Advanced Ultrasound Quantitative Analysis in Hepatology: A Systematic Review of Methodologies for Characterizing Focal Liver Lesions

This systematic review evaluates advanced ultrasound quantitative techniques including contrast-enhanced ultrasound, elastography, quantitative ultrasound (QUS), multiparametric ultrasound, and artificial intelligence for characterizing focal liver lesions (FLLs). It critically appraises their technical principles, parameter extraction methodologies, and clinical validation frameworks. It further integrates and comparatively analyzes their diagnostic performance across major FLL subtypes, including hepatocellular carcinoma, metastases, hemangioma, and focal nodular hyperplasia. This work provides a foundation for improving noninvasive FLL diagnosis and highlights the imperative for standardization and clinical translation of advanced QUS in hepatology.