The Renaissance Modality
Lisa Fratt, Editor
Over the last several years, ultrasound has resided in a state of near constant transformation and signs point to the beginning of a Renaissance era. However, radiologists need to remain cognizant of a few critical caveats as they reflect on the future of ultrasound.

One of the most startling developments in the ultrasound market has been the continued downsizing of both size and price point, with the latest systems on par with smartphones in the size department. This downsizing of the handheld segment is fueling double-digit growth in the compact ultrasound market (defined as systems weighing less than 14 pounds).

According to a new report, produced by Klein Biomedical Consultants, the U.S. compact market spiked 21 percent in 2010, and the global market will hum along with continued double-digit growth over the next five years.

The hitch for radiologists is that the uber-portable, low-cost handhelds can be easily diffused across the enterprise to cardiologists, emergency medicine physicians and other clinicians and may displace full-featured, stand-alone systems housed in radiology departments. It’s critical that stakeholders across the enterprise discuss and agree on appropriate applications and understand the benefits and limits of handheld systems as we edge nearer to the “ultrasound stethoscope.”

At the same time, high-frequency ultrasound (HIFU) is emblematic of a promising future for radiology, according to Jeff Goldsmith, PhD, of University of Virginia department of public health sciences and Health Futures, both in Charlottesville. HIFU represents the nascent science of theranostics, which weds diagnosis and therapy. Current applications include using HIFU to heat and destroy uterine fibroids and prostate tumors. Researchers are exploring the possibility of employing ultrasound to locate arterial bleeding sites and using the HIFU signal to stop the bleeding. Such developments could spur new roles for radiology.

Finally, as CT continues to come under fire for radiation exposure, clinicians are turning to ultrasound as an alternate modality where applicable. For example, physicians should consider ultrasound as a reasonable screening tool in the evaluation of acute appendicitis, according to a study of pediatric patients in the December issue of the Journal of Ultrasound in Medicine. For indications in which ultrasound is clinically valid, it brings a pair of key advantages. It’s ubiquitous and economical. However, it’s critical that the ultrasound study provide the needed information rather than the open a Pandora’s box, spurring additional diagnostic questions and tests.

As always, we welcome your insights and comments. Stay in touch.

Lisa Fratt
Editor of Health Imaging & IT