The Role of Medical Imaging in Liver Masses

Table [.1] of Contents

Introduction. 3

Selection and Assessment of Articles. 3

Evaluation of the Review Article. 3

Evaluation of the Original Report 4

Evaluation of the Case Study. 4

Similarities between the Evaluated Articles. 4

Differences between the Evaluated Articles. 5

Contribution of the Analysis of the Three Articles. 5

Contribution to my Future Project Research Techniques. 6

Conclusion. 6

References. 7

Introduction

To establish the exact health disorder that a patient is suffering from, medical practitioners prefer to use medical imaging to assist in diagnosis and treatment. For instance, Buttaro¹ asserts that medical imaging provides a foundation for [.2] the prevention and detection of various cancers that often go unnoticed in situations where patients fail to undergo health procedures[.3] . Because of its extreme impact upon the medical field, this paper seeks to conduct an analysis of the role of medical imaging in diagnosing and treating liver masses, through evaluation of three health articles: an original report, a review [.4] article, and a case study[.5] . The evaluation will determine the diverse approaches applied in health articles when explaining a given topic.

Selection and Assessment of Articles

The article that served as the original report, authored by Park et al.,² was entitled, “Characterization of Focal Liver Masses Using Acoustic Radiation Force Impulse (ARFI) Elastography.” It was accessed through a search of databases that contain medical research articles, including PubMed and Google Scholar. Within PubMed, articles are classified in relation to genre, that is, peer-reviewed articles, research papers, and case studies. The article by Park et al. was selected because an original research paper that contained information related to focal liver masses [.6] was required, and this paper fit both criteria.

The review article that was selected for evaluation was authored by Bahirwani and Reddy³ and is entitled, “Review Article: The Evaluation of Solitary Liver Masses.” It was accessed through Ebscohost, an academic database and search engine. Thus, upon entering the search criteria related to the chosen topic, focal liver masses[.7] , the search engine presented all the articles containing those keywords. Bahirwani and Reddy’s article was selected for evaluation because of its relevance to the search criteria and its status as a review article, which was verified by filtering the search options to review articles only.[.8] 

For the case study evaluated in this paper, “Incidental Findings: A Case Study of Benign Liver Masses” by C. L. Boodt⁴ was selected after entering the keywords “case study on focal liver masses” into the Google search engine. This search offered the option of viewing scholarly articles, which led to Google Scholar, where a number of case study articles on the same topic were presented. Through this search, the article by Boodt was selected for its relevance to the topic under study.

Evaluation of the Review Article

The article authored by Bahirwani and Reddy³ is a review article, as illustrated by the words “Review Article” in its title as well as the fact that it has been published by well-established and renowned company, Blackwell Publishing, Ltd. This ensures that the article underwent thorough scrutiny by several scholars in the medical field prior to its publication in the journal of Alimentary Pharmacology & Therapeutics[.9] . The article’s aim is to offer a comprehensive review of the subject matter, liver masses. Following an evaluation of existing literature review conducted through a PubMed search, the authors concluded that rudimentary knowledge is the logical approach towards liver masses diagnosis, management, and follow-up[.10] .

Evaluation of the Original Report

The article by Park et al.,² “Characterization of Focal Liver Masses Using Acoustic Radiation Force Impulse (ARFI) Elastography,” is an original report, as the authors themselves conducted primary research on the topic to offer conclusive insights concerning the study topic. The research aim was to investigate the diagnostic performance of Acoustic Radiation Force Impulse (ARFI) elastography through stiffness qualification of the characterised focal live mass. The research concluded that ARFI elastrography offered valuable information [.11] concerning liver masses differential diagnosis. Nonetheless, the authors recommend that the results of the research should be analysed in a clinical context owing to the existence of overlapping ARFI values amid liver masses.

Evaluation of the Case Study

The article by Boodt⁴ is a case study, as illustrated by its title, “Incidental Findings: a Case Study of Benign Liver Masses.” The study outlined the case of an asymptomatic woman in her mid-50s whose sonography showed that she had countless solid liver tumours. The patient’s liver was initially scanned because her mother had died from cholangiocarcinoma; sonography revealed a haemangioma echogenic nodule characteristic in the right lobe. [.12] The liver masses from which this woman was suffering were an incidental finding that allowed the author to research benign liver masses. The article presents a unique case study of the various benign liver masses: liver cell adenomas (LCAs), focal nodular hyperplasias (FNHs), and haemangiomas. Although there is a need for further research on the topic, the researcher concluded that individuals in developed nations have a minimal chance of suffering from benign liver masses, as only 10 to 20% of the population experience them.[.13] 

Similarities [.14] between the Evaluated Articles

The main similarity, established through the evaluation of these three articles, is that their expressed aim was to examine the effectiveness of diagnosing and treating liver masses through imaging. The efficacy of using imaging to evaluate liver masses as a diagnostic strategy has recently caused controversy [.15] in the medical community as medical professionals have attempted to establish methods of diagnosis, management, and appropriate follow-up techniques to assist in monitoring the health condition. In an attempt to simplify the imaging process of liver masses, the three articles focused on two lesions that were distinctly diagnosed: FNHs and hemangiomas. These two lesions are diagnosed through an imaging approach that is distinct from that used to diagnose other lesions examined during the evaluation process of liver masses.

There is a similarity between Park et al.² and Bahirwani and Reddy³ in that both assert that it was difficult to differentiate malignant liver masses from benign liver masses, even with the application of the diverse strategies that aimed at helping them achieve the stipulated aims of their studies. Further, in their conclusions, the two studies assert that the results of the findings should be interpreted in a clinical context, meaning that because the research conclusion showed varying ARFI values, ARFI elastrography should be used with another medical imaging strategy for the medical professionals to have conclusive results, especially while differentiating amid malignant liver masses and benign liver masses. [.16] 

Differences between the Evaluated Articles

There is a variation in the aims of the three articles regardless of their focus on liver masses. For instance, the original article by Park et al.² aimed to research the diagnostic reaction of ARFI elastrography, which qualifies the stiffness of focal liver mass. The review article by Bahirwani and Reddy,³ however, aimed to offer a comprehensive review of common liver masses and assist in identifying a strategy for their evaluation and management. Lastly, the case study by Boodt⁴ aimed to identify the effectiveness of sonography in benign liver masses, which are difficult to distinguish from malignant liver masses.

Moreover, the three articles showed diversity in the use of liver mass imaging techniques. Park et al.² utilised ARFI elastrography as the appropriate medical imaging technique for liver masses and established that the technique resulted in the differential diagnosis of liver masses. Another author, Carpenito,⁵ asserts that differential diagnosis is a strategy applied by medical professionals to assist them in weighing the possibility of one health condition versus that of other health conditions in accounting for a patient’s illness. Thus, through differential diagnosis, healthcare practitioners establish the underlying health conditions related to the diagnosed condition of the patient. [.17] On [.18] the other hand, Bahirwani and Reddy³ utilised existing literature on liver masses to attain their stipulated goal of evaluating solitary liver masses. The results of their evaluation illustrated that benign liver masses were the most common, although it was hard to differentiate them from malignant liver masses. [.19] Finally, Boodt⁴ used sonography to carry out the case study and the research was performed by the author herself.

Further, although the articles focus on the same topic, liver mass medical imaging, they present diverse conclusions. Park et al.² concluded that ARFI elastography—the medical imaging strategy that the research applied—offered information for the differential diagnosis of liver masses. The research by Bahirwani and Reddy,³ however, concluded that an appropriate medical imaging approach was necessary to assist in the diagnosis, management, and follow-up of cases involving liver masses, revealing that their analysis did not establish a single medical imaging approach that was appropriate for liver masses, especially incidental or benign liver masses, which were the most common according to their research. In addition, the research concluded that there was need for a rudimentary expertise in the presentation[.20] , laboratory and clinical features, and treatment options available for the health condition. In contrast to both of these, Boodt’s⁴ case study concluded that sonography alone was an inappropriate strategy to diagnose liver masses and lesions as it failed to offer quality results concerning benign liver masses. It further established that 10 to 20% of individuals in developed nations have benign liver tumours. However, this conclusion raises a question: how did the results of a study that focused on one asymptomatic, mid-50s woman result in generalized conclusions about developed nations? The response to this question will assist in establishing whether the case study results and conclusion are valid. [.21] 

Contribution of the Analysis of the Three Articles

The three articles contributed tremendously to my comprehension of liver masses and the diagnostic approaches applied to evaluate them. First, the analysis established that benign liver masses are the most common type of focal liver masses, and this has raised the interest of medical scholars who seek to determine the efficiency of medical imaging. As Valentino⁶ [.22] asserts, following the diagnosis of liver masses, the imaging process is utilized to help in the management and follow-up processes, which ensure that the treatment options are adequate for the focal liver masses. Various imaging approaches were applied in the three articles—ARFI elastrography, sonography, and the evaluation of existing literature—to diagnose liver masses. The first article, by Park et al.,² offered an elaborate analysis of ARFI elastrography, which helped the researchers establish the aim of their study. The article added to existing research and helped bridge the literature gap between ARFI elastrography and other approaches with regard to the diagnosis of benign liver masses and malignant liver masses[.23] . Nonetheless, in relation to the conclusions made by the three articles, further research is necessary [.24] to offer an opportunity to examine areas in which the articles were not conclusive, such as illustrating ways to differentiate the two common focal liver masses.

Contribution to my Future Project Research Techniques[.25] 

 Through an analysis of these three articles, I have learned the diverse ways through which health research can be conducted to investigate a given topic, and in this case, the diagnosis of focal liver masses and its relation with medical imaging. The three articles applied different research methods, each of which is valuable in its own way. The first was an original article in which the authors conducted primary research to establish their study aims, and this article exemplified ways in which to conduct primary research and offer new findings that are used to fill an existing literature gap. The reviewed article illustrated a research method that applies secondary sources in an attempt to establish the diverse research strategies that were applied to attain their research aims. The authors evaluated a number of existing literatures from PubMed search, showing me the value of literature review techniques and evaluating existing research to best suit research aims. Finally, the case study gave me the chance to learn ways in which to present a case study and conduct related research. The case study presented the real case of a patient who fit the research requirements. In the future, I will be in a position to apply the research techniques utilised in these three articles and to evaluate diverse medical research articles investigating a given topic. Although the three medical articles applied diverse techniques to investigate the same topic and came to diverse conclusions, the diversity of their approaches results in a richer understanding of the topic at hand.[.26] 

Conclusion

This paper evaluated medical research papers that focused on the same topic but conducted research in different ways. The three articles evaluated included an original report, in which the authors conducted primary research and helped fill the literature gap concerning focal liver masses; a review article, which analysed previous literature on the subject; and a case study, which focused on a real case of liver masses and the diverse approaches that can be used to diagnose and manage the medical condition. Finally, the paper reflected on the contributions of the study to my future research techniques.  [.27] 

References

1. Buttaro TM, Trybulski J, Polgar Bailey, P, Sandberg-Cook, J. Primary Care: A Collaborative Practice. 4th ed.St. Louis, MO: Mosby; 2013.
2. Park H, Park JY, Kim DY, Ahn SH, Chon CY, Han K-H, Kim SU. Characterization of focal liver masses using acoustic radiation force impulse elastography. World J Gastroenterol. 2013;19(2):219-226. doi: 10.3748/wjg.v19.i2.219.
3. Bahirwani R, Reddy KR. Review article: The evaluation of solitary liver masses. Aliment Pharmacol Ther. 2008;28;953-965. doi: 10.111/j.1365-2036.2008.03805.x.
4. Boodt CL. Incidental findings: A case study of benign liver masses. J Diagn Med Sonog. 2008;27(3):135-143. doi: 10.1177/875647311407197
5. Carpenito LJ. Nursing Care Plans & Documentation: Nursing Diagnosis and Collaborative Problems. 5th ed.Philadelphia: Wolters Kluwer; 2009.
6. Valentino PL, Ling SC, Ng VL, John P, Bonasoni P, Castro DA, Taylor G, Chavhan GB, Kamath BM. The role of diagnostic imaging and liver biopsy in the diagnosis of focal nodular hyperplasia in children. Liver Int. 2014;34(2):227-234. doi: 10.111/liv.12241.

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 [.1]I have ensured that page numbers and titles all match those in the document and I have made the font match the rest of the document, for consistency.

 [.2]Please check that I have not changed the intended meaning.

 [.3]It’s not quite clear what health procedure you are referring to here. Please specify. Alternatively, consider the following edit: “that would have gone unnoticed in the absence of the technology” (i.e., medical imaging technology).

 [.4]Throughout the paper, the term “peer-reviewed” and “review” were used interchangeably. Because the article you selected was most notably a review article, I have made this change throughout to avoid confusion. To be clear, a review article reviews material about a certain subject, while a peer-reviewed article is one that was examined by experts in the field prior to publication.

 [.5]I noticed that the order in which these articles were presented here did not match the order they were presented in the text. I re-ordered them here to ensure a logical flow and also made appropriate changes to make sure the paragraphs in the main body matched the order given here. I thought it best to start with the original report to firmly establish the topic, then discuss the review article to develop it, then outline the case study for a specific example of the general ideas presented in the first two. Please ensure this is okay with you.

 [.6]Should this be, “focal liver masses and medical imaging was required”?

 [.7]Was medical imaging also a search term? If so, please note that here.

 [.8]Please check that I have not changed the intended meaning.

 [.9]This section has more to do with explaining that the article has been peer-reviewed rather than the fact that it is a review article. Because your primary concern is with the latter, I suggest removing this and focusing more on how the content of the article reflects its status as a review article. For instance, you could say, “as illustrated by the words “Review Article” in its title and the fact that the article presents a thorough review of literature on the given topic.”

 [.10]A suggestion for this paragraph would be to include a bit less about how the article was selected for this paper (include this information in the above section, instead) and more about the content of the article itself. This last sentence does a good job of introducing the subject, but try to be more specific, if possible, about what the article is about.

 [.11]Could you state what information, specifically was contributed?

 [.12]I moved this information up from below because it seemed to relate better to this section.

 [.13]I suggest removing this sentence, as this fact was not meant as something that this study proved, but as a statistic illustrating that discovering benign liver tumors with the “medical imaging of “incidentalomas” is commonplace.”

 [.14]If possible, I suggest expanding this section a bit. Were any parts of their research methods similar? The similarities/differences section should be about 2 full pages, so please expand here if possible.

 [.15]Please check that I have not changed the intended meaning. Also, I suggest explaining why this has been a concern.

 [.16]I moved and combined some information from a later section here because it fits better within this category.

 [.17]As you are looking to cut material to achieve a 2200 word count, I suggest that this section could be removed. The assignment instructions don’t mention the need to reference further authors, so this description could be taken out, if needed.

 [.18]I have combined three paragraphs into a single paragraph, as all support the topic sentence that the three showed diversity in the use of liver imaging techniques.

 [.19]I strongly suggest removing this sentence as it strays from the idea of the topic sentence.

 [.20]Please specify: the presentation of what, exactly?

 [.21]I suggest that this section could be removed. After reviewing the case study, it seems that the authors simply referred to the statistic to support the claim that the “discovery by medical imaging of “incidentalomas” is commonplace.” They simply stated that, but didn’t seek to prove it with their own study.

 [.22]It might be better to refer to one of the three analysed documents here, as that will better illustrate how it contributed to your understanding of the subject.

 [.23]Please check that I have not changed the intended meaning.

 [.24]A suggestion I have for this section is to make sure to stick to how your analysis of the three articles added to your own understanding of the material (as opposed to how the articles contributed to the field).

 [.25]In the assignment instructions, the professor says to analyse how these experiences contribute to your “future research project/CPD.” Is there a specific project that you were supposed to relate this to?

 [.26]This sentence was a bit unclear; please ensure that I have conveyed your intended meaning.

 [.27]I suggest expanding on this a bit to make note of some of the things that most impacted you while performing this analysis.