Korean Journal of RadiologyRecommendation and GuidelineeI5SN2005-8330htp5:/doi.0rg/10.3348/kjr.2023.0324Korean J Radiol 2023;24(6):482-497Check for updatesKJRDiagnosing Hepatocellular Carcinoma Using SonazoidContrast-Enhanced Ultrasonography:2023 GuidelinesFrom the Korean Society of Radiology andthe Korean Society of Abdominal RadiologyWoo Kyoung Jeong',Hyo-Jin Kang2,Sang Hyun Choi3,Mi-Suk Park',Mi Hye Yu3,Bohyun Kim,Myung-Won You',Sanghyeok Lim,Young Seo Cho,Min Woo Lee',Jeong Ah Hwang',Jae Young Lee2,Jung Hoon Kim2,Ijin Joo2,Jae Seok Bae2,So Yeon Kim3,Yong Eun Chung,Dong Hwan Kim,Jeong Min Lee2Department of Radiology and Center for Imaging Science,Samsung Medical Center,Sungkyunkwan University School of Medicine,Seoul,Korea2Department of Radiology and Research Institute of Radiological Science,Seoul National University Hospital,Seoul National University College ofMedicine,Seoul,KoreaDepartment of Radiology and Research Institute of Radiology,Asan Medical Center,University of Ulsan College of Medicine,Seoul,Korea"Department of Radiology and Research Institute of Radiological Science,Severance Hospital,Yonsei University College of Medicine,Seoul,KoreaDepartment of Radiology,Konkuk University Hospital,Konkuk University College of Medicine,Seoul,KoreaDepartment of Radiology,Seoul St.Mary Hospital,College of Medicine,The Catholic University of Korea,Seoul,KoreaDepartment of Radiology,Kyung Hee University Hospital,Kyung Hee University College of Medicine,Seoul,KoreaDepartment of Radiology,Soonchunhyang University Bucheon Hospital,Soonchunhyang University College of Medicine,Bucheon,Korea'Department of Radiology,Hanyang University Guri Hospital,Hanyang University College of Medicine,Guri,KoreaSonazoid,a second-generation ultrasound contrast agent,was introduced for the diagnosis of hepatic nodules.To clarify theissues with Sonazoid contrast-enhanced ultrasonography for the diagnosis of hepatocellular carcinoma (HCC),the KoreanSociety of Radiology and Korean Society of Abdominal Radiology collaborated on the guidelines.The guidelines are de novo,evidence-based,and selected using an electronic voting system for consensus.These include imaging protocols,diagnosticcriteria for HCC,diagnostic value for lesions that are inconclusive on other imaging results,differentiation from non-HCCmalignancies,surveillance of HCC,and treatment response after locoregional and systemic treatment for HCC.Keywords:Guideline;Ultrasound,Contrast-enhanced;Hepatocellular carcinoma;Sonazoid;PerfluorobutaneINTRODUCTIONuse in China,Japan,Korea,Norway,Singapore,and Taiwan.The approved indication for Sonazoid in these countries isSonazoid(perfluorobutane;GE Healthcare)is a second-contrast-enhanced ultrasonography (CEUS),which is used togeneration ultrasound contrast agent approved for clinicalcharacterize focal hepatic disease in adults [1.Although all second-generation agents have similarities,Received:April 7,2023 Accepted:April 11,2023Sonazoid is a combination of blood-pool and K
