Official Proceedings - AIUM

American Institute of Ultrasound in Medicine Proceedings J Ultrasound Med 32(suppl):S1–S134, 20131540628 Carotid Plaque Classification System: A New StandardDiagnostic CriterionLysa Legault Kingstone, 1,2 * Carlos Torres, 1 Geoffrey Currie 21Diagnostic Imaging, Ottawa Hospital, Ottawa, Ontario,Canada; 2 School of Dentistry and Health Sciences, CharlesSturt University, Wagga Wagga, New South Wales, AustraliaObjectives—2D and 3D ultrasound (US) for carotid plaque imagingcan provide valuable information on the morphology. Particularsonographic features of the plaque have been recognized as the foundationfor stroke. Carotid plaque imaging is increasingly recognized as being asimportant as stenotic grading; however, various methods of echographicimage standardization have been described. Standard plaque analysis andcharacterization are lacking, and, to our knowledge, no global classificationsystem or form of image standardization exists. Our objective was todevelop a standard US characterization method and reporting system forcarotid atherosclerotic lesions.Methods—We created and implemented a quality assurancetool for plaque classification criteria in an effort to globalize image and reportingstandardization without the use of complex or expensive software.US images were subjectively graded using a standardized classification reportform that combines echographic image features. Three categoricalgroups were defined according to risk of vulnerability: type A (low risk),type B (moderate risk), and type C (high risk). Accuracy of the method wasdetermined by measuring the agreement of plaque characterization usingstandardized US images and comparing inter-observer agreement andinter-reader reliabilities. In addition, highly vulnerable plaques incorporatedRadpath correlation.Results—At the time of submission, final data analysis wasbeing completed. Preliminary results indicate that our plaque classificationsystem provided excellent sensitivity, specificity, positive predictive value,negative predictive value, and accuracy.Conclusions—Our standardized classification system has allowedus to improve the consistency and accuracy of plaque characterizationimaging and assessment without of the use of computed orautomated methodologies. This plaque analysis criterion may help promotethe use of a standard global US classification analysis and uniformreporting for carotid atherosclerotic lesions. Large-scale studies are requiredto fully assess the potential of this grading system.1540646 A Decade of Ultrasound Practice Accreditation at CaliforniaPrenatal Diagnosis Centers and Experience With FetalEchocardiography AccreditationSara Goldman Genetic Disease Screening Program, CaliforniaDepartment of Public Health, Richmond, California USAObjectives—Monitor the ultrasound practice accreditation andreaccreditation at prenatal diagnosis centers (PDCs) from 2001 to 2011and fetal echocardiography accreditation since April 2011.Methods—All PDCs were required to achieve obstetric (OB)ultrasound practice accreditation by 2000. By March 2012, Fetal echo–approvedPDCs were required to apply for fetal echocardiography accreditationwith the AIUM or Intersocietal Commission for the Accreditationof Echocardiography Laboratories (ICAEL).Results—In 2001, 50 ultrasound practices (65 %) had achievedAIUM accreditation; 17 practices (22%) were in the process of achievingAIUM accreditation; and 10 practices (13%) had chosen American Collegeof Radiology (ACR) accreditation. In 2011, there were a total of 80ultrasound practices at 141 PDC sites. Seventy-five practices (94%) hadachieved AIUM accreditation, and 5 ultrasound practices had chosen ACRaccreditation. On average, 18 ultrasound practices achieve reaccreditationeach year. In March 2012, 34 ultrasound or pediatric cardiology practicessubmitted a fetal echocardiography accreditation application representing56 PDC sites, and 18 (53%) practices are currently accredited by either theAIUM or ICAEL representing 30 PDC sites.Conclusions—A requirement for OB ultrasound practice accreditationat PDCs and fetal echocardiography accreditation at fetal echo–approved PDCs is achievable through monitoring of the reaccreditationprogress.1540658 Medical Student Ultrasound Education as Part of theClinical Skills Immersion ExperienceZachary Robinson, 1 Colin Turney, 1 Creagh Boulger, 2 DavidBahner 2 *1 Ohio State University College of Medicine,Columbus, Ohio USA; 2 Emergency Medicine, Wexner MedicalCenter, Ohio State University, Columbus, Ohio USAObjectives—Focused ultrasound (US) allows physicians toquickly obtain high-quality, cost-effective images. While the technologyhas advanced, education in ultrasound has lagged at the graduate medicaleducation and medical student levels. Over the last several years, OhioState has emerged as a leader in ultrasound education by teaching focusedUS to medical students. US has been integrated into the Clinical SkillsImmersion Experience (CSIE), a unique 7-day course providing third-yearmedical students with experience in a variety of procedural and imagingtechniques.Methods—The CSIE curriculum consists of a series of lecturesand workshops over a variety of clinical skills. As part of this curriculum,we conducted a 3-hour session on focused ultrasound, which includedpelvic, aorta, and cardiac imaging, as well as evaluation of lung sliding andthe focused assessment with sonography for trauma scan. The session includeda brief lecture on basic US principles followed by extensive handsonexperience. After the session, students completed a survey evaluatingtheir skills with US using a 5-point Likert scale, where 1 = low skill leveland 5 = highly skilled. They were also asked how well the session improvedtheir understanding of ultrasound, where 1 = not at all and 5 =greatly improved.Results—Ten of 38 students responded to the survey for theAugust session (response rate, 26%). Nine of 10 respondents had performed