DMBN: How has ultrasound technology advanced and improved over the last 40-plus years?

Goldberg: There has always been an effort to produce transducers that penetrate the body at the highest frequency possible because we know that in physics, the higher the frequency, the better the resolution. Also from physics we know the deeper in the body you go, the more sound wears out.
When I first started working with ultrasound the basic transducers available were only about 2 megaHertz. Currently the standard for scanning the abdomen is anywhere from 8 to 10 megaHertz. There are now frequencies for superficial imaging at 20 megaHertz, and people are working on 40 megaHertz and even 100 megaHertz transducers. Thus, there's been significant improvement in image resolution. The current generation of machines has the highest frequencies available for depth, and you can use one single transducer and image at several frequencies, so that there is an accommodation for using the lower frequencies coming out of the same transducer for deeper structures, and then the higher frequencies for superficial structures, taking advantage of the high frequencies, but also understanding their limitations.
DMBN: Would you like to comment on the quality and/or capabilities of the ultrasound equipment from the different OEMs?

Goldberg: At JUREI we have 20 scanning rooms and we have essentially all the major and most of the minor ultrasound manufacturers. What I have seen over the years is a continual increase in the equipments' capabilities. Almost all the companies have very good machines. Some now have advantages over others for a time, but quite rapidly the others catch up, and maybe somebody else makes a breakthrough. I have seen this sort of leapfrogging over the years. I think the exciting thing is that there is competition, and that competition has led to continued improvements. Much of that is made possible by computer software and hardware advances that we are seeing all over the world: miniaturization, new transducer materials, and high-speed computers have all made ultrasound what is today.

DMBN: What about the hand-carried units? Are they the wave of the future?

Goldberg. Well certainly everything is getting smaller now. We see that from cell phones to computers, and the same thing is happening in ultrasound, but in a slightly different way. Many of these smaller machines are dedicated to specific areas of the body and specific purposes. Eventually we are going to have ultrasound machines as small as the palm of your hand. Some people are predicting that one day there will be the ultrasound equivalent to the stethoscope - maybe it will be called an "ultrascope." Perhaps every physician will have one, and when they find something, just as they do with a stethoscope or by palpation, they'll then send the patient for a more complete study, whether it's ultrasound, CT or MR. I think it will improve diagnosis. I wouldn't expect the small machines to offer complete capabilities, but they would be focused on scanning specific areas, and the patient would be referred on for more advanced imaging.

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