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How to Use DEFINITY®: System Optimization

DEFINITY delivers enchancement
* MI settings for LVO will vary by contrast agent, patient and ultrasound system used.
* The safety of activated DEFINITY® at mechanical indices of >0.8 and with end-systolic triggering has not been established.5
  1. Burgess P, et al. Performing an echocardiographic examination with a contrast agent: a series on contrast echocardiography, article 2. J Am Soc Echocardiogr. 2000;13:629-636.
  2. Feigenbaum H. Feigenbaum's Echocardiography. 6th ed. Philadelphia, Pa. Lippencott Williams & Wilkins; 2005:11-45.
  3. Witt SA, et al. Achieving a diagnostic contrast-enhanced echocardiogram: a series on contrast echocardiography, article 4. J Am Soc Echocardiogr. 2001;14:327-334.
  4. McCulloch M, et al. Ultrasound contrast physics: a series on contrast echocardiography, article 3.
    J Am Soc Echocardiogr. 200:13:959-967.
  5. DEFINITY® US Package Insert.
  

Mechanical Index (MI)

  • Measure of acoustic ultrasound power1
  • High MI increases microsphere disruption1
  • MI setting of <0.8 for LVO1*

Focus

  • Narrowest area of the ultrasound beam with the greatest ultrasound intensity2
  • Place focal zone at the mitral valve level 1

Receiver Gain

  • Boosts the amplification of received echoes3

Dynamic Range

  • Adjusts the range of "shades of gray" displayed in the 2D image3

Frame Rate

  • Determines the number of frames per unit of time 2
  • Affects microsphere disruption 4

INDICATIONS

Activated DEFINITY® (Perflutren Lipid Microsphere) Injectable Suspension is indicated for use in patients with suboptimal echocardiograms to opacify the left ventricular chamber and to improve the delineation of the left ventricular endocardial border.

The safety and efficacy of DEFINITY® with exercise stress or pharmacologic stress testing have not been established.

CONTRAINDICATIONS

Do not administer DEFINITY® to patients with known or suspected right-to-left, bi-directional or transient right-to-left cardiac shunts, by intra-arterial injection, or to patients with known hypersensitivity to perflutren.

IMPORTANT SAFETY INFORMATION

WARNING: Serious Cardiopulmonary Reactions 

Serious cardiopulmonary reactions, including fatalities, have occurred during or following perflutren-containing microsphere administration.

  • Assess all patients for the presence of any condition that precludes DEFINITY® administration (see CONTRAINDICATIONS).
  • In patients with pulmonary hypertension or unstable cardiopulmonary conditions, monitor vital sign measurements, electrocardiography and cutaneous oxygen saturation during and for at least 30 minutes after DEFINITY® administration (see WARNINGS).
  • Always have resuscitation equipment and trained personnel readily available.


In post marketing use, rare but serious cardiopulmonary or anaphylactoid reactions have been reported during or shortly following perflutren-containing microsphere administration (see ADVERSE REACTIONS). The risk for these reactions may be increased among patients with pulmonary hypertension or unstable cardiopulmonary conditions. It is not always possible to reliably establish a causal relationship to drug exposure due to the presence of underlying cardiopulmonary disease.

Please See Full Prescribing Information and Letter to Healthcare Providers.