Editorial.

Abstract

The UK Covid-19 vaccination programme appears to have been a remarkable success and is allowing us as a nation to dare to dream again about leisure time and freedom as our summer approaches. That said, many ultrasound departments are still battling with appointment backlogs and managers are probably dreading staff taking time off for holidays even though breaks are, for healthcare workers, more important than ever now. I hope hospital services are able to return soon to normal levels of activity and that, perhaps in some imaging departments, staff have developed new and better ways of working, which will persist after the Covid-19 pandemic is passed. I’d welcome good quality articles exploring this topic. In the meantime, the Spring issue of Ultrasound offers some very interesting papers. It is reassuring to read that research findings from a team based in the south of England suggest that the British Thyroid Association guidelines for grading thyroid nodules are safe and robust enough to work equally well whether being used by a novice or experienced ultrasound practitioner. Sehgal et al. from the USA offer a small but very compelling study comparing Doppler flow and echogenicity in benign and malignant prostate lesions. They found that malignant lesions were hypoechoic, had faster blood flow and a lower resistive index compared with benign lesions. There are three obstetric-focused papers but investigating very different issues; Miloro et al. use a tissue mimicking phantom to produce and measure ultrasound-induced temperature rises in utero. They compare transducer types and frequencies and, although the values obtained remain within current safety recommendations, they are certainly significant. The team also reminds us that reducing the acoustic power is an easy way to minimise heating effects. Good simple advice, especially when machines’ default settings may be at 100% power output. Dyer and Chudleigh present an interesting audit of third trimester fetal abdominal circumference measurements. A good abdominal section is arguably one of the most difficult views to achieve in late pregnancy yet precision is essential if measurements are to be of value and reproducible. Factors influencing sonographers’ decision making on what constitutes a good image are explored, along with other variables like calliper placement. Agarwal et al. investigate the value of an ultrasound-based index for stratifying the risk of morbidly adherent placenta, in terms of its accuracy, ease of use and interobserver reliability. Nice supporting images are a timely reminder of this potentially devastating condition. Yumna Haroon et al. offer a comprehensive guide to ultrasound applications regarding paediatric anaesthetic procedures, while Panayiotou et al. offer an informative case report on focal nodular hyperplasia in a teenager. Excellent comparative imaging is what makes this report superior and the take-home message is of course to avoid where possible unnecessary radiation imaging in the paediatric population. Furthermore, a team from Malaysia presents a second interesting case report for this issue, which demonstrates the value of lung ultrasound in populations where tuberculosis is prevalent and healthcare resources are limited. If you have opinions on any of these articles please consider sending a letter to the editor.