Is Sonography Radiology’s Ne’re-Do-Well?
There is little doubt that the glamourous diagnostic imaging modalities in the United States have been, for many years, CT and MRI. Tremendous strides have taken place in both of those technologies, particularly in terms of the speed of data acquisition, tissue characterization capabilities and image detail resolution. These advances combined with others like sophisticated software and enhanced utilization of digital storage (e.g., PACS, etc.) permits 3D reconstructions and provides the interpreting physician the ability to "fly" through data sets at a computer workstation located across the hall from the scanner or half way around the world.
Furthermore, intra- and internet connectivity is allowing not only the imaging specialists but also referring physicians access to the images so that they can review the scans themselves to make decisions regarding the most appropriate surgical approach or other therapeutic management choices (which, for obvious reasons, doesn't always make the radiologists happy).
As sonographers, we must recognize the potential and real benefits that these competing modalities offer in terms of reduced user dependence, reproducibility of data, and-perhaps most important to some-relatively larger reimbursements to service providers. Thus, for many years sonography has not been the favored child of radiology.
If you were an outsider perusing through some of the peer-reviewed radiology journals or trade magazines you might get the impression that sonography has not benefited from any technological advances and that the modality is rapidly being over-shadowed by the capabilities of CT, CT Angiography, MRI and MR Angiography. One could argue that this would be a correct assumption, but that doesn't mean that sonography hasn't advanced out of the dark ages of bistable B-mode and mechanical transducers.
What the layperson and many imaging professionals alike may fail to recognize is that while the utilization of ultrasound imaging technology within radiology practices is waning, its use outside of dedicated imaging labs and other traditional users like obstetrical, gynecological and cardiac practices is gaining rapidly. Thus, when turf battles ensue over the utilization of sonography by non-traditional users such as endocrinologists, emergency medicine specialists and anesthesiologists, perhaps those in radiology are partly to blame.