Ultrasound Education

Daniel Rukstalis, MD, Advocating Ultrasound Across Disciplines

Daniel Rukstalis, MD, residency program director for the Department of Urology at Wake Forest School of Medicine, advocates for the use of ultrasound technology in his field to improve patient care and therapeutic outcomes.

An early practitioner of advanced imaging and novel therapeutics in urology, Rukstalis came to Wake Forest in 2012. He believes Wake Forest’s openness to innovation and creativity allows for significant advances in health care. He promotes these values by encouraging what he calls “transdisciplinary applications’’ of medical ultrasound.

For Rukstalis, a transdisciplinary approach to medical ultrasound means using the technique in a range of clinical settings and across areas of expertise. Rukstalis believes assets like Wake Forest’s Program for Medical Ultrasound create an environment for thoughtful interdisciplinary dialogue. He is eager to create conversations around the use and advancement of ultrasound within the medical community.

Stirring up conversation

One topic in which Rukstalis is highly invested is ultrasound point-of-care. “Hospitals really need to think about how imaging is done on inpatients,” Rukstalis says. “Is there an opportunity for point-of-service care at the bedside? Ultrasound can be used diagnostically and therapeutically in patient rooms rather than moving people to a centralized imaging place and then back to their bed.’’

To Rukstalis, sharing knowledge and creating dialogue comes naturally.
As director of abdominal and pelvic examination for the American Urological Association, Rukstalis has helped lead a movement to teach physicians and allied health professionals about the uses of ultrasound, particularly in point-of-service diagnostic tests.

“Arriving here at Wake Forest was the catalyst for doing point-of-service ultrasound even more because of the presence of the Program for Medical Ultrasound,’’ he says.

A patient-focused career

Rukstalis’s interest in patient care has been a consistent theme throughout his career. While attending Eastern Virginia Medical School, a program aimed at training primary care providers, he decided to become a surgeon. But once in the surgery program at Dartmouth Medical School, he found it was not as fulfilling to him as working directly with patients.

What he missed as a surgeon, he says, was the “longitudinal experience’’ of interacting with patients throughout their medical journeys. The field of urology was the exception. It gave him the opportunity to practice advanced treatments through surgery while still managing ongoing patient care.

“I like being involved as the initial diagnostician, as well as having the skills both medically and surgically to treat those conditions, and being able to remain the patient’s physician over time,’’ Rukstalis says.

Early innovator in imaging

In addition to his thought leadership on patient care, Rukstalis’s inclination toward transdisciplinary applications of ultrasound spills over into his practice of urology. Rukstalis is heavily involved in developing new therapeutic uses of ultrasound, and has been advancing the use of imaging in his field for many years.

As a young urologist, Rukstalis became interested in novel therapeutics and developed surgical procedures that are now being conducted around the world. He and a colleague performed the world’s first renal ablation in 1995, killing kidney cancer by freezing it through traditional surgery. Once he discovered the benefits of minimally invasive techniques, he was an early adopter of using ultrasound to guide renal ablations performed laparoscopically or percutaneously.

At Wake Forest, he has participated in the Prostate Center, a group within Wake Forest’s nationally recognized Comprehensive Cancer Center. The Prostrate Center is a collaboration among the urology, anesthesiology and radiation oncology departments that offers an array of minimally invasive treatments for prostate cancer.

One of the items purchased to assist the prostrate team is a new ultrasound machine that performs advanced Doppler imaging and elastography. Rukstalis says the machine improves Wake Forest’s ability to visualize prostate cancer and target lesions. Rukstalis envisions Wake Forest one day creating an “ablation institute’’ in which a transdisciplinary team can use a full spectrum of imaging tools to perform ablations to eliminate cancer and reduce symptoms.

The right place to innovate

Behind the successes enjoyed so far and still to come, he says, is the realization that the Program for Medical Ultrasound “is a great platform for transdisciplinary applications of ultrasound,” as it brings together multiple fields with the goal of training individuals in the latest ultrasound techniques.

Rukstalis chose Wake Forest in large part because of its “rich history of curiosity and research’’ and with the hope of developing manufacturing pathways for new products and treatments “with a focus on quality and safety.’’

To learn more about the Program for Medical Ultrasound contact us at cmu@wakehealth.edu or +1.336.716.4505.