Quantitative Lung Ultrasonography. The best has yet to come.
In lung US the crowding of the so called B-lines artifacts is correlated in pulmonary edema to the amount of extra vascular fluid accumulation. When the alveolar phase is reached crowding becomes so relevant that the all lung appears white. Although computer-aided Quantitative-Lung Ultrasonography (Q-LUS) represents just a new software application to LUS, it offers the advantages of extracting more information without increasing complexity and examination time and of increasing
operator perception because the human retina can differentiate only 30 shades of gray, whereas Q-LUS can differentiate 255 shades of gray, therefore providing more detailed quantification of ultrasound intensity.This software could be a robust approach for developing a portable device for the individualized and automatic detection of pulmonary interstitial
edema in chronic heart failure out-of-patients, which could have a high impact on public health. Because telemedicine is being increasingly used in many different scenarios for patient monitoring and specialist consultations, the development of operator-independent, computer-based systems to support clinical judgment contributes to promoting radical changes toward a patient-centric healthcare environment. I think this application could be used in the next future as a remote monitoring tool for chronic heart failure out-of-hospital patients, in order to anticipate the diagnosis of acute on chronic decompensation. Potentially this tool would trigger early medical management avoiding hospitalization and reducing costs.
US is a non-invasive and non-radiative technique that can be use as alternative replacement for other radiative and costly diagnostics techniques such as CT, MRI etc. The major limitation of US is that data acquisition and interpretation requires US-specialists (data acquisition and interpretation is individual dependent!), as there are no user friendly friendly software available for direct analysis of the captured videos or images. The market leaders in US are now working on developing software for analyzing US images/videos frame - by-frame (Philips to strengthen its ultrasound business with the acquisition of clinical applications and imaging software company TOMTEC).
One of the software that got FDA approval is Vascular Tools 5. (http://www.mia-llc.com/products/vascular_fda.htm).
Vascular Tools 5 - FDA approved Software for clinical use (Software to aid analysis of vascular ultrasound images and image sequences)
Brachial Analyzer 5
- Quantitative analysis of endothelial function via measurement of Flow Mediated Dilatation (FMD) of brachial arteries.
Carotid Analyzer 5
- Quantitative analysis of Intima-Media Thickness (IMT) in carotid arteries.
- Vascular age estimates from the population studies.
There are new smart phone highly portable US is available in the market (GE Introduces Its First App-Based, Pocket-Sized Dual-Probe Ultrasound Vscan Extend offers high image quality, wireless connectivity and cloud integration with a touch-screen interface).
Non only Philips and not only Vascular tools. Check for Quantitative Lung Ultrasonography. The best has yet to come. I'm sure PMID: 27130285 Computer-Aided Quantitative Ultrasonography for Detection of Pulmonary Edema in Mechanically Ventilated Cardiac Surgery Patients, PMID: 23584050 Assessment of extravascular lung water by quantitative ultrasound and CT in isolated bovine lung.