[Technical innovations to optimize ultrasound imaging]. / Technische Innovationen zur Optimierung der Ultraschallbildgebung.

Due to the high incidence of thyroid disease, ultrasound examination of the neck has high priority in many nuclear medicine departments. A precise sonogram with high spatial resolution and image sharpness over the entire imaging area, combined with minimal artifacts, is the prerequisite for meeting the demand for high diagnostic accuracy in modern medicine. In the last 20-30 years, a number of significant technical innovations have been implemented, such as the development of the matrix array, electronic image focusing, realtime compound imaging, artifact limitation by speckle reduction and harmonic imaging, as well as the possibility to extend the field of view.

[Perspectives and Challenges of hand-held Ultrasound]. / Entwicklungen, Herausforderung und Perspektiven des Handheld-Ultraschalls (HHUS).

The use of handheld ultrasound devices from a technical and data protection point of view, device properties, functionality, documentation, indications, delegation of performance, applications by doctors, students and non-medical staff is examined and discussed.

Best Practice Guideline - DEGUM Recommendations on Breast Ultrasound. / Best Practice Guideline ­ Empfehlungen der DEGUM zur Durchführung und Beurteilung der Mammasonografie.

Alongside mammography, breast ultrasound is an important and well-established method in assessment of breast lesions. With the "Best Practice Guideline", the DEGUM Breast Ultrasound (in German, "Mammasonografie") working group, intends to describe the additional and optional application modalities for the diagnostic confirmation of breast findings and to express DEGUM recommendations in this Part II, in addition to the current dignity criteria and assessment categories published in Part I, in order to facilitate the differential diagnosis of ambiguous lesions.The present "Best Practice Guideline" has set itself the goal of meeting the requirements for quality assurance and ensuring quality-controlled performance of breast ultrasound. The most important aspects of quality assurance are explained in this Part II of the Best Practice Guideline.

How safe is it to use ultrasound in prenatal medicine? Facts and contradictions - Part 2 - Laboratory experiments regarding non-thermal effects and epidemiological studies.

The first part of this CME article (issue 5/20) provided a detailed examination of the biophysical effects of ultrasound waves, the exposure values, and in particular the thermal effect. In vivo and in vitro measurements have shown that the temperature increase in tissue associated with B-mode ultrasound is far too low to pose a potential risk. Even experiments with exposure values in the range of pulsed Doppler have shown that temperature increases of over 1.5 °C can only occur in areas in direct contact with the probe, thus making a limited exposure time particularly in the case of transvaginal application advisable. The second part of this CME article describes various laboratory and animal experiments for evaluating non-thermal effects and also presents the most important epidemiological studies in the last 30 years in the form of an overview and review. In addition to direct insonation of isolated cells to examine possible mutagenic effects, the blood of patients exposed in vivo to ultrasound was also analyzed in multiple experiments. Reproducible chromosome aberrations could not be found in any of the studies. In contrast, many experiments on pregnant rodents showed some significant complications, such as abortion, deformities, and behavioral disorders. As in the case of thermal effects, the results of these experiments indicate the presence of an intensity- or pressure-dependent effect threshold. Numerous epidemiological studies examining possible short-term and long-term consequences after intrauterine ultrasound exposure are available with the most important studies being discussed in the following. In contrast to information presented incorrectly in the secondary literature and in the lay press, health problems could not be seen in the children observed in the postpartum period in any of these studies.

How Safe Is the Use of Ultrasound in Prenatal Medicine? Facts and Contradictions. Part 1 - Ultrasound-Induced Bioeffects.

The "Ordinance on Protection Against the Harmful Effects of Non-Ionizing Radiation in Human Applications" will go into effect at the beginning of 2021 1. §â€Š10 of this ordinance prohibits non-medical fetal ultrasound exposure thereby resulting in uncertainty, particularly among affected patients, with respect to the generally accepted theory regarding the lack of ultrasound side effects. Although not a single study has shown a detrimental effect on fetal or child development following exposure to ultrasound, the Federal Ministry for the Environment, Nature Conservation and Nuclear Safety has justified the ban with the purely hypothetical possibility of an unidentified side effect. The first part of the following study shows which ultrasound-induced biophysical effects are known and which dose-dependent threshold values must be taken into consideration. In particular, the study focuses on the well-researched heat effect with some in vivo measurements in humans showing that the actual temperature increase is less than the theoretically calculated values. The planned second part of this study will discuss the non-thermal effects and present the most important epidemiological studies.

DEGUM Recommendations on Infection Prevention in Ultrasound and Endoscopic Ultrasound.

Microbial contamination of ultrasound probes for percutaneous or endoscopic use is common. However, infectious diseases caused by transmission of microorganisms by US procedures have rarely been reported. In Germany, legal regulations address hygiene in ultrasound procedures. Based on these regulations and the available literature, an expert panel of the German Society of Ultrasound in Medicine (DEGUM) has formulated sophisticated recommendations on hygienic measures in percutaneous and endoscopic US, including US-guided interventions.

The 'Radiant Effect': Recent Sonographic Image-Enhancing Technique and Its Impact on Nuchal Translucency Measurements.

Background: This study assesses the effects of the 'Radiant' image enhancement technique on fetal nuchal translucency (NT) measurements during first-trimester sonographic exams. Methods: A retrospective analysis of 263 ultrasound images of first-trimester midsagittal sections was conducted. NT measurements were obtained using a semi-automatic tool. Statistical methods were applied to compare NT measurements with and without 'Radiant' enhancement. An in vitro setup with predefined line distances provided additional data. Results: Incremental increases in NT measurements were observed with varying levels of 'Radiant' application: an average increase of 0.19 mm with 'Radiant min', 0.24 mm with 'Radiant mid', and 0.30 mm with 'Radiant max.' The in vitro results supported these findings, showing consistent effects on line thickness and measurement accuracy, with the smallest mean deviation occurring at the 'Radiant mid' setting. Conclusions: 'Radiant' image enhancement leads to significant increases in NT measurements. To avoid systematic biases in clinical assessments, it is advisable to disable 'Radiant' during NT measurement procedures. Further studies are necessary to corroborate these findings and to consider updates to the NT reference tables based on this technology.