3.1
Ultrasound scanning, along with other imaging technologies such as CT and MRI, is important in diagnosing and planning treatment for many people with liver disease. Liver imaging sometimes identifies focal abnormalities that cannot be characterised initially and another test may be needed to further explore the abnormality. The main aim of subsequent liver imaging is to distinguish between cancer and benign abnormalities that are not likely to need further treatment. Liver lesions are commonly found at an initial unenhanced ultrasound scan. If the abnormality is not characterised by an unenhanced ultrasound scan, the person is usually referred for either MRI and/or CT. The definition of the term 'inconclusive' in this evaluation is an unenhanced ultrasound scan in which a focal liver lesion is detected but not characterised. The aim of this evaluation was to compare the clinical and cost effectiveness of contrast-enhanced ultrasound using the contrast agent SonoVue with contrast-enhanced CT and contrast-enhanced MRI for investigating and characterising focal liver lesions in adults, in whom previous liver imaging has been inconclusive. Three specific clinical indications were assessed:
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characterising focal liver lesions identified through monitoring of people with cirrhosis
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investigating potential liver metastases in people with colorectal cancer
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characterising incidentally detected focal liver lesions unrelated to the clinical indication for which the imaging was requested.