Ultrasound First, Possible Benefits Later

Ultrasounds may be safer and more cost-effective than other options like CT scans and MRIs

(RxWiki News) Doctors use several tools to examine women who might have pelvic problems. These tools include CT scans, MRIs, X-rays and ultrasounds. One of those tools may now be the preferred first choice.

A group of experts in the field of obstetrics and gynecology recently announced that ultrasound should be the first choice for pelvic pain and related symptoms. Ultrasound, they maintained, is more cost-effective.

It may also be safer because the woman is not exposed to radiation, these researchers noted. Ultrasound uses high-frequency sound waves instead of radiation.

Beryl R. Benacerraf, MD, a professor at Harvard Medical School and Brigham and Women's Hospital in Boston, led this study.

Dr. Benacerraf is also the current president of the American Institute of Ultrasound in Medicine (AIUM). AIUM launched a program in 2012 called “Ultrasound First.” The program is designed to encourage doctors to use ultrasound over CT scans or MRIs.

Both of the latter technologies use radiation to create images of body structures. Excessive exposure to radiation may increase the risk of cancer.

"The use of CT scans has tripled since 1993," said study co-author Steven R. Goldstein, MD, past AIUM president and current professor at the NYU School of Medicine, in a press release. "An estimated 29,000 future cancers could be related to CT done in the U.S. in 2007. The largest contribution to this projected risk of cancer (14,000 cancers) was attributed to CT of the pelvis and abdomen. For example, patients with suspected kidney stones frequently have a CT scan first, despite the associated radiation burden. In a recent study, most of the patients evaluated first by ultrasound did not ultimately need a CT scan, sparing radiation exposure."

Dr. Benacerraf pointed out in the press release that for some kinds of problems, women have a CT scan or MRI, but the findings are unclear. These women often have an ultrasound to clarify the diagnosis.

The quality of ultrasound images has improved dramatically in recent years, Dr. Benacerraf and team noted. Ultrasounds can provide 3-D imaging and produce hundreds of images.

An ultrasound often takes less time than an MRI, and the equipment costs less. Ultrasounds can be used in combination with a physical exam. This allows doctors to both feel and see the pelvic structures at the same time.

Doppler — a type of sound wave — can be used during ultrasounds to assess the flow of blood in the areas being studied.

"A skillfully performed and well-interpreted ultrasound usually eliminates the need to perform additional more costly and complex cross-sectional imaging techniques," Dr. Benacerraf said. "Doing a CT scan first for female patients with lower abdominal pain is dangerous, wasteful, and expensive."

This report was published March 31 in the American Journal of Obstetrics and Gynecology.

The report did not receive outside funding. Dr. Goldstein had a Philips ultrasound on loan. None of the other study authors disclosed conflicts of interest.

Review Date: 
April 1, 2015