Live Outside of Your Comfort Zone: Ultrasound Education

Earlier this year, I attended a new-to-me scientific meeting—the 21st meeting of the International Society for Therapeutic Ultrasound (ISTU) in the beautiful city of Toronto. As I sat in sessions immersed in topics ranging from immunotherapy of liver tumors with histotripsy, to sonogenetic neuromodulation, to focused ultrasound for alleviating the pain from bone metastases, I was overwhelmed. And I was humbled by the vast swaths of knowledge that were nearly completely foreign to me, despite being a senior academic who does research in the field of biomedical ultrasound. I know less about the immune system than I should, and I don’t quite get the nuances of genetics and the brain—well, let’s just say that I like to use mine, but I am unaware of how it all works. I spent a lot of the meeting learning the background to the background of these areas so that I could understand more and better appreciate all the amazing science.

It was a pain and totally out of my comfort zone, but it was exhilarating! I learned so much, and I now appreciate the challenges, opportunities, and potential impact of this field much more than I did before. I met the brilliant physicians and scientists who were all more than willing to enlighten me about the details of their work and their up-and-coming innovations. It was refreshing. As I listened, I thought about the big picture and the potential impact of all this work on patient care and where the field will go in the future.

You may be thinking—why did I choose to attend this meeting? Why did I not go to a conference that was more aligned with my area of research? The answer is simple—I wanted to learn new things. I wanted my students to be exposed to innovative research directions and world experts in a related but distinct area. I wanted to better understand the evidence supporting the research so that I can shape my views with data, not dogma or hearsay. I also contributed a bit by sharing our group’s work on nanobubbles and the lessons we have learned from mostly diagnostic imaging research with these agents that can be applied to therapeutic strategies with focused ultrasound. I am most grateful to the organizers for having the foresight to explore how our research can complement therapeutic ultrasound applications and for inviting me to deliver one of the invited talks. I walked away, ready and inspired to foray into the intimidating world of ultrasound-mediated immunotherapy. Armed with the lay of the land and having met the pioneers of this field, I think the foundations we learned at this meeting will shape the next 5–10 years of our research.

I want to encourage all of you to expose yourself, your colleagues, and your trainees to new concepts, new science, and new clinical approaches. Be open-minded to change, think, consider the evidence, and make rational, data-driven decisions as you move forward with your clinical practice, research, and day-to-day obligations. Educate yourself in the new research and translational directions in the field. The world of biomedical ultrasound is complex, multidisciplinary, and rich with burgeoning ideas that will someday revolutionize clinical practice. Many recent innovations, like the focused ultrasound treatment of essential tremor, are doing so already.

Live outside of your comfort zone—it will refresh and energize you, and it will stimulate new ideas that may someday save one patient, or save the world. Of course, it’s fine to do things as you’ve always done and stay where it’s cozy and comfortable, but I promise you will enjoy it if you venture beyond, even a little bit. Enjoy your summer and science on!

Agata A. Exner, PhD (@AgExner;, is the Henry Paine Willson Professor and Vice Chair in the Department of Radiology at Case Western Reserve University & University Hospitals of Cleveland.