Introduction: Metabolic dysfunction-associated steatotic liver disease is one of the world's greatest health epidemics. B-mode ultrasound has poor inter-observer reliability for quantifying liver fat deposition. Histogram technology is standard technology with a number of vendors. Normal hepatic echogenicity should be equal to, or slightly brighter than the spleen, this difference between becoming more pronounced with increasing liver steatosis. The primary aim of this work is to formulate an index between the spleen and liver using histogram technology.
Method: Imaging was performed on the Canon a550 ultrasound machine. Region of interests (ROI's) were placed both superficially and deep in the liver and spleen to obtain mean echo intensity in each region. A hepato-splenic ratio was subsequently calculated for each region. Attenuation imaging (ATI) was performed using standard guidelines to quantify normal to severe fat infiltration for each participant.
Results:The ATI liver fat infiltration grading’s of none (5%), mild (5-33%), moderate (33-66%) and severe (65%) had 55,12,17 and 18 participants enrolled respectively. The superficial hepato-splenic ratio for each group rose with increasing steatosis. The mean ratio for none, mild, moderate and severe categories was 0.99(±0.18), 1.09(±0.36), 1.53(±0.39) and 1.65(±0.31) respectively. There was no trend between the deep hepato-splenic ratio and ATI grading.
Conclusion: Interim results show that there appears to be an increasing difference in the superficial echo intensity between the liver and spleen, with increasing fat deposition.
Take home message: The low cost and availability of histogram analysis may be of value to assist Sonographers to quantify liver steatosis.

The provision of ultrasound services requires a nuanced approach—there is no universal model that meets all clinical needs. This session draws on UK experience in implementing diverse head and neck imaging pathways, highlighting key insights, benefits, and challenges. It will critically examine the impact of these approaches on patient experience, diagnostic accuracy, and overall quality of care.

The pancreas is notoriously difficult to visualise well on ultrasound. When pathology is identified, a systematic approach to sonographic description is essential to stratify lesions into higher and lower suspicion categories and to guide further imaging and tissue sampling. However, significant overlap exists between benign and malignant appearances, and the presence of rare or atypical entities can make interpretation particularly challenging, even for experienced operators.
This session will review less common pancreatic pathologies, outline their key ultrasound features, and highlight additional sonographic clues that can refine differential diagnosis. Practical tips and tricks will be shared to help distinguish between mimics and pathology specific findings, with an emphasis on recognising subtle patterns that can elevate confidence in day-to-day clinical practice.

Introduction: Abdominal pain related to intestinal pathology is surprisingly common, yet many sonographers shy away from evaluating the bowel leading to missed opportunity to identify bowel pathology and expedite patient treatment.
Methods: This presentation will provide a comprehensive overview of the intestinal ultrasound scanning technique, normal and abnormal appearances, common pathologies (inflammatory bowel disease, infection, diverticular disease) and outline the nuances of bowel findings in different patient groups.
Results: The key message of this presentation is that sonographers do not need to provide a specific diagnosis in bowel pathology. The simple recognition that something is wrong is sufficient because this alone will trigger a clinical review followed by the appropriate testing which may include microbiology on stool samples, biochemical markers (calprotectin, inflammatory markers), imaging (MRI, CT) or endoscopy (with biopsies).
Conclusion: It's time to incorporate intestinal ultrasound in the evaluation of all patients with abdominal pain.

Introduction; Bladder neck support is often compromised in voiding dysfunction and remains challenging to evaluate. Although transperineal ultrasound during voiding offers reliable assessment, it is not yet implemented in clinical practice. This study investigated whether conventional assessments of bladder neck position during straining and pelvic floor muscle contraction correlate with support during voiding, and whether they could serve as surrogate measures.
Participants and Methods: Thirty asymptomatic women underwent transperineal ultrasound to measure bladder neck position during voiding, maximal straining and maximal pelvic floor muscle contraction. Measurements included the pubourethral angle and the distance between the symphysis pubis and the bladder neck. Data were recorded at rest, start and end of voiding, and during maximal strain and contraction. Correlations were analysed between bladder neck displacement during voiding and changes observed during the other tasks.
Results: No significant correlations were found between bladder neck displacement during voiding and the movements observed during straining or pelvic floor muscle contraction. However, moderate to strong correlations were observed between the bladder neck position at the end of voiding and its position during other tasks.
Conclusion: These findings indicate that bladder neck displacement during voiding cannot be reliably predicted from the movements during straining or pelvic floor muscle contraction. Although static positional similarities exist across tasks, it does not reflect the dynamic behaviour of the bladder neck during voiding which appears crucial for clinical evaluation and understanding of voiding dysfunction.