Expert consensus regarding the clinical application of liver contrast-enhanced US with Sonazoid (Sonazoid CEUS).

Sonazoid, a combined blood pool and Kupffer-cell agent, can be specifically phagocytosed by Kupffer cells in the liver, allowing lesion detection and characterization of focal liver lesions (FLLs) at the post-vascular phase, apart from the vascular phase, which is similar to that of other second-generation ultasound (US) contrast agents. Sonazoid contrast-enhanced US (CEUS) is currently approved for use in some Asian countries. With the increasing use of Sonazoid CEUS for FLLs in clinical practice, developing consensus or guidelines to help standardize its use is required. The expert consensus aimed to review recent evidence and make evidence-based recommendations for radiologists and clinicians involved in the management of liver diseases regarding the use of Sonazoid CEUS in the surveillance or detection, characterization of FLLs, CEUS for interventional and intraoperative use, and tumor treatment response evaluation in patients with FLLs. This consensus was conducted without using artificial intelligence tools in accordance with the TITAN Guidelines 2025.