Feature | September 13, 2013| Dave Fornell

Going Beyond 3-D in Cardiovascular Ultrasound: The Next Step to Improve Reproducibility, Speed

There are two main issues facing clinical practice today, including lower reimbursements and the need to see more patients, which combined calls for technology that can improve efficiency and increased patient throughput. In addition, there are inherent issues with traditional 2-D ultrasound imaging technology, including that the quality of image acquisition relies on the skill and experience of the operator. Also, 2-D images are flat slices, so measurements are dependent on the transducer angle, section of the anatomy chosen to take a measurement, and again on user experience and skill level. Combined, this leads to issues with reproducibility. 
 
There have been several technological advancements to help address these issues, the biggest of which is 3-D echo. While 3-D echo adoption started out slow because it was time-consuming to use, today’s systems offer much improved speed and automation. It used to take 30 minutes to an hour to create cardiac images manually. But, as faster computer processing became available and vendors streamlined workflow and automated steps, today it takes less than 30 seconds to create the same cardiac views.
 
The use of 3-D echo can help improve the accuracy and reproducibility of cardiac quantification. The technology has the advantage of removing the inter-operator variability by imaging whole volume datasets of the heart, so specific images or organ views can be extracted and reconstructed in any position, similar to CT or MRI datasets. Also, because a volumetric dataset is captured, exam times can be shortened, instead of spending time trying to get just the right angle for a 2-D slice view. Cardiac quantification can also be improved by measuring the entire heart or ventricle, rather than just slices of it. New software also automates this quantification.
 
At the American Society of Echocardiography’s (ASE) 24th Annual Scientific Sessions held in June, it was evident there is growing adoption of 3-D echo. The main trends in 3-D focused on increased automation to streamline and the collection of more quantitative data from images. 
 
Among the new technologies discussed was what I consider the next step in 3-D echo ­— the use of artificial intelligence to immediately identify the anatomy being imaged and then extract the views required for automated quantification and clinical diagnosis. While the technology is cool from the sci-fi standpoint, there are many who will wonder why we need this and stand by the belief that only a highly skilled echocardiographer should be doing this job. I would agree, but in light of increasing numbers of patients entering the system under healthcare reform and as the baby boomers continue to age, this type of automation may help speed exams to timeframes never before possible.
 
Philips Healthcare has developed smart anatomical imaging software, which it released commercially Aug. 30 with the introduction of its new Epiq premium ultrasound system. It addition to being able to identify cardiac anatomy on its own with out human interface, the system can identify anatomy throughout the body for use in OB/GYN and general imaging. This might help in leveling the playing field between experienced echo and ultrasound technologists and novice ultrasound system users. The need for this type of technology is becoming greater as the number of patients in the U.S. healthcare system expands, while at the same time as the proliferation of point-of-care ultrasound systems is rapidly expanding into all areas of medicine.
 
I suspect this type of smart anatomical imaging will be among the top highlights of new medical imaging advances at the Radiological Society of North America (RSNA) meeting in December. 

Related Content

Arterys, 4-D Flow software, cardiac MRI, RSNA 2016
Technology | Advanced Visualization| November 21, 2016
November 21, 2016 — Arterys will showcase its recently U.S.
Sponsored Content | Videos | CT Angiography (CTA)| November 18, 2016
A discussion with Simon Dixon, M.D., MBChB, on the use of fractional flow reserve-computed tomography (FFR-CT) to eva
TeraRecon, WhiteClouds, 3-D printing, 3D Print Packs, RSNA 2016
Technology | 3-D Printing| November 16, 2016
TeraRecon, together with full-color 3-D printing cloud provider WhiteClouds, announced new technological and workflow...
PET/CT, calcium blockages, heart attack risk, Intermountain study, American Heart Association, AHA Scientific Sessions 2016
News | PET-CT| November 15, 2016
Many people who experience chest pain but don’t have a heart attack breathe a big sigh of relief when a stress test...
Siemens, Healthineers, public listing, healthcare business
News | Business| November 11, 2016
Siemens announced it intends to further develop its healthcare business, Siemens Healthineers, and give it even greater...
PET/CT, atherosclerotic plaque detection, Stanford University

Application of dual-modality optical and PET/CT activity-based probe in experimental carotid inflammation model. Coronal noninvasive PET/CT scans of (A) healthy and (B) diseased mice with and without ligated carotid arteries respectively. Inset images show optical ex vivo florescence imagining of (A) healthy and (B) diseased carotid arteries.  PET/CT and optical images courtesy of Xiaowei Ma, Toshinobu Saito and Nimali Withana.

News | PET-CT| November 01, 2016
Researchers at Stanford University have demonstrated for the first time the use of a dual optical and positron emission...
cybersecurity, healthcare industry, SecurityScorecard report, social engineering, cyberattacks
News | Information Technology| October 31, 2016
SecurityScorecard, a security rating and continuous risk monitoring platform, released its 2016 Healthcare Industry...
GE Healthcare, Revolution CT, Whisper Drive, RSNA 2016, cardiac imaging
News | CT Angiography (CTA)| October 31, 2016
At the 2016 annual meeting of the Radiological Society of North America (RSNA 2016), GE Healthcare will introduce the...
RFID inventory control in the cath lab, inventory management, cardinal

An example of RFID cabinets in a cath lab. As items are pulled from the cabinet, the inventory control system automatically determines what items were take out and adds them to the patient case. The system can also help locate recalled or expired items, and automatically track on-hand inventory to avoid manual counts.

Feature | Inventory Management| October 28, 2016 | Jean-Claude Saghbini
The healthcare industry’s transition to value-based care leaves no room for waste, and yet we know that inefficiency
Sponsored Content | Videos | Inventory Management| October 28, 2016
With quality of care and cost efficiency at the top of your mind, there is no room in your hospital for waste from hi
Overlay Init