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The European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB) introduced the first Guidelines on the use of contrast enhanced ultrasound (CEUS) in 2004[1].This EFSUMB document mainly focused on liver applications.New applications, in addition to the liver,were developed in the following years.Therefore,in the update of the clinical recommendations on the use of CEUS by EFSUMB,published in 2008 [2],applications to other organs were described as well.In the following years an increasing interest in the clinical applications of CEUS technique and new fields has been investigated, so that up to now nearly all organ systems have been subject to CEUS studies.Therefore,EFSUMB initiated a new update of guidelines in 2011 including this knowledge [3].Some of the indications are established whereas others are not which are categorized as emergent CEUS applications since evidence is insufficient for general recommendation.One of the most important applications is in the liver where it is frequently a first-line technique for the detection and diagnosis (characterization) of focal liver lesions (FLL).In this setting the accurate differentiation of benign from malignant lesions is critical to ensure the patient undergoes the appropriate therapeutic option.The role of CEUS in the characterization of FLL is described in a WFUMBEFSUMB initiated guidelines in 2012 in terms of the enhancement patterns of the most common FLL hemangioma,focal nodular hyperplasia hepatocellular adenoma and their differentiation from malignant lesions [4].In addition, an additional EFSUMB document provides some recommendations and descriptions of the quantification of uhrasound images,technical requirements for analysis of time-intensity curves (TICs), methodology for data analysis, and interpretation of the results in dynamic contrast enhanced ultrasound(DCE-US)[5].In conclusion, the presentation focusses on comments, illustrations and examples of the EFSUMB guidelines on CEUS.