Physicians have been using traditional ultrasound, also called b-mode ultrasound, for diagnostic imaging since the 1970s. However, in the last a decade 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 it 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 continues to favor the usage of more inexpensive solutions, this trend is anticipated to persist until ultrasound is used in every single doctor’s office.
Today, ultrasound images can be purchased with higher resolutions, allowing physicians to view 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 starting 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 with regards to transducer sensitivity, the beam former, image processing speed and the quality of the last data display,” he explained. These improvements have ended in an image quality in b-mode imaging that is preferable to it had been even a decade ago. Physicians are able to see things which are a lot smaller as well as a lot deeper than was previously possible. “We are able to see flow in vessels as small as 2 mm in diameter in organs such as the kidney and lymph nodes.”
Due partly to those image-quality improvements, ultrasound is currently being utilized in interventional procedures generally covered with computed tomography (CT) and magnetic resonance imaging (MRI). And although a lot of interventional physicians still depend on CT and MRI for lung procedures, it is common for interventionalists to make use of ultrasound rather than CT for image-guided biopsies and ablations.
Volumetric ultrasound has additionally continued to improve. Ultrasound once was only capable of capture a single imaging plane, but today it can acquire volumes. “Transducers that enable for that 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 designed for conventional use for the last few years. And furthermore, as volumetric ultrasound allows physicians to characterize tissue better than before and perform conventional procedures with much greater accuracy, this place of ultrasound will keep growing.
Newer technologies are positioned to revolutionize ultrasound technician salary. One technology is sonoelastography, a method that has been in development for nearly 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 providing physicians the opportunity to see stiffer and softer areas within the tissue, sonoelastography will aid in liver fibrosis staging, thyroid nodule, lymph node and indeterminate breast lump characterization, as well as the detection of prostate cancer, all of which can not be completed with conventional ultrasound. Elastography has been available in Europe for some time and systems in the United States 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) continues to be offered in Canada, Australia, China and Europe for a number of years, but has not been available in the usa outside of echocardiography. CEUS grants a lot more sensitivity for that detection of tumors, allowing ultrasound use to grow into most of the functions currently done by CT and MRI.
Healthcare reform as well as other legislation is playing a large role in the widespread adoption of ultrasound. This could be observed in the legislation that many states have passed requiring radiologists to tell women should they have dense breasts, and also to inform them of the advantages of supplemental screening.