From the March 2022 issue of HealthCare Business News magazine


A second-best practice example is the case of an incidental liver lesion in a child. The default practice in the past is to refer the child to have a CT or an MR scan. What is the disadvantage of doing so? CT means significant radiation exposure, MR entails, for younger children in particular, sedation or anesthesia, with their own disadvantages. In addition, both are more expensive and not as easy as ultrasound to schedule. However, the use of contrast ultrasound allows just-in-time study with real-time dynamic imaging that delivers definite diagnosis, leaving out CT or MR. It is not hard to imagine the positive experience this diagnostic test will deliver to the patients and families.

HCB News: CEUS is beneficial for patients, particularly pediatric patients, because it uses no radiation. Are there other reasons why it may be preferable over other imaging techniques?
KD: For one imaging modality to be regarded equal or better, the driving force is the comparable diagnostic results. All other ancillary stuff is secondary. If the former is fulfilled an imaging modality will struggle to be used in place of the existing ones. In the case of contrast ultrasound in children, in many comparisons it is equal to or better than the conventional imaging modalities in terms of its diagnostic capability. In addition to this main advantage there are a number of additional ones as follows.
– Pediatric patients, particularly those younger than 7 years, often require sedation or anesthesia to carry out an MR exam. This adds complexity to the imaging service: coordination of scheduling, space for pre- and post-sedation/anesthesia care, specialized personnel, more MR room time, and higher study cost. Furthermore, the potential negative effects of sedation/anesthesia on the developing brain cannot be ignored. If an MR study with sedation/anesthesia can be replaced by contrast US, the advantage is enormous.

– Safer imaging practice for children is strongly advocated by the “Image Gently” campaign. The campaign has resulted in a significant reduction in radiation exposure to children by advocating for the implementation of various processes and methods to lower radiation exposure, including low-dose CT and pulsed fluoroscopy. Contrast US goes further by eliminating radiation completely when it fully replaces a diagnostic imaging study that uses ionizing radiation.

- A positive patient and family experience is particularly important in pediatric imaging. Children require more ancillary comfort measures than adults to conduct a study. Often the child’s parent or guardian is present for the examination and therefore their needs are also taken into consideration. Thus, it is necessary to satisfy the requirements of not one but two or three persons. Compared to fluoroscopy, CT or MR studies, US can offer a more child-friendly environment by virtue of having a small imaging transducer and without an associated equipment enclosure surrounding the patient. Parents or guardians are also able to access their child much more easily. An ultrasound scan can be performed with the child in different positions, including with a parent or guardian holding the child or on the exam bed with the child.

March 2022 Magazine

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