John S. Pellerito

The role of radiology in the era of compact ultrasound systems: SRU Conference, October 14 and 15, 2003.

PREAMBLE The Society of Radiologists in Ultrasound (SRU) convened its first industry conference in Chicago, Illinois, on October 14 and 15, 2003. Representatives from the SRU and the ultrasound industry met for 2 days to discuss the impact of compact ultrasound on the practice of ultrasound by radiologists. SRU participants were Robert Bree (moderator), Carol Benson, James Bowie Beverly Coleman, Barbara Hertzberg, Alfred Kurtz, Ted Lyons, John Pellerito, Phil Ralls, and Carol Rumack. Industry was represented by Peter Pellerito, Jeff Peiffer, and Nahi Hallman from General Electric; Toni Burkett and Roy Peterson from Philips; Richard Begin and Heike Seck from Siemens; Patrick Martin and Kent Mueller from Sonosite; Robert McClure from Terason; and Anil Singhal and Terry Duesterhoeft from Zonare. Pamela Kassing, Senior Director Economics and Health Policy from the American College of Radiology spoke about the economic impact of compact ultrasound. Formal lectures with active discussion were followed by SRU members adjourning into an executive session to prepare a draft statement. This was presented to the entire group on the second day and the points were discussed until a consensus was reached. Subsequently the revised draft was distributed for further comments. The following document summarizes the final opinion of the group.

Native renal artery duplex sonography

The American Institute of Ultrasound in Medicine (AIUM) is a multidisciplinary association dedicated to advancing the safe and effective use of ultrasound in medicine through professional and public education, research, development of guidelines, and accreditation. To promote this mission, the AIUM is pleased to publish, in conjunction with the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Radiologists in Ultrasound (SRU), this AIUM Practice Guideline for the Performance of Native Renal Artery Duplex Sonography. We are indebted to the many volunteers who contributed their time, knowledge, and energy to bringing this document to completion. The AIUM represents the entire range of clinical and basic science interests in medical diagnostic ultrasound, and, with hundreds of volunteers, the AIUM has promoted the safe and effective use of ultrasound in clinical medicine for more than 50 years. This document and others like it will continue to advance this mission. Practice guidelines of the AIUM are intended to provide the medical ultrasound community with guidelines for the performance and recording of high-quality ultrasound examinations. The guidelines reflect what the AIUM considers the minimum criteria for a complete examination in each area but are not intended to establish a legal standard of care. AIUM-accredited practices are expected to generally follow the guidelines with recognition that deviations from these guidelines will be needed in some cases, depending on patient needs and available equipment. Practices are encouraged to go beyond the guidelines to provide additional service and information as needed.

Proceedings: Beyond Ultrasound First Forum on improving the quality of ultrasound imaging in obstetrics and gynecology

&NA; The Beyond Ultrasound First Forum was conceived to increase awareness that the quality of obstetric and gynecologic ultrasound can be improved, and is inconsistent throughout the country, likely due to multiple factors, including the lack of a standardized curriculum and competency assessment in ultrasound teaching. The forum brought together representatives from many professional associations; the imaging community including radiology, obstetrics and gynecology, and emergency medicine among others; in addition to government agencies, insurers, industry, and others with common interest in obstetric and gynecologic ultrasound. This group worked together in focus sessions aimed at developing solutions on how to standardize and improve ultrasound training at the resident level and beyond. A new curriculum and competency assessment program for teaching residents (obstetrics and gynecology, radiology, and any other specialty doing obstetrics and gynecology ultrasound) was presented, and performance measures of ultrasound quality in clinical practice were discussed. The aim of this forum was to increase and unify the quality of ultrasound examinations in obstetrics and gynecology with the ultimate goal of improving patient safety and quality of clinical care. This report describes the proceedings of this conference including possible approaches to resident teaching and means to improve the inconsistent quality of ultrasound examinations performed today.

Findings of acute appendicitis on transvaginal ultrasound.

CLINICAL HISTORY A 19-year-old woman presented with 1 day of acute onset severe, colicky right adnexal pain. She had no other symptoms. The patient is sexually active and irregularly uses contraception. On examination, she had right adnexal tenderness without rebound. There was no vaginal discharge or cervical motion tenderness. The white blood cell count was 15,000 and the AYhuman chorionic gonadotropin was negative. A transvaginal ultrasound was obtained to evaluate for right adnexal pathology (Figs. 1Y6).

Proceedings: Beyond Ultrasound First Forum on Improving the Quality of Ultrasound Imaging in Obstetrics and Gynecology: Beyond Ultrasound First Forum

The Beyond Ultrasound First Forum was conceived to increase awareness that the quality of obstetric and gynecologic ultrasound can be improved, and is inconsistent throughout the country, likely due to multiple factors, including the lack of a standardized curriculum and competency assessment in ultrasound teaching. The forum brought together representatives from many professional associations; the imaging community including radiology, obstetrics and gynecology, and emergency medicine among others; in addition to government agencies, insurers, industry, and others with common interest in obstetric and gynecologic ultrasound. This group worked together in focus sessions aimed at developing solutions on how to standardize and improve ultrasound training at the resident level and beyond. A new curriculum and competency assessment program for teaching residents (obstetrics and gynecology, radiology, and any other specialty doing obstetrics and gynecology ultrasound) was presented, and performance measures of ultrasound quality in clinical practice were discussed. The aim of this forum was to increase and unify the quality of ultrasound examinations in obstetrics and gynecology with the ultimate goal of improving patient safety and quality of clinical care. This report describes the proceedings of this conference including possible approaches to resident teaching and means to improve the inconsistent quality of ultrasound examinations performed today.

Breaking Borders: A Case Report of Borderline Ovarian Tumor in the Pregnant Patient.

CLINICAL HISTORY A 28-year-old Gravida 1 Para 0 at 20 weeks gestation was referred for evaluation of a pelvic mass seen on routine fetal ultrasound. At 8 and 12 weeks, sonograms demonstrated an enlarged right adnexa. At 16 weeks, the sonogram showed a healthy fetus with a complex right adnexal mass (Fig. 1) and free fluid in the cul-de-sac. The patient subsequently obtained pelvic magnetic resonance imaging (MRI) and underwent surgical evaluation. The patient reported that she felt well except for increasing midline pelvic discomfort and bloating. Her pregnancy had otherwise been unremarkable. Her medical history is significant for polycystic ovarian syndrome and surgical history is remarkable for excision of bilateral phyllodes tumors in the breasts 2 years ago, with pathology demonstrating benign findings.