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Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Oct 15, 2021; 13(10): 1302-1316
Published online Oct 15, 2021. doi: 10.4251/wjgo.v13.i10.1302
New frontiers in liver ultrasound: From mono to multi parametricity
Tommaso Vincenzo Bartolotta, Adele Taibbi, Angelo Randazzo, Cesare Gagliardo
Tommaso Vincenzo Bartolotta, Adele Taibbi, Angelo Randazzo, Department of Radiology, University Hospital "Paolo Giaccone", Palermo 90127, Italy
Tommaso Vincenzo Bartolotta, Radiology Department, Fondazione Istituto G. Giglio Hospital, Cefalù 90015, Italy
Cesare Gagliardo, Department of Biopathology and Medical and Forensic Biotechnologies, University of Palermo, Palermo 90127, Italy
Author contributions: Bartolotta TV, Taibbi A, Randazzo A and Gagliardo C contributed equally to this work; all authors have read and approve the final manuscript.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tommaso Vincenzo Bartolotta, MD, PhD, Associate Professor, Department of Radiology, University Hospital "Paolo Giaccone", Via del Vespro 129, Palermo 90127, Italy. tommasovincenzo.bartolotta@unipa.it
Received: February 21, 2021
Peer-review started: February 21, 2021
First decision: May 8, 2021
Revised: July 17, 2021
Accepted: August 24, 2021
Article in press: August 24, 2021
Published online: October 15, 2021
Processing time: 233 Days and 18.4 Hours
Abstract

Modern liver ultrasonography (US) has become a “one-stop shop” able to provide not only anatomic and morphologic but also functional information about vascularity, stiffness and other various liver tissue properties. Modern US techniques allow a quantitative assessment of various liver diseases. US scanning is no more limited to the visualized plane, but three-dimensional, volumetric acquisition and consequent post-processing are also possible. Further, US scan can be consistently merged and visualized in real time with Computed Tomography and Magnetic Resonance Imaging examinations. Effective and safe microbubble-based contrast agents allow a real time, dynamic study of contrast kinetic for the detection and characterization of focal liver lesions. Ultrasound can be used to guide loco-regional treatment of liver malignancies and to assess tumoral response either to interventional procedures or medical therapies. Microbubbles may also carry and deliver drugs under ultrasound exposure. US plays a crucial role in diagnosing, treating and monitoring focal and diffuse liver disease. On the basis of personal experience and literature data, this paper is aimed to review the main topics involving recent advances in the field of liver ultrasound.

Keywords: Ultrasonography; Contrast-enhanced ultrasound; Elastography; Interventional; Doppler ultrasonography

Core Tip: Modern liver ultrasound has become fully multiparametric able to provide not only anatomic and morphologic but also vascularity, stiffness and dynamic assessment of contrast agent kinetic. Over the years, ultrasound has seen a dramatic increase of its clinical applications in diagnosing, treating and monitoring focal and diffuse liver disease. In this review we will focus on the main topics involving recent advances and modern applications in the field of liver ultrasound.