Volume 11 Issue 1 (February) - Australasian Society for Ultrasound ...

“Approximately 20 to 50 percent of our case
load involves technically difficult patients”
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Improved image quality means more
accurate diagnoses
To help address these challenges, St. Paul’s recently
upgraded its lab to include two Philips iU22 ultrasound
systems featuring the new C5-1 transducer. The C5-1 is
designed specifically to address challenges associated with
imaging technically difficult patients. Through state-of-theart,
clinically proven PureWave crystal technology, the
C5-1 transducer provides exceptionally clear imaging to
help ultrasound practitioners save valuable time and obtain
greater diagnostic confidence.
The C5-1’s new tissue aberration correction technology
compensates for the speed of sound as it passes through
adipose tissue, improving penetration when imaging
technically difficult patients. As a result, sonographers
are getting better detail, better contrast resolution, less
speckle, and reduction in side lobes or reverberation.
“Eighty percent of our work here at St. Paul’s is abdominal
work,” said Fix. “Of that 80 percent, 25 to 30 percent
can be technically difficult, meaning not only the size of
the patient, but also the kind of pathologies we see in the
liver. For example, we see a lot of hepatitis patients and a
lot of patients with very fatty livers. From an ultrasound
perspective, these targets can be very technically
challenging because they attenuate the sound.
“About 20 percent of our work flow is obstetrics for which
we do detailed 18-week and dating scans,” said Fix. “With
the C5-1, I now have staff fighting to get into that particular
room because the quality of the echo in viewing the heart
is so much better. The valves are crisper; the chambers
are better—so much so that we picked up two congenital
anomalies we might otherwise have missed before. In one
case scanned earlier, we had a feeling there was something
wrong with the heart. After further evaluation by imaging
with the C5-1, it became clearly evident that there was a
transposition of the great vessels, which is a huge impact to
the patient. We now have more confidence when scanning
detail obstetrics, especially the fetal heart, as well as
imaging the fibroid uterus.”
Fix also cites the improved image quality in saving time
typically spent by radiologists needing to rescan patients.
“We show all of our cases to our radiologists prior to
letting our patients go. In a lot of our cases they have to
come in and scan the patients themselves as the images do
not display the pathology that we describe, especially with
technically challenging patients. With the C5-1, not only is
our technical confidence high, the image quality is better,
which has reduced the number of rescans required by our
radiologist since they have a better sense of the
underlying pathology.”
“We found with the C5-1 we don’t have to work the probe
as hard,” added Fix, “we’re getting anterior [images] from
the front of the liver to the back wall penetration as well
as good pixel size. In other words, we have really good
contrast and spatial resolution. This is critical when we’re
looking at livers that have hepatitis or fatty infiltration,
since we are looking for primary cancers in the liver. To
make these diagnoses, we need penetration and good
spatial and contrast resolution and the C5-1 has those.”
Reducing time imaging technically difficult patients
Patient throughput is important to a hospital’s bottom
line. The C5-1 is helping St. Paul’s sonographers to save
time on each exam, while obtaining high-quality images on
technically challenging patients.
Obstetrical work is another area in which image quality is
crucial in making diagnoses. Fix says the C5-1 has helped
staff diagnose conditions that may otherwise have
been missed.
ASUM Ultrasound Bulletin 2008 February 11 (1)
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