Oman-based hardware engineer Christopher D’Souza (36) was in Goa last month for his marriage. But D’Souza fell sick and thanks to a wrong diagnosis, he had to cancel his April 24 wedding and spend the next four weeks visiting doctors.
It began with a bout of diarrhoea and abdominal pain. After performing an endoscopy and ultrasound, doctors at a Goa hospital concluded that D’Souza suffered from liver cirrhosis, a fatal complication. “They told me I would need a liver transplant in the near future and I could not get married,” said D’Souza. “I went to five other doctors and all of them diagnosed cirrhosis because my liver was small.”
D’Souza came to Mumbai’s Jaslok Hospital for a transplant. Liver specialist Dr Abha Nagral prescribed another ultrasound to confirm the diagnosis. Surprisingly, it showed D’Souza did not have cirrhosis. His liver was small because of obstruction in the veins. “This is a treatable condition. I don’t need transplant,” said D’Souza, who is now looking forward to a winter wedding.
The scan that gave D’Souza a new lease of life is the latest advance in ultrasound technology: elastography ultrasound. This new-age technology enables doctors to virtually feel the organ or lump being examined.
They can now gauge the stiffness (elasticity) of the organ/tissues in addition to the anatomy (structure) and blood flow, which is seen in routine ultrasound. “Diseased organs and tissues are always stiffer. So, if the liver is hard, we know it is a case of cirrhosis,” said Dr Chander Lulla, consultant radiologist at Jaslok Hospital.
Elastography ultrasound machines were installed at Jaslok Hospital, Dr Lulla’s clinic at Gamdevi and a centre in Dadar two months ago. Around 75 scans have already been performed at Jaslok.
While routine ultrasound picks up liver disease only in late stages when it is irreversible, elastography often makes it possible to detect even minor liver damage. “In an early stage, we can ask the patient to stop consuming alcohol or take other steps to reverse the damage,” said Dr Nagral.
Elastography has also enabled doctors to accurately diagnose cancer — especially breast, prostate and thyroid cancer — since a tumour or cancerous growth is five to 28 times stiffer than normal tissue. A lot of unnecessary biopsies (invasive procedure in which tissue is removed and tested) are being avoided. “Earlier, most patients had to undergo biopsies after ultrasound. Now, we can clearly distinguish a cancerous growth from a non-cancerous one. So, there is often no need for biopsy,” said Dr Lulla.
Doctors at Jaslok Hospital are conducting a trial to scientifically assess the accuracy of elastography. “We will put around 100 patients through both elastography and liver biopsy and compare the results,” said Nagral.