Radio frequency (RF) thermal ablation is a technique that uses the thermal effect created by radio frequencies to destroy tumors or metastases in the liver.
This treatment for liver cancer can accurately be evaluated by contrast enhanced ultrasound. RF thermal ablation monitored by sonography can lead to immediate re-treatment, preventing a second anesthesia and shortening the hospitalization time.

Sonography [aka: ultrasonography] is a term that encompasses the entire process of performing ultrasound examinations and interpreting the obtained images.
Sonography involves the skilled application of ultrasound technology by trained professionals known as sonographers or ultrasound technologists. These specialists operate the ultrasound equipment, manipulate the transducer, and acquire the necessary pictures for diagnostic imaging purposes. Sonography requires in-depth knowledge of anatomy, physiology, and pathology to accurately interpret the ultrasound images and provide valuable information to the treating physician.
Sonography uses equipment that generates high frequency sound waves to produce images from muscles, soft tissues, fluid collections, and vascular structures of the human body. Obstetric sonography is commonly used during pregnancy. Sonography visualizes anatomy, function, and pathology of for example gallbladder, kidneys, pancreas, spleen, liver, uterus, ovaries, urinary bladder, eye, thyroid, breast, aorta, veins and arteries in the extremities, carotid arteries in the neck, as well as the heart.
A typical medical ultrasound machine, usually a real-time scanner, operates in the frequency range of 2 to 13 megahertz.

See also Musculoskeletal and Joint Ultrasound, Pediatric Ultrasound, Cerebrovascular Ultrasonography and Contrast Enhanced Ultrasound.

(AUS) Abdominal ultrasound, also known as abdominal sonography, is a medical imaging technique that focuses on the visualization and assessment of the abdominal organs. While 'abdominal ultrasound' is the commonly used term, there are alternative terms that can be used to refer to this imaging modality: (TAE) transabdominal echography, abdominal ultrasonography, sonogram, FAST (Focused Assessment with Sonography for Trauma).
Abdominal ultrasound imaging is an invaluable clinical tool for identifying the underlying cause of abdominal pain. An abdominal ultrasound examination encompasses a comprehensive evaluation of the liver, gallbladder, biliary tree, pancreas, spleen, kidneys, and abdominal blood vessels. It is a cost-effective, safe, and non-invasive medical imaging modality that is typically utilized as the initial diagnostic investigation.
Advanced ultrasound techniques, such as high-resolution ultrasound, endoscopic ultrasound, and contrast-enhanced Doppler, further enhance the detection of small lesions and provide detailed information for precise diagnosis.
To prepare for an abdominal ultrasound, it is recommended to have nothing to eat or drink for at least 8 hours, starting from midnight the night before the examination.

Indications:
FAST (Focused Assessment with Sonography for Trauma) is a rapid diagnostic test used for trauma patients. It sequentially evaluates the presence of free fluid in the pericardium (hemopericardium) and in four specific views of the abdomen. These views include the right upper quadrant (RUQ), left upper quadrant (LUQ), subcostal, and suprapubic views. They aid in identifying hemoperitoneum in patients with potential truncal injuries. The space between the liver and the right kidney (RUQ), known as Morison's pouch, is a location where intraperitoneal fluid can accumulate.
Emergency abdominal ultrasonography is indicated in cases of suspected aortic aneurysm, appendicitis, biliary and renal colic, as well as blunt or penetrating abdominal trauma. It plays a crucial role in the timely assessment and management of these conditions, providing critical information to guide appropriate treatment decisions.

See also Handheld Ultrasound, Pelvic Ultrasound, Pregnancy Ultrasound, Prostate Ultrasound, Interventional Ultrasound and Pediatric Ultrasound.

(UCA / USCA) Ultrasonography is the most commonly performed diagnostic imaging procedure. The introduction of sonographic contrast media into routine practice modifies the use of ultrasound in a variety of clinical applications. USCAs consist of microbubbles filled with air or gases and can be classified according to their pharmacokinetics. Among the blood pool agents, transpulmonary ultrasound contrast agents offer higher diagnostic potential compared to agents that cannot pass the pulmonary capillary bed after a peripheral intravenous injection. In addition to their vascular phase, some USCAs can exhibit a tissue- or organ-specific phase.
The sonogram image quality is improved either by decreasing the reflectivity of the undesired interfaces or by increasing the backscattered echoes from the desired regions.

Different types of ultrasound contrast agents:
Ultrasound contrast agents act as echo-enhancers, because of the high different acoustic impedance at the interface between gas and blood. The enhanced echo intensity is proportional to the change in acoustical impedance as the sound beam crosses from the blood to the gas in the bubbles.

The ideal qualities of an ultrasound contrast agent:
A typical ultrasound contrast agent consists of a thin flexible or rigid shell composed of albumin, lipid, or polymer confining a gas such as nitrogen, or a perfluorocarbon. The choice of the microbubble shell and gas has an important influence on the properties of the agent.
Current generations of microbubbles have a diameter from 1 μm to 5 μm. The success of these agents is mostly dependent on the small size and on the stability of their shell, which allows passage of the microbubbles through the pulmonary circulation. Microbubbles must be made smaller than the diameter of capillaries or they would embolize and be ineffective and perhaps even dangerous.
The reflectivity of these microbubbles is proportional to the fourth power of a particle diameter but also directly proportional to the concentration of the contrast agent particles themselves.
Ultrasound contrast agents produce unique acoustic signatures that allow to separate their signal from tissue echoes and to depict whether they are moving or stationary. This enables the detection of capillary flow and of targeted microbubbles that are retained in tissues such as normal liver.
The new generation of contrast media is characterized by prolonged persistence in the vascular bed which provides consistent enhancement of the arterial Doppler signal. Contrast agents make it also possible to perform dynamic and perfusion studies. Targeted contrast imaging agents are for example taken up by the phagocytic cell systems and thus have liver/spleen specific effects.

See also Ultrasound Contrast Agent Safety, Adverse Reaction, Tissue-Specific Ultrasound Contrast Agent, and Bubble Specific Imaging.

From Bayer Schering Pharma AG:
Available in Europe since 1996 and in Japan since 1999. Currently, the marketing situation is unclear.
Levovist® is a first generation USCA consisting of galactose (milk sugar) ground into tiny crystals whose irregular surfaces act as nidation sites on which air pockets form when it is suspended in water, much as soda water bubbles form at small irregularities on the surface of the glass. A trace of palmitic acid is added as a surfactant to stabilize the resultant microbubbles. When Levovist® dissolves in blood, air trapped inside the galactose is released as free gas bubbles. These bubbles have a weak encapsulating shell and are easily destroyed by ultrasound.
Different contrast ultrasonography methods have been developed since the introduction of Levovist®. Initially, Levovist® was an echo contrast medium for improving sensitivity in color Doppler and Power Doppler examinations, but was found to suffer from significant blooming, making it difficult to observe small blood vessels. However, Levovist® improves the accuracy of echocardiographic examinations in such indications as assessment of left ventricular function.
In addition to their vascular phase, some ultrasound contrast agents (USCAs) can exhibit a tissue- or organ-specific phase. Levovist® can accumulate within the liver and the spleen for up to 20 min once it has disappeared from the blood pool and improves the detectability of focal liver lesions and allows more reliable control of interventional tumor treatments. Varied types of information can be obtained by applying contrast imaging at different times after the injection using Levovist® in both the arterial phase and the late organ-specific phase.
1 g Levovist® granules contain 999 mg D-galactose and 1 mg palmitic acid.
Brand names in other countries: Levovist/Levograf