As ultrasound becomes ubiquitous, smart technologies are playing a vital role in diagnostic speed and accuracy. Medical device manufacturer, Mindray, is pioneering smart tools for ultrasound applications to enhance accuracy and speed of examinations and boost clinical confidence and decision-making.
Following the pandemic, the UK’s waiting list for non-obstetric ultrasound was reported to be the largest out of all imaging modalities, accounting for 33% of the 1.34 million outstanding diagnostic tests – an increase of +65% since June 2020.1 According to NHS England, demand for non-obstetric ultrasound had risen 3.8% between 2014-2019, equivalent to 7.6 million exams.2
The demand for diagnostic imaging is typically rising 10% faster than other healthcare demands3 and, in point of care, ultrasound has been demonstrated to reduce the number of imaging tests required, and complement patient assessment and diagnostic reasoning.4
Trade bodies, like AXREM, are campaigning for sustained investment into diagnostic imaging so that the UK’s healthcare system can access cutting-edge equipment, address talent shortages, and ensure the Government’s 19 new community diagnostic centres are equipped to cut down NHS waiting lists effectively.5
Smart tools and artificial intelligence are increasingly being identified in health strategies, such as the NHS Long Term Plan, as a key approach to meeting increasing demand, improving efficiency and to enhancing quality.6
Mindray’s national sales and marketing manager for ultrasound, Paul Johnston, explains the company’s approach to research and development in this field: “The bulk of our technologies support faster assessments with high quality imaging and automatic calculations. With such a broad range of clinicians and practitioners using the company’s machines, many smart tools in devices like the TEX20, TE9 and ME8 also guide users’ transducer placement to secure accurate images and replicate results more easily across a multitude of clinical scenarios.
“In addition to the smart tools for ultrasound, the devices can connect to electronic patient records (EPRs) and enable two-way interoperability, where reports can be uploaded instantly to reduce transcription errors and enable seamless data flow.”
An essential tool for every clinician
Studies have indicated that point-of-care ultrasound (PoCUS) can produce high sensitivity, high specificity and high accuracy compared to other established diagnostic imaging modalities. PoCUS has also shown faster time for diagnosis and change in management.
Dr. Madan Narayanan has 12 years’ experience as a consultant for anaesthetics and intensive care, currently based at Frimley Park Hospital. A heavy user of ultrasound, he is among the specialists who have been instrumental in optimising the adoption of ultrasound technologies within their hospital: “One of the biggest risks we face is underutilising ultrasound machines. It’s something we’re very conscious of at Frimley Park. When our colleagues undergo training, we always ask: ‘Do you know how much these machines can do?
“I’ve seen every department embrace ultrasound; in a way, it’s replaced the stethoscope as an everyday medical tool. To ensure we work efficiently, colleagues who use ultrasound in any capacity must go through regular training to demonstrate that they can use the machines effectively to obtain clear images and make accurate assessments
“For learners, the smart tools in our Mindray ultrasound machines help them develop their confidence and obtain much more accurate images right from the outset. I’ve done a lot of demonstrations with the TE9 and, thanks to the AI transducer guidance, I can get a very clear image of the heart even though it’s outside of my specialty.
“Although our clinical teams regularly complete ultrasound training, it’s reassuring for them to have an arsenal of tools that ensure their assessments are conducted swiftly and accurately, especially in emergency scenarios. They’re a vital part of developing competence, standardisation and consistency, and enhancing clinical confidence across departments.”
Ready for Action
Specialist applications of ultrasound in perioperative care and cardiovascular assessment are the primary focus for Mindray’s smart tools. For instance, the aspiration of gastric contents is a serious complication of anaesthesia and is associated with high morbidity and mortality8 but the Auto GA tool automatically identifies the edge of the gastric antrum and calculates the area with a single screen tap. This provides great clinical value for quick decisions regarding patient suitability for surgery.
More smart tools are available to support clinicians, as Dr. Narayanan continues: “The smart tools in Mindray’s ultrasound machines make it much easier for me to complete nerve blocks and conduct routine examinations in the ICU. By way of example, Smart Nerve automatically recognises the brachial plexus and highlights the nerve so I can complete nerve blocks with much greater accuracy
“The artificial intelligence with iNeedle is a major benefit for line placements too as the beam steering means I can quickly adjust a needle’s trajectory if needed. Coupled with 4D magnetic guidance with the eSpacial Navi tool you can place lines much more accurately. This improves outcomes for patients and the quality of training for our teams.”
All Mindray machines also come with iScanHelper, a dedicated inbuilt educational tool which covers applications in FAST, Focused Echo, Nerve, Abdomen, Thyroid, Breast, Testicle and OB/GYN ultrasound.
Heart monitoring and SHOCK
In a market-leading move, Mindray’s latest ultrasound machine, the TEX20, incorporates haemodynamic assessment with shock through the X-Pilot suite. Based on the professional society guidelines for point of care ultrasound this smart tool integrates historic diagnostic images and multi-organ data into a concise and precise view of the patient status.
It can be used to identify shock types in accordance with RUSH, FALLS and GDE protocols, evaluate acute respiratory distress in accordance with BLUE protocol, and locate free fluid in the thorax, pericardium, abdomen and pelvic cavity to expedite FAST and eFAST exams.
There are also a number of tools to support cardiac examinations in ICUs and emergency departments, even by non-cardiologists. Paul explains: “For faster cardiac examinations there are several tools that can complete automatic calculations such as the velocity time integral, cardiac output, stroke volume variation, collapsibility index and distensibility index and IVC variation.
“The Auto DFR tool can also reduce the number of steps for DFR by 70% through automatic calculation of the E/A, E/E’ indices. To support standardisation, the Smart Echovue tool includes automatic recognition of the standard cardiac view, captures images and clips, and guides the user to the next scanning plane
“The TEX20 and TE9 machines also feature AutoEF Plus, which analyses 2D echo in real-time to automatically recognise and trace endocardium, and provide EDV/ESV/EF calculation results by the Simpson method.
“Smart TTQA automatically recognises different cardiac planes, locates the endocardium and tracks the continuous contraction of the ventricular wall and then displays the mechanical changes of each segment of the left ventricle, offering accurate and effective evaluation of myocardial motion.”
Streamlined workflows
Mindray’s ZONE Sonography Technology (ZST+) platform provides clinicians with immensely powerful image acquisition and processing capabilities, resulting in high contrast resolution, excellent uniformity and reduced motion artefacts.
Using a variable number of large imaging “ZONES”, ZST can utilise up to 90% more ultrasound data than conventional ultrasound imaging platforms and at 10 times the speed.
This expanded acoustic data set is retained and processed by patented high-speed digital processing techniques and software algorithms that are radically different from slow and cumbersome hardware-based imaging methods. Dual single crystal transducers are also enhancing imaging capabilities and this year, Mindray will be launching a wireless transducer that can accompany clinicians on the move.
Hands-free operation is also transforming examinations. The iVocal tool provides a simple but extensive list of vocal commands that allow clinicians to focus on transducer placement and patient comfort rather than manually scrolling through operational lists.
Integrated data
While there are varying levels of connectivity between devices and electronic patient records across the UK, full two-way data flow is certainly the ultimate aspiration. Operational expenditure for NHS Digital in 2021-22 stood at £380.8m, while staff costs came in at £263m; in both cases, this equates to an annual increase of almost 30%.9
Dr. Narayanan adds: “There is a mixed approach to how diagnostic images are recorded. In the USA it’s mandated for images to be added to clinical records but in the UK it isn’t. At Frimley Park, we have this as an aspiration for the entire trust and use local images in mentoring to gradually change mindsets. The ones leading the way for our imaging record keeping are our pain doctors who always store images when using blocks.”
By default, Mindray devices are equipped to connect with third party EPRs so clinicians can easily access patient records and instantly upload reports to reduce administrative burdens and transcription errors.
With the TEX20, it’s taken a step further. Clinicians can use X-Link to overlay live patient waveforms on top of the current ultrasound image, all on one screen. The U-View application allows the ultrasound image and physiological information to be integrated to a central station for a general view. It’s a comprehensive summary of the patient that can facilitate multi-disciplinary treatment and more advanced clinical research.
Adapted for demanding environments
Paul concludes: “As ultrasound becomes more mobile and prevalent, we’ve been careful to develop equipment that will resist corrosion from harsh cleaning agents. The latest machines – TEX20 and TE9 – are seamless to avoid damage from microscopic amounts of moisture.
“Ultrasound is very nuanced – everyone has their own approach and what works for one specialist might not work for another. Our smart tools can provide the groundwork for any assessment, but clinicians and practitioners also have the power to customise alerts, views, and what information they see on screen to suit each and every scenario they face.”
Mindray UK Limited,
Mindray House,
Kingfisher Way,
Hinchingbrooke Business Park,
Huntingdon,
Cambs,
PE29 6FN
Tel: 01480 416840
Fax: 01480 436588
Web: www.mindrayuk.com
