Pre-eclampsia, Growth Restriction, and a Placenta Bank

Our Maternal-Fetal Medicine fellow was talking about a delivery that occurred while I was away. The fetus was growth-restricted and developed worsening indices on Doppler ultrasound of the umbilical arteries. What was initially an increased Systolic/Diastolic ratio became first absent and then reversed end-diastolic flow. As this occurred over several weeks, the patient herself had worsening blood pressures and symptoms related to her pre-eclampsia and the fetal tracing became more concerning. She was ultimately delivered and her tiny and premature baby was now in the care of the neonatologists.201500581_Hill-7

The fellow’s presentation focused on the ultrasound findings and the surveillance of pregnancies that become complicated in this way. What was known was the best current management in this case. The unknown was why this had happened in the first place. I was about to interrupt the presentation when our fellow, knowing what I was going to ask, looked over at me and said “Yes, I did collect the placenta.”

Pre-eclampsia is a common condition and growth restriction, by definition, occurs in 10% of pregnancies. The conditions are highly related. We have risk factors for both, but we seldom know the cause. Our treatments seem crude to a bench researcher; try to control the condition as long as you can, and if either patient or her fetus becomes too sick, deliver the pregnancy.

As an obstetrics and gynecology resident I was fascinated by developmental programming in these fetuses and sent in a grant application to the American Institute of Ultrasound in Medicine requesting seed funding to look at the hormonal associations with growth restriction. Their contribution to my research was a turning point for me. I had always thought of myself as a clinical researcher and this was my first exploration of translational research. During my fellowship in Maternal-Fetal Medicine I collected ultrasound data on growth restricted pregnancies and sampled placentas and cord blood from the pregnancies when they delivered. What I had thought would be a one-off project became a jumping off point for continued exploration into placental biology.

Five years later, I have established a placenta bank at the University of Arizona. What was a small study focusing on just one condition has inspired the creation of a bigger project. Our residents and fellows now contribute to the bank and have the ability to answer their own questions with the samples already collected. The bank is a resource to all of us and has fostered collaborations with the University of Arizona Biorepository and the department of Animal and Comparative Biomedical Sciences. My initial work focused on changes in leptin, renin, and C-reactive protein in cord blood, but as I learned more, the objective changed to include RNA analysis of the placental tissue. We noted that the structural protein expression was different in the growth-restricted pregnancies. This has led to the proposal of a whole different model regarding the causation of preeclampsia and growth restriction.

We will wait and see how this baby does in the neonatal intensive care unit. As we go about our conservative management until the risk becomes too great to continue, it is a comfort to know we are looking for reasons; if we understand possible mechanisms better, there is the potential to mitigate or reverse the development of fetal and maternal morbidities.

 

How has ultrasound shaped your career? Has an ultrasound study led you down an unexpected path? Comment below or let us know on Twitter: @AIUM_Ultrasound.

Meghan Hill, MBBS, is Assistant Professor at The University of Arizona College of Medicine, Department of Obstetrics & Gynecology.

Bigger and Better in the Big Apple

Last week a near-record 1,500 physicians, sonographers, scientists, students, and educators from across the country and around the world gathered in New York City to network, share, and learn. It was, by all accounts, one of the biggest and best AIUM Conventions yet!

What it made so great? A variety of educational opportunities covering a wide range of topics addressing at least 19 different specialties is just the start. More interaction across disciplines to share techniques, more hands-on learning labs, new product releases, and collaborative learning events added to the excitement and collegiality.

If you were in New York City, we hope you shared your feedback in the follow-up surveys. If you were unable to make it this year, here are a few of the highlights:

New Offerings—As if putting on the AIUM Convention weren’t enough, we decided to make a host of changes. We doubled the number of hands-on learning labs (most sold out), we added the more intimate Meet-the-Professor sessions (again, most sold out), we enhanced networking by adding exhibit hall receptions, we brought back the mobile app to make navigating the event easier, and we invited our corporate partners to host Industry Symposia, which included education, networking, and food. Whew!

New Offerings

SonoSlam—In its third year, a record number of medical schools (21) sent teams to compete for the coveted Peter Arger Cup. This year’s winning team, F.A.S.T. and Furious, is from the University of Connecticut. They competed last year and had so much fun they returned and were triumphant! Save the date for next year—April 6. Big thanks to headline sponsor CoapTech.

SonoSlam 2018

Global Plenary—AIUM President Brian Coley, MD, hosted the Plenary session that featured a lecture on global health from John Lawrence, MD, President of the Board of Directors for Doctors Without Borders-USA. This was followed by Roberto Romero, MD DMedSci, who presented the William J. Fry Memorial Lecture on ultrasound imaging and computational methods to improve the diagnosis and care of pregnant women and their unborn children. The entire Plenary Session is available on the AIUM Facebook Page.

Social Media—This year was the most active social media convention ever for the AIUM. StatsFrom streaming live videos on Facebook to more than 754 individuals participating and sharing on Twitter (a 50% increase over last year), the social media scene was active and engaging.

Fun Activities—Not only was #AIUM18 educational, it was also fun. This year attendees could participate in a morning jog through Central Park; do a scavenger hunt with the AIUM app (Congrats to Offir Ben-David, RDMS, from Stamford, CT, and Jefferson Svengsouk, MD, MBA, RDMS, from Rochester, NY, for winning prizes by completing the scavenger hunt); network during 3 different AIUM receptions and the new Industry Symposia; and win prizes at the AIUM booth (Congrats to Jenna Rothblat who won a free 2019 AIUM Convention registration).

Fun Activities

Sold-out Exhibit Hall—This year’s exhibit hall was the most exciting and active it has ever been. At least 3 companies unveiled new ultrasound machines and several others shared their insights with live video feeds. Combine that with networking receptions and New York street fare at lunch time, and the exhibit hall was always the place to be.

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

Wesley Lee, MD, FAIUM—Joseph H. Holmes Clinical Pioneer Award

William D. Middleton, MD—Joseph H. Holmes Clinical Pioneer Award

Thomas R. Yellen-Nelson, PhD, FAAPM, FAIUM—Joseph H. Holmes Basic Science Pioneer Award

Tracy Anton, BS, RDMS, RDCS, FAIUM—Distinguished Sonographer Award

Alfred Abuhamad, MD, FAIUM—Peter H. Arger, MD Excellence in Medical Student Education Award

Creagh Boulger—Carmine M. Valente Distinguished Service Award

Rachel Liu—Carmine M. Valente Distinguished Service Award

Lexie Cowger—Carmine M. Valente Distinguished Service Award

Adriana Suely de Oliveira Melo, MD, PhD—AIUM Honorary Fellow

Simcha Yagel, MD, FAIUM—AIUM Honorary Fellow

E-poster winners—Every year, the AIUM supports an e-poster program. This year, a record number of abstracts were submitted and the AIUM recognized the following e-poster winners:

  • First place, Basic Science: Construction and Characterization of an Economical PVDF Membrane Hydrophone for Medical Ultrasound, presented by Yunbo Liu, PhD, from the FDA, Silver Spring, MD.
  • First place, Education: Investigation into the Role of Novel Anthropomorphic Breast Ultrasound Phantoms in Radiology Resident Education, presented by Donald Tradup, RDMS, RT, from Mayo Clinic-Department of Radiology, University of Pittsburgh Medical Center-Department of Radiology, Dublin Institute of Technology, Ireland.
  • First place, Clinical Science: Sonography of Pediatric Superficial Lumps and Bumps: Illustrative Examples from Head to Toe presented by Anmol Bansal, MD, Mount Sinai Hospital, Icahn School of Medicine.
  • Second place, Basic Science: Strain Rate Imaging for Visualization of Mechanical Contraction, presented by Martin V. Andersen, MS, from Duke University.
  • Second place, Education: Tommy HeyneSonography in Internal Medicine, Baseline Assessment (MGH SIMBA Study), presented by Tommy Heyne, MD, MSt, Massachusetts General Hospital-Department of Internal Medicine and Department of Emergency Medicine.
  • Second place, Clinical Science: Serial Cervical Consistency Index Measurements and Prediction of Preterm Birth < 34 Weeks in Twin Pregnancies, presented by Vasilica Stratulat, CRGS, ARDMS, MD, Sunnybrook Health Sciences.

Up and Comers—In addition to our national awards and our eposter winners, the AIUM also recognizes its New Investigators, which this year were sponsored by Canon.

Nonclinical
Winner— Ivan M. Rosado-Mendez, PhD, for “Quantitative Ultrasound Assessment of Neurotoxicity of Anesthetics in the Young Rhesus Macaque Brain.”

Clinical Ultrasound
Winner— Ping Gong, PhD, for “Ultra-Sensitive Microvessel Imaging for Breast Tumors:  Initial Experiences.”

Honorable Mentions
Juvenal Ormachea, MS,
for “Reverberant Shear Wave Elastography: Implementation and Feasibility Studies.”

Kathryn Lupez, MD, for “Goal Directed Echo and Cardiac Biomarker Prediction of 5-Day Clinical Deterioration in Pulmonary Embolism.”

2019

 

 

Focused Ultrasound and the Blood-Brain Barrier

When does a barrier protect and when does it hinder? This question is central to the challenge of delivering therapeutics to the brain. For many neuropathologies, the answer is clear: there is a critical need for strategies that can allow clinicians to effectively deliver drugs to the brain. We believe focused ultrasound (FUS) has the potential to be a powerful tool in this quest.

Part of this challenge lies in the unique nature of the blood vessels in the brain. The cells that line these vessels are tightly linked together, creating a complex obstacle—called the blood-brain barrier (BBB)—that prevents the vast majority of drugs from entering the brain from the bloodstream. Throughout the years, several strategies of bypassing the BBB have been used, with limited success and many adverse effects. These range from directly inserting a needle into the brain for injections, to the administration of hyperosmotic solutions, which create gaps between cells in the BBB throughout a large volume.

In 1956, Bakay et al successfully ablated brain tumors using high-intensity FUS. In doing so, he observed that the permeability of the BBB was enhanced in the periphery of the ablated tissue. While this was exciting news for BBB enthusiasts, the necessity of damaging tissue in the process of opening the BBB was clearly unacceptable. Several decades later, this approach was successfully modified by administering microbubbles, an ultrasound contrast agent, before sonicating (Hynynen et al 2001). This made it possible to use much lower power levels to produce the desired increase in BBB permeability, thereby avoiding brain damage. By adjusting where the ultrasound energy is focused, specific brain regions can be targeted. For a few hours after treatment, drugs can be administered intravenously, bypass the BBB, and enter the neural tissue in the targeted areas.

Over the past 16 years, many preclinical studies have used FUS to increase the permeability of the BBB, delivering a wide range of therapeutic agents to the brain, from chemotherapeutics and viruses, to antibodies and stem cells. Efficacy has been demonstrated in models of Alzheimer’s disease, Parkinson’s, brain tumors, and others. Moreover, the safety of using FUS to increase BBB permeability has been tested in every commonly used laboratory animal.

The flexibility of FUS as a tool for treating neuropathologies may go beyond the delivery of drugs to the brain. Recently, FUS was shown to reduce the amount of β-amyloid plaques and improve memory deficits in the brains of transgenic mice (Burgess et al 2014, Leinenga and Gotz 2015, Jordao et al 2013).

The success of these preclinical trials has led to the initiation of 3 human trials. Two of these trials are testing the safety of increasing the permeability of the BBB in brain tumors for chemotherapy delivery, and the third is evaluating the safety and initial effectiveness of FUS in patients with early stage Alzheimer’s disease. The rapid movement towards clinical testing has been accompanied by impressive technological advancements in the equipment used to focus ultrasound through the human skull. Arrays of thousands of ultrasound transducers can be controlled to produce sound waves that travel through bone and brain, and arrive at precisely the same time in the targeted location. The sound produced by vibrating microbubbles can be detected and used to ensure the treatment is progressing as planned.

If the barrier to drug delivery to the brain can be bridged by FUS, the development of effective treatment strategies for a wide range of neuropathologies will expand. Given the clear need for such treatments and the flexibility of FUS, the recent push toward clinical testing is encouraging. The coming years will be critical in demonstrating the safety of the technique and spreading awareness. Success in these regards will go a long way in establishing FUS as an impactful tool in the fight against inflictions of the central nervous system.

 

If you deliver drugs to the brain, how do you do so? Have you found a way to permeate the blood-brain barrier using ultrasound? Comment below or let us know on Twitter: @AIUM_Ultrasound.

Charissa Poon and Dallan McMahon are PhD students at the Institute of Biomaterials & Biomedical Engineering, University of Toronto, and the department of Medical Biophysics, University of Toronto, respectively.

Kullervo Hynynen, PhD, is professor at the department of Medical Biophysics and the Institute of Biomaterials & Biomedical Engineering, University of Toronto, and a senior scientist at Sunnybrook Research Institute in Toronto, Canada.

Puzzle Solver

During the 2016 AIUM Annual Convention, Michael Kolios, PhD, was awarded the Joseph H. Holmes Basic Science Pioneer Award. We asked him a few questions about the award,November 11, 2015 what interests him, and the future of medical ultrasound research. This is what he had to say.

  1. What does being named the Joseph H. Holmes Basic Science Pioneer Award winner mean to you?
    It means a lot to me to be recognized by my peers in this manner. It motivates me to work even harder to contribute more to the community.  I have been associated with the AIUM for a long time and have thoroughly enjoyed interacting with all the members over the years. When I peruse the list of the previous Joseph H. Holmes Basic Science Pioneer Awardees and look at their accomplishments, I feel quite humbled by being the recipient of this award, and hope one day to match their contributions to the field.
  1. What gets you excited the most when it comes to research?
    I get excited when I generate/discuss new ideas, participate in the battle of new and old ideas, and the immensely complex detective work that is required to prove or disprove these new ideas. I thoroughly enjoy the interactions with all my colleagues and trainees that join me in this indefatigable and never-ending detective work, as solving one puzzle almost always creates many new ones. This is what I’ve encountered in the last 2 decades while probing basic questions on the propagation of ultrasound waves in tissue, and how different tissue structures scatter the sound. Finally, I get very excited when I try to think about how to use the basic science knowledge generated from this research to inform clinical practice, and envisioning the day this will potentially make a difference in the lives of people.
  1. How can we encourage more ultrasound research?
    We need to provide the resources to people in order to do the research in ultrasound. Most funding agencies are stretched to the limit and success rates are sometimes in the single digits. This makes it very challenging to do research in general, including ultrasound research. Therefore, pooling resources and providing environments where ultrasonic research can excel will partially help—creating/promoting/maintaining centers for ultrasound research. This can also be promoted through networking and professional societies, such as the AIUM.Another thing to do to encourage more ultrasound research is by demonstrating the clinical impact of ultrasound and how it could be used to save the lives of patients. Only through the close collaboration of basic scientists/engineers with clinicians/clinician-scientists/sonographers can this be achieved. Developments in therapeutic ultrasound for example are very exciting, and have recently attracted the attention of both public and private funding agencies with many success stories. Moreover, providing seed money through opportunities such as the ERR (Endowment for Education and Research) is a step in the right direction—to give people the opportunity to pursue their ideas in the field of ultrasound research.
  1. What new or upcoming research has you most intrigued?
    While I spent a lot of time trying to understand ultrasound scattering, and how changes in tissue morphology influence this scattering, I’m currently dedicating most of my time to the new field called photoacoustic imaging. It is known that conventional clinical ultrasound has relatively poor soft tissue contrast, but in photoacoustic imaging light is used to generate ultrasound. These ultrasound waves, created when light is absorbed by tissue, provides exciting results that allow not only probing tissue anatomy, but also function in ways that not many other modalities can. After the light is absorbed and the waves initiated, everything we know about ultrasound applies—and in fact we can use the same ultrasound instrumentation to create images. I expect this imaging modality to have clinical impact in the near future.
  1. You are well accomplished within the medical ultrasound research community, but when you were young what did you want to be when you grew up?
    When I was young I wanted to be firstly an astronaut, then a philosopher, pondering basic questions and fundamental problems in nature. I ended up studying physics and its applications in medicine. It has been a highly rewarding choice!
  1. If you were presenting this award at the 2017 AIUM Annual Convention, who would you like to see receive it and why?
    I’d like to see someone that has contributed to ultrasound, with work spanning from the basic science/engineering to clinical application! It would also be encouraging to see the next recipient being a woman or minority, reflecting the true diversity from which new ideas come, and representing a constituency for which society has relatively recently given the opportunity to contribute to science in a meaningful and sustained manner.

Who would you like to see win an AIUM award? What ideas do you have to increase the interest in and funding for research? Comment below or let us know on Twitter: @AIUM_Ultrasound.

Michael Kolios, PhD, is Professor in the Department of Physics, and Associate Dean of Science, Research and Graduate Studies at Ryerson University.

Research in Ultrasound: Why We Do It

“Medicine, the only profession that labors incessantly to destroy the reason for its existence.” –James Bryce

We all know the important medical discoveries clinical research has given us over time. stamatia-v-destounis-md-facrYou could even make the case that the high standards of care we have today are built on centuries of research.

The world of medical ultrasound is no stranger to clinical research—dating back to the early work of transmission ultrasound of the brain. This work was especially important, as it was the first ultrasonic echo imaging of the human body.

Since then, research has brought about gray scale imaging, better transducer design, better understanding of beam characteristics, tissue harmonics and spatial compounding, and the development of Doppler. All of these research developments, as well as many others, were highly significant and have lead us to today’s high-quality handheld, real-time ultrasound imaging.

For me, the biggest and most important developments were and have been in breast ultrasound. In 1951, the research of Wild and Neal discovered and qualified the acoustic characteristics of benign and malignant breast tumors through use of an elementary high-frequency (15-MHz) system that produced an A-mode sonogram. These researchers published the results of additional ultrasound examinations in 21 breast tumors: 9 benign and 12 malignant, with two of the cases becoming the first 2-dimensional echograms (B-mode sonograms) of breast tissue ever published.

It is research that leads to landmark publications that change the way we practice. The ACRIN 6666 trial led by Dr Wendie Berg and her co-authors evaluated women at elevated risk of breast cancer with screening mammography compared with combined screening mammography and ultrasound. This pivotal study demonstrated that adding a single screening ultrasound to mammography can increase cancer detection in high-risk women. In our current environment this is even more relevant, as breast density notification legislation is being adopted in states across the country. With the legislation, patients with dense breast tissue are often being referred for additional screening services, with ultrasound most often being the screening modality of choice.

Screening ultrasound is an area on which I have focused much of my own research. I practice in New York State, where our breast density notification legislation became effective in January 2013. I have been interested in reviewing my practice’s experience with screening ultrasound in these patients to evaluate cancer detection and biopsy rates. My initial experience was published in the Journal of Ultrasound in Medicine in 2015, and supported what other breast screening ultrasound studies have found, an additional cancer detection rate of around 2 per 1000. Through my continued evaluation of our screening breast ultrasound program, I have found a persistently higher cancer detection rate by adding breast ultrasound to the screening mammogram–which is of great importance to all breast imagers, as we are finding cancers that were occult on mammography.

Participating in valuable research is important to me and my colleagues because part of our breast center’s mission is to investigate new technologies and stay on the cutting-edge by offering the latest and greatest to our patients. Participating in clinical research provides us important experience with new technology, and an opportunity to evaluate firsthand new techniques, new equipment, and new ideas and determine what will most benefit our patients. This is what I find the most important aspect of research, and why I do it; to be able to find new technologies that improve upon the old, to continue to find breast cancers as early as possible, and to improve patient outcomes.

Why is medical research/ultrasound research so important to you? What research questions would you like to see answered? Share your thoughts and ideas here and on Twitter: @AIUM_Ultrasound.

Stamatia Destounis, MD, FACR, is an attending radiologist and managing partner at Elizabeth Wende Breast Clinic. She is also Clinical Professor of Imaging Sciences at the University of Rochester School of Medicine & Dentistry.

Greater Trochanteric Pain Syndrome

In a study funded in part by AIUM’s Endowment for Education and Research, Jon Jacobson, MD, and his team from the University of Michigan set out to determine the effectiveness of percutaneous tendon eer_logo_textsidefor treatment of gluteal tendinosis. The full results of this study were recently published in the Journal of Ultrasound in Medicine.

Greater trochanteric pain syndrome is a condition that most commonly affects middle-aged and elderly women but can also affect younger, and more active, individuals. It has been shown that the underlying etiology for greater trochanteric pain syndrome is most commonly tendinosis or a tendon tear of the gluteus medius, gluteus minimus, or both at the greater trochanter and that tendon inflammation (or tendinitis) is not a major feature. This condition can be quite debilitating and often does not respond to conservative management.

Treatment of greater trochanteric pain syndrome should therefore include treatment of the underlying tendon condition. Ultrasound-guided percutaneous needle fenestration (or tenotomy) has been used to effectively treat underlying tendinosis and tendon tears, including tendons about the hip and pelvis. Similarly, autologous platelet-rich plasma (PRP), often combined with tendon fenestration, has been used throughout the body to treat tendinosis and tendon tears.

Although studies have shown patient improvement with PRP treatment, the true effectiveness of this treatment compared to other treatments remains uncertain. Although percutaneous ultrasound-guided tendon fenestration has been shown to be effective about the hip and pelvis, there are no data describing the use of PRP for treatment of gluteal tendons, and there is no study comparing the effectiveness of each treatment for gluteal tendinopathy. The purpose of this blinded prospective clinical trial was to compare ultrasound-guided tendon fenestration and PRP for treatment of gluteus tendinosis or partial-thickness tears in greater trochanteric pain syndrome.

We designed a study in which patients with symptoms of greater trochanteric pain syndrome and ultrasound findings of gluteal tendinosis or a partial tear (<50% depth) were blinded and treated with ultrasound-guided fenestration or autologous PRP injection of the abnormal tendon. Pain scores were recorded at baseline, week 1, and week 2 after treatment. Retrospective clinic record review assessed patient symptoms.

To break this down a little further, the study group consisted of 30 patients (24 female), of whom 50% were treated with fenestration and 50% were treated with PRP. The gluteus medius was treated in 73% and 67% in the fenestration and PRP groups, respectively. Tendinosis was present in all patients. In the fenestration group, mean pain scores were 32.4 at baseline, 16.8 at time point 1, and 15.2 at time point 2. In the PRP group, mean pain scores were 31.4 at baseline, 25.5 at time point 1, and 19.4 at time point 2. Retrospective follow-up showed significant pain score improvement from baseline to time points 1 and 2 (P < .0001) but no difference between treatment groups (P = .1623). There was 71% and 79% improvement at 92 days (mean) in the fenestration and PRP groups, respectively, with no significant difference between the treatments (P >.99).

These results led us to conclude that both ultrasound-guided tendon fenestration and PRP injection are effective for treatment of gluteal tendinosis, showing symptom improvement in both treatment groups.

What is your experience with treating greater trochanteric pain syndrome? Are you familiar with the Endowment for Education and Research?  Share your thoughts and ideas here and on Twitter: @AIUM_Ultrasound.

Jon A. Jacobson, MD, is Professor of Radiology, Director of the Division of Musculoskeletal Radiology, Assistant Medical Director of Northville Health Center, and Medical Director of Taubman Radiology within the University of Michigan Health System.

5 Questions with Dr Lee

Every year, the AIUM William J. Fry Memorial Lecture Award recognizes an AIUM member who has significantly contributed in his or her particular field to the scientific progress of medical ultrasound.

Wesley Lee MDAt the 2015 AIUM Convention, Wesley Lee, MD received this award.

  1. What did being named the William J. Fry Memorial Lecture Award winner mean to you?

The William J. Fry Memorial Lecture Award was an unexpected surprise because all of my professional accomplishments simply reflect who I am and what I enjoy doing.  I am truly honored and feel privileged to have received this special recognition among my special friends and colleagues.

  1. You have been involved with the AIUM for more than 3 decades. From your perspective, how has the AIUM changed over that span?

Over the past 3 decades, I have seen enthusiastic growth within our membership and more diversified multidisciplinary collaborations between many specialties for various areas of diagnostic and therapeutic ultrasonography. The AIUM has certainly raised the bar for technical and clinical practice standards that are now often developed with other professional organizations. The AIUM plays an pivotal role for political advocacy involving important issues that may impact how cost-effective and health care is delivered.

  1. You have written extensively and currently serve on the editorial board for Ultrasound in Obstetrics and Gynecology, as well as deputy editor of the Journal of Ultrasound in Medicine. Based on what you are seeing and writing, where is medical ultrasound headed?

The quality of medical ultrasound research has improved with the use of standard writing guidelines and detailed imaging protocols, as well as the application of evidenced-based medicine. We are seeing many novel applications of ultrasound technology that can now be delivered or used in combination with other imaging modalities in our patients. The Journal of Ultrasound in Medicine has become an important international resource with submissions from all over the world.  Original research articles constitute approximately 60% of the total papers submitted.

  1. What medical ultrasound question or concern keeps you up at night?

We use ultrasound imaging technology every day in our clinical practices. I am constantly trying to understand how diagnostic ultrasonography practice can be improved for patient care through development/application of new technologies, better education, and innovative research initiatives.

  1. Finish this sentence…”It’s best to use ultrasound first when…”

It’s best to use ultrasound first when providing obstetrical care to pregnant women because of its cost-effectiveness as a screening tool, established benefit for the prenatal diagnosis of fetal anomalies/complications, and long safety record in pregnant women.

Do you have any questions for Dr Lee? Comment below or let us know on Twitter: @AIUM_UltrasoundLearn more about the AIUM Awards Program at www.aium.org/aboutUs/awards.aspx.

Wesley Lee, MD, is Co-Director, Texas Children’s Fetal Center at Texas Children’s Hospital Pavilion for Women. He is also Professor, Department of Obstetrics and Gynecology; Section Chief, Women’s and Fetal Imaging; and Director of Fetal Imaging Research all at Baylor College of Medicine.

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