Inter-System Variability of Eight Different Handheld Ultrasound (HHUS) Devices—A Prospective Comparison of B-Scan Quality and Clinical Significance in Intensive Care

Background: the use of handheld ultrasonography (HHUS) devices is well established in prehospital emergency diagnostics, as well as in intensive care settings. This is based on several studies in which HHUS devices were compared to conventional high-end ultrasonography (HEUS) devices. Nonetheless, t...

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Main Authors: Johannes Matthias Weimer, Diana Beer, Christoph Schneider, Masuod Yousefzada, Michael Gottwald, Tim Felix Züllich, Andreas Weimer, Christopher Jonck, Holger Buggenhagen, Roman Kloeckner, Daniel Merkel
Format: Article
Language:English
Published: MDPI AG 2023-12-01
Series:Diagnostics
Subjects:
Online Access:https://www.mdpi.com/2075-4418/14/1/54
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author Johannes Matthias Weimer
Diana Beer
Christoph Schneider
Masuod Yousefzada
Michael Gottwald
Tim Felix Züllich
Andreas Weimer
Christopher Jonck
Holger Buggenhagen
Roman Kloeckner
Daniel Merkel
author_facet Johannes Matthias Weimer
Diana Beer
Christoph Schneider
Masuod Yousefzada
Michael Gottwald
Tim Felix Züllich
Andreas Weimer
Christopher Jonck
Holger Buggenhagen
Roman Kloeckner
Daniel Merkel
author_sort Johannes Matthias Weimer
collection DOAJ
description Background: the use of handheld ultrasonography (HHUS) devices is well established in prehospital emergency diagnostics, as well as in intensive care settings. This is based on several studies in which HHUS devices were compared to conventional high-end ultrasonography (HEUS) devices. Nonetheless, there is limited evidence regarding potential variations in B-scan quality among HHUS devices from various manufacturers, and regarding whether any such differences hold clinical significance in intensive care medicine settings. Methods: this study included the evaluation of eight HHUS devices sourced from diverse manufacturers. Ultrasound videos of five previously defined sonographic questions (volume status/inferior vena cava, pleural effusion, pulmonary B-lines, gallbladder, and needle tracking in situ) were recorded with all devices. The analogue recording of the same pathologies with a HEUS device served as gold standard. The corresponding findings (HHUS and HEUS) were then played side by side and evaluated by sixteen intensive care physicians experienced in sonography. The B-scan quality and the clinical significance of the HHUS were assessed using a five-point Likert scale (5 points = very good; 1 point = insufficient). Results: both in assessing the quality of B-scans and in their ability to answer clinical questions, the HHUS achieved convincing results—regardless of the manufacturer. For example, only 8.6% (B-scan quality) and 9.8% (clinical question) of all submitted assessments received an “insufficient” rating. One HHUS device showed a significantly higher (<i>p</i> < 0.01) average points score in the assessment of B-scan quality (3.9 ± 0.65 points) and in the evaluation of clinical significance (4.03 ± 0.73 points), compared to the other devices. Conclusions: HHUS systems are able to reliably answer various clinical intensive care questions and are—while bearing their limitations in mind—an acceptable alternative to conventional HEUS devices. Irrespective of this, the present study was able to demonstrate relevant differences in the B-scan quality of HHUS devices from different manufacturers.
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spelling doaj.art-78ec5866c9d84436baa2af7a95469bea2024-01-10T14:53:48ZengMDPI AGDiagnostics2075-44182023-12-011415410.3390/diagnostics14010054Inter-System Variability of Eight Different Handheld Ultrasound (HHUS) Devices—A Prospective Comparison of B-Scan Quality and Clinical Significance in Intensive CareJohannes Matthias Weimer0Diana Beer1Christoph Schneider2Masuod Yousefzada3Michael Gottwald4Tim Felix Züllich5Andreas Weimer6Christopher Jonck7Holger Buggenhagen8Roman Kloeckner9Daniel Merkel10Rudolf Frey Learning Clinic, University Medical Center, Johannes Gutenberg University Mainz, 55131 Mainz, GermanyImmanuel Klinik Rüdersdorf, University Hospital of the Brandenburg Medical School, 15562 Rüdersdorf bei Berlin, GermanyImmanuel Klinik Rüdersdorf, University Hospital of the Brandenburg Medical School, 15562 Rüdersdorf bei Berlin, GermanyImmanuel Klinik Rüdersdorf, University Hospital of the Brandenburg Medical School, 15562 Rüdersdorf bei Berlin, GermanyImmanuel Klinik Rüdersdorf, University Hospital of the Brandenburg Medical School, 15562 Rüdersdorf bei Berlin, GermanyImmanuel Klinik Rüdersdorf, University Hospital of the Brandenburg Medical School, 15562 Rüdersdorf bei Berlin, GermanyCenter of Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, 69118 Heidelberg, GermanyRudolf Frey Learning Clinic, University Medical Center, Johannes Gutenberg University Mainz, 55131 Mainz, GermanyRudolf Frey Learning Clinic, University Medical Center, Johannes Gutenberg University Mainz, 55131 Mainz, GermanyInstitute of Interventional Radiology, University Hospital Schleswig-Holstein—Campus Lübeck, 23538 Lübeck, GermanyImmanuel Klinik Rüdersdorf, University Hospital of the Brandenburg Medical School, 15562 Rüdersdorf bei Berlin, GermanyBackground: the use of handheld ultrasonography (HHUS) devices is well established in prehospital emergency diagnostics, as well as in intensive care settings. This is based on several studies in which HHUS devices were compared to conventional high-end ultrasonography (HEUS) devices. Nonetheless, there is limited evidence regarding potential variations in B-scan quality among HHUS devices from various manufacturers, and regarding whether any such differences hold clinical significance in intensive care medicine settings. Methods: this study included the evaluation of eight HHUS devices sourced from diverse manufacturers. Ultrasound videos of five previously defined sonographic questions (volume status/inferior vena cava, pleural effusion, pulmonary B-lines, gallbladder, and needle tracking in situ) were recorded with all devices. The analogue recording of the same pathologies with a HEUS device served as gold standard. The corresponding findings (HHUS and HEUS) were then played side by side and evaluated by sixteen intensive care physicians experienced in sonography. The B-scan quality and the clinical significance of the HHUS were assessed using a five-point Likert scale (5 points = very good; 1 point = insufficient). Results: both in assessing the quality of B-scans and in their ability to answer clinical questions, the HHUS achieved convincing results—regardless of the manufacturer. For example, only 8.6% (B-scan quality) and 9.8% (clinical question) of all submitted assessments received an “insufficient” rating. One HHUS device showed a significantly higher (<i>p</i> < 0.01) average points score in the assessment of B-scan quality (3.9 ± 0.65 points) and in the evaluation of clinical significance (4.03 ± 0.73 points), compared to the other devices. Conclusions: HHUS systems are able to reliably answer various clinical intensive care questions and are—while bearing their limitations in mind—an acceptable alternative to conventional HEUS devices. Irrespective of this, the present study was able to demonstrate relevant differences in the B-scan quality of HHUS devices from different manufacturers.https://www.mdpi.com/2075-4418/14/1/54B-scansonographyqualitycomparison image qualityHEUShigh-end ultrasound
spellingShingle Johannes Matthias Weimer
Diana Beer
Christoph Schneider
Masuod Yousefzada
Michael Gottwald
Tim Felix Züllich
Andreas Weimer
Christopher Jonck
Holger Buggenhagen
Roman Kloeckner
Daniel Merkel
Inter-System Variability of Eight Different Handheld Ultrasound (HHUS) Devices—A Prospective Comparison of B-Scan Quality and Clinical Significance in Intensive Care
Diagnostics
B-scan
sonography
quality
comparison image quality
HEUS
high-end ultrasound
title Inter-System Variability of Eight Different Handheld Ultrasound (HHUS) Devices—A Prospective Comparison of B-Scan Quality and Clinical Significance in Intensive Care
title_full Inter-System Variability of Eight Different Handheld Ultrasound (HHUS) Devices—A Prospective Comparison of B-Scan Quality and Clinical Significance in Intensive Care
title_fullStr Inter-System Variability of Eight Different Handheld Ultrasound (HHUS) Devices—A Prospective Comparison of B-Scan Quality and Clinical Significance in Intensive Care
title_full_unstemmed Inter-System Variability of Eight Different Handheld Ultrasound (HHUS) Devices—A Prospective Comparison of B-Scan Quality and Clinical Significance in Intensive Care
title_short Inter-System Variability of Eight Different Handheld Ultrasound (HHUS) Devices—A Prospective Comparison of B-Scan Quality and Clinical Significance in Intensive Care
title_sort inter system variability of eight different handheld ultrasound hhus devices a prospective comparison of b scan quality and clinical significance in intensive care
topic B-scan
sonography
quality
comparison image quality
HEUS
high-end ultrasound
url https://www.mdpi.com/2075-4418/14/1/54
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