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The standard Focused Assessment with Sonography in Trauma (FAST) remains a cornerstone of emergency medicine. However, its sensitivity for detecting solid organ injuries often falls short compared to more advanced modalities. Recently, handheld contrast-enhanced ultrasound (cFAST) has emerged as a potential solution to bridge the diagnostic gap between bedside sonography and computed tomography (CT) scans. This technology enhances the visualization of parenchymal and vascular injuries, making it invaluable in high-pressure trauma settings.
A recent study rigorously evaluated six ultrasound systems to determine their ability to visualize contrast enhancement without dedicated software settings. Researchers tested the Philips Lumify, Butterfly IQ3, GE Vscan Air, Fujifilm Sonosite Edge II, Fujifilm Sonosite M-Turbo, and the GE Venue. Consequently, they maintained a low mechanical index to preserve the microbubble contrast agents. Notably, the results showed that the majority of portable systems failed to provide adequate visualization. Therefore, the GE Vscan Air was the only handheld device that successfully visualized contrast, performing comparably to the cart-based GE Venue.
The ability to perform handheld contrast-enhanced ultrasound in the field or at the bedside could revolutionize trauma management. Specifically, this capability allows for faster triage and more accurate assessment of internal hemorrhages. While the GE Vscan Air showed significant promise, other devices lacked the necessary sensitivity under standard configurations. Accordingly, manufacturers may need to develop dedicated software upgrades or specific contrast-imaging presets to enable these features across more platforms.
Moving forward, researchers must investigate if dosing adjustments or hardware modifications can improve visualization on other handheld systems. Furthermore, reliable cFAST methods are essential for military and remote medical environments where access to CT scanners is non-existent. Enhancing these portable tools will ultimately lead to better patient outcomes in emergency care. Consequently, the medical community should prioritize the integration of contrast-capable software into next-generation handheld devices.
cFAST provides significantly higher sensitivity for diagnosing solid organ and vascular injuries, reaching a level of diagnostic accuracy that rivals CT scans while remaining available at the bedside.
The GE Vscan Air was the only handheld device in the study that successfully visualized contrast enhancement, whereas several other popular portable systems failed to do so.
Most portable systems currently lack dedicated contrast imaging settings and software optimizations, which are necessary to manage the low-power output required to prevent microbubble destruction.
Disclaimer: This content is for informational and educational purposes only. It does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.
References
Alexandri M et al. Contrast-Enhanced Focused Assessment with Sonography for Trauma (cFAST) Far Forward: Contrast Visualization Methods Testing of Six Field-Portable and Handheld Ultrasound Systems. J Spec Oper Med. 2026 Mar 22. doi: undefined. PMID: 41865312.
Valentino DJ et al. Contrast-enhanced ultrasound in abdominal trauma. J Trauma Acute Care Surg. 2024;92(4):654-662.
Ripolles T et al. Contrast-enhanced ultrasound (CEUS) in abdominal trauma: a review. Insights Imaging. 2023;14:102.
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