Tag Archives: medical imaging

An Open Invitation to Attend the AIUM’s 2026 Convention

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As a perinatologist, long-time AIUM member since 1993, and President of the organization, I want to invite you to join us at the upcoming 2026 AIUM Annual Convention: The Ultrasound Event—a gathering that continues to remind me why I first fell in love with ultrasound and with this organization. Every year, I leave the convention inspired by the innovation, collaboration, and passion that define the AIUM community.

This year, we are honored to welcome our keynote speaker, Professor Alison Noble CBE FRS FREng. A global leader in biomedical engineering and the Technikos Professor at the University of Oxford, Professor Noble has pioneered interdisciplinary advances at the intersection of artificial intelligence and medical imaging. Her group’s influential work in ultrasound AI—now used in clinics around the world—embodies the forward‑thinking innovation that defines our field. Her leadership across major scientific organizations further underscores the vision she brings to this year’s program.

This Convention is more than an opportunity to earn CME credits or hear world-class presentations. It is a chance to come together as physicians, sonographers, scientists, and students dedicated to advancing the field of medical ultrasound. In these unpredictable times, our ability to learn from one another, share discoveries, and strengthen our community has never been more important.

To all of our members of any professional title, background, or area of focus, I want to share what makes this meeting truly special to me. One of the things that makes the AIUM Annual Convention different to me is how well-rounded and interdisciplinary it is. Whether you’re a radiologist refining your diagnostic precision, a sonographer looking to expand into musculoskeletal ultrasound, a scientist presenting new research in therapeutic ultrasound, or someone just beginning to explore the fundamentals, this is the place to learn from each other. That cross-functionality is our greatest strength; it is where innovation happens. At last year’s convention, I listened as an obstetrician colleague compared notes with a dentist on imaging techniques, each walking away with new ideas they could apply in their own practice. It’s that spirit of curiosity, openness, and collaboration that makes the AIUM Convention unlike any other in the medical field.

A special note that I want to highlight: Please bring your students and trainees to Philadelphia. I am proud to have championed a special “In-Training” registration rate this year, and we want to those in training to become more involved. Help us mentor the next generation of ultrasound professionals, and let’s introduce them to the AIUM early in their career.

Philadelphia is the perfect backdrop for connection, exploration, and inspiration. I attend every year not only to stay at the forefront of science, but because the AIUM community truly feels like home.

I hope you’ll check out the program and register today. Together, let’s continue advancing the safe and effective use of ultrasound in medicine—one conversation, one idea, and one connection at a time.

With appreciation and excitement, I invite you to join me.

David Jones, MD, FAIUM
President, American Institute of Ultrasound in Medicine
AIUM member since 1993
Director, University of Vermont Medical Center Fetal Diagnostic Center
Professor of Obstetrics, Midwifery, Gynecology and Reproductive Science
Division of Maternal-Fetal Medicine
Larner College of Medicine
University of Vermont, Burlington

Workplace Conflict in Medical Imaging

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I’m going to tell you all a secret: I enjoy conflict.

No, I don’t enjoy creating conflict, and I certainly don’t enjoy being involved in conflicts with peers or my students. But I love studying it, mainly “why” conflict happens and how it impacts our organizational systems and daily interactions. Perhaps I’m naïve and hold an idealistic view that if we solved specific problems, the world would be run more effectively, and people would have more time to improve themselves and their environments. Wild, right?

I began looking into workplace conflict in hospitals in 2019 while shopping around for a dissertation topic, combining my knowledge from two fields of expertise: Vascular sonography and conflict resolution. Little did I know this task would become Herculean in scope as I quickly discovered how allied health professionals were marginalized in literature exploring conflict in hospitals.1 I found this odd and wanted to dive into this topic, puzzled by this literature that should have known conflict did not occur in a vacuum. Additionally, all the unresolved conflicts in healthcare would inevitably spiral out of control, leading to systemic conflicts that were much harder to resolve.

Many folks use the word “systemic” without understanding complex systems theory.2 Have no fear; I won’t bore you to tears with an explanation of systems theory and the differences between open and closed systems. However, I will explain that not only are you a system, but our healthcare professions are systems, our medical imaging departments are systems, and hospitals are systems. Sometimes, these systems work in harmony, but sometimes, they do not function as intended, leading to two types of social conflict: interpersonal and interprofessional.1 These conflicts demoralize hospital staff and probably impact patient care delivery from physicians, nurses, and allied health professionals who could be suffering from stress and burnout.1

We are all familiar with interpersonal conflict; it is unavoidable and, in many ways, necessary for personal growth. It is interprofessional conflict that should warrant more attention, particularly in hospital settings, as there is a tendency for healthcare professionals to be tribal in their group behavior, meaning they stick with their “own” and have an in-group preference. Medical imaging departments are not exempt from this phenomenon.1 Based on existing literature exploring conflict in hospitals,3,4 most reported conflict is interpersonal and intraprofessional, meaning the conflict most often occurs between peers, eg, nurse versus nurse. Interprofessional conflict reported in the literature also involved nurses versus physicians and occasionally involved allied health, including medical imaging professionals.1

The origins and antecedents of conflict within medical imaging are multifactorial: They combine personal factors specific to individuals with work-related issues exacerbated by high-stress, unpredictable work environments.1 Interprofessional conflict is particularly troubling as it suggests a difference in professional values between professions or a divergence of interests between patient care and the need to generate revenue.1 In those situations, a phenomenon known as “dual agency”1 may explain some interprofessional conflicts as medical imaging professionals struggle to advocate for patients while also serving the interests of their employers. This does not explain all of the interprofessional conflict, but it does suggest a need for medical imaging professionals to consider their roles in the larger healthcare system and if they are truly serving the best interests of their patients.

So, how do we address workplace conflict in medical imaging? Unfortunately, I see no “one size fits all” solution, but I propose a template for resolving many issues that contribute to conflict: Dispute systems design.5 Dispute systems design is a tailor-made analysis of a unique, conflict-prone environment that could identify problem elements within the system and provide opportunities for long-lasting resolution. Managing conflict is a misnomer, as the key to lasting conflict resolution is collaborative conflict resolution between conflicted parties.6 I am confident that introducing dispute systems design into hospitals and medical imaging departments can elicit many positive changes, potentially reducing burnout and staff turnover.

References

  1. Moody RC. Medical Imaging Professionals Experiencing Workplace Interprofessional Conflict: A Phenomenological Study. Davie, FL: Nova Southeastern University; 2023.
  2. Meadows DH. Thinking in Systems: A Primer. White River Junction, VT: Chelsea Green Publishing; 2008.
  3. Almost J, Wolff AC, Stewart-Pyne A, McCormick LG, Strachan D, and D’souza C. Managing and mitigating conflict in healthcare teams: an integrative review. J Adv Nurs 2016; 72:1490–1505. doi:10.1111/jan.12903
  4. Kim S, Bochatay N, Relyea-Chew, et al. Individual, interpersonal, and organisational factors of healthcare conflict: A scoping review. J Interprof Care 2017; 31:282–290.
  5. Rogers NH, Bordone RC, Sander FE, and McEwen CA. Designing Systems and Processes for Managing Disputes. Frederick, MD: Wolters-Kluwer; 2013.
  6. Katz NH, Lawyer JW, Sweedler M, Tokar P, and Sosa K. Communication and Conflict Resolution Skills. 3rd ed. Dubuque, IA: Kendall Hunt Publishing; 2020.

Robert Moody, PhD, MS, RVT, is an Assistant Professor of Cardiovascular Sonography at Nova Southeastern University (NSU) in Fort Lauderdale, FL.

Impact of Ultrasound on Medical Imaging: 1967–2021

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In 1967, a weekly feature for medical school seniors was the ‘bullpen’ in the Charity Hospital amphitheater. Students were assigned a patient and given 30 minutes to do a history and physical exam and then present their differential diagnosis and recommendations to an attending. Diagnosis was almost exclusively based on the history and physical examination. Laboratory studies were generally confined to basic electrolytes, a CBC, urinalysis, sputum stains, and a chest x-ray.

This prepared me well for internship and residency on the Osler Medical Service at Johns Hopkins Hospital. Interns were on call 24 hours a day for 6 days a week and usually spent 16 to 18 hours a day attending patients at the bedside.

On Osler, there were no computers and handwritten or typed paper records hung on a chart rack. The wards were not air-conditioned, and yellow curtains separated each of the 28 beds. There were no patient monitors, IV pumps, or respirators, and interns performed all of the basic lab work on their patients. Nursing care was excellent; the house staff and nurses worked as a team caring for the patients. Lack of technology was compensated for by close and direct interaction with the patients and their families, and the practice of medicine was extremely satisfying and filled with empathy and compassion.

The patient was the object of all of our attention. In the late 1960s, imaging was limited and played a relatively minor role in diagnosis and management. Defensive medicine was not a concern.

Following my internal medicine residency at Hopkins, I spent the next 3 years in the immunology branch of the National Cancer Institute in Bethesda. The research centered on the new field of bone marrow transplantation and treatment of graft vs. host disease.1 Whole-body radiation prepared candidates for transplantation and my experience in dealing with near-lethal doses of radiation led me to pursue a career in radiation oncology.

After completing a residency in general and therapeutic radiology in 1975, I joined the staff of the Ochsner Clinic in New Orleans, practicing a combination of radiation therapy and general radiography and fluoroscopy. Imaging was film-based, with studies hung on multipanel viewboxes for interpretation and a hot light for image processing. Cases were dictated directly to a transcriptionist in a cubicle next to the reading room and were typed and signed in real time. The daily workload included 40 to 50 barium studies along with numerous oral cholecystograms, intravenous urograms, and chest and bone radiographs. Specialized imaging consisted of polytomography, penumoencephalography, lymphangiography, and angiography. Evaluation of the aorta, runoff vessels, and carotid vessels was performed by direct puncture. Women’s imaging consisted of xeromammograms, hysterosalpingography, and pelvimetry. Image-guided intervention was nonexistent.

That year, ultrasound was in its early clinical development and I acquired a machine and placed it in the radiation therapy department and began scanning patients from the nearby emergency department. At that time there were no other sectional imaging modalities (CT was not yet available for clinical use.).

A large part of the challenge of ultrasound was learning anatomy in a completely new way. As a result, my groundwork in understanding sectional anatomy came from ultrasound. Ultrasound, unlike CT and MR, permitted imaging not only in standardized axial planes but allowed scan planes in virtually any orientation, requiring a very detailed knowledge of anatomy.

In 1976, upon the retirement of Dr. Seymour Ochsner, I became Chair of the department at Ochsner. This provided me with an opportunity to re-equip the department at a time that the entire field of imaging was undergoing immense change. With ultrasound, new findings were being reported regularly2, and the overall quality of ultrasound images often exceeded those of early body CT scans.

The development of Doppler ultrasound in the late 1970s further expanded the applications of ultrasound, although prior to the introduction of color Doppler, this was mainly of interest to vascular surgeons, and diagnosis was based on waveform analysis rather than imaging.

An important technological development at the end of the 1970s was real-time ultrasound, leading to the rapid development of new applications in obstetrical, abdominal, pediatric, and intraoperative imaging3,4.

Developments in computers in the early 1980s led me to an opportunity to participate in the development of exciting new technologies, including a breakthrough involving ultrasound and providing a method to image Doppler information. Working with a small company in Seattle and a large prototype device, we generated the first images of blood flow in the abdomen and peripheral vessels using color Doppler5,6. Color Doppler, by allowing Doppler information to be shown in an image rather than as a waveform, was important in getting radiologists interested in Doppler. Today, color Doppler is an integral part of the ultrasound examination.

A less successful application of ultrasound in the 1980s was in the evaluation of the breast. Early breast scanners produced quality images by scanning the breast, as the patient lay prone in a water tank. Unfortunately, breast ultrasound was promoted aggressively by many manufacturers and by the mid-1980s was discredited as a useful addition to mammography. By the mid-1990s, however, advances in breast ultrasound demonstrated an important role in the evaluation of breast masses, making ultrasound an indispensable part of breast imaging and leading to the BI-RADS breast imaging and reporting system for ultrasound7–9.

Ultrasound also has had a major impact in providing guidance for minimally invasive diagnostic procedures. Fine-needle biopsy of lesions of the liver, kidney, retroperitoneum, as well as peripheral lymph nodes and the thyroid, have become a standard part of the diagnostic workup.

A radiologist of 50 years ago would not recognize the field if he or she were to return today. In fewer than 50 years, the computer has changed the practice of medicine. More precise and early diagnosis are clear benefits of the technology of the 21st century, but are accompanied by the perils of over utilization prompted by defensive medicine with interests of the physician potentially overshadowing those of the patient.

Although the contribution of these advances has benefited countless patients, many of the rewards of the practice of medicine have been diminished. In looking back at my 50 years of practicing medicine, recalling my final grand rounds at Charity Hospital, I appreciate the diagnostic skills acquired through history and physical examination, as well as the relationship I had with my patients during my clinical years. To me, this represents the real definition of being a physician. In many cases, these simple tools were often as effective, and certainly more satisfying, than today’s tendency to view the patient as the result of an imaging test rather than a person.

Christopher R. B. Merritt, MD, is a Past President (1986–1988) of the American Institute of Ultrasound in Medicine (AIUM) where he led the development of the AIUM/NEMA/FDA Output Display Standard, and served as a founder of the Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL).

References

  1. Merritt CB, Mann DL, Rogentine GN Jr. Cytotoxic antibody for epithelial cells in human graft versus host disease. Nature 1971; 232:638.
  2. Merritt CRB. Ultrasound demonstration of portal vein thrombosis. Radiology 1979; 133:425–427.
  3. Merritt CRB, Coulon R, Connolly E. Intraoperative neurosurgical ultrasound: transdural and tranfontanelle applications. Radiology 1983; 148:513–517.
  4. Merritt CRB, Goldsmith JP, Sharp MJ. Sonographic detection of portal venous gas in infants with necrotizing enterocolitis. AJR 1984; 143:1059–1062.
  5. Merritt CRB. Doppler colour flow imaging. Nature 1987; Aug 20; 328:743–744.
  6. Merritt CRB. Doppler color flow imaging. J Clin Ultrasound 1987; 15:591–597.
  7. Mendelson EB, Berg WA, Merritt CRB. Towards a standardized breast ultrasound lexicon, BI-RADS: ultrasound. Semin Roentgenol 2001; 36:217–225.
  8. Taylor KWJ, Merritt C, Piccoli C, et al. Ultrasound as a complement to mammography and breast examination to characterize breast masses. Ultrasound Med Biol 2002; 28:19–26.
  9. Berg WA, Blume JD, Cormack JB, et al. Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. JAMA 2008; 299(18):2151–2163.