New Device Offers Expert Battlefield Diagnoses

A portable ultrasound system, bundled into an 85-pound backpack load, could enable technicians on remote battlefields to scan injuries and transmit images to doctors hundreds of miles away.

The portable system was tested recently in Bosnia, with doctors in Germany interpreting the data stored in computers by the technicians who moved a 12-inch-wide scanner over soldiers’ bodies.

All the technician needs to know is the general area of the injury or health problem. It’s up to the professionals to interpret the blurry shades of gray that the device transmits to their computer screens.

Scientists at Battelle’s Pacific Northwest National Laboratory, working with medical technology experts from the Army, adapted existing technology to create the device used by the doctors in Germany, said Battelle project manager Rik Littlefield.

The Battelle scientists combined a $1,500 device used for virtual reality games with a plastic version of the hand-held probes used to perform traditional ultrasounds.

Doctors interpreting the data can manipulate the plastic probe-like device to change the view of the ultrasound on the computer screen. They can move the probe just as they would if they were holding it against the patient’s body, Littlefield said.

“For the first couple minutes they’re distracted by the machine. They play with it and complain about how it’s different,” he said, gesturing as though he held one of the plastic probes.

“But there was not a single doctor or technician who within five minutes did not forget completely about the probe and concentrate on the data,” he added.

It was important to make the device easy to use because it takes at least two full years of specialized study to learn how to interpret ultrasound images, which are created by sending high-frequency sound waves through the body.

The device known as MUSTPAC (short for Medical Ultrasound, Three-Dimensional and Portable with Advanced Communications) also offers three-dimensional images. While that capacity is available in some hospitals, the standard ultrasound produces a two-dimensional image.

The three-dimensional feature helped save the life of a pregnant woman treated at Madigan Army Medical Center in Tacoma, Wash., said Sam Stevens, team leader of the lab’s medical technology group.

The woman received a standard fetal ultrasound, which confirmed doctors’ belief that the placenta had grown over part of the cervix. But it appeared that the blockage could simply be moved out of the way for a vaginal birth, Stevens said.

She then gave permission for a MUSTPAC scan. Its three-dimensional image gave doctors a broader view than the standard two-dimensional ultrasound and showed that her uterus had grown toward her bladder, he said.

“Had the woman gone ahead and had a traditional birth, there was a strong possibility she could have had a rupture to her bladder and she could have bled to death,” Stevens said.

“Instead, the woman delivered C-section, and today, both mother and child are fine,” he said.

The project is funded by a $5.2-million grant from the U.S. Department of Defense’s Defense Advanced Research Projects Agency. Already cleared by the Food and Drug Administration for clinical tests, it is expected to win approval for military use within a year.

Littlefield says MUSTPAC should win FDA approval for civilian use within four years.

One major advantage over conventional ultrasound is that MUSTPAC offers unprecedented opportunity for follow-up interpretation and reconsideration of results.

A hospital ultrasound is performed by a technician whose expertise determines “exactly where to put the probe and how to interpret what he’s looking at,” Littlefield said.

“You end up with 12 or so snapshots showing a little piece of the patient’s anatomy. If you bring in another expert, that’s all they have to look at to make a diagnosis unless they bring the patient back and do their own scan,” Littlefield said.

But with MUSTPAC’s computer storage of 3-D images, “We give him the ability to use that original ultrasound information, but to view it like he’s doing his own procedure.

“He’s not just limited to those snapshots the technician thought were key,” Littlefield said.