Remembering one of the great pioneers

Abstract

Sadly, Professor John MacVicar, the pioneering obstetrician in ultrasound died in May this year. His contributions to obstetrics and gynaecology, and to ultrasound were immeasurable. John was one of the co-authors, along with Donald and Brown, of the seminal paper ‘Investigation of abdominal masses using pulsed ultrasound’ published in The Lancet in 1958, which helped to secure ultrasound’s future as a serious imaging modality – not that the sketchy line ‘images’ obtained back then would have meant much to any of us practising today. In view of John’s achievements and of the subsequent technological developments in ultrasound in the last 50 years, the title of his MD thesis in 1959 could be considered one of the great understatements of the 20th century; ‘Ultrasound as a diagnostic aid in obstetrics and gynaecology’. I am grateful to one of John MacVicar’s former colleagues, John Fleming, for writing a fine tribute to this great man (p 118). These are exciting times to be involved in ultrasound education. It is undergoing many changes as higher education institutions, professional organizations and private companies attempt to meet the ultrasound training needs of growing numbers of individuals working in and outside the National Health Service. In the UK various guidelines, standards and recommendations have been set. However, as more focused applications of ultrasound emerge it may be that these standards are not appropriate for all users. It may be timely to consider revisions or the development of new guidance while ensuring, of course, that clinical competence is still achieved and measured. An illustration of this idea is included in this issue of Ultrasound; an article by Bidwai and Casserley discusses the need for focused ultrasound training for orthopaedic surgeons. Arguably their proposal could be echoed by a number of practitioners from other specialties. I anticipate their paper will generate debate and I look forward to hearing your views on this important subject. Still on the theme of focused education, we also include the next two articles in the Point of Care Ultrasound (PoCUS) series aimed specifically at emergency physicians. There is a special feature by Pat Ward, Director of the Fetal Anomaly Screening Programme, who reviews the current situation regarding combined screening for Down’s syndrome. Staying with first trimester ultrasound imaging, Chudleigh et al. offer guidance on how to date pregnancies for combined screening where head circumference and crown rump length measurements do not correlate. They also provide advice on how to date a pregnancy when parents have declined combined screening. Practitioners who have previously been unsure as to whether to employ head circumference or crown rump length measurements towards the end of the first trimester may well find this information useful. A team from South Africa report on the value of abdominal ultrasound in children with tuberculosis. Hoskins reviews errors in blood velocity and flow measurements, and suggests that they may be minimized by the development of standard protocols. A collaboration from India presents a technical paper on digital scan converters and signal processing in relation to B-mode imaging. As well as the usual book reviews and Echoes, this edition also contains a thought-provoking letter by Tom Brown, the retired engineer and former colleague of John MacVicar, who suggests a method for reducing work-related musculoskeletal disorders in sonographers. Again, I welcome your response.