Table 2.

EFSUMB minimum ultrasound training requirements for level 1 gastroenterological ultrasound practitioners

Knowledge base	Physics and technology, ultrasound techniques and administration
Sectional and ultrasonic anatomy	Liver Gallbladder Bile ducts Pancreas Spleen Kidneys, bladder and adrenal glands Other structures (uterus, ovaries, lymph nodes, vessels, hollow digestive tube)
Pathology in relation to ultrasound	Liver: cysts, benign and malignant tumours, metastatic disease, fatty change, cirrhosis Biliary system: gallbladder stones, acute and chronic cholecystitis, gallbladder tumours, bile duct obstruction, including level of obstruction, intrahepatic duct gas and stones Pancreas: pancreatitis (acute and chronic), duct stones, duct dilatation, pancreatic tumours Portal venous system and spleen: splenic enlargement, portal venous distension, varices, thrombosis, ascites and loculated fluid collections Kidneys: size, hydronephrosis and masses Other structures: gastrointestinal masses and masses of gynaecological origin including cysts, tumours, fibroids and unexpected pregnancy
Liver - to be able to:	Perform a thorough ultrasound examination of the liver in different scan planes Recognise normal hepatic anatomy and variants Recognise normal and abnormal liver texture, such as fatty change and anatomical variants Recognise focal lesions and be able to determine those requiring further investigation Recognise normal hepatic and portal venous anatomy within the liver Perform ultrasound controlled biopsy for the evaluation of parenchymal liver disease
Gallbladder and bile ducts - to be able to:	Perform a thorough evaluation of the biliary system Recognise normal ultrasonic anatomy of the biliary system and its frequent normal variants Recognise abnormalities of the gallbladder wall Recognise gallbladder stones Be able to assess bile duct dilatation at intra- and extrahepatic levels
Pancreas - to be able to:	Perform a thorough examination of the pancreas Recognise the limitations of pancreatic ultrasound because of bowel gas Recognise solid and cystic tumours within the head and body of the pancreas Recognise the changes seen in pancreatitis (acute and chronic) Recognise pancreatic duct dilatation and pancreatic duct stones
Portal venous system and spleen - to be able to:	Evaluate the size of the spleen and recognise focal lesions Evaluate the portal vein and its diameter and the presence of portal venous thrombosis
Other - to be able to:	Recognise abdominal aortic aneurysm Recognise hydronephrosis and other renal abnormalities Recognise free and loculated fluid collections Recognise lymphadenopathy Recognise gynaecological and other pelvic abnormalities
Bowel - to be able to:	Recognise normal stomach, small and large bowel Recognise focal intestinal abnormalities and understand the principles of further investigation Recognise intestinal obstruction

EFSUMB, European Federation of Societies for Ultrasound in Medicine and Biology.