Developments in Sonography
In Canada our governing body, Sonography Canada regulates our professional obligations. These include a Code of Ethics, focusing on continuing education, patient safety and advocacy, and professional conduct. Ultrasound, known more formally as Diagnostic Medical Sonography (DMS), is a relatively new diagnostic imaging tool.
Check out the professional and governmental guidelines, and follow along as passionate Canadian sonographers work towards professional regulation
Professional Guidelines: Sonography Canada is the national governing body for Canadian sonographers. As such its principle focuses include advancing the profession, defining the role and professional expectations, and representing the profession to organizations, government, and the community. Some of these responsibilities include, but are not limited to, outlining the educations expectations and continuing education tracking systems for sonographers, providing national competency testing, providing provincial regulations, providing professional insurance liability, and upholding the professional Code of Ethics
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Ultrasound in Canada: In Canada DMS is not regulated meaning people performing ultrasounds do not have to be part of Sonography Canada or hold official licenses. Luckily in a healthcare setting this is exceedingly uncommon as all reputable employers and health authorities require licensing and membership to a governing body. The provision of care in Alberta, serving urban and rural communities, is guided by multiple layers of governmental bi-laws. In Alberta, we have to uphold the principles outlined in the Health Professionals Act (2023). This document provides professional guidelines for registered health care professions, which includes DMS as of 2016). You can learn more about the regulation of ultrasound on my Blog.
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The Canadian healthcare system is a multi-layered organization which has legislative responsibilities at the corporate, municipal, provincial/territorial, and federal level. Registered DMS practitioners also have responsibilities to their governing bodies. Below are some key Canadian links that guide our professional practices
Advancements in DMS
DMS physics and technology have improved and it is now a safe, radiation-free way to evaluate the lungs among neonates before and after surgery, particularly for congenital diaphragmatic hernias.
Gregorio-Hernández, R., Ramos-Navarro, C., Vigil-Vázquez, S. et al. (2023) Lung Ultrasound and Postoperative Follow-up of Congenital Diaphragmatic Hernia. European Journal of Pediatrics, 182, 3973–3981 (2023). https://doi.org/10.1007/s00431-023-05074-1
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Transducer material and capabilities are constantly evolving to provide better diagnostic capabilities and to enhance ergonomic and workplace safety
Li, J., Zhang, T., Shung, K.K. & Zhu, B. (2022). Recent Advancements in Ultrasound Transducer: From Material Strategies to Biomechanical Applications. BMEF. DOI: 10.34133/2022/9764501
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Improvements in contrast-enhanced ultrasound have improved the detection of prostate cancer in transrectal imaging, similar to those of CT or MRI
Salib, A., Halpern, E., Eisenbrey, J. et al. The evolving role of contrast-enhanced ultrasound in urology: a review. World J Urol 41, 673–678 (2023). https://doi.org/10.1007/s00345-022-04088-y
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A recent study has shown up to a 93% correlation between ultrasound measurements of renal masses and CT size, and a 90% correlation between ultrasound measurements and pathological measurements
Seo, S., Kim, S.S.Y, Breau, R., Mallick, R., Lavallee, L., So, A., Rendon, R. (2022). Ultrasound Correlates Highly with Cross Sectional Imaging for Small Renal Masses in Contemporary Cohort. Oncology, 165: 212-217. https://doi.org/10.1016/j.urology.2022.02.020
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Incidental findings in the pursuit of illness evaluation and surveillance is an inevitable part of health care provision. This article explores the complexities involved in evaluating and treating incidental findings and the potential ramifications.
Schoonbeek, R.C., Bult, F.F.S., Plaat, B.E.C., Witjes, M.J.H., van der Hoorn, A., van Dijk, B.A.C., Halmos, G.B. (2021). Incidental Findings During the Diagnostic Work-up in the Head and Neck Cancer Pathway: Effects on Treatment Delay and Survival. Oral Oncology; 118. https://doi.org/10.1016/j.oraloncology.2021.105350
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Ultrasound is typically reserved for soft tissue and vascular imaging due to its limitations in evaluating structures containing air, such as lungs and bowel. However with improving capabilities, ultrasound has shown to be applicable in the detection and radiation-free follow up of COVID-19 patients experiencing lung damage
Zhao, L. & Lediju Bell, M.A. (2022). A Review of Deep Learning Applications in Lung Ultrasound Imaging of COVID-19 Patients. BMEF, DOI: 10.34133/2022/9780173