Physicians have been using conventional ultrasound, also referred to as b-mode ultrasound, for diagnostic imaging since the 1970s. However, over the past ten years there have been significant technological improvements within the equipment, in addition to development of new technologies that allowed ultrasound to become more widely adopted. Ultrasound equipment has gotten physically smaller, generates less heat and has become a little more power efficient. These upgrades, along with vast enhancements in image quality, have pushed ultrasound into the point-of-care setting. Point-of-care ultrasound has become widely performed in emergency rooms, PCP offices and obstetric practices. As healthcare reform will continue to favor the use of more cost-effective solutions, this trend is expected to persist until ultrasound is utilized in every doctor’s office.
Today, ultrasound images are available with higher resolutions, allowing physicians to see much clearer definition. “Everyone can be 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 starting 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 might be credited to upgrades in ultrasound equipment. “The b-mode technology has improved enormously in terms of transducer sensitivity, the beam former, image processing speed and the quality of the ultimate data display,” he said. These improvements have resulted in a picture quality in b-mode imaging that is better than it absolutely was even ten years ago. Physicians have the ability to see things that are a lot smaller as well as a lot deeper than was previously possible. “We are able to see flow in vessels no more than 2 mm in diameter in organs like the kidney and lymph nodes.”
Due to some extent to these image-quality improvements, ultrasound is currently used in interventional procedures generally covered with computed tomography (CT) and magnetic resonance imaging (MRI). And even though many 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 also continued to enhance. Ultrasound once was only capable of capture just one imaging plane, but today it may acquire volumes. “Transducers that permit for the acquisition of real-time volumes of tissue allow us to image in multiple planes – as an example, the transverse and sagittal dimensions – simultaneously,” Samir said. While volumetric ultrasound has been doing development for quite some time, the transducers only have been available for conventional use for recent years. And because volumetric ultrasound allows physicians to characterize tissue much better than before and perform conventional procedures with much greater accuracy, this region of ultrasound will continue to grow.
Newer technologies are positioned to revolutionize ultrasound technician. One such technology is sonoelastography, a technique that has been in development for pretty much two decades. Sonoelastography utilizes the same machine that does b-mode ultrasound to measure tissue stiffness. It measures the mechanical characteristics of tissues and after that displays qmdirp mechanical characteristics overlaid on the conventional b-mode ultrasound image. By offering physicians the cabability to see stiffer and softer areas inside the tissue, sonoelastography will aid in liver fibrosis staging, thyroid nodule, lymph node and indeterminate breast lump characterization, and the detection of prostate cancer, which cannot be finished with conventional ultrasound. Elastography continues to be obtainable in Europe for 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 the usage of ultrasound contrast agents. Contrast-enhanced ultrasound (CEUS) has become available in Canada, Australia, China and Europe for many years, but is not available in the United States away from echocardiography. CEUS grants much more sensitivity for your detection of tumors, allowing ultrasound use to grow into lots of the functions currently done by CT and MRI.
Healthcare reform and other legislation is playing a large role within the widespread adoption of ultrasound. This can be seen in the legislation that numerous states have passed requiring radiologists to tell women should they have dense breasts, and also to let them know of some great benefits of supplemental screening.