Karen Boyd, ASQ CQA As long as there is a sonographer or ultrasonographer to accompany portable devices...

Alessandro Mazzarisi I would like to contribute to Edoardo Pagnini questions, sharing a few snippets of Luna Gargani and Giovanni Volpicelli's Open Access article. Young researchers that spent their life for extend US uses to improve quality of care: "How I do it: Lung ultrasound"
http://www.cardiovascularultrasound.com/content/12/1/25 -
* "In the next few years, point-of-care LUS is likely to become increasingly important in many different clinical settings, from the emergency department to the intensive care unit, from cardiology to pulmonology and nephrology wards."
- "In the last 15 years, a new imaging application of sonography has emerged in the clinical arena: lung ultrasound (LUS). From its traditional assessment of pleural effusions and masses, LUS has moved towards the revolutionary approach of imaging the pulmonary parenchyma, mainly as a point-of-care technique."

https://www.slideshare.net/ChrisBeckman/samnow-available-wrs?from_m_app=ios
More than imaging!!!😊

Marco Daoura Underutilized for three reasons:
1. - technology advancement. No longer a barrier, since now you can carry an ultrasound on you that is light, very capable for many protocols, empowering user to make decisions at the patient side, and very connected, wirelessly, to systems and networks...

2 - the thinking that only sonographers use ultrasound. Still a barrier in some cases. Physicians of many specialties are using ultrasound today, but not everywhere. And with advanced connectivity and improved information security, telemedicine is opening the door to other clinical provider roles to use ultrasound, such as mid-wives, technicians, paramedics, NP, nurses, and PA's, and leverage on telemedicine to bring scanner and decision maker closer in time and space.

Marco Daoura Continued -

3 - my second point brings us to training. Still a barrier, but with movements across the globe to improve. There are three types of trainings RE: ultrasound; a) knowing how to use the ultrasound system. A very simple problem. b) knowing how to get the needed images/views. And this requires knowledge of physiology and anatomy to potentially capture pathology. c) making a diagnosis, and this is the hardest to learn, because it takes many years of training and practice, and must be done by a physician. However, ultrasound can be used in many cases to rule things out and make an assessment, for a decision on how to proceed with patient care path. Let's note that many medical schools now include ultrasound training and many of the future physicians will have ultrasound training.

Interesting.....I appreciate the utility of US movement towards POC. Based on your questions posed Edoardo and LI group responses, I am beginning to think that its all around clinical nature of the modality. Though I am not clinical, but do greatly appreciate its importance with respect to imaging, but medical devices are business tools, i.e., SAP, Oracle, Office Suites, iPad/iPhone, etc. So would it be fair to add questions/responses with regards to reimbursements rates, cannibalization to other modality, and my favorite - Marketing the product. US is a "friendly" device to both patients and staff....no radiation to emit, and it costs less to both capex and opex. So, how should US be improved/positioned....and perhaps it starts with applications.

David Lim, Ph.D. RAC, CQA I am curious about what makes you say that "ultrasound is still underutilized" based on what criteria?

David Lim, Ph.D. RAC, CQA Joanne, I work with different types of medical products including devices based on various energy sources. So I have burning desire to hear more from you! :-) Please be more specific re "while less safe methods are being used."

I have worked on/with ultrasound for 25 years, and the changes in technologies is tremendous, but it takes a VERY skilled technician to find a diagnostic image. That is getting into cost effectiveness in many Hospital environments.

David Lim, Ph.D. RAC, CQA Joanne, OK, I see. You focus on imaging devices. I was more generally looking at the "use of ultrasound in medicine" including US-based surgical and imaging devices. US refers to UltraSound.

Apart from Imaging. I see Ultrasound becoming the next big thing in pain relief neurostimulators. Sound is far more controllable than RF based devices with less interference...

However the industry is far from accepting this technology..

David Lim, Ph.D. RAC, CQA Thanks, Joanne! Our gaps filled!

Oxford

Bedside pneumothorax continuous monitoring

On October 9th, the FDA approved High Intensity Focused Ultrasound (HIFU) for the treatment of prostate tissue. http://www.massdevice.com/fda-clears-sonacare-hifu-prostate-device-prompts-edap-to-yank-de-novo-go-for-510k/

HIFU will be one upcoming technology, but looking at the research community Ultrasound will hopefully allow much more applications in the future. Ultrasound tomography to be named as one (e.g. replacing mammography), or a higher acceptance of 3D ultrasound technologies (new imaging applications). Finally, with US you can in the future also provide functional imaging (using techniques such as ultrafast ultrasound) as a completely new domain. There will be more applications coming up, and as Yashwanth mentioned pain relief could be also one of them.