{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:39:06Z","timestamp":1788863946621,"version":"build-2803163510"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rofo"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>To develop a training model for contrast-enhanced ultrasound (CEUS)-guided biopsy during the learning phase.<\/jats:p>\n                  <jats:p>An in-vitro model using porcine liver with olive-shaped lesions marked by pepper seeds was employed to simulate tumor biopsies. After targeted injection of sulfur-hexafluoride microbubbles as contrast agent, both native and CEUS-guided biopsies were performed using 18G core needles. Linear transducers of a high-end ultrasound device (3\u201315 MHz) and of a portable handheld ultrasound device (3\u201312 MHz) were utilized. Freehand biopsies were conducted both in-plane and out-of-plane. Twelve procedures each were performed by experienced and novice examiners on lesions located at depths of 2\u20134 cm, with comparisons made regarding procedure duration and image quality. Image and procedure quality were assessed by two independent readers using a scale from 0 (insufficient) to 5 (excellent).<\/jats:p>\n                  <jats:p>CEUS enabled more precise localization and marking of poorly delineated lesions, thereby facilitating targeted biopsy, even in deeper tissue layers. Particularly under challenging acoustic conditions, CEUS improved the planning and execution of interventions for both experienced and novice users when using handheld ultrasound devices. In this in-vitro study, CEUS provided a significant advantage for experienced users working with handheld systems (p &lt; 0.05), whereas its integration into high-end systems did not lead to a significant difference in procedure time (p &gt; 0.05). Novice users, however, benefited significantly from CEUS when using high-end systems (p &lt; 0.01).<\/jats:p>\n                  <jats:p>CEUS-marked lesions in the in-vitro model allow for realistic training of targeted punctures and biopsies \u2013 even for lesions not clearly visible in B-mode imaging. Despite the absence of circulation, the contrast effect remains sufficiently stable to practice CEUS techniques under conditions closely resembling clinical practice. This supports the safe application of portable ultrasound systems in interventional procedures.<\/jats:p>","DOI":"10.1055\/a-2719-5885","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:07:03Z","timestamp":1761869223000},"page":"774-780","source":"Crossref","is-referenced-by-count":1,"title":["In Vitro Model Employing Contrast-enhanced Ultrasound (CEUS) for the Simulation of Radiologic Intraoperative Liver Punctures and Biopsies"],"prefix":"10.1055","volume":"198","author":[{"given":"Moritz Konstantin","family":"Brandenstein","sequence":"additional","affiliation":[{"name":"University Hospital Regensburg, Bayern, Germany","place":["Regensburg"],"department":["Department of Radiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus","family":"Becker","sequence":"additional","affiliation":[{"name":"University Hospital Regensburg, Bayern, Germany","place":["Regensburg"],"department":["Department of Radiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura S.","family":"Kupke","sequence":"additional","affiliation":[{"name":"University Hospital Regensburg, Bayern, Germany","place":["Regensburg"],"department":["Department of Radiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Zhang","sequence":"additional","affiliation":[{"name":"University Hospital Regensburg, Bayern, Germany","place":["Regensburg"],"department":["Department of Radiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Meiler","sequence":"additional","affiliation":[{"name":"University Hospital Regensburg, Bayern, Germany","place":["Regensburg"],"department":["Department of Radiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Stroszczynski","sequence":"additional","affiliation":[{"name":"University Hospital Regensburg, Bayern, Germany","place":["Regensburg"],"department":["Department of Radiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernst Michael","family":"Jung","sequence":"additional","affiliation":[{"name":"University Hospital Regensburg, Bayern, Germany","place":["Regensburg"],"department":["Department of Radiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"publisher","first-page":"181","DOI":"10.3233\/CH-239100","article-title":"Current aspects of multimodal ultrasound liver diagnostics using contrast-enhanced ultrasonography (CEUS), fat evaluation, fibrosis assessment, and perfusion analysis \u2013 An update","volume":"83","author":"EM Jung","year":"2023","journal-title":"Clin Hemorheol Microcirc"},{"issue":"03","key":"ref2","doi-asserted-by":"publisher","first-page":"362","DOI":"10.15403\/jgld-5589","article-title":"New High-resolution 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