Acoustic lens improves superficial in-plane ultrasound-guided procedures - The significance of the beam width artefact

Harm J Scholten; Yomi Hoever; Fredericus H J van Loon; Elke Kanters; Tamara Hoveling; Marco de Wild; R Arthur Bouwman; Erik H M Korsten

doi:10.1016/j.jclinane.2022.110666

Acoustic lens improves superficial in-plane ultrasound-guided procedures - The significance of the beam width artefact

Harm J Scholten^*, Yomi Hoever, Fredericus H J van Loon, Elke Kanters, Tamara Hoveling, Marco de Wild, R Arthur Bouwman, Erik H M Korsten

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

STUDY OBJECTIVE: The three-dimensional shape of the ultrasound beam produces a thicker scan plane than most users assume. Viewed longitudinally, a needle placed lateral to a vessel just outside the central scanning plane can be displayed incorrectly in the ultrasound image as if placed intravascularly. This phenomenon is called the beam width artefact, also known as the elevation or slice thickness artefact. The goal of this study was to demonstrate the potential negative effect of the beam width artefact on the performance of in-plane ultrasound-guided vascular access procedures, and to provide a solution.

DESIGN: Randomized, double-blinded study SETTING: Department of anaesthesiology and intensive care of a teaching hospital PARTICIPANTS: 31 experienced (anesthesiologists and intensivists) and 36 inexperienced (anesthetic nurses) ultrasound users INTERVENTIONS: We developed an acoustic lens that narrows the scan plane to reduce the beam width artefact. The lens was tested in a simulated vascular access study.

MEASUREMENTS: The primary endpoint was first pass success. Secondary endpoints were the number of punctures and needle withdrawals, procedure time, needle visibility and operator satisfaction.

MAIN RESULTS: First pass success was highly enhanced using the acoustic lens, with a success rate of 92.5% versus 68.7% without the lens (difference 23.8, 95% confidence interval 11.0-35.3, p < 0.001). The total number of punctures needed to obtain intravenous access was also reduced using the lens (1.10 versus 1.38, difference 0.27, 95% CI 0.11-0.43, p = 0.002). Procedure time, needle withdrawals, needle visibility and satisfaction were similar. Both inexperienced and experienced users benefited from the acoustic lens.

CONCLUSIONS: The beam width artefact has a significant effect on the performance of ultrasound-guided needle-based procedures. The efficacy of in-plane superficial vascular access procedures can be enhanced by narrowing the imaging plane using an acoustic lens.

Original language	English
Article number	110666
Number of pages	6
Journal	Journal of Clinical Anesthesia
Volume	78
DOIs	https://doi.org/10.1016/j.jclinane.2022.110666
Publication status	Published - Jun 2022

Keywords

Beam width artefact
OF-PLANE
Peripheral veins
Phantom study
RADIAL ARTERY CANNULATION
THICKNESS
Technical development
Ultrasound-guided vascular access

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Cite this

@article{9fd0d2bb521448fb9d14642f7ed6e189,

title = "Acoustic lens improves superficial in-plane ultrasound-guided procedures - The significance of the beam width artefact",

abstract = "STUDY OBJECTIVE: The three-dimensional shape of the ultrasound beam produces a thicker scan plane than most users assume. Viewed longitudinally, a needle placed lateral to a vessel just outside the central scanning plane can be displayed incorrectly in the ultrasound image as if placed intravascularly. This phenomenon is called the beam width artefact, also known as the elevation or slice thickness artefact. The goal of this study was to demonstrate the potential negative effect of the beam width artefact on the performance of in-plane ultrasound-guided vascular access procedures, and to provide a solution.DESIGN: Randomized, double-blinded study SETTING: Department of anaesthesiology and intensive care of a teaching hospital PARTICIPANTS: 31 experienced (anesthesiologists and intensivists) and 36 inexperienced (anesthetic nurses) ultrasound users INTERVENTIONS: We developed an acoustic lens that narrows the scan plane to reduce the beam width artefact. The lens was tested in a simulated vascular access study.MEASUREMENTS: The primary endpoint was first pass success. Secondary endpoints were the number of punctures and needle withdrawals, procedure time, needle visibility and operator satisfaction.MAIN RESULTS: First pass success was highly enhanced using the acoustic lens, with a success rate of 92.5% versus 68.7% without the lens (difference 23.8, 95% confidence interval 11.0-35.3, p < 0.001). The total number of punctures needed to obtain intravenous access was also reduced using the lens (1.10 versus 1.38, difference 0.27, 95% CI 0.11-0.43, p = 0.002). Procedure time, needle withdrawals, needle visibility and satisfaction were similar. Both inexperienced and experienced users benefited from the acoustic lens.CONCLUSIONS: The beam width artefact has a significant effect on the performance of ultrasound-guided needle-based procedures. The efficacy of in-plane superficial vascular access procedures can be enhanced by narrowing the imaging plane using an acoustic lens.",

keywords = "Beam width artefact, OF-PLANE, Peripheral veins, Phantom study, RADIAL ARTERY CANNULATION, THICKNESS, Technical development, Ultrasound-guided vascular access",

author = "Scholten, {Harm J} and Yomi Hoever and {van Loon}, {Fredericus H J} and Elke Kanters and Tamara Hoveling and {de Wild}, Marco and Bouwman, {R Arthur} and Korsten, {Erik H M}",

year = "2022",

month = jun,

doi = "10.1016/j.jclinane.2022.110666",

language = "English",

volume = "78",

journal = "Journal of Clinical Anesthesia",

issn = "0952-8180",

publisher = "Elsevier Science",

}

TY - JOUR

T1 - Acoustic lens improves superficial in-plane ultrasound-guided procedures - The significance of the beam width artefact

AU - Scholten, Harm J

AU - Hoever, Yomi

AU - van Loon, Fredericus H J

AU - Kanters, Elke

AU - Hoveling, Tamara

AU - de Wild, Marco

AU - Bouwman, R Arthur

AU - Korsten, Erik H M

PY - 2022/6

Y1 - 2022/6

N2 - STUDY OBJECTIVE: The three-dimensional shape of the ultrasound beam produces a thicker scan plane than most users assume. Viewed longitudinally, a needle placed lateral to a vessel just outside the central scanning plane can be displayed incorrectly in the ultrasound image as if placed intravascularly. This phenomenon is called the beam width artefact, also known as the elevation or slice thickness artefact. The goal of this study was to demonstrate the potential negative effect of the beam width artefact on the performance of in-plane ultrasound-guided vascular access procedures, and to provide a solution.DESIGN: Randomized, double-blinded study SETTING: Department of anaesthesiology and intensive care of a teaching hospital PARTICIPANTS: 31 experienced (anesthesiologists and intensivists) and 36 inexperienced (anesthetic nurses) ultrasound users INTERVENTIONS: We developed an acoustic lens that narrows the scan plane to reduce the beam width artefact. The lens was tested in a simulated vascular access study.MEASUREMENTS: The primary endpoint was first pass success. Secondary endpoints were the number of punctures and needle withdrawals, procedure time, needle visibility and operator satisfaction.MAIN RESULTS: First pass success was highly enhanced using the acoustic lens, with a success rate of 92.5% versus 68.7% without the lens (difference 23.8, 95% confidence interval 11.0-35.3, p < 0.001). The total number of punctures needed to obtain intravenous access was also reduced using the lens (1.10 versus 1.38, difference 0.27, 95% CI 0.11-0.43, p = 0.002). Procedure time, needle withdrawals, needle visibility and satisfaction were similar. Both inexperienced and experienced users benefited from the acoustic lens.CONCLUSIONS: The beam width artefact has a significant effect on the performance of ultrasound-guided needle-based procedures. The efficacy of in-plane superficial vascular access procedures can be enhanced by narrowing the imaging plane using an acoustic lens.

AB - STUDY OBJECTIVE: The three-dimensional shape of the ultrasound beam produces a thicker scan plane than most users assume. Viewed longitudinally, a needle placed lateral to a vessel just outside the central scanning plane can be displayed incorrectly in the ultrasound image as if placed intravascularly. This phenomenon is called the beam width artefact, also known as the elevation or slice thickness artefact. The goal of this study was to demonstrate the potential negative effect of the beam width artefact on the performance of in-plane ultrasound-guided vascular access procedures, and to provide a solution.DESIGN: Randomized, double-blinded study SETTING: Department of anaesthesiology and intensive care of a teaching hospital PARTICIPANTS: 31 experienced (anesthesiologists and intensivists) and 36 inexperienced (anesthetic nurses) ultrasound users INTERVENTIONS: We developed an acoustic lens that narrows the scan plane to reduce the beam width artefact. The lens was tested in a simulated vascular access study.MEASUREMENTS: The primary endpoint was first pass success. Secondary endpoints were the number of punctures and needle withdrawals, procedure time, needle visibility and operator satisfaction.MAIN RESULTS: First pass success was highly enhanced using the acoustic lens, with a success rate of 92.5% versus 68.7% without the lens (difference 23.8, 95% confidence interval 11.0-35.3, p < 0.001). The total number of punctures needed to obtain intravenous access was also reduced using the lens (1.10 versus 1.38, difference 0.27, 95% CI 0.11-0.43, p = 0.002). Procedure time, needle withdrawals, needle visibility and satisfaction were similar. Both inexperienced and experienced users benefited from the acoustic lens.CONCLUSIONS: The beam width artefact has a significant effect on the performance of ultrasound-guided needle-based procedures. The efficacy of in-plane superficial vascular access procedures can be enhanced by narrowing the imaging plane using an acoustic lens.

KW - Beam width artefact

KW - OF-PLANE

KW - Peripheral veins

KW - Phantom study

KW - RADIAL ARTERY CANNULATION

KW - THICKNESS

KW - Technical development

KW - Ultrasound-guided vascular access

U2 - 10.1016/j.jclinane.2022.110666

DO - 10.1016/j.jclinane.2022.110666

M3 - Article

C2 - 35124347

SN - 0952-8180

VL - 78

JO - Journal of Clinical Anesthesia

JF - Journal of Clinical Anesthesia

M1 - 110666

ER -