This session will explore the seven-sweep approach to neck ultrasound, a systematic technique designed to ensure comprehensive evaluation of essential anatomical structures and lymph node levels. By applying this method, sonographers can enhance diagnostic confidence, support accurate differential diagnosis, and provide optimal reporting for surgical planning. The presentation will outline each sweep in detail and illustrate common pathological findings associated with specific anatomical regions

Trans-cervical sonographic imaging of the adult palatine tonsils is easily performed to investigate the tonsils and peritonsillar space and can be used to distinguish between tonsillitis, peri-tonsillar cellulitis, intra-tonsillar and peri-tonsillar abscesses. Peri-tonsillar cellulitis and abscesses need to be diagnostically distinguished to inform patient management. An understanding of the sonographic anatomy, imaging technique, sonographic landmarks and sonographic appearances is essential to correctly perform and interpret ultrasound imaging of the adult palatine tonsils and exclude a peri-tonsillar or intra-tonsillar abscess and such topics will be covered in this presentation.

Background: You probably don't think of yourself as a below-average sonographer. That would be pretty depressing. But there is a 50% statistical probability that this is exactly what you are. Perhaps you have had the experience of diagnosing a small echogenic renal lesion as an angiomyolipoma and later found out that the lesion turned out to be a kidney cancer. Sickening. Or perhaps you routinely do something in your practice that you know is a complete waste of time, such as bladder jets in an outpatient presenting for a renal ultrasound, but you do it anyway. Why do you willing waste your life? The above scenarios represent a thought-provoking (and perhaps a little provocative) sample of common cognitive biases: self-enhancement (aka superiority bias), availability bias and bandwagon bias. As humans, we are prone many cognitive biases. These can dramatically affect how we perceive the world and what actions we take. Cognitive biases can enter into our ultrasound practice and lead to misdiagnosis and adverse patient outcomes.
Response: But don't despair, there is hope for all of us! If we arm ourselves with the knowledge of biases, become aware of our own way of thinking, and consciously deploy System 2 (slow analytical reasoning) as opposed to relying on System 1 (quick-fire heuristics), we have a good chance of overcoming even the most powerful biases and becoming more mindful, analytical and accurate practitioners. This presentation will provide an overview of the most common biases in ultrasound with examples from clinical practice.

Introduction: Patients with chronic hepatitis are in high demand for 2D-shear wave elastography (2D-SWE) modality for longitudinal monitoring as a non-invasive tool to assess liver stiffness. Therefore, software such as “confidence map” are being developed to improve the accuracy and consistency of the measurements. The aim of this research study was to evaluate the impact of “confidence map” on the intra- and inter- operator repeatability of 2D-SWE in patients with chronic hepatitis.
Methods: A prospective, blinded study was performed on 30 patients with chronic hepatitis B (CHB) infection using a Philips Epiq ultrasound system. Two experienced sonographers each acquired five right hepatic lobe measurements with and without (blinded) the confidence map enabled. Blinding was achieved by covering the on-screen measurement readings with a sticky note, a method not reported in the published literature. Median shear wave values were analysed using intraclass correlation coefficients (ICC) and standard deviation (SD) to assess repeatability, and paired t-tests to compare inter-operator differences.
Results: As a result, when the confidence map was applied, intra-operator repeatability increased and inter-operator repeatability was not significantly impacted.
Conclusion: The results suggest that the confidence map may improve individual operator reliability and measurements consistency in 2D-SWE. Its impact on inter-operator consistency needs further validation in larger, more diverse cohorts with histopathologic or Magnetic Resonance Imaging correlation.
Take Home message: Training in using new software is necessary to ensure continual improvement, consistency and reliability of measurements. More studies should be conducted to validate the software.

This presentation draws on a compendium of case studies involving patients referred for neck ultrasound with suspected abnormal lymph nodes or lesions initially reported as lymph nodes. Through review and discussion, the session will challenge the assumption that all neck lumps represent lymphadenopathy. By examining diverse pathological entities and their sonographic characteristics, the presentation aims to enhance diagnostic accuracy and critical appraisal skills in neck imaging.

This lecture will cover the use of US for the oral cavity, oropharynx and larynx, with an emphasis on probe selection, scanning technique and case based examples. There will also be an overview of advanced techniques including US guided transoral biopsy for deep space lesions and the use of US on advanced robotic systems to target small oropharyngeal lesions.