From the Guidelines
Laboratory screening for sonography-related conditions should prioritize tests that complement ultrasound findings and are tailored to the clinical context and anatomical region being examined. When screening for sonography-related conditions through laboratory tests, it is essential to consider the specific clinical context and the anatomical region being examined by ultrasound.
- Blood tests like complete blood count (CBC) can detect infections or bleeding disorders, while comprehensive metabolic panels assess liver and kidney function which may correlate with abdominal ultrasound findings 1.
- For pregnancy-related sonography, beta-hCG levels confirm pregnancy and help date gestational age, while alpha-fetoprotein (AFP) screens for neural tube defects, although its utility as a screening test for hepatocellular carcinoma (HCC) is limited due to its low positive predictive value, especially in low-prevalence populations 1.
- Thyroid function tests (TSH, T3, T4) are essential when thyroid nodules are detected on ultrasound.
- When investigating gallbladder or liver abnormalities, liver function tests including ALT, AST, and bilirubin are crucial, and tumor markers like CA-125 (ovarian cancer), PSA (prostate cancer), and CEA (colorectal cancer) may be ordered when masses are detected on ultrasound.
- The American College of Radiology Appropriateness Criteria recommend ultrasound for screening for hepatocellular carcinoma, but also suggest consideration of MRI or multiphase CT in patients with obesity, nonalcoholic fatty liver disease, and nodular cirrhotic livers, or those on the liver transplant wait list 1. The choice of laboratory tests should be guided by the clinical context and the goal of providing a comprehensive clinical picture that complements sonographic findings, rather than relying on a single test or marker. In clinical practice, the selection of laboratory tests should prioritize those that provide the most relevant information for diagnosis and treatment decisions, while minimizing unnecessary testing and potential harm to patients.
- For example, in patients with suspected liver disease, a combination of liver function tests, tumor markers, and imaging studies like ultrasound or MRI may be necessary to establish a diagnosis and guide treatment.
- In contrast, patients with suspected kidney stones or abnormalities may require urinalysis, creatinine levels, and imaging studies like ultrasound or CT scans to confirm the diagnosis and plan treatment. Ultimately, the key to effective laboratory screening for sonography-related conditions is to tailor the selection of tests to the individual patient's clinical context and anatomical region being examined, while prioritizing tests that provide the most relevant information for diagnosis and treatment decisions.
From the Research
Laboratory Tests for Sonography Related Conditions
To screen for sonography related conditions through laboratory tests, the following tests can be utilized:
- Complete Blood Count (CBC) to assess various components in the blood, including white blood cell (WBC), neutrophil-to-lymphocyte ratio (NLR), hemoglobin (Hb), mean corpuscular volume (MCV), red cell distribution width (RDW), platelet count, mean platelet volume (MPV), and platelet-to-lymphocyte ratio (PLR) 2
Components of CBC and Their Significance
The components of CBC are useful markers to predict various diseases, including:
- Cardiovascular disease (CVD)
- Arteriosclerosis
- Type 2 diabetes (T2DM)
- Metabolic syndrome
- Cancer These components can help clinicians assess the risk of developing these conditions and make informed decisions about further testing or treatment 2
Limitations and Future Directions
While CBC is a useful tool for screening sonography related conditions, it is essential to note that it is just one aspect of a comprehensive diagnostic workup. Further research is needed to fully understand the relationship between CBC components and diseases, and to explore the potential applications of CBC in clinical settings 2