Hepatocellular carcinoma (HCC) is a primary liver malignancy and a leading cause of cancer-related deaths globally. Early detection and accurate diagnosis are essential for effective management and improved survival rates. Ultrasound (US) technology has advanced significantly, playing a critical role in the surveillance, diagnosis, and treatment of HCC. Among various techniques, two-dimensional gray-scale ultrasound is fundamental for HCC monitoring due to its non-invasive nature, cost-effectiveness, and ability to provide real-time liver imaging. Regular surveillance with this technique is recommended for high-risk patients, as studies indicate that consistent monitoring can lead to early detection, significantly enhancing survival rates.
Doppler ultrasound techniques, including color Doppler imaging, are crucial for assessing the vascular characteristics of HCC, helping clinicians evaluate blood flow within tumors and inform therapeutic decisions like transarterial chemoembolization (TACE). Contrast-enhanced ultrasound (CEUS) represents a significant advancement, improving the visualization of blood flow and tissue perfusion in liver lesions. CEUS is increasingly favored for preoperative diagnosis and post-treatment monitoring due to its superior accuracy and absence of radiation exposure. Additionally, tissue harmonic imaging enhances ultrasound image quality, making it easier to differentiate between HCC and benign lesions, particularly in patients with fatty liver disease.
Ultrasound elastography provides valuable insights into tissue stiffness, aiding in distinguishing malignant from benign tumors, while ultrasound fusion imaging integrates real-time ultrasound with CT or MRI for precise lesion localization. Collectively, these ultrasound techniques form the cornerstone of HCC surveillance programs, significantly reducing mortality by facilitating early detection and timely intervention. Ongoing advancements in ultrasound technology promise to further improve the accuracy and efficacy of HCC management, ultimately leading to better patient outcomes.
