Handheld Ultrasound: Technical Review and International Expert Consensus Recommendations

Background: Handheld ultrasound (HHUS) is increasingly used in point-of-care imaging because of its portability, accessibility, versatility, and comparatively low cost. Methods: This structured narrative technical review evaluated current HHUS technology, image quality and functionality, clinical applications, regulatory considerations, and future perspectives using recent literature, comparative studies, technical sources, and previous EFSUMB/WFUMB position papers. A structured SWOT analysis informed draft recommendations, which underwent three rounds of scientific discussion and revision by a 17-member international multidisciplinary expert panel. Each of the seven final recommendations was subsequently voted on separately, with consensus predefined as ≥80% agreement. Results: While HHUS devices are increasingly suitable for routine clinical use, further standardization, clinician training, and regulatory alignment are essential for widespread adoption. Conclusions: HHUS can expand access to focused ultrasound imaging, particularly in point-of-care and resource-limited settings. Its appropriate use requires task-specific device selection, adequate training, quality assurance, and recognition of its limitations compared with comprehensive ultrasound systems.