Ultrasound Education
diagnostics

Twenty-first Century Ultrasound: New Directions in Ultrasound Technology and Training

For nearly four decades, Wake Forest Baptist Medical Center has been a pioneer in ultrasound education and research.

Now the Program for Medical Ultrasound is positioned to take its leadership in the field to a new phase—both in education of the latest ultrasound techniques and in bringing ultrasound’s emerging therapeutic uses to the forefront.

The program’s co-directors are Frederick Kremkau, PhD, and John Bennett, PhD, RVT. They say the future is limitless.

“Over the years we’ve been able to get more and more information out of the instruments. And the other thing is they are now smaller and are getting less expensive,’’ Kremkau says. “And so now with the portability and the price, the question is ‘How will this allow ultrasound to become more pervasive in medicine than it’s ever been before?’’’

Ultrasound Research Initiatives

Bennett, a longtime lecturer for what he calls a “legacy’’ program, has been working in the year since he became co-director to lay the groundwork for ultrasound research initiatives.

“My vision and objective is to stimulate ultrasound-related research and innovations through the Wake Forest community, which we can then use to improve patient care and outcomes,’’ Bennett says.

Among the developments under way and to come in the Program for Medical Ultrasound:

  • Utilizing ultrasound to identify tumors and deliver drugs to the tumor. “It’s kind of like targeted bombing, a strategic missile,’’ Bennett says. “Ultrasound allows you to release the drug in the highest concentrations in the area where it’s needed, and you can inject much less of the drug in the entire system, where it can be toxic.’’
  • Supporting Ultrasound First, an initiative to integrate ultrasound into the medical school and training process so that in the future, physicians first turn to ultrasound before choosing more expensive modalities such as CT or MRI.
  • Increasing the use of point-of-care ultrasound. Thanks to advances in technology—equipment is much smaller and less expensive—ultrasound is being used more in intensive care units and emergency departments, among others.
  • Investigating the potential benefits of the emerging use of contrast enhanced ultrasound.
  • Courses in new ultrasound techniques such as elastography—which creates an image of the relative motion in tissue, an ultrasonic version of mechanical palpation, and has demonstrated value in tumor identification in the breast and in the staging of chronic liver disease.

Emerging Therapeutic Uses

Kremkau says the emergence of ultrasound for therapeutic use and its continuing growth as a diagnostic tool are exciting.

The growing availability of portable ultrasound devices allows it to be used at the site of accidents or on the battlefield, he says. And even when physicians at such scenes might be limited in their ability to interpret ultrasound images because of the small size, the images can be sent electronically and field physicians or medics can consult with those at a medical center in real time.

“Could an ultrasound device become the 21st century device for doctors as the stethoscope has been for decades?” Kremkau asks. “I don’t know. But I do know that ultrasound is going to penetrate medicine in a lot of areas where it has not done so before.’’