However, challenges with transient respiratory motion artifacts, judging washout, and other technical limitations must be considered [57,58]. US Abdomen with IV Contrast CEUS has been shown to be highly sensitive for the diagnosis of HCC at centers of excellence [14,67,68]. However, CEUS requires focused observation of a single region of interest, and although the ability to reinject after a period of washout allows for more than one region to be evaluated during a single examination, this may not be well-suited for whole-liver assessment as is needed for screening and surveillance [69]. Chronic Liver Disease US Shear Wave Elastography Abdomen The use of SWE has been described for assessment of focal liver lesions in a limited number of small studies [70,71]. However, SWE assessments are typically performed slice by slice; thus, the technique is poorly suited to whole- liver surveillance. To date, most reported investigations on the application of SWE in the liver have focused on liver fibrosis assessment and, to a lesser extent, on differentiating benign from malignant focal lesions. US Duplex Doppler Abdomen Doppler US is typically performed in conjunction with conventional grayscale US assessment. The duplex Doppler component may add value to the grayscale examination, allowing tumor in vein to be more readily identified. Variant 3: Chronic liver disease. Previous diagnosis of HCC. Post-treatment monitoring for HCC. Treatment options for patients with HCC may include liver transplantation, surgical resection, external beam radiation therapy, chemotherapy, and locoregional treatments, including percutaneous ablative and embolic modalities. After liver transplantation and surgical resection with negative margins, the goal of post-treatment monitoring is surveillance for new foci of HCC. After treatments in which the HCC is not actually removed, both monitoring of the treatment site as well as surveillance for distant foci of HCC must be accomplished.
Chronic Liver Disease. However, challenges with transient respiratory motion artifacts, judging washout, and other technical limitations must be considered [57,58]. US Abdomen with IV Contrast CEUS has been shown to be highly sensitive for the diagnosis of HCC at centers of excellence [14,67,68]. However, CEUS requires focused observation of a single region of interest, and although the ability to reinject after a period of washout allows for more than one region to be evaluated during a single examination, this may not be well-suited for whole-liver assessment as is needed for screening and surveillance [69]. Chronic Liver Disease US Shear Wave Elastography Abdomen The use of SWE has been described for assessment of focal liver lesions in a limited number of small studies [70,71]. However, SWE assessments are typically performed slice by slice; thus, the technique is poorly suited to whole- liver surveillance. To date, most reported investigations on the application of SWE in the liver have focused on liver fibrosis assessment and, to a lesser extent, on differentiating benign from malignant focal lesions. US Duplex Doppler Abdomen Doppler US is typically performed in conjunction with conventional grayscale US assessment. The duplex Doppler component may add value to the grayscale examination, allowing tumor in vein to be more readily identified. Variant 3: Chronic liver disease. Previous diagnosis of HCC. Post-treatment monitoring for HCC. Treatment options for patients with HCC may include liver transplantation, surgical resection, external beam radiation therapy, chemotherapy, and locoregional treatments, including percutaneous ablative and embolic modalities. After liver transplantation and surgical resection with negative margins, the goal of post-treatment monitoring is surveillance for new foci of HCC. After treatments in which the HCC is not actually removed, both monitoring of the treatment site as well as surveillance for distant foci of HCC must be accomplished.