The Invaluable Role of CEUS in HCC Imaging: Diagnosis, Management Planning, Guidance of Ablative Therapy, and Secondary Surveillance
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HEMMATI, Shayan et al.
The Invaluable Role of CEUS in HCC Imaging: Diagnosis, Management Planning, Guidance of Ablative Therapy, and Secondary Surveillance.
Medical Research Archives, [S.l.], v. 12, n. 12, jan. 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6175>. Date accessed: 06 jan. 2025.
doi: https://doi.org/10.18103/mra.v12i12.6175.
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Editorial
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-49.
2. Fattovich G, Stroffolini T, Zagni I, Donato F. Hepatocellular carcinoma in cirrhosis: incidence and risk factors. Gastroenterology. 2004;127(5):S3 5-S50.
3. McIntyre CA, Chou JF, Gonen M, Shia J, Gambarin-Gelwan M, Balachandran VP, et al. Hepatocellular carcinoma in patients with no identifiable risk factors. HPB (Oxford). 2021;23(1):1 18-26.
4. Chen H, Zhan Y, Zhang J, Cheng S, Zhou Y, Chen L, et al. The Global, Regional, and National Burden and Trends of NAFLD in 204 Countries and Territories: An Analysis From Global Burden of Disease 2019. JMIR Public Health Surveill. 2022;8 (12):e34809.
5. Fung A, Shanbhogue KP, Taffel MT, Brinkerhoff BT, Theise ND. Hepatocarcinogenesis. Magnetic resonance imaging clinics of North America. 2021;29(3):359-74.
6. Tsilimigras DI, Bagante F, Moris D, Hyer JM, Sahara K, Paredes AZ, et al. Recurrence patterns and outcomes after resection of hepatocellular carcinoma within and beyond the Barcelona clinic liver cancer criteria. Annals of surgical oncology. 2020;27:2321-31.
7. Zhang J, Yu Y, Li Y, Wei L. Diagnostic value of contrast-enhanced ultrasound in hepatocellular carcinoma: a meta-analysis with evidence from 1998 to 2016. Oncotarget. 2017;8(43):75418.
8. Huang J-Y, Li J-W, Lu Q, Luo Y, Lin L, Shi Y-J, et al. Diagnostic accuracy of CEUS LI-RADS for the characterization of liver nodules 20 mm or smaller in patients at risk for hepatocellular carcinoma. Radiology. 2020;294(2):329-39.
9. Hanna RF, Miloushev VZ, Tang A, Finklestone LA, Brejt SZ, Sandhu RS, et al. Comparative 13-year meta-analysis of the sensitivity and positive predictive value of ultrasound, CT, and MRI for detecting hepatocellular carcinoma. Abdominal radiology. 2016;41:71-90.
10. Wang G, Zhu S, Li X. Comparison of values of CT and MRI imaging in the diagnosis of hepatocellular carcinoma and analysis of prognostic factors. Oncology letters. 2019;17(1):1184-8.
11. Hu J, Burrowes DP, Caine BA, Gibson N, Bhayana D, Medellin A, et al. Nodules Identified on Surveillance Ultrasound for HCC: CEUS or MRI as the Initial Test? Journal of Ultrasound in Medicine. 2023;42(6):1181-90.
12. Eisenbrey JR, Gabriel H, Savsani E, Lyshchik A. Contrast-enhanced ultrasound (CEUS) in HCC diagnosis and assessment of tumor response to locoregional therapies. Abdominal Radiology. 2021;46:3579-95.
13. Bansal S, Gui J, Merrill C, Wong JK, Burak KW, Wilson SR. Contrast-enhanced US in Local Ablative Therapy and Secondary Surveillance for Hepatocellular Carcinoma. RadioGraphics. 2019;3 9(5):1302-22.
14. Bansal S, Lu F, Frehlich L, Wong JK, Burak KW, Wilson SR. A new proposal for secondary surveillance following potentially curative therapy of HCC: alternating MRI and CEUS. Abdominal Radiology. 2022:1-12.
15. Radiology ACo. CEUS LI-RADS® v2017 CORE. 2020.
16. Radiology ACo. CT/MRI LI-RADS v2018 core. Liver Imaging Reporting and Data System. 2018.
17. Radiology ACo. LI-RADS® Ultrasound Surveillance v2024 Core. 2024.
18. Radiology ACo. Quality and safety resources: Liver Imaging–Reporting and Data System. Reston, VA: ACR. 2012.
19. Choi J-Y, Cho HC, Sun M, Kim HC, Sirlin CB. Indeterminate observations (liver imaging reporting and data system category 3) on MRI in the cirrhotic liver: fate and clinical implications. American Journal of Roentgenology. 2013;201(5): 993-1001.
20. Hu J, Bhayana D, Burak KW, Wilson SR. Resolution of indeterminate MRI with CEUS in patients at high risk for hepatocellular carcinoma. Abdominal Radiology. 2020;45:123-33.
21. Lee S, Kim YY, Shin J, Hwang SH, Roh YH, Chung YE, et al. CT and MRI Liver Imaging Reporting and Data System Version 2018 for Hepatocellular Carcinoma: A Systematic Review With Meta-Analysis. J Am Coll Radiol. 2020;17(10):1199-206.
22. Mavros MN, Economopoulos KP, Alexiou VG, Pawlik TM. Treatment and prognosis for patients with intrahepatic cholangiocarcinoma: systematic review and meta-analysis. JAMA surgery. 2014;149 (6):565-74.
23. Bridgewater J, Galle PR, Khan SA, Llovet JM, Park J-W, Patel T, et al. Guidelines for the diagnosis and management of intrahepatic cholangiocarcinoma. Journal of Hepatology. 2014;60(6):1268-89.
24. Lyshchik A, Wessner CE, Bradigan K, Eisenbrey JR, Forsberg F, Yi M, et al. Contrast-enhanced ultrasound liver imaging reporting and data system: clinical validation in a prospective multinational study in North America and Europe. Hepatology. 2024;79(2):380-91.
25. Venkatesh SK, Hennedige T, Johnson GB, Hough DM, Fletcher JG. Imaging patterns and focal lesions in fatty liver: a pictorial review. Abdominal radiology (New York). 2017;42(5):1374-92.
26. Botros SM, Ahmed KS, Ismail MZ, Ali WKIH. Non-Alcoholic Fatty Liver Disease-Associated Hepatocellular Carcinoma: Effect of Hepatic Steatosis on Major Hepatocellular Carcinoma Features at MRI. QJM : An International Journal of Medicine. 2023;116(Supplement_1).
27. Wilson SR, Burrowes DP, Merrill C, Caine BA, Gupta S, Burak KW. Unique portal venous phase imaging discordance between CEUS and MRI: a valuable predictor of intrahepatic cholangiocarcinoma? Abdom Radiol (NY). 2024;49 (1):11-20.
28. Wang DC, Jang H-J, Kim TK. Characterization of indeterminate liver lesions on CT and MRI with contrast-enhanced ultrasound: what is the evidence? American Journal of Roentgenology. 2020;214(6): 1295-304.
29. Maruyama H, Takahashi M, Ishibashi H, Yoshikawa M, Yokosuka O. Contrast-enhanced ultrasound for characterisation of hepatic lesions appearing non-hypervascular on CT in chronic liver diseases. The British journal of radiology. 2012;85 (1012):351-7.
30. Kim J-E, Kim Y-s, Rhim H, Lim HK, Lee MW, Choi D, et al. Outcomes of patients with hepatocellular carcinoma referred for percutaneous radiofrequency ablation at a tertiary center: analysis focused on the feasibility with the use of ultrasonography guidance. European Journal of Radiology. 2011;79(2):e80-e4.
31. Renzulli M, Tovoli F, Clemente A, Ierardi AM, Pettinari I, Peta G, et al. Ablation for hepatocellular carcinoma: beyond the standard indications. Med Oncol. 2020;37(4):23.
32. Iezzi R, Pompili M, Posa A, Coppola G, Gasbarrini A, Bonomo L. Combined locoregional treatment of patients with hepatocellular carcinoma: State of the art. World J Gastroenterol. 2016;22(6):1935-42.
33. Qiao A, Samuel AS, Merrill C, Brahmania M, Wilson SR. Occult Liver Nodules: their Detection and Characterization with CEUS Abdominal Radiology. 2024;In print.
34. Maruyama H, Takahashi M, Ishibashi H, Okugawa H, Okabe S, Yoshikawa M, et al. Ultrasound‐guided treatments under low acoustic power contrast harmonic imaging for hepatocellular carcinomas undetected by B‐mode ultrasonography. Liver International. 2009;29(5):708-14.
35. Chan AK, Hegarty C, Klass D, Yoshida E, Chung S, Liu DM, et al. The Role of Contrast-Enhanced Ultrasound in Guiding Radiofrequency Ablation of Hepatocellular Carcinoma. Canadian Association of Radiologists Journal. 2015;66 (2):171-8.
36. Lencioni R, Della Pina C, Bartolozzi C. Percutaneous image-guided radiofrequency ablation in the therapeutic management of hepatocellular carcinoma. Abdominal imaging. 2005;30:401-8.
37. Heimbach JK, Kulik LM, Finn RS, Sirlin CB, Abecassis MM, Roberts LR, et al. AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology. 2018;67(1):358-80.
38. Facciorusso A, Di Maso M, Muscatiello N. Microwave ablation versus radiofrequency ablation for the treatment of hepatocellular carcinoma: A systematic review and meta-analysis. Int J Hyperthermia. 2016;32(3):339-44.
39. Germani G, Pleguezuelo M, Gurusamy K, Meyer T, Isgrò G, Burroughs AK. Clinical outcomes of radiofrequency ablation, percutaneous alcohol and acetic acid injection for hepatocelullar carcinoma: a meta-analysis. J Hepatol. 2010;52(3):380-8.
40. Raoul J-L, Forner A, Bolondi L, Cheung TT, Kloeckner R, de Baere T. Updated use of TACE for hepatocellular carcinoma treatment: How and when to use it based on clinical evidence. Cancer Treatment Reviews. 2019;72:28-36.
41. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2012;56(4):908-43.
42. Salem R, Lewandowski RJ, Kulik L, Wang E, Riaz A, Ryu RK, et al. Radioembolization results in longer time-to-progression and reduced toxicity compared with chemoembolization in patients with hepatocellular carcinoma. Gastroenterology. 2011; 140(2):497-507.e2.
43. Şen T, Tüfekçioğlu O, Koza Y. Mechanical index. Anatol J Cardiol. 2015;15(4):334-6.
44. Pang EHT, Chan A, Ho SG, Harris AC. Contrast-Enhanced Ultrasound of the Liver: Optimizing Technique and Clinical Applications. American Journal of Roentgenology. 2018;210 (2):320-32.
45. Mauri G, Porazzi E, Cova L, Restelli U, Tondolo T, Bonfanti M, et al. Intraprocedural contrast-enhanced ultrasound (CEUS) in liver percutaneous radiofrequency ablation: clinical impact and health technology assessment. Insights into imaging. 2014;5:209-16.
46. Lekht I, Gulati M, Nayyar M, Katz MD, Ter-Oganesyan R, Marx M, et al. Role of contrast-enhanced ultrasound (CEUS) in evaluation of thermal ablation zone. Abdominal radiology. 2016;41:1511-21.
47. Meloni MF, Andreano A, Franza E, Passamonti M, Lazzaroni S. Contrast enhanced ultrasound: Should it play a role in immediate evaluation of liver tumors following thermal ablation? European journal of Radiology. 2012;81(8):e897-e902.
48. Facciorusso A, Del Prete V, Antonino M, Crucinio N, Neve V, Di Leo A, et al. Post-recurrence survival in hepatocellular carcinoma after percutaneous radiofrequency ablation. Digestive and Liver Disease. 2014;46(11):1014-9.
49. Catalano O, Lobianco R, Esposito M, Siani A. Hepatocellular carcinoma recurrence after percutaneous ablation therapy: helical CT patterns. Abdominal imaging. 2001;26:375-83.
50. Kei SK, Rhim H, Choi D, Lee WJ, Lim HK, Kim Y-s. Local tumor progression after radiofrequency ablation of liver tumors: analysis of morphologic pattern and site of recurrence. American Journal of Roentgenology. 2008;190(6):1544-51.
51. Catalano O, Izzo F, Vallone P, Sandomenico F, Albino V, Nunziata A, et al. Integrating contrast-enhanced sonography in the follow-up algorithm of hepatocellular carcinoma treated with radiofrequency ablation: single cancer center experience. Acta Radiologica. 2015;56(2):133-42.
52. Radiology ACo. LI-RADS® CEUS Nonradiation TRA v2024 Core. 2024.
2. Fattovich G, Stroffolini T, Zagni I, Donato F. Hepatocellular carcinoma in cirrhosis: incidence and risk factors. Gastroenterology. 2004;127(5):S3 5-S50.
3. McIntyre CA, Chou JF, Gonen M, Shia J, Gambarin-Gelwan M, Balachandran VP, et al. Hepatocellular carcinoma in patients with no identifiable risk factors. HPB (Oxford). 2021;23(1):1 18-26.
4. Chen H, Zhan Y, Zhang J, Cheng S, Zhou Y, Chen L, et al. The Global, Regional, and National Burden and Trends of NAFLD in 204 Countries and Territories: An Analysis From Global Burden of Disease 2019. JMIR Public Health Surveill. 2022;8 (12):e34809.
5. Fung A, Shanbhogue KP, Taffel MT, Brinkerhoff BT, Theise ND. Hepatocarcinogenesis. Magnetic resonance imaging clinics of North America. 2021;29(3):359-74.
6. Tsilimigras DI, Bagante F, Moris D, Hyer JM, Sahara K, Paredes AZ, et al. Recurrence patterns and outcomes after resection of hepatocellular carcinoma within and beyond the Barcelona clinic liver cancer criteria. Annals of surgical oncology. 2020;27:2321-31.
7. Zhang J, Yu Y, Li Y, Wei L. Diagnostic value of contrast-enhanced ultrasound in hepatocellular carcinoma: a meta-analysis with evidence from 1998 to 2016. Oncotarget. 2017;8(43):75418.
8. Huang J-Y, Li J-W, Lu Q, Luo Y, Lin L, Shi Y-J, et al. Diagnostic accuracy of CEUS LI-RADS for the characterization of liver nodules 20 mm or smaller in patients at risk for hepatocellular carcinoma. Radiology. 2020;294(2):329-39.
9. Hanna RF, Miloushev VZ, Tang A, Finklestone LA, Brejt SZ, Sandhu RS, et al. Comparative 13-year meta-analysis of the sensitivity and positive predictive value of ultrasound, CT, and MRI for detecting hepatocellular carcinoma. Abdominal radiology. 2016;41:71-90.
10. Wang G, Zhu S, Li X. Comparison of values of CT and MRI imaging in the diagnosis of hepatocellular carcinoma and analysis of prognostic factors. Oncology letters. 2019;17(1):1184-8.
11. Hu J, Burrowes DP, Caine BA, Gibson N, Bhayana D, Medellin A, et al. Nodules Identified on Surveillance Ultrasound for HCC: CEUS or MRI as the Initial Test? Journal of Ultrasound in Medicine. 2023;42(6):1181-90.
12. Eisenbrey JR, Gabriel H, Savsani E, Lyshchik A. Contrast-enhanced ultrasound (CEUS) in HCC diagnosis and assessment of tumor response to locoregional therapies. Abdominal Radiology. 2021;46:3579-95.
13. Bansal S, Gui J, Merrill C, Wong JK, Burak KW, Wilson SR. Contrast-enhanced US in Local Ablative Therapy and Secondary Surveillance for Hepatocellular Carcinoma. RadioGraphics. 2019;3 9(5):1302-22.
14. Bansal S, Lu F, Frehlich L, Wong JK, Burak KW, Wilson SR. A new proposal for secondary surveillance following potentially curative therapy of HCC: alternating MRI and CEUS. Abdominal Radiology. 2022:1-12.
15. Radiology ACo. CEUS LI-RADS® v2017 CORE. 2020.
16. Radiology ACo. CT/MRI LI-RADS v2018 core. Liver Imaging Reporting and Data System. 2018.
17. Radiology ACo. LI-RADS® Ultrasound Surveillance v2024 Core. 2024.
18. Radiology ACo. Quality and safety resources: Liver Imaging–Reporting and Data System. Reston, VA: ACR. 2012.
19. Choi J-Y, Cho HC, Sun M, Kim HC, Sirlin CB. Indeterminate observations (liver imaging reporting and data system category 3) on MRI in the cirrhotic liver: fate and clinical implications. American Journal of Roentgenology. 2013;201(5): 993-1001.
20. Hu J, Bhayana D, Burak KW, Wilson SR. Resolution of indeterminate MRI with CEUS in patients at high risk for hepatocellular carcinoma. Abdominal Radiology. 2020;45:123-33.
21. Lee S, Kim YY, Shin J, Hwang SH, Roh YH, Chung YE, et al. CT and MRI Liver Imaging Reporting and Data System Version 2018 for Hepatocellular Carcinoma: A Systematic Review With Meta-Analysis. J Am Coll Radiol. 2020;17(10):1199-206.
22. Mavros MN, Economopoulos KP, Alexiou VG, Pawlik TM. Treatment and prognosis for patients with intrahepatic cholangiocarcinoma: systematic review and meta-analysis. JAMA surgery. 2014;149 (6):565-74.
23. Bridgewater J, Galle PR, Khan SA, Llovet JM, Park J-W, Patel T, et al. Guidelines for the diagnosis and management of intrahepatic cholangiocarcinoma. Journal of Hepatology. 2014;60(6):1268-89.
24. Lyshchik A, Wessner CE, Bradigan K, Eisenbrey JR, Forsberg F, Yi M, et al. Contrast-enhanced ultrasound liver imaging reporting and data system: clinical validation in a prospective multinational study in North America and Europe. Hepatology. 2024;79(2):380-91.
25. Venkatesh SK, Hennedige T, Johnson GB, Hough DM, Fletcher JG. Imaging patterns and focal lesions in fatty liver: a pictorial review. Abdominal radiology (New York). 2017;42(5):1374-92.
26. Botros SM, Ahmed KS, Ismail MZ, Ali WKIH. Non-Alcoholic Fatty Liver Disease-Associated Hepatocellular Carcinoma: Effect of Hepatic Steatosis on Major Hepatocellular Carcinoma Features at MRI. QJM : An International Journal of Medicine. 2023;116(Supplement_1).
27. Wilson SR, Burrowes DP, Merrill C, Caine BA, Gupta S, Burak KW. Unique portal venous phase imaging discordance between CEUS and MRI: a valuable predictor of intrahepatic cholangiocarcinoma? Abdom Radiol (NY). 2024;49 (1):11-20.
28. Wang DC, Jang H-J, Kim TK. Characterization of indeterminate liver lesions on CT and MRI with contrast-enhanced ultrasound: what is the evidence? American Journal of Roentgenology. 2020;214(6): 1295-304.
29. Maruyama H, Takahashi M, Ishibashi H, Yoshikawa M, Yokosuka O. Contrast-enhanced ultrasound for characterisation of hepatic lesions appearing non-hypervascular on CT in chronic liver diseases. The British journal of radiology. 2012;85 (1012):351-7.
30. Kim J-E, Kim Y-s, Rhim H, Lim HK, Lee MW, Choi D, et al. Outcomes of patients with hepatocellular carcinoma referred for percutaneous radiofrequency ablation at a tertiary center: analysis focused on the feasibility with the use of ultrasonography guidance. European Journal of Radiology. 2011;79(2):e80-e4.
31. Renzulli M, Tovoli F, Clemente A, Ierardi AM, Pettinari I, Peta G, et al. Ablation for hepatocellular carcinoma: beyond the standard indications. Med Oncol. 2020;37(4):23.
32. Iezzi R, Pompili M, Posa A, Coppola G, Gasbarrini A, Bonomo L. Combined locoregional treatment of patients with hepatocellular carcinoma: State of the art. World J Gastroenterol. 2016;22(6):1935-42.
33. Qiao A, Samuel AS, Merrill C, Brahmania M, Wilson SR. Occult Liver Nodules: their Detection and Characterization with CEUS Abdominal Radiology. 2024;In print.
34. Maruyama H, Takahashi M, Ishibashi H, Okugawa H, Okabe S, Yoshikawa M, et al. Ultrasound‐guided treatments under low acoustic power contrast harmonic imaging for hepatocellular carcinomas undetected by B‐mode ultrasonography. Liver International. 2009;29(5):708-14.
35. Chan AK, Hegarty C, Klass D, Yoshida E, Chung S, Liu DM, et al. The Role of Contrast-Enhanced Ultrasound in Guiding Radiofrequency Ablation of Hepatocellular Carcinoma. Canadian Association of Radiologists Journal. 2015;66 (2):171-8.
36. Lencioni R, Della Pina C, Bartolozzi C. Percutaneous image-guided radiofrequency ablation in the therapeutic management of hepatocellular carcinoma. Abdominal imaging. 2005;30:401-8.
37. Heimbach JK, Kulik LM, Finn RS, Sirlin CB, Abecassis MM, Roberts LR, et al. AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology. 2018;67(1):358-80.
38. Facciorusso A, Di Maso M, Muscatiello N. Microwave ablation versus radiofrequency ablation for the treatment of hepatocellular carcinoma: A systematic review and meta-analysis. Int J Hyperthermia. 2016;32(3):339-44.
39. Germani G, Pleguezuelo M, Gurusamy K, Meyer T, Isgrò G, Burroughs AK. Clinical outcomes of radiofrequency ablation, percutaneous alcohol and acetic acid injection for hepatocelullar carcinoma: a meta-analysis. J Hepatol. 2010;52(3):380-8.
40. Raoul J-L, Forner A, Bolondi L, Cheung TT, Kloeckner R, de Baere T. Updated use of TACE for hepatocellular carcinoma treatment: How and when to use it based on clinical evidence. Cancer Treatment Reviews. 2019;72:28-36.
41. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2012;56(4):908-43.
42. Salem R, Lewandowski RJ, Kulik L, Wang E, Riaz A, Ryu RK, et al. Radioembolization results in longer time-to-progression and reduced toxicity compared with chemoembolization in patients with hepatocellular carcinoma. Gastroenterology. 2011; 140(2):497-507.e2.
43. Şen T, Tüfekçioğlu O, Koza Y. Mechanical index. Anatol J Cardiol. 2015;15(4):334-6.
44. Pang EHT, Chan A, Ho SG, Harris AC. Contrast-Enhanced Ultrasound of the Liver: Optimizing Technique and Clinical Applications. American Journal of Roentgenology. 2018;210 (2):320-32.
45. Mauri G, Porazzi E, Cova L, Restelli U, Tondolo T, Bonfanti M, et al. Intraprocedural contrast-enhanced ultrasound (CEUS) in liver percutaneous radiofrequency ablation: clinical impact and health technology assessment. Insights into imaging. 2014;5:209-16.
46. Lekht I, Gulati M, Nayyar M, Katz MD, Ter-Oganesyan R, Marx M, et al. Role of contrast-enhanced ultrasound (CEUS) in evaluation of thermal ablation zone. Abdominal radiology. 2016;41:1511-21.
47. Meloni MF, Andreano A, Franza E, Passamonti M, Lazzaroni S. Contrast enhanced ultrasound: Should it play a role in immediate evaluation of liver tumors following thermal ablation? European journal of Radiology. 2012;81(8):e897-e902.
48. Facciorusso A, Del Prete V, Antonino M, Crucinio N, Neve V, Di Leo A, et al. Post-recurrence survival in hepatocellular carcinoma after percutaneous radiofrequency ablation. Digestive and Liver Disease. 2014;46(11):1014-9.
49. Catalano O, Lobianco R, Esposito M, Siani A. Hepatocellular carcinoma recurrence after percutaneous ablation therapy: helical CT patterns. Abdominal imaging. 2001;26:375-83.
50. Kei SK, Rhim H, Choi D, Lee WJ, Lim HK, Kim Y-s. Local tumor progression after radiofrequency ablation of liver tumors: analysis of morphologic pattern and site of recurrence. American Journal of Roentgenology. 2008;190(6):1544-51.
51. Catalano O, Izzo F, Vallone P, Sandomenico F, Albino V, Nunziata A, et al. Integrating contrast-enhanced sonography in the follow-up algorithm of hepatocellular carcinoma treated with radiofrequency ablation: single cancer center experience. Acta Radiologica. 2015;56(2):133-42.
52. Radiology ACo. LI-RADS® CEUS Nonradiation TRA v2024 Core. 2024.