Bina Lanka MBBS, Presenter: Nothing to Disclose

Hyun-Jung Jang, Abstract Co-Author: Nothing to Disclose

Tae Kyoung Kim MD, Abstract Co-Author: Nothing to Disclose

Stephanie Ruth Wilson MD, Abstract Co-Author: Research Consultant, Bristol-Myers Squibb Company Advisory Board, Koninklijke Philips Electronics NV

To assess the impact of introduction of contrast enhanced ultrasound(CEUS)in a tertiary clinical practice.

From July2003 to December2005,900 consecutive CEUS performed as part of routine care were reviewed to determine the source of examination- incidental mass on baseline or clinician referral.The clinical impact was evaluated as positive impact(shortened time to diagnosis, reduced hospital visits, decreased referral for further imaging, diagnosis of indeterminate masses and guidance for therapy),concordant diagnosis and negative impact.

255/900(28.3%) examinations were motivated by incidental detection of a mass at baseline ultrasound, 104/255(40.8%) in high risk patients and 151/255(59.2%) in no risk patients. 645/900(71.6%) patients were referred from clinicians for characterization of a mass from previous imaging, 400/645(62%) in our institution and 200/645(31%) from outside scans and for monitoring radiofrequency ablation in 45/645(6.9%). The number of patients referred from clinicians increased to 191 in the last six months of the study compared from 56 in the first six months. A significant positive impact from CEUS was found in 391/900(43.4%) patients including reduced referral for other imaging in 205/900(22.8%) patients; 72.1% had no further imaging and 27.8% had interval follow-up. Decreased time to diagnosis occurred in 329/900(36.5%) patients when CEUS was performed on the first visit and a specific diagnosis made; 136/329(41.3%) had no further imaging for confirmation. CEUS achieved the correct diagnosis in 827/874(94.6%) known final diagnoses and significantly contributed to correct diagnosis and alteration of patient management in 169/900(17.8%) patients.Concordant imaging with either CT or MR occurred in 509/900(56.5%) patients.In 3(0.3%) patients a negative impact was present(delayed/wrong diagnosis with incorrect management).

Referrals for CEUS have increased progressively.CEUS has a positive impact on patient management providing rapid accurate diagnosis of incidentally detected masses and resolving nodules found on surveillance scans and indeterminate on other imaging.

CEUS is a using modality in the diagnosis and management of liver masses.

Lanka, B, Jang, H, Kim, T, Wilson, S, Impact of Contrast-enhanced Ultrasound in a Tertiary Clinical Practice.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4436009.html