Medical scan transformed into digital images

Ultrasound Advances: How AI and Expert Parsing Are Changing Medical Imaging

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Avery Sinclair in Health & Wellness December 2025 • 5 min read.

"Discover how innovative techniques in contrast-enhanced ultrasound (CEUS) are improving diagnoses and streamlining medical workflows, making healthcare more efficient for everyone."


Contrast-enhanced ultrasound (CEUS) is poised to become an increasingly vital tool in United States radiology practices, especially with the FDA's approval of Lumason for characterizing indeterminate liver lesions. CEUS offers real-time visualization of the vascular space using gas-filled microbubbles, providing excellent acoustic enhancement without the interstitial accumulation seen in CT or MRI contrast agents.

CEUS has several advantages, including its ability to provide real-time imaging, its relative inexpensiveness, and its lack of impact on renal function. The contrast agent is completely removed via the lungs and reticuloendothelial system, allowing for repeated administrations during a single imaging session if necessary. Clinically, CEUS has demonstrated high accuracy in characterizing focal liver lesions and indeterminate renal masses, as well as in detecting residual blood flow following tumor ablations and embolizations.

Despite these benefits, several barriers have hindered the widespread adoption of CEUS in the United States. These include limited physician experience with noncardiac CEUS, a lack of standardized terminology and classification criteria, and challenges related to incorporating CEUS into existing radiology department workflows. Transferring and reviewing long CEUS exam cine clips can be cumbersome, and many radiologists are unaccustomed to reviewing entire ultrasound exams, often relying on a subset of representative images selected by the sonographer.

The Influence of Data Parsing on CEUS Exams: A Detailed Look

Medical scan transformed into digital images

A recent study explored the influence of data parsing on CEUS exams, specifically examining how different methods of selecting images (either at set time intervals or by an experienced sonographer) impact physician diagnoses and confidence levels. The research aimed to determine whether representative images could provide the same diagnostic value as reviewing the entire cine loop, potentially reducing review time and data storage costs.

The study involved forty consecutive CEUS exams, including ten cases each of indeterminate liver lesions, indeterminate renal lesions, renal cell carcinoma (RCC) post-ablation follow-up, and hepatocellular carcinoma (HCC) post-chemoembolization follow-up. These exams were then parsed into sets of five images selected by the performing sonographer and sets containing systematically stored frames every 10, 30, and 60 seconds. Three blinded physicians reviewed the cine loop and each set of images in randomized order, providing a diagnosis and confidence level for each.

  • Sonographer Selection: Images selected by experienced sonographers maintained diagnostic accuracy and confidence levels comparable to reviewing the entire cine loop.
  • Time-Interval Parsing: Parsing at 10-second intervals preserved diagnostic performance but reduced reader confidence.
  • Longer Intervals: Parsing at 30-60 second intervals significantly reduced both diagnostic performance and reader confidence.
The results indicated that for all clinical applications investigated, there were no statistically significant differences in diagnostic performance measures or reader confidence between reviewing the entire cine loop and images selected by the performing sonographer (p > 0.42). Diagnostic performance at 10-second intervals also did not show statistically significant changes compared to the full cine loop review (p > 0.18), although reader confidence decreased. However, at 30-60 second intervals, both diagnostic performance and reader confidence showed statistically significant reduction compared to review of the full cine loop (p < 0.045).

The Future of CEUS: Balancing Efficiency and Accuracy

This study underscores that transferring and reviewing large cine loops from CEUS exams can be a barrier to adoption within United States workflows. However, it also demonstrates that images selected by a performing trained sonographer may provide the same diagnostic value without the review time and data storage costs needed for full cine loop review. Parsing by time points, on the other hand, reduced reader confidence and diagnostic performance, suggesting that this approach may not be optimal for all clinical applications. As CEUS continues to evolve, finding the right balance between efficiency and accuracy will be critical to its successful integration into routine clinical practice.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.acra.2018.09.013, Alternate LINK

Title: Influence Of Data Parsing On Contrast Enhanced Ultrasound Exams

Subject: Radiology, Nuclear Medicine and imaging

Journal: Academic Radiology

Publisher: Elsevier BV

Authors: Jingzhi Li, Laurence Needleman, Ji-Bin Liu, Andrej Lyshchik, Flemming Forsberg, Maria Stanczak, James Mcalister, John Eisenbrey

Published: 2019-08-01

Everything You Need To Know

1

What is contrast-enhanced ultrasound (CEUS), and how does it work?

Contrast-enhanced ultrasound (CEUS) uses gas-filled microbubbles to visualize the vascular space in real-time. These microbubbles enhance the ultrasound image, providing a clearer view of blood flow without the interstitial accumulation seen in other imaging techniques like CT or MRI. CEUS is a valuable tool for assessing various conditions, including liver lesions and renal masses.

2

Why is contrast-enhanced ultrasound (CEUS) considered a valuable diagnostic tool?

CEUS is important because it offers several advantages over other imaging methods. It provides real-time imaging, is relatively inexpensive, and doesn't impact renal function, unlike some contrast agents. The contrast agent used in CEUS is eliminated through the lungs and reticuloendothelial system, enabling multiple administrations during a single session. This makes it suitable for various clinical applications such as characterizing liver lesions and monitoring tumor treatments.

3

What were the key findings of the study regarding data parsing in CEUS exams?

The study's findings indicate that experienced sonographers can select representative images from CEUS exams that maintain diagnostic accuracy and reader confidence, similar to reviewing the entire cine loop. This can significantly reduce the time and costs associated with reviewing and storing large CEUS exam cine clips. However, parsing the CEUS exams at 30-60 second intervals reduced both diagnostic performance and reader confidence, highlighting the importance of the method used for reviewing CEUS data.

4

What is meant by 'data parsing' in the context of CEUS exams, and why is it important?

Data parsing in CEUS refers to the process of selecting and reviewing specific images from the entire ultrasound exam. Different parsing methods, such as selecting images at set time intervals or using the expertise of a sonographer, can influence the diagnostic accuracy and efficiency of the exam review. The study investigated how these different methods affect physician diagnoses and confidence levels, ultimately impacting the workflow and adoption of CEUS.

5

How might CEUS evolve in the future to balance efficiency and accuracy?

The future of CEUS involves finding the right balance between efficiency and accuracy. The research suggests that while reviewing the entire CEUS cine loop offers complete data, methods like using a trained sonographer to select images can maintain diagnostic value while reducing review time and storage costs. Integrating AI and other data parsing techniques could further optimize CEUS workflows, enhancing its role in medical imaging.

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