Validation of an assessment tool for estimation of abdominal aortic aneurysm compression in diagnostic ultrasound

The study investigated ultrasound (US) transducer push, tantamount to applied transducer pressure, during abdominal aortic aneurysm (AAA) US scanning in a simulated non-clinical setup. During an assessment of maximal AAA diameter on a three-dimensional print-based AAA phantom, US transducer push varied as much as 2000% (range: 0.52-12.45 kPa) amongst 16 experienced sonographers. The mean transducer push was 5.54 ± 3.91 kPa (CV = 0.71). Deformation of a standardized gel-pad allowed for transducer push calculation based on US images; Young's modulus of the gel-pad was estimated to 44,26 N/m2. The method is theoretically validated in a safe and non-clinical environment. Future investigations with the aim of clinical validation of the gel-pad principle on AAA patients are suggested, including the objectification of the magnitude of an eventual transducer push-related error during US AAA diameter measurement.

Training the trainees: a pilot study of inter-observer discrepancy and learning curve in the maternal foetal unit of a tertiary centre

Our study aims to present the preliminary findings of an ongoing prospective cohort study that assesses the trainees' ability to perform foetal biometry during the third trimester of pregnancy. Sixty-three women with third-trimester singleton pregnancies were included. A biometry scan was performed byboth residents and a foetal medicine specialist in the Third department of Obstetrics and Gynaecology of Attikon University Hospital. For each case, the ultrasonographic measurements of the two operator groups were compared. The mean difference of the resident group compared to the specialist group was: for the biparietal diameter +1.3 mm (CI 95%, range -10.6 to +13,3, ±1.96 SD), for the occipitofrontal diameter -2.6 mm (CI 95%, range -31.5 to +26.2), for the anterior-posterior abdominal diameter -2.6 mm (CI 95%, range -17.9 to +12.8), for the transverse abdominal diameter -0.7 mm (CI 95%, range -17.1 to +15.7) and for the femur length -1.1 mm (CI 95%, range -11.7 to +9.6). We observed that, among all biometric parameters, the most accurate -based on the specialist group were the head circumference measurements. The highest discrepancy was noted for the abdominal assessment. Given that foetal biometry is of utmost importance in obstetrical clinical evaluation and management, a study that highlights the weaknesses of residents in this field could open new horizons in optimising the learning procedure.Impact statementWhat is already known on this subject? After review of the literature, we found only a few studies on inter- and intra-observer discrepancy in foetal biometry measurements among specialists.What the results of this study add? To our knowledge, our study is the first to evaluate residents' capacity of performing a biometry scan, by comparing their measurements to those of MFM specialists.What the implications are of these findings to clinical practice and/or further research? The need for constant evaluation of residents is indisputable. Our study could help to improve their ultrasound skills by giving emphasis on residents' weaknesses. With further research on this subject, a standard system of evaluation could be formed and determine the duration and type of training required for each resident.