title: Comparison of Two High-End Ultrasound Systems for Contrast-Enhanced Ultrasound Quantification of Mural Microvascularity in Crohn's Disease.
abstract: OBJECTIVE
  To verify the reproducibility of contrast-enhanced ultrasound (CEUS) quantification results of two different high-end ultrasound systems and to evaluate the clinical utility of the method in patients with Crohn's disease (CD).
  
  
  METHODS
  18 patients with histologically confirmed CD (36.8 % women, 63.2 % men; mean age 43.7 ± 14.1 years) and wall segments thicker than 5 mm were recruited. CEUS quantification and conventional ultrasound investigation were performed under standardized settings using Toshiba Aplio500 and Siemens Acuson S3000 high-end ultrasound systems. CEUS was performed at a low mechanical index of 0.1 after bolus application of 4.8 ml of SonoVue(®) contrast medium. The recorded DICOM clips were quantified using VueBox(®) (version 4.3) calculating 11 quantitative parameters. Subsequently, CEUS quantification and conventional ultrasound results were analyzed.
  
  
  RESULTS
  Correlation of quantitative parameters between the Aplio500 and AcusonS3000 systems for peak enhancement (PE), rise time (RT), wash-in-rate (WiR) and quality of fit (QOF) yielded significance levels of p < 0.05 and p < 0.0001 for wash-in-wash-out area under the curve (WiWoAUC). Spearman rank test showed moderate levels of correlation for PE, RT, WiR and QOF (r = 0.5, 0.49, 0.49 and 0.5 respectively), and high correlation for WiWoAUC (r = 0.89) between the two ultrasound systems.
  
  
  CONCLUSIONS
  Due to multiple uncontrollable affecting factors, the method of CEUS quantification by VueBox in the intestine cannot be recommended for device-independent multicenter studies. Therefore we suggest to use identical ultrasound systems and probes as well as to establish adequate reference ROIS, like a AIF-ROI.
authors.affiliation: Department of Internal Medicine I, University Hospital Ulm, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Zink
authors.affiliation: Department of Internal Medicine I, University Hospital Ulm, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Kratzer
authors.affiliation: Department of Interventional and Diagnostic Radiology, University Hospital Ulm, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Schmidt
authors.affiliation: Department of Internal Medicine I, University Hospital Ulm, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Oeztuerk
authors.affiliation: Department of Veterans Affairs, Louis Stokes Cleveland Medical Center, Brecksville, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Mason
authors.affiliation: Department of Internal Medicine I, University Hospital Ulm, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Porzner
authors.affiliation: Department of Internal Medicine I, University Hospital Ulm, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Klaus
authors.affiliation: Department of Internal Medicine I, University Hospital Ulm, Germany.
authors.forename: M M
authors.initials: MM
authors.lastname: Haenle
authors.affiliation: Department of Interventional and Diagnostic Radiology, University Hospital Ulm, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Graeter
mesh_terms: D000328:Adult; D003287:Contrast Media; D003424:Crohn Disease / Q000000981:diagnostic imaging*; D004867:Equipment Design / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007082:Ileum / Q000098:blood supply* / Q000000981:diagnostic imaging*; D007413:Intestinal Mucosa / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008297:Male; D055806:Microvessels / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010743:Phospholipids; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D013459:Sulfur Hexafluoride; D018615:Ultrasonography, Doppler, Color / Q000295:instrumentation*
chemical_list: D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride