Physicians have been utilizing traditional ultrasound, also called b-mode ultrasound, for diagnostic imaging since the 1970s. However, within 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 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 use of more cost-effective solutions, this trend is anticipated to persist until ultrasound is utilized in every doctor’s office.
Today, ultrasound images can be purchased with higher resolutions, allowing physicians to view 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 starting to get images that 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 when it comes to transducer sensitivity, the beam former, image processing speed and the quality of the last data display,” he explained. These improvements have led to a graphic quality in b-mode imaging that is preferable to it had been even a decade ago. Physicians are able to see stuff that are a lot smaller as well as a lot deeper than was once possible. “We can see flow in vessels as small as 2 mm in diameter in organs such as the kidney and lymph nodes.”
Due to some extent 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 even though many interventional physicians still rely 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 improve. Ultrasound once was only in a position to capture just one imaging plane, but today it can acquire volumes. “Transducers that allow for your acquisition of real-time volumes of tissue let us image in multiple planes – as an example, the transverse and sagittal dimensions – simultaneously,” Samir said. While volumetric ultrasound has been doing development for several years, the transducers just have 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 place of ultrasound will continue to grow.
Newer technologies are set to revolutionize ultrasound technician. One particular technology is sonoelastography, a method that has been in development for nearly two decades. Sonoelastography utilizes exactly the same machine that does b-mode ultrasound to measure tissue stiffness. It measures the mechanical characteristics of tissues then displays qmdirp mechanical characteristics overlaid on the conventional b-mode ultrasound image. By giving physicians the ability to see stiffer and softer areas inside of the tissue, sonoelastography will assist in liver fibrosis staging, thyroid nodule, lymph node and indeterminate breast lump characterization, and the detection of prostate cancer, all of which can not be finished with conventional ultrasound. Elastography has been offered in Europe for quite 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 usage of ultrasound contrast agents. Contrast-enhanced ultrasound (CEUS) has become obtainable in Canada, Australia, China and Europe for several years, but has not been available in the United States outside of echocardiography. CEUS grants much 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 along with other legislation is playing a large role inside the widespread adoption of ultrasound. This can be seen in the legislation that numerous states have passed requiring radiologists to tell women if they have dense breasts, and to let them know of the benefits of supplemental screening.