{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T03:02:49Z","timestamp":1784516569343,"version":"3.55.0"},"reference-count":89,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Intraoperative ultrasound (IOUS) has become an integral component of modern hepatic oncology surgery, providing real-time imaging guidance during liver resections for hepatocellular carcinoma, colorectal liver metastases, and other primary or secondary hepatic malignancies. Despite substantial improvements in preoperative imaging modalities, occult lesions, disappearing metastases after chemotherapy, and complex vascular relationships continue to represent major intraoperative challenges. This structured narrative review aimed to evaluate the contemporary role of IOUS in hepatic oncology surgery, with particular emphasis on contrast-enhanced intraoperative ultrasound (CE-IOUS), minimally invasive liver surgery, navigation-assisted hepatectomy, and emerging artificial intelligence-based technologies. Methods: A structured literature review was conducted using PubMed\/MEDLINE, Scopus, Web of Science, and Google Scholar databases. Peer-reviewed studies, international guidelines, consensus statements, systematic reviews, and technological reports addressing IOUS applications in liver surgery were analyzed. Particular focus was placed on studies evaluating lesion detection, intraoperative strategy modification, disappearing colorectal liver metastases, parenchymal-sparing hepatectomy, laparoscopic and robotic liver surgery, navigation systems, augmented reality integration, and AI-assisted imaging technologies. Results: Contemporary evidence demonstrates that IOUS continues to significantly influence intraoperative decision-making despite advances in magnetic resonance imaging and multidetector computed tomography. CE-IOUS improves the detection of occult hepatic lesions and residual disease after systemic chemotherapy, particularly in disappearing colorectal liver metastases. IOUS-guided anatomical and parenchymal-sparing resections contribute to the preservation of functional liver parenchyma while maintaining oncologic radicality. In minimally invasive liver surgery, laparoscopic ultrasound remains essential for lesion localization and vascular mapping. Recent developments integrating navigation systems, augmented reality platforms, and AI-assisted image recognition suggest a progressive transition toward digitally integrated precision liver surgery. Conclusions: IOUS remains a cornerstone of modern hepatic oncology surgery and continues to evolve from a localization tool into a comprehensive platform for precision-guided liver resection. The integration of CE-IOUS, navigation technologies, and artificial intelligence may further enhance intraoperative accuracy, oncologic safety, and individualized surgical planning in the future.<\/jats:p>","DOI":"10.3390\/cancers18142309","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T02:32:08Z","timestamp":1784514728000},"page":"2309","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intraoperative Ultrasound in Hepatic Oncology Surgery: A Narrative Review of Its Impact on Surgical Strategy and Oncologic Outcomes"],"prefix":"10.3390","volume":"18","author":[{"given":"Cosmin","family":"Nicolescu","sequence":"first","affiliation":[{"name":"Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of T\u00e2rgu Mure\u0219, 540139 Targu Mures, Romania"},{"name":"General Surgery Clinic No.1, County Emergency Clinical Hospital of T\u00e2rgu-Mure\u0219, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2109-7557","authenticated-orcid":false,"given":"Catalin Dumitru","family":"Cosma","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of T\u00e2rgu Mure\u0219, 540139 Targu Mures, Romania"},{"name":"General Surgery Clinic No.1, County Emergency Clinical Hospital of T\u00e2rgu-Mure\u0219, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7608-4306","authenticated-orcid":false,"given":"Marian","family":"Botoncea","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of T\u00e2rgu Mure\u0219, 540139 Targu Mures, Romania"},{"name":"General Surgery Clinic No.1, County Emergency Clinical Hospital of T\u00e2rgu-Mure\u0219, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Barto\u0219","sequence":"additional","affiliation":[{"name":"Institute of Advanced Studies in Science and Technology, Babe\u0219-Bolyai University, 400347 Cluj-Napoca, Romania"},{"name":"Faculty of Medical and Health Sciences, Babe\u0219-Bolyai University, 400347 Cluj-Napoca, Romania"},{"name":"Regina Maria Hospital, 400117 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u0103lin","family":"Molnar","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of T\u00e2rgu Mure\u0219, 540139 Targu Mures, Romania"},{"name":"General Surgery Clinic No.1, County Emergency Clinical Hospital of T\u00e2rgu-Mure\u0219, 540136 Targu Mures, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.jhep.2024.08.028","article-title":"EASL Clinical Practice Guidelines on the management of hepatocellular carcinoma","volume":"82","author":"Sangro","year":"2025","journal-title":"J. Hepatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"P759","DOI":"10.1016\/j.annonc.2026.03.005","article-title":"Metastatic colorectal cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up","volume":"37","author":"Cremolini","year":"2026","journal-title":"Ann. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"iii1","DOI":"10.1136\/gut.2006.098053","article-title":"Guidelines for resection of colorectal cancer liver metastases","volume":"55","author":"Garden","year":"2006","journal-title":"Gut"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1093\/annonc\/mdw235","article-title":"ESMO consensus guidelines for the management of patients with metastatic colorectal cancer","volume":"27","author":"Cervantes","year":"2016","journal-title":"Ann. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2655","DOI":"10.1007\/s00268-013-2183-6","article-title":"Intraoperative liver ultrasound still affects surgical strategy for patients with colorectal metastases in the modern era","volume":"37","author":"Ferrero","year":"2013","journal-title":"World J. Surg."},{"key":"ref_6","first-page":"318","article-title":"Intraoperative ultrasonography and surgical strategy in hepatic resection: What difference does it make?","volume":"58","author":"Jrearz","year":"2015","journal-title":"Can. J. Surgery. J. Can. Chir."},{"key":"ref_7","first-page":"235","article-title":"Impact of intraoperative ultrasound on surgical treatment of hepatic metastases from colorectal cancer","volume":"42","author":"Cohen","year":"2005","journal-title":"Arq. Gastroenterol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1917","DOI":"10.1007\/s00464-009-0874-8","article-title":"The impact of intraoperative ultrasonography on the surgical treatment of patients with colorectal liver metastases","volume":"24","author":"Sietses","year":"2010","journal-title":"Surg. Endosc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1634\/theoncologist.2007-0142","article-title":"Expanding criteria for resectability of colorectal liver metastases","volume":"13","author":"Pawlik","year":"2008","journal-title":"Oncologist"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1634\/theoncologist.2012-0121","article-title":"The oncosurgery approach to managing liver metastases from colorectal cancer: A multidisciplinary international consensus","volume":"17","author":"Adam","year":"2012","journal-title":"Oncologist"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.jamcollsurg.2005.04.026","article-title":"Radical but conservative is the main goal for ultrasonography-guided liver resection","volume":"201","author":"Torzilli","year":"2005","journal-title":"J. Am. Coll. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1001\/archsurg.134.9.984","article-title":"No-mortality liver resection for hepatocellular carcinoma in cirrhotic and noncirrhotic patients: Is there a way? A prospective analysis of our approach","volume":"134","author":"Torzilli","year":"1999","journal-title":"Arch. Surg."},{"key":"ref_13","first-page":"674","article-title":"Contrast-enhanced intraoperative ultrasonography during hepatectomies for colorectal cancer liver metastases","volume":"245","author":"Torzilli","year":"2007","journal-title":"Ann. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3207","DOI":"10.3748\/wjg.14.3207","article-title":"Contrast-enhanced intraoperative ultrasonography for colorectal liver metastases","volume":"14","author":"Nakano","year":"2008","journal-title":"World J. Gastroenterol."},{"key":"ref_15","first-page":"1049","article-title":"Combined use of contrast-enhanced intraoperative ultrasonography and navigation surgery for liver tumors","volume":"35","author":"Uchiyama","year":"2011","journal-title":"World J. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1007\/s11605-012-2043-y","article-title":"Usefulness of contrast-enhanced intraoperative ultrasonography after preoperative chemotherapy for colorectal liver metastases","volume":"17","author":"Ruzzenente","year":"2013","journal-title":"J. Gastrointest. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2627","DOI":"10.1007\/s11605-021-04925-2","article-title":"Intraoperative contrast-enhanced ultrasound has the highest diagnostic accuracy in colorectal liver metastasis surgery","volume":"25","author":"Stavrou","year":"2021","journal-title":"J. Gastrointest. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1007\/s00268-015-3269-0","article-title":"Intraoperative contrast-enhanced ultrasound in colorectal liver metastasis surgery improves the identification and characterization of nodules","volume":"40","author":"Hoareau","year":"2016","journal-title":"World J. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1055\/a-2249-6791","article-title":"Intraoperative contrast-enhanced ultrasound has an outcome-relevant impact on surgery of primary and metastatic liver lesions. Intraoperativer kontrastmittelverst\u00e4rkter Ultraschall beeinflusst klinisch relevant das chirurgische Outcome von prim\u00e4ren Lebertumoren und Lebermetastasen","volume":"46","author":"Bitterer","year":"2025","journal-title":"Ultraschall Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1002\/bjs.8844","article-title":"Contrast-enhanced intraoperative ultrasonography using perfluorobutane microbubbles for the enumeration of colorectal liver metastases","volume":"99","author":"Takahashi","year":"2012","journal-title":"Br. J. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1007\/BF02258295","article-title":"Laparoscopic ultrasound for the detection of hepatic metastases during colorectal surgery","volume":"43","author":"Hartley","year":"2000","journal-title":"Dis. Colon Rectum"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"4362","DOI":"10.1007\/s00464-020-07817-9","article-title":"Comparison of laparoscopic ultrasound and liver-specific magnetic resonance imaging for staging colorectal liver metastases","volume":"35","author":"Russolillo","year":"2021","journal-title":"Surg. Endosc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"S390","DOI":"10.1245\/s10434-014-3576-y","article-title":"Usefulness of contrast-enhanced intraoperative ultrasound in identifying disappearing liver metastases from colorectal carcinoma after chemotherapy","volume":"21","author":"Arita","year":"2014","journal-title":"Ann. Surg. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1007\/s11605-011-1810-5","article-title":"Intraoperative detection of disappearing colorectal liver metastases as a predictor of residual disease","volume":"16","author":"Ferrero","year":"2012","journal-title":"J. Gastrointest. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/j.hpb.2018.02.377","article-title":"Clinical implications of disappearing colorectal liver metastases have changed in the era of hepatocyte-specific MRI and contrast-enhanced intraoperative ultrasonography","volume":"20","author":"Oba","year":"2018","journal-title":"HPB"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.hpb.2015.10.009","article-title":"Colorectal liver metastases: Disappearing lesions in the era of Eovist hepatobiliary magnetic resonance imaging","volume":"18","author":"Owen","year":"2016","journal-title":"HPB"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"3566","DOI":"10.1245\/s10434-012-2596-8","article-title":"Upper transversal hepatectomy","volume":"19","author":"Torzilli","year":"2012","journal-title":"Ann. Surg. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1097\/SLA.0b013e31816387d7","article-title":"Systematic extended right posterior sectionectomy: A safe and effective alternative to right hepatectomy","volume":"247","author":"Torzilli","year":"2008","journal-title":"Ann. Surg."},{"key":"ref_29","first-page":"959","article-title":"Usefulness of intraoperative ultrasonography for anatomical liver resection","volume":"254","author":"Arita","year":"2011","journal-title":"Ann. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"17","DOI":"10.21037\/ales-20-106","article-title":"The value of laparoscopic intraoperative ultrasound of the liver by the surgeon","volume":"6","author":"Bosscha","year":"2021","journal-title":"Ann. Laparosc. Endosc. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.1002\/bjs.7125","article-title":"Fluorescent cholangiography illuminating the biliary tree during laparoscopic cholecystectomy","volume":"97","author":"Ishizawa","year":"2010","journal-title":"Br. J. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2491","DOI":"10.1002\/cncr.24291","article-title":"Intraoperative fluorescent imaging for liver tumors using indocyanine green","volume":"115","author":"Ishizawa","year":"2009","journal-title":"Cancer"},{"key":"ref_33","first-page":"593","article-title":"Navigation surgery using fluorescence imaging for liver tumors","volume":"403","author":"Aoki","year":"2018","journal-title":"Langenbecks Arch. Surg."},{"key":"ref_34","first-page":"1483","article-title":"Ultrasound guided liver resection: Does this approach limit the need for portal vein embolization?","volume":"56","author":"Torzilli","year":"2009","journal-title":"Hepato-Gastroenterol."},{"key":"ref_35","first-page":"1369274","article-title":"Intraoperative ultrasound in the detection of disappearing colorectal liver metastases after chemotherapy","volume":"2019","author":"Langella","year":"2019","journal-title":"HPB Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1148\/radiol.2017161619","article-title":"Use of imaging to predict complete response of colorectal liver metastases after chemotherapy: MR imaging versus CT imaging","volume":"284","author":"Park","year":"2017","journal-title":"Radiology"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3088","DOI":"10.1007\/s00330-016-4644-4","article-title":"Disappearing or residual tiny colorectal liver metastases after chemotherapy on gadoxetic acid-enhanced liver MRI and diffusion-weighted imaging: Is local treatment required?","volume":"27","author":"Kim","year":"2017","journal-title":"Eur. Radiol."},{"key":"ref_38","first-page":"619","article-title":"Recommendations for laparoscopic liver resection: A report from the second international consensus conference held in Morioka","volume":"261","author":"Wakabayashi","year":"2015","journal-title":"Ann. Surg."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Papakonstantinou, M., Fantakis, A., Torzilli, G., Donadon, M., Chatzikomnitsa, P., Giakoustidis, D., Papadopoulos, V.N., and Giakoustidis, A. (2025). A systematic review of disappearing colorectal liver metastases: Resection or no resection?. J. Clin. Med., 14.","DOI":"10.3390\/jcm14041147"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1097\/SLA.0000000000002524","article-title":"The Southampton Consensus Guidelines for laparoscopic liver surgery","volume":"268","author":"Aldrighetti","year":"2018","journal-title":"Ann. Surg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/S1470-2045(23)00572-7","article-title":"MRI in addition to CT in patients scheduled for local therapy of colorectal liver metastases (CAMINO): An international, multicentre, prospective, diagnostic accuracy trial","volume":"25","author":"Hansen","year":"2024","journal-title":"Lancet Oncol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.jhep.2019.08.032","article-title":"Development of a nomogram to predict outcome after laparoscopic liver resection for hepatocellular carcinoma","volume":"72","author":"Berardi","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_43","first-page":"699","article-title":"A systematic review and meta-analysis comparing laparoscopic and open liver resection for hepatocellular carcinoma","volume":"26","author":"Ciria","year":"2019","journal-title":"Ann. Surg. Oncol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/j.hpb.2020.10.005","article-title":"Management of disappearing colorectal liver metastases: An international survey","volume":"23","author":"Melstrom","year":"2021","journal-title":"HPB"},{"key":"ref_45","first-page":"25","article-title":"New lesions detected by intraoperative ultrasound during liver resection for hepatocellular carcinoma","volume":"170","author":"Takigawa","year":"2001","journal-title":"Cancer Lett."},{"key":"ref_46","first-page":"344","article-title":"Intraoperative ultrasound in patients with hepatocellular carcinoma: From daily practice to future trends","volume":"30","author":"Donadon","year":"2013","journal-title":"Dig. Surg."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1097\/SLA.0b013e3182a6183e","article-title":"Liver surgery for colorectal metastases after chemotherapy: Impact of chemotherapy-related liver injuries, pathological tumor response, and micrometastases","volume":"258","author":"Vigano","year":"2013","journal-title":"Ann. Surg."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.hpb.2023.01.003","article-title":"The dilemma of the disappearing colorectal liver metastases: Defining international trends in management","volume":"25","author":"Ghazanfar","year":"2023","journal-title":"HPB"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1097\/SLA.0b013e31828329b8","article-title":"A snapshot of the effective indications and results of surgery for hepatocellular carcinoma in tertiary referral centers: Is it adherent to the EASL\/AASLD recommendations?","volume":"257","author":"Torzilli","year":"2013","journal-title":"Ann. Surg."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1056\/NEJMra065156","article-title":"Strategies for safer liver surgery and partial liver transplantation","volume":"356","author":"Clavien","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/S1072-7515(00)00261-1","article-title":"Seven hundred forty-seven hepatectomies in the 1990s: An update to evaluate the actual risk of liver resection","volume":"191","author":"Belghiti","year":"2000","journal-title":"J. Am. Coll. Surg."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"320","DOI":"10.21614\/chirurgia.112.3.320","article-title":"State of the art of intraoperative ultrasound in liver surgery: Current use for resection-guidance","volume":"112","author":"Torzilli","year":"2017","journal-title":"Chirurgia"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.surg.2013.08.009","article-title":"Initial experience of intraoperative three-dimensional navigation for liver resection using real-time virtual sonography","volume":"155","author":"Satou","year":"2014","journal-title":"Surgery"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"S34","DOI":"10.1016\/j.ejrad.2004.03.025","article-title":"Contrast-enhanced intraoperative ultrasonography in surgery for liver tumors","volume":"51","author":"Torzilli","year":"2004","journal-title":"Eur. J. Radiol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1097\/01.sla.0000197708.77063.07","article-title":"Potential value of contrast-enhanced intraoperative ultrasonography during partial hepatectomy for metastases","volume":"243","author":"Leen","year":"2006","journal-title":"Ann. Surg."},{"key":"ref_56","first-page":"261","article-title":"Navigation systems in liver surgery: The new challenge for surgical research","volume":"23","author":"Oldhafer","year":"2013","journal-title":"J. Laparoendosc. Adv. Surg. Tech A"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"2145","DOI":"10.1002\/mp.14825","article-title":"CBCT-based navigation system for open liver surgery: Accurate guidance toward mobile and deformable targets with a semi-rigid organ approximation and electromagnetic tracking of the liver","volume":"48","author":"Ivashchenko","year":"2021","journal-title":"Med. Phys."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"znae110","DOI":"10.1093\/bjs\/znae110","article-title":"A surgical navigation system to aid the ablation of vanished colorectal liver metastases","volume":"111","author":"Olthof","year":"2024","journal-title":"Br. J. Surg."},{"key":"ref_59","first-page":"500","article-title":"State of the art of intraoperative ultrasound in hepatobiliary surgery","volume":"35","author":"Donadon","year":"2014","journal-title":"Ultraschall Med."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"562","DOI":"10.2214\/AJR.10.4729","article-title":"Intraoperative ultrasound of the liver in primary and secondary hepatic malignancies: Comparison with preoperative 1.5-T MRI and 64-MDCT","volume":"196","author":"Wagnetz","year":"2011","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"3939","DOI":"10.1200\/JCO.2006.05.8727","article-title":"Complete response of colorectal liver metastases after chemotherapy: Does it mean cure?","volume":"24","author":"Benoist","year":"2006","journal-title":"J. Clin. Oncol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1007\/s11605-010-1348-y","article-title":"Disappearing colorectal liver metastases after chemotherapy: Should we be concerned?","volume":"14","author":"Pawlik","year":"2010","journal-title":"J. Gastrointest. Surg."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1002\/cncr.24912","article-title":"Predictors of a true complete response among disappearing liver metastases from colorectal cancer after chemotherapy","volume":"116","author":"Auer","year":"2010","journal-title":"Cancer"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1186\/s12957-020-02037-w","article-title":"Imaging in disappearing colorectal liver metastases and their accuracy: A systematic review","volume":"18","author":"Barimani","year":"2020","journal-title":"World J. Surg. Oncol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"2579","DOI":"10.1016\/j.ultrasmedbio.2020.04.030","article-title":"Guidelines and good clinical practice recommendations for contrast-enhanced ultrasound (CEUS) in the liver\u2014Update 2020 WFUMB in cooperation with EFSUMB, AFSUMB, AIUM, and FLAUS","volume":"46","author":"Dietrich","year":"2020","journal-title":"Ultrasound Med. Biol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.hpb.2015.09.003","article-title":"Robot-assisted laparoscopic liver resection: A systematic review and pooled analysis of minor and major hepatectomies","volume":"18","author":"Nota","year":"2016","journal-title":"HPB"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1001\/archsurg.2011.145","article-title":"Totally robotic right hepatectomy: Surgical technique and outcomes","volume":"146","author":"Giulianotti","year":"2011","journal-title":"Arch. Surg."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"281","DOI":"10.21037\/hbsn.2016.03.03","article-title":"What has changed after the Morioka Consensus Conference 2014 on laparoscopic liver resection?","volume":"5","author":"Wakabayashi","year":"2016","journal-title":"Hepatobiliary Surg. Nutr."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/j.ebiom.2019.02.017","article-title":"Digital and intelligent liver surgery in the new era: Prospects and dilemmas","volume":"41","author":"Fang","year":"2019","journal-title":"eBioMedicine"},{"key":"ref_70","first-page":"221","article-title":"The role of artificial intelligence and image processing in the diagnosis, treatment and prognosis of liver cancer: A narrative review","volume":"19","author":"Dimopoulos","year":"2024","journal-title":"Prz. Gastroenterol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1002\/jhbp.12089","article-title":"An artificial intelligence-based recognition model of colorectal liver metastases in contrast-enhanced intraoperative ultrasonography","volume":"32","author":"Takayama","year":"2025","journal-title":"J. Hepatobiliary Pancreat. Sci."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1055\/s-0032-1313026","article-title":"An EFSUMB introduction into dynamic contrast-enhanced ultrasound (DCE-US) for quantification of tumour perfusion","volume":"33","author":"Dietrich","year":"2012","journal-title":"Ultraschall Med."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"e16","DOI":"10.1055\/s-0043-103952","article-title":"EFSUMB Guidelines and Recommendations on the Clinical Use of Liver Ultrasound Elastography, update 2017","volume":"38","author":"Dietrich","year":"2017","journal-title":"Ultraschall Med."},{"key":"ref_74","first-page":"319","article-title":"Intraoperative ultrasound in liver and pancreatic surgery","volume":"23","author":"Dindelegan","year":"2021","journal-title":"Med. Ultrason."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1097\/SLA.0b013e31821ad704","article-title":"Patients operated on for initially unresectable colorectal liver metastases with missing metastases experience a favorable long-term outcome","volume":"254","author":"Gaujoux","year":"2011","journal-title":"Ann. Surg."},{"key":"ref_76","first-page":"201","article-title":"Intraoperative ultrasound: A review on its role in liver surgery for primitive and metastatic tumors","volume":"71","author":"Garancini","year":"2016","journal-title":"Minerva Chir."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1007\/s00464-023-10523-x","article-title":"Anatomical liver resection using the ultrasound-guided compression technique in minimal access surgery","volume":"38","author":"Procopio","year":"2024","journal-title":"Surg. Endosc."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1007\/s00268-013-2401-2","article-title":"ALPPS for patients with colorectal liver metastases: Effective liver hypertrophy, but early tumor recurrence","volume":"38","author":"Oldhafer","year":"2014","journal-title":"World J. Surg."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.hbpd.2021.09.002","article-title":"Navigated liver surgery: State of the art and future perspectives","volume":"21","author":"Gavriilidis","year":"2022","journal-title":"Hepatobiliary Pancreat. Dis. Int."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1007\/s11605-016-3100-8","article-title":"What is the learning curve for laparoscopic major hepatectomy?","volume":"20","author":"Brown","year":"2016","journal-title":"J. Gastrointest. Surg."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1016\/j.amjsurg.2013.01.041","article-title":"Planning of anatomical liver segmentectomy and subsegmentectomy with 3-dimensional simulation software","volume":"206","author":"Takamoto","year":"2013","journal-title":"Am. J. Surg."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"44","DOI":"10.4174\/astr.2025.109.1.44","article-title":"Leveraging augmented reality for dynamic guidance in three-dimensional laparoscopic liver surgery","volume":"109","author":"Oh","year":"2025","journal-title":"Ann. Surg. Treat. Res."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1148\/rg.264055120","article-title":"Intraoperative US of the liver: Techniques and clinical applications","volume":"26","author":"Kruskal","year":"2006","journal-title":"Radiographics"},{"key":"ref_84","first-page":"12","article-title":"Current use of intraoperative ultrasound in modern liver surgery","volume":"45","author":"Chu","year":"2023","journal-title":"Oncol. Times"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1038\/s41575-020-0310-z","article-title":"Cholangiocarcinoma 2020: The next horizon in mechanisms and management","volume":"17","author":"Banales","year":"2020","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1016\/j.jhep.2014.01.021","article-title":"Guidelines for the diagnosis and management of intrahepatic cholangiocarcinoma","volume":"60","author":"Bridgewater","year":"2014","journal-title":"J. Hepatol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"45","DOI":"10.21037\/tgh.2018.07.03","article-title":"A learning curve for laparoscopic liver resection: An effective training system and standardization of technique","volume":"3","author":"Saito","year":"2018","journal-title":"Transl. Gastroenterol. Hepatol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1007\/s11548-026-03581-8","article-title":"Navigated hepatic tumor resection using intraoperative ultrasound-generated three-dimensional models: Proof-of-concept study","volume":"21","author":"Olthof","year":"2026","journal-title":"Int. J. Comput. Assist Radiol. Surg."},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Caringi, S., Paiella, S., Ratti, F., Cipriani, F., and Aldrighetti, L. (2025). Hot topics in the surgical treatment of intrahepatic cholangiocarcinoma. Cancers, 17.","DOI":"10.3390\/cancers17193127"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/14\/2309\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T02:47:21Z","timestamp":1784515641000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/14\/2309"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,17]]},"references-count":89,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["cancers18142309"],"URL":"https:\/\/doi.org\/10.3390\/cancers18142309","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,17]]}}}