title: Hepatic contrast-enhanced ultrasound: impact of its introduction in the Australian context.
abstract: BACKGROUND
  Contrast-enhanced ultrasound (CEUS) is a relatively new imaging modality in Australia. We discuss our early experience with CEUS at Royal Melbourne Hospital in assessment of focal liver lesions and its clinical impact.
  
  
  METHODS
  Radiology department and hospital computerised information systems were used to identify and collate information regarding the indication, previous and follow-up imaging, CEUS findings and subsequent final diagnoses of patients who underwent hepatic CEUS from 12/12/2007 to 20/4/2012.
  
  
  RESULTS
  A total of 388 hepatic CEUS were performed, examining 409 lesions. The cases were grouped as either 'initial study' or 'follow-up' group, with main focus on the former group. Of the 367 lesions in the 'initial study' group, CEUS was able to distinguish benign from malignant pathology in 344 cases (93.8%). This was especially beneficial in setting of known malignancy with indeterminate liver lesions found on CT to confidently exclude metastatic disease. For 124 of 162 patients who had an incidentally detected indeterminate liver lesion, CEUS was the final imaging investigation required to make a diagnosis.
  
  
  CONCLUSIONS
  CEUS is a valuable tool in assessment of focal liver lesions in conjunction with other conventional modalities in a variety of clinical settings. In particular, it provided definitive diagnosis in a significant proportion of incidentally identified liver lesions many of which are benign, saving patient anxiety and further unnecessary follow-up.
authors: Radiology Department, Concord Repatriation Hospital, Sydney.
authors: So Yeun
authors: SY
authors: Won
authors: Neha
authors: N
authors: Singh
authors: Beng Ghee
authors: BG
authors: Lim
authors: Damien
authors: D
authors: Stella
authors: Robert
authors: R
authors: Gibson
mesh_terms: D003287:Contrast Media; D005466:Fluorocarbons; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008485:Medical Audit; D009517:New South Wales / Q000453:epidemiology; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000706:statistics & numerical data*; D014600:Utilization Review
chemical_list: D003287:Contrast Media; D005466:Fluorocarbons; C042852:perflutren
keywords: contrast enhanced ultrasound; liver lesions