SYSTEMATIC REVIEW article
Front. Radiol.
Sec. Interventional Radiology
Volume 5 - 2025 | doi: 10.3389/fradi.2025.1661522
This article is part of the Research TopicImage-based Diagnostic and/or Therapeutic Agent Delivery Models in CancerView all 5 articles
Evaluation of the Effectiveness of Contrast-enhanced Ultrasound In the Diagnosis of Early Hepatocellular Carcinoma: A Systematic Review
Provisionally accepted
Abdulaziz AlTaweel1
Faisal Joueidi2*Ahmad Joueidi2Ahmed AlDhubaiki1Hamad Mohammed Qabha3Homoud Abdulaziz AlZaid1- 1Department of Radiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- 2Alfaisal University College of Medicine, Riyadh, Saudi Arabia
- 3Department of Radiology, Dallah Hospitals, Riyadh, Saudi Arabia
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Objectives: To investigate the evaluation of the effectiveness of contrast-enhanced ultrasound (CEUS) in the diagnosis of small hepatocellular carcinoma (HCC). Methods: A thorough search was conducted for pertinent literature using PubMed, SCOPUS, Web of Science, Science Direct, and Wiley Library. Rayyan QRCI was used throughout this extensive procedure. Results: Our results included thirteen studies with a total of 2016 patients, and 1672 (82.9%) were males. The follow-up duration ranged from 3 months to 24 months. CEUS was useful in anticipating the early recurrence of HCC, predicting the early recurrence of solitary lesion HCC patients, and differentiating between HCC and intrahepatic cholangiocarcinoma <3 Cm, distinguishing HCC from dysplastic nodules from tiny liver nodules, and CEUS in cirrhotic patients. When paired with CEUS, conventional ultrasonography can detect minor HCC and assist in patient monitoring for those who receive an early diagnosis of HCC. CEUS showed high concordance with CECT for diagnosing lesions 2.1–3.0 cm in size. Notable limitations included heterogeneity in protocols and predominance of Asian populations (12/13 studies). Conclusion: CEUS offers significant clinical value as a noninvasive diagnostic tool, particularly for 1-3 cm lesions in cirrhotic patients and cases where CT is contraindicated, though protocol standardization and Western population validation remain needed.
Keywords: Hepatocellular Carcinoma, contrast-enhanced ultrasound, early cancer, Ultrasound -, Systematic review
Received: 07 Jul 2025; Accepted: 26 Aug 2025.
Copyright: © 2025 AlTaweel, Joueidi, Joueidi, AlDhubaiki, Qabha and AlZaid. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Faisal Joueidi, Alfaisal University College of Medicine, Riyadh, Saudi Arabia
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