Greg Freiherr, Industry Consultant

Greg Freiherr has reported on developments in radiology since 1983. He runs the consulting service, The Freiherr Group.

Blog | Greg Freiherr, Industry Consultant | September 09, 2011

Ultrasound: Bone of contention

It’s old school that bone and ultrasound don’t mix. And it makes sense. Sonography is all about echoes, and what reflects sound better than bone? But modern ultrasound has entered a gray area, where such clear-cut distinctions no longer apply.  

Nothing less than a complete revamping of the modality is needed to change the fact that ultrasound has a tough time penetrating bone. But clinicians are finding that visualizing the outer surface of bony structures and the tissue surrounding them may be enough.  

Dr. Simon Ostlere, a consultant musculoskeletal radiologist at the Nuffield Orthopaedic Centre in Oxford, U.K., advocates the use of ultrasound to initially evaluate patients suspected of complications arising from total hip replacements and hip resurfacing. This is particularly so for patients who have metal-on-metal implants, because ultrasound is not prone to artifacts caused by metal, as are computed tomography (CT) and magnetic resonance imaging (MRI).

In the September issue of the American Journal of Roetgenology, Dr. Ostlere notes that “small lesions lying close to the prosthesis may be overlooked on MRI but are clearly visible on ultrasound.” (http://www.ajronline.org/content/197/3/558.abstract) Consequently, this simple, low-cost and extraordinarily safe modality – thanks to its lack of ionizing radiation – is the method of choice for initially evaluating orthopedic implants, he concludes.

While ultrasound cannot see what’s inside bone, it can contribute to orthopedics as part of a tag team. Earlier this year, at the annual meeting of the American Academy of Orthopaedic Surgeons, Dr. Michael Mott, an orthopaedic oncologist at Henry Ford, reported that fusing CT data with real-time ultrasound allows safe and precise needle biopsy of bone cancers.

Biopsy under ultrasound fusion was found to be 93 percent accurate, substantially better than the 90 percent accuracy achieved when biopsy was done under CT alone. But patient convenience and clinical productivity, rather than accuracy, will likely be the driving forces, if this pairing is adopted. It’s easier to schedule a biopsy for an ultrasound suite, Mott reported, than for a CT suite.

Convenience, simplicity and low cost will win converts to ultrasound in the years to come, as innovators come up with new ways to press into applications once beyond the traditional bounds. Orthopedics exemplifies how, when it comes to ultrasound, old school thinking no longer applies.
 

Related Content

Feature | RSNA 2017 | November 20, 2017
Here is an aggregation of ITN content for all major radiology technology areas this past year.
Light and Ultrasound Waves Allow More Precise Excision of Skin Cancer Tumors

3-D MSOT rendering of a basal cell carcinoma. Image courtesy of Singapore BioImaging Consortium

News | Oncology Diagnostics | November 20, 2017
Scientists and clinicians from Singapore and Germany have successfully used multispectral optoacoustic tomography (MSOT...
DiA Imaging Analysis Partners With GE Healthcare on Automatic Imaging Analysis Tools

LVivo EF analysis software. Image courtesy of DiA Imaging Analysis

News | Ultrasound Imaging | November 20, 2017
DiA Imaging Analysis announced it has signed a multi-year, non-exclusive licensing and professional services agreement...
News | Ultrasound Imaging | November 17, 2017
CIRS Inc. recently announced the acquisition of ATS Laboratories in Bridgeport, Conn. This merger brings together both...
Sponsored Content | Videos | 3-D Printing | November 17, 2017
Dee Dee Wang, M.D., Director, Structural Heart Imaging at Henry Ford Hospital, Detroit, explains how her center uses
Keith Dreyer, DO, said artificial intelligence is one of the most important developments to watch in radiology at the opening session of RSNA 2016.

Keith Dreyer, DO,  said artificial intelligence is one of the most important developments to watch in radiology at the opening session of RSNA 2016.

Feature | Artificial Intelligence | November 17, 2017
November 16, 2017 — The American College of Radiology Data Science Institute (DSI) will provide the framework, strate
Verathon Introduces BladderScan Prime Plus Portable 3-D Ultrasound
Technology | Ultrasound Imaging | November 16, 2017
Verathon Inc. announced the launch of its new portable 3-D ultrasound instrument, BladderScan Prime Plus. Powered by...
Carestream Begins Shipping MyVue Center Self-Service Kiosk in Select Countries
News | PACS Accessories | November 16, 2017
Carestream Health began shipping its MyVue Center Self-Service Kiosk that can enhance patients’ ability to access and...
Siemens Healthineers Signs Service Agreement With WhidbeyHealth Community Health System
News | Population Health | November 14, 2017
November 14, 2017 — Siemens Healthineers and WhidbeyHealth of Washington State have signed a ten-year, enterprise-wid
Upcoming radiology conferences, meetings and events.
News | November 13, 2017
ITN maintains a comprehensive listing of radiology specialty meetings on its website at ...
Overlay Init