Physicians have been using conventional ultrasound, also known as b-mode ultrasound, for diagnostic imaging since the 1970s. However, within the last a decade there have been significant technological improvements within the equipment, along with growth and development of new technologies that allowed ultrasound to become extensively adopted. Ultrasound equipment has gotten physically smaller, generates less heat and it has become more power efficient. These upgrades, in addition to vast enhancements in image quality, have pushed ultrasound into the point-of-care setting. Point-of-care ultrasound is becoming widely performed in emergency rooms, PCP offices and obstetric practices. As healthcare reform continues to favor the usage of more inexpensive solutions, this trend is expected to persist until ultrasound is utilized in each and every doctor’s office.
Today, ultrasound images can be found with higher resolutions, allowing physicians to see much clearer definition. “Everyone is used to ultrasound pictures being fuzzy,” said Tomo Hasegawa, director, ultrasound business unit, Toshiba America Medical Systems. “With enhancement in computer systems doing real-time processing, we’re beginning to get images which can be so clear, people don’t even realize it’s ultrasound.”
Anthony Samir, M.D., associate medical director, ultrasound imaging, Massachusetts General Hospital, said these improvements may be credited to upgrades in ultrasound equipment. “The b-mode technologies have improved enormously when it comes to transducer sensitivity, the beam former, image processing speed and the standard of the final data display,” he said. These improvements have ended in an image quality in b-mode imaging that is preferable to it was even a decade ago. Physicians have the ability to see things that are many smaller as well as a lot deeper than once was possible. “We are able to see flow in vessels no more than 2 mm in diameter in organs such as the kidney and lymph nodes.”
Due in part to those image-quality improvements, ultrasound has become being used in interventional procedures generally covered with computed tomography (CT) and magnetic resonance imaging (MRI). And although a lot of interventional physicians still count on CT and MRI for lung procedures, it is now common for interventionalists to utilize ultrasound rather than CT for image-guided biopsies and ablations.
Volumetric ultrasound has additionally continued to enhance. Ultrasound was previously only able to capture a single imaging plane, but today it may acquire volumes. “Transducers that enable for the acquisition of real-time volumes of tissue permit us to image in multiple planes – as an example, the transverse and sagittal dimensions – simultaneously,” Samir said. While volumetric ultrasound has been in development for many years, the transducers have only been available for conventional use for recent years. And because volumetric ultrasound allows physicians to characterize tissue a lot better than before and perform conventional procedures with much greater accuracy, this place of ultrasound will keep growing.
Newer technologies are set to revolutionize ultrasound technician. One technology is sonoelastography, a technique that has been in development for almost two decades. Sonoelastography utilizes the same machine that does b-mode ultrasound to measure tissue stiffness. Its dimensions are the mechanical characteristics of tissues then displays qmdirp mechanical characteristics overlaid on the conventional b-mode ultrasound image. By giving physicians the opportunity to see stiffer and softer areas within the tissue, sonoelastography will assist in liver fibrosis staging, thyroid nodule, lymph node and indeterminate breast lump characterization, and the detection of prostate cancer, which can not be completed with conventional ultrasound. Elastography has become available in Europe for quite a while and systems in the usa started receiving U.S. Food and Drug Administration (FDA) approval in the last year.
Another recent development is using ultrasound contrast agents. Contrast-enhanced ultrasound (CEUS) has become offered in Canada, Australia, China and Europe for a number of years, but has not been available in the usa outside echocardiography. CEUS grants far more sensitivity for that detection of tumors, allowing ultrasound use to expand into many of the functions currently done by CT and MRI.
Healthcare reform as well as other legislation is playing a huge role inside the widespread adoption of ultrasound. This is often seen in the legislation that lots of states have passed requiring radiologists to tell women when they have dense breasts, as well as let them know of some great benefits of supplemental screening.