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EUS liver assessment using contrast agents and elastography.

Andrea Lisotti1, Marta Serrani1, Giancarlo Caletti1

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Summary

Endoscopic ultrasound (EUS) with elastography (EUS-E) and contrast harmonic-EUS (CH-EUS) show potential for evaluating liver diseases, particularly for detecting small lesions and assessing fibrosis. Further research is needed to establish their clinical roles beyond specialized applications.

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Contrast agentEUSelastographyliver

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Area of Science:

  • Gastroenterology and Hepatology
  • Medical Imaging
  • Diagnostic Endoscopy

Background:

  • Transabdominal ultrasound is the primary imaging tool for liver parenchyma and vascularization.
  • Endoscopic ultrasound (EUS) has limitations in fully assessing the liver but is valuable for detecting small focal lesions (<1 cm).
  • Limited data exist on the use of EUS-elastography (EUS-E) and contrast harmonic-EUS (CH-EUS) for liver parenchyma investigation.

Purpose of the Study:

  • To review the clinical utility of EUS-elastography (EUS-E) and contrast harmonic-EUS (CH-EUS) in evaluating liver diseases.
  • To assess the current and potential applications of these advanced EUS techniques in hepatology.

Main Methods:

  • Systematic review of existing literature on EUS-E and CH-EUS for liver disease evaluation.
  • Analysis of studies focusing on lesion detection, characterization, fibrosis assessment, and guided interventions.

Main Results:

  • EUS-E is currently limited to research for differentiating benign/malignant lesions and quantifying liver fibrosis, with future potential in shear-wave elastography for real-time fibrosis assessment.
  • CH-EUS utility is constrained by EUS's limited field of view but can enhance detection and characterization of small liver lesions and aid tissue sampling.
  • Both techniques show promise for improving diagnostic accuracy and guiding interventions in specific liver conditions.

Conclusions:

  • EUS-E and CH-EUS are emerging techniques with potential roles in liver disease evaluation, complementing conventional imaging.
  • Further clinical validation and technological advancements are necessary to fully integrate EUS-E and CH-EUS into routine hepatology practice.
  • Future applications may include real-time fibrosis assessment and targeted EUS-guided therapies.