Central Middlesex Hospital

Central Middlesex Hospital has implemented Acoustic Radiation Force Impulse (ARFI) technology on an ACUSON S2000 ultrasound system from Siemens Healthcare to deliver full liver assessments in one day.

By using this technology, the hospital, which is part of London North West Healthcare NHS Trust, reduced the number of liver biopsies, the current gold standard method for assessing liver disease.

With this technology, patients were able to have a full liver assessment in a single hospital visit, whereas previous pathways could take up to three visits.

The technology’s main use has been in viral hepatitis, which has been recently endorsed by NICE guidelines. Its use was also extended to a wider range of liver damage and patient groups, as well as the identification of portal hypertension.

Central Middlesex Hospital consultant radiologist Dr Philip Shorvon said: "Liver disease is on the rise far more than any other major disease group and is one of the biggest killers amongst working age adults.

"Therefore the need for a faster, safer and more effective diagnosis is more important than ever.

"There are also a number of cost-efficiencies associated with reducing the number of visits."

"As one of the first sites in the UK to identify the use of ARFI in evaluating and observing the increased liver stiffness in patients with acute liver disease, we are advocating its use to avoid the necessity of liver biopsy in some cases."

Once liver disease is suspected, a rapid and accurate diagnosis is the key to developing treatment strategies, monitoring them and then providing long-term follow-up.

The company noted the ARFI technique uses ultrasound to gently displace tissue for quantitative evaluation of liver tissue stiffness properties and takes less than five minutes to complete.

In addition to traditional ultrasound examination of the liver performed in the same sitting, ARFI allows the non-invasive exclusion of significant liver diseases in patients referred with abnormal liver blood tests.

Shorvon said: "A liver biopsy is an expensive and potentially risky invasive procedure for patients and can be avoided in some patients by using the alternative ARFI method on the Siemens ultrasound system.

"This has helped us to improve patient safety and increased efficiency and patient throughput. There are also a number of cost-efficiencies associated with reducing the number of visits."

At a specialist liver user day, taking place on 23 October 2015, the hospital in collaboration with Siemens Healthcare will share its knowledge and suggestions with other gastroenterologists, hepatologists, radiologists, radiographers and specialist nurses.

The day will cover current evidence for the benefit of Siemens Virtual Touch Quantification software (VTQ) against other non-invasive techniques, as well as provide an insight into NICE guidelines and practical tips to setting up an efficient and cost-effective one stop liver diagnosis service.

Image: Central Middlesex Hospital is providing rapid liver disease diagnosis with the help of ARFI technology on the ACUSON S2000 ultrasound systems from Siemens. Photo: courtesy of Siemens AG.