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While browsing through the hospital’s library a few days ago, I came across a bunch of old issues of Radiologic Clinics of North America (RCNA). All of them were more than twenty years old. Labels on the inside front covers of the books proclaimed that they were gifted to the Hospital under the Literacy Library Project of a Rotary International Matching Grant in 1995, involving Rotary District 5810, USA and District 2980, India.

I got some of the more interesting issues to my office to read at leisure to find out how things were done then, and how radiolgoy has changed now. This is the first of what I hope will be a series of posts….

For this first Flashback, I have reproduced the Foreword for the December 1975, ‘Symposium on B-Scan Ultrasound’ issue.

The Foreword was written by the Guest Editor of the issue, Dr. Roger C. Sanders, MD., who was then in The Johns Hopkins Hospital, Baltimore.

Foreword

No excuses are given for devoting the whole of this volume to B-scan ultra-sound for a survey has shown that it is already the most widely used variety of diagnostic ultrasound. Even considering this, the potential applications far out-strip current uses; for example, the use of diagnostic ultrasound in the breast and chest has only just begun. Few comprehensive reviews of “abdominal ultrasound” exist. Whereas at least four books describe the principles and applications of echoencephalography, three volumes deal with ophthalmic ultrasound, and two books concern themselves primarily with echocardiography. None of the books that attempt to survey the whole field of diagnostic ultrasound gives more than a superficial review of the field of B-scan ultrasound. Presently, only one book in the English language is devoted to “abdominal ultrasound” (Barnett and Morley, 1974) and it has been difficult to obtain in the United States. Other texts on B-scan ultrasound are imminent but their gestational period seems unduly long, perhaps because the advent of gray scale with the increased information it brings has forced authors to their illustrations.

Departments concerned with two dimensional organ visualization by ultrasound are usually called “abdominal ultrasound laboratories.” This term is inappropriate since B-scan techniques are used in the chest, limbs breast, and as described in this volume, the thyroid and eye. For the future the term “ B-scan ultrasound” would seem most appropriate since B-mode, often used interchangeably with the term B-scan, actually refers to the process of reducing the echo spike amplitude to a bright dot and is also used in echocardiography.

This volume is intended as an introduction to B-scan ultrasound for those unfamiliar with the field. I should like to stress the word “Introduction,” for B-scan ultrasound is a constantly evolving and expanding discipline. To be a confident ultrasonographer, a multifaceted approach is required encompassing knowledge of cross-sectional anatomy, clinical medicine, diagnostic radiology, and an understanding of the physical principle and limitations of the particular ultrasonic unit being used. B-scan ultrasound is a field demanding both intellectual capability and manual dexterity, and it cannot be too heavily emphasized that “abdominal ultrasound” is not a discipline that can be acquired after reading a textbook or attending a one-week course. Practical experience in transducer handling and echographic interpretation is essential. An attempt to describe in detail the technique involved in obtaining satisfactory views of the kidney is made in the article on Renal Ultrasound. However, the relationship between the time gain compensation, the output and transducer frequency is so complex and variable that it defies description and is far better understood if the trainee acts as an apprentice to an experienced sonographer. It is generally felt by experts in the field that a satisfactory standard of practice can only be acquired after several months didactic instruction and practical experience, preferably of six to twelve months’ duration.

………

Dr. Roger C. Sanders is well known amongst Radiologists as an author of some of the best basic medical sonography textbooks.

I would not be able to practice without one of the books that he edited, an excellent and comprehensive tabletop reference for fetal anomalies.

It is humbling to realize that in December 1975, I was less than three years old!

I wonder if Dr. Sanders imagined how much medical ultrasonography would grow in 30 years.

I’m sure fellow radiologists and sonographers would agree that one thing hasn’t changed much..

Ultrasonography remains a filed that “demands both intellectual capability and manual dexterity, and it …is not a discipline that can be acquired after reading a textbook or attending a one-week course. Practical experience in transducer handling and echographic interpretation is essential.”

It is also true that the best way to learn ultrasonography is as an “apprentice to an experienced sonographer.”

I was fortunate to have good teachers.

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