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Giorgio et al. Hepatoma Res 2019;5:20 Hepatoma Research
DOI: 10.20517/2394-5079.2019.05

Review Open Access

Contrast-enhanced ultrasound with sulphur-
hexafluoride in diagnosis of early HCC in cirrhosis

Antonio Giorgio , Pietro Gatti , Paolo Matteucci , Valentina Giorgio 4
3
2
1
1 Department of Medicine, Interventional Ultrasound Unit, Athena Clinical Institute, Caserta 81016, Italy.
2 Department of Medicine, Brindisi General Hospital, Brindisi 72100, Italy.
3 Radiation Oncology Institute, Campus Biomedico University, Rome 00128, Italy.
4 Fondazione Policlinico A.Gemelli IRCCS, Department of Woman and Child Health and Public Health, Roma 00168, Italy.
Correspondence to: Dr. Antonio Giorgio, Department of Medicine, Interventional Ultrasound Unit, Athena Clinical Institute,
Caserta, Italy. E-mail: agiorgio28@gmail.com

How to cite this article: Giorgio A, Gatti P, Matteucci P, Giorgio V. Contrast-enhanced ultrasound with sulphur-hexafluoride in
diagnosis of early HCC in cirrhosis. Hepatoma Res 2019;5:20. http://dx.doi.org/10.20517/2394-5079.2019.05

Received: 12 Jan 2019 First Decision: 25 Mar 2019 Revised: 29 Apr 2019 Accepted: 7 May 2019 Published: 13 Jun 2019
Science Editor: Jin-Lin Hou Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Received: First Decision: Revised: Accepted: Published: Abstract

Science Editor: Copy Editor: Production Editor: Contrast-enhanced ultrasound (CEUS) with pure blood stream contrast agents allow the study of blood supply of
focal liver lesions and especially of hepatocellular carcinoma (HCC) in cirrhosis. Its sensitivity and specificity in
diagnosis of small tumors is very high. This review summarizes the recent results on CEUS with SonoVue, which is
one of the second generation contrast agents, in the diagnosis of early HCC in cirrhosis emphasizing its increasing
role in routine clinical practice.

Keywords: Hepatocellular carcinoma, contrast-enhanced ultrasound, cirrhosis, early hepatocellular carcinoma

INTRODUCTION
Today the use of dynamic imaging modalities allows the study of liver vasculature and in particular the
study of the blood supply of the focal liver lesions. Focal liver lesions can be non-invasively differentiated and
characterized in benign or malignant on the basis of their vascular support, so to avoid the need of biopsy.
This revolution was provided non-invasively by the dynamic study of liver vasculature using contrast-
enhanced CT (CECT), contrast-enhanced MRI (CEMRI) and, lastly, Contrast-enhanced ultrasound (CEUS).
These new dynamic imaging techniques have had a strong impact especially in the field of diagnosis of
hepatocellular carcinoma (HCC) in cirrhosis, and have achieved considerable importance in the management

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
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