Ultrasound

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Breast ultrasound is a highly useful tool in the hands of an expert, but it is notoriously operator-dependent. Systems that offer partial or full automation to minimize performance variability are gaining attention, as trial data accumulate and system designs evolve.

Siemens' P-10, a palm-sized ultrasound scanner shown for the first time at the RSNA meeting, is due out later this year. But radiologists probably won't be using the Blackberry-like device.

Over the years, we've had the privilege of checking the vital signs of many imaging modalities. Diagnostic Imaging served as a witness to the rise and fall of digital subtraction angiography and reported the PET crisis of the mid-1990s.

Contrast-enhanced lymphosonography finds more sentinel lymph nodes than can established nuclear medicine techniques, according to preliminary animal studies focusing on melanoma.

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Most radiologists surveyed by the Society for Radiologists in Ultrasound said they perform more than 10 thyroid aspirations each week. However, few of them used consistent criteria to determine which nodules were chosen for aspiration, according to data released at the RSNA meeting.

Although ultrasound can find occult cancers in women with dense breasts, it is time-consuming, operator dependent, and limited in penetration and interpretation. Conventional scanners typically provide only 2D images. U-Systems has spent the last three years building an ultrasound machine that overcomes these problems.

Most radiologists surveyed by the Society for Radiologists in Ultrasound said they perform more than 10 thyroid aspirations each week. But few used consistent criteria to determine which nodules were chosen for aspiration. Institutions performing more thyroid aspirations seem to find more malignant nodules, but the survey didn’t determine if this was a result of better methodology or simply a matter of patient selection.

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Over the past 50 years, imagers have witnessed dramatic improvements in ultrasound image quality, resolution, availability, and range of indications. Most of these advances occurred within the confines of 2D planar imaging.

Contrast-enhanced ultrasound may offer more sensitive and more detailed detection of endoleaks for aortic stent-grafts than CT angiography, according to research presented at the 2006 RSNA meeting. The two techniques might best be used in combination, said researchers from the University of Insubria in Varese, Italy.

Use of breast ultrasound and MRI in Medicare beneficiaries has been on the rise in a big way, but the picture of mammography utilization in this patient population is less rosy.

The thrust for Richland, WA-based Advanced Imaging Technologies over the last four years has been to transform the acoustical holography system developed by its predecessor firm, Advanced Diagnostics, into a commercial product. The fruit of those labors is the company’s first product, its Aria Breast Imaging System.

Cryotherapy is often portrayed as radiofrequency ablation's little brother. But the thermal ablation technique is proving safer and more effective than previously thought, according to several papers presented at the RSNA meeting.

The swift rise of percutaneous ablative interventions represents one example of the power of innovation-and how it can crush barriers that stand between discovery and adoption.

Canadian and U.S. radiologists face different regulatory restrictions for the use of ultrasound contrast agents. However, both sides are coming up with similar evidence about their positive effect on clinical practice.

The FDA has denied a request for over-the-counter sales of handheld Doppler fetoscopes.

Breast ultrasound elastography allows radiologists to accurately distinguish benign from malignant breast lesions. The technique correctly identified both cancerous and benign lesions in nearly 125 cases studied.

As a practicing radiologist for 28 years, I was happy to see the Point/Counterpoint repartee between Dr. Carter Newton and Dr. David Dowe in Diagnostic Imaging (September 2006, pages 24 and 25) regarding cardiac CT angiography. It's time the radiology community and the medical community at large understand the difference between real imaging professionals and doctors who believe that cardiac imaging is some type of divine entitlement.

Half of the people in the U.S. older than 50 could suffer fractures caused by osteoporosis over the next 13 years, according to a 2005 Surgeon General's report. Such ominous predictions move musculoskeletal conditions to the top of a long list of chronic diseases confronting baby boomers.

MRI and ultrasound can be useful tools in evaluating patients with early rheumatoid arthritis. Both techniques can detect pre-erosive synovial inflammation. They can also identify early bone damage before it becomes apparent on x-rays.

As part of its plan to transfer the advanced features on its high-end Accuvix ultrasound product to midrange systems, Medison USA introduced the SonoAce X4 at the 2006 RSNA meeting.

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In 2007, Siemens Medical Solutions plans to introduce what could be the market's smallest handheld ultrasound system. The company selectively demonstrated the palm-sized, Blackberry-like device at the 2006 RSNA meeting, typical treatment for a new product or a work-in-progress.

Outgoing Society of Nuclear Medicine president Dr. Peter Conti proposed at the organization's 2006 meeting that nuclear medicine is synonymous with molecular imaging.

A British research team is applying a new twist to an old technique for treating ankle injuries in high-performance athletes. The procedure involves use of ultrasound to guide steroid and anesthetic injections and was originally described in the literature a decade ago for treating ankle impingement in ballet dancers.

Radiologists face a choice between relinquishing control of ultrasound for good or reclaiming a modality that could thrive in their hands through the next decade. An indication of which way the specialty is leaning can be gleaned from an October seminar in which luminaries dissected practice trends and applications in use of ultrasound.