Contrast-enhanced ultrasonography in the characterization of benign focal liver lesions: activity-based cost analysis

Faccioli, Niccolò; D’Onofrio, Mirko; Comai, Alessio; Cugini, Christian

doi:10.1007/s11547-007-0185-x

Cited by 43 publications

(33 citation statements)

References 14 publications

(6 reference statements)

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“…Its high capability to show tumoral vascularization makes CEUS accurate in the study of neoangiogenesis and in the follow-up of residual tumor or recurrence after treatment [2][3][4][5][6][7] . The technique is simple, easy and inexpensive compared to CT and MRI, sufficiently noninvasive to be performed on an outpatient basis, and can also be used in patients with renal failure and who are allergic to iodine contrast agents [1,8] . Therefore, CEUS can significantly improve the accuracy of US, leading to improved identification and characterization in the study of pancreatic lesions [2][3][4][5][6][7] .…”

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confidence: 99%

Contrast-Enhanced Ultrasonography of the Pancreas

et al. 2009

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confidence: 99%

Contrast-Enhanced Ultrasonography of the Pancreas

et al. 2009

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“…In a German study of incidentally detected hepatic lesions of uncertain nature [13], CEUS was found to be the most cost-effective approach to diagnosis in outpatients, and was even superior to multiphase CT in this sense. In an Italian decisionmaking model [14], emphasis was placed on the savings associated with CEUS in the diagnosis of benign focal lesions, where it proved to be the least costly of the second-line options. Similar conclusions can be drawn regarding patients with liver disease who have a single, small liver nodule: a prospective study [15] has shown that the extensive use of CEUS after US identification of the nodules can reduce health-care costs.…”

Section: Discussionmentioning

confidence: 99%

Source and clinical motivation of orders for contrast-enhanced sonography (CEUS) of the liver: A prospective single-center survey

Catalano

Sandomenico

Nunziata³

et al. 2011

Journal of Ultrasound

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KEYWORDSContrast-enhanced sonography; Liver; Focal liver lesions; Indications; Patient referral.Abstract Contrast-enhanced sonography (CEUS) has become a routine part of diagnostic imaging of the liver. Its possibilities, limitations, and indications have been defined in adequately large clinical series and in guidelines and recommendations. We prospectively evaluated physicians' orders for hepatic CEUS received in the radiology department of a large oncology center in Naples, Italy from May 2009 to April 2010. Radiologists performing the CEUS examinations filled out a form that included patient demography, source and type of patient referral, and clinical indications for the examination. During the study period, 564 patients aged 17e86 years (mean, 58 years) were referred to our department for CEUS liver studies (total: 644; 491 outpatient studies, 153 inpatient studies). This included 4 examinations that were ordered by the patient's physician but not performed by our staff. The majority of the CEUS examinations (n Z 583; 90.5%) were regularly scheduled procedures ordered by clinical specialists from our center (77.3%) or other centers (11.8%); by general practitioners (on their own initiative) (0.8%); or by other figures (0.6%). The remaining 61 examinations (9.5%) were unscheduled procedures done on the initiative of a radiologist following conventional sonography (US). Fewer than half (47.8%) of the examinations were requested as first-line assessments. The others were ordered to clarify inconclusive findings generated by conventional US (30%) or by a more sophisticated imaging study (CT, MRI, PET) (16.1%) or to resolve discrepancies between CT, MRI, and/or PET findings (6%). CEUS is a relatively noninvasive, low-cost imaging study that is simple to perform and requires no particular patient preparation. This may explain its increasing use to clarify doubts raised by conventional US and other more sophisticated imaging studies.Sommario L'ecografia con mezzo di contrasto (CEUS) è ormai entrata nella routine dell'imaging, quantomeno del fegato, essendo le sue possibilità, limiti e indicazioni state definite in base a casistiche adeguate e secondo linee guida e raccomandazioni. Valutiamo la tipologia delle richieste di esami CEUS eseguiti presso un singolo centro oncologico. Maggio 2009 -aprile 2010 abbiamo raccolto dati prospettici sugli esami di CEUS epatica praticati. Il singolo radiologo, che eseguiva ciascun esame CEUS, compilava la scheda di raccolta dati: anagrafica del paziente, tipologia della provenienza, tipologia del richiedente, quesito clinico. Si trattava di 564 pazienti di 17-86 anni (media 58) ai quali abbiamo praticato 644 esami CEUS epatici (491 esami ambulatoriali, 153 esami su degenti); 4 casi in cui la CEUS era stata richiesta, ma non praticata venivano comunque inclusi. La CEUS era programmata in 583 casi e decisa estemporaneamente nei rimanenti 61. Il richiedente era: lo stesso operatore che si trovava a eseguire l'ecografia (US) convenzionale nel 9,5% dei casi, uno specialista interno ...

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“…It is noninvasive and can be accomplished in an outpatient setting. It can also be performed on patients with renal failure or patients allergic to iodine contrast agents [3,15]. Contrary to the contrast agents used in CT or MRI, US contrast agents are generally well tolerated.…”

Section: Introductionmentioning

confidence: 99%

Transabdominal Contrast-Enhanced Ultrasonography of Pancreatic Cancer

Kersting¹,

Roth²,

Bunk³

2011

Pancreatology

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Since its introduction, contrast-enhanced ultrasonography (CEUS) has significantly extended the value of ultrasonography (US). CEUS can be used to more accurately determine pancreatic lesions compared to conventional US or to characterize lesions already detectable by US. Thus, CEUS can aid in the differential diagnosis of pancreatic tumors. Using US contrast media, it is possible to visually detect microvessels in the majority of pancreatic ductal adenocarcinomas. Thus, the use of quantitatively evaluated transabdominal CEUS can help in the differentiation of patients with mass-forming pancreatitis from patients with pancreatic adenocarcinomas. In neuroendocrine pancreatic tumors, different enhancement patterns can be observed in relation to the tumor mass: larger ones show a rapid early enhancement sometimes combined with necrotic central structures, and smaller ones disclose a capillary-blush enhancement. Pseudocysts, the most widespread cystic lesions of the pancreas, are not vascularized. They do not show any signal in CEUS and remain entirely anechoic in all phases, while true cystic pancreatic tumors usually have vascularized septa and parietal nodules. In summary, CEUS is effective for differentiating solid pancreatic tumors in most cases. CEUS is safe and cost effective and can better discriminate solid from cystic pancreatic lesions, thereby directing further imaging modalities.

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Contrast-enhanced ultrasonography in the characterization of benign focal liver lesions: activity-based cost analysis

Abstract: This cost analysis shows that CEUS is the least expensive second-line modality after baseline US for the diagnosis of BFLL.

Cited by 43 publications

References 14 publications

Contrast-Enhanced Ultrasonography of the Pancreas

Contrast-Enhanced Ultrasonography of the Pancreas

Source and clinical motivation of orders for contrast-enhanced sonography (CEUS) of the liver: A prospective single-center survey

Transabdominal Contrast-Enhanced Ultrasonography of Pancreatic Cancer

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