Fact Check: Are ultrasounds safe?

Are Ultrasounds Safe?

Introduction

The safety of ultrasound technology, particularly in medical applications, is a topic of ongoing discussion among healthcare professionals and patients alike. Claims regarding the safety of ultrasounds often arise in the context of their use in various medical fields, including obstetrics, cardiology, and therapeutic treatments. This article examines the available evidence surrounding the safety of ultrasound procedures, considering both the potential risks and benefits.

What We Know

1. Mechanisms of Ultrasound: Ultrasound works by emitting sound waves at frequencies higher than the audible range, which can create images of internal body structures. The two primary mechanisms by which ultrasound can affect biological tissues are thermal (heating) and mechanical (cavitation) effects 78.

2. Clinical Applications: Ultrasound is widely used in medical diagnostics and treatment. For instance, it is a standard tool in obstetrics for monitoring fetal development and is also employed in therapeutic settings, such as the EKOS system for treating pulmonary embolism 14.

3. Regulatory Oversight: The U.S. Food and Drug Administration (FDA) regulates ultrasound devices, ensuring they meet safety standards before approval for clinical use. The American Institute of Ultrasound in Medicine (AIUM) provides guidelines on the safe use of ultrasound, emphasizing the importance of minimizing exposure to patients 8.

4. Potential Risks: While ultrasound is generally considered safe, there are concerns regarding its potential biological effects. The AIUM's Medical Ultrasound Safety document outlines possible ultrasound-induced bioeffects, including thermal and mechanical effects, and stresses the need for judicious use to keep exposure levels as low as reasonably achievable 8.

5. Guidelines and Recommendations: Professional organizations, such as the Society of Radiographers (SoR) and the British Medical Ultrasound Society (BMUS), regularly update guidelines to reflect current best practices in ultrasound use, focusing on safety and efficacy 59.

Analysis

The claim regarding the safety of ultrasounds is supported by a substantial body of literature, but it is essential to critically evaluate the sources of this information.

• Source Reliability: The National Institute of Biomedical Imaging and Bioengineering (NIBIB) provides a comprehensive overview of ultrasound technology, including its applications and associated risks, which is a credible source given its affiliation with the National Institutes of Health 2. Similarly, the AIUM's guidelines and statements are based on extensive research and expert consensus, making them reliable references for understanding ultrasound safety 78.

• Potential Biases: While many sources are reputable, it is crucial to consider potential biases. For instance, organizations that promote ultrasound technology may emphasize its benefits while downplaying risks. The SoR and BMUS guidelines, while informative, may reflect the interests of practitioners who benefit from the continued use of ultrasound in clinical settings 59.

• Methodological Concerns: Some studies, such as those assessing ultrasound enhancing agents (UEAs), highlight a lack of comprehensive safety assessments, indicating that more research is needed to fully understand the comparative safety of these agents 34. This suggests that while ultrasound itself may be safe, the safety of specific applications or enhancements is still under investigation.

• Conflicts of Interest: It is also important to note that some studies may be funded by companies that manufacture ultrasound equipment or related technologies, which could introduce conflicts of interest. Transparency in funding sources is vital for evaluating the reliability of research findings.

Conclusion

Verdict: Mostly True

The claim regarding the safety of ultrasounds is mostly true, supported by a significant body of evidence indicating that ultrasound technology is generally safe for medical use. Key evidence includes regulatory oversight by the FDA, guidelines from reputable organizations like the AIUM, and extensive clinical applications demonstrating its utility in various medical fields. However, it is important to acknowledge the potential risks associated with ultrasound, particularly concerning specific applications and enhancements that may require further research.

The nuances of this verdict stem from the recognition that while ultrasound is broadly considered safe, there are still concerns about its biological effects and the need for judicious use. Additionally, the presence of potential biases in the sources and conflicts of interest in some studies highlight the importance of critical evaluation of the information available.

Readers are encouraged to remain skeptical and critically assess the information they encounter regarding ultrasound safety, as ongoing research may continue to refine our understanding of its risks and benefits.

Sources

1. Overview of Therapeutic Ultrasound Applications and Safety. Retrieved from PMC
2. Ultrasound. Retrieved from NIBIB
3. Comparative Safety of Ultrasound Enhancing Agents: A Systematic Review. Retrieved from PubMed
4. Comparative Safety of Ultrasound Enhancing Agents: A Systematic Review. Retrieved from ScienceDirect
5. Professional ultrasound practice guidelines updated for 2023. Retrieved from SoR
6. Now available: 8th edition of the SoR / BMUS Guidelines for Professional Ultrasound Practice. Retrieved from BMUS
7. Statement on Biological Effects of Therapeutic Ultrasound. Retrieved from AIUM
8. Medical Ultrasound Safety (MUS) - AIUM. Retrieved from AIUM
9. SoR and BMUS Guidelines for Professional Ultrasound Practice. Retrieved from SoR
10. 2023 Scientific Program - Journal of Ultrasound in Medicine. Retrieved from Wiley