The Research Sonographer

Research sonography is not a common term when talking with fellow sonographers. There is no specialty exam or formal training involved. I would like to say research fell into my lap, but I was determined to learn as much as possible about ultrasound research in my earliest days. As a student at Thomas Jefferson University, I spent a lot of time hanging around the Research Institute. During my first job at UCSD, I started volunteering with the contrast ultrasound research team. I volunteered my lunch breaks and came in early before my shift at 7 am.  An opportunity opened to work on 2 simultaneous CEUS clinical trials as a research coordinator/sonographer. Looking back, I had no idea what I was doing but I knew I was up for the challenge.IMG_1175

Together with help from my mentors, we created a research sonography position. I asked A LOT of questions. I learned how to write research protocols and submit for IRB (Institutional Review Board) review. The clinical trial monitors were gracious enough to teach me source documentation and the regulatory aspect. When the clinical trials ended, I spent nearly 10 years at Philips learning the medical device side of ultrasound. Eventually, I followed my passion and went back to clinical research when an opportunity opened at the FDA as a contractor; and now I am pursuing my master’s in clinical research management-Regulatory Science. Opportunities are always created if you follow the instincts that drive you.

The first hurdle is funding a research position. Whether funded by a clinical trial or applying for grant money, the process can be laborious. Sometimes a lapse between awards can occur but, in general, the budget is stretched so there is no loss in coverage. Every year, the project or position can be up for financial renewal. Planning for the next financial award is always on the horizon. Therefore, research sonography jobs usually hire for short-term employment, unless a Radiologist you are working with has grant money for a project. I recognize this path is not a stable one, not nearly as long-term as a departmental position would be.

Some crave the stability of 10–20 years ahead with one employer. I think the Research Sonographer is one that likes to accept challenges; is interested in science, research, and development; and has a yearning to think outside the clinical box and challenge the status quo in a way clinical sonography does not present itself. But this is not for everyone.

There are differences in clinical and research ultrasound. The investigators’ research protocol is the imaging parameters that will be followed, not The Standards, CPT codes, or departmental protocol. I ascertain this as a challenge; once you have the transducer and start driving, it is difficult to not diagnose and document images in an orderly fashion. Instead, we are examining a hypothesis and proving specific aims. There is a shift in cognitive thinking that needs to occur. Setting up a controlled environment with repetitive imaging to prove a hypothesis is imperative. It is most important to re-create the same controlled imaging environment on all subjects and then analyze the data off-line.

How does one become a research sonographer? Situations arise that are different in every corner of the country. Align with a research-based physician, coordinator, or mentor, at a university hospital or outpatient center that performs research. Start on a small project, volunteering your time and evaluate the differences. You may find research is not at all interesting for your personality type. Search for clinical trials in need of a sonographer, usually posted on on-line ultrasound job boards. A good website to search for on-going or upcoming trials is http://www.clinicaltrials.gov. Search for clinical trials that involve sonography, ie, fertility, where the exam times are usually early morning before the volunteers go to work. Remember research sonography is not the same as performing an entire pelvic exam. The sponsor will only want images on what the protocol states, so exam times and ergonomics are reduced. You might be measuring the bladder volume or the volume of an ovary, in total. Align with a mentor that will help you carve out your path, follow your instincts, and seek out opportunities that will lead in your direction.


Are you a research sonographer? Share your experience. Comment below, or, AIUM members, continue the conversation on Connect, the AIUM’s online community.

Karen Alton, BS, RDMS, RVT, is a graduate student at Arizona State University, an owner of Karen Alton Consulting, LLC, and is an Ultrasound Imaging Research contractor at the US Food and Drug Administration.

POCUS in Pediatrics

Do you work in a children’s hospital? Do you perform POCUS? Do you ever wonder if other divisions in your hospital are using POCUS as well?

Point-of-care ultrasound (POCUS) is growing quickly across all medical specialties, including pediatrics. Within pediatrics, POCUS is being utilized in the emergency department, intensive care unit, operating room, clinic as well as on the inpatient floor. While the scope of practice may differ across sub-specialties, the issues pertaining to education, training, credentialing, equipment procurement, and workflow solutions are universal.A Abo

At Children’s National Medical Center (CNMC) in Washington, DC, we have established a hospital-wide oversight committee for POCUS, which is a multi-disciplinary effort throughout the institution. Our aim is to standardize the use of POCUS across the hospital with respect to
1) education/training/credentialing,
2) documentation/image archival, and
3) maximizing the financial benefit.

Education, Training, and Credentialing

Each division who uses POCUS should have a champion who is responsible for the education and training of both trainees and faculty within the division. Many faculty in pediatrics, and pediatric sub-specialties, were not trained in POCUS as part of their residencies and fellowships; therefore, the opportunity to learn POCUS as a faculty member is incredibly important. Once competent in POCUS, faculty should have the ability to become credentialed in POCUS. A hospital-wide POCUS initiative can promote POCUS education across divisions through collaboration. Divisions can share POCUS curriculums with one another in addition to sharing resources. For example, divisions can bring their resources together and host a hospital-wide POCUS course. Furthermore, at CNMC, we recently received a grant to establish an ultrasound simulation program, which will be incorporated into our hospital-wide simulation program.

Documentation and Image Archival

Divisions that are using point-of-care ultrasound for medical decision making or procedural guidance should be documenting their findings in the medical record and archiving the appropriate images. In an ideal world, the ultrasound images would be accessible in the medical record, along with the documentation. The ability to view the POCUS images, by all clinicians providing care, improves the flow of knowledge among clinicians and in turn, improves patient care. From a workflow standpoint, the ability to archive the images in a centralized location, with the ability to connect the images to the electronic medical record, may be better accomplished as a hospital-wide initiative.

Maximizing the Financial Benefit

Collaboration among the divisions using point-of-care ultrasound can have a financial impact as well. For instance, when purchasing ultrasound equipment, the cost per machine is lowered when purchased in bulk. Furthermore, once the infrastructure is in place with respect to credentialing as well as the ability to document and store ultrasound images, clinicians may have the ability to bill for their services.

In order to accomplish the aforementioned aims, it is crucial to have hospital-wide support. To that end, we have strong partnerships with other clinical divisions, such as Radiology and Cardiology, who share their ultrasound expertise with the POCUS community. Furthermore, we have established relationships with other groups as well, such as information technology, purchasing, legal, biomed, and credentialing.

Are you interested in doing something similar at your institution? Wondering where to start? One suggestion is to send out a survey to all the division chiefs to better understand if POCUS is currently being used (or will be used in the future) in their respective divisions. Be sure to ask if the division has a POCUS champion. From there, plan a meeting with all the champions and start a discussion on how to improve POCUS at your institution. For a resource, check out the following reference.

Strony R, Marin JR, Bailitz J, et al. Systemwide clinical ultrasound program development: an expert consensus model. West J Emerg Med. 2018; 19:649–653.

 

Do you work in a children’s hospital? Do you perform POCUS? Do you ever wonder if other divisions in your hospital are using POCUS as well? Comment below, or, AIUM members, continue the conversation on Connect, the AIUM’s online community.

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Alyssa Abo, MD, FAAP, FACEP, is Director of Clinical Ultrasound in Emergency Medicine, and Chair of the Hospital Oversight Committee for Point-of-Care Ultrasound at Children’s National Medical Center in Washington, DC, as well as Associate Professor of Pediatrics and Emergency Medicine at George Washington University School of Medicine and Health Sciences in Washington, DC.

Artificial Intelligence and Point-of-Care Ultrasound

One of the greatest ongoing challenges of POCUS (point-of-care ultrasound) is educating existing physicians, residents, students and others. There are not even enough teachers to teach everyone who wants to learn. Clinicians would like to get the results from POCUS performed on their patients but have difficulty investing the effort required to learn, practice, and then become credentialed. Further complicating things for some is the dreaded self-doubting period, which could last months or years, where providers worry they may make a mistake and be ridiculed for it, or worse.Blaivas

One potential answer is thought to be artificial intelligence (AI); kind of like it seems to be for everything in medicine today. What good is AI in POCUS anyway? What if the education required was simply to find the correct spot on the body to apply the probe? Then the algorithm would do the rest and it would be more accurate than the best POCUS masters. Not only would training be truly minimized, maybe to minutes, but the examination would be shortened as well. A few sweeps through organs, whether it is the liver and gallbladder or the heart, may be enough for the AI algorithm to do its thing. This would mean all those busy clinicians really would get a great return on their time investment. If the algorithm is that accurate and expert, providers will not be questioned easily when they document an AI US finding.

AI is an inescapable topic of sensational news stories and movies alike. AI is simply a machine approximation of human-like intelligence in task performance. The type most associated with image interpretation is deep learning. How does it work? Programmers develop software architectures roughly resembling levels of neurons in the cerebral cortex, with multiple connections. The levels of neurons have specific functions and transmit messages to neurons in the next row via mathematical functions. They are also capable of sending messages in reverse as feedback. Such a deep network is often termed a convolutional neural network (CNN; or some variant on the name). It can learn to interpret images, whether CXR, head CT, or ultrasound, by scanning each image one tiny part at a time, then pooling all of the neuronal-like reactions to those tiny parts and coming up with an answer. Give it enough training data and such a CNN can become very accurate.

Well, imagine a CNN algorithm plugged into your favorite POCUS machine. The CNN is trained on the liver and gallbladder; it has seen millions of example images, both normal and abnormal. It can recognize liver anatomy and point it out for you, the same for every detail around the gallbladder and biliary tree. It’s great at identifying pathology and can make measurements in the correct spots for the wall, common bile duct (CBD), and more. Once again, who really cares? I spent 2 decades scanning the gallbladder, performing research studies, and publishing on it. Well, while it may not have been an issue for me, not everyone invests their free time like that. Yet, many would like to be able to put a probe on the abdomen, have the ultrasound machine tell them where to move it, point out pathology, and come up with a likely diagnosis. Did I mention it could happen in real time, at the patient’s bedside, while you are casually speaking to them? How useful would this be? It could substitute for years of training, maybe even over 2 decades worth. There are other subtle benefits too. Although some studies seem to show that CNN CT algorithms seem to catch so much pathology radiologists can miss, the individual CNN may not be as good at finding something a rare expert might pick up, at least for now. But the CNN never gets tired. It never gets hit with a massive wave of scans to read late at night or overwhelmed with clinicians calling to discuss imaging studies. Thus, even experts can benefit from such algorithms as an aid.

Not happy with the image quality due to patient body habitus or another factor? It turns out another algorithm can actually artificially improve the image clarity and quality, and do so accurately without introducing false data. This has not been introduced into clinical use of POCUS but is likely to be just around the corner. The key is to make sure nothing is invented by the algorithm that is not actually there.

Imagine incredible ultrasound expertise from a short exam that required minimal training to perform. This scenario will come, but not this year or the next. As some speakers and authors have noted, AI coupled with POCUS is a big step toward the fabled and elusive “tricorder” first depicted in the 1960s Star Trek television series. An incredible hand-held device (that does not even require body contact), which diagnoses maladies in a few short sweeps over the patient. The eventual outcome of approaching such a device is greatly increased speed, efficiency, confidence, and accuracy of patient assessment and diagnosis. The benefit of significantly decreased skill/training requirements will also pose some challenges for the workforce, but these are likely to appear gradually and may be hardly noted.

What about combining other data feeds along with the ultrasound images? AI algorithms are great at interpreting EKG tracings and even cardiac and lung auscultation. Studies analyzing digital auscultation signals using deep learning systems are able to diagnose many more abnormalities than humans are. The result could be synergistic and add redundancy in diagnosis, such as for abnormal lung or heart sounds during ultrasound evaluation. Maybe other signals could be incorporated also.

These algorithms just need data, lots of data, and that is the conundrum for people seeking to develop AI apps. What do you think about companies getting de-identified image data without provider and patient awareness? Do you think it would help you to have a smart machine that analyzed the images and made calculations within seconds? What about incorporating other diagnostic signals such as digital auscultation, EKG tracings, or maybe some other signal?

 

 

Share your thoughts on AI in ultrasound: comment below, or, AIUM members, continue the conversation on Connect, the AIUM’s online community.

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Michael Blaivas, MD, MBA, FACEP, FAIUM, is an Affiliate Professor of Medicine in the Department of Medicine at the University of South Carolina, School of Medicine. He works in the Department of Emergency Medicine at St. Francis Hospital in Columbus, Georgia.

Women in Ultrasound Leadership: Seeing the Future

At first, I was excited for the opportunity to write a piece for The Scan on Women in Ultrasound Leadership. I love ultrasound and I love trying to advocate for women in medicine, especially women in medicine leadership. Sounds great, right? Then my efforts quickly became like the purgatory on a page of my personal statement for internal medicine residency application. Next came a hard-core resurgence of the “Impostor Syndrome” I’ve been working pretty hard to quell, with the support of some great colleagues and friends. In case you’re one of the few people who have never experienced this, Impostor Syndrome is defined by Dr Google as “the persistent inability to believe that one’s success is deserved or has been legitimately achieved as a result of one’s own efforts or skills.” So, how do you write for yourself and try to encourage others to keep waging and winning these internal AND external battles? Especially when you so very acutely remember all those doubts (and *may* have had to take propranolol for near panic over giving a Meet the Professor session on POCUS at the American College of Physicians convention last year)?! Here’s how: You look at the numbers, get fired up, think about yourself in the past—plus all of the other women out there—and get down to it.Renee

Since you’re probably wondering who in the heck I am, and why I am qualified to write about women in ultrasound leadership, let me introduce myself. I am a lifelong Oregonian outside of 3 years in Boston at Massachusetts General Hospital for my internal medicine residency. During my residency, I fell in love, first with simulation as an educational method, and later with point-of-care ultrasound (POCUS). I felt these methods could do so much to advance the care of medical patients beyond the ED, where POCUS was most common. Then, I returned home to my first attending role in the Division of Hospital Medicine at Oregon Health & Science University (OHSU). My passion for ultrasound developed further as I learned additional clinical uses and saw just how much you could use ultrasound to teach residents and students in the foundational sciences and beyond.

With the knowledge, support, and sponsorship of my former provost, Dr Jeanette Mladenovic, I started my ultrasound leadership journey. My first experience with the incredibly welcoming national POCUS community was when the World Congress of Ultrasound in Medical Education came to OHSU in October of 2014. With Dr Mladenovic’s encouragement, I helped out with logistics, including scheduling and faculty, room, and machine assignments, and did a bit of teaching. But mostly I fan-girled over my POCUS heroes, learned, and connected. There were probably only 10–15 other internists that year, but I was so inspired by their work and the POCUS community in general that I will forever fondly remember that meeting.

Since then, via connections, friends, mentors, and sponsors made at that meeting, I have been able to teach at national internal medicine (IM) pre-courses, give lectures, webinars, and podcasts, and create and deliver local, regional, and national/international POCUS curricula at OHSU, including for the AIUM (where I now also serve on the Board of Governors).

It’s been a wild ride, and I’d like to take a quick pause to define and highlight the concept of sponsorship, and what it has done for me. “The Real Benefit of Finding a Sponsor” in Harvard Business Review (HBR) asserted:

“The Sponsor Effect” defines a sponsor as someone who uses chips on his or her protégé’s behalf and advocates for his or her next promotion as well as doing at least two of the following: expanding the perception of what the protégé can do; making connections to senior leaders; promoting his or her visibility; opening up career opportunities; offering advice on appearance and executive presence; making connections outside the company; and giving advice. Mentors proffer friendly advice. Sponsors pull you up to the next level.

Another HBR piece I love highlights the importance of women supporting each other, instead of responding to inequality in the workplace by holding down other women. The article describes sponsorship as “connecting a protégé with opportunities and contacts and advocating on their behalf, as opposed to the more advice-focused role of mentorship.”

Setting aside the actual promotion piece of sponsorship (given the rather structured, CV-driven nature of the academic promotion process) in my mind really drills down to someone with influence going above and beyond suggesting high-yield activities and relationships for a mentee. Instead, a sponsor makes those connections for them, putting their name up there for that national committee, speaking role, suggesting them for that multi-site study, etc.

So why am I telling you all this? Because we NEED TO ACT. Across the spectrum, there are profound discrepancies between the two sexes: woman are paid less, promoted less, funded less, published less, and finally, invited to speak & peer review less (https://www.bmj.com/content/363/bmj.k5232).

I want to acknowledge that both men and women in the POCUS and ultrasound communities have supported me, but we all have more to do. The ultrasound community is not immune to the “manel.”

“Conceptually, the reason why a panel would be organized in the first place, whether at a conference, on cable news, or as part of a legislative session, is to ensure a diversity of opinions and perspectives are brought to the issue up for discussion…The term manel has, like its predecessors, become a useful way to take note of a circumstance in which men may not realize that something they’re involved in has the effect of marginalizing women.”

Once we acknowledge that there is gender inequality, we can all play an active role in addressing it. Here are a few places to start:

  • Don’t wait for women to come to you. Step up and volunteer to be a sponsor without being asked.
  • Nominate a female colleague for an award.
  • If you find yourself on a planning committee, make sure speaker suggestions include women as well.
  • Be fair in your authorship, and make sure if you suggest peer reviewers you suggest women and In fact, being inclusive of women can translate to all aspects of your life!

Finally, my message to junior female colleagues: Focus on your strengths and what you have to give. Don’t be like me and be petrified by your lack of formal training, supplemental degrees or certificates, being the only woman or internist or sonographer in the room. No one knows everything. Own what you don’t, be honest, and do NOT let obsession with limitations or perfection be the enemy of good. Take it from me. And if you don’t have one, get out there & find yourself a sponsor. Okay, actually that was my message to all female colleagues!

In closing, I am thankful for the ultrasound community and all of the opportunities I have had to contribute to the AIUM mission and ultrasound use in general. I am honored to be on the Board of Governors for an organization with a female CEO. I am proud to be on faculty at a university with a female Dean, Provost, Chief Medical Officer, and Assistant Dean of Undergraduate Medical Education. Finally, I am thrilled to contribute my love of POCUS as both an educational & diagnostic tool, along with my love of “gab” & connections to help promote and bring this community closer together in any way I might.

 

Do you know of a woman whose career advanced with the help of a sponsor? Have you been a sponsor? Comment below, or, AIUM members, continue the conversation on Connect, the AIUM’s online community.

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Renee Dversdal, MD, FACP, is Associate Professor of Medicine and Director of OHSU Point of Care Ultrasound as well as General Medicine Ultrasound Fellowship Director at Oregon Health & Science University, Portland, Oregon.

The Buzz in Orlando

From the moment you stepped foot inside the Hilton Bonnet Creek Resort, you knew this was going to be a different kind of AIUM Convention. Maybe it was the new venue. Maybe it was all the new offerings. Maybe it was the excitement about connecting and reconnecting with colleagues from around the world.IMG_7012

Whatever it was, it caused a buzz in Orlando.

If you were in Orlando, we hope you felt the same. If you were unable to make it this year, here are a few of the highlights (you can see and learn even more if you search #AIUM19 on your favorite social media site):

 

IMG_7019 copyNew Offerings—Each year, the AIUM and the Annual Convention Committee look to enhance and improve the event. This year was no exception. To get the juices flowing, attendees could participate in a morning exercise class that varied each day. We added the Recharge Lounge where attendees could relax and charge up their devices. We partnered with the International Contrast Ultrasound Society on a one-day educational event. And we enhanced the Meet-the-Professor sessions.

SonoSlam—In its fourth year, 24 teams battled it out for the coveted Peter Arger Cup. The University of Connecticut’s team, PoCUS Maximus, came out on top–and defended their title! Save the date for next year—March 21 in New York City! Big thanks to headline sponsor Canon.

 

 

Social Media—From Instagram to Twitter to Facebook, Convention attendees were very active on social media at #AIUM19. And, for the first time, there was a takeover! Kristy Le, a recent RDMS graduate, took the reigns of our social accounts to give her perspective on the AIUM Convention! Search #AIUM19 to get her take!Twitter_AIUM19

Kristys Takeover

Networking–It’s not an AIUM event if there isn’t networking. IMG_6998 copyThis year there were even more opportunities to make new contacts and reconnect with colleagues from around the world. From the morning workouts to the Presidential Reception. From Community meetings to the Welcome Reception. From the intimate Meet-the-Professor sessions to the Exhibit Hall breaks. You almost couldn’t help but expand your network.

Global Plenary—AIUM President Brian Coley, MD, hosted the Plenary session that featured a lecture on reducing workplace injuries from Kevin D. Evans, PhD, RT, RDMS, RVS, FSDMS, FAIUM, Professor at The Ohio State University College of Medicine. This talk launched a series of sessions and events at the AIUM Convention that focused on ergonomics. The entire Plenary Session is available on the AIUM Facebook Page.

Fun Activities—Not only was #AIUM19 educational, it was also fun. Buttons_IMG_1967_EDITEDThis year attendees could participate in morning exercise classes (yoga, jogging, bootcamp); do a scavenger hunt with the AIUM app (Congrats to Julie Abe, MD, from Brazil for winning the free #AIUM2020 registration); collect specialty-specific buttons (Congrats to Joanne Richards, RT, RDMS, RT on winning the smartwatch for collecting at least 15 buttons); and participate in Industry Symposia.

 

Sold-out Exhibit Hall—This year’s exhibit hall was the most exciting and active it has ever been. There were more new companies at this year’s event than ever, making the exhibit hall vibrant and exciting! IMG_7035New product releases, special offers, and cool giveaways created a buzz we haven’t seen in years. Plus, there was cake! Thanks to all the exhibitors!

Award Winners—The AIUM was proud to recognize the following award winners (look for upcoming blog posts and/or videos from some of these individuals):

James A. Zagzebski, PhD–William J Fry Memorial Lecture Award
Steven R. Goldstein, MD, FAIUM—Joseph H. Holmes Clinical Pioneer Award
Keith A. Wear, PhD, FAIUM—Joseph H. Holmes Basic Science Pioneer Award
Kevin David Evans, PhD, RT, RDMS, RVS, FAIUM—Distinguished Sonographer Award
Michael Blaivas, MD, MBA, FAIUM, FACEP—Peter H. Arger, MD Excellence in Medical Student Education Award
Bryann Bromley, MD, FAIUM—Carmine M. Valente Distinguished Service Award
Liat Gindes, MD—AIUM Honorary Fellow
Tammy Stearns, MS, RT(R), RDMS, RVT, FSDMS—AIUM Honorary Fellow

The AIUM also recognized the life and achievements of these individuals who were inducted into the Memorial Hall of Fame:

Michael L. Manco-Johnson, MD
Terry J. DuBose, MS, RDMS, FAIUM, FSDMS
Donald Baker

Up and Comers—In addition to our national awards, the AIUM also recognizes its New Investigators. This year’s winners and runners-up are:

Basic Science
Winner—Viktor Bollen, Postdoctoral Fellow, University of Chicago for “A Comparison Of Thrombus Dissolution Efficacy With Single And Multiple-Cycle Histotripsy Pulses In Vitro.
Runner-Up–Lakshmanan Sannachi, PhD, Postdoctoral Fellow, Department of Physical Sciences, Sunnybrook Health Sciences Centre for “Quantitative Ultrasound Texture-Derivative Methods Combined with Advanced Machine-Learning for Therapy Response Prediction: Method Development and Evaluation.”

Clinical Ultrasound
Winner—Misun Hwang, MD, Assistant Professor of Radiology, Children’s Hospital of Philadelphia, University of Pennsylvania for “Quantitative Detection of Brain Injury with Contrast-Enhanced Ultrasound in Neonates and Infants.”
Runner-Up–Michal Fishel Bartal, Maternal Fetal Medicine Fellow, McGovern Medical School, University of Texas at Houston (UTHealth) for “Validation of 3D Power Doppler Volume Analysis in Patients with 2D Ultrasound Suspected Morbidly Adherent Placenta.

Convention attendees say that the reason they attend this event is because of the multi-specialty nature of the AIUM. This event brings together physicians, sonographers, scientists, students, and others from at least 20 specialties–all focused on medical ultrasound! No other event–or professional society–does this. To all of those who joined us in Orlando, thanks and we hope you were able to take back some contacts, a lot of information, and resources to improve patient care. For everyone else, we hope to see you in New York City for AIUM2020.

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Physics of Ultrasound

Snell’s Law [in-class demonstration]

The concept that sound reflects and propagates in varied angles is an abstract concept that many students struggle to understand. I review this concept by providing an in-class demonstration that makes this less abstract and something that can be seen with glasses of liquids.

Evans_Fig 1

 

If speed 1 < speed 2, then the incident angle < transmitted angle.

The difference in the stiffness and resulting propagation speeds helps to explain why the straw appears to be “broken” when you look through the side of the glass of water. The angle of transmission is measured against the vertical black line drawn on the glass of water. This helps to illustrate the 30-degree oblique incidence vs. the increased angle of transmission. A real-world example would be the change in imaging of a needle in a fluid-filled structure.

Example:

The propagation speed of sound through air is 900 m/sec while the propagation speed of sound through water is 1200 m/sec. To figure out the change in the angle of transmission, we form a ratio that will allow us to arrive at a percentage of change. So, 900/1200 = .75 and, therefore, that ratio of change from air to water in the glass is 100 – 75 = 25%. To figure out the angle, take 30 times .25 = 7.5 degrees. Therefore, 30 + 7.5 = 37.5 degree angle of transmission.

Now, consider a different glass of liquid as part of this demonstration by viewing a glass of Karo syrup.

Evans_Fig 2

This time, the glass is filled with Karo syrup, which is stiffer and denser than the water, and the transmitted angle is greater due to the increased ability to travel quickly in the second media.

 

If speed 1 < speed 2, then the incident angle < transmitted angle.

Example:

The propagation speed of sound through air is 900 m/sec while the propagation speed of sound through Karo is 1500 m/sec. To figure out the change in the angle of transmission, we form a ratio that will allow us to arrive at a percentage of change. So, 900/1500 = .60 and, therefore, the ratio of change from air to Karo syrup in the glass is 100 – 60 = 40% gain. To figure out the angle, take 30 times .4 = 12 degrees. 30 + 12 = 42 degree angle of transmission. The real world example for this is noting a speed propagation artifact.

A final demonstration can be a glass that has 1/3 air, 1/3 vinegar, and 1/3 cooking oil. Do not forget to add a straw so that several bends in the straw are noted by viewing through the side of the glass.

 

 

Kevin D. Evans, PhD, RT (R) (M) (BD), RDMS, RVS, FSDMS, FAIUM, is Chair and Professor of Radiologic Sciences and Respiratory Therapy at The Ohio State University in Columbus, OH.

 

Life Hacks for the 2019 AIUM Convention

If you will be joining us in Orlando for the 2019 AIUM Convention, here are a few things you can do to get the most out of your experience:

GET REGISTERED

Register to attend the 2019 AIUM Conventionthe meeting for medical ultrasound, if you haven’t done so already. You have the choice of registering for the whole convention or selecting a 1-day registration, which is available for Sunday, Monday, Tuesday, and Wednesday. Up to 7 CME credits can be earned for each 1-day registration, for a total of up to 28 credits!

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GET THE APP

Before and during the convention, use the app to plan your schedule, read about sessions, take notes, learn about exhibitors, and engage with other attendees. To keep on top of all things #AIUM19, download the eventScribe app now:

(1) Download eventScribe
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(2) Find our event by searching
2019 AIUM Convention

Then, check out the quick video tutorials on how to get the most out of the app.

 

GET SOCIAL

Connect on social media with #AIUM19 on Connect, Facebook, Twitter, LinkedIn, and Instagram.

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GET AROUND

Hilton Orlando Bonnet Creek and Waldorf Astoria Orlando are approximately 18 miles from Orlando International Airport (MCO), which offers information on multiple forms of transportation. The hotels also offer complimentary transportation to Disney® theme parks. For the current shuttle schedule, access the Bonnet Shuttle website, visit the front desk, or call the hotel at 407-597-3600.

Transportation

 

GET MOVING

Each morning of the main convention, at 6:30 am, join us for a bit of fitness to start your day.

  • Sunday: Morning Run (meet in the Hilton Lobby)
  • Monday: Yoga (meet in the Bonnet Creek Pavilion on the Ground Level)
  • Tuesday: Morning Run (meet in the Hilton Lobby)
  • Wednesday: Boot Camp (meet in the Bonnet Creek Pavilion on the Ground Level)

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GET MORE 

New this year: Power Hour Lunch. This year you have the opportunity to attend sessions during lunch. Grab a bite in the Exhibit Hall and keep the learning going!

PowerHour

 

GET A 1ST LOOK AT NEW PRODUCTS

Visit the Exhibit Hall to see the following new products:

Exibitors

While you’re in the Exhibit Hall, check out MEDNAX in booth 504 to learn about career opportunities for radiologists and maternal-fetal medicine specialists. And stop by the ARDMS (booth 228) to pick up one of their “world-famous” pizza cutters.


GET SOME REST

Need to relax? Need to charge your cell phone? Do both at the new Recharge Lounge, located just outside the Exhibit Hall.

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GET BUTTONS

Throughout the convention, we have scattered buttons, each representing 1 of the 20 AIUM specialty-focused communities. Collect all of the communities! If you collect at least 15, you can enter a drawing to win a smartwatch.

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GET REFRESHMENTS

If you are feeling a bit peckish, stop by the Exhibit Hall or the Foyer just outside of it to grab some refreshments.

Refreshments

 

GET TOGETHER

Check out the many networking opportunities available at the 2019 AIUM Convention:

  • Attend community meetings to meet with colleagues in your specialty
  • Mingle at the Welcome Reception
  • Connect with other attendees using the Mobile App
  • Stop by our Resource Booth to volunteer to get involved

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aium2019