How Ultrasound Became Ultra Small
spectrum.ieee.org
spectrum.ieee.org
Medical imaging is not about getting the expected result as is typical in most bodies, rather, it is about getting the actual result as is found in this body.
Similar to blood work maybe nothing comes back conclusive but it might be interesting enough to trigger follow on investigation.
But the general theme is around augmenting the human decision maker rather than "preprocessing" the data in a way that might obscure or hallucinate important details.
I’m more interested in AIs ability to do things like read x-rays and identify illnesses with higher accuracy than a tired doctor on a 12 hour shift.
Sure, there are many applications and more coming. In your example of an actual result as is found in this body, the image segmentation [0] and recognition task is applicable.
One of the bullet points in the above is "Intra-surgery navigation." Let's say there is a known position of a tumor within an organ based on previous imaging. The human body is squishy and interior organs may shift in position or shape when a procedure is performed. Deformable image registration [1] guides the surgeon (human or robot) to the tumor location with greater precision than what was possible before.
0. https://en.wikipedia.org/wiki/Image_segmentation
1. https://paperswithcode.com/paper/voxelmorph-a-learning-frame...
I was in a lot of pain and was a bit groggy but my one clear memory is being fascinated by this and watching the tablet closely.
(The nerve block worked, but I don’t know that I would ever get one again. It definitely freaked me out).
I was able to watch the procedure on the screen. The ultrasound image was overlayed on a prior MRI image, and it was used to guide the biopsy where 12 core samples were taken of the prostate with a needle. It sounded like a staple gun each time a sample was taken!
Tiny Ultrasounds will be very useful for all sorts of biopsy procedures like this...
Wait till you have to have a catheter inserted up your pp.
From a physician (specifically radiologist) perspective, I'm a big fan of handheld/point-of-care ultrasound and am excited about their potential at democratizing a very useful and low-cost/low-risk imaging technology. (I also own a Butterfly.)
That being said, the "cart-based" ultrasounds will likely always have a place in a hospital; the size of the ultrasound probes is not why the cart is big/expensive/useful. The cart is a big floating screen and also an image/record management system. You (or at least, a trained ultrasound technician) can manipulate ultrasound parameters and annotate images (critical for ultrasound interpretation) way way faster on the cart's set of wonky keys/dials/trackball than on a smartphone.
Also, with the rise of handheld/point-of-care ultrasound, we've noted with amusement in the radiology department the frequency with which patients get referred for additional imaging because the ED or primary doctor saw some pathology on their handheld ultrasound... and when we take a look it is just not there. I think this is probably more of a training issue, as ultrasound is truly quite challenging both to perform AND to interpret (and a major part of using an ultrasound probe is essentially real-time interpretation), which is even more challenging given the lower image quality and field-of-view of smaller probes.
In radio we are seeing phased arrays and software defined systems becoming more popular.
Why can't we expand the resolution and increase the bandwidth with ultrasound as well using the same ideas.
Wouldn't we be able to get a more clear tomographic pictures if we used many receivers places around the body and layered different frequencies? I'm especially wondering why not use lower frequencies for deeper penetration, using phased arrays to offset the loss in resolution.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8774352
https://www.animalultrasoundassociation.org/what-is-ultrasou...
Secondary effect is that it lubricates the probe when you move it on the skin.
And then it also gives you a good chill which is to notify your organs that they are about to be photographed.
CT and MRI give pretty clean images that even a layman can understand. I have no problem identifying things on them.
Ultrasound is looking for a vague voxel of density that is or isn't where it's supposed to be. The implies that you need to know what the density looks like when it's normal vs abnormal. It's more like "Your liver is supposed to be there but there is a blob of water instead. Let's get you a CT scan." If it's abnormal, then you go confirm with a high-resolution scan system.
This has a LOT of room for error. Ultrasound is how they identify gallstones, but, in my case, the ultrasound said "Yeah, you've got some gallstones, but no big deal." When they removed them after my gallbladder exploded, they were almost an inch and a half across. The problem is that gallstones are mostly just globs of cholesterol that isn't much diferent in density from the surrounding fluid.
Ultrasound is okay, but cheaper, smaller, faster CT/MRI systems that don't need contrast dye would enable far better diagnosis as it would put imaging much closer to office physicians.
Imagine high school and junior high health classes teaching the use of these devices, getting the students certifications that require maybe 8 hours of coursework plus a 30-minute exam, then sending most of the clas home with a 21st century tricorder.
This is also an answer to a perceived problem, mixed with the XY problem; the problem isn't that there's not enough at-home diagnostic tools (a thermometer is enough for most households), the problem is access to health care, which has been messed with directly (cost of health care) and indirectly (people's physical health due to overconsumption, mental health due to gestures everywhere vaguely) by capitalism.
There is also a revolution in hone medical technology.
It takes a long time for us lay people with cool medical gadgets we got off eBay to learn what the results mean, but we will get there.
If fed.gov wants to help, they could test these devices, then offer training and certification so those who take advantage of the certification classes will know how to get reliable results and (more importantly) what the machines can not do.
What these small, portable machines will support is a lot of pre-hospital medics, working in remote or austere environments, to carry these devices and use them effectively.
There are already courses available to teach exactly this:
I suspect the main cost in running a diagnostic scan is labour rather than capital - and these low cost ultrasound devices will only have an impact in the developed world if they go hand in hand with AI.
Obviously they'll make a huge difference in developing countries where labour is relatively cheap compared to equipment - but even then it'll still require trained professionals to operate.
Thank you! As an ultrasound tech myself, I got a little ruffled at how many people in this thread think my job is pretty easy.
Great, even more of my private data being sucked up by big tech via my doctor's phone.
Did you know that post-Brexit / post-being-subject-to-EU-privacy-laws, Amazon got NHS's data?https://www.theguardian.com/society/2019/dec/08/nhs-gives-am...
While the article states that it did not include patient data, people living in the UK a few years before that had to opt out of their data being given to Amazon. Imagine that.
It's different from the MEMS-based devices this article talks about, which have the novelty of letting you do everything with a single probe. Though of course that comes with trade-offs.
Turning it into a small consumer level device sounds like it could lead to people causing themselves harm.
I'm simply stating that ultrasound does impact the body. Despite the innocuous sounding name referencing 'sound', it is less like music and more like a microwave, capable of breaking kidney stones, burning tumors.
Re the most common usage, I don't think lots of scans in pregnancy can be beneficial. Perhaps one or 2 scans are worth the risk in special circumstances. Present day scanning machines are way more powerful than historical ones; the dose is not getting safer.
I mean if you want to fearmonger, there's plenty more examples of things that can cause damage if used in a different way, like water, air, electricity, light, etc.
You seem to want to claim that any use of ultrasound is dangerous, but you fail to provide evidence, you just bring in extreme cases and try to claim equivalence. I'm sure there's a fancy sounding fallacy name for that.
The failure in the provision of evidence, is with those that claim it is safe. Its not for me to prove it is harmful.
Ask yourself, how can a treatment that breaks kidney stones or burn tumours also be 'safe'? It may be that the impact is negligible, but that is not safe. In the womb especially, a slight impact may have a large effect on a growing foetus.
Ask yourself too, what level of radiation is safe? How much microwaving? Is any?
So am I fearmongering, or is this a valid concern? I think it is clearly a valid concern. I do not simply accept medical consensus over the reasoning of my own mind.
I can see use cases where the information that is provided by ultrasound is useful and outweighs the risk. I think that casual, repeated usage of ultrasound for pregnant women, for the 'gender reveal'/colour scans or whatever, with powerful machines, is ill advised though. I don't recommend anyone undertake any unnecessary medical procedures.
I also think that an adult that has awareness of the scope of a potential impact, can do what they want - its their choice to do as they want. I object to inflicting avoidable harm (albeit the harm might not be obvious) to individuals that cannot consent - eg infants, foetuses.
FWIW, I do have kids, and - to my regret - I did scan them before they were born. I wouldn't do it now, knowing what I do.
The same way taking a bath can be safe, but a tsunami is not.
Why are you acting like you have scientific consensus behind what you're saying? There is literally zero proof of anything you're claiming.
>So am I fearmongering, or is this a valid concern?
You're fearmongering. That's it. Nothing else. It's the same kind of attitude that has led to such a self-important, 'I know better than doctors' attitude about vaccines.
Water has an impact on your body. Drink too much and it can harm you. What amount of water is safe?
etc., etc.
The technology enables us to learn and prevent so many problems, that to write it off just because at extreme levels it can be harmful is foolish.
And it's fearmongering to make that claim without evidence. See the summary here:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3262273/
> The first mention that ultrasound could be used to produce images of the foetal head was probably in a lecture given by Ian Donald in 1959. Since that time, the use of ultrasound in obstetrics has grown rapidly, and has a generally accepted excellent safety record. However, it is impossible to prove zero risk, and the absence of evidence of harm should not be taken as evidence of absence of harm. The epidemiological evidence that exists is reassuring as to the safety of routine ultrasound scanning, but of necessity it only includes subjects who were imaged with devices that were state of the art at the time (mostly early 1980s). No pulsed Doppler or colour flow examinations are included, and the output from modern ultrasound scanners is considerably higher today than it was at that time. It is, therefore, essential to remain vigilant, and to assess new technologies and applications from a safety aspect as they arise.
So TL;DR: Ultrasound is safe, the benefits outweigh the risks by a large margin, and we should always insist that Ultrasound, and any modern medical technology is held to rigorous scientific testing standards.