Volume 6 Issue 3 - Australasian Society for Ultrasound in Medicine

Live scanning at Annual Scientific Conferences: a new look at ASUM policy
ultrasound and its use is not contra-indicated for medical
purposes when a benefit from additional diagnostic
information is expected. When a subject is repeatedly
scanned for purposes other than achieving medical benefit,
then it may be justifiable to impose greater margins of safety,
particularly for obstetrics examinations. There are also ethical
considerations that impact on standards of practice and
policy guidelines. When non-medical applications are
involved it may be most appropriate to adopt the simple
approach of preventing live scanning of either 1 st trimester,
or of pregnant models in general.
NON-MEDICAL APPLICATIONS
The prudent use of medical ultrasound as advocated by
ASUM and other ultrasound societies usually refers to
“medically indicated” procedures, ie, those where an
improved diagnostic outcome is expected from the
procedure. The use of diagnostic imaging simply to view
the fetus for demonstration purposes or to obtain a
personal photograph or video does not constitute a
medical use, in its strictest sense. In response to increasing
commercial interest in marketing non-diagnostic
“keepsake” videos and photos, the American Institute of
Ultrasound in Medicine (AIUM) issued cautionary
statements against what it describes as the non-medical use
of diagnostic ultrasound 3 .
The FDA Centre for Devices and Radiological Health has
also been quite outspoken, threatening regulatory action
against the practice of commercial imaging of fetuses for
“keepsake” videos 2 . The FDA notified the medical
community in the USA in 1994 regarding its concerns about
the misuse of diagnostic ultrasound equipment and sought
to discourage their patients from having sonograms for socalled
“non-medical” reasons. The published FDA rationale
states,
“Although there is no evidence that these physical effects can harm
the fetus, public health experts, clinicians and industry agree that
casual exposure to ultrasound, especially during pregnancy, should
be avoided. Viewed in this light, exposing the fetus to ultrasound
with no anticipation of medical benefit is not justified.” 2
The British Medical Ultrasound Society has published
guidelines that permit the use of non-medical ultrasound,
but only under conditions that significantly limit the
ultrasound output 4 and, hence reduce the risk to the patient
in the absence of known benefit. The BMUS defines nondiagnostic
use of ultrasound equipment as that including
repeated scans for operator training, equipment
demonstration using normal subjects, and the production
of souvenir pictures or videos of a fetus. The BMUS
guidelines for non-diagnostic uses of diagnostic ultrasound
provide upper limits to the thermal index (TI