EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 1: Basic principles and technology. Ultraschall in Med 2013; 34 (2) 169-184
• 8 Cosgrove D, Piscaglia F, Bamber J et al. EFSUMB Guidelines and Recommendations on the Clinical Use of Ultrasound Elastography. Part 2: Clinical Applications. Ultraschall in Med 2013; 34 (3) 238-253
• 9 Bolondi L. The appropriate allocation of CEUS in the diagnostic algorithm of liver lesions: a debated issue. Ultraschall in Med 2013; 34 (1) 8-10
• 10 Ingravallo F, Dietrich CF, Gilja OH et al. Guidelines, clinical practice recommendations, position papers and consensus statements: definition, preparation, role and application. Ultraschall in Med 2014; 35 (5) 395-399
• 11 Claudon M, Dietrich CF, Choi BI et al. Guidelines and good clinical practice recommendations for Contrast Enhanced Ultrasound (CEUS) in the liver - update 2012: A WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultraschall Med Biol 2013; 39 (2) 187-210
• 12 Dietrich CF, Nuernberg D. Interventional ultrasound. Stuttgart: Thieme Publisher; 2014
• 13 Dietrich CF, Nuernberg D. Interventionelle Sonographie. Stuttgart: Thieme; 2011
• 14 Eltoum IA, Alston EA, Roberson J. Trends in pancreatic pathology practice before and after implementation of endoscopic ultrasound-guided fine-needle aspiration: an example of disruptive innovation effect?. Arch Pathol Lab Med 2012; 136 (4) 447-453
• 15 Yonei A, Nonoue T, Sari A. Real-time ultrasonic guidance for percutaneous puncture of the internal jugular vein. Anesthesiology 1986; 64 (6) 830-831