This week Canadian hepatologists (The Canadian Association for the Study of Liver Disease) joined the movement and released 5 new Things Physicians and Patients Should Question.
Of interest to those of us in primary care is one regarding benign focal liver lesions and what we like to call the diagnostic merry go round! Ultrasound of the abdomen shows a benign looking liver cyst, CT is recommended, gets done and then recommends and ultrasound, and then just be sure, better repeat it in 6 months!
The hepatologists tell us don’t perform computed tomography (CT) or magnetic resonance imaging (MRI) routinely to monitor benign focal liver lesions (e.g., focal nodal hyperplasia, hemangioma).
Patients with benign focal liver lesions who do not have underlying liver disease and have demonstrated clinical (asymptomatic) and radiologic stability do not need repeated imaging as the likelihood of evolving into neoplastic lesions is very low. In contrast, patients with radiologic evidence of hepatocellular adenoma may have an increased risk of complications and/or neoplasia thus warranting closer observation.
Check out our "Quick Links" section for some more reading. It will be interesting to see if this gets passed along to radiology.