Tag Archives: imaging

I Enjoy Being a Detective

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I chose the specialty of radiology, and subsequently diagnostic ultrasound, because I enjoy the “detective” aspect of medicine. It is exciting to use diagnostic imaging to attempt to determine the cause of a patient’s illness. Obstetrical ultrasound has been of interest because most pregnant patients are healthy and happy and one always got an answer, whether right or wrong, 20-30 weeks hence.

I began my career in ultrasound in 1976 joining Dr. Roy Filly at UCSF. He and I are still practicing (perhaps the longest pair in academic medicine). The early days of arguing whether it was better to view images as white on a black background or black on a white background and whether static articulated arm scanning was better than “real-time scanning” are long gone, replaced by incredible technology.

Peter CallenThe pitfalls of image analysis has been a curiosity of mine. I have always been intrigued as to how one looks at a series of images and achieves the right (or occasionally wrong) conclusion. I am thrilled that most medical centers are introducing diagnostic ultrasound to medical student teaching early in their training. This has helped generate a lot of awareness and better understanding of our specialty. I am proud to have been a member of our organization, the AIUM. While there are some that only know the AIUM for its guidelines, it has served as a strong core of support for our specialty for the past several decades with support and advice to and from ultrasound professionals, including physicians, sonographers, scientists, engineers, other healthcare providers, and manufacturers of ultrasound equipment. This award is especially meaningful to me to be included with the true founders and leaders of our specialty.

What is your story? Why did you start using ultrasound? Comment below or let us know on Twitter: @AIUM_Ultrasound.

Dr Peter Callen received the 2015 Joseph H. Holmes Clinical Pioneer Award from the AIUM. Dr Callen’s contributions span decades and he is currently Emeritus Professor of Radiology, Obstetrics, and Gynecology at the University of California, San Francisco.

The Nerve of Ultrasound

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I’m a fan of ultrasound. In the past, ultrasound has been seen as the less attractive cousin of the other imaging modalities, CT and MRI. Maybe that’s why I champion it so much, because I can’t help but root for the underdog! Either way, I am always eager to find ways to incorporate ultrasound in my practice as a musculoskeletal radiologist. It is fast, convenient Ultrasound and MRI of Nerveand inexpensive, and patients tend to find the experience less daunting than being in a metal tube.

Now, I think it is high time that ultrasound take a place on the front lines of nerve imaging. We’ve made several advances in the imaging of nerves under ultrasound; nerves have a characteristic appearance on ultrasound and it is often used for image guidance in nerve blocks. In my practice, we use ultrasound to diagnose and treat nerve pathology. However, a lot of nerve imaging is still primarily done via MRI. This is probably because much of the research in nerve imaging has been done in MRI. Additionally, many clinicians are not aware of the diagnostic capabilities of high resolution ultrasound in nerve imaging. I’m hoping to change that!

Funded by a generous grant from the AIUM’s Endowment for Education and Research, my colleagues and I are hoping to compare the utility of ultrasound in nerve imaging to MRI. What we hope to confirm is that ultrasound has similar diagnostic capabilities to MRI in the imaging of neuropathy. In addition, we plan to use ultrasound’s capability for dynamic imaging to produce new methods for evaluation of the brachial plexus and peripheral nerves. This grant will fund one of the largest volume studies of ultrasound in nerve imaging, which will in turn help to further expand the role of one of the most valuable imaging modalities we have. So, hopefully soon, this “underdog” will have its day.

In what other areas is ultrasound emerging from its “underdog” label? Where can we use Ultrasound First? Comment below or let us know on Twitter: @AIUM_Ultrasound.

Ogonna Kenechi “Kenny” Nwawka, MD is the assistant attending radiologist in the Hospital for Special Surgery as well as assistant professor of radiology at the Weill Medical College of Cornell University.

Dr. Nwawka’s research project is being funded by a $50,000 grant from the Endowment for Education and Research. To help support these and other projects, consider donating.