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Targeted ultrasound of the liver: Impact on scanning time of a new approach in chronic liver disease
Author(s) -
Harris Nicole,
Gorelik Alexandra,
Gibson Robert N
Publication year - 2017
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/1754-9485.12595
Subject(s) - medicine , cirrhosis , hepatocellular carcinoma , chronic liver disease , ultrasound , cohort , liver disease , fatty liver , gastroenterology , retrospective cohort study , population , physical examination , disease , radiology , environmental health
Targeted ultrasound of the liver ( TUSL ) has been proposed as a new approach in chronic liver disease to meet the increasing demands on ultrasound services in this patient population. This study analyses the impact of TUSL on examination time. Methods Retrospective cohort analysis of time taken to perform liver ultrasound on consecutive chronic liver disease patients pre‐ ( n = 230) and post‐ ( n = 147) introduction of TUSL . Within each cohort, patients were subdivided into three categories based on the clinical indication: Group 1. hepatocellular carcinoma ( HCC ) surveillance; Group 2. detection of cirrhosis, fibrosis or fatty liver; Group 3. detection of portal hypertension. The primary outcome was difference in examination time in the pre‐ and post‐intervention groups. Results Introduction of TUSL led to 49% reduction in examination time (median (Q1–Q3) 23.7 (16.7–36.2) min in pre‐ TUSL period vs 12.1 (6.4–19.5) min in post, P < 0.001) and it was consistent across all three clinical indication groups (gr1: median 23.1 minutes vs 8.1 minutes ( P < 0.001), gr2: 23.0 minutes vs 14.3 minutes ( P < 0.001), gr3: 32.2 minutes vs 15.3 minutes ( P = 0.006)). After the adjustment for clinical indication and sonographer's experience, impact of TUSL on time reduction remained significant with a 66.6% time reduction (95% CI 53.6 to 79.5). Conclusion Targeted ultrasound of the liver improves efficiency of chronic liver disease ultrasound with halving of examination times and consequently has the potential to greatly improve resource utilization.