Looking Into the Body—and the Future

Handheld ultrasound tested at UVA

Handheld ultrasound devices are providing quick and accurate diagnoses in UVA emergency rooms. Photo by Stacey Evans
An ultrasound device about the size of a smartphone might soon be as common as a stethoscope at the UVA Medical Center's emergency department.

Handheld ultrasound machines are being tested for their efficacy in assessing patients in a study led by Dr. James Moak, an assistant professor of emergency medicine.

The device, produced by General Electric Co., costs about an eighth of the typical ultrasound machine commonly wheeled around exam rooms and has roughly the same picture quality, Moak says.

Moak is leading a team of physicians investigating whether these devices can help medical students make more accurate diagnoses in ER patients than in a typical evaluation.

"Bedside ultrasonography is already an important part of the care we provide," says Moak. "This technology could take on an even larger role now that ultrasound devices have gotten smaller and more portable. Not every disease process is amenable to sonographic visualization, but in the emergency department, where time is often critical, having a device like this in your pocket can be invaluable."

Moak and his colleagues have already found the devices invaluable enough that they recently won funding from the emergency department's advisory board to purchase an additional half dozen units.

Moak says he once relied on bedside ultrasonography to confirm fluid around the heart in a stabbing victim, which sped up his decision to go to the operating room.

He says the smaller, handheld devices could someday become commonplace in combat zones, refugee camps, and even in the toolkit of EMTs and other first responders. They might use the device on accident victims, for instance, to find internal bleeding they might not otherwise know exists.

"They call it the stethoscope of the future," Moak says. "I can see a day come when we don't even have the device, where we can just connect a probe to our smartphones and use an app for ultrasound. I don't think that's a very long way off."

Scalpel-Free Brain Surgery

UVA doctor explores potential of ultrasound

Dr. Jeffrey Elias
The emergency department isn't the only place where UVA doctors and scientists are finding new uses for ultrasound.

Dr. Jeffrey Elias (Med '94, Res '95, '02), an associate professor in the department of neurological surgery, is widening his trials of a noninvasive procedure that uses focused ultrasound to remove diseased brain tissue that causes essential tremor, an involuntary shaking that occurs mostly in patients' hands and arms.

Elias said that roughly two-thirds of the 15 patients who underwent the scalpel-free procedure had reduced shaking in their hands, with only mild side effects.

"These preliminary results have given us great optimism that focused ultrasound may indeed be used to treat a variety of neurologic disorders in the future," Elias told UVA Today. "We are very excited to proceed with further clinical trials in essential tremor and other neurological diseases."

UVA will serve as the lead site for an international trial scheduled to begin this summer, which will include more than 70 patients.

Cancer-Fighting Protein

New models of tumor growth developed by researchers at the UVA Medical Center have shown that a protein once thought to promote cancer may actually inhibit its growth.

The protein, found in many tumors, including bladder and ovarian cancers, is often produced by both cancer cells and the tissue surrounding them in less aggressive tumors. In aggressive tumors, the protein is lost in the cancer but still found in surrounding tissue, a fact that led many cancer researchers to believe it was helping promote its growth.

But modeling developed by Neveen Said, an assistant professor in the department of radiation oncology, found that the protein actually acts as a sort of anti-inflammatory, slowing the development of the cancer and stopping its ability to make new blood vessels, thus preventing it from metastasizing.

Dr. Said says she aims to identify whether the protein can be restored in tumors that aren't expressing it, hopefully slowing or even stopping their growth.