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The future of ultrasonics in diagnostic medicine

Ultrasonics has been the poor relation of twentieth century physics and it is only recently that thought has been given to investigating the scientific basis of ultrasonic diagnostic methods. The physics of acoustic wave interactions with human tissues is complex but suggests the existence of a rich supply of diagnostically useful information. Static imaging technology may now be approaching a resolution limit imposed by variability of refractive index in overlying tissues, but advances are to be expected in the direction of quantification of the imaging process. Supplementary information on fine structure of tissues is also to be expected from the application of analytical techniques, of which frequency dependence of backscattering and diffraction pseudo-crystallography are two examples in which there is current research interest. Recent rapid advances in dynamic or ‘real time’ imaging reflect the potential of ultrasound for providing hitherto unobtainable information on patterns of tissue movement both in health and disease. Major advances in application will come, in many areas of medicine, simply as good equipment, experience and expertise become more generally available but particular impact from scientific advances may occur in the diagnosis and management of both cardiovascular disease and cancer, with effective early detection of breast cancer being one of a number of distant but compelling prospects.