Skip to main content
SpringerLink
Log in

Increasing utilization of contrast-enhanced ultrasound during abdominal biopsies: impact of an educational training program

  • Published:
Journal of Ultrasound Aims and scope Submit manuscript

Abstract

Rational and objectives

To increase utilization of contrast-enhanced ultrasound (CEUS) during ultrasound-guided targeted liver biopsies.

Material and methods

Two educational training interventions performed to increase use of CEUS. First, 14 radiologists (fellowship-trained in Abdominal Imaging) given didactic teaching and case presentations on the use of CEUS. Second, hands-on teaching on how to use CEUS provided to the same group. To determine the efficacy of these two interventions, radiologists completed anonymous surveys to determine the level of understanding and acceptability of using CEUS before and 6 months after CEUS training. In addition, the percentage of CEUS assisted liver biopsies was compared for the 6 months before and 6 months after the training.

Results

Pre-training survey completed by 11 radiologists and post-training survey completed by 9 radiologists. Before training, 11% survey responders use CEUS routinely, whereas 89% never or rarely used it. After training, 54% of respondents were new users and 100% reported they planned to use CEUS in the future. Unfamiliarity (71%) was the main reason for not using it. After training, 25% reported lack of comfort with using CEUS as the main reason for not using CEUS. During six months before training, CEUS was administered in 6% (10/172) of targeted liver biopsies. Six months after training, CEUS was used nearly twice as often (10%, 16/160, P = 0.09, 1-sided Boschloo test). The number of radiologists using CEUS increased to 57% (8/14) after training compared to 20% (3/14, P = 0.03, 1-sided Boschloo) before training.

Conclusion

Educational training intervention increases use of CEUS during ultrasound-guided targeted liver biopsies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Sheafor DH, Paulson EK, Simmons CM et al (1998) Abdominal percutaneous interventional procedures: comparison of CT and US guidance. Radiology 207:705–710. https://doi.org/10.1148/radiology.207.3.9609893

    Article  CAS  PubMed  Google Scholar 

  2. Sparchez Z, Mocan T, Hagiu C et al (2019) Real-time contrast-enhanced-guided biopsy compared with conventional ultrasound-guided biopsy in the diagnosis of hepatic tumors on a background of advanced chronic liver disease: a prospective, randomized. Clinical Trial Ultrasound Med Biol 45:2915–2924. https://doi.org/10.1016/j.ultrasmedbio.2019.07.678

    Article  PubMed  Google Scholar 

  3. Huang DY, Yusuf GT, Daneshi M et al (2017) Contrast-enhanced US-guided interventions: improving success rate and avoiding complications using US contrast agents. Radiographics 37:652–664. https://doi.org/10.1148/rg.2017160123

    Article  PubMed  Google Scholar 

  4. Skjoldbye B, Pedersen MH, Struckmann J et al (2002) Improved detection and biopsy of solid liver lesions using pulse-inversion ultrasound scanning and contrast agent infusion. Ultrasound Med Biol 28:439–444. https://doi.org/10.1016/s0301-5629(02)00484-2

    Article  PubMed  Google Scholar 

  5. Cao X, Liu Z, Zhou X et al (2019) Usefulness of real-time contrast-enhanced ultrasound guided coaxial needle biopsy for focal liver lesions. Abdom Radiol 44:310–317. https://doi.org/10.1007/s00261-018-1713-y

    Article  Google Scholar 

  6. Malone CD, Fetzer DT, Monsky WL et al (2020) Contrast-enhanced US for the interventional radiologist: current and emerging applications. Radiographics 40:562–588. https://doi.org/10.1148/rg.2020190183

    Article  PubMed  Google Scholar 

  7. Schlottmann K, Klebl F, Zorger N et al (2004) Contrast-enhanced ultrasound allows for interventions of hepatic lesions which are invisible on convential B-mode. Z Gastroenterol 42:303–310. https://doi.org/10.1055/s-2004-812712

    Article  CAS  PubMed  Google Scholar 

  8. Wu W, Chen MH, Yin SS et al (2006) The role of contrast-enhanced sonography of focal liver lesions before percutaneous biopsy. AJR Am J Roentgenol 187:752–761. https://doi.org/10.2214/AJR.05.0535

    Article  PubMed  Google Scholar 

  9. Yoon SH, Lee KH, Kim SY et al (2010) Real-time contrast-enhanced ultrasound-guided biopsy of focal hepatic lesions not localised on B-mode ultrasound. Eur Radiol 20:2047–2056. https://doi.org/10.1007/s00330-010-1757-z

    Article  PubMed  Google Scholar 

  10. Wu W, Jing X, Xue GQ et al (2022) A multicenter randomized controlled study of contrast-enhanced US versus US-guided biopsy of focal liver lesions. Radiology. https://doi.org/10.1148/radiol.212317

    Article  PubMed  PubMed Central  Google Scholar 

  11. Coco D, Leanza S (2020) Routine intraoperative ultrasound for detection of liver metastases during resection of primary colorectal cancer–a systematic review. Maedica (Bucur) 15:250–252

    PubMed  Google Scholar 

  12. Piscaglia F, Bolondi L et al (2006) The safety of sonovue in abdominal applications: retrospective analysis of 23188 investigations. Ultrasound Med and Biol 32:1369–1375

    Article  Google Scholar 

  13. Wilson SR, Merrill CD, Darge K, Barr RG (2023) Increasing CEUS utilization in the USA: a call to action for the adult and pediatric body imaging community. Abdom Radiol 48:418–423. https://doi.org/10.1007/s00261-022-03686-z

    Article  Google Scholar 

  14. Kruskal JB, Eisenber R, Sosna J et al (2011) Quality initiatives: quality improvement in radiology: basic principles and tools required to achieve success. Radiographics 31:1499–1509. https://doi.org/10.1148/rg.316115501

    Article  PubMed  Google Scholar 

Download references

Funding

None recieved.

Author information

Authors and Affiliations

  1. Department of Radiology, Duke University Medical Center, 2301 Erwin Road, Box 3808, Durham, NC, 27710, USA

    Lisa M. Ho, James Ronald & Benjamin Wildman-Tobriner

Authors
  1. Lisa M. Ho
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. James Ronald
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Benjamin Wildman-Tobriner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lisa M. Ho.

Ethics declarations

Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Duke University Health System Institutional Review Board (9/6/2021, protocol ID Pro00108967).

Consent to participate and to publish

Informed consent was waived by the Duke University Health System Institutional Review Board in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ho, L.M., Ronald, J. & Wildman-Tobriner, B. Increasing utilization of contrast-enhanced ultrasound during abdominal biopsies: impact of an educational training program. J Ultrasound (2024). https://doi.org/10.1007/s40477-023-00862-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s40477-023-00862-9

Keywords

Search

Navigation