At the recent emergency and critical care ultrasound section meeting in San Diego, the topic of increasing risk of ionizing radiation was brought up.   The focus was whether the AIUM or another organization should advocate for more use of ultrasound versus the traditional default of CT scanning when presented with diagnostic uncertainty.

The topic is multifactorial and includes ease of getting the exam, diagnostic certainity of CT vs operator dependence of ultrasound, and the infrastructure and workflow of medical practices.

• The challenge is that the slope of change with ultrasound penetrance into mainstream medicine is still 5-10 years away despite the technology being ready for the bedside today.
• My question is how does the brand of focused Ultrasound as a cost effective, safe, non ionizing imaging modality become more mainstream and eliminate some of the excessive CT scan use?
• I believe CT's for hydronephrosis in patients with flank pain could be low lying fruit while CT's for suspected appy would be on the more difficult side of this argument.

Does anyone have any ideas on whether an organization like AIUM or maybe the AMA, or whether the government or third party payors need to get involved to help frame a new culture of bedside imaging?