Physicians have been using traditional ultrasound, also known as b-mode ultrasound, for diagnostic imaging since the 1970s. However, in the last 10 years there have been significant technological improvements within the equipment, as well as 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 has become widely performed in emergency rooms, PCP offices and obstetric practices. As healthcare reform will continue to favor the use of more inexpensive solutions, this trend is anticipated to persist until ultrasound is used 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 technology doing real-time processing, we’re beginning to get images which are 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 standard of the last data display,” he said. These improvements have ended in a picture quality in b-mode imaging that is superior to it was even a decade ago. Physicians can see things that are many smaller and a lot deeper than was previously possible. “We can see flow in vessels no more than 2 mm in diameter in organs such as the kidney and lymph nodes.”
Due partly to such image-quality improvements, ultrasound is now being utilized in interventional procedures generally covered with computed tomography (CT) and magnetic resonance imaging (MRI). And although many interventional physicians still rely on CT and MRI for lung procedures, it has become common for interventionalists to utilize ultrasound rather than CT for image-guided biopsies and ablations.
Volumetric ultrasound also has continued to enhance. Ultrasound was previously only capable of capture one particular imaging plane, however nowadays it may acquire volumes. “Transducers that permit for that acquisition of real-time volumes of tissue let us image in multiple planes – for instance, the transverse and sagittal dimensions – simultaneously,” Samir said. While volumetric ultrasound has been doing development for several years, the transducers only have been available for conventional use for the last few years. And since volumetric ultrasound allows physicians to characterize tissue 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 particular technology is sonoelastography, an approach which has been in development for nearly two decades. Sonoelastography utilizes the identical 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 ability to see stiffer and softer areas inside of the tissue, sonoelastography will help with liver fibrosis staging, thyroid nodule, lymph node and indeterminate breast lump characterization, and also the detection of prostate cancer, all of which can not be completed with conventional ultrasound. Elastography has been available in Europe for a while and systems in the usa started receiving U.S. Food and Drug Administration (FDA) approval within the last year.
Another recent development is the use of ultrasound contrast agents. Contrast-enhanced ultrasound (CEUS) has become available in Canada, Australia, China and Europe for several years, but is not available in america outside of echocardiography. CEUS grants much more sensitivity for the detection of tumors, allowing ultrasound use to expand into lots of the functions currently performed by CT and MRI.
Healthcare reform along with other legislation is playing a huge role inside the widespread adoption of ultrasound. This could be noticed in the legislation that lots of states have passed requiring radiologists to inform women should they have dense breasts, and also to inform them of some great benefits of supplemental screening.