title: Recall strategies for patients found to have a nodule in cirrhosis: is there still a role for CEUS?
abstract: Development of liver tumors and their evolution to hepatocellular carcinoma (HCC) is a multi-step process in which different HCC-etiologies induce continuous rounds of hepatocyte damage and regeneration. Over an extended time, this triggers cirrhosis which is a pathological state of the liver in which lesions can progress to become dysplastic nodules. Later, these nodules may evolve into HCC and occasionally generate metastatic events. To provide optimal care, patients with liver cancer should be managed using a multidisciplinary approach in specialized centers in which all the diagnostic and therapeutic resources are available. Among the different imaging modalities the introduction on contrast agents for ultrasound use has opened new further applications in different clinical settings. In fact, contrast enhanced ultrasound (CEUS) has been applied for more than ten years and plays increasingly important roles in the management of HCC. Since early 2000, international societies including the American Association for the Study of Liver Diseases (AASLD), the European Association for the Study of the Liver (EASL), the Asian Pacific association for the Study of the Liver (APASL), the Japanese society of Hepatology (JSH), the Italian society for the study of the liver (AISF), the World Federation for Ultrasound in Medicine and Biology (WFUMB), and the European Federation of Societies for Ultrasound in Medicine and Biology (EFUSMB) have discussed the important role of CEUS in the diagnosis of HCC. In the present review an update of the literature and a detailed discussion of the present Guidelines regarding the role of CEUS in the evaluation of nodules in cirrhotic patients is offered.
authors.affiliation: Department of Radiology, Oncology, and Anatomy Pathology, "Sapienza" University of Rome, Italy. vito.cantisani@uniroma1.it.
authors.forename: Vito
authors.initials: V
authors.lastname: Cantisani
authors.affiliation: Department of Radiology, Oncology, and Anatomy Pathology, "Sapienza" University of Rome; Department of Medical Sciences and Morphological and Functional Imaging, Univ. Messina, Messina, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: David
authors.affiliation: Dipartimenti servizi diagnostici Ospedale Valduce, Como, Italy.
authors.forename: Franca Maria
authors.initials: FM
authors.lastname: Meloni
authors.affiliation: Caritas Krankenhaus Bad Mergentheim, Germany.
authors.forename: Christoph Frank
authors.initials: CF
authors.lastname: Dietrich
authors.affiliation: Ultrasound Imaging Laboratory, Department of Imaging and Radiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Radu
authors.initials: R
authors.lastname: Badea
authors.affiliation: Department of Radiology, Oncology, and Anatomy Pathology, "Sapienza" University of Rome, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Messineo
authors.affiliation: Department of Radiology, Oncology, and Anatomy Pathology, "Sapienza" University of Rome, Italy.
authors.forename: Ferdiando
authors.initials: F
authors.lastname: D'Ambrosio
authors.affiliation: Division of Internal Medicine, Department of Medical and Surgical Sciences DIMEC, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Pisgalia
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000209:etiology; D003287:Contrast Media / Q000592:standards*; D005762:Gastroenterology / Q000592:standards; D006801:Humans; D038622:Internationality; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology; D008113:Liver Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D017410:Practice Guidelines as Topic; D011871:Radiology / Q000592:standards; D014463:Ultrasonography / Q000379:methods / Q000592:standards*
chemical_list: D003287:Contrast Media