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Addressing Ultrasound’s Myths and Misunderstandings

By Liesel Tavenner, MBA, PMP, CSPO, RDMS, RVT

Ultrasound’s popularity as a diagnostic imaging tool continues to grow across many clinical specialties, thanks to the technology becoming more portable, affordable, and convenient. In addition, the COVID-19 pandemic has helped elevate ultrasound’s role as a first line of defense in triaging COVID’s impact on patients. This rising popularity, however, has had an unfortunate consequence of generating more myths and misunderstanding around ultrasound’s use, safety, and requirements. This is understandable, given the fact that ultrasound is a complex technology with hundreds of unique nuances many patients don’t understand or appreciate. Countering misinformation is critical to gaining and maintaining patient trust.

Inteleos and its medical imaging certification body, the American Registry for Diagnostic Medical Sonography (ARDMS), recently conducted an impromptu, but statistically valid, survey of the sonographer community to get a better sense of which myths are most problematic. While misunderstandings around ultrasound’s safety are prevalent, the findings suggest even greater confusion around the roles and expertise of sonographers.

Myth #1: Performing Ultrasound Is Easy
When asked, “What is the most common ultrasound myth that nonmedical people believe?” nearly 60% of respondents said people believe sonographers have an easy job that doesn’t require a lot of training. Similarly, another 10% of respondents pointed to the myth that sonographers are merely “picture takers.”

These perceptions couldn’t be farther from the truth. Most sonographers undergo rigorous training, dedicating 18 to 24 months at accredited schools focused on a single track of ultrasound imaging, such as cardiac, vascular, or OBGYN/abdomen sonography. A two-year higher education program can be required to acquire the skills for image acquisition, image interpretation, and hands-on clinical training. ARDMS reports that more than 90% of registered sonographers have higher education training.

Many health care employers in the United States and Canada require sonographers to be certified to seek and maintain employment. While it’s true that only a handful of US states require medical sonographers to possess specific credentials as a job requirement, this level of professional training and certification reduces risk, giving health care providers the strongest foundation for performing accurate and timely ultrasound examinations. The technical and scientific skill set acquired during the rigorous certification assessment ensures repeatable, consistent proficiency that noncredentialed ultrasound users may lack.

Myth #2: Sonographers Only Scan Fetuses
In the ARDMS survey, roughly 30% of respondents agreed there is a perception that sonographers merely scan babies. It’s understandable that many consumers equate sonography with obstetrics, since sonograms have become standard for nearly every pregnancy as a noninvasive way for health care providers to monitor the baby’s and mother’s health. Thanks to dramatic improvements in ultrasound image quality, resolution, and accessibility over recent decades, ultrasound is becoming a pervasive diagnostic tool across an array of clinical practices.

Ultrasound exams can help diagnose a multitude of conditions and assess pain, swelling, and infection in organs. The Focused Assessment with Sonography in Trauma, or FAST, is used internationally in emergency departments to quickly assess injuries to patients. Bone sonometry is used to assess bone density and osteoporosis in aging patients. Cardiologists rely on carotid, abdominal aorta, doppler echocardiogram, and other ultrasounds to evaluate heart patients. Pelvic ultrasounds help doctors examine prostate conditions, bladder infections, ovarian cysts, and much more. Vascular ultrasounds allow doctors to better understand blood flow and detect clots or other types of blockages.

Myth #3: Sonographers Don’t Know How to Read Images
Giving patients a diagnosis or interpretation from an ultrasound image is solely the physician’s responsibility, but, while diagnosis is not within the sonographer’s scope of practice, they are quite astute at recognizing normal vs abnormal ultrasound images. Sonographers need to be able to recognize what is on an ultrasound image so they can appropriately adjust their scans, if needed, or identify anything in the image that could be critical and require immediate attention. They need to ensure that images are of good quality and helpful for diagnosis as well as identify any abnormal results that need to be shared with the doctor.

Myth #4: Sonography Uses Radiation
The false belief that ultrasounds employ ionizing radiation has persisted for decades. Ultrasound does not expose a patient to ionizing radiation; it uses high-frequency sound waves to create anatomical images of the body’s internal organs. Ultrasounds are highly safe when used by certified sonographers, as they are trained to follow ALARA principles in the exposure of ultrasound waves to the human body.

Final Thoughts
The myths and misunderstandings revealed in the sonographer survey reaffirm the need for high-level training and certification in ultrasound medicine to allay patients’ concerns. Maintaining high standards through credentialed medical professionals is the best way to ensure that patients achieve the best outcomes.

Credentialed sonographers provide greater assurance that medical imaging procedures will be performed to the highest standard of care, regardless of the circumstances, location, or financial situation. The technical and scientific skill set acquired during the rigorous certification assessment ensures repeatable quality for the benefit of all patients.

— Liesel Tavenner, MBA, PMP, CSPO, RDMS, RVT, is the assessment clinical project manager at Inteleos.