Artificial intelligence(AI)-augmented contrast-enhanced ultrasonography(CEUS)is emerging as a powerful tool in liver imaging,particularly in enhancing the accuracy of Liver Imaging Reporting and Data System(known as L...Artificial intelligence(AI)-augmented contrast-enhanced ultrasonography(CEUS)is emerging as a powerful tool in liver imaging,particularly in enhancing the accuracy of Liver Imaging Reporting and Data System(known as LI-RADS)classi-fication.This review synthesized published data on the integration of machine learning and deep learning techniques into CEUS,revealing that AI algorithms can improve the detection and quantification of contrast enhancement patterns.Such improvements led to more consistent LI-RADS categorization,reduced interoperator variability,and enabled real-time analysis that streamlined work-flow.The enhanced sensitivity of AI tools facilitated better differentiation between benign and malignant lesions,ultimately optimizing patient management.These advances suggest that AI-augmented CEUS could transform liver imaging by providing rapid,reliable,and objective assessments.However,the review also highlighted the need for further large-scale,multicenter studies to fully validate these findings and ensure the safe integration of AI into routine clinical practice.INTRODUCTION International hepatology society guidelines have established contrast-enhanced computed tomography(CT)and contrast-enhanced magnetic resonance imaging(MRI)as the imaging modalities of choice for diagnosing hepatocellular carcinoma(HCC)lesions larger than 1 cm.MRI remains the gold standard for detecting small HCC nodules in cirrhotic livers due to its superior soft-tissue contrast and functional imaging capabilities.However,early or atypical presentations remain challenging for differential diagnosis,staging,and treatment planning.In these scenarios contrast-enhanced ultrasonography(CEUS)is a valuable second-line tool,offering real-time,radiation-free evaluation and repeatability for follow-up.A recent meta-analysis of head-to-head studies reported comparable diagnostic performance between CEUS and CT/MRI with pooled sensitivities and specificities of 0.67/0.88 for CEUS vs 0.60/0.98 for CT/MRI in non-HCC malignancies,and similar specificities for HCC diagnosis(0.70 for CEUS vs 0.59 for CT;0.81 for CEUS vs 0.79 for MRI)[1].Given the limitations of individual imaging modalities,hybrid techniques and multimodal approaches are gaining traction for improving lesion detection,especially in cases where standard methods fall short.Artificial intelligence(AI)has emerged as a powerful tool in medical imaging,enhancing diagnostic accuracy and reliability across platforms.In CEUS liver imaging dynamic enhancement patterns often challenge consistent interpretation across observers.AI holds particular promise for standardizing assessments.The growing complexity of liver tumor evaluation has also driven interest in approaches that integrate serum bio-markers with advanced imaging.However,no single strategy currently meets all the diagnostic and prognostic re-quirements.Recent studies highlighted the potential of AI to bridge this gap by enabling precise image interpretation and facilitating the integration of heterogeneous clinical and imaging data[2].Altogether the convergence of CEUS with AI and radiomics offers a dynamic,quantitative,and potentially reproducible paradigm for liver lesion assessment,comple-menting traditional imaging methods.This review aimed to provide an overview of current advances in AI-driven CEUS for liver lesion assessment with a particular focus on automated Liver Imaging Reporting and Data System(LI-RADS)classification,radiomics-based models,and future clinical integration.While another recent systematic review[3]provided a comprehensive analysis of AI applications in CEUS,our approach offers a targeted perspective,emphasizing LI-RADS-centered scoring,automated lesion characterization,and clinical utility,particularly in the context of HCC diagnosis and management.In the methodological process of this narrative mini-review,the literature selection was primarily based on targeted PubMed searches.ChatGPT-4o(OpenAI)[4]was employed to assist in refining query parameters and identifying relevant,up-to-date peer-reviewed sources on CEUS-based AI applications.展开更多
文摘Artificial intelligence(AI)-augmented contrast-enhanced ultrasonography(CEUS)is emerging as a powerful tool in liver imaging,particularly in enhancing the accuracy of Liver Imaging Reporting and Data System(known as LI-RADS)classi-fication.This review synthesized published data on the integration of machine learning and deep learning techniques into CEUS,revealing that AI algorithms can improve the detection and quantification of contrast enhancement patterns.Such improvements led to more consistent LI-RADS categorization,reduced interoperator variability,and enabled real-time analysis that streamlined work-flow.The enhanced sensitivity of AI tools facilitated better differentiation between benign and malignant lesions,ultimately optimizing patient management.These advances suggest that AI-augmented CEUS could transform liver imaging by providing rapid,reliable,and objective assessments.However,the review also highlighted the need for further large-scale,multicenter studies to fully validate these findings and ensure the safe integration of AI into routine clinical practice.INTRODUCTION International hepatology society guidelines have established contrast-enhanced computed tomography(CT)and contrast-enhanced magnetic resonance imaging(MRI)as the imaging modalities of choice for diagnosing hepatocellular carcinoma(HCC)lesions larger than 1 cm.MRI remains the gold standard for detecting small HCC nodules in cirrhotic livers due to its superior soft-tissue contrast and functional imaging capabilities.However,early or atypical presentations remain challenging for differential diagnosis,staging,and treatment planning.In these scenarios contrast-enhanced ultrasonography(CEUS)is a valuable second-line tool,offering real-time,radiation-free evaluation and repeatability for follow-up.A recent meta-analysis of head-to-head studies reported comparable diagnostic performance between CEUS and CT/MRI with pooled sensitivities and specificities of 0.67/0.88 for CEUS vs 0.60/0.98 for CT/MRI in non-HCC malignancies,and similar specificities for HCC diagnosis(0.70 for CEUS vs 0.59 for CT;0.81 for CEUS vs 0.79 for MRI)[1].Given the limitations of individual imaging modalities,hybrid techniques and multimodal approaches are gaining traction for improving lesion detection,especially in cases where standard methods fall short.Artificial intelligence(AI)has emerged as a powerful tool in medical imaging,enhancing diagnostic accuracy and reliability across platforms.In CEUS liver imaging dynamic enhancement patterns often challenge consistent interpretation across observers.AI holds particular promise for standardizing assessments.The growing complexity of liver tumor evaluation has also driven interest in approaches that integrate serum bio-markers with advanced imaging.However,no single strategy currently meets all the diagnostic and prognostic re-quirements.Recent studies highlighted the potential of AI to bridge this gap by enabling precise image interpretation and facilitating the integration of heterogeneous clinical and imaging data[2].Altogether the convergence of CEUS with AI and radiomics offers a dynamic,quantitative,and potentially reproducible paradigm for liver lesion assessment,comple-menting traditional imaging methods.This review aimed to provide an overview of current advances in AI-driven CEUS for liver lesion assessment with a particular focus on automated Liver Imaging Reporting and Data System(LI-RADS)classification,radiomics-based models,and future clinical integration.While another recent systematic review[3]provided a comprehensive analysis of AI applications in CEUS,our approach offers a targeted perspective,emphasizing LI-RADS-centered scoring,automated lesion characterization,and clinical utility,particularly in the context of HCC diagnosis and management.In the methodological process of this narrative mini-review,the literature selection was primarily based on targeted PubMed searches.ChatGPT-4o(OpenAI)[4]was employed to assist in refining query parameters and identifying relevant,up-to-date peer-reviewed sources on CEUS-based AI applications.
