How Handheld Ultrasound Helped One Family Catch Thyroid Disease Early

GE Healthcare

Like many clinicians do, Dr. Leigh Ann Cashwell finds herself providing care for her own family from time to time in her small hometown in Mississippi.

A mother of three boys, she was scanning her 15-year-old son, Luke, using the Vscan Extend handheld ultrasound technology when she came across something unexpected.

 “I was scanning his neck, and when I got to his thyroid, I immediately knew that there was nothing normal about what I was looking at,” said Dr. Cashwell. “The thyroid was enlarged and heterogenous with multiple small nodules throughout. I was speechless.”

Working as a diagnostic radiologist at George Regional Hospital in Mississippi, Dr. Cashwell called to see if they could get Luke in for a follow-up ultrasound scan on the hospital’s LOGIQ E9, a larger ultrasound unit often used for in-depth scans in the hospital, that evening. Thankfully, the ultrasound technologist was still in-house.

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“The image on the larger ultrasound unit [LOGIQ E9] looked just like it did on the Vscan Extend,” explained Dr. Cashwell. “We sent the scan to my partner at the hospital and got an appointment set up with his Primary Care doctor for lab testing that Monday.”

Lab tests confirmed Dr. Cashwell’s suspicion. Luke had a thyroid condition known as Hashimoto’s disease, an auto-immune disease in which the body attacks the thyroid, gradually destroying the thyroid tissue.  This results in life-long hypothyroidism with possible severe complications including neurologic damage, depression, and cardiac complications, if left untreated. Within three days, Luke’s workup was complete, and he was started on treatment for the disease.

“This is something Luke will have for his entire life, but if we hadn’t done that scan on the Vscan Extend, who knows how long it would have been before we knew that he had hypothyroidism,” said Dr. Cashwell. “It was an absolute blessing that we were able to find this and get it fixed so quickly so he can live a healthy, normal life.”

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Handheld Ultrasound Helps Primary Care Doctors See What They Can’t Feel or Hear

Like Dr. Cashwell, many clinicians have experienced the value of handheld ultrasound in an emergency or primary care environment. Clinical experts report the device provides quick information and enable them to see what cannot be easily seen or felt.

“Throughout a recent experience with handheld ultrasound I kept thinking to myself, ‘what an advantage it is for Primary Care doctors to have a technology like this,’” said Dr. Cashwell. “Incorporating handheld ultrasound in a typical physical exam could help them quickly see things that could otherwise be missed.”

Accordingly, the American Academy of Family Physicians refers to Point of Care Ultrasound as the “the biggest advance in bedside diagnosis since the advent of the stethoscope 200 years ago” with recommendation that family medicine residents in the United States all be proficient in Point of Care Ultrasound.

In typical circumstances, handheld ultrasound has proven additional value as an easy-to-use, lightweight and portable ultrasound tool that clinicians can have on-hand throughout their day to evaluate and triage patients with pulmonary, cardiac and other diseases. One study finds the performance of handheld ultrasound devices comparable to standard ultrasonography for general practices, as well as suggesting an incremental benefit when used in physical examinations.[1]  

Outside of primary care, handheld ultrasounds can be found throughout the hospital helping clinicians from the ICU to the Oncology unit scan the body to see what they can’t feel or hear.  

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Throughout the COVID-19 pandemic, handheld ultrasound has played a critical role in helping clinicians manage the treatment of patients with the virus.  Providers worldwide are tapping into this tool to quickly monitor patient deterioration or progress of the lungs and heart with the added benefits of portability, affordability and ease of use and disinfection that handheld ultrasound provides. In addition to these benefits, Vscan Extend users have had the potential to make their COVID-19 workflows more efficient with the help of on-device software and an AI application for cardiac ejection fraction evaluations.

“Handheld ultrasound facilitates early and reliable diagnosis. More globally, it allows for increased confidence by improving clinical evaluation, management, patient follow-up and referral to specialists or in emergencies. Conversely, it can help avoid referring a patient to additional care when ultrasound provides evidence of no increased risk,” said Dr. Francis Pellet, General Practitioner at Leopold Ollier Medical Station - Les Vans in France.

“In the case of the COVID-19, it allowed us to affirm or exclude the presence of clinical indicators of infected patients with the ultrasound’s images and findings.”

[1] : Colli A, Prati D, Fraquelli M, Segato S, Vescovi PP, Colombo F, et al. (2015) The Use of a Pocket-Sized Ultrasound Device Improves Physical Examination: Results of an In- and Outpatient Cohort Study. PLoS ONE 10(3): e0122181. doi:10.1371/ journal.pone.0122181