Schellhaas B, et al. – A comparative analysis was performed of the two contrast–enhanced ultrasound (CEUS) algorithms for the diagnosis of hepatocellular carcinoma (HCC) in high–risk patients: Erlanger Synopsis of Contrast–enhanced Ultrasound for Liver lesion Assessment in Patients at Risk (ESCULAP) and American College of Radiology Contrast–Enhanced Ultrasound–Liver Imaging Reporting and Data System (ACR–CEUS–LI–RADSv.2016). It was determined that CEUS–based algorithms contributed toward standardized analysis and reporting of HCC–suspect lesions in high–risk patients. ESCULAP illustrated markedly higher diagnostic accuracy, sensitivity and negative predictive value with no loss of specificity compared with CEUS–LI–RADS. Both reported remarkable positive predictive value (PPV). Arterial hyperenhancement served as the vital feature for the diagnosis of HCC with CEUS. It was noted that CEUS–LI–RADS in its current version was found to be inferior to ESCULAP for the noninvasive diagnosis of HCC.