Pocket-size ultrasound device in cholelithiasis: diagnostic accuracy and efficacy of short-term training

Abstract

Pocket-size ultrasound devices (PSUD) are now widely available becoming a useful tool for diagnostic and therapeutic purposes. We aim to investigate the accuracy of PSUD in diagnosing cholelithiasis as compared to traditional ultrasonography. Moreover, we tested the reliability of PSUD when performed by inexperienced internal medicine residents after a short-term training. We consecutively enrolled inpatients and outpatients referred to undergo abdominal ultrasonography for signs or symptoms of gallbladder diseases in two different hospitals. Every patient underwent two independent examinations with PSUD by both expert (EXP) and nonexpert operators (N-EXP), and a conventional examination with traditional abdominal ultrasound (AUS). Every naive operator underwent a short-term training with a 2-h theoretical lesson, and a practical training focused on gallbladder under expert operator supervision. Overall, 146 patients were consecutively enrolled. Considering conventional AUS as the reference standard, sensitivity and specificity of EXP were, respectively, 93.75 and 100%. Sensitivity and specificity of N-EXP were, respectively, 75 and 91.25%. Nevertheless, when considering outpatients, PSUD has a high diagnostic accuracy even when performed by N-EXP with sensitivity of 93% and specificity of 88%. PSUD is a reliable tool for the diagnosis of cholelithiasis when used by expert operators potentially reducing the need for further diagnostic tests. It can even be successfully used by non-expert operators in outpatients setting after a short focussed training.

Hand-Held Ultrasound Devices Compared with High-End Ultrasound Systems: A Systematic Review

“…The included articles are presented in Table 1. Of the 16 included articles [12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27], four were related to the chest and lungs [12,13], five focused on abdominal ultrasound [14,15,16,17,18], two were related to urology [19,20], four to gynaecology and obstetrics [21,22,23,24] and three to vascular topics [25,26,27].…”

“…Fifteen of the 16 included articles used the hand-held device Vscan (GE Medical) [12,13,14,15,17,18,19,20,21,22,23,24,25,26,27] and one article used the device Acuson P10 (Siemens) [16]. The high-end ultrasound systems used in the included studies comprised of at least 24 different systems.…”

“…Five studies provided a training period of a few days or weeks before comparison with a high-end system for either nurses, family physicians, medical residents or medical students [12,13,15,18,26]. One article compared the hand-held examinations of both experienced and non-experienced operators with those made on high-end ultrasound systems [14].…”

Point‐of‐care ultrasound with pocket‐size devices in emergency department

“…All of this information can be detected by handheld device ultrasonography . A specific anatomic side of infection can be detected by point‐of‐care ultrasound examination performed with handheld device in case of septic shock …”

“…,93 A specific anatomic side of infection can be detected by point-of-care ultrasound examination performed with handheld device in case of septic shock 94,95. …”