Published online Dec 27, 2025. doi: 10.4254/wjh.v17.i12.115551
Revised: October 27, 2025
Accepted: November 24, 2025
Published online: December 27, 2025
Processing time: 68 Days and 1.4 Hours
The study by Devan et al presents an ultrasound-based protocol for monitoring tumor growth in a syngeneic orthotopic rat model of hepatocellular carcinoma (HCC). This approach is commendable for its reproducibility, cost-effectiveness, and alignment with ethical imperatives, particularly in reducing the need for invasive assessments. The strong correlation of ultrasound-based volumes with histology and therapeutic response highlights its translational promise. However, certain considerations merit further discussion. Ultrasound imaging, while accessible, is inherently operator-dependent, and its accuracy may decline with irregular or heterogeneous tumor morphology. Moreover, the exclusive reliance on the rat hepatoma cell line (N1S1) cells raises questions about generalizability to other HCC models with differing immune interactions. Future refinements should standardize training protocols, incorporate multimodal validation, and explore diverse tumor settings. Despite these limitations, the study provides a useful app
Core Tip: High frequency ultrasound is a rapid, low-cost, minimally invasive tool for serial volumetric monitoring of orthotopic hepatocellular carcinoma that correlates well with terminal histology and can match micro computed tomography (CT)/magnetic resonance imaging (MRI) for gross tumor size, but it lacks cellular resolution and remains operator-dependent. To increase translational impact, future work should standardize acquisition and training, perform multimodal validation in subset cohorts (histology, micro CT/MRI), and adopt contrast-enhanced/photoacoustic imaging, along with automated radiomics/artificial intelligence segmentation to reduce bias and improve sensitivity.