Round Table
As you know, the upcoming European Symposium on Ultrasound Contrast Imaging in Rotterdam marks a special milestone: it will be the 30th edition. Since its start in 1996, this conference has been characterized by dynamic presentations, provoking posters, and intense, vivid discussions. While topics have evolved over the years, three core subjects—microbubbles, imaging, and therapeutics—have remained central to our conference. At the very first conference, many companies showcased their new microbubbles and contrast agents, such as Sonovue, Quantison, Imagent, and BR963. At the time, only Albunex and Levovist were available as left ventricle agents, with Levovist entering the market a year later. Today, while current microbubbles are well-established, they remain far from optimized. New approaches hold great promise for molecular imaging, drug delivery, and non-invasive pressure measurements. Imaging has also been a key focus from the beginning. Although the harmonic behavior of agents and their destruction under ultrasound pressure were known at the time, these phenomena were not yet utilized by echocardiographic machines. In fact, it was thought impossible to image the harmonic signal due to its low signal level—an assumption that proved pivotal in imaging microbubbles in the myocardium. Today, high-frame-rate imaging has paved the way for advancements like ULM and parametric imaging. The question now is: where will these innovations take us next and what about AI and contrast imaging? Therapeutic applications of contrast agents were explored as early as the second conference, with a presentation titled “Drug Delivery Application of Ultrasound Contrast Agents.” Though these ideas were in their infancy, they were visionary, and now clinical applications are becoming a reality.