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

3D Systems Announces On Demand Anatomical Modeling Service
Technology | Medical 3-D Printing | June 18, 2018
3D Systems announced availability of its new On Demand Anatomical Modeling Service. This new service provides a wide...
News | Remote Viewing Systems | June 14, 2018
International Medical Solutions (IMS) recently announced that the American College of Radiology (ACR) added IMS'...
Hitachi Medical Systems Europe Named Imaging Supplier for London Prostate Cancer Program
News | Prostate Cancer | June 14, 2018
Hitachi Medical Systems Europe has been awarded the contract to supply six ultrasound systems as part of the RAPID...
Technology | Orthopedic Imaging | June 13, 2018
EOS imaging announced it has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for its hipEOS...
Wake Radiology Launches First Installation of EnvoyAI Platform
News | Artificial Intelligence | June 13, 2018
Artificial intelligence (AI) platform provider EnvoyAI recently completed their first successful customer installation...
Reduced hippocampal volume on MRI

This figure shows reduced hippocampal volume over the course of 6 years as seen on progressive volumetric analysis and also coronal MRI evaluations (arrows).Progressive volume loss in the mesial temporal lobe on MRI is a characteristic imaging feature of AD. This patient was a case of Alzheimer’s Dementia.

 

News | Neuro Imaging | June 12, 2018
According to a UCLA Medical Center study, a new technology shows the potential to help doctors better determine when...
How AI and Deep Learning Will Enable Cancer Diagnosis Via Ultrasound

The red outline shows the manually segmented boundary of a carcinoma, while the deep learning-predicted boundaries are shown in blue, green and cyan. Copyright 2018 Kumar et al. under Creative Commons Attribution License.

News | Ultrasound Imaging | June 12, 2018 | Tony Kontzer
June 12, 2018 — Viksit Kumar didn’t know his mother had...
High Prevalence of Atherosclerosis Found in Lower Risk Patients
News | Magnetic Resonance Imaging (MRI) | June 08, 2018
Whole-body magnetic resonance angiography (MRA) found a surprisingly high prevalence of atherosclerosis in people...
Zebra Medical Vision Unveils AI-Based Chest X-ray Research
News | Artificial Intelligence | June 08, 2018
June 8, 2018 — Zebra Medical Vision unveiled its Textray chest X-ray research, which will form the basis for a future
Konica Minolta Launches AeroRemote Insights for Digital Radiography
Technology | Analytics Software | June 07, 2018
Konica Minolta Healthcare Americas Inc. announced the release of AeroRemote Insights, a cloud-based, business...
Overlay Init