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Impressions of the 2008 AIUM Conference
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By Daniel A.
Merton, BS, RDMS, FSDMS, FAIUM
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San Diego
Marriott Marina Hotel, venue for the 2008 AIUM Annual Convention
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This year’s
Annual Convention of the American Institute of Ultrasound in Medicine (AIUM)
was held in March along the harbor of beautiful San Diego, CA. Southern
California’s warm sunshine, palm trees and mega-yachts in the marina district
provided a beautiful setting for this yearly gathering of sonography
professionals, obstetricians, gynecologists and cardiologists as well as others
from such diverse disciplines as emergency medicine, internal medicine,
endocrinology and rheumatology.
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Captivating
tropical surroundings enhanced the attendees experience at this year’s
convention.
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one were to attempt to identify the single most significant trend in the field
it probably would be the dramatic increases in utilization of the modality by
non-traditional users. The rapid expansion of sonography into “emerging
markets” was apparent not only in the assortment of niche application
instruments on display in the exhibit area (e.g., compact scanners that hang on
an IV pole and iPod-size units that fit in the clinician’s lab coat pocket) but
also in the diversity of topics covered in the four-day conference Categorical
Courses, Meet-the-Professor Sessions and Scientific Presentations.
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Latest Technology on Display
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Exhibit Hall this year, although not particularly convenient to access, was
filled with booths from sonography equipment manufacturers and vendors of
ultrasound-related products and services. Perhaps the hottest features being
incorporated into high-end scanners are those that are designed to reduce
operator dependence and streamline the examination process; namely
auto-optimization and auto-calculation functions. These features transcend
image quality (which continues to improve with each generation) and the
dazzling, but perhaps less clinically important modes (e.g., 4D imaging and
elastography), to provide users with additional and more effective tools that
they can employ on a day-to-day basis.
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Although image
auto-optimization capabilities have been available for several years, only
recently have the engineers been able to make these features work consistently
over a broad range of patient imaging characteristics. “One-button”
optimization features, now available for gray scale, color flow and spectral
Doppler modes, have the potential to speed data acquisition, improve
consistency between users and generally enhance the overall examination
process.
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| Refinements
in automatic measurement capabilities, like image optimization, are making
great strides towards being user friendly, accurate and consistent. Scanners
are now available that can automatically obtain virtually all the necessary
biometric measurements (particularly useful for obstetrical exams) and blood
flow velocity estimations, ratios and other and calculations. As in the past,
the data acquired can then be incorporated into on-board reports for later
comparison as well as for use during formal interpretations. |
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Automation has
also been applied to the detection and delineation of tumor boundaries and
tissue characterization using pattern recognition and other computer-aided
diagnosis (CAD) software. Furthermore, expanded capabilities of post-processing
permits users to change parameters such as TGC settings and gain control levels
after the examination has been completed. Many of these post-processing
features can be performed on PACS work stations long after the patient has left
the exam table thus providing a means to recover what could otherwise have been
a sub-optimal or even non-diagnostic study. All of these automated features
will no doubt prove valuable to enhance workflow as well as improve the
diagnostic consistency and accuracy across the field of sonography and
continued improvements will only increase their clinical utilization in the
future.
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| While
the most powerful diagnostic capabilities are typically only available on
high-end cart- based scanners, the quality and capabilities of compact
ultrasound systems are also rapidly advancing. Unlike the original hand-carried
scanners of the past that had limited functionality and relatively poor image
quality, the latest compact scanners possess all modes of operation and nearly
comparable image quality of traditional cart-based units. These features,
combined with their portability and low cost are making compact scanners
attractive to imaging professionals and non-traditional users alike.
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| Pre-Convention
Learning Opportunities
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Pre-Convention Course on Wednesday, March 12th offered a wide
variety of individual topics ranging from abdominal vascular diseases, fetal
nuchal translucency screening and the use of sonography for critically ill
patients to the use of ultrasound in reproductive medicine and musculoskeletal
imaging. Each of these applications was covered in-depth through sessions that
lasted from four to eight hours. The half-day long “First-Trimester Screening:
Nuchal Translucency Credentialing and More” course addressed a current
hot-topic in the profession and provided participants with an opportunity to
learn about the unique measurement techniques used for early OB screening as
well as the potential benefits of 11 to 14-week screening assessments.
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| The “Bedside
Ultrasound in the Critically Ill and Injured Patient” course included
presentations by several well-known emergency medicine physicians. This
full-day seminar was an opportunity for practitioners to learn about the use of
sonography for evaluation and treatment of trauma victims, patients with
unexplained hypotension and patients in respiratory failure. The half-day “Musculoskeletal
Ultrasound: Special Topics” seminar reviewed some of the basic
principles of MSK imaging as well as more advanced topics such as
interventional procedures, rheumatologic and sports medicine applications. This
course also included discussions on the use of sonography to image peripheral
nerves, soft-tissue masses and foreign bodies which made it an attractive
educational experience for a wide range of professionals. Musculoskeletal
sonography is another hot area that has gained considerable attention which
likely explains why so many sessions were devoted to it throughout this year’s
Convention. |
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| Something
for Everyone
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AIUM Convention began on Thursday, March 13th and ran through
Saturday. It provided attendees with ample opportunities to hone existing
clinical skills, learn new cutting-edge applications and hear about the latest
advances such as ultrasonic tissue characterization and signal processing
techniques. Categorical Courses allowed participants to hear several
presentations on a specific topic while Scientific Sessions provided
investigators the opportunity to share their research findings with the
community. The clinical potentials of many of the technological advances on
display in the Exhibit Hall (as described above) were discussed by leaders in
the field who have been working with the manufacturers to refine the
technologies and identify how to incorporate the new tools into daily practice
and for research applications.
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| Throughout
the Convention there were Just Images Sessions as well as Meet-the-Professor
Sessions (MTPs) which were offered twice each day and provided participants
with an opportunity to learn from well-known sonographers, physicians and
scientists who covered a wide variety of topics of interest. Topics covered in
the MTPs ranged from the use sonography in trauma, obstetrics, gynecology and
pediatrics to artifacts, bioeffects, vascular exam interpretation and the
treatment of venous reflux. Many of the MTPs were sold out well in advance of
the start of the meeting. In addition to the formal lectures and scientific
presentations, more than thirty Scientific Posters were on display with two
sessions for attendees to meet the authors and learn more about their work. |
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the MTPs, some of the Categorical Courses (CC) covered established applications
such as genitourinary ultrasound, evaluation of superficial masses and vascular
imaging while others addressed more advanced uses including ultrasound contrast
agents and volume (3D / 4D) sonography. Volume sonography is proving to be a
valuable clinical tool for both obstetric and non-obstetric applications. A CC
on “Three-Dimensional Ultrasound: Diving for Data”was conducted so that
faculty members could demonstrate to the audience the proper methods to
manipulate 3-D data on workstations. Another CC described how to incorporate
the use of volume imaging into daily practice to enhance patient through-put as
well as improve the diagnostic potential of examinations. Volume sonography was
also the topic of several Scientific Session presentations primarily in the
area of obstetrics including assessment of the fetal heart. |
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As previously
mentioned, many presentations described the growing application of sonography
for MSK applications. One CC focused on the evaluation of the wrist and hand
and included presentations on scanning techniques, pathologies of the tendons
and joints, and rheumatology applications. Two additional courses addressed the
use of sonography for evaluation of the shoulder, one of which was a hands-on
session with a scanning demonstration and live models that participants could
scan to polish their techniques. There was also a Just Images session devoted
to MSK applications as well as a Scientific Session. Other special topics
covered this year included transcranial Doppler (TCD) which was addressed
through a didactic session as well as a hands-on practical lab with
representatives from most of the current manufacturers of TCD systems providing
instruction, a practice accreditation workshop, and several courses on fetal
echocardiography.
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The
majority of sessions provided opportunities for professionals to learn from
experienced users of the modality and directly apply what they learned in their
own labs to enhance patient care. These included sessions on emergency
medicine, women’s imaging (including breast, GYN and reproductive medicine) and
a variety of vascular applications. One such Categorical Course was entitled “Doppler
Tricks and Techniques”. This session was very well attended indicating
that there remains a need to continue to provide participants with a foundation
of practical instruction that they can build on and utilize in everyday
clinical practice. The potential of targeted ultrasound contrast agents (i.e.,
molecular agents) combined with the ease of use and wide availability of
ultrasound technology makes this an exciting and important area for
investigation. Coverage of this area included presentations on “Ultrasound
Contrast in Thrombolysis” or “Complex Microbubbles for Molecular Imaging and
Therapy”.
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| There
were plenty of educational opportunities for basic scientists - both
experienced researchers as well as young investigators. The AIUM has been
recognized as a leader in the field of ultrasound imaging for it’s diligence
regarding the topics of bioeffects, safety and technical standards, and the
scientists within the organization play an important role in all of these
areas. Categorical Courses of interest to the basic scientists included a
session on high-frequency imaging and an up-date on bioeffects. There were also
several Scientific and MTPs Sessions including a Scientific Session that
offered a forum for presentations on tissue characterization. Other Sessions
dealt with the latest advances in contrast agents and contrast-enhanced
sonography.
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AIUM is a unique experience for each individual who attends. To provide a
different perspective, I asked two individuals to share their impressions of
the meeting. |
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David
P. Bahner M.D., RDMS
is an Associate Professor and Director of Ultrasound for the Department of Emergency
Medicine at Ohio State University.
After attending the AIUM 2008 conference in San Diego, there is a lot to be
excited about. First the technology continues to improve and portable palm sized
machines (Siemens P10) were displayed during the convention. The AIUM conference
draws from ultrasound enthusiasts from across many disciplines to gather and
discuss the practice of ultrasound in medicine. As a sonographer, it is always
nice to see fellow sonographers deliver lectures and serve the AIUM as they are
the backbone in the ultrasound community. As an emergency physician, I saw more
fellow colleagues at this meeting than at others before. Additionally, critical
care specialists have seen the power of bedside ultrasound and took part in the
conference proceedings. I always like to see the many familiar faces at the AIUM
as it is the one conference where everyone shares a passion for ultrasound. It
seems to me that a revolution is going on in medicine as portable ultrasound is
changing the way in which we evaluate different patient presentations. The AIUM
is the organization for medical ultrasound and the conference is an ideal way
to witness the people, equipment, and utility of ultrasound in medicine. |
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Oscar Barahona, RDMS
is an entrepreneur and lab director, and presently serves as the 2nd Vice
President of the AIUM.
Arriving in San Diego for this years Annual Convention of the American Institute
of Ultrasound in Medicine (AIUM) is an event I always look forward to attend
and participate in. It gives me the opportunity to join and meet the past,
present and future leaders of all specialties from the world in the field of
ultrasound.
The eye openers
of this year’s event for me was new sophisticated state of the art ultrasound
diagnostic imaging technology, availability of wireless transmission of images
and reporting data to pacs systems. Another modality that was also impressive to
see was manufactures creating friendlier 3-D, 4-D systems. This will allow a
new user often reluctant to use this modality to manipulate 3-D volumes.
As Chair of New
Investigators, I had an opportunity to review in conjunction with other
reviewers all of this year’s new scientific papers being presented at the
meeting, These scientific papers speak about the future of the ultrasound
science and its applications, and secondly it gives all the member attending
the meeting an opportunity to recognize what is driving the mind of many new
investigator’s. As a sonographer it was also impressive to see a great number of
sonographer contributing to research projects.
As a member of
the leadership of the AIUM, it was impressive to hear various speakers'
lectures on several specialty topics which illuminate our careers. The 2008
convention was a tremendous success considering our present concern with the
economy and the troubled world we are living in today. My dream world will be
to see more sonographers attending the AIUM Annual Convention Meeting and
becoming participants on existing committees. |
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| Peter
Burns, PhD, recipient of the William J. Fry Memorial Lecture Award
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AIUM Awards Ceremony held on Thursday afternoon was when the society paid
tribute to individuals who have made significant contributions to the field. A
list of Award winners is available on the
AIUM web site . Peter Burns, PhD. received The William J. Fry Memorial
Lecture Award. Dr. Burns was recognized for his contributions in the
development of ultrasound contrast agents and contrast-specific ultrasound
imaging technologies. He provided a fascinating presentation that reviewed the
early development of contrast microbubbles and how contrast agents are used
throughout the world to enhance (pun intended) ultrasound diagnoses. Dr. Burns’
presentation included an impressive array of images and video clips
demonstrating the potential of contrast-enhanced sonography to improve the
detection and characterization of hepatic lesions as well as a glimpse at how
contrast agents may be used in the future for diagnostic and therapeutic
applications. |
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| Joan
Embery, wildlife conservationist and lecturer. |
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| After
the Awards ceremonyJoan
Embery, a well-known wildlife conservationist, entertained the crowd
with a presentation on the diversity of wildlife and the importance of
conservation. Her talk was a nice diversion from the educational sessions that
most of the attendees had sat through all day. Ms. Embery and her assistants
introduced the crowd to a diverse group of “wildlife ambassadors” that included
a variety of interesting furry, feathery and scaly friends representing the
animal world. After her presentation the Opening Reception was held in the
Exhibit Hall where everyone enjoyed an assortment of cocktails and delicious
appetizers while they networked with other professionals and perused the
exhibitors’ wares and services. |
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unique interactive presentation at this year’s meeting was entitled “Court TV at
the AIUM” This was a mock malpractice trial that centered around a
fictional obstetrical case gone bad (a baby was born missing a limb). Some
well-known sonography professionals functioned as “Defendants” and “Expert
Witnesses” while actual trial lawyers from both sides of the medical-legal
system pleaded their cases in front of an actual sitting Judge and two audience
members selected to represent the jury. The simulated drama provided those in
attendance with a glimpse into how the legal system works for and against the
medical professionals and the legal risks involved in our profession. It was an
interesting and entertaining scenario which hopefully many of us will never
encounter in real life. |
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addition to all the educational and networking opportunities that this year’s
Convention offered there was also plenty of other things to do in San Diego.
The conference hotel had a very nice pool area with lush tropical trees and
plants as well as a koi-filled pond that provided an easy escape. The location
of the hotel along the San Diego harbor offered attendees a place to take a
fitness run or just stroll the waterfront esplanade to admire the yachts in the
marina and visit the quaint shops in the Seaport Village. The Gaslamp Quarter,
also within walking distance, had a number of outstanding restaurants,
boutiques and art galleries where professionals could unwind and relax after
their long days spent in the lecture halls. The AIUM’s 2009 Annual Conference
will be held in March in New York City. If it is anything like this year’s
meeting it’s a safe bet that the AIUM will continue to address the diverse
educational needs and interests of the many medical professionals who now
practice sonography. |
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| For
more information about the 2008 AIUM Conference see the
AIUM 2008 Annual Convention Final Program |
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Daniel
A. Merton is the Technical Coordinator of Research at the Jefferson Ultrasound
Research and Education Institute, Department of Radiology, Thomas Jefferson
University Hospital in Philadelphia. He is also on the AIUM’s Board of
Governors. |