Ultrasound Exams, who Should Perform them and how Should they be Documented?

 

The Danish Society of Diagnostic Ultrasound (DSDU) is a multispeciality society whose primary purpose is to spread the use and knowledge of US. It is not a governing body but an advisory society with policies and recommendations.

Over the years our policy concerning who should perform ultrasound (US) has been that it should be a well trained medical person. In that policy we have always stated that whoever performs the examination also interprets it and writes the report. This policy was formed in the early days of US when image documentation was of relatively low quality and limited to still images. Today, still images and live clips may be stored digitally with no loss of quality and we found it relevant to reevaluate the above policy.

We were inspired by the work of Lasse Thorelius who has developed Sonodynamics (see http://www.sonodynamics.com). As a group we were invited to visit the department in Linnköping, Sweden, and see Sonodynamics in use. Very briefly, the concept of Sonodynamics is that an exam has a protocol with a predefined set of still images and live clips (sweeps). The sum of still images and live clips ensure that all US information of the examination region is recorded for subsequent evaluation/re-evaluation. Lasse Thorelius uses this for quality control (older colleague checks younger colleague) and for production where the radiologist interprets the exam which was carried out by a non-physician trained to perform the standardised exam.

As an example, Lasse Thorelius (in Denmark) writes reports on parts of the US production in Linnköping from image information received electronically.

After the visit, a group was formed under DSDU to work with possible implementation and recommendation of standardised exams in Denmark. As a primary task the group was asked to draft a paper describing DSDU’s policy concerning documentation of US exams and who should perform them.

The group continues its work with standardised exams. Standardisation of a number of well defined US exams each with a predefined set of still images and live clips will in the group’s opinion increase the quality of US, facilitate training and to some degree make re-evaluation possible. We wish to thank Lars Thorelius for his inspiration. The following text was approved by all members of the group and subsequently also by the board of DSDU.