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Prospects and challenges of US and CEUS

Ultrasound is already a major technique to study focal liver lesions. Particularly since the arrival of the ultrasound contrast agents which allows a sensitivity greater than 90% for characterizing incidentally detected focal liver lesions in adults in whom an unenhanced ultrasound scan is inconclusive or with inconclusive MRI/CT. However the role of ultrasound will probably rise even more in the near future because of rapid software and hardware developments.

Future prospects are:

1) The development of image fusion and navigation technology combining US and CT or MRI to improve the possibility to perform difficult percutaneous ultrasound guided biopsy or thermo ablation procedures with a higher rate of success.

2) The development of 3D imaging technology in ultrasound to improve liver tumour response assessment particularly by means of a combination with ultrasound contrast agents. The challenge will be to be able to reach a real time 3D imaging through matrix technologies also capable of handling contrast agents enhanced modes in order to get enhancement curves of the whole tumour with a adapted temporal resolution.

3) The development of targeted imaging through targeted microbubbles against a variety of targets located on the vessel wall. Indeed contrast enhanced ultrasound is probably the second more sensitive technique to the presence of a small amount of targeted contrast compound after PET. Many feasibility studies on animal models have already been conducted and currently a hypo allergenic targeted microbubble that includes in its membrane a heterodimer peptide having a high affinity to VEGFR2 (BR55) is being tested in humans.

Beside CT and MRI, US must be also considered as a major technique that has much to offer particularly in liver imaging and the near future of ultrasound is undoubtedly exciting.

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Correspondence to Olivier Lucidarme.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Lucidarme, O., Correas, J.M. Prospects and challenges of US and CEUS. cancer imaging 14 (Suppl 1), O13 (2014).

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