Role of CEUS as a Secondary Diagnostic Modality

Role of Sonazoid-enhanced Ultrasound as a Secondary Diagnostic Modality in Non-invasive Diagnostic Algorithms for Hepatocellular Carcinoma

To determine the role of contrast-enhanced ultrasound (CEUS) as a second-line imaging modality after gadoxetate-enhanced MRI (Gd-EOB-MRI) for identifying hepatocellular carcinoma (HCC) among at-risks observations.

The purpose of our study was to evaluate the diagnostic ability of CEUS with perflubutane to identify HCC on the indeterminate observation in Gd-EOB-MRI and to establish the role of CEUS as a second-line (post-Gd-EOB-MRI) modality for HCC diagnosis.

Inclusion Criteria:

• at risk of HCC by Liver Imaging Reporting and Data System (LI-RADS)
• at least one treatment-naïve solid hepatic observation (≥1 cm) while surveillance using US, CT or MRI
• signed informed consent

Exclusion Criteria:

• congestive hepatopathies
• severe cardiovascular dysfunction
• no recent cross-sectional images within 4 weeks
• suboptimal cross-sectional images quality