The most utilized ultrasound enhancing agent is approved for use in pediatric patients
Data on file, Lantheus.
Image
Optimization
DEFINITY® Delivers High-Quality Images
Image optimization is important when performing a DEFINITY® echo where the image always dictates the appropriate settings.1
Are You Optimizing the Use of Contrast
Echocardiography? A Case-Based Discussion
Anita M. Kelsey, MD, and Steven Walling, RDCS, explore 2 cases to illustrate the importance of teamwork, operational efficiency, and the appropriate use of DEFINITY® in achieving quality echocardiographic imaging.
Image Optimization Guide
Image Optimization Guide
Ultrasound System Control Adjustments Vary by Patient and Ultrasound System
Key Controls to Optimize Image Quality
Mechanical Index/Power: Strength of Ultrasound Beam2
Adjust power to adequately visualize cardiac anatomy
Frequency: Affects the Penetration
of the Ultrasound Beam and
Image Resolution3
Choose a frequency for optimal image resolution
Focus: Narrowest Area of the
Ultrasound Beam With the
Greatest Ultrasound Intensity3
Place focus at the mitral valve level for optimal visualization of the left ventricle
Position focus at area of interest when evaluating pathologies, regional wall motion
High frequencies provide less depth of penetration with greater image resolution.2
Low frequencies provide greater depth of penetration with lower image resolution.2
Power/Mechanical Index Can Have the Greatest Impact on Overall Image Quality
Power adjustments vary by patient and ultrasound system
Power too low
Power Optimized
Secondary Controls to Optimize Image Quality
Gain: boosts the amplification of received echoes1
When gain is set too high, the image may appear too bright
When gain is set too low, the image may appear too dark
Dynamic range/compression: adjusts the range of shades of gray displayed in 2D images1
When setting is too high, the image may appear washed out
When setting is too low, the image may appear dark
Speed of administration and system settings contribute to optimal
image quality
Optimal Opacification
- An ideal administration rate enables a homogeneous fill of the left ventricular cavity
Fast Injection — Attenuation1
- Creates a high concentration of microbubbles in the apex
- Helps to evaluate apical abnormalities
Swirling1
Insufficient opacification inhibits the adequate assessment of structural abnormalities, wall motion, and left ventricular function
- Injection rate too slow or insufficient dose
- Inadequate system settings
- Poor LV function
Left ventricular function plays an important role in the rate at which DEFINITY® should be injected
- Poor LV function or low heart rate may require a more rapid speed of injection to allow DEFINITY® to completely fill the entire LV
- High heart rate may require a slower administration rate
LV=left ventricle.
References:
-
Witt SA, McCulloch M, Sisk E, et al. Achieving a diagnostic contrast-enhanced echocardiogram: a series on contrast echocardiography, article 4. J Am Soc Echocardiogr. 2001;14(4):327-334.
-
Burgess P, Moore V, Bednarz J, et al. Cardiac sonographer's communication. Performing an echocardiographic examination with a contrast agent: a series on contrast echocardiography, article 2. J Am Soc Echocardiogr. 2000;13(6):629-636.
-
Armstrong WF, Ryan T. Feigenbaum's Echocardiography. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2010:9-38.
INDICATIONS
DEFINITY® is indicated, after activation, for use in adult and pediatric patients with suboptimal echocardiograms to opacify the left ventricular chamber and to improve the delineation of the left ventricular endocardial border.
IMPORTANT SAFETY INFORMATION
WARNING: SERIOUS CARDIOPULMONARY REACTIONS
Serious cardiopulmonary reactions, including fatalities, have occurred uncommonly during or following perflutren-containing microsphere administration. Most serious reactions occur within 30 minutes of administration.
- Assess all patients for the presence of any condition that precludes DEFINITY® administration [see Contraindications (4)].
- Always have resuscitation equipment and trained personnel readily available [see Warnings and Precautions (5.1)].
References:
- Witt SA, McCulloch M, Sisk E, et al. Achieving a diagnostic contrast-enhanced echocardiogram: a series on contrast echocardiography, article 4. J Am Soc Echocardiogr. 2001;14(4):327-334.
- Burgess P, Moore V, Bednarz J, et al. Cardiac sonographer's communication. Performing an echocardiographic examination with a contrast agent: a series on contrast echocardiography, article 2. J Am Soc Echocardiogr. 2000;13(6):629-636.
- Armstrong WF, Ryan T. Feigenbaum's Echocardiography. 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2010:9-38.
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