Italian guidelines for noninvasive imaging assessment of focal liver lesions

Abstract

The recommendations reported in the study are based on an extensive literature evaluation and were developed by considering the appropriateness of the choice of the imaging techniques while noninvasively detecting and characterizing focal liver lesions.

Contrast enhanced ultrasound in the evaluation and percutaneous treatment of hepatic and renal tumors

“…For the follow-up of metastases post-ablation, CEUS is highly accurate because complete scanning of the liver is achievable during the prolonged late phase [31]. In fact, several studies have confirmed that the accuracy of CEUS in the detection of liver metastases is comparable to that of CECT and CEMRI [14,34,35].…”

“…(a) 10 min after ablation CEUS shows a small thermolesion (17 × 23 mm) (b) 24 h later CEUS shows a thermolesion larger than before (25 × 33 mm). [2,31]. CEUS can be particularly useful when a small area of recurrence is suspected by US, CECT, or CEMRI.…”

Focal masses in a non-cirrhotic liver: The additional benefit of CEUS over baseline imaging

“…According to Italian Guidelines for the role of imaging techniques in the characterization and diagnostic confirmation of FLLs, in all patients (patients with unknown pathology, patients with chronic hepatopathies, oncological patients) [62]:…”

Contrast-enhanced ultrasonography of the liver using SonoVue

“…However, the use of CEUS for the characterization of nodules in cirrhotic livers is recommended by the Italian Association for the Study of the Liver and the Italian National Institute of Health’s Sistema Nazionale Linee Guida [ 20 , 21 ]. The British National Institute for Health and Clinical Excellence recommends the use of SonoVue for characterizing FLLs in adults whose cirrhosis is being monitored if CE-MR is not clinically appropriate, is not accessible or is not acceptable to the person, and when an unenhanced US scan is inconclusive [ 22 ].…”