title: Liver metastases: Contrast-enhanced ultrasound compared with computed tomography and magnetic resonance.
abstract: The development of ultrasound contrast agents with excellent tolerance and safety profiles has notably improved liver evaluation with ultrasound (US) for several applications, especially for the detection of metastases. In particular, contrast enhanced ultrasonography (CEUS) allows the display of the parenchymal microvasculature, enabling the study and visualization of the enhancement patterns of liver lesions in real time and in a continuous manner in all vascular phases, which is similar to contrast-enhanced computed tomography (CT) and contrast-enhanced magnetic resonance imaging. Clinical studies have reported that the use of a contrast agent enables the visualization of more metastases with significantly improved sensitivity and specificity compared to baseline-US. Furthermore, studies have shown that CEUS yields sensitivities comparable to CT. In this review, we describe the state of the art of CEUS for detecting colorectal liver metastases, the imaging features, the literature reports of metastases in CEUS as well as its technique, its clinical role and its potential applications. Additionally, the updated international consensus panel guidelines are reported in this review with the inherent limitations of this technique and best practice experiences.
authors.affiliation: Vito Cantisani, Hektor Grazhdani, Cristina Fioravanti, Maria Rosignuolo, Daniela Messineo, Maria Giulia Bernieri, Adriano Redler, Carlo Catalano, Ferdinando D'Ambrosio, Department of Radiology, Oncology and Anatomo-Pathology "Sapienza" University of Rome, 00161 Rome, Italy.
authors.forename: Vito
authors.initials: V
authors.lastname: Cantisani
authors.affiliation: Vito Cantisani, Hektor Grazhdani, Cristina Fioravanti, Maria Rosignuolo, Daniela Messineo, Maria Giulia Bernieri, Adriano Redler, Carlo Catalano, Ferdinando D'Ambrosio, Department of Radiology, Oncology and Anatomo-Pathology "Sapienza" University of Rome, 00161 Rome, Italy.
authors.forename: Hektor
authors.initials: H
authors.lastname: Grazhdani
authors.affiliation: Vito Cantisani, Hektor Grazhdani, Cristina Fioravanti, Maria Rosignuolo, Daniela Messineo, Maria Giulia Bernieri, Adriano Redler, Carlo Catalano, Ferdinando D'Ambrosio, Department of Radiology, Oncology and Anatomo-Pathology "Sapienza" University of Rome, 00161 Rome, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Fioravanti
authors.affiliation: Vito Cantisani, Hektor Grazhdani, Cristina Fioravanti, Maria Rosignuolo, Daniela Messineo, Maria Giulia Bernieri, Adriano Redler, Carlo Catalano, Ferdinando D'Ambrosio, Department of Radiology, Oncology and Anatomo-Pathology "Sapienza" University of Rome, 00161 Rome, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Rosignuolo
authors.affiliation: Vito Cantisani, Hektor Grazhdani, Cristina Fioravanti, Maria Rosignuolo, Daniela Messineo, Maria Giulia Bernieri, Adriano Redler, Carlo Catalano, Ferdinando D'Ambrosio, Department of Radiology, Oncology and Anatomo-Pathology "Sapienza" University of Rome, 00161 Rome, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Calliada
authors.affiliation: Vito Cantisani, Hektor Grazhdani, Cristina Fioravanti, Maria Rosignuolo, Daniela Messineo, Maria Giulia Bernieri, Adriano Redler, Carlo Catalano, Ferdinando D'Ambrosio, Department of Radiology, Oncology and Anatomo-Pathology "Sapienza" University of Rome, 00161 Rome, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Messineo
authors.affiliation: Vito Cantisani, Hektor Grazhdani, Cristina Fioravanti, Maria Rosignuolo, Daniela Messineo, Maria Giulia Bernieri, Adriano Redler, Carlo Catalano, Ferdinando D'Ambrosio, Department of Radiology, Oncology and Anatomo-Pathology "Sapienza" University of Rome, 00161 Rome, Italy.
authors.forename: Maria Giulia
authors.initials: MG
authors.lastname: Bernieri
authors.affiliation: Vito Cantisani, Hektor Grazhdani, Cristina Fioravanti, Maria Rosignuolo, Daniela Messineo, Maria Giulia Bernieri, Adriano Redler, Carlo Catalano, Ferdinando D'Ambrosio, Department of Radiology, Oncology and Anatomo-Pathology "Sapienza" University of Rome, 00161 Rome, Italy.
authors.forename: Adriano
authors.initials: A
authors.lastname: Redler
authors.affiliation: Vito Cantisani, Hektor Grazhdani, Cristina Fioravanti, Maria Rosignuolo, Daniela Messineo, Maria Giulia Bernieri, Adriano Redler, Carlo Catalano, Ferdinando D'Ambrosio, Department of Radiology, Oncology and Anatomo-Pathology "Sapienza" University of Rome, 00161 Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Catalano
authors.affiliation: Vito Cantisani, Hektor Grazhdani, Cristina Fioravanti, Maria Rosignuolo, Daniela Messineo, Maria Giulia Bernieri, Adriano Redler, Carlo Catalano, Ferdinando D'Ambrosio, Department of Radiology, Oncology and Anatomo-Pathology "Sapienza" University of Rome, 00161 Rome, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: D'Ambrosio
mesh_terms: D003287:Contrast Media; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D011237:Predictive Value of Tests; D011379:Prognosis; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D003287:Contrast Media
keywords: 18F-fluorodeoxyglucose positron emission tomography; Colorectal cancer; Colorectal liver metastases; Computed tomography; Contrast enhanced ultrasound; Intraoperative ultrasound; Magnetic resonance imaging; Ultrasound; Ultrasound contrast agent
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