· Expecting Big Things from Smallest Ultrasound
· Spotlight on Screening: Ultrasound on the Move!
· First Again!
· Tech Zoom: SonoSite’s M-Turbo Promises Big Processing Power

Expecting Big Things from Smallest Ultrasound

With the portable ACUSON P10, hospital personnel can perform ultrasound exams at the patient’s bedside.

Siemens Medical Solutions, Malvern, Pa, made a big announcement in early October about the launch of the world’s smallest ultrasound system, a pocket-size solution named the ACUSON P10.

A little larger than the size of a common PDA, the diagnostic ultrasound system weighs a mere 1.6 pounds, fitting easily into a lab coat pocket. According to Siemens, it is intended for use in complementary initial diagnostic care and triage, specifically in the fields of cardiology, emergency care, and obstetrics.

“There is always a need to bridge the gap between the traditional stethoscope and the echo machine,” said Eyal Herzog, MD, director of the Cardiac Care Unit at St Luke’s-Roosevelt Hospital Center in New York.

In emergency situations, users can operate the Focused Assessment with Sonography for Trauma (FAST) application to detect fluid that can determine cardiac activity and pericardial effusion. FAST also can be used to detect abdominal aortic aneurysms and perform pelvic exams. In obstetrics, the device can determine fetal viability and positioning, amniotic fluid volume, and bleeding.

Herzog said he is currently in the process of testing the pocket ultrasound in clinical trials, comparing the quality of the image with that of a regular echocardiography machine. While he cannot divulge the results of the trials until after the information has been published in a medical journal, Herzog said he has already submitted his findings and is awaiting a decision on its acceptance.

He also discussed some of its obvious benefits, including its flexibility, portability, and the potential for better patient outcomes stemming from the change in the way physical exams are administered.

“Instead of having to rush the patient to the technology, the P10 system brings the technology to the patient,” Herzog said. “This can save critical minutes, especially when a patient is in cardiac distress or with trauma patients, who have multiple injuries.”

Herzog went on to point out one disadvantage, a downside that is akin to that of many of the pocket ultrasound models currently available in the market: the lack of color flow. However, he anticipates that roadblock to be hurdled very soon.

“I do believe that in the near future, they are going to overcome this, and when they do have color flow, this will be a fascinating tool,” he said. “We hope that in a few years, this may be a tool that could be similar to the way we practice with stethoscopes.”

The device, which has been cleared by the FDA, will be made available for direct purchase via www.pocketultrasound.com. It may be purchased and operated only by licensed medical professionals.

—Elaine Sanchez

Spotlight on Screening: Ultrasound on the Move!

Mobile units screen for carotid artery blockages and more

Screening for carotid artery blockages has the potential to prevent stroke before death or disability, and one company is leveraging the power and affordability of portable ultrasound to bring Doppler screening to patients over 50 for a low price. Life Line Screening, Cleveland, dispatches more than 80 teams all over the 48 contiguous states every year, screening more than a million people for asymptomatic carotid artery stenosis, abdominal aortic aneurysms, peripheral arterial disease, and osteoporosis, charging $129 for the four tests.

“What we do is send the tests to a board-certified physician licensed in the state,” explained Rena Law, Life Line’s director of clinical operations. “They review the results, and our processing center sends them to the recipient within 21 days. But if someone has a critical finding, we go ahead and give them the information that day and recommend that they take it to their physician within 24 hours.”

The Life Line Screening teams, which consist primarily of ultrasound technologists—the company is the largest single employer of ultrasound techs in the country—move from location to location in vans. “All of our equipment fits in the van,” said Law. “So we take everything out of the van and set it up at the site,” which is generally a church or community center, according to Law. “We form four screening stations, and most people choose to get all four screenings.”

Since starting up in 1993, the business has screened more than 5 million people. Only 1% or so of findings qualify as critical, but around a tenth of the total test results register as abnormal. “For abnormal results,” Law explained, “we have a protocol in place where a second technologist will come over and scan that patient again, and then the results are FedEx-ed to the participant so they get it earlier and we have a record of them receiving it.” The physicians who review the exams are vascular surgeons, cardiologists, and radiologists.

Recent advances in ultrasound technology have helped Life Line Screening expand its reach, Law noted. “We’re in the process of switching to the GE LOGIQ e laptop,” she said. “All the teams don’t have it yet, but hopefully, they’ll all get it within the next year. Our older machines that we have in use [weigh] 400 pounds. The laptop’s four pounds. It really makes a difference.”

Law also notes that, with an abnormal findings rate of 8% to 10%, it’s important for people over the age of 50 to be screened before problems manifest themselves in a serious way. “If you have symptoms, you can go to your doctor and order these tests,” she said. “This screening is meant for people who are asymptomatic.”

—Cat Vasko

First Again!

Philips ranks #1 in IMV’s overall service performance in ultrasound

For the 15th consecutive year, customers who participated in the 2007 IMV ServiceTrak surveys have billed the Medical Systems division of Royal Philips Electronics of Andover, Mass, as best in overall service performance for Ultrasound All Systems, comprising radiology/ob-gyn and cardiology instruments.

This year’s analysis also showed Philips to have the top ranking in overall manufacturer satisfaction, in addition to sharing the No. 1 spot in probability of repurchase for ultrasound.

Tom Kirkland, senior vice president of customer services in North America for Philips Medical Systems, said the results are a testament to Philips’ team of dedicated service professionals. Kirkland also applauded the company’s continued success in overall service performance feedback.

“IMV ServiceTrak surveys provide valuable feedback, not only to measure what we’re doing well but also to identify areas for improvement,” Kirkland said. “As we seek to deliver on our promise of sense and simplicity, we will continue to work harder and smarter every day to help our customers provide superb patient care.”

The independent survey, issued by IMV Limited, prompted customers to rate ultrasound systems manufacturers on a broad range of factors across the product-ownership life cycle.

The survey reflected a total of 2,345 responses. Participants were asked to examine 34 unique factors.

For the Ultrasound All Systems report, Philips achieved top ratings in 20 factors, including service follow-up, service engineer performance, satisfaction with service and manufacturer, effectiveness in help desk telephone support, remote dial-in diagnostic support, and system installation. The company scored equal or above the industry average in 32 categories.

Industrywide, the company also holds the lowest callback rate for a recurring problem within 48 hours of service. In addition, it possesses the lowest number of on-site visits in a 90-day period.

In a separate Ultrasound Radiology/Ob Gyn ServiceTrak report published this year by IMV, Philips earned 12 top ratings, receiving the most No. 1 ratings in the industry this year and an overall service performance rating well above the nearest competitor.

—E. Sanchez

Tech Zoom: SonoSite’s M-Turbo Promises Big Processing Power

New from SonoSite Inc, Bothell, Wash, is the company’s latest hand-carried ultrasound unit, the M-Turbo. The release of M-Turbo marks the launch of the company’s fourth major product platform in 8 years.

M-Turbo weighs slightly less than SonoSite’s popular MicroMaxx hand-carried system, but delivers a 16-fold increase in processing power by simultaneously running multiple advanced algorithms. SonoADAPT Tissue Optimization adjusts imaging parameters based on exam type and patient size, eliminating clinician manipulation of multiple controls. SonoHD Imaging Technology uses the system’s advanced processing power to reduce speckle noise and other image artifacts; SonoMB Multi-beam Imaging, available on all M-Turbo transducers, increases the resolution of small structures and enhances border delineating while maintaining temporal resolution.

“I think the system is fantastic,” said Diku Mandavia, MD, attending staff in the Department of Emergency Medicine at Cedars-Sinai Medical Center, Los Angeles. “SonoSite has truly evolved its product to a very powerful system that integrates the latest technology. The image provides clarity at every level and by definition will make a major improvement to patient care. They have provided an exceptionally high level of performance, but streamlined the process to obtain an image in an already easy-to-use interface.”

SonoSite also is introducing a new phased array transducer and intracavitary probe with the system; M-Turbo comes with a total of seven transducers designed to cover a full range of clinical and procedural guidance applications for abdominal, nerve, vascular, cardiac, venous access, small parts, and superficial imaging. The two new transducers—the P21x/5-1 phased array transducer and the ICTx/8-5 curved array transducer—offer higher image quality and improved design for optimal patient and clinician comfort.

“The image quality of the nerve sub-structure and nerve bundles delivered by the M-Turbo system is truly outstanding,” said Stuart A. Grant, MD, director of medical student education and assistant professor of anesthesiology at Duke University Medical School, Durham, NC. “Its image quality and ease of use will make it easier for clinicians to learn and successfully perform regional nerve blocks. Additionally, the ability to download images onto a USB thumb drive makes it simple to acquire and archive images for use in teaching and for patient records.”

Also of use in teaching is SonoSite’s new “education key,” a thumb drive containing system operation visual tutorials, application-specific video refresher programs, and an image reference library of application-specific sonographic anatomy, all available for playback on the M-Turbo system.

Finally, M-Turbo is the first medical device to integrate Da Vinci technology from Texas Instruments Inc, Dallas. Da Vinci enables the export of digital videos and images to a USB storage device in standard PC formats, including MPEG4, JPEG, HTML, and BMP.

“Rapid boot from a cold start and reliability are hallmarks of our products and essential in critical medical situations,” said Dave Willis, vice president at SonoSite. “The Da Vinci processor, which offers state-of-the-art multimedia capabilities in a small footprint and requires minimal power, fits with our product philosophy. Our proprietary, dedicated ASIC microchips perform the bulk of the ultrasound processing and eliminate the need for large power-hungry processors and operating systems.”

—C. Vasko