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Lee PYC, Mohamed Afif A, Anthony A, Goodyear M, Lombardo P. Ambient light intensity affecting ultrasound operator detection of liver lesions in cine-clips. Radiography (Lond) 2024; 30:1151-1157. [PMID: 38843760 DOI: 10.1016/j.radi.2024.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/20/2024] [Accepted: 05/22/2024] [Indexed: 07/03/2024]
Abstract
INTRODUCTION Ambient light (AL) is an important factor to improve ultrasound pathology detection. However, there are no established room AL levels recommended during an ultrasound examination. We aim to examine the diagnostic accuracy using different intensity of AL for the detection of liver lesions in anonymised pre-recorded cine-clips. METHODS Eight ultrasound operators with 5-14 years' professional experiences were prospectively recruited to evaluate 51 randomised cine-clips directly from one ultrasound machine. These 15-s clips of the right lobe of the liver in longitudinal and transverse planes were meant to simulate the ultrasound examination. Operators reviewed all cine-clips and responded to two questions per cine-clip regarding their detection performance under 3 AL settings; 3, 15 and 25 lux, at one lighting per visit. A repeat visit under each AL was performed to assess for intra-operator variability. Each operator completed six visits in total, with at least a 2-day washout period. The operators' performance was compared against imaging reference standards from contrast CT/MRI for cine-clips with lesion and serial US for those without. RESULTS AL with highest degree of diagnostic accuracy was found to be at 25 lux. Results from 8 operators revealed sensitivity ranged from 79% to 100%, specificity ranged from 94% to 100%. Positive and negative predictive values were up to 100% with AL at 25 lux. Both intra-and interrater reliability were excellent at 0.85-1.0 (0.79-0.98) and 0.98 (0.97, 0.99) respectively, with AL at 25 lux. CONCLUSION This study proved that ambient light intensity affects the ultrasound operator detection of liver lesions on cine-clips. IMPLICATIONS FOR PRACTICE Identifying suitable AL levels will influence future ultrasound room construct.
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Affiliation(s)
- P Y C Lee
- Department of Radiography, Allied Health Division, Singapore General Hospital, Singapore.
| | - A Mohamed Afif
- Department of Radiography, Allied Health Division, Singapore General Hospital, Singapore.
| | - A Anthony
- Department of Radiography, Allied Health Division, Singapore General Hospital, Singapore.
| | - M Goodyear
- School of Rural Health, Monash University, Clayton, Victoria, Australia.
| | - P Lombardo
- Department of Medical Imaging and Radiation Sciences, Monash University, Clayton, Victoria, Australia.
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2
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Miravent S, Jiménez C, Barbancho N, Lobo MD, Figueiredo T, Gomes C, Ratusneac I, Gonçalves JM, Hasnas C, de Almeida R. Renal screening sonography-A comparative study in a Portuguese basic emergency service. J Med Radiat Sci 2024. [PMID: 38888376 DOI: 10.1002/jmrs.802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 05/28/2024] [Indexed: 06/20/2024] Open
Abstract
INTRODUCTION Renal Point-of-Care Ultrasound (POCUS) is a screening modality that aids in clinical decision-making for patients with suspected renal colic. This study intends to compare the accuracy and pertinence of sonographic findings obtained by a sonographer in a Basic Emergency Service (BES) with the imaging findings at the Referral Hospital (RH). METHODS Thirty-one patients suspected of having renal pathology underwent initial sonography screening with POCUS at the BES and were subsequently referred to the RH for additional imaging examinations. The results of both examinations were compared to verify whether the findings from the BES were confirmed by the radiologist in the RH and to ensure that the patient referrals from BES to RH were appropriate. RESULTS In our sample, the majority of patients (80%) exhibited varying degrees of pyelocaliceal distension, with nearly half (48%) patients presenting obstructions. A strong association between the sonographic findings in the BES and the RH was found in the variables 'Dilatation of pyelocaliceal system' (V = 0.895; P = 0.00), 'Simple cystic formation' (V = 0.878; P = 0.000), respectively. There was a statistically significant correlation between BES and RH findings, indicating a strong association between these two variables, respectively (k = 0.890; P = 0.000) and (k = 0.870; P = 0.000). There was also a strong statistically significant correlation in the ultrasonographic findings between BES and RH performers (k = 0.890; P = 0.000 and k = 0.870; P = 0.000). In this research, an achieved sensitivity of 96% and a specificity of 85% were demonstrated in the identification of pyelocaliceal dilatation. CONCLUSION Renal POCUS screening successfully detected abnormalities in the urinary system of patients suspected of having renal colic. The sonographic findings at the BES had a good correlation with the complementary imaging results obtained at the RH in Portugal. These results suggest that Radiographers/Sonographers can have an important role in the preliminary assessment of urgent renal pathology in remote areas, contributing to a correct referral and early treatment.
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Affiliation(s)
- Sérgio Miravent
- Algarve Local Health Unit, Basic Emergency Center of Vila Real de Santo António, Faro, Portugal
- Medical Imaging and Radiotherapy Department, University of Algarve, Faro, Portugal
| | - Carmen Jiménez
- Algarve Local Health Unit, Basic Emergency Center of Vila Real de Santo António, Faro, Portugal
| | - Narciso Barbancho
- Algarve Local Health Unit, University Hospital Center of Algarve, Intensive Care Unit- Resuscitation Room, Faro, Portugal
| | - Manuel Duarte Lobo
- Local Health Unit of the Northeast, Bragança, Portugal
- Polytechnic University of Castelo Branco, Castelo Branco, Portugal
| | - Teresa Figueiredo
- Integrated Master of Medicine, Faculty of Medicine and Biomedical Sciences, University of Algarve, Faro, Portugal
| | - Carla Gomes
- Algarve Local Health Unit, Basic Emergency Center of Vila Real de Santo António, Faro, Portugal
- Integrated Master of Medicine, Faculty of Medicine and Biomedical Sciences, University of Algarve, Faro, Portugal
- Algarve Local Health Unit, Levante Family Health Unit, Faro, Portugal
| | - Ion Ratusneac
- Integrated Master of Medicine, Faculty of Medicine and Biomedical Sciences, University of Algarve, Faro, Portugal
- Algarve Local Health Unit, Levante Family Health Unit, Faro, Portugal
| | - João Mário Gonçalves
- Integrated Master of Medicine, Faculty of Medicine and Biomedical Sciences, University of Algarve, Faro, Portugal
- Algarve Local Health Unit, Levante Family Health Unit, Faro, Portugal
| | - Corina Hasnas
- Medical Imaging and Radiotherapy Department, University of Algarve, Faro, Portugal
| | - Rui de Almeida
- Medical Imaging and Radiotherapy Department, University of Algarve, Faro, Portugal
- CHRC-Comprehensive Health Research Center, University of Evora, Évora, Portugal
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3
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Asif MA, Zahid AS, Naseer A, Khan MUU, Bhatti Z, Khan MWW, Nizami MFK, Shehzad K, Younas UA, Ahmad H, Mehmood Qadri H, Bilal S. Structured Reporting of Superficial Soft Tissue Masses on Ultrasonography: A Closed-Loop Clinical Audit From a Tertiary Care Hospital in Pakistan. Cureus 2024; 16:e61884. [PMID: 38975542 PMCID: PMC11227745 DOI: 10.7759/cureus.61884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2024] [Indexed: 07/09/2024] Open
Abstract
Background Among all the modalities of diagnostic radiology, ultrasonography is considered the least invasive one. However, this benefit usually comes at the cost of its subjective evaluation since it is purely a dynamic diagnostic modality. Thus, instead of ultrasonography, most clinicians usually rely on the report written by the radiologist. Objective The objective of this study is to evaluate the clinical practices of ultrasound reporting of superficial soft tissue masses. Materials and methods A closed-loop retrospective and prospective study was conducted at the Department of Radiology and Medical Imaging, Jinnah Hospital, Lahore between December 2023 and March 2024. In the pre-intervention phase, a randomly collected sample of 100 ultrasound reports documenting superficial soft tissue masses were included in the study and judged against standard criteria set by the Royal College of Radiologists (RCR). The intervention phase included regular presentations, identification of problems, and designing of preformed reporting forms. Post-intervention assessments were based on the judgment of 100 ultrasound reports in each cycle twice. Intervention and post-intervention assessments were done twice to correct the ongoing practices. Results During the pre-intervention phase, the ultrasound reports issued by the department of study showed only 41.5% compliance with the RCR structured reporting guidelines. However, after the first and second post-intervention phases, this percentage increased up to 98.3%. Overall, we observed a compliance difference of 56.5% between the pre-intervention and second post-intervention phases. Conclusion Integration of methods, such as briefing the residents on RCR guidelines, displaying parameters, and making structured report templates available, can greatly increase adherence to RCR guidelines for structured ultrasonography reporting. It also greatly enhances the comprehensiveness and reliability of ultrasonography reports for clinicians. Clinical audits should be routinely practiced in the settings of radiology.
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Affiliation(s)
| | | | - Ayesha Naseer
- Radiology and Medical Imaging, Jinnah Hospital, Lahore, PAK
| | | | | | | | | | | | | | | | | | - Saira Bilal
- Radiology and Medical Imaging, Jinnah Hospital, Lahore, PAK
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Dubey G, Srivastava S, Jayswal AK, Saraswat M, Singh P, Memoria M. Fetal Ultrasound Segmentation and Measurements Using Appearance and Shape Prior Based Density Regression with Deep CNN and Robust Ellipse Fitting. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024; 37:247-267. [PMID: 38343234 DOI: 10.1007/s10278-023-00908-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 03/02/2024]
Abstract
Accurately segmenting the structure of the fetal head (FH) and performing biometry measurements, including head circumference (HC) estimation, stands as a vital requirement for addressing abnormal fetal growth during pregnancy under the expertise of experienced radiologists using ultrasound (US) images. However, accurate segmentation and measurement is a challenging task due to image artifact, incomplete ellipse fitting, and fluctuations due to FH dimensions over different trimesters. Also, it is highly time-consuming due to the absence of specialized features, which leads to low segmentation accuracy. To address these challenging tasks, we propose an automatic density regression approach to incorporate appearance and shape priors into the deep learning-based network model (DR-ASPnet) with robust ellipse fitting using fetal US images. Initially, we employed multiple pre-processing steps to remove unwanted distortions, variable fluctuations, and a clear view of significant features from the US images. Then some form of augmentation operation is applied to increase the diversity of the dataset. Next, we proposed the hierarchical density regression deep convolutional neural network (HDR-DCNN) model, which involves three network models to determine the complex location of FH for accurate segmentation during the training and testing processes. Then, we used post-processing operations using contrast enhancement filtering with a morphological operation model to smooth the region and remove unnecessary artifacts from the segmentation results. After post-processing, we applied the smoothed segmented result to the robust ellipse fitting-based least square (REFLS) method for HC estimation. Experimental results of the DR-ASPnet model obtain 98.86% dice similarity coefficient (DSC) as segmentation accuracy, and it also obtains 1.67 mm absolute distance (AD) as measurement accuracy compared to other state-of-the-art methods. Finally, we achieved a 0.99 correlation coefficient (CC) in estimating the measured and predicted HC values on the HC18 dataset.
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Affiliation(s)
- Gaurav Dubey
- Department of Computer Science, KIET Group of Institutions, Delhi-NCR, Ghaziabad, U.P, India
| | | | | | - Mala Saraswat
- Department of Computer Science, Bennett University, Greater Noida, India
| | - Pooja Singh
- Shiv Nadar University, Greater Noida, Uttar Pradesh, India
| | - Minakshi Memoria
- CSE Department, UIT, Uttaranchal University, Dehradun, Uttarakhand, India
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5
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Klobasa I, Denham G, Baird M, Sim J, Petrie D, Roebuck DJ, Tonks A, Tu C, Sarrami P, Best J, Abood J, Jones C. Real-time x-ray abnormality alerts for emergency departments using a radiographer comment model - a multisite pilot study. Radiography (Lond) 2024; 30:52-60. [PMID: 37866158 DOI: 10.1016/j.radi.2023.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 09/11/2023] [Accepted: 10/02/2023] [Indexed: 10/24/2023]
Abstract
INTRODUCTION The timely communication of clinically significant image appearances to Emergency Department (ED) referrers is necessary for optimum patient care. Australian reliance on verbal communication only is time-limited, open to misinterpretation and lacks transparency. A combined radiographer alert and comment model was designed to reliably communicate image abnormalities to ED referrers in real-time. METHODS A multidisciplinary steering group designed the model for all ED general imaging. Protocols were developed to document radiographer comments (critical, urgent and clinically significant) in patients' medical records. Critical findings were communicated directly to ED. Five NSW hospitals varying in size, complexity and population demographics piloted the model between three to twelve months during 2021-2022. Site auditors compared comments with the radiology report and designated each as True Positive (TP), False Positive (FP), indeterminate and clinically significant. Indeterminate cases were analysed by an external radiologist. Inter-observer consensus was obtained for all classifications via two independent auditors. The Positive Predictive Value (PPV), or precision of the comment, was calculated for each site. RESULTS Radiographers (n = 69) provided comments for 1102 cases. The pooled average PPV for TP was 0.96; (0.947-0.971; 95% CI). The weighted mean error (FP comments) was 3.9%; (2.9% - 5.3%.; 95% CI). CONCLUSION The Radiographer Comment model provided consistent levels of commenting precision and reproducibility across a range of sites with a pooled average PPV (0.96). The False Positive rate or weighted mean error (FP) of 3.9% (2.9% - 5.3%.; 95% CI) was low. IMPLICATIONS FOR FUTURE PRACTICE A strategic, interprofessional approach in the implementation of an image alert combined with a Radiographer Comment can be adapted across a variety of hospital settings for ED and other departments.
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Affiliation(s)
- I Klobasa
- Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia.
| | - G Denham
- Manning District Hospital, Taree, New South Wales, Australia
| | - M Baird
- Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - J Sim
- Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - D Petrie
- School of Health Economics, Monash University, Clayton, Victoria, Australia
| | - D J Roebuck
- Department of Medical Imaging, Perth Children's Hospital, Nedlands 6009, Australia; Division of Paediatrics, Medical School, University of Western Australia, Crawley 6009, Western Australia, Australia
| | - A Tonks
- Sydney Adventist Hospital, Wahroonga, New South Wales, Australia
| | - C Tu
- Sydney Adventist Hospital, Wahroonga, New South Wales, Australia
| | - P Sarrami
- Agency for Clinical Innovation (ACI), NSW Health. St Leonards New South Wales, Australia; South-Western Sydney Clinical School University of New South Wales, Australia
| | - J Best
- Wyong Hospital, Wyong, New South Wales, Australia
| | - J Abood
- Bathurst Hospital, Bathurst, New South Wales, Australia
| | - C Jones
- Broken Hill Hospital, Broken Hill, New South Wales, Australia
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Thaker N, Dhande R, Parihar P. Role of Transvaginal Sonography in the Diagnosis of Female Infertility: A Comprehensive Review. Cureus 2023; 15:e50048. [PMID: 38186406 PMCID: PMC10767472 DOI: 10.7759/cureus.50048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/06/2023] [Indexed: 01/09/2024] Open
Abstract
Female infertility, a complex and emotionally challenging condition, impacts millions of women worldwide. Timely and accurate diagnosis is crucial for tailoring effective solutions to overcome fertility challenges. Transvaginal sonography, a real-time and non-invasive imaging modality, is pivotal in this diagnostic process. This review focuses on the structural abnormalities of the female reproductive system related to female infertility, particularly highlighting the capabilities of transvaginal sonography in assessing ovulatory disorders, structural anomalies, endometrial conditions, ovarian reserve, and other contributing factors. It is important to note that while transvaginal sonography excels in detecting structural abnormalities, it may not effectively identify lifestyle and hormonal changes. This limitation underscores the necessity for a comprehensive diagnostic approach that includes additional modalities to address the multifaceted nature of female infertility. Despite acknowledging the inherent limitations and operator dependence of transvaginal sonography, we emphasize its significance in guiding clinicians toward well-informed decisions and personalized treatment plans. Looking forward, we anticipate the continual evolution of sonographic technology, offering enhanced diagnostic capabilities. The commitment to improving fertility outcomes for individuals and couples navigating the intricate path toward parenthood remains paramount. In conclusion, a holistic diagnostic approach incorporating various modalities is essential for a thorough understanding and effective management of female infertility.
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Affiliation(s)
- Nirja Thaker
- Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Rajasbala Dhande
- Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pratapsingh Parihar
- Radiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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7
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Necas M, Thomas S, Prout K. Transient intussusception - What the sonographer needs to know. Australas J Ultrasound Med 2023; 26:191-198. [PMID: 37701765 PMCID: PMC10493360 DOI: 10.1002/ajum.12352] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023] Open
Abstract
Intussusception is typically considered an acute emergency; however, the increased utilisation of medical imaging has revealed that intussusceptions can also be transient, asymptomatic and possibly physiologic. Sonographers should be aware of three categories of intussusceptions: (i) persistent intussusceptions resulting in acute abdomen and requiring urgent intervention, (ii) transient symptomatic intussusceptions which may be amenable to a 'wait-and-see' strategy and (iii) transient asymptomatic intussusceptions which almost always involve the small bowel. In particular, the incidental discovery of enteroenteric intussusceptions in children should not be confused with acute pathology. In adults, sonographers should be mindful of the frequent presence of pathological lead points and further investigations may be warranted. In this literature review, we provide an overview of transient intussusceptions, highlight important differences between children and adults and describe sonographic appearances of various intussusceptions and their mimics.
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Affiliation(s)
- Martin Necas
- Ultrasound DepartmentWaikato HospitalHamiltonNew Zealand
| | - Stacey Thomas
- Ultrasound DepartmentWaikato HospitalHamiltonNew Zealand
| | - Kara Prout
- Ultrasound DepartmentWaikato HospitalHamiltonNew Zealand
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8
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Necas M, Prout K, Wackrow W, Manunui E, Lewis E. The accuracy of sonographers in reporting abnormal ultrasound findings: A prospective study comparing sonographers' and radiologists' reports in 1000 hospital patients. SONOGRAPHY 2023. [DOI: 10.1002/sono.12346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Affiliation(s)
- Martin Necas
- Ultrasound Department Waikato Hospital Hamilton New Zealand
| | - Kara Prout
- Ultrasound Department Waikato Hospital Hamilton New Zealand
| | - Wendy Wackrow
- Ultrasound Department Waikato Hospital Hamilton New Zealand
| | - Emma Manunui
- Ultrasound Department Waikato Hospital Hamilton New Zealand
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Ferreira CA, van Dyk B, Mokoena PL. The experiences of sonographers with regard to report writing and communicating their findings. Health SA 2022; 27:2066. [PMID: 36483501 PMCID: PMC9724032 DOI: 10.4102/hsag.v27i0.2066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/27/2022] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Sonographers in South Africa are legally allowed to write their own reports; however, they often lack adequate training in providing a well-structured and coherent formal written report. AIM The aim of this study was to explore and describe how sonographers in the Gauteng province experience the responsibility of report writing and to develop recommendations that could assist sonographers in the execution of their duty. SETTING Focus group discussions (FGDs) with sonographers from private and public hospitals located in Gauteng province were conducted at neutral locations that were convenient for the sonographers. METHODS A qualitative phenomenological research design was used for this study. A two-stage sampling approach was employed to recruit information-rich sonographers to partake in this study. Purposeful sampling was used to select sonographers based on their first-hand experience of report writing, followed by snowball sampling which allowed the researcher access to new participants on the recommendation of previous sonographers. Thirteen female sonographers voluntarily participated in the study, and the FGDs continued until data saturation was reached. The views and opinions of the sonographers were analysed using content analysis. RESULTS Key findings of this study indicated that sonographers felt unprepared to describe ultrasound findings correctly in order to provide a coherent and well-structured formal written report. CONCLUSION Sonographers suggested the use of workshops or further training at higher educational institutions (HEIs) to support sonographers in their report-writing role. CONTRIBUTION The experiences identified by sonographers can assist HEIs to provide further training or workshops to support sonographers in communicating their findings effectively.
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Affiliation(s)
- Cassandra A Ferreira
- Department of Medical Imaging and Radiation Sciences, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Barbara van Dyk
- Department of Medical Imaging and Radiation Sciences, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Padidi L Mokoena
- Department of Medical Imaging and Radiation Sciences, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
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10
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Olaleye OA, Olatunji OO, Jimoh KO, Olaleye AO. Bland-Altman Plot: Agreement Between Ultrasound-measured Placenta Thickness and Other Biometric Parameters in the Determination of Gestational Age. JOURNAL OF THE WEST AFRICAN COLLEGE OF SURGEONS 2022; 12:46-51. [PMID: 36590778 PMCID: PMC9802599 DOI: 10.4103/jwas.jwas_165_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 08/17/2022] [Indexed: 01/03/2023]
Abstract
Purpose The aim of this article is to evaluate the agreement of placenta thickness (PT) with other foetal biometric parameters in the determination of gestational age (GA) in normal singleton foetuses. Materials and Methods The study was a cross-sectional descriptive study conducted among 406 consecutively recruited pregnant women with singleton foetuses at 15-40 weeks of gestation at the National Hospital, Abuja, Nigeria from October to December 2019. Biparietal diameter (BPD), femur length (FL), head circumference (HC), abdominal circumference (AC), and PT were measured using standard measurement protocols. Bland and Altman (BA) plots were used to compare PT and other foetal biometric parameters. The significant statistical level was determined at a critical value of P < 0.05. Results The mean age of study participants was 31.8 ± 4.8 years. The BA plot of PT and HC demonstrated a normal distribution; the mean difference was around zero (3.968) and 95% of the measurements fell within 2SD of the mean. The BA plot of HC and AC measurements also showed that the 95% limits of agreement for differences fell within 10% of the mean of the measurements (-4.236 to 15.987 with a mean difference of 5.876), indicating good agreement between the two pairs of variables. However, BA plots between PT and BPD as well as PT and FL showed no agreement. Conclusion This study indicates that there is good agreement or comparability between PT and HC measurements as well as between PT and AC measurements. Hence, either HC or AC measurements may be interchangeable with PT measurements in the ultrasound determination of GA. However, PT measurements did not agree well with BPD and FL measurements, respectively.
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Affiliation(s)
| | | | | | - Abiola O. Olaleye
- Department of Community Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife, Nigeria
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11
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Smith SL. Peer review audit (
PRA
) in ultrasound practice: A paper based on established
UK
sonography
PRA
models which are generalizable to other jurisdictions. SONOGRAPHY 2022. [DOI: 10.1002/sono.12308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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12
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Hammes K, Kook PH. Effects of medical history and clinical factors on serum lipase activity and ultrasonographic evidence of pancreatitis: Analysis of 234 dogs. J Vet Intern Med 2022; 36:935-946. [PMID: 35438226 PMCID: PMC9151483 DOI: 10.1111/jvim.16426] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/31/2022] [Accepted: 04/02/2022] [Indexed: 12/19/2022] Open
Abstract
Background Lipase measurements and ultrasonographic (US) evidence of pancreatitis correlate poorly. Objectives Identify explanations for discrepant lipase and pancreatic US results. Animals Two hundred and thirty‐four dogs with gastrointestinal signs. Methods A retrospective study was conducted, in which lipase activity and US were performed within 30 hours. Medical history, clinical examination results, lipase activity, and US results were recorded. Results Lipase and US results were weakly correlated (rs = .25, P < .001). At both evaluated time cut‐offs, median lipase activities were significantly higher with shorter durations of clinical signs before presentation (≤2 days, 334 U/L; >2 days, 118 U/L; P = .03; ≤7 days, 334 U/L; >7 days, 99 U/L; P = .004), but US was not significantly more frequently positive. For both cut‐offs (>216/≤216 U/L, >355/≤355 U/L; reference range, 24‐108 U/L), median disease duration was significantly shorter (3 vs 4 days) with higher lipases. Previous pancreatitis episodes were significantly associated with an US diagnosis of pancreatitis (P = .04), but median lipase activities were not significantly higher (386 U/L vs 153 U/L; P = .06) in these dogs. Pancreatic US was significantly more often positive when the request contained “suspicion of pancreatitis” (P < .001) or “increased lipase” (P = .01). Only changes in pancreatic morphology, echogenicity, and peripancreatic mesentery were significantly associated with a positive US diagnosis, and also had significantly higher lipase activities. Conclusions and Clinical Importance Duration of clinical signs before presentation differently affects laboratory and US evidence of pancreatitis. Previous pancreatitis episodes and information given to radiologists influence US results. These findings can be helpful for future studies on pancreatitis in dogs.
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Affiliation(s)
- Karen Hammes
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Peter H Kook
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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Dando C, Lane G, Bowen C, Henshaw F. The evaluation of podiatrists, with knowledge and training in diagnostic musculoskeletal ultrasound, to describe sonographic images of diabetic foot wounds in the United Kingdom and Australia. J Foot Ankle Res 2022; 15:5. [PMID: 35078511 PMCID: PMC8787913 DOI: 10.1186/s13047-022-00511-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 01/11/2022] [Indexed: 11/10/2022] Open
Abstract
AIMS Currently, wound management decisions are based largely on visual observations such as photographs, descriptors or measurements which can lack detail and do not always capture the sub-wound area. A previous case series suggests that there is benefit in using ultrasound imaging (USI) to evaluate diabetic foot ulcers (DFU) at point-of-care, however no guidance exists to inform its use. This scoping exercise explores the capacity of podiatrists with experience in interpreting musculoskeletal structures using USI to interpret sonographic images of DFU. METHODS Following a short briefing session, podiatrists with previous musculoskeletal (MSK) USI training were asked to review and report on previously recorded static sonographic images (n = 8) of active DFU. Content analysis was utilised to identify recurring keywords within the podiatrists' reports which were coded and assigned to categories to gain context to the data. RESULTS Seven podiatrists participated in the study. Four categories were constructed for the purposes of analysis: 1) Frequency of reporting, 2) Language used in reporting, 3) Observations, 4) Clinical impression Frequently, the reported findings between podiatrists were found to be similar, especially those related to bone morphology. However greater variability was seen in the reporting of wound specific soft-tissue observations. CONCLUSION This scoping exercise has shown that podiatrists can translate their existing USI skills to make rudimentary reports on clinical findings in DFU. All participants were consistently able to identify and describe characteristics associated with DFU from a single b mode static wound ultrasound image. Findings from this investigation can be used as a foundation for further work to establish accuracy and reliability to validate DFU sonography. In conjunction the development of protocols and training materials will enable the adoption of USI to assess DFU in clinical practice. This will in turn, contribute to improved patient care and establish a new paradigm for wound surveillance which is translatable to other wound types.
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Affiliation(s)
- Charlotte Dando
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Georgia Lane
- Podiatry Department, Solent NHS Trust, Southampton, UK
| | - Catherine Bowen
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Centre for Sport, Exercise and Osteoarthritis Versus Arthritis, University of Southampton, Southampton, UK
| | - Frances Henshaw
- School of Medicine, Western Sydney University, Penrith, Australia
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14
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Mijwil MM, Aggarwal K. A diagnostic testing for people with appendicitis using machine learning techniques. MULTIMEDIA TOOLS AND APPLICATIONS 2022; 81:7011-7023. [PMID: 35095329 PMCID: PMC8785023 DOI: 10.1007/s11042-022-11939-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/09/2021] [Accepted: 01/03/2022] [Indexed: 05/07/2023]
Abstract
Appendicitis is a common disease that occurs particularly often in childhood and adolescence. The accurate diagnosis of acute appendicitis is the most significant precaution to avoid severe unnecessary surgery. In this paper, the author presents a machine learning (ML) technique to predict appendix illness whether it is acute or subacute, especially between 10 and 30 years and whether it requires an operation or just taking medication for treatment. The dataset has been collected from public hospital-based citizens between 2016 and 2019. The predictive results of the models achieved by different ML techniques (Logistic Regression, Naïve Bayes, Generalized Linear, Decision Tree, Support Vector Machine, Gradient Boosted Tree, Random Forest) are compared. The covered dataset are 625 specimens and the total of the medical records that are applied in this paper include 371 males (60.22%) and 254 females (40.12%). According to the dataset, the records consist of 318 (50.88%) operated and 307 (49.12%) unoperated patients. It is observed that the random forest algorithm obtains the optimal result with an accurately predicted result of 83.75%, precision of 84.11%, sensitivity of 81.08%, and the specificity of 81.01%. Moreover, an estimation method based on ML techniques is improved and enhanced to detect individuals with acute appendicitis.
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Affiliation(s)
- Maad M. Mijwil
- Computer Techniques Engineering Department, Baghdad College of Economic Sciences University, Baghdad, Iraq
| | - Karan Aggarwal
- Electronics and Communication Engineering Department, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, India
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15
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Elsingergy MM, Carlsson T, Andronikou S. Evaluation of quality of renal tract ultrasound scans and reports performed in children with first urinary tract infection. J Med Imaging Radiat Sci 2021; 53:65-74. [PMID: 34893454 DOI: 10.1016/j.jmir.2021.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 11/16/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To determine the quality of renal tract ultrasound (US) imaging records performed in children for evaluation of urinary tract infection (UTI) by multiple professionals with different levels of experience in a dedicated academic children's hospital. METHODS Retrospective analysis of US images and reports for children ≤ 13-years with first presentation of a UTI. 9 Operators (6 consultant radiologists and 3 sonographers) were anonymised and the adequacy of their US images and reports were evaluated for the following categories; Image acquisition, Image labelling, Metric labelling, and Final reporting. The frequency of the reporting quality of the elements assessed was compared between radiologists and sonographers using Chi-square or fisher exact test. RESULTS Renal tract US studies for 100 children (20 males, 80 females) with first UTI episode were assessed. Mean age was 4.5 ± 3.4 years. 54% of the studies were performed by sonographers and 46% by radiologists. Kidneys and pre-micturition bladder scans were acquired in more than 96% of exams by both sonographers and radiologists. Kidney image and metric labelling was adequate in almost all exams (98-100%) with the exception of plane labelling which was not routinely done by US operators (less than 3%). Sonographers performed consistently better than radiologists in post-micturition bladder scanning, pre- and post-micturition bladder labelling and renal length reporting (p<0.05). Least to be recorded by US operators (both radiologists and sonographers) were doppler scan acquisitions (less than 3%), bladder wall thickness labelling (less than 3%), and renal calculi reporting (less than 1%). CONCLUSION The inconsistency of the reporting quality between the different elements assessed highlights the difference in US training and experience received by sonographers and radiologists. A pro-forma structured reporting template may ensure US operators provide consistent, thorough and good quality ultrasound images and reports.
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Affiliation(s)
- Mohamed M Elsingergy
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, United States.
| | - Tarryn Carlsson
- Department of Radiology, Bristol Royal Hospital for Children, University Hospitals Bristol, Bristol, United States
| | - Savvas Andronikou
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Department of Radiology, Bristol Royal Hospital for Children, University Hospitals Bristol, Bristol, United States; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
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16
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Necas M. Routine disclosure statements about ultrasound examinations during Covid‐19 pandemic are unhelpful and should be avoided. SONOGRAPHY 2021. [DOI: 10.1002/sono.12295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Martin Necas
- Department of Ultrasound, Radiology Waikato Hospital Hamilton New Zealand
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17
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Necas M, Adams M, Brennan O, Curtis N, Heslop R, Woodrow‐Smith E. The value of evaluating the abdominal aorta in patients <50 years of age presenting for abdominal ultrasound. Australas J Ultrasound Med 2021; 24:27-30. [PMID: 34760608 PMCID: PMC8412018 DOI: 10.1002/ajum.12212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Practitioners of US routinely include a survey of the abdominal aorta during abdominal US in accordance with international guidelines. Such practice is of uncertain value in younger patients. METHODOLOGY This study was a retrospective review of 2000 abdominal US examinations which included visualisation of the aorta in patients <50 years of age. Patient demographics and referral details were recorded, and US images and reports were reviewed for the presence of aortic and periaortic pathology. RESULTS The most common indications for US were abdominal pain (1337, 44%), deranged liver function tests (453, 15%), nausea and/or vomiting (229, 8%), elevated inflammatory markers (146, 5%), pancreatitis (134, 4%) and pyrexia (127, 4%). Fewer than half (977, 49%) of the reports contained a comment regarding the aorta. Aortic pathology was reported in 2 (0.1%) cases. Both were reported as aortic ectasia and both represented a false-positive diagnosis. One male patient had a known abdominal aortic aneurysm with endovascular aortic repair. No new aortic aneurysms were found. All cases of atherosclerotic disease were ignored, and none were reported. Periaortic pathology was encountered on 1 patient, but this was known. No case of new periaortic pathology was detected. CONCLUSION Routine and indiscriminate imaging of the abdominal aorta during abdominal US in patients <50 years of age is not evidence based. No new case of abdominal aortic aneurysm or new para-aortic pathology was detected, all cases of atherosclerosis were ignored, and two false-positive diagnoses of aortic ectasia were made.
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Affiliation(s)
- Martin Necas
- Department of UltrasoundRadiologyWaikato HospitalPembroke StreetHamilton3204New Zealand
| | - Matt Adams
- Department of UltrasoundRadiologyWaikato HospitalPembroke StreetHamilton3204New Zealand
| | - Orlaith Brennan
- Department of UltrasoundRadiologyWaikato HospitalPembroke StreetHamilton3204New Zealand
| | - Nicole Curtis
- Department of UltrasoundRadiologyWaikato HospitalPembroke StreetHamilton3204New Zealand
| | - Rachel Heslop
- Department of UltrasoundRadiologyWaikato HospitalPembroke StreetHamilton3204New Zealand
| | - Emma Woodrow‐Smith
- Department of UltrasoundRadiologyWaikato HospitalPembroke StreetHamilton3204New Zealand
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18
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Necas M, Shen Y, Ong QH, Prout K, Wackrow W. Do radiologists need to review abdominal ultrasound examinations reported as 'normal' by the sonographer? Australas J Ultrasound Med 2020; 23:167-175. [PMID: 34760596 PMCID: PMC8411718 DOI: 10.1002/ajum.12202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Sonographers demonstrate a high standard of diagnostic performance and work with a considerable degree of professional independence. In Australasia, sonographers typically generate a preliminary report which is reviewed by the radiologist who issues a final report. The aim of this study was to determine whether radiologist's review is required in cases reported as normal by the sonographer. METHODS This study was a retrospective review of 1000 abdominal US examinations considered normal by sonographers that were subsequently reported by radiologists. Any findings reported by radiologists that were not reported by sonographers were analysed and separated into errors or discrepancies according to commonly accepted definition. RESULTS The 1000 abdominal examinations included 244 complete abdominal, 200 hepatobiliary, 506 urinary tract and 50 other abdominal examinations. Patients' age ranged from < 1 to 94 years (mean = 35 years, median = 32 years). US examinations were performed by any one of 14 sonographers with 1-21 years (mean = 6 years, median = 7 years) of clinical experience. Two diagnostic errors were made by sonographers and two errors by radiologists. In no single case did the radiologist uncover a case of an acute or serious illness, illness requiring admission or urgent clinical review, nor did the radiologist identify the cause for the presenting symptoms. Eighteen discrepancies were found, but these were of trivial nature and most were rated by specialist clinicians as irrelevant. CONCLUSION Sonographers are accurate in distinguishing normal abdominal US examinations. The involvement of a radiologist in a second reading of normal abdominal US examinations is unnecessary.
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Affiliation(s)
- Martin Necas
- Waikato HospitalPembroke StreetHamilton3204New Zealand
| | - Yi Shen
- Waikato HospitalPembroke StreetHamilton3204New Zealand
| | - Qi Hao Ong
- Waikato HospitalPembroke StreetHamilton3204New Zealand
| | - Kara Prout
- Waikato HospitalPembroke StreetHamilton3204New Zealand
| | - Wendy Wackrow
- Waikato HospitalPembroke StreetHamilton3204New Zealand
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19
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Necas M, Ong QH. Barriers to
contrast‐enhanced
ultrasound in New Zealand and proposed solutions. SONOGRAPHY 2020. [DOI: 10.1002/sono.12220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Martin Necas
- Department of UltrasoundWaikato Hospital Hamilton New Zealand
| | - Qi Hao Ong
- Department of UltrasoundWaikato Hospital Hamilton New Zealand
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20
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Necas M, Keating J, Abbott G, Curtis N, de Ryke R, Hill G. How to set-up and perform contrast-enhanced ultrasound. Australas J Ultrasound Med 2019; 22:86-95. [PMID: 34760544 PMCID: PMC8411709 DOI: 10.1002/ajum.12135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Contrast-enhanced ultrasound (CEUS) is an important part of current ultrasound imaging practice. Sonographers, radiologists and other sonologists should consider CEUS as a standard tool in the diagnostic toolbox of ultrasound and utilise it liberally to solve a wide range of imaging problems whilst reducing the need to resort to CT or MRI. Setting up a CEUS service is within easy reach of all motivated practitioners. The initial process requires assessment of the demand for CEUS, ensuring staff readiness, preparing administrative processes and obtaining CEUS supplies. The CEUS examination includes gaining informed consent, ensuring authorisation to administer contrast agent (preferably by means of a standing order), conventional pre-scan of the area of interest, insertion of a peripheral IV cannula, preparation of the contrast agent, initiation of the contrast imaging mode, administration of the contrast agent, performance of the examination and aftercare. A number of other important considerations are discussed including cannulation and IV certification, scopes of practice for sonographers performing CEUS, contrast dosing, scheduling, training, interpretation, reporting and quality control.
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Affiliation(s)
- Martin Necas
- Department of UltrasoundWaikato HospitalPembroke StreetHamiltonNew Zealand
| | - Jane Keating
- Department of UltrasoundThe Royal Melbourne Hospital300 Grattan StParkvilleVictoriaAustralia
| | - Grant Abbott
- Vascular LabWaikato HospitalPembroke StreetHamiltonNew Zealand
| | - Nicole Curtis
- Vascular LabWaikato HospitalPembroke StreetHamiltonNew Zealand
| | - Rex de Ryke
- Christchurch HospitalRiccarton AvenueChristchurchNew Zealand
| | - Gerry Hill
- Otago Vascular DiagnosticsDepartment of SurgeryDunedin School of MedicineDunedinNew Zealand
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Brennan O, Oh S, Necas M. The value of surveying the kidneys during pelvic ultrasound examinations. Australas J Ultrasound Med 2019; 22:118-128. [PMID: 34760548 PMCID: PMC8411717 DOI: 10.1002/ajum.12122] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Pelvic ultrasounds are commonly performed for various clinical indications in female patients presenting to the hospital. A survey of the kidneys is routinely included as part of the examination, but there is limited justification for their inclusion in the assessment of every female presenting for a pelvic ultrasound. METHOD We examined the utility of surveying the kidney ultrasound during pelvic ultrasonography by reviewing the records of 1009 pelvic ultrasound examinations in 1000 women. RESULTS In total, 46 incidental findings were identified, but 91% of these were clinically inconsequential. Only four patients had incidental findings of high clinical priority requiring specialist treatment. Of these, two patients were symptomatic and had urinary tract obstruction due to stones. The other two patients harboured asymptomatic renal cell carcinomas. The overall incidence of renal incidental findings of high clinical priority in asymptomatic patients was two in 1009 examinations (1999 kidneys). CONCLUSION Indiscriminate uncritical screening of the kidneys in women presenting for pelvic ultrasound is not evidence-based and represents a low-yield examination with extremely low rate of incidental findings of clinical significance.
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Affiliation(s)
| | - Sheila Oh
- Department of UltrasoundWaikato HospitalHamiltonNew Zealand
| | - Martin Necas
- Department of UltrasoundWaikato HospitalHamiltonNew Zealand
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