Ultrasound

The elderly patient was a major donor to the hospital. Intraoperative ultrasound revealed an unexpected liver lesion. Color Doppler showed vascularity. If the lesion was a cancerous tumor, the entire liver would need to be removed, the surgeon told radiologist Dr. Stephen Horii. Only histology would reveal actual pathology.

Quantitative ultrasound, the standard method for measuring bone quality, also correlates with bone mineral density and biochemical markers for bone turnover in women aged 66 to 77, according to a study from Greece. Older women in rural areas and others who lack access to biochemical labs and dual-energy x-ray absorptiometry equipment, the standard for measuring bone density, could therefore be screened for complete bone status using ultrasound.

Hysterosalpingography is the radiographic evaluation of the uterine cavity and fallopian tubes after injection of radiopaque contrast through the cervical canal. The first hysterosalpingography, performed in 1910, was considered to be the first interventional radiological procedure.

Expectant parents no longer seem satisfied with keeping 3D fetal videos in their DVD collection armoire. Now they are posting them on the web. This practice could undermine organized radiology efforts to rein in unwarranted fetal sonography scans.

Ultrasound could make the diagnosis of rheumatoid arthritis considerably more accurate, aiding in recommendations for treatment. Treatment decisions can depend on how far the disease has progressed, and the only way to measure the progression of rheumatoid arthritisis to identify which of a patient’s joints show synovitis. Yet a recent study shows that doctors miss swelling in the shoulder joints of 30% of patients.

Revenues from ultrasound scanners in the U.S. rose more than 5% last year compared with 2005 on the heels of increasing demand for echocardiography. A drop of 23% in upgrades, however, damped overall growth to just 2.6%, according to a new report by Klein Biomedical Consultants. Still the ultrasound market rose to a record $1.33 billion in 2006 and could go much higher. Sales are expected to grow at an annual rate of 5.8% to reach $1.76 billion by 2011, according to the report, “Medical Diagnostic Ultrasound Market in the USA: Challenges & Opportunities in the New Millennium, 2006.”

Earlier this year it was SonoSite and Zonare preparing to battle in court over ultrasound patents. Last week GE opened a new front, alleging SonoSite infringement of five GE patents.

Hepatitis and related syndromes may be a stronger predictor of early atherosclerosis than such classic risk factors as insulin resistance, according to Italian researchers.

Treatment guidelines from the FDA limit the ultrasonic ablation of uterine fibroids to 50% of the lesion mass, as seen and targeted with MRI, a limitation that has raised doubts in the medical community about whether the treatment can be effective. But Dr. Phyllis Gee, medical director of the North Texas Uterine Fibroid Institute in Plano, says physicians need not be concerned about the efficacy or long-lasting effect of this treatment.

Nerve blocks used for regional anesthesia in knee surgery can be made safer using ultrasound guidance for needle placement, lowering the necessary dose, according to a recent Italian study.

Features of high-end cart-based ob/gyn scanners officially trickled down to lapsize ultrasound systems this week when GE Healthcare launched its new ob/gyn portfolio at the American College of Obstetricians and Gynecologists meeting in San Diego.

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Researchers have found a way to use ultrasound as a diagnostic tool for gout. The noninvasive modality could serve as a potential supplement to blood, urine, and joint fluid tests, which don't always provide a definitive diagnosis.

Practitioners can choose either vertebroplasty or kyphoplasty to treat vertebral compression fractures until a prospective trial comparing the two techniques says otherwise, according a multisociety position statement in the Journal of Vascular and Interventional Radiology. The statement does not fully address the economic impact of each treatment choice.

An increased demand for vascular ultrasound technologists and interventional technologists parallels an increase in the number of peripheral vascular disease cases and minimally invasive procedures.

Lower costs, speedier recovery, and reduced pain give uterine artery embolization an edge over surgery for fibroid treatment, according to a multicenter trial that examined the relative merits of the two methods.

Current teleradiology image transfer systems were developed for high-bandwidth networks and therefore cannot support radiographs or sonograms from remote or underdeveloped areas due to limited bandwidth availability at those locations.

Cutaneous malignant melanoma is a relatively common malignancy, and its incidence is increasing worldwide, especially in the Caucasian population. The clinical course of melanoma depends on tumor thickness, localization, ulceration, growth rate, and histology of the primary tumor. Metastatic spread may arise from very small masses.

Diagnosing pancreatic disease generally requires many different imaging procedures. Ultrasound and CT are most commonly used to evaluate the pancreatic ducts, parenchyma, and adjacent soft tissues. CT-based assessment of pancreatic pathology has been greatly aided by the advent of multislice technology.

In late November, nearly 300 doctors and imaging center managers paid $325 each for a day-long seminar sponsored by the law firm McDermott Will & Emery. They packed a large ballroom in the swank Ritz-Carlton Hotel at Water Tower Place in Chicago to learn how to turn referrals to imaging facilities into lucrative income streams.

Technical advances in MRI have paved the way for functional imaging of the abdomen, moving beyond simple morphological evaluation of disease and in some cases proving superior to multislice CT.

Patients with major depressive disorder can show actual physical changes to the brain structure on sonographic evaluation, according to German researchers. One study found that depressed patients with a history of responding to serotonin reuptake inhibitors also had a high incidence of reduced echogenicity of the brain stem raphe. Another found that many patients diagnosed with depression also showed increased echogenicity in a specific area of the midbrain common in patients with Parkinson’s disease.

Engineers at Duke University’s Pratt School of Engineering have come up with software that twists the data composing volumetric ultrasound images into stereoscopic views, creating images that appear to float off display monitors into 3D space. The software splits the single ultrasound image into two separate images 7° from each other -- one seen by the right eye and the other by the left.

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Several studies published in the top peer-reviewed journals in April caught our eye, particularly those relevant to current trends and clinical practice issues. Credible indications suggest that the rate of thyroid cancer in the U.S. may be on the rise. A ground-breaking study published in Radiology from Japanese and U.S. researchers assesses the value of elastography to tell benign from malignant lymph nodes in the neck. The same publication also ran an editorial by a leading Thomas Jefferson University sonologist that sheds light on this issue. Researchers in Michigan discovered relevant changes in fetal cardiac development that have been overlooked, even with 3D technology. Italian investigators published a study comparing sonography and multislice CT to characterize renal cysts and found the former could help reduce unnecessary surgery and radiation dose exposure. And an interesting study from Iran assesses the feasibility of replacing invasive endoscopic cholangiopancreatography with ultrasound for detection of biliary gallstones.

The first quarter of this year was the slowest of any in the seven years during which DI SCAN has tracked FDA clearances. The radiology industry was able to clear just 55 devices in the first three months of 2007. Only once since the decade began has the FDA cleared fewer than 60 devices during the first quarter. That was in 2004, when radiological device makers earned 59 clearances.

A technique previously shown to diagnose cardiogenic pulmonary edema has now been used to successfully diagnose pulmonary edema brought on by high altitude. Pulmonary edema is the primary cause of death from altitude sickness, and ultrasound could be an effective, low-cost test suitable for field hospitals.

A method of automatically combining CT, PET, and ultrasound scans into one image may help clinicians diagnose gynecological cancers. Together, the three modalities provide a clearer picture of indeterminate solid masses in the pelvic area.

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