Physicians have been utilizing conventional ultrasound, also called b-mode ultrasound, for diagnostic imaging since the 1970s. However, over the past 10 years there have been significant technological improvements within the equipment, as well as growth and development of new technologies that allowed ultrasound to become more widely adopted. Ultrasound equipment has gotten physically smaller, generates less heat and has become more power efficient. These upgrades, together with 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 cost-effective solutions, this trend is predicted to persist until ultrasound can be used in every doctor’s office.
Today, ultrasound images can be purchased with higher resolutions, allowing physicians to find out 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 technology 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 in terms of transducer sensitivity, the beam former, image processing speed and the quality of the last data display,” he stated. These improvements have resulted in a picture quality in b-mode imaging that is better than it absolutely was even a decade ago. Physicians are able to see things which are many smaller along with a lot deeper than was previously possible. “We are able to see flow in vessels as small as 2 mm in diameter in organs just like the kidney and lymph nodes.”
Due partly to those image-quality improvements, ultrasound has become being used in interventional procedures generally dominated by 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 use ultrasound instead of CT for image-guided biopsies and ablations.
Volumetric ultrasound has additionally continued to boost. Ultrasound was previously only able to capture a single imaging plane, these days it may acquire volumes. “Transducers that permit for that 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 around development for quite some time, the transducers have only been readily available for conventional use for the recent years. And since volumetric ultrasound allows physicians to characterize tissue a lot better than before and perform conventional procedures with much greater accuracy, this area of ultrasound will keep growing.
Newer technologies are positioned to revolutionize ultrasound technician. One such technology is sonoelastography, a technique which 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 and then displays qmdirp mechanical characteristics overlaid on the conventional b-mode ultrasound image. By giving physicians the cabability 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 also the detection of prostate cancer, all of these should not be finished with conventional ultrasound. Elastography has been available in Europe for quite a while and systems in the usa started receiving U.S. Food and Drug Administration (FDA) approval over the past year.
Another recent development is using ultrasound contrast agents. Contrast-enhanced ultrasound (CEUS) continues to be available in Canada, Australia, China and Europe for many 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 lots of the functions currently performed by CT and MRI.
Healthcare reform and other legislation is playing a huge role within the widespread adoption of ultrasound. This could be seen in the legislation that lots of states have passed requiring radiologists to inform women should they have dense breasts, and to inform them of the advantages of supplemental screening.