BOSTON — A new nationwide study of more than 11 million patients has confirmed that contrast-enhanced ultrasound (CEUS) is not only safe but also associated with a reduced risk of death. Published in the Journal of the American Heart Association, the peer-reviewed research found that serious adverse reactions to ultrasound enhancing agents (UEAs) are rare, occurring in only one out of every 10,000 cases.
Lead author Dr. Jordan Strom, Associate Professor of Medicine at Harvard Medical School and Director of the Echocardiography Laboratory at Beth Israel Deaconess Medical Center, called the safety profile “exceptionally strong.” He noted that the study used a large, representative dataset covering a four-year period from 2018 to 2022, reflecting real-world healthcare activity across the United States.
The findings reinforce earlier research and suggest that CEUS remains a safe diagnostic option even for seriously ill patients. Dr. Steven Feinstein, Co-President of the International Contrast Ultrasound Society (ICUS), emphasized the clinical importance of the data, describing CEUS as both “very safe” and capable of saving lives.
CEUS is widely used to diagnose cardiovascular disease, evaluate tumors, monitor gastrointestinal conditions, and guide therapy decisions. Unlike contrast agents used in CT or MRI, UEAs do not contain dye, do not pose risks to kidney function or leave brain deposits, and do not expose patients to ionizing radiation. This makes CEUS a safer option for patients with kidney disease or those who are unable to undergo CT or MRI scans.
Dr. Strom stressed that despite CEUS’s established benefits, it remains underused in North America. He urged more healthcare providers to offer it, citing not only safety and clinical value but also the potential to cut healthcare costs by reducing unnecessary follow-up testing.
The study also found that patients who received UEAs were generally sicker than those who did not, yet still experienced a lower risk of death within two days of undergoing echocardiography with UEAs. The analysis tracked outcomes such as anaphylaxis, heart attack, arrhythmias, cardiac arrest, and death, and found no increase in these risks compared to patients who underwent echocardiography without UEAs.
Dr. Stephanie Wilson, Co-President of ICUS and a radiologist at the University of Calgary, said the findings confirm what clinicians observe in practice. She noted that CEUS consistently provides high-resolution imaging and is often the only advanced imaging option for patients who cannot tolerate CT or MRI.
The authors also addressed recent concerns over possible links between COVID-19 vaccines and adverse reactions to UEAs. According to Dr. Strom, the new study found no such association across any agent or year studied.
Three ultrasound enhancing agents are currently approved by the U.S. Food and Drug Administration: Definity (Lantheus), Lumason (Bracco Imaging), and Optison (GE Healthcare). The study’s authors concluded that the low rate of serious adverse events should not deter use of CEUS, especially when compared to the higher risks associated with other types of contrast media.
