Moving on to civilian life (back in the US), I watched diagnostic imaging history unfold throughout my career and marveled at the inspired evolution of the ultrasound protocol. Its remarkable growth in engineering, its data-gathering (quantifiable) milestones and breakthrough features conquered the arena of patient scanning while forging a safe, non-invasive and high-performance paradigm to physicians and health responders alike. From the high-powered large format hospital scanners to the latest in hand-held portable designs (aka. the digital stethoscope), ultrasound technology holds a solid place in the ever-shaping future of medicine and ancillary disciplines it supports. In 1974, my residency program director told me not to waste my time learning, ultrasound. I went to the Armed Forces Institute of Pathology in D.C. and then to Europe to advance my training. 50 years later, ultrasound has replaced many other invasive imaging technologies.
In the United States, imaging is mostly performed by a technician where the patient holds no interactive part in the scanning process. In Europe, it is standard procedure for the medical team to perform the imaging directly on the patient - creating a more efficient diagnostic experience overall. Patient and physician can see what's going on and discuss treatment options at the same time. This real-time assessment comes direct from the doctor without any potential misinterpretation from secondary parties like the technician.
In 1976, during my early days as a young radiologist, I was approached by Dr. Henry Leis Jr., the pioneer doctor who wrote the very first text on breast cancer and developed mammography 18- a means of early diagnosis and instrumental in the use of many of the less invasive procedures used in the treatment of breast cancer today. He confessed with great concern that he had all these patients with lumpy or cystic breasts developing tumors that he could clearly feel but the mammogram kept missing it. Seeking my help through sonogram technology, we worked on his patients together and the sonogram clearly identified and quickly diagnosed a mass as either a cancer or a benign cyst, in a dense, lumpy breast. Since then we've incorporated the sonogram in high-risk patients’ regimen every six months religiously because it finds tumors while they're small and “lumpectomy” surgery is curative if the mass is less than 1 cm. This is alongside doing mammograms once a year in women over 50 or unless they have a history of cancer- at which case, we do it starting at age 45.