Abstract No. 135 Point-of-care ultrasound (POCUS) versus conventional ultrasound imaging quality

Abstract

To compare the quality of point-of-care-ultrasound (POCUS) imaging guidance for interventional procedures compared to that of conventional ultrasound (US) imaging Intra-procedural US images from the first 119 procedures in 108 patients using POCUS following its integration into our practice were uploaded to a HIPAA compliant cloud. When conventional US imaging from these cases was also captured and stored on our picture archival system (PACS) for quality assurance and documentation, these images were also evaluated. 119 comparable procedures in patients with similar body mass indices and matched procedural type where conventional US was utilized were identified. Studies were reviewed by the P.I. and the intra-procedural images stripped of PHI and proprietary ultrasound unit graphics or annotations. Representative images from each case were imported into a PowerPoint (Microsoft Corp. Redmond, WA) presentation, 1-2 images per slide, for a total of 331 case slides (123 POCUS-guided procedures with 101 correlative images taken with conventional US imaging, and 107 matched procedures performed with conventional US imaging). Slides were assorted using a random sequence generator. The PowerPoint presentation was then stored in an electronic folder on the Departmental share-drive for review by three blinded co-investigators for image quality on a 10-point Likert scale (inadequate ≤ 4.9; adequate 5.0-6.9; good 7.0-8.9; excellent 8.0-10). Scores were compared between procedures completed with the two different US technologies (POCUS versus conventional) and across procedural categories. 331 total observations were made. Overall quality of the POCUS images was rated as 5.7, compared with 7.0 for conventional US images of the same cases and 6.8 for the other conventional US-guided cases. For POCUS cases, all procedural categories had images rated as adequate (5.0-5.8) except vascular access which was rated as good (6.8) and conversely nephrostomy access which was rated as 4.7. This compares to conventional US images, which were rated as good for all categories (6.4-7.9), except nephrostomy access which was rated as 5.7. In 10 cases, two of three of the reviewers deemed the image quality ≥ adequate for procedural guidance compared to the third reviewer; 9 of these cases were in the POCUS group. Point-of-care ultrasound pocket-sized imaging was rated as “adequate“ for guidance of most vascular access and non-vascular procedures compared to “good“ for conventional ultrasound imaging.