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NICE publishes guidance for ultrasound testing to diagnose liver cancer

31 August, 2012
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Guidance published by the National Institute for Health and Clinical Excellence (NICE) supports the use of contrast-enhanced ultrasound with SonoVue (Bracco UK) to diagnose liver cancer.

The guidance recommends the use of SonoVue in adults to investigate lesions to the liver that are detected incidentally, but not characterised, on an unenhanced ultrasound scan.

The guidance also recommends its use in adults to investigate potential liver cancer that has spread from other cancers in the body, and to investigate liver damage in adults with cirrhosis where unenhanced ultrasound scans are inconclusive, and if contrast-enhanced CT and contrast enhanced-MRI respectively cannot be used.

SonoVue is a second generation contrast agent and is licensed for contrast-enhanced ultrasound imaging in adults in whom unenhanced ultrasound is inconclusive. It uses sulphur hexafluoride microbubbles which are injected into the bloodstream to enhance the blood's ability to reflect ultrasound waves (echogenicity) and thus improve the signal to noise ratio in ultrasound. It improves display of the blood vessels in liver lesions during ultrasound scanning, allowing more specific characterisation of lesions.

Professor Carole Longson, NICE Health Technology Evaluation Centre Director, said: “One drawback with unenhanced liver imaging is that it sometimes identifies damage to the liver which cannot be characterised initially and another test may therefore be needed to fully explain the abnormality. One important potential benefit of SonoVue is that it can be carried out at the same appointment as the initial scan, thereby minimising any delay to diagnosis and subsequent treatment, with associated reduction in anxiety for patients and their families.

“The independent Diagnostics Advisory Committee concluded that the evidence presented showed that contrast-enhanced imaging with SonoVue is less costly and more effective compared to contrast-enhanced CT and MRI for characterising incidentally detected liver lesions. The Committee also concluded that SonoVue is an effective use of NHS resources in patients with suspected cancer of the liver that has spread from other cancers in the body and in patients with liver cirrhosis for whom CT scanning or MRI scanning respectively are not suitable.”

Click here to download the guidance.

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