Trevor Rieger
10-28-2003, 11:00 AM
.
Newest technology snaps 25 images a second for the clearest
look yet inside the womb
By Susan Jenks
FLORIDA TODAY
The fetal images appear dusted in gold as they flicker across a monitor, recording a kick here, a gesture there.
The "seeing eye" of ultrasound -- now able to capture real-time motion -- allows Suntree residents Stacy and Jack Jeffcoat to watch their developing twins jostle for position inside the womb, as well as see minute details, down to an eyelash or a wiggling thumb.
"I even saw 'little Jack' sticking his tongue out," 33-year-old Stacy said during a recent sonogram to monitor the twins' health at Viera Diagnostic Center. The center is one of several locations in Brevard County that offerRealTime 4D ultrasound. The difference
Traditional ultrasound images are two dimensional, forcing a doctor to create three-dimensional images in his or her mind. Visible movement appears erratic, and picture resolution is fuzzy.
4-D ultrasound reconstructs 25 images per second of the developing fetus in three planes, and displays them in real-time motion. Movements within the womb are clear, and photo resolution is defined.
As an expectant mother of twins, Stacy's high-risk pregnancy automatically would be followed closely with conventional ultrasound.
Whether adding a smoother motion to the visual mix brings any added diagnostic benefit is widely debated. Most insurers do not cover the estimated $150 charge for each session.
"It's definitely cool -- a gee-whiz technology," said Dr. Thomas Foster, chief of radiology at Wuesthoff Medical Center, Melbourne, referring to the latest software upgrades.
But, from a medical perspective, most physicians detect potentially life-threatening fetal abnormalities, such as heart malformations, using standard "bread-and-butter" ultrasound, with just two dimensions, he said.
"It's just a video instead of a still picture," Foster stressed.
While a four-dimensional ultrasound may pick up facial anomalies, such as a cleft palate, "it is not seeing anything on the inside."
Nor would the newer technology offer medical information to someone not adequately trained, he said.
Ultrasound works by bouncing sound waves off tissue to generate pictures deep inside the womb. A computer converts the reflected waves into two-dimensional images or, more recently, the still-experimental freeze-frame detail of three-dimensional ones.
The fourth dimension adds what physicians refer to as "real time," meaning instantaneous images of the fetus as it moves.
In 4-D, the three-dimensional image is photographed 25 times per second, instantly reconstructed and continuously updated, providing a "live-action" view.
For prospective parents, oblivious to the ongoing debate over the latest technology's medical value, there is an almost palpable thrill of having a clear window on their future offspring.
"The pictures they got were totally amazing," said 38-year-old Kristy Stuart of Indian Harbour Beach.
"One was crystal clear, where you could see everything," she said.
Two other pictures had less clarity, but showed her son, Joshua, who was born Aug. 15, sucking his thumb and gesturing "in a sweet way" with one arm up against his face, she said. The pictures were taken during her sixth month of pregnancy.
A curiosity
Stuart and her husband, Rusty, opted for the new high-tech technology, not out of medical necessity, but out of curiosity and a desire to watch a human life unfold.
"I think most people do it purely for the interest of it," she said.
Many of them watched television's Kelly Ripa display 4-D images of her baby on "Live with Regis and Kelly," and wanted to do it themselves, Stuart said.
Drs. Jeffrey Araj and Allen Powell, radiologists at the Spyglass Court diagnostic center, agreed the new technology's advantage is more personal than diagnostic at this point.
The two physicians and administrator Francis Olomu, former administrative director of radiology at the University of California, Los Angeles, are partners in the new center, which opened in Viera earlier this year.
"We give them CDs and videos to send to grandma up north, who loves these ultrasound pictures," said Powell, who recently moved to Brevard from Bowling Green, Ky.
"But, when we do a four-dimensional ultrasound, we do look to make sure everything is normal," he said.
As radiologists trained to look at cross-sectional images every day, "we can easily spot a cleft lip or a neural tube defect" associated with spinal bifida, in which the spine fails to close properly, he said.
"Do I need three-dimensional images to see these things? Probably not," Powell conceded.
But for parents-to-be, further proof their offspring will be OK "adds peace of mind."
The technology "certainly brings an emotional benefit," both Powell and Araj, the former chief of radiology at Cape Canaveral Hospital in Cocoa Beach, said.
The center's Olomu estimates the center has provided more than 60 four-dimensional fetal ultrasounds since it officially began offering them in April.
"We do about two a week," he said.
Low risk
Virtually all of the women self-referred, meaning they or their partners chose to do so for personal reasons, rather than on the advice of a physician.
As a technology, ultrasound is considered safe to the mother and to the fetus, despite some concerns during the mid-1980s that the heat generated by sound waves might cause tissue damage to the fetus, which was seen in animal studies.
However, the intensity of sound-wave energy is so low and exposure so brief, health risks are considered minimal, experts say.
"There is no indication the technology causes any harm," Powell said. "And, if it can help a mother-to-be sleep better at night, that's a good thing.
Araj said it's possible to take a decent image in-utero of a fetus at about 18 to 20 weeks of pregnancy with the four-dimensional technology.
"But if you are concerned about having a really nice picture of the baby, 25 weeks or so is the best time to do 4-D," he said.
Eventually, besides fetal monitoring, the 4-D technology may include a number of other uses, such as giving physicians a sharper glimpse inside the heart as it beats.
That's where some think real-time motion will play its most significant clinical role some day.
"I think the technology will be most useful in visualizing heart defects in babies and in big people," Powell predicted.
He said studies, examining this use are under way.
Reluctant subjects
For now, parents like the Jeff-coats willingly seize the opportunity to catch the earliest snapshots of their twins technology can offer.
The couple has picked out names -- "Jack the fourth and Emily the first" -- even though a cesarean section is not scheduled until Nov. 4 or Nov. 5. A cesarean is necessary because one of the twins -- the girl -- is in a breech position, straddling her mother's belly.
From the sonogram, "we know the twins form a 'T' inside her," said Gillian Martin, the ultrasonographer who Stacy Jeffcoat describes "as the most-important person in my pregnancy."
That awkward sidelong position has made it tough to get good visuals on both twins, despite the sharp eye of the technology.
"While 'little Jack' is front row and center, "our little girl is face down, so we can't really see her," Stacy said.
That will have to wait until her birth.
As for the name choices, husband Jack laughed and indicated he wasn't entirely satisfied.
"I tried for Jack and Jill, but she wouldn't let me," he said.
Posted By Trevor Rieger
TVTalkShows.com Webmaster
Newest technology snaps 25 images a second for the clearest
look yet inside the womb
By Susan Jenks
FLORIDA TODAY
The fetal images appear dusted in gold as they flicker across a monitor, recording a kick here, a gesture there.
The "seeing eye" of ultrasound -- now able to capture real-time motion -- allows Suntree residents Stacy and Jack Jeffcoat to watch their developing twins jostle for position inside the womb, as well as see minute details, down to an eyelash or a wiggling thumb.
"I even saw 'little Jack' sticking his tongue out," 33-year-old Stacy said during a recent sonogram to monitor the twins' health at Viera Diagnostic Center. The center is one of several locations in Brevard County that offerRealTime 4D ultrasound. The difference
Traditional ultrasound images are two dimensional, forcing a doctor to create three-dimensional images in his or her mind. Visible movement appears erratic, and picture resolution is fuzzy.
4-D ultrasound reconstructs 25 images per second of the developing fetus in three planes, and displays them in real-time motion. Movements within the womb are clear, and photo resolution is defined.
As an expectant mother of twins, Stacy's high-risk pregnancy automatically would be followed closely with conventional ultrasound.
Whether adding a smoother motion to the visual mix brings any added diagnostic benefit is widely debated. Most insurers do not cover the estimated $150 charge for each session.
"It's definitely cool -- a gee-whiz technology," said Dr. Thomas Foster, chief of radiology at Wuesthoff Medical Center, Melbourne, referring to the latest software upgrades.
But, from a medical perspective, most physicians detect potentially life-threatening fetal abnormalities, such as heart malformations, using standard "bread-and-butter" ultrasound, with just two dimensions, he said.
"It's just a video instead of a still picture," Foster stressed.
While a four-dimensional ultrasound may pick up facial anomalies, such as a cleft palate, "it is not seeing anything on the inside."
Nor would the newer technology offer medical information to someone not adequately trained, he said.
Ultrasound works by bouncing sound waves off tissue to generate pictures deep inside the womb. A computer converts the reflected waves into two-dimensional images or, more recently, the still-experimental freeze-frame detail of three-dimensional ones.
The fourth dimension adds what physicians refer to as "real time," meaning instantaneous images of the fetus as it moves.
In 4-D, the three-dimensional image is photographed 25 times per second, instantly reconstructed and continuously updated, providing a "live-action" view.
For prospective parents, oblivious to the ongoing debate over the latest technology's medical value, there is an almost palpable thrill of having a clear window on their future offspring.
"The pictures they got were totally amazing," said 38-year-old Kristy Stuart of Indian Harbour Beach.
"One was crystal clear, where you could see everything," she said.
Two other pictures had less clarity, but showed her son, Joshua, who was born Aug. 15, sucking his thumb and gesturing "in a sweet way" with one arm up against his face, she said. The pictures were taken during her sixth month of pregnancy.
A curiosity
Stuart and her husband, Rusty, opted for the new high-tech technology, not out of medical necessity, but out of curiosity and a desire to watch a human life unfold.
"I think most people do it purely for the interest of it," she said.
Many of them watched television's Kelly Ripa display 4-D images of her baby on "Live with Regis and Kelly," and wanted to do it themselves, Stuart said.
Drs. Jeffrey Araj and Allen Powell, radiologists at the Spyglass Court diagnostic center, agreed the new technology's advantage is more personal than diagnostic at this point.
The two physicians and administrator Francis Olomu, former administrative director of radiology at the University of California, Los Angeles, are partners in the new center, which opened in Viera earlier this year.
"We give them CDs and videos to send to grandma up north, who loves these ultrasound pictures," said Powell, who recently moved to Brevard from Bowling Green, Ky.
"But, when we do a four-dimensional ultrasound, we do look to make sure everything is normal," he said.
As radiologists trained to look at cross-sectional images every day, "we can easily spot a cleft lip or a neural tube defect" associated with spinal bifida, in which the spine fails to close properly, he said.
"Do I need three-dimensional images to see these things? Probably not," Powell conceded.
But for parents-to-be, further proof their offspring will be OK "adds peace of mind."
The technology "certainly brings an emotional benefit," both Powell and Araj, the former chief of radiology at Cape Canaveral Hospital in Cocoa Beach, said.
The center's Olomu estimates the center has provided more than 60 four-dimensional fetal ultrasounds since it officially began offering them in April.
"We do about two a week," he said.
Low risk
Virtually all of the women self-referred, meaning they or their partners chose to do so for personal reasons, rather than on the advice of a physician.
As a technology, ultrasound is considered safe to the mother and to the fetus, despite some concerns during the mid-1980s that the heat generated by sound waves might cause tissue damage to the fetus, which was seen in animal studies.
However, the intensity of sound-wave energy is so low and exposure so brief, health risks are considered minimal, experts say.
"There is no indication the technology causes any harm," Powell said. "And, if it can help a mother-to-be sleep better at night, that's a good thing.
Araj said it's possible to take a decent image in-utero of a fetus at about 18 to 20 weeks of pregnancy with the four-dimensional technology.
"But if you are concerned about having a really nice picture of the baby, 25 weeks or so is the best time to do 4-D," he said.
Eventually, besides fetal monitoring, the 4-D technology may include a number of other uses, such as giving physicians a sharper glimpse inside the heart as it beats.
That's where some think real-time motion will play its most significant clinical role some day.
"I think the technology will be most useful in visualizing heart defects in babies and in big people," Powell predicted.
He said studies, examining this use are under way.
Reluctant subjects
For now, parents like the Jeff-coats willingly seize the opportunity to catch the earliest snapshots of their twins technology can offer.
The couple has picked out names -- "Jack the fourth and Emily the first" -- even though a cesarean section is not scheduled until Nov. 4 or Nov. 5. A cesarean is necessary because one of the twins -- the girl -- is in a breech position, straddling her mother's belly.
From the sonogram, "we know the twins form a 'T' inside her," said Gillian Martin, the ultrasonographer who Stacy Jeffcoat describes "as the most-important person in my pregnancy."
That awkward sidelong position has made it tough to get good visuals on both twins, despite the sharp eye of the technology.
"While 'little Jack' is front row and center, "our little girl is face down, so we can't really see her," Stacy said.
That will have to wait until her birth.
As for the name choices, husband Jack laughed and indicated he wasn't entirely satisfied.
"I tried for Jack and Jill, but she wouldn't let me," he said.
Posted By Trevor Rieger
TVTalkShows.com Webmaster