Targeted ultrasound of the liver: Impact on scanning time of a new approach in chronic liver disease.

INTRODUCTION: 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.