What has been the most significant change you have seen in ultrasound technology?

In my opinion, the most significant innovation was the introduction of real-time gray scale.   I saw the gamut: from static B-scan, to real-time gray scale, Doppler (continuous at first at King’s College Hospital with David Griffin, then pulsed), color Doppler and, naturally 3D/4D. All of these and many others (harmonic imaging, ultrasound contrast agents, elastography) have advanced our clinical diagnostic (and, in some cases, therapeutic) capabilities but real-time gray-scale is what we still use nowadays, every day, everywhere and is really the basis of what we do, clinically.

What has been your most recent involvement with ultrasound?   

I must distinguish clinical and research involvement.

Clinical: I’ve been performing diagnostic ultrasound in obstetrics and gynecology since arriving in the United States in 1987, first as a fellow at the Eastern Virginia Medical School in Norfolk VA, then Rochester NY, Chicago, and Detroit. I returned to the University of Chicago in 2016 as director of Ultrasound and the Fetal and Neonatal care Center which I was instrumental in establishing. In fact I had wanted to create such an entity at the University of Chicago since 2000 but various factors prevented the creation.  When I joined Rush University Medical Center in Chicago in 2005, very quickly such a center was founded and I was its first co-director.   More recently, with the arrival of the Covid-19 epidemic, I became involved with infection control, particularly practice of infection control within the frame of the epidemic.  Finally, I am now dedicated to ultrasound quality assurance which is a topic that is, unfortunately, too often neglected.

Research: This has taken me from the use of ultrasound contrast agents (UCA) in the placental circulation (I published the first review on the use of UCA in ObGyn in 1997) to the use of targeted agents in early diagnosis of ovarian cancer in egg-laying chicken, the only animal which develops ovarian cancer identical in every aspect to the human cancer. The model was mostly conceived by Animesh Barua, PhD with whom we have been collaborating for almost 15 years.  We were the first group to publish in peer-reviewed journals images of chicken ovarian cancer, first with gray-scale, with transvaginal or, rather transcloacal ultrasound (yes, a regular vaginal probe and don’t go “OMG, this is huge for a small chicken” because if the egg can come out, the probe can go in!)), then pulsed and color Doppler and, finally, with UCA.

Safety: This has been my passion since becoming involved with ob ultrasound. I had the good fortune of becoming part of a select group involved with bioeffects and safety, mostly basic scientists with very few physicians and have been involved in bioeffects and safety education and the writing of many safety-related documents and guidelines.  I chaired the committee that revised/wrote the 4th edition of the manual entitled ‘‘Medical Ultrasound Safety’’ which accompanies all ultrasound instruments sold in the United States, as required by the FDA.

Committees: I’ve been involved with committees work for AIUM, ISUOG, WFUMB and others from the beginning of my career.  I have been part of AIUM’s Bioeffects Committee since 1997, elected its Chair twice, Chair of AIUM’s Subcommittee on Epidemiology of Bioeffects Committee for 10 years, Chair of the ISUOG Safety Committee for 9 years and Chair of the WFUMB Safety Committee for 10 years. I’m also on the WHO Task Force on Non-ionizing Radiation and member of the ultrasound expert group of the International Commission on Non-Ionizing Radiation Protection (ICNIRP).

I was a member of WFUMB for 12 years, Chair of the WFUMB Safety committee for 10 years, treasurer for 6 years and President-elect from 2021-2022. I had the pleasure, privilege and honor to work with many wonderful people and be involved in spreading ultrasound to the underserved world.