Portable Ultrasound for the Win

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Tommaso Di Ianni, MSc
2017 New Investigator Award winner for Basic Science

 

What does being named the New Investigator Award winner mean to you?

It was an honor being appointed the New Investigator Award for the Basic Science category for “In Vivo Vector Flow Imaging for a Portable Ultrasound Scanner.” It means a lot to me to see my scientific contributions being recognized by some of the leading experts in the field. It provides a great stimulus to continue to focus on researching imaging solutions that will hopefully improve the clinical practice.

 

How did you get into working with ultrasound?

After the masters I was looking for open PhD positions, and I found an opening about portable ultrasound imaging at Professor Jørgen A. Jensen’s Center for Fast Ultrasound Imaging at the Technical University of Denmark. I didn’t know much about ultrasound at the time, but I was fascinated about its great capabilities as a risk-free imaging modality. Even more, I was attracted by the fact that ultrasound scanners can be scaled like any other electronic device and can become so small it can fit in a lab coat pocket. Currently, this does not apply to other imaging technologies, and I believe that ultrasound has a lot of potential to make a difference at the point of care.

 

What do you like the most about working with ultrasound?

I am overwhelmed about the patterns that the blood can depict when flowing into the vessels. With ultrasound, we can obtain a very high temporal resolution and we can visualize dynamic details on a millisecond scale. Sometimes, we can see vortices forming when the valves in the jugular vein close, or the helical flow in the ascending aorta. Also, the vortices forming in the heart are absolutely impressive to look at. I believe there’s a lot of diagnostic potential in that wealth of information.

 

What are your future research plans?

Currently, I’m completing my PhD and I will continue my research as a postdoc for some more months. In the future, I plan to continue to do research in the biomedical engineering field. I’m very interested in imaging the microvasculature in cancer to improve the characterization of the tumor’s functional activity and to track the response to the therapy.

 

Why did you becoming interested in ultrasound? Where did you learn your ultrasound skills? Comment below or let us know on Twitter: @AIUM_Ultrasound. Learn more about the AIUM Awards Program at www.aium.org/aboutUs/awards.aspx.

Tommaso Di Ianni, MSc, is a PhD student at Technical University of Denmark.

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.