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POCUS: What does the Future Hold?

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A Practical Guide to Point of Care Ultrasound (POCUS)

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Abstract

Point-of-care ultrasound (POCUS) is taking an even more prominent role in medical imaging, as healthcare systems around the world integrate more advanced technology into clinical medicine. We introduce and discuss the concepts that are revolutionizing the field of ultrasound-enabled clinical evaluation and decision-making. We outline the integration of artificial intelligence into ultrasonography and describe how deep learning technology aids the operator to obtain high-quality images. We look at the benefits miniaturization of ultrasound devices may potentially bring, and we consider how contrast-enhanced ultrasound and tele-ultrasound augment diagnostic imaging and provide rapid and accurate diagnosis in remote settings. Our goal is to broaden the readers’ mind and provide an insight into some futuristic utilities of POCUS.

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Author information

Authors and Affiliations

  1. Department of Anaesthesia, National University Health System, Singapore, Singapore

    Rachel Hui Xuan Chia & Balakrishnan Ashokka

Authors
  1. Rachel Hui Xuan Chia
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  2. Balakrishnan Ashokka
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Corresponding author

Correspondence to Rachel Hui Xuan Chia .

Editor information

Editors and Affiliations

  1. Department of Anaesthesia, Critical Care and Pain, Tata Medical Center, Newtown, Kolkata, West Bengal, India

    Arunangshu Chakraborty

  2. Department of Anaesthesia, National University Hospital, Singapore, Singapore

    Balakrishnan Ashokka

Self-Test MCQ (20 Questions)

Self-Test MCQ (20 Questions)

  1. 1.

    Fluid appears _____ on the ultrasound screen

    1. A.

      White

    2. B.

      Black

    3. C.

      Grey

    4. D.

      Not seen

  2. 2.

    The linear probe has a range of frequency of

    1. A.

      2–5 MHz

    2. B.

      4–7 MHz

    3. C.

      5–10 MHz

    4. D.

      10–15 MHz

  3. 3.

    If the image on the monitor screen is too dark, you should

    1. A.

      Increase depth

    2. B.

      Use more ultrasound gel

    3. C.

      Decrease gain

    4. D.

      Increase gain

  4. 4.

    Which of the following is a piezoelectric material?

    1. A.

      Nickel

    2. B.

      Tourmaline

    3. C.

      Iron

    4. D.

      None of the above

  5. 5.

    Speed of ultrasound is the fastest when traveling through

    1. A.

      Bone

    2. B.

      Air

    3. C.

      Water

    4. D.

      Muscle

  6. 6.

    Properties of sound waves include

    1. A.

      Amplitude

    2. B.

      Frequency

    3. C.

      Wavelength

    4. D.

      All of the above

  7. 7.

    The main factor affecting attenuation is

    1. A.

      Scattering

    2. B.

      Divergence

    3. C.

      Absorption

    4. D.

      Reflection

  8. 8.

    Which of the following are not reported benefits of using artificial intelligence (AI) in ultrasonography?

    1. A.

      Improved survival rates

    2. B.

      Enhanced diagnostic accuracy

    3. C.

      Wide clinical applications

    4. D.

      Image capture assistance

  1. 9.

    Which of the following statements regarding artificial intelligence (AI) is FALSE?

    1. A.

      Deep learning technology is one of the machine learning techniques used in AI

    2. B.

      AI-powered systems may lower false-positive rates in cancer detection

    3. C.

      Untrained operators may obtain diagnostic quality imaging

    4. D.

      AI allows automated calculation of cardiac ejection fraction

  2. 10.

    Which of the following statements regarding handheld ultrasound is FALSE?

    1. A.

      Piezoelectric crystals have a lower cost of production compared to Capacitive Micromachined Ultrasound Transducers (CMUT)

    2. B.

      Devices may use single or multiple probes

    3. C.

      2D imaging is classically used

    4. D.

      Epidural depth is one of the parameters that can be measured

  3. 11.

    Which of the following is not a benefit of handheld ultrasound compared to traditional cart-based ultrasound?

    1. A.

      Low cost

    2. B.

      Improved image quality

    3. C.

      Portable

    4. D.

      Reduced examination time

  4. 12.

    Current ultrasound contrast agents in the market consist of

    1. A.

      Hydrofluorocarbons

    2. B.

      Agarose gel

    3. C.

      Galactose and air

    4. D.

      Sulfur hexafluoride

  5. 13.

    The incidence of hypersensitivity reactions with the use of contrast-enhanced ultrasound (CEUS) is reported to be

    1. A.

      2%

    2. B.

      0.2%

    3. C.

      0.002%

    4. D.

      0.0002%

  6. 14.

    Which of the following is not a contraindication of contrast-enhanced ultrasound (CEUS)

    1. A.

      Coronary artery disease

    2. B.

      Acute respiratory distress syndrome

    3. C.

      Acute kidney injury

    4. D.

      Arrhythmias

  1. 15.

    Which of the following statements regarding contrast-enhanced ultrasound (CEUS) is FALSE?

    1. A.

      The US was the first country to approve the use of CEUS

    2. B.

      CEUS may be used in pediatric patients

    3. C.

      POCUS lung ultrasound may benefit from CEUS in detecting lung infarcts

    4. D.

      CEUS is highly accurate in differentiating benign and malignant lesions

  2. 16.

    The gold standard for diagnosis of hepatocellular carcinoma (HCC) is

    1. A.

      Computed tomography (CT) perfusion

    2. B.

      Liver biopsy

    3. C.

      Contrast-enhanced ultrasound (CEUS)

    4. D.

      Magnetic resonance imaging (MRI)

  3. 17.

    In contrast-enhanced ultrasound of the liver, microbubbles are taken up by

    1. A.

      Sinusoid cells

    2. B.

      Kupffer cells

    3. C.

      Stellate cells

    4. D.

      Hepatocytes

  4. 18.

    Which of the following regarding POCUS lung ultrasound is FALSE?

    1. A.

      B-lines are artifacts caused by acoustic impedance due to the underlying lung

    2. B.

      Loss of lung sliding is sensitive to pneumothorax

    3. C.

      In M-mode, the “barcode” sign suggests a pneumothorax

    4. D.

      “Lung point” is the most specific sign of pneumothorax

  5. 19.

    Which of the following regarding the FAST exam is true?

    1. A.

      It leads to few diagnostic peritoneal lavages

    2. B.

      FAST can be repeated for serial examinations

    3. C.

      It is safe for use in pregnant and pediatric patients

    4. D.

      All of the above

  6. 20.

    Regarding the FAST exam

    1. A.

      FAST is more sensitive in obese patients

    2. B.

      Solid organ injuries are easily identified

    3. C.

      Peritoneal free fluid will not be detected until more than 500 ml is present

    4. D.

      Diagnostic accuracy differs significantly between radiologists and non-radiologists

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Chia, R.H.X., Ashokka, B. (2022). POCUS: What does the Future Hold?. In: Chakraborty, A., Ashokka, B. (eds) A Practical Guide to Point of Care Ultrasound (POCUS). Springer, Singapore. https://doi.org/10.1007/978-981-16-7687-1_9

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  • DOI: https://doi.org/10.1007/978-981-16-7687-1_9

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