1. Ultrasound QA Review
2017 – 4th Quarter

2. Agenda John David (see US: Education for slides)
US Dept Update
David (see US: Education for slides)
Fistula Presentation
Dr. Gump (see US: Education for slides)
Elastography Research Presentation
Jenelle
RSNA – New US Technologies
QA Review
VP Upgrade
Bladder Jets
Renal measurements with cysts
OB – TV Cervix Indications
Elastography – non-fasting patient
Thyroid nodule – microcalcs vs colloid crystals
Continuing educational opportunities

3. New Ultrasound Technologies

4. GE – Logiq E9 XDclear 1st Pick – High End
Vertical banding in virtual convex is fixed on latest software
Our software was upgraded last month
Is the 9L penetration better on the upgrade?
Major new release is anticipated soon (?1-2yrs)
GPU = super fast
High frame rates
No limitations in triplex
All glass w/ touchscreen
Amazing color

5. Philips – Epiq 7 2nd Pick (distant) – High End Pros Cons
Quality monitor
Overall nice image
Good color
Cons
Start up 2.5min
Lateral resolution stinks
No raw data
Protocols available but…
can’t rearrange order
No gel warmer
Monitor tint map change stays
Frequency changes automatically

6. GE – Logiq S8 1st Pick – Midrange Great in the near field
?Breast US
Not good for penetration

7. Philips – Epiq 5
2nd Pick (distant) – Midrange

8. GE – Venue 1st Pick – Point of Care (large) Beautiful image GPU
Very easy to use
Depth and gain
All touch screen
Automations
Wall mount or cart

9. Mindray – TE7 2nd Pick – Point of Care (large) Nice image
Very easy to use
Depth and gain
All touch screen
Wall mount or cart

10. Philips – Lumify 1st Pick – Point of Care (handheld) $8K per tx
App based
Runs on non-IOS only
Great image
Very user friendly
No PW

11. Sonosite – iVIZ
2nd Pick – Point of Care (handheld)

12. Other Systems Evaluated
High End
Carestream (Touch Prime XE)
No elasto
Toshiba (Aplio i800)
Seimens (S3000/S2000)
Mindray
Point of Care
Seimens (Freestyle) – wireless
GE (V-Scan) – handheld
Clarius – wireless

13. Bladder Jets
Please include if there is known or suspected obstructive uropathy
hydronephrosis (including pregnancy)
hydroureter
ureterocele
stone at UPJ
Providers driven
helps to stage degree of obstruction
effects treatment planning

14. Kidney Measurements – with cysts
Which measurement would you have made? A B

15. Kidney Measurements – with cysts
Our radiologists would prefer a measurement excluding cysts
IF there are only a few cysts and IF they are avoidable
Exception – polycystic kidneys

16. OB2/3 – TV Cervix Indications
Automatic TV evaluation of cervix if the patient is high risk for preterm delivery:
Shortened TA cervix (<3cm)
Low-lying placenta (<2cm from os)
Hx of previous preterm delivery (<37wks)
Hx of cervical procedure
Any procedure performed after an abnormal pap smear
LEEP
cryoablation
Will be added to OLF

17. Maybe right here?
Stay tuned…
Yes/No “Hx Cervical Procedure”

18. Elastography – Non-Fasting Patient
The patient population for our elastography exams frequently do not prep properly
A non-fasting state can create an artificially high fibrosis score (up to 3hrs after eating)

19. Elastography – Non-Fasting Patient
If an elastography patient has not fasted appropriately, you can proceed with the exam IF:
GB is not contracted
AND
Fasting for at least 3 hours
3 hours

20. Viewpoint Upgrade coming “soon”
Will allow for more customization between sites
Fields that we don’t need will be deleted

21. Thyroid “Microcalcifications”
Thyroid nodule microcalcifications???

22. Thyroid “Microcalcifications”
Colloid Crystals
Increases likelihood of malignant nodule
Tend to be smaller and rounder
No comet-tail artifact
May shadow
Increases likelihood of benign nodule
Tend to be larger and flatter
Comet-tail artifact

23. Thyroid “Microcalcifications”
Look for and document comet-tail artifact
May be easiest to appreciate with a good cine
Try removing crossbeam as it can diminish posterior artifacts

24. Educational Opportunities
US Journal Meetings – every other week
Dr. Arnett Breast Imaging Lectures – every 6 weeks
Breast Ultrasound Registry Exam Study Group
Organized by Kathy Walker
In progress
first meeting was Oct. 26th
Vascular Ultrasound Registry
Exam Study Group
Starting at the end of the month
x8 weeks
Interesting Case Presentations
February