Contrast-Enhanced Ultrasound for Guidance of Percutaneous Liver Interventions in Neoplastic Hepatic Disease

Contrast-enhanced ultrasound (CEUS) is an evolving technique for the detection and characterization of focal liver lesions. Currently, it is recommended mainly for inconclusive cases and for patients with contraindications to computed tomography (CT)/magnetic resonance imaging. For percutaneous liver interventions, image guidance is of utmost importance to detect the target lesion. Primarily, ultrasound guidance is used for liver biopsies and ablations. CT is reserved for challenging cases, for example, when the target or the surrounding structures are not well identified with standard B-mode ultrasound. Instead of CT guidance, CEUS has gained increasing interest for percutaneous liver interventions. CEUS has the advantage of superior target visualization, real-time imaging guidance of probe or needle advancement without exposure to radiation.