Pocket-sized Ultrasound Device Research Articles

Accuracy of Pocket-sized Ultrasound Devices to Evaluate Inferior Vena Cava Diameter and Variability in Critically Ill Patients.

By using inferior vena cava (IVC) measurements, clinicians can detect fluid status and responsiveness and find out the etiology of hypotension, acute heart failure, and sepsis easier. Pocket-sized ultrasound devices (PSUD) may take this advantage a few steps further by their lower costs, user-friendly interface, and easily applicable structure.In this study, we aimed to determine the diagnostic value of a PSUD compared with a standard ultrasound device (SD) for the measurement of IVC diameter (IVCD) and its respiratory variability. We measured the inspiratory, expiratory diameters of IVC, and calculated the inferior vena cava collapsibility index (IVCCI). We investigated 42 intensive care unit (ICU) patients. There was no difference in inspiratory (PSUD: 1.34 ± 0.67 cm; SD: 1.35 ± 0.68 cm) and expiratory (PSUD: 1.98 ± 0.53 cm; SD: 2.01 ± 0.49 cm) IVCD among measurements with PSUD and SD (p > 0.05). There was also no difference between IVCCI's measured with PSUD (39 ± 20%) and SD (39 ± 20%) (p > 0.05). The Bland-Altman analysis revealed that the width of 95% limits of agreement were similar for both devices. There was a good inter-device agreement among PSUD and SD for measurements of IVCD, and there was no difference between IVCCI's measured using both ultrasound devices. We support that the idea of a PSUD is as reliable as a SD for IVC measurements. Inci K, Gürsel G. Accuracy of Pocket-sized Ultrasound Devices to Evaluate Inferior Vena Cava Diameter and Variability in Critically Ill Patients. Indian J Crit Care Med 2024;28(4):369-374.

Reproducibility and accuracy of a pocket-size ultrasound device in assessing liver steatosis

BackgroundThis diagnostic prospective study compared the feasibility and diagnostic accuracy of Pocket-size Ultrasound Devices (PUDs) against standard ultrasound (US) in detecting liver steatosis using the controlled attenuation parameter (CAP) and liver biopsy as reference standards. Materials and MethodsConsecutive patients with chronic liver diseases were assessed for the presence of steatosis using PUD and US. A CAP cut-off value >275 dB/m was applied to establish ≥S1. A 26-patient subgroup underwent liver biopsy. PUD reproducibility was evaluated using Cohen's k statistic. Diagnostic accuracy of PUD and US was given as Sensibility (Sn), Specificity (Sp), Positive and Negative Predictive Values (PPV, NPV), positive and negative Likelihood Ratio (LR+, LR-). Results81 consecutive patients (69% males) with multiple etiologies were enroled. PUD inter-observer agreement was good (k 0.77, 95%CI 0.62–0.93). PUD and US identified ≥S1 according to CAP values respectively with Sn 0.87, Sp 0.61, PPV 0.49, NPV 0.91, LR+ 2.04, LR- 0.07, AUROC 0.74 and Sn 0.96, Sp 0.54, PPV 0.47, NPV 0.97, LR+ 2.10, LR- 0.07, AUROC 0.75. ConclusionsPUD shows good reproducibility and diagnostic accuracy in ruling liver steatosis out, representing a useful point-of-care tool to avail of hepatologists interested in excluding NAFLD, but with basic US skills.

Feasibility of a point-of-care ultrasound protocol for cardiorespiratory evaluation of horses in different clinical settings.

A point-of-care ultrasound (POCUS) protocol for evaluation of the cardiac and respiratory systems in horses does not exist. (a) Describe the windows of a POCUS protocol for cardiorespiratory assessment of horses (CRASH); (b) Estimate the number of acoustic windows that can be acquired by a sonographer-in-training; (c) Estimate the time required to complete the protocol for specific groups of horses; (d) Describe the sonographic abnormalities detected in horses presented with cardiovascular, respiratory, or systemic disease. Twenty-seven healthy horses, 14 horses competing in athletic events, and 120 horses with clinical disease. A pocket-sized ultrasound device was used to acquire 7 sonographic cardiorespiratory windows in various clinical scenarios. The duration of the examination was timed, and images were evaluated for diagnostic quality. Abnormalities in horses with clinical disease were determined by an expert sonographer. The CRASH protocol could be performed in healthy and diseased horses in hospital, barn, and competition settings between 5.5 ± 0.9 (athletic horses) and 6.9 ± 1.9min (horses with clinical disease). Thoracic windows were obtained most consistently, followed by right parasternal long-axis echocardiographic windows. Frequently detected abnormalities were pleural fluid, lung consolidation, B-lines, and moderate-to-severe left-sided heart disease. The CRASH protocol was feasible using a pocket-sized ultrasound device in various groups of horses, could be completed rapidly in a variety of settings, and frequently identified sonographic abnormalities when evaluated by an expert sonographer. The diagnostic accuracy, observer agreement, and utility of the CRASH protocol merit further evaluation.

Reproducibility and diagnostic accuracy of pocket-sized ultrasound devices in ruling out compensated cirrhosis of mixed etiology

ObjectiveFibrosis is the key prognostic factor in chronic liver disease patients. Liver surface nodularity (LSN) is the ultrasonographic sign with the highest accuracy to detect advanced liver fibrosis. The use of pocket-sized ultrasound devices (PUDs) has been assessed in several clinical settings but never as regards chronic liver disease (CLD) severity. Our study aimed at evaluating the feasibility, reproducibility, and diagnostic accuracy of PUD in LSN identification.MethodsWe enrolled all the consecutive adults referred for percutaneous liver biopsy. Two independent operators evaluated LSN by PUD; one sonographer used standard ultrasound (US). Transient elastography (TE) and liver biopsy were performed on all the patients. PUD reproducibility was evaluated by Cohen’s k statistic. PUD, standard US, and TE results were compared with histology staging.ResultsA total of 104 consecutive patients (aged 54 ± 14 years) with mixed-etiology CLD were studied. Assessment by PUD was feasible in all the patients and showed very good inter-observer agreement with Cohen’s k = 0.87 (95% CI 0.72–0.95). The diagnostic accuracy estimates for PUD in diagnosing compensated cirrhosis (F = 4) were 87.5% sensitivity, 76.8% specificity, positive likelihood ratio (LR) 3.78, and negative likelihood ratio (LR-) 0.16, while those for standard US and TE (> 12.5 kPa) were, respectively, 87.5% sensitivity, 72.6% specificity, LR+ 3.2, and LR- 0.17, and 87.5% sensitivity, 90.5% specificity, LR + 9.2, and LR- 0.13.ConclusionsPUD reproducibility in assessing LSN was excellent even with operators of different experience. PUD performed very well in excluding advanced CLD. PUD can be used as a first-line tool for screening patients to undergo more invasive techniques, thus shortening the time for clinical decision-making.Key Points• PUD is highly reproducible in assessing the sign of liver surface nodularity.• PUD showed high diagnostic accuracy in excluding the presence of advanced chronic liver disease.• PUD can be used as a first-line tool for screening patients with CLD who should undergo more invasive techniques.

Accuracy of Optic Nerve Sheath Diameter Measurements in Pocket-Sized Ultrasound Devices in a Simulation Model.

IntroductionTransorbital sonographic measurement of optic nerve sheath diameter (ONSD) is an emerging non-invasive technique for the identification and monitoring of intracranial hypertension. In recent years, new pocket ultrasound devices have become available, and it is uncertain if they have the resolution to measure such small structures appropriately as compared to their predecessors. In this study, we measure the performance of three ultrasound units on a simulation model to establish their precision and accuracy.MethodsONSD was measured by three expert point-of-care sonographers using ultrasound machines three times on each of seven discrete ONS model sizes ranging from 3.5 to 7.9 mm. Two pocket ultrasounds (IVIZ, Sonosite, and Lumify, Philips) and one standard-sized portable ultrasound (M-Turbo, Sonosite) were used. Measurements were analyzed for mean error and variance and tested for significance using blocked covariance matrix regression analyses.ResultsThe devices differed in their variances (Lumify: 0.19 mm2, M-Turbo: 0.26 mm2, IVIZ: 0.34 mm2) and their mean error (Lumify: −0.05 mm, M-Turbo: 0.10 mm, IVIZ: −0.10 mm). The difference in mean error between users is not significant (p = 0.45), but there is a significant difference in mean error between devices (p = 0.02).ConclusionsAccurate ONSD measurement is possible utilizing pocket-sized ultrasound, and in some cases, may be more accurate than larger portable ultrasound units. While the differences in these devices were statistically significant, all three were highly accurate, with one pocket device (Lumify) outperforming the rest. Further study in human subjects should be conducted prior to using pocket ultrasound devices for in vivo diagnosis of intracranial hypertension.

Influence of head-of-bed elevation on the measurement of inferior vena cava size using a pocket-sized ultrasound device in healthy male volunteers

Influence of head-of-bed elevation on the measurement of inferior vena cava size using a pocket-sized ultrasound device in healthy male volunteers

Pocket-size ultrasound devices may improve the prompt assessment of Covid-19 patients

Abstract Introduction Clinical usefulness of pocket-size ultrasound device [PSUD] was previously confirmed in numerous clinical scenarios. During the previous year Covid-19 patients have become a focal point of the cardiology and internal medicine wards. However, there is no data on the use of PSUD in this scenario. Purpose To asses if PSUD may be useful in providing additional information in Covid-19 patients. Methods In 63 patients (41 men, mean age 63±11) with confirmed Covid-19 the scope of physical examination was expanded with bedside assessment performed with PSUD equipped with dual probe. PSUD examination included: right ventricle measurement, automated LVEF assessment, 4-point compression ultrasound test of lower limbs and lung ultrasound (presence of B-lines, lung consolidations or thickening of pleura). Subsequently, within the next 24 hours all patients underwent chest CT scan, CT pulmonary angiogram and full echocardiographic examination performed on a high-end stationary device. Results Lung lesions typical for Covid-19 were confirmed in CT in 53 (84%) patients. The sensitivity and specificity of bedside PSUD examination for diagnosing lung involvement was 92% and 90%, respectively, when presence of any pathology on lung ultrasound was considered as a positive criterion. Increased number of B-lines had a sensitivity of 81%, specificity 83% for the ground glass symptom in CT detection, (AUC 0,82; p<0,0001). Pleural thickening was diagnosed by PSUD with a 95% sensitivity and 88% specificity (AUC 0,91, p<0,0001), whereas lung consolidations with a 71% sensitivity and 86% specificity (AUC 0,79, p<0,0001). In 20 patients (32%) pulmonary embolism was confirmed by angioCT – in 10 among them embolism was limited to subsegmental arteries. RV was found to be dilated in PSUD examination in 27 patients (43%), CUS was positive in 1 patient. Thus, RV enlargement treated as a marker of PE had low sensitivity and specificity (60% i 65% respectively), AUC=0,62, p=0,06. Mean LVEF in standard echocardiography was 46±12%, but during PSUD examination automated LV function analysis software failed to calculate LVEF in 29 (46%) cases due to suboptimal image quality. Conclusion In Covid-19 patients PSUD is particularly useful for lung ultrasound and the detection of lung pathologies. RV enlargement observed during PSUD examination has relatively low sensitivity and specificity for the detection of pulmonary embolism in Covid-19. Furthermore, due to low quality of images automated LV function assessment failed to provide any result in almost half of patients. Funding Acknowledgement Type of funding sources: None.

Pocket-sized Ultrasound versus Cardiac Auscultation in Diagnosing Cardiac Valve Pathologies: A Prospective Cohort Study

Background: Pocket-sized ultrasound devices are used to perform focused ultrasound studies (POCUS). We compared valve malfunction diagnosis rate by cardiac auscultation to POCUS (insonation), both conducted by medical students.
 Methods: A prospective cohort study was conducted among patients with and without clinically relevant valve dysfunction. Recruitment to the study group was based on the presence of at least one valve pathology of at least moderate severity identified on recent echocardiography study that was required for clinical reasons. Three final-year medical students examined the patients. Each patient underwent auscultation and a POCUS using a pocket-sized ultrasound machine. Sensitivity was defined as the percentage of patients correctly identified as having a valve disorder. Specificity was defined as correct identification of the absence of valve pathology.
 Results: The study included 56 patients. In 18 (32%), no valve pathology was found. Nineteen patients (34%) had at least two valvular pathologies. Sixty valve lesions were present in the whole cohort. Students' sensitivity for detecting any valve lesion was 32% and 64% for auscultation and insonation; respectively, specificity was similar. 
 The sensitivity for diagnosing mitral regurgitation, mitral stenosis, and aortic regurgitation rose significantly by using POCUS compared to auscultation alone. When using POCUS, Students identified valve pathologies in 22 cases (39%) from the patients with at least two valve dysfunctions, and none when using auscultation.
 Conclusions: Final-year medical students' competency to detect valve dysfunction by performing cardiac auscultation is poor. Cardiac ultrasound-focused training significantly improved medical students' sensitivity for diagnosing a variety of valve pathologies.

Ultrasound-guided internal jugular venipuncture using pocket-sized versus standard ultrasound devices: a prospective non-inferiority trial.

Pocket-sized ultrasound devices (PUDs) are commonly adopted for bedside use despite their inferior performance compared with standard ultrasound devices (SUDs). We investigated the non-inferiority of PUDs versus SUDs for ultrasound-guided internal jugular venipuncture. All patients undergoing scheduled surgery with general anesthesia and internal jugular vein catheter placement were prospectively included in this randomized non-inferiority trial to compare the qualities of the internal jugular venipuncture between the PUD group (Group P) and SUD group (Group S). The primary endpoint was puncture time, and the secondary endpoints included number of punctures, needle and guidewire visibility, and anatomic visibility. Fifty-two patients were randomized to one of the two groups (26 per group). The mean (SEM) puncture time was 56.4 (10.9) s in Group P and 45.5 (4.0) s in Group S. The mean difference of 10.9s was within the prespecified non-inferiority margin of 100% (two-sided 95% CI: - 12.9-34.6, upper limit of the 95% CI: 45.5) for puncture time. The mean (SEM) number of punctures was 1.15 (0.12) times in Group P and 1.12 (0.06) times in Group S. The difference of 0.04 punctures was within the prespecified non-inferiority margin of 100% (two-sided 95% CI: - 0.24-0.31, upper limit of the 95% CI: 1.12) for number of punctures. Non-inferiority was not shown for needle and guidewire visibility and anatomic visibility. PUDs for internal jugular venipuncture are not inferior to SUDs with regard to puncture time and number of punctures, despite differences in visibility and device performance.

One-day seminar for residents for implementing abdominal pocket-sized ultrasound

Despite its proven high utility, integration of pocked-sized portable ultrasound (US) into internal medicine residency training remains inconsistent. For 10 years, we have held a 1-d seminar biannually, consisting of lecture (half-day) and hands-on training (half-day) on pocket-sized US of the abdomen and lungs. The lecture consists of training on US physics and clinical applications of pocket-sized US, followed by a lecture covering the basic anatomy of the abdomen and lungs and introducing the systemic scanning method. Given the simple structure of pocket-sized US devices, understanding the basic physics is sufficient yet necessary to operate the pocket-sized US device. It is important to understand the selection of probes, adjustment of B mode gain, adjustment of color gain, and acoustic impedance. Basic comprehension may have a significant positive impact on the overall utilization of pocket-sized US devices. The easiest and most reliable way to observe the whole abdomen and lungs is a combination of transverse, sagittal, and oblique scanning, pursuing the main vascular system from the center to the periphery of the organ in the abdomen and systemic scanning of the pleura. There is usually a marked change in knowledge and attitudes among the program participants, although skill gaps remain among them. We discuss the limitations and problems to this education system as well.

Pocket-Sized Ultrasound Versus Traditional Ultrasound Images in Equine Imaging: A Pictorial Essay

This pictorial essay aims to display the image quality of pocket-sized ultrasound devices and hospital-based equipment to provide clinicians visual information about the potential uses of point-of-care ultrasonography (POCUS) in equine practice. Twenty-two paired images were obtained using traditional ultrasound equipment and pocket-sized ultrasound devices from patients evaluated at veterinary teaching hospitals. Images of many common ultrasound windows and miscellaneous sonographic abnormalities were obtained using pocket-sized ultrasound equipment.

Ultrasound guided paracentesis: A study on reproducibility and diagnostic accuracy of a Pocket-size Ultrasound Device (PUD)

Introduction: The usefulness of Pocket-size ultrasound devices (PUDs) in assessing the presence of ascites and assisting paracentesis has been tested but not validated yet.

Preoperative detection of pleural adhesions using pocket-sized ultrasound.

Although preoperative detection of pleural adhesions is important in thoracic surgery, it is not widely performed. We report the availability of a pocket-sized ultrasound device for the preoperative detection of pleural adhesions. Between September 2019 and September 2020, pleural adhesions were assessed preoperatively using a pocket-sized ultrasound device in 62 patients who underwent thoracic surgery. Evaluations were performed using the Vscan Dual Probe on the wards or just before surgery in the operating theater. We used a linear probe to scan the chest wall where the incision was scheduled, and evaluated the sliding sign. We compared ultrasound results with intraoperative findings. Of the 62 patients, the sliding sign was observed in 58 patients, 56 of whom demonstrated no pleural adhesions intraoperatively. The sensitivity was 96.6%. Four patients were negative for the sliding sign; of these, three had pleural adhesions and one did not. The specificity was 75.0%. Among all 62 patients, the diagnostic accuracy of ultrasound for pleural adhesions was 95.2%. False negatives were caused by loose adhesions. False positives were caused by the absence of vertical lines on ultrasound. Accuracy was not influenced by the timing of the test. A pocket-sized ultrasound device was useful for the preoperative detection of pleural adhesions in thoracic surgery.

Accuracy of Optic Nerve Sheath Diameter Measurements in Pocket Sized Ultrasound Devices on a Simulation Model

Johnson, Garrett G. MD; Jelic, Tomislav MD, FRCPC-EM, FACEP; Derksen, Angela MD, CCFP; Unger, Bertram MD, PhD; Zeiler, Frederick BSc, MD, PhD, CIP, FRCSC; Ziesmann, Markus T. MD, MSc; Marshall Gillman, Lawrence MD, MMedEd, FRCSC, FACS Author Information

Diagnostic accuracy of a pocket-size ultrasound device in identifying liver surface nodularity for fibrosis staging in chronic liver disease

Diagnostic accuracy of a pocket-size ultrasound device in identifying liver surface nodularity for fibrosis staging in chronic liver disease

Feasibility of Using a Pocket-Sized Ultrasound Device to Measure the Inferior Vena Cava Diameter of Patients With Heart Failure in the Community Setting: A Pilot Study.

Background: The incidence of heart failure as well as its treatment costs and rehospitalization rates are increasing worldwide. Physical assessment of elderly patients with heart failure living in their homes is challenging for community nurses. Pocket-sized echocardiographs will be useful for assessing the condition of the patients with heart failure during home-visit care. Objectives: This pilot study aimed to examine the feasibility of measuring the inferior vena cava (IVC) diameter using a pocket-sized ultrasound device. Methods: Nursing students were trained to use the pocket-sized ultrasound device (PUSD) for measuring the inferior vena cava diameter of a healthy subject. We evaluated the accuracy and rapidity of the nursing students’ measurements compared with those of an expert sonographer. Results: In total, 83.3% of the participants accurately visualized the IVC using the PSUD. There was no significant difference in the mean IVC diameter between that measured by the students and the sonographer. In total, 25% of the participants accurately measured the IVC diameter. The mean measurement time was 201 seconds. Conclusion: Our training program allowed the participants to accurately visualize the IVC using the PSUD. However, these results on accuracy and measurement time still need to be improved before community nurses can use the PSUD during home visits.

Use of pocket-sized ultrasound device in vascular surgery.

Ultrasound is widely used in vascular surgery. Pocket-sized ultrasound devices have limited functionality compared to conventional ultrasound scanners, but are cheaper and highly portable. The aim of this study was to investigate whether vascular surgeons could benefit from using a pocket ultrasound device in everyday clinical practice. Pocket-sized ultrasound devices were made available in the Department of Vascular Surgery at St. Olavs Hospital, Trondheim University Hospital, for a 10-month period. Eleven doctors participated and were free to choose between a conventional ultrasound scanner and a pocket ultrasound device. After each use of a pocket ultrasound device, participants completed a form describing the indication for use, whether the clinical question was answered, the image quality experienced and the need for supplementary diagnostic imaging. At the end of the study period, each user completed a questionnaire. Pocket ultrasound devices were mainly used preoperatively. The clinical question was answered in 51 (85%) of 60 registered examinations with a pocket ultrasound device. Image quality was subjectively rated as good in 32 (53%) examinations, moderate in 21 (35%) and poor in 7 (12%), with the clinical question answered in 94%, 90% and 29% of cases, respectively. Doctors with less than five years of experience with ultrasound chose pocket ultrasound more frequently than more experienced users. For the examinations selected, the images supplied by the pocket ultrasound device were generally of sufficient quality and often answered the clinical question. Pocket ultrasound devices can be a useful supplementary tool in vascular surgery, especially for venous examinations.

Use of Pocket-Sized Ultrasound Device in the Diagnosis of Shoulder Pathology.

Musculoskeletal ultrasound imaging is increasingly being used for static and dynamic imaging of tendons, muscles, ligaments, and bones. New, hand-held, pocket-sized ultrasounds are more portable and affordable. The purpose of this study was to evaluate the feasibility of pocket-sized ultrasound to diagnose shoulder pathology. Prospective cohort study. Tertiary Care Hospital. Ten consecutive patients (mean age 54; range 42-68 years) referred for a shoulder ultrasound for evaluation of shoulder pain were recruited. A diagnostic ultrasound was performed first with a pocket-sized ultrasound machine (VScan; General Electric, Northville, MI) and cine images saved for later review. Next, standard diagnostic ultrasound by a radiology technician specialized in musculoskeletal ultrasound was performed using (LOGIQ; General Electric, Northville, MI) ultrasound. The radiology report from the standard diagnostic ultrasound was used as the gold standard for diagnoses. Two independent evaluators, a musculoskeletal-trained radiologist and a sports-medicine-trained physician with over 8 years of experience with musculoskeletal ultrasound, reviewed the images from the pocket-sized ultrasound. Nine of the studies were diagnosed with a pathologic entity during the standard diagnostic ultrasound and 1 was found to be normal. Diagnoses ranged from biceps tendinopathy, calcific tendonitis, and partial-articular-sided rotator cuff tear. Evaluator 1 correctly identified 7/10 diagnoses and evaluator 2 correctly identified 8/10 diagnoses. The evaluators also rated their confidence in diagnosis as 4.2/5 and the image quality as 3.7/4 from the pocket-sized ultrasound. The findings from this study demonstrate that pocket-sized, hand-held ultrasound machines may be used to identify shoulder pathology.

Diagnostic Capacity of Pocket-Sized Ultrasound Devices at Point of Care by a Non-radiologist Resident in Patients with Suspected Abdominal Pathology

Studies have reported the usefulness and tolerability in practice of abdominal ultrasound performed by non-radiologists in various clinical situations. This prospective observational single-center study included 184 patients hospitalized in an internal medicine department who underwent conventional abdominal ultrasound. A medical resident with basic training performed point-of-care clinical ultrasound using a pocket-sized device. The concordance obtained between the researcher and the radiologist was good (k >0.6) for the gallbladder, splenomegaly, longitudinal diameter of the kidney, presence of renal cysts and hydronephrosis. The specificity was >90% for all parameters assessed except normal renal size. A negative predictive value >90% was obtained for all variables studied except the presence of hepatic space-occupying lesions and gallbladder pathology, the negative predictive values for which were >80%. A positive predictive value >80% was obtained for all of these variables, except the presence of adenopathies, hepatomegaly, space-occupying lesions, echogenicity and/or enlargement of the biliary tract, left renal atrophy and right renal masses. We conclude there was a high concordance between a conventional abdominal study and that performed with a pocket-sized ultrasound device after a brief learning curve.

Utility of a Bedside Pocket-Sized Ultrasound Device to Promptly Manage Abdominal Pain in the Emergency Department

Introduction: Abdominal pain is a frequent reason for Emergency Department (ED) admission; it amounts for around 5–10% of all ED visits. Early assessment should focus on immediately distinguishing cases of acute abdomen that require urgent surgical intervention. The clinical localization of pain is crucial, suggesting an initial evaluation of the origin of the abdominal pain; however, imaging is often required for final diagnosis. Ultrasound (US) represents a rapid imaging modality that is readily available in the ED and does not involve radiation or contrast agent administration. A new generation of portable, battery-powered, low-cost, hand-carried ultrasound devices have become available recently; these devices can provide immediate diagnostic information in patients presenting with abdominal pain in ED.The aim of the study was to demonstrate the diagnostic usefulness of a bedside pocket-sized ultrasound (BPU) device (Vscan from General Electrics) in non-traumatic patients complaining of acute abdominal pain in a tertiary care university hospital in Italy. Methods: Patients with acute non-traumatic abdominal pain presenting in ED were prospectively enrolled and underwent physical examination, traditional imaging and BPU. Results: A total number of 230 patients with acute non-traumatic abdominal pain were enrolled. Overall agreement between routine standard imaging and BPU turned out to be equal for computed tomography (K=0.3) and traditional ultrasound (K=0.29). Receiver operating characteristics curve (ROC) analysis for diagnostic power of the BPU in comparison with traditional US showed an area under the curve of 0.65, sensitivity and specificity of 87.2% and 42.31% respectively. Conclusions: Emergency use of BPU in patients with non-traumatic abdominal pain demonstrated good diagnostic performance when compared to traditional imaging, with the potential advantage of reducing costs and delay in patient final disposition.