Advances in Medical Imaging

Dr. Fiona Gilbert, Roland Sutton Chair of Radiology at University of Aberdeen Institute of Medical Sciences, discusses her research findings that showed that the rate of breast cancer detection by two experts reading a mammogram was the same as one expert aided by a computer. Dr. Gilbert explains to host Dr. Jason Birnholz that, unlike in the United States, it is normal practice in the United Kingdom for two trained readers to examine mammograms. Tune in to hear how computer-aided detection is likely to improve breast cancer detection in those countries where a single reader is used, as well as improve efficiencies in countries that require two readers. 

Thanks to extremely sensitive ultrasound technology, thyroid nodules are being detected and treated at unprecedented rates. Host Dr. Beverly Hashimoto welcomes Dr. John Cronan, professor of diagnostic imaging at the Brown University School of Medicine and chairman of the diagnostic imaging department at Rhode Island Hospital, to discuss the phenomenon of over-treatment of thyroid nodules. Is this pattern of care helping or harming our patients?

Developments in ultrasound technologies yield superior image quality.  But these new technologies are also designed to maximize information density– minimizing acquisition time, decreasing analysis time, and simplifying reporting. Dr. Roee Lazebnik, a radiologist with a PhD in biomedical engineering, employed by Siemens Healthcare, explains to host Dr. Jason Birnholz how the new ultrasound imaging equipment gives greater information density by increasing the amount of clinical information derived from an image.

Dr. Vicki Noble, director of the Division of Emergency Ultrasound at Massachusetts General Hospital in Boston, discusses with host Dr. Beverly Hashimoto the importance of ultrasound in the critical care setting.  In the emergency department, ultrasound can improve the physican's ability to administer appropriate treatment during the crucial "golden hour" of trauma.  Dr. Noble also discusses six additional applications for ultrasound in the emergency department.

More than amazing images, the utility of three dimensional ultrasound images in obstetrics is expansive, according to guest Dr. Beryl Benacerraf, director of obstetrical ultrasound at Massachusetts General Hospital. Dr. Benacerraf and host Dr. Beverly Hashimoto talk about the ability of volume imaging to capture an image of the uterus from a coronal view, a view that is critical for assessment but could not be obtained through traditional portals of entry prior to 3-D imaging. Dr. Benacerraf also illuminates the diagnostic benefits of other display modalities permitted by volume imaging, such as surface renderings and tomographic cuts.

Ultrasound elastography, or tissue strain imaging, can provide real-time quantitative analysis on deep tissue and small nodules that elude palpation.  Dr. Brian Garra, professor and vice chair of radiology at the University of Vermont College of Medicine, discusses with host Dr. Jason Birnholz, what makes this method of imaging like “palpation on steroids.”  How can elastography technology help catch disease in its earliest stages, and in some cases even make biopsy unnecessary?

So small, it is called the ‘pocket ultrasound,' Dr. Eyal Herzog, director of the cardiac care unit at St. Luke's-Roosevelt Hospital Center in New York, discusses with host Dr. Jason Birnholz the results of his research on the handheld portable ultrasound unit in the cardiac care department. Dr. Herzog reports no significant differences in image quality compared to the larger, high-end machine. The portability of the handheld has the capacity to improve care by increasing the speed at which we can assess critically ill patients.

Dr. David Hellman, chairman of the department of medicine at Johns Hopkins Bayview Medical Center, examines with host Dr. Jason Birnholz the limitations of the current physical exam, and the potential of the portable ultrasound to improve the primary care physician's diagnostic capabilities. Dr. Hellman outlines studies done at Johns Hopkins Bayview Medical Center which indicate that, while physicians did not acquire the images as well as ultrasound technicians, their interpretations were almost as accurate. Someday, Dr. Hellman expects, this technology may become a commonplace tool of the physician.

Dr. Mani Vannan, professor of clinical internal medicine at the Ohio State University College of Medicine, reports how the latest ultrasound technology has dramatically improved echocardiography by enabling the acquisition of a full volume image in one heartbeat. In addition, the new technology of the ultrasound equipment produces meaningful output information from the image. Dr. Vannan also explains to host Dr. Jason Birnholz the practical implications these enhancements have in terms of diagnosing cardiovascular conditions and enhancing workflow productivity.

Although most abnormal vaginal bleeding is caused by hormone imbalance, it can be indicative of polyps, myomas, and cancers of the cervix and endometrium. Dr. Dawna Kramer, a radiologist within the department of radiology, ultrasound section at the Virginia Mason Medical Center in Seattle, discusses with host Dr. Beverly Hashimoto several ultrasound techniques, including sonohysterography, for determining the cause of post- and pre-menopausal vaginal bleeding.