Enhanced Diagnostic Imaging: Arrival-Time Parametric Imaging in Contrast-Enhanced Ultrasound for Multi-Organ Assessment

Contrast-enhanced ultrasonography (CEUS) is a novel technology in ultrasound medicine that has gained widespread application in clinical practice. While CEUS offers various quantitative and qualitative parameters, it is limited by factors such as the single-color transient coverage of the contrast agent and its dependence on the operator, rendering it less suitable for detecting blood in organ lesions. Additionally, fluid dynamic perfusion remains unsatisfactory. Recently, arrival-time parametric imaging (At-PI) has emerged as a promising alternative; this technology not only uses color overlay to statically represent the dynamic perfusion of blood flow within lesions but also enhances visualization, minimizes operator variability, and provides insights into the vascular patterns of both benign and malignant lesions. At-PI has demonstrated numerous advantages and has been successfully applied to the liver, adrenal gland, breast, lymph nodes, prostate, and gastrointestinal tract, yielding encouraging preliminary results. This review synthesizes existing research findings, highlights significant parameters, examines the current global research landscape regarding this technology, and outlines the research directions pursued by scholars in the field. Furthermore, we offer a critical analysis and discussion of the limitations of these findings. The ultimate aim is to elucidate the role of At-PI in clinical diagnosis and treatment.