Soundeffects news | Strength in Collaboration Issue

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soundeffects news

MARCH 2024

To ensure everyone can join the excitement of the ASA2024 Sydney Conference, we offer multiple registration types to fit your needs, including both in person and remote options.

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Join us in celebrating sonographers on 27 October for Australasian Sonographers Day

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Welcome to the ASA2024 Sydney Conference Special Edition of Soundeffects news. We are thrilled to present the largest sonography conference in the world – the ASA’s 30th annual international summit in Sydney. This year’s conference theme, ‘Strength in Collaboration’, aims to foster a sense of unity and cooperation within the sonography profession and the wider healthcare community.

In this special issue of Soundeffects news, we invite you to explore the in-depth interviews with our esteemed keynote speakers, providing a sneak peek into their careers, aspirations, and thoughts on the future – all in line with the collaborative spirit of this year’s theme.

While nothing compares to the on-site experience – featuring over 170 lectures, 55+ workshops, 9 masterclasses, 6 ASA Arena panels and networking opportunities during the Welcome Drinks and Gala Awards Dinner – we’ve extended our reach with remote access on the first two days of the conference for those unable to attend in person.

New to this year’s summit are the exclusive, in-person, conference masterclasses. Masterclasses have been designed to elevate delegates’ workshop experience by guiding them through the practical aspects of various specialty areas with the addition of hands-on learning in a small group setting.

Building on the success of last year’s ASA Arena, we are excited to continue this interactive panel session in the Exhibition Hall throughout the program. ASA Arena serves as a platform for robust discussion on hot topics in sonography, fostering collaboration and shared knowledge. For those attending in person, we invite you to get your questions ready.

For cardiac sonographers, we present a dedicated 3-day cardiac program, with over 30 sessions across 3 days. With a room dedicated to cardiac lectures and workshops, we also encourage cardiac sonographers to explore the program, consider the professional topics stream and attend ASA Arena.

We extend our heartfelt gratitude to the dedicated volunteers, staff, and the Program Committee who have played a pivotal role in shaping this conference’s success. Their tireless efforts have truly brought the theme of collaboration to life.

We thank our partners for their support, with special recognition for our Gold Conference Partners: Canon Medical, GE Healthcare, Mindray Medical, Philips Healthcare and Siemens Healthineers, whose contributions make the outstanding workshops possible – with over 30 organisations contributing to the vibrant atmosphere of the conference.

The Gala Dinner will again host the Awards of Excellence, induction of our newest ASA Fellows, and the Pru Pratten Memorial Lifetime Achievement Award recognising outstanding sonographer achievement. Whether you attend in person or online for the awards part of the night, we encourage you to celebrate with your peers and applaud them for their achievements.

For all the information you need about the ASA2024 Sydney Conference, head to the conference website. Discover the detailed schedule, speaker profiles, and registration details. Whether you join us in person or remotely, the program ensures an enriching experience tailored to every sonographer’s needs.

Join us for an unforgettable experience, learning from and celebrating the best in our profession.

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Dr Merri Bremer (USA)


As the Echocardiography Lab Education and Quality Coordinator and ACS Program Director at the Mayo Clinic, Minnesota, Dr Merri Bremer brings over 30 years of echocardiography expertise to the ASA2024 Sydney Conference. A board-certified RN with a Doctorate in Educational Leadership, she’s also an assistant professor of medicine at Mayo Clinic College of Medicine.

Dr Bremer is an active member of ASE and SDMS and is a leader in maintaining industry standards through ultrasound program accreditation (JRC-DMS) and the CCI ACS Credentialing Exam Committee. With numerous national lectures and co-authored publications, Dr Bremer is dedicated to advancing knowledge in echocardiography, education, and quality improvement. We ask Dr Bremer to delve into her remarkable journey in cardiovascular sonography and answer our questions on AI and what she is most looking forward to when she visits for our conference in May.

Looking ahead, what emerging trends or developments in AI do you anticipate will have the most profound impact on the future of education and clinical echocardiography, and how can sonographers best prepare for these changes?

Looking ahead, several emerging trends and developments in AI are likely to have a profound impact on education and clinical echocardiography:

• AI-powered diagnostic and scanning assistance: AI algorithms are increasingly capable of analysing echocardiographic images to assist clinicians in diagnosis. These algorithms can help detect abnormalities, quantify parameters, and provide decision support, ultimately improving diagnostic accuracy and efficiency. In addition, AI algorithms can provide direction and immediate feedback to novice scanners to obtain required images and improve image quality. The use of these technologies in resource-limited environments may be critical for prioritising and guiding patient care.

• Personalised learning platforms: AI-driven personalised learning platforms can adapt educational content and strategies to individual student needs, learning styles, and progress. In the field of echocardiography education, such platforms could offer tailored curricula, interactive simulations, and adaptive assessments to optimise learning outcomes.

• Virtual and augmented reality (VR/AR) simulation: VR and AR technologies are revolutionising medical education by

providing immersive, hands-on training experiences. In echocardiography, VR/AR simulations can offer realistic scenarios for practising scanning techniques, interpreting images, and diagnosing cardiac conditions, enhancing both education and clinical skills training.

To prepare for these changes, sonographers can take the following steps:

• Stay informed and up to date: Keep abreast of the latest developments in AI, medical imaging, and echocardiography through conferences, workshops, journals, and online resources. Stay informed about emerging technologies and their potential applications in education and clinical practice.

• Acquire AI literacy and skills: Develop a basic understanding of AI concepts, algorithms and applications relevant to echocardiography.

• Collaborate across disciplines: Collaborate with colleagues, educators, researchers, and AI experts to explore innovative approaches to education and clinical practice. Engage in interdisciplinary projects and initiatives that leverage AI, technology and data science to improve patient care and educational outcomes.

Are there any emerging technologies or innovations in ergonomic design or workplace interventions that you believe hold promise for further reducing the incidence of WRMSDs in ultrasound?

Yes, some helpful technologies are currently being incorporated into clinical practice. Manufacturers continue to improve machine and transducer design to aid proper ergonomics. For example, transducer and cable weight continue to decrease, which reduces musculoskeletal strain. In addition, portable and handheld devices and wireless transducers may reduce awkward postures and the risk of injury. At Mayo Clinic, we piloted the use of an exoskeleton that provided arm support and improved posture. Most importantly, more and more facilities are recognising the critical need for robust ergonomic programs that teach and reinforce appropriate techniques for reducing the risk of WRMSD.

How do you balance the need for structured learning experiences with opportunities for independent exploration and problem-solving among learners in clinical settings?

Very carefully.

My most important priorities:

Clear learning objectives – These provide the framework. Learners must know expectations and the desired goals. Practice – It is important to provide guided practice opportunities, as learners typically cannot learn well in the absence of feedback. I think back to the first time I visited

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Australia. My husband and I went snorkelling, which I had never done before. Without the safety briefing and ongoing feedback from the crew, it would have taken much longer for me to become comfortable.

Active learning experiences – Particularly for sonographers, hands-on learning is critical. I encourage robust interaction between learners and preceptors, which may take the form of questions, observations, and case or problem-based learning. Promotion of critical thinking is key. I also encourage learners to explore different methods for achievement of the learning objectives if the provided methods don’t meet their needs.

Self-directed learning – For my ACS program courses, I provide the basic structure and resources, but my students are encouraged to explore beyond what is provided. Those who utilise this opportunity are generally the strongest students, and they are well prepared for lifelong continuous learning after graduation.

Self-reflection – Many learners have been taught to ‘memorise, regurgitate, repeat’. Periodically, I require students to pause and review what they have learned, what that means to them, and how they will change their practice going forward. This approach definitely helps with their self-awareness.

Autonomy – As learners become more skilled, there is a natural desire to operate more independently. The key is to guide an appropriate scope of independent practice while still providing supervision and support. This can be a tricky balance and is

likely to be different for different learning environments. A well-defined milestone-oriented approach may be helpful – when certain milestones are achieved, learners can move to the next defined step of independence. For example, our senior entrylevel echo students can move to 2:1 status (two students assigned with one clinical instructor) after having completed all their senior competencies.

Why do you think it’s important for sonographers and other health professionals to gather at conferences like ASA2024 Sydney?

This is an easy question. For any sonographer, this is an important professional development and career opportunity. Conference attendees have the opportunity to learn new technologies and concepts, network and share experiences with like-minded professionals, and of course, obtain that all-important CME credit. Some of my best friends are sonographers and physicians I see once a year at the ASE meeting in the United States (although we certainly keep in touch in between). In addition, many professional or volunteer opportunities have arisen for me because of attending or participating in conferences like ASA2024. Most importantly, I am re-energised by conference attendance. I gain valuable perspectives, make new friends, develop new personal and professional goals (despite getting closer to retirement) and am inspired by the people I meet. I can’t wait!

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Prof Adrian Lim (UK)

Imperial College London and Healthcare Trust BREAST & GENERAL

Professor Adrian Lim trained at Hammersmith and Charing Cross Hospitals, London, where he became a consultant radiologist in 2003. Simultaneously holding an honorary senior lecturer position at Imperial College London, Prof Lim progressed to reader in radiology in 2010, adjunct professor in 2013, and professor of practice in 2017.

Adrian is head of ultrasound at Charing Cross Hospital, London and his specialist areas include advancing technologies of ultrasound and the use of novel techniques in functionally assessing disease processes with particular respect to breast, oncological and musculoskeletal imaging.

He has published over 130 peer-reviewed articles and book chapters and is an editor of the Ultrasound International Open Journal and associate editor of Ultrasound Medicine and Biology, Clinical Radiology and Ultrasound journals. He is the current president of the British Medical Ultrasound Society and an executive board member of EFSUMB. We ask Dr Lim some questions about his presentations ahead of ASA2024 Sydney.

What are some of the pitfalls of breast ultrasound? What sonographic tools do we have to improve lesion detection?

The isoechoic lesions, particularly those that are difficult to distinguish from normal glandular breast tissue, as well as microcalcifications, remain a challenge for breast ultrasound. Good B-mode imaging and continually improving image resolution with the utility of higher frequency probes are the key. Many of the manufacturers are working on artificial intelligence solutions to help detect and characterise breast lesions.

How could MRI/US fusion reduce the need for MRI-guided biopsies?

You will have to come to my workshop at the ASA meeting in Sydney to find out!

Do you see AI as a beneficial tool in assisting lesion identification and characterisation?

Yes, very much so, but the technology is still some years away from being fully integrated into our routine clinical practice.

What would be the key takeaway from your workshop ‘Elastography and fat quantification’?

Functional information about the liver, which ultrasound can now offer, is equally as important as the structural anatomical detail, particularly in chronic liver disease.

You talk about the following ultrasound technologies MFI, CEUS, SWE, ATI and Fusion as the ‘one-stop shop’ in assessing the liver. What advantages do these emerging techniques have over the more conventional B-mode liver assessment? Do you see these as useful screening tools or more feasible targeted assessments of the liver?

They provide additional information as an adjunct to conventional B-mode ultrasound and have shown to be integral to characterising focal liver lesions, and to a degree, lesion detection. The functional information attainable from these techniques is proving valuable in the management of patients with chronic liver disease.

What advice do you have for sonographers who are looking to advance their careers or stay updated in a rapidly evolving field?

Be part of the evolving field! Get involved in research projects and look to undertake a PhD. In addition, being part of learned societies such as ASA, BMUS, EFSUMB and WFUMB offers many educational and networking opportunities.

Dr Steven Rogers (UK)

The College and Society for Clinical Vascular Science of Great Britain & Ireland


Dr Steven Rogers, the UK’s first NIHR clinical lecturer in vascular science at The University of Manchester, holds an honorary senior clinical vascular scientist status at Manchester University NHS FT. With a focus on advanced vascular ultrasound, his research explores 3D and contrast-enhanced ultrasound for prevention and surgical planning. As president-elect and founding member of the SVT Research Committee, he contributes to leadership positions in medical ultrasound societies. Dr Rogers, an award-winning researcher, also teaches and examines academic programs, supervises students, and provides expertise to organisations like NICE and the UK Biobank. We chat with Dr Rogers about AI, the benefits of interdisciplinary collaboration and the MAVRIC initiative.

Do you think AI techniques for carotid artery disease are better suited to measuring carotid artery stenosis or to better identify features of plaque vulnerability?

AI is everywhere. It’s certainly a hot topic and it’s not surprising that some, if not all, ultrasound scanners already have a degree of AI capability. When it comes to vascular disease, I don’t think

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the question should be whether AI is better suited to stenosis or identifying vulnerable plaque. The important question is, should we? We already know that the stenosis value itself isn’t predictive of who will have a future stroke. What atherosclerosis is made of and how much of it is far more interesting in terms of determining risk and probably represents the future of personalised medicine for carotid assessment. The power of AI in that decision-making process will be invaluable.

Can you explain what MAVRIC stands for and why the project was initiated?

Manchester Academic Vascular Research and Innovation Centre (MAVRIC) was an initiative set up and launched in 2023 and is a joint venture between the University of Manchester and Manchester University NHS FT (the UK’s largest hospital group). We have clinical and non-clinical staff including engineers, data scientists and operational support. We aimed to develop research opportunities for both staff and patients with the ambition of improving outcomes across the region. We are fortunate in Manchester that health and social care decisions are devolved from central government and we have a very successful Greater Manchester and East Cheshire network that spans primary and secondary care. In the secondary care setting, we have close to 30 consultant vascular surgeons and over 60 clinical vascular scientists serving a specialised population of close to four million. It has certainly been an interesting experience and I look forward to presenting the lessons we learned from creating MAVRIC in such a large centre.

How does interdisciplinary collaboration between sonographers and vascular surgeons enhance diagnostic accuracy, patient outcomes, and innovation in vascular medicine?

Collaboration not competition is key to team success. No surgeon can work without a sonographer and vice versa. Equally, nursing and allied health/therapy staff groups are just as important. In the 2021 Provision of Vascular Services (POVS) document, the UK vascular societies (surgeons and scientists) for the first time stipulated that there had to be a minimum number of scientists/sonographers in each unit as well as a whole host of other wellbeing-based recommendations such as mixed scan lists. This set a standard that aimed at improving capacity and workforce numbers and reducing RSI risk. That in itself improves diagnostic accuracy and patient outcomes. However, the close bond between surgeon and sonographer/ scientist is critical to ensuring the scan report addresses the specific need the surgeon wants to understand and produce the best surgical plan. When it comes to innovation, the benefit of a one-team approach is paramount. One individual might think of a research question but another might have the solution to answer it. Research takes a multidisciplinary team to succeed.

How has tomographic ultrasound revolutionised the way we visualise vascular structures? Is there one clinical application you feel highlights its advantages the best?

This comes back to the surgeon-sonographer/scientist trust that needs to exist. We build 3D mental images when we scan them and then write them down. As a result, most surgeons need a CT or MR angiogram to help visualise the 3D problem they are repairing. If we can present our mental 3D image from the ultrasound scanner itself, we immediately address that unique situation. Importantly, having 3D images means we can measure and monitor disease in completely different ways, which opens up the possibility of personalised care. As an example, combining 3D ultrasound and contrast agents to produce angiogram-like images might prevent the need for catheter angiography, which is often needed as CT and MRI angiograms of the foot are diagnostically poor. It also means those patients with allergies to radiological contrast can receive the same standard of care as those who don’t.

Dr Tom Watson (UK)

Great Ormond Street Hospital for Children


Meet Dr Tom Watson, a consultant paediatric radiologist at Great Ormond Street Hospital for Children in London, UK. Trained at the University of Birmingham, Dr Watson’s expertise in paediatric radiology flourished during fellowships at Great Ormond Street and The Hospital for Sick Children, Toronto. Appointed as consultant radiologist in 2014, he now leads in ultrasound and serves as the specialist radiologist for gastroenterology and oncology services. Dr Watson’s research focuses on ultrasound and MRI techniques in bowel imaging, paediatric inflammatory bowel disease, and applications of ultrasound in paediatric oncology. We ask him a few questions about his approach to paediatric radiology.

What are some of the unique challenges or considerations specific to performing contrastenhanced ultrasound in young children, and how do these differ from imaging adults?

Many of the issues in paediatric contrast ultrasound are the same as for general paediatric ultrasound. Deciding which lesions are suitable for CEUS also involves an assessment of the child: Can they lie still for a few minutes? Is IV access possible? Is the lesion big enough to keep in the field of view without a breath hold? After you have decided that a contrast ultrasound is needed, the next most important consideration is whether the child can stay still and hold their breath for a few minutes. If not, this can

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make it difficult to keep the lesion of interest in the image, which is critical when you are trying to assess the vascularity of a lesion and may mean that a different modality is required.

Intravenous contrast ultrasound requires IV access and this can be distressing for children. Getting IV access can be much more difficult in children. It is often better to arrange for this to be done in advance away from the ultrasound department by an experienced practitioner to give the child some time to relax. CEUS is much easier in a calm and relaxed child.

In the UK, the contrast agent we tend to use (Sonovue TM, Bracco Italy) must be prescribed as an ‘off-label’ medication, meaning that it does not have regulatory approval to be used in children. This is the case for many commonly used paediatric drugs, but it does mean you need to coordinate with your pharmacists and a parent needs to give consent for the contrast to be used intravenously.

How do you assess the learning curve and proficiency of surgical teams in incorporating IOUS into their practice, and what strategies do you employ to facilitate ongoing training and skill development?

A fundamental part of IOUS is trust between colleagues in different specialties. IOUS relies on a good working relationship between radiologists and surgeons. The surgeon must be confident in the ultrasound findings. At my hospital, we have a

dedicated pre-surgery meeting to plan the surgical approach and the specific imaging questions that need to be answered on the day. During surgery, it is imperative to have two people from radiology present: one to scan and one to operate the ultrasound machine and optimise images. This helps to make things as clear as possible for the operating team. Post-surgery, we have a debrief about what went well and what could be improved. We continuously audit the IOUS service and the outcomes in terms of positive or negative resection margins and postoperative complications.

How do you navigate communication with patients and parents when discussing imaging findings of soft tissue lumps in paediatric patients, particularly when addressing concerns about potential malignancy?

This is one of the most challenging aspects of paediatric radiology. I cannot claim to be an expert at this, but I have learnt a few important principles over the years:

• Some parents need a definitive answer at the time of the scan, some parents do not want to know anything. Judging which parent you have in the room takes time and experience and a few wrong turns …

• Being economical with the truth is the worst thing you can do. Either tell the parents what you know or ask them to contact their doctor for the results.

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• Be confident expressing uncertainty – ultrasound is not histopathology.

• If you tell a parent that you are not sure what the lump is, spell out what steps you are going to take next to help get to an answer. Don’t leave a parent/patient more uncertain than when you started the scan.

• Regardless of how many times you have seen a normal 5 mm cervical lymph node, remember that this is usually the first time a parent or child has encountered a lump on their body.

Can you share a specific experience or project in your career that has had a profound impact on your approach to sonography?

No single experience comes to mind. In general, paediatric radiology is an ultrasound-based specialty. There is almost no part of the body that you can’t see with ultrasound at some point in a child’s life. If you take your time and look hard enough there is very little pathology that you can’t diagnose with ultrasound that you could do with a different imaging modality. Ultrasound is one of the few opportunities in radiology where you can take a history, examine the patient, and diagnose the problem all at the same time. There is nothing as rewarding as being able to help a sick child and their worried parents and family; it is a privilege.

Erika Cavanagh, FASA (AUS)

Mater Centre for Maternal Fetal Medicine OBSTETRICS

Meet Erika Cavanagh, a senior sonographer and expert in obstetric ultrasound at the Mater Centre for Maternal Fetal Medicine in Brisbane, Queensland. With 20 years of experience and a focus on tertiary level obstetrics, Erika specialises in areas such as placental dysfunction, fetal echocardiography, and multiple pregnancy assessment. Currently pursuing a PhD on the correlation between placental imaging and function in fetal growth restriction, Erika’s dedication to advancing the field is clear. Her commitment extends to sonographer education, where she actively contributes by presenting on various topics at ASA conferences and serving as a sessional lecturer at the Queensland University of Technology. We asked Erika about the topics she will be presenting at this year’s ASA conference and how important collaboration is in our profession.

Do you think placenta accreta spectrum incidence is increasing or are we improving detection rates as our knowledge of the physiological changes

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improves and we become more aware of key US findings? Is there one diagnostic sign that is the most accurate in detecting PAS?

The incidence of PAS is certainly increasing with an increase in caesarean section rates; however, we are improving our detection of ultrasound signs of the condition. Ultrasound has been proven as a very sensitive diagnostic tool in suspected PAS, but we need to remember that PAS is a diagnosis that can only be made at delivery. Some placentas that look as though they may likely be adherent come away easily at delivery. With ultrasound, we can only see signs of PAS. The one ultrasound sign that I think is the key to PAS is a thickened, heterogeneous, low-lying placenta. It is a very characteristic appearance and should raise the sonographer’s suspicions about PAS instantly.

What are some of the common signs of congenital fetal infection, and what are the key takeaways from your lecture for sonographers?

A lot of different fetal infections have similar presentations on ultrasound. Probably the most obvious and serious sign is non-immune hydrops and/or a raised MCA peak systolic velocity, associated with fetal anaemia. Whenever a fetus has unexplained hydrops, congenital infections should be assumed until proven otherwise. Another ultrasound sign common to many congenital infections is a fetus that is small for gestational age. Within my department, we operate a fetal growth clinic where we work up pregnancies that are SGA or growth restricted. A significant proportion of these pregnancies are found to have congenital CMV, so it pays to think outside the box a little when you come across an SGA baby in your day-today practice.

Can you discuss the implications of an incorrect diagnosis of FGR/SGA?

SGA refers to a statistical deviation from the normal fetal growth – that is, EFW under the 10th percentile. By definition, 10% of fetuses will measure at or under the 10th percentile. SGA may be constitutional (meaning that the fetus is genetically preordained to measure in the smaller range) or it may be pathological, often caused by placental dysfunction. The trick is working out whether the fetus is meant to be small, or whether it is not reaching its growth potential because of uteroplacental circulatory issues. In addition, some fetuses that ARE pathologically growth restricted don’t actually measure under the 10th percentile.

It is very important to perform a good quality, accurate growth scan, looking at all the biometric and Doppler parameters so that we don’t overlook a fetus that is growth restricted.

Fetal growth restriction is one of the leading causes of fetal morbidity and mortality. These fetuses need to be closely monitored to optimise the timing of delivery because there is no treatment for fetal growth restriction, and the fetus is at a much higher risk of stillbirth.

What are the common misconceptions about fetal cardiac imaging?

The most common misconception about fetal cardiac imaging is that if the heart is normal at the morphology scan, then there is no need to look any further later in the pregnancy. Many cardiac anomalies are progressive, meaning that they may be subtle or even not present at the morphology scan, but they develop throughout the pregnancy. Some of these pathologies, such as coarctation of the aorta, aortic stenosis or pulmonary stenosis can be extremely serious for the newborn. Any advance notice of a severe cardiac anomaly before birth is beneficial for planning and counselling.

The other misconception is that the quality of cardiac assessment significantly decreases after 24 weeks’ gestation. The key to a good quality cardiac assessment in the third trimester is appropriate image optimisation, careful interrogation of imaging windows, and knowing what appearances are normal and abnormal. This last point is often the most difficult, and that is where practice and experience come in.

Can you share a positive experience where collaboration or networking played a crucial role in your professional journey?

In my time as a director on the ASA board, and my years as a volunteer for the ASA, I have been introduced to countless sonographers from all different parts of Australia and New Zealand, and all different professional backgrounds and levels of experience. This has provided invaluable networking possibilities. As a result, I have benefitted from the opportunity to work collaboratively with a diverse range of people in research, professional development, advocacy and guiding the profession. This has been invaluable in my occupational journey and has opened a lot of doors in my career.

Greg Curry (AUS)

Monash Health VASCULAR

Greg Curry is a senior sonographer at Monash Health in Melbourne where he has been the vascular ultrasound clinical lead for the network since 2013. Greg continues to be involved in education and training for vascular and general ultrasound across the Monash Health network, including the role of acting tutor sonographer in 2021. Greg has been a contributor at various state and national meetings and has a passion for vascular ultrasound, education and quality. Greg chats to us about the sonographer’s role in a team of medical professionals and his thoughts on networking and collaboration.

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What are some of the challenges in finding the best way to apply ICA stenosis criteria?

Identifying and accurately quantifying ICA stenosis is a really important part of our job as sonographers, but it can be hard. I think the main challenge in applying stenosis criteria is educating sonographers to understand that even the best criteria have intrinsic limitations. Criteria provide a solid framework but there is a significant proportion of studies where velocity criteria are at risk of misleading sonographers and clinicians. Understanding secondary criteria such as ratios and B-mode diameter measurements and how to apply them is critical.

I think we all naturally like things to fit neatly into categories, but we need to understand and leave room for nuance in our worksheets and reports. While some of the limitations of carotid criteria are intrinsic, other variables can be reduced by things like using quality techniques, collaborating with peers and describing limitations clearly so clinicians can make the best decisions for the patient. Local auditing can also be useful to help apply the right criteria within your group.

What impact is it having on the sonographer and patient when there is no clear unified consensus for ICA stenosis criteria?

Often sonographers are oriented to certain criteria based on where they are trained and go on to adopt that method ongoing. They might rarely if ever consider that there are other criteria. Being presented with different criteria can confuse sonographers, but more importantly, if clinicians are getting reports from different institutions using different criteria it may lead to misunderstanding about when and how to manage patients. In the end, we want to make sure that high-risk patients who need invasive treatments are recognised to reduce their risk of stroke. At the same time, we don’t want to treat people who won’t benefit. Finding the balance is key.

What is the sonographer’s role in a haemodialysis team?

In my opinion, we play a really important role within the team, even if we aren’t aware of it. Haemodialysis is a life-saving process and it takes a wide range of specialists and clinicians to help maintain treatment. Sonographers are often asked to help identify problems in the fistulas of the most vulnerable dialysis patients. We can guide and direct treatments that can keep dialysis access going for them. A thrombosed fistula is a disaster for a patient, which invariably leads to hospital admission and painful invasive procedures or sometimes worse. If sonographers know how to recognise the markers for identifying a fistula that is at risk of thrombosing and take on the responsibility of forwarding that information back to the rest of the team, then we can have a big impact on patients.

What are the key takeaways from your workshop ‘Thoracic outlet ultrasound techniques: Bias beware’?

In my experience, thoracic outlet assessment is an examination that can lead to confusion and doubt. Every time I think I’m close to having it down pat, I soon find that it isn’t that easy. I’m lucky to often discuss cases with various clinicians and it seems to be difficult for them too. The main takeaways will be to recap the goals of the examination and how clinicians might use the information we give them. I’ll also attempt to give an example of how to approach the examination that might help provide a consistent approach. I’m hoping that I might learn something from my peers at the conference in the process too.

What are some of the challenges in diagnosing thoracic outlet syndrome?

It is a tricky area. The anatomy and pathophysiology are complex and like many examinations sonographers are faced with there are many variables. We are being asked to bring together clinical information and symptoms and describe functional and dynamic changes that can be technically challenging to perform. Confirmation bias can creep into how we identify and describe compression in and around the thoracic outlet. On top of that, there are different types of thoracic outlet syndromes and different types of clinicians requesting examinations who often have varying goals in treating their patients.

Why is ultrasound an important tool in diagnosing GCA? And what measures can be adopted to improve the diagnosis of GCA?

The value of ultrasound in diagnosing GCA is the combination of high resolution imaging and correlation with symptoms. Clinically diagnosing GCA involves a complex algorithm of information, and imaging can be very helpful in providing a final diagnosis one way or another. Biopsy has been the gold standard, but it is invasive and has poor sensitivity, and recent evidence has reinforced the need for ultrasound. By using good techniques and extending our protocol beyond basic temporal artery assessment, the ultrasound can help improve diagnostic accuracy and timely treatment.

Our conference theme this year is ‘Strength in Collaboration’. Can you share a positive experience where collaboration or networking played a crucial role in your professional journey?

I am fortunate to have many examples of collaboration which have helped in my professional development as a sonographer over the years. One of the best things about collaboration with other groups is the sharing of knowledge and I’ve learnt so much from radiologists, nurses, surgeons, clinicians, and others who have been generous enough to include me in multidisciplinary team meetings and clinical

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discussions. As sonographers, we are linked to so many different clinical areas and have a lot of knowledge and experience to contribute. While there are many examples, one of the most fulfilling to me has been my involvement with the haemodialysis team at Monash Health. Our sonographer group is highly valued, and we have contributed directly to improving protocols and patient pathways that help patients maintain lifesaving dialysis.

Aaron Fleming (AUS)


Aaron Fleming graduated from radiography at Newcastle University in 2009 and completed a Postgraduate Diploma in Medical Ultrasound in 2013 at QUT. He currently works at Q-scan Red Hill in Brisbane where he is part of a team that provides imaging for a number of elite sporting teams and organisations, including the NRL, AFL and Super Rugby. He was recently involved with imaging for the FIFA Women’s World Cup, as well as other international touring teams. Aaron has presented at a number of ultrasound conferences and his ‘Medial Gastroc vs Plantaris’ lecture was the most viewed at the ASA2023 Brisbane Conference. We ask Aaron about his advice

for building confidence as a sonographer and some key takeaways from his upcoming talks at the ASA2024 Sydney Conference.

For sonographers who are new to performing hamstring ultrasound, what advice or recommendations do you have for building proficiency and confidence in this area of practice?

Understand the anatomy of hamstrings, specifically the muscle-tendon units and their ultrasound appearance. Then it’s about developing a methodical and systematic approach to these scans. This will increase proficiency and give you the confidence to scan even the smallest of tears.

What is your approach when confronted with unusual findings or in a situation where you just don’t know where to begin?

Don’t panic. I’ll usually lean on past experiences and cases. I’ll simplify the problem I’m confronted with and ensure the clinical question is answered. It’s important to acknowledge weaknesses and call on the strengths of colleagues when needed.

What do you hope sonographers will learn from your lecture on ‘Quadriceps assessment and injury grading’?

Quadriceps assessment and referrals asking to grade a muscle

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injury can be intimidating. This presentation will examine the anatomy of the quads and discuss and simplify injury grading systems. We will examine various rectus femoris tears and how best to describe these injuries and will derive an approach that applies to any acute muscle injury scan.

How do you approach differential diagnosis when evaluating sports injuries with ultrasound, particularly when multiple structures may be involved or when the clinical presentation is ambiguous?

Often musculoskeletal and sporting injuries will involve multiple structures and the mechanism of injury will not always be known. I’ll discuss with the patient the injury and their symptoms and then perform a comprehensive ultrasound to provide as much information as possible to the radiologist and referring clinician. This information can be integral to the team that oversees the care and treatment of the patient/athlete and can often dictate return to play times.

What tips can you provide those just beginning their journey into MSK ultrasound? How can collaboration between colleagues enhance knowledge development?

MSK ultrasound can be difficult, especially when starting. Stick with it and be patient and it can become very rewarding. Expand your learning avenues and reach out to colleagues for advice and resources. Collaboration is invaluable and crucial, particularly with MSK development.

Can you tell us about your experience working with the teams for the FIFA Women’s World Cup?

Our department was part of the team that provided imaging for the FIFA women’s World Cup teams in Brisbane. If imaging was required we were on hand to do so. We saw soft tissue injuries of the calf, hamstring and quadriceps which even if low grade are hugely significant in such tournaments. It was a great experience to be part of the radiology team that plays a crucial role in the diagnosis, prognosis and overall management of the athlete.

Dr Damon Jeetoo (AUS)


Dr Damon Jeetoo is a diagnostic and interventional musculoskeletal radiologist. After completing his radiology training, he undertook his first subspecialty fellowship in musculoskeletal radiology in Perth, where he was introduced to nerve imaging. This was then followed by a second subspecialty fellowship at Olympic Park in Melbourne, focused on interventions, sports and muscle injuries. Dr Jeetoo’s interests include imaging of sports injuries, imaging of

SPECIAL CONFERENCE ISSUE soundeffects news 16

nerves, and musculoskeletal interventions. We chat to Dr Jeetoo about his upcoming conference presentation topics and his thoughts on the conference theme ‘Strength in Collaboration’.

Do you think it would be beneficial to develop sonographic TEAR classification for specific muscles and/or muscle groups?

I am not familiar with the TEAR classification. I think clinicians are accustomed to current classifications e.g. the British Athletics Muscle Injury Classification. In my opinion, it is best to tailor the ultrasound findings in conjunction with what referrers use.

Do you recommend certain measurement techniques for forearm nerves and what dynamic interrogation do you find more effective?

Measurements are helpful but can be misleading. Measurements are helpful to compare to the contralateral normal side. We all know how measurements are related to scanning techniques and are therefore limited in that regard. I prefer a combination of clinical and imaging characteristics.

Do you believe ultrasound can stand alone to answer clinical questions regarding dorsal foot neuropathy or do most patients still rely on MRI?

I think that there is a place for both. The dorsal foot is a tricky area because of the multiple articulations. MRI is great for excluding underlying pathology. It can also show denervation oedema, which raises the suspicion of neuropathy. Why choose between U/S or MRI when you can use both?

Are there any measurement thresholds and specific patient positions that should be utilised in rotator interval assessment?

I use a specific position that A/Prof David Connell taught me. Having said that, the position that allows you to image the supraspinatus should allow you to follow the intra-articular long head of the biceps, and hence image the rotator interval. I do not use measurement thresholds.

Our conference theme this year is ‘Strength in Collaboration’. How important is a collaboration between a sonographer and a radiologist?

I cannot overemphasise how important this is. The real challenge is to make it happen during work hours when the workload is demanding on both parties. This topic is worthy of discussion on its own, which is beyond the scope of this answer.

Jane Keating (AUS)

Royal Melbourne Hospital GENERAL

Jane Keating is currently an ultrasound clinical educator at Royal Melbourne Hospital. As well as helping organise the conferences of ASUM and WFUMB, she has been involved with organising ASA conferences. She has presented at various national conferences as well as travelling workshops and education evenings. She has co-authored two book chapters on Portal hypertension and transplant renal Dopplers for inside ultrasound: Vascular Reference Guide. Jane was awarded the ASA Pru Pratten Memorial Lifetime Achievement Award in 2006. We asked Jane about emerging technologies in her field, how to bridge the gap between those technologies and traditional methods, as well as who she is most excited to see present at ASA2024.

Can you outline some of the key advantages in contrast-enhanced ultrasound of the liver over some other image modalities like MRI or CT?

Contrast-enhanced ultrasound (CEUS) is an amazing tool that we have been lucky enough to use at Royal Melbourne Hospital (RMH) since 2007. This has been an integral part of the daily service that the RMH ultrasound department provides.

There are many advantages of CEUS over other imaging modalities, and the textbook advantages are that it avoids radiation, it is not nephrotoxic and it can be performed at the bedside. One of the more important advantages is that there is less risk of an adverse reaction to the ultrasound contrast media than CT or MRI, and there are fewer contraindications. The patients tend to tolerate CEUS very well, and we have had very few reactions with our patients at RMH over the last 17 years.

CEUS is also unique in that we can see vascularisation and perfusion of lesions in real-time, and from the dynamic assessment of these enhancement patterns in all phases (arterial, portal venous, and late phase) we can characterise liver lesions or determine if a renal cyst is simple or complicated. CEUS has high spatial resolution and has been proven to be equal, if not better than CT, and is good at diagnosing small lesions.

These are all advantages that you can find on the internet. For me, the most amazing advantage is when you can give instantaneous peace of mind to anxious patients who have been told they have a lesion, and their minds have instantly conjured up that they have cancer. At RMH we often perform CEUS on incidentally found lesions and the radiologist can reassure them while they are there that it is benign without having to do any further tests. This is the most rewarding part of being able to be involved with CEUS.

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How do advancements in technology and operator experience influence the reliability and accessibility of liver elastography for assessing fibrosis and cirrhosis in patients with chronic liver disease?

Liver shearwave elastography has been around for the last 15 years and we have been utilising this technology at RMH since 2012.

The use of shearwave has grown rapidly, and with vast research and improved technology, it has become more readily accepted by referrers as an accurate method of fibrosis scoring for patients with chronic liver disease. With the increasing demand for the management of these patients, it is now a tool found in many radiology practices, whether they be in the public or private sectors.

Elastography accuracy can be very operator-dependent, and it isn’t an examination that you can attempt without training, and this is a crucial factor in improving interobserver reproducibility. Before sonographers begin using elastography, it is important to be educated and learn from colleagues who are experienced, or by engaging in webinars or workshops to understand the

technology and the protocols required. I encourage everyone to enrol in webinars and online learning videos by Marilyn Zelesco on this topic.

By increasing the availability of this non-invasive tool in clinical practice, and with the increasing confidence of referrers, elastography has led to a reduced number of liver biopsies that need to be performed.

How can sonography students effectively bridge the gap between traditional techniques and emerging technologies in the field?

I love teaching ultrasound trainees and imparting my knowledge of experience, although we need to keep in mind that we can also learn and be challenged through their learning journey. The university content today is so different compared to the ‘olden days’ (as my children call it) when one of our assignments was on how a lightbox worked! Post and undergraduate ultrasound curricula have advanced greatly over the years, and the content includes ever-evolving new technologies, such as elastography and CEUS, which are considerably more important things than the extinct lightbox.

Clinical educators are always on their toes, and one of the challenges is always making sure they are one step ahead of their students. Trainees remind us that ultrasound requires the mindset of lifelong learning, and remaining open to exploring new ideas and experimenting with new techniques and technologies. Educating trainees encourages us to push the boundaries in the workplace, and adapt to the latest advancements in technologies as they emerge, which enables us to deliver high quality patient care.

I must also point out that ultrasound trainees are also very important when you need computer-related problems fixed!

As a seasoned and well-respected sonographer, who are you most excited to see present at ASA2024?

This is a difficult question, as there are so many amazing speakers in the excellent program. I am very keen to attend the general sessions, as we are always up for learning something new in the staple examinations that we perform. I am excited that we have Adrian Lim as one of our international guest speakers. He is one not to be missed.

I also have a few favourites who are the oldies but the goodies: Louise Worley, Greg Curry, Gillian Profaca, Frauke Lever and Andrew Grant. For entertainment and education, you can’t go past Peter Russel, Paula King, Stephen Bird, and the legendary Coombsy (Peter Coombs).

Presenting is very rewarding, as well as self-educating, and while I love the oldies but the goodies, I would love to see young sonographers venturing into the world of education at future conferences. Go on, do it! •

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A/Prof Suresh de Silva

Co-founder and Chairperson of Radiology Across Borders

Associate Professor Suresh de Silva is a radiologist and fellow of the Royal Australian and New Zealand College of Radiologists with subspecialty interests in oncological, urogenital, gastrointestinal radiology and body and pelvic MRI. He has an associate professor appointment at UNSW and is committed to clinical and radiological research having completed in 2016 a postgraduate degree in clinical trials research at the University of Sydney. He has published in peer-reviewed journals in urological/oncological work and has a special interest in radiological and clinical trial research. He is on the review board for several local and international journals and the RCC subcommittee for the peak research group ANZUP. Suresh is passionate about philanthropy having founded and presently chairing Radiology Across Borders (RAB). He strongly believes that good education and infrastructure should be made available to all and is committed to seeing this vision come to fruition. The ASA is a proud major

partner of RAB, and we are delighted to have A/Prof de Silva as our opening plenary speaker at this year’s conference. We sat down with Suresh to find out how he started RAB, how sonographers support RAB’s mission and some of the key takeaways from his opening plenary speech.

How did the idea for Radiology Across Borders come about, and how did you go about setting it up?

I guess the idea is something that took many years. So, when I finished medical school in the 1990s I was as an intern and then resident.

At the back of my mind at that stage was how can I give back? I have always thought about how can I give back to emerging nations or developing nations through my profession, but you don’t really take it seriously until you become a specialist because you’ve got to get the runs on the board, get your specialisation, etc.

But I have always wanted to do that, and I have always thought to myself that everyone else does too. But I have subsequently realised that that was not the case.

I was born in Sri Lanka and lived in England before I came to Australia and so I have got to see the two sides of the world in terms of those who have and those who haven’t. I think that was partly because we used to go back to Sri Lanka a lot and that



probably inspired me to do something like this. But I’ve also got to say that the desire to do this really came from my parents.

I think I’ve got to thank my parents because we were never a well-off family, and they did it tough, but I think that is what inspired me to do something to help others.

So those are probably the two reasons: experiencing first-hand the disparity and then when you finish your medical degree, there’s a certain part of you that says you’ve got to give back. So, I think a combination of both those things was how it came about.

At the start of 2010, I approached Don Swinburne who was then the CEO of the College of Radiologists and I got some contacts. I got a contact in Fiji and a contact in the Solomon Islands, and then set it up from there with an inaugural site visit to Fiji in 2010. So, it came through collaboration with the college or rather Don Swinburne and then from there it took off when I brought other people on board, and we had Siemens come on as a major partner in 2016.

So, it has been a gradual process, and it took about five years until we started to achieve recognition.

Do you think that’s something that you could have done straight out of medical school, or do you think that anyone with a great idea can bring about change if they’ve got the drive?

If we take the first part concerning specifically radiology, the answer is no. I don’t think I could have done it when I left medical school. I definitely couldn’t have done it in the nineties, because a lot of what we do now is connectivity through online teaching, and that didn’t exist then.

And, secondly, because I didn’t have any radiological experience, you have to get that before you can venture into the area. So the answer is no. I couldn’t have done it in the 1990s.

If I was a consultant, yes, very much so, but not coming straight out of med school. Having said that, we do have quite a few junior doctors who are part of what we do, but they need support. In terms of an idea, can I say that I think any idea can be made successful, philanthropy or corporate if you have the following three things:

One – You’ve got to have a good idea and something that’s very different. You can’t be reinventing the wheel.

Two – I think you have to work hard at it. It’s not enough to have a good idea. You’ve got to put the effort in to make it successful.

Three – You’ve got to bring people along with you. And the way I think you bring people along with you is to show the value of it and you need to articulate it. If you don’t articulate it and tell them why it’s so important and make them believe in it, it doesn’t work. But if you have those three things you can make anything succeed.

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How do you see the role of sonographers in supporting RAB’s mission and outreach projects?

Can I say that I think sonography and sonographers are becoming almost the most important part of what we do?

Firstly, most of the emerging nations have two things. They have X-rays and they have sonography. Not all, but most countries now have CT, but maybe one CT for the whole country. If you go to the regional and the remote areas there, it’s an ultrasound machine or an X-ray machine.

So sonography is at the coalface as is imaging with X-ray. Secondly, it’s portable. Wherever we go, we can teach if we go into a remote community if we have an ultrasound machine.

Siemens has just recently donated us an Accuson P 500 –the Siemens mobile machine, which is very kind of them. The beauty of sonography is that it’s so critical everywhere and secondly it’s portable.

And the other reason why sonography is becoming more and more significant for RAB is because we collaborate with ASA, because we’ve got the wealth of your resources combined with the wealth of our resources. And the combination is redefining education in emerging nations and sonography.

Sonographers and ultrasound play an important role in our outreach programs. We recently formed the RAB Ultrasound Committee to reflect on the importance of sonography in what we do and its increasing role.

Can you share a specific experience or project that has had a profound impact on your career?

Probably two. One is to do with the actual charity. When I did the first visit to Fiji in 2010, I went with another radiologist and while we were there his daughter, who was only six weeks of age, got quite sick.

We took her to Suva Hospital. She ended up having a lumbar puncture and treatment. The management by the doctors there was really good, but the hospital had one functioning toilet and cockroaches everywhere, and it made us realise first-hand just how important this initiative was. Here we are [in Australia] complaining about excessive wait times in casualty, which in some circumstances can be difficult, but when you compare it to the resources they have in these emerging nations, we are very lucky. This cemented in my mind the importance of what we are doing and the importance of continuing to do this and bringing in as many resources as we can to make it more manageable for these developing nations or emerging nations. I didn’t think it would get to the stage where we are now. It will continue to grow.

If we can bring in finance as well to help these countries, we’ll make a huge difference.

Secondly, the most significant experience in terms of my career, and this is going to sound very corny, was the birth of my first child. I have two children. The arrival of my first child shifted my perspective on a lot of things. I was trying to be a jack of all trades in radiology. I was doing both intervention and high-end intervention and diagnostics. And I cut back to just diagnostics and that enabled me to do a little bit more family wise and also enabled me to concentrate more on RAB.

I think both of those were significant in terms of the influence on RAB in my career.

The theme of our conference this year is ‘Strength in Collaboration’. What does that phrase mean to you?

To me, strength in collaboration means individuals or organisations such as RAB and ASA coming together to work on a common goal or goals. Working together strengthens us so that we can leverage off each other. We might have weaknesses, but together we’re much more likely to achieve a common goal or goals.

And that comes through working together intellectually to respect and cooperate. So I think that’s what it means: working together to achieve a common goal.

As opening plenary speaker, what key takeaways or knowledge do you hope attendees will gain from your presentation?

That’s pretty easy. The first one is strength in collaboration. I plan to show images when I get around to talking about how ASA is collaborating with RAB to achieve what we do along with our other major partners Siemens, I-MED, Lumus Imaging and Sonic Healthcare Foundation, project partners and professional collaborations.

I’ll be showing how we’re working together and how together we can achieve many goals.

But I do want to illustrate the needs that are out there. For example, in 2018 the World Bank estimated that 9 per cent of the population was living on less than $1.90 a day, which is extreme poverty, and how if people, when they can, can commit a small fraction of time or make a small financial donation can make a real difference in addressing this.

Hopefully, through RAB we’ll be able to show how clever technologies online can be utilised by people to make a small contribution to playing their part in changing the way emerging nations and other countries of need can benefit. So hopefully the combination of the strength in collaboration and the importance of philanthropy will be my two messages. •

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ASA2024 Sydney Conference Program Committee

We would like to introduce the Program Committee for the ASA2024 Sydney Conference and thank them for their time, effort and dedication to develop and deliver an outstanding conference program for you in 2024.

ASA2024 Sydney Program Committee Members


Paula Brown

Inhwa Kang


Pepse Ryan

Linda Thebridge


Matthew Adams

Donna Oomens, FASA


Siobhan Tranter

Kobe Petterson

Professional Topics: Dr Paul Stoodley

Catherine Robinson, FASA


Kobe Petterson

Anita Tatham

Women’s Health:

Wendy Collier

Jane McCrory

ASA2023 Representative:

Saba Harrington

EAC Representative:

Matthew Adams

SPECIAL CONFERENCE ISSUE soundeffects news 22

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10.00–10.10 AM Welcome to Country

10.10–10.15 AM Convenor’s Welcome

10.15–10.25 AM ASA President’s Welcome

10.25–11.30 AM Opening Plenary

11.30–12.30PM LUNCH


Darling Harbour Theatre

Vascular | Better Together

12.30–12.40 PM Advances in 3D ultrasound AI to assess carotid disease

12.40–12.50 PM

Dr Steven Rogers

12.50–1.00 PM Haemodialysis access: It’s a team effort

Mr Greg Curry

1.00–1.10 PM

1.10–1.20 PM Comparison between 2DUS and t3Dus for the assessment of the lower limb artery

Dr Adel Alzahrani

1.20–1.30 PM Mesenchymal chondrosarcoma originates from the femoral vein

Dr Hao Nguyen Thi

1.30–1.40 PM Role of ultrasound in vascular surgery

Dr David Robinson

1.40–1.50 PM

1.50–2.00 PM

2.00–2.10 PM

Understanding CT for vascular sonographers

Mrs Jamie Feeney

2.10–2.20 PM Cystic adventitial disease case study

Mr Heath Edwards

Gynaecology | Ovarian Odyssey

Perimenopause and beyond – What should we be on the look out for?

Mrs Vanessa Pincham

Benign ovarian findings

Dr Valeria Lanzarone

‘To be or not to be’: the pelvic cyst enigma

Ms Gillian Profaca

Tarlov cyst – An incidental finding of a meningeal cyst in a ‘routine’ pelvic examination

Ms Teresa Clapham

Ovarian cancer: Screening and approach to adnexal pathology

Dr Kate Stone

A pictorial essay of ovarian masses

Dr Karen Mizia

Information is correct at the time of publication; however, is subject to change without notice. Please visit our conference website [link: https://sonographers.] for the latest details and to download and print a copy of the program.

Musculoskeletal | Let’s start at the very beginning

How muscles fail: the enthesis organ unit, tendon and musculo-tendinous junction

Mr Stephen Bird

Why and when the physio needs ultrasound

Mr Peter Esselbach

Proximal intersection syndrome

Mr Brian Richards

Insights into shoulder impingement: Understanding the causes and ultrasound findings

Ms Lisa Smith

Scanning inguinal hernias: Not so hard at all

Mrs Erin Geeves

Shoulder fundamentals

Mrs Siobhan Tranter

Professional Topics | Research Matters

Sonographer-led research Assoc Prof Ann Quinton

Fostering collaboration in sonography teams

Mrs Alison White

Preliminary results and challenges of a randomised clinical trial of ergonomic education in a sonographer cohort

Ms Kristie Sweeney

Students’ perceptions on transfer of learning from online sonography courses to traineeships

Ms Sandhya Maranna

Collaborative research: a student’s perspective

Mr Eunjae Lee

Networking research across Europe’s largest vascular surgery centre: lessons from MAVRIC

Dr Steven Rogers

What is being done to improve wellbeing in the workplace? Job demands and resources experienced by public and private Australian sonographers

Ms Catherine Hall

Cardiac Echo in special

Left ventricular ECMO

Ms Kate Sturwohld

Cardiac transplants

Mrs Cynthia

Complications miles away Mr Lucas Neilsen

TTE assessment Mr Michael

Live scanning transplant

Mrs Cynthia

2.20–2.30 PM Q&A Session Q&A Session Q&A Session Q&A Session Q&A Session


Obstetrics | First Trimester

3.00–3.10 PM The changing landscape that is first trimester screening and where ultrasound fits Dr Jennifer Alphonse


3.20–3.30 PM Missed miscarriages and complications

Dr Karen Mizia

3.30–3.40 PM

3.40–3.50 PM Audit of first trimester biometry following ISUOG (2023) first trimester guidelines update Dr Narelle Kennedy

3.50–4.00 PM

4.00–4.10 PM

4.10–4.20 PM

4.20–4.30 PM

4.30–4.40 PM

4.40–4.50 PM

Open spina bifida and sonographic cranial markers in the late first trimester scan

Mrs Keely Cardew

Obstetric ultrasound – Are we scanning the mother or the baby? Is it only a medical examination or is it an experience?

Ms Teresa Clapham

Efficacy of midwife obstetric ultrasound training with handheld ultrasound devices in rural Cambodia

Ms Celia Lim

How useful is NIPT beyond screening for trisomies 13, 18 and 21

Assoc Prof Fergus Scott

Breast | Cancer and Correlations General | Hepatic Happenings

Beyond the scan: The untold magic of patient histories in revolutionising breast imaging

Mrs Naz Clifford

Advancing U/S technologies –are they useful for breast assessment?

Prof Adrian Lim

AI in breast imaging

Ms Louise Worley

Post MRI second look ultrasound

Ms Nazrate Negasi

‘Same, same but different’ – Our experience in Vietnam

Ms Julie Cahill

Assessment of the liver with two-dimensional shear wave elastography following COVID-19 infection: A pilot study

Ms Joyce Yea See Lau

Liver transplants

Mrs Christina Farr

Elastography and fat quantification for staging of liver fibrosis

Mrs Jane Keating

State-of-the-art: Multiparametric ultrasound for liver assessment

Prof Adrian Lim

Ultrasound-guided approaches to breast surgery and patient care

Dr Belinda Chan

Contrast enhanced ultrasound (CEUS) for focal liver lesions

Mrs Jane Keating

The clinical utility of the FAST scan for general practice

Mrs Myra Theisz

Paediatrics | The Basics Cardiac Cardiac

Unravelling intussusception

Ms Sharon Williams

Tips and tricks Mr Tony Forshaw

Paediatric breast ultrasound

Ms Natasha Roussel

Neonatal kidney development in preterm babies using micro colour Doppler

Dr Eveline Staub

Paediatric oncology: Common tumours and ultrasound appearance

Dr Tom Watson

Soft tissue lumps and bumps. When to be worried

Dr Tom Watson

Tips and tricks

Ms Kate Sturwohld

Pulmonary of being right

Ms Kim Prince

Live scanning

Prof Liza Thomas

4.50–5.00 PM Q&A Session Q&A Session Q&A Session Q&A Session Q&A Session

5.00–7.00 PM DAY ONE CLOSE | Welcome Function in the Exhibition Hall

SPECIAL CONFERENCE ISSUE soundeffects news 28
C4.5 C4.11 C4.6 C3.2
The left atrium Prof Liza Thomas

General Cardiac Obstetrics





Professional Topics

WORKSHOPS Room C4.4 Room C4.9 Room C4.10 Room C4.8 Room C4.3

| special populations Philips Siemens Canon GE


Sonography of hip dysplasia


ASA Arena


Mindray ASA ARENA ventricular assist devices and Sturwohld

Mr Cain Brockley

MUSCULOSKELETAL Adhesive capsulitis of the shoulder

Mrs Sumi Shrestha Taylor


Unveiling of arterial abdominal ultrasound: Beyond the gas

Miss Lara Anders


Pre-eclampsia & uterine arteries

Ms Kate Wilson

GENERAL Men’s health Mr Peter Coombs

Fostering sonographer longevity: Nurturing a happier more sustainable workforce transplants Cynthia Hayward

Complications from heart failure Neilsen BREAK

assessment in pregnancy Michael Stephens


“Woah! We can see that?”

Mr Bryce Allen

scanning – Scanning the cardiac patient Cynthia Hayward

Session | Chambers Philips

tricks of the left ventricle Forshaw

atrium Thomas


Early fetal anatomy

Mrs Joanne Logan


Third trimester Dopplers – Tips and troubleshooting for the general sonographer


Appendix Ms Margaret Yuen & Ms Angela Tegg

Mrs Erika Cavanagh


Camouflaging breast lesions

Ms Louise Worley

GENERAL Elastography and fat quantification

Prof Adrian Lim

Siemens Canon GE Mindray ASA ARENA


Mr Andrew Grant


Beginner’s guide to endometriosis in a routine pelvic ultrasound


Ms Paula van der Gugten

Mrs Petrina Rousel


Multi-parametric liver assessment

Prof Ernst-Michael Jung

Developing tomorrow’s workforce today

tricks of the right ventricle Sturwohld



Abdominal wall nerves

Mrs Marguerite Leber

hypertension: the pressures right Prince

scanning | Left atrial optimisation Thomas Session

GYNAECOLOGY Advanced endometriosis assessment (DIE)

Dr Kate Stone


Hand/wrist/forearm nerves

Mr Stephen Bird


Navigating tough communication

Ms Julie Cahill & Mrs Naz Clifford


Neuroanatomy in the first trimester

Ms Lisa Clarke

SPECIAL CONFERENCE ISSUE 29 soundeffects news




General | Lumps, Bumps, Bits and Bobs

9.00–9.10 AM Just put a probe on it

Prof Adrian Lim

9.10–9.20 AM

9.20–9.30 AM Ultrasound of rheumatological diseases: What do general sonographers need to know?

Ms Robyn Boman

9.30–9.40 AM Mucocele appendix – What’s the onion skin sign?

Mr Ian Schroen

9.40–9.50 AM Bowel ultrasound – Collitis

Ms Grace Eccles

9.50–10.00 AM

10.00–10.10 AM AI in thyroid ultrasound

Ms Louise Worley

10.10–10.20 AM


Gynaecology | Understanding the Uterus

Consent in O&G sonography

Ms Catherine Robinson & Ms Wendy Collier

The myometrium: Beyond fibroids

Dr Kate Stone

Dysfunctional uterine bleeding

Ms Sue Drinic

Am I seeing double?’ – Mullerian duct anomalies

Mrs Rowena Gibson


Obstetrics | Multifetal Pregnancy

Abnormal placentation and placenta accreta spectrum

Mrs Erika Cavanagh

Complications in monochorionic twin pregnancy Assoc Prof Andrew McLennan


Information is correct at the time of publication; however, is subject to change without notice. Please visit our conference website [link: QuickEventWebsitePortal/asa2024/asaevi2024/Agenda] for the latest details and to download and print a copy of the program.


Musculoskeletal | Peripheral Nerves – Can U/S outshine MRI? Cardiac | The Profession of Cardiac Sonography

Upper limb nerves – Ultrasound vs MRI

Mrs Sophie O’Brien

Musculoskeletal ultrasonography: Can we influence pain outcomes?

Mr Philip Millner

Having the upper hand on nerves: A pictorial approach to scanning nerves of the upper limb

Ms Susan Diep

Doppler and innovative vascular assessment in multifetal pregnancy

Dr Laura Gerhardy

Placental cord insertion migration: Implications for ultrasound documentation and follow-up of abnormal placental cord insertion site

Ms Samantha Ward

A rare case of type 3 vasa previa

Mr Shane Bowden

Femoral nerve and its branches Dr Michelle Fenech

Forearm nerve entrapment

Dr Damon Jeetoo

Supervising the trainee sonographer Mr Tony Forshaw

Quality improvement in the echo lab Dr Merri Bremer

Reproducibility and callibration in the echo lab

Dr Faraz Pathan

10.20–10.30 AM Q&A Session Q&A Session Q&A Session Q&A Session Q&A Session

10.30–11.15 AM MORNING TEA

Musculoskeletal | Sports Injuries – The elite athlete and the weekend warrior

11.15–11.25 AM

Top 10 sports injuries

Mr Aaron Fleming

11.25–11.35 AM

11.35–11.45 AM Would you like some cortisone with that?

Mr Rob McGregor

11.45 –11.55 AM

11.55–12.05 PM

12.05–12.15 PM

12.15–12.25 PM

12.25–12.35 PM

12.35–12.45 PM


12.55–2.00 PM

Describing muscle tears

Dr Damon Jeetoo

Achilles rupture Dr Michelle Fenech

Achilles/calf injuries Miss Jacqui Roots

Vascular | Advanced Practice Paediatrics | The Challenges Professional Topics | Breaking Barriers Cardiac | 3D and Contrast

The role of the interventional vascular scientist

Mr Gurdeep Jandu

Endovascular arteriovenous fistula

creation: A new treatment

Dr Richard Allan

Paediatrics and paddocks: Challenges of paediatric ultrasound in outback Australia

Ms Angela Currey

Paediatric tumours

Mr Gregory O’Conner

Dysmorphology screen – Is cranial ultrasound useful?

Ms Ilona Lavender

Tomographic ultrasound

Dr Steven Rogers

Paediatric vascular

Mr Nathan Campbell

A review of literature between the correlation between CT and US in the assessment of carotid body tumours

Mr Michael Yao

Hip dysplasia and ultrasound: Where to from here?

Mr Cain Brockley

Case Review: Persistance required Ms Kobe Pettersen

The KKIND Project: Keeping Kids In No


Mrs Narelle Morin

An update on regulation: Overcoming the current impasse

Dr Tony Coles

Diverse minds, effective communication: Improving the journey for the neurodivergent

Mrs Myra Theisz

Breaking barriers: Addressing the underrepresentation of women in leadership roles in Australian radiology

Mrs Aarti Bajaj

Inclusive communication – Breaking barriers and improving health outcomes for people with intellectual disability

Mrs Natalie Graham and Ms Olivia Sidhu

Just in a different way Miss Aimee Fisher

Who do we really work for?

Mr Rob McGregor

Cardiac structure and function of Australian jockeys differs to the general population: An observational crosssectional study

Mrs Angela Farley

3D of the mitral valve

Dr Rebecca Perry

3D echo for left ventricular assessment

Prof Timothy Tan

Contrast for left ventricular opacification

Mr Tony Forshaw

Live scanning | Acquiring 3D images of the mitral valve

Dr Bec Perry

SPECIAL CONFERENCE ISSUE soundeffects news 30
Q&A Session Q&A Session Q&A Session Q&A Session Q&A Session

General Cardiac


Room C4.4

Room C4.9



Room C4.10

Philips Siemens Canon


Research from concept to completion Dr Steven Rogers


Neonatal spine

Mrs Lorna Hardiman & Mrs Mary Lin


Breast elastography Mr Andrew Grant

Gynaecology MSK

Room C4.8

Room C4.3


Professional Topics




Renal Doppler

Mr Daniel Rae



Contrast-enhanced ultrasound of the liver: A practical guide

Mrs Jane Keating


Sonographer ergonomics: Scanning considerations

Dr Merri Bremer


The use of new and emerging technology in breast ultrasound

Prof Adrian Lim

Philips Siemens Canon


The how, why and what of scanning peripheral leg arteries

Mrs Donna Oomens



Advanced second trimester fetal heart

Assoc Prof Ann Quinton


Third trimester cardiac imaging

Mrs Erika Cavanagh


Neuropathies of the ankle and foot

Mr Phillip Jones


Ms Natasha Roussel


Mr Rob McGregor

Vascular ASA Arena

Navigating the evolution of ultrasound in medicine


First trimester cardiac screening

Mrs Vanessa Pincham



Implementing IOTA into practice

Dr Jennifer Alphonse

PROFESSIONAL TOPICS Probe movement language

Ms Suean Pascoe

Leaving a legacy: Making an impact in your profession

MUSCULOSKELETAL Hip ultrasound – Beyond trochanteric bursitis

Mrs Sophie O’Brien

GENERAL Neck pathologies, lymph nodes, neck levels and salivary glands

Mr Craig Winnett

GE Paediatric ultrasound - the perfect storm!

Ms Sara Kernick


‘Don’t be half-hearted’ – A lesson in fundamental fetal heart views

Ms Rowena Gibson

SPECIAL CONFERENCE ISSUE 31 soundeffects news




Obstetrics | Fetal Heart

2.00–2.10 PM

2.10–2.20 PM

Cardiac soft markers, congenital variants and subtle findings – What is significant?

Dr Kate Russo

2.20–2.30 PM Transposition of the great arteries: Not so simple after all Ms Alison Lee-Tannock

2.30–2.40 PM

2.40–2.50 PM

2.50–3.00 PM

3.00–3.10 PM

3.10–3.20 PM

Congenital heart abnormalities

Assoc Prof Ann Quinton

Fetal heart safari: A journey through the three vessel tracheal view

Dr Ritu Mogra

Ultrasound classification and prognosis of congenital pulmonary airway malformation

Ms Joanna Pillai


Professional Topics | Education Matters

Changing landscapes: A review of point-of-care ultrasound educational development in Australasia

Ms Carolynne Cormack

Aiming for success: Goal setting and reflecting for the educator

Ms Suean Pascoe

Sonographer competencies

Dr Jessie Childs

Tips and tricks for sonographer orientation and training

Dr Merri Bremer

The benefits of reflection for constructing and delivering feedback

Mrs Alison White & Mrs Donna Oomens


Breast | Painful Problems

Black box thinking in breast imaging – How aviation can help medicine

Mr Michael Foster-Greenwood

Ultrasound of the breast in the emergency department

Ms Paula King

Breast implants

Mrs Sophie O’Brien

Inflammatory breast conditions

Mrs Frauke Lever


Information is correct at the time of publication; however, is subject to change without notice. Please visit our conference website [link: QuickEventWebsitePortal/asa2024/asaevi2024/Agenda] for the latest details and to download and print a copy of the program.

General | Renal Reflections

Advanced renal ultrasound ‘more than a measurement’

Mrs Jane Keating


A case of unusual orchitis

Mr Peter Russell

Renal transplants – What the doctors want to know

Dr Aisim Khan

Tricks, tips and complications in renal biopsies

Mr David Su


Cardiac | The Aortic Valve

Assessment of the prosthetic valve

Dr Merri Bremer

Acute aortic syndrome in an 82-year-old woman – Utility of multimodality approach in a less typical clinical presentation

Mr Michael Bartlett

Aortic stenosis

Ms Kate Sturwohld

Assessment of transcatheter aortic valves on echocardiography

Ms Bianca Coelho

Live scanning | Scanning for aortic stenosis

Ms Monica Gerges

3.20–3.30 PM Q&A Session Q&A Session Q&A Session Q&A Session Q&A Session


General | Back to Basics Professional Topics | Topics that Matter

4.00–4.10 PM Windows of the abdomen Mr Jaryd Reid

4.10–4.20 PM

4.20–4.30 PM

4.30–4.40 PM

4.40–4.50 PM

Putting the puzzle pieces together –Renal and transplant scanning

Ms Linda Thebridge

Liver segments

Ms Paula King

4.50–5.00 PM

5.00–5.10 PM TIRADS Mr Stephen Bird

5.10–5.20 PM

Sonographers role in enhancing POC training

Dr Paul Stoodley

Returning from mat leave … the elephant in the room and how managers and colleagues can support the transition back to work

Mrs Sarah-Joy Hubble

Health equity in medical imaging for patients with disability

Mrs Rachel Williams

Hand-held devices: Current state of play

Mrs Caterina Watson

Gynaecology | Extending the Examination Vascular | Mastering the Basics

Emergency gynaecological ultrasound Mrs Sarah Dowthwaite

No strings, no problem: A guide to identifying and removing IUCDs with ultrasound guidance

Dr Kathryn Graham

Getting grafts right Dr Nicole Hallahan

Reliability and accuracy of tomographic 3-D ultrasound for grading vessel stenosis: A phantom study Dr Adel Alzahrani

Arterial waveforms and percutaneous endovascular thrombolysis of a prosthetic graft following occlusion

Mr Tim Fairgray

Detecting pouch of Douglas obliteration for endometriosis diagnosis, combining unpaired transvaginal ultrasound and magnetic resonance imaging using artificial intelligence

Ms Alison Deslandes

Endometriosis and the younger patient –Time to rethink our approach

Ms Gillian Profaca

AI in sonography: Harnessing potential, avoiding pitfalls

Dr Merri Bremer

What the sonographer should know about common vaginal and vulval disorders

Dr Elizabeth Luxford

Importance of recognising disordered flow

Mr Nathan Gallagher

Cardiac | The Mitral Valve

Calcific mitral stenosis Ms Kate Sturwohld

Assessment of TEER (mitral clips) using echocardiography

Ms Bianca Coelho

Carotid criteria: Searching for the sweet spot

Mr Greg Curry

Live scanning | Mitral stenosis Ms Kate Sturwohld

5.20–5.30 PM Q&A Session Q&A Session Q&A Session Q&A Session Q&A Session


SPECIAL CONFERENCE ISSUE soundeffects news 32


Room C4.4 Room C4.9 Room C4.10 Room C4.8 Room C4.3

Professional Topics

Vascular ASA Arena


Philips Siemens Canon GE Mindray ASA ARENA


Paediatric & adolescent gynaecology

Dr Kate Stone

Sponsored Session


Neck muscles to help define neck levels and other structures

Dr Michelle Fenech

GENERAL Navigating common mistakes, tips and measurement techniques

Mrs Mehrnaz Clifford


Mr Matt Adams

The digital health revolution: Are we prepared for the future?



Mr Aaron Fleming

VASCULAR Thoracic outlet ultrasound techniques: Bias beware

Mr Greg Curry


Cranial ultrasound

Ms Glenda McLean


Seeing in 3D

Mrs Rowena Gibson


Ins and outs of multifetal pregnancy

Dr Laura Gerhardy

Philips Siemens Canon GE Mindray ASA ARENA


Don’t forget the house’ – assessing the placenta and cord

Ms Kate Wilson

MUSCULOSKELETAL Neuropathy of the dorsal foot

Dr Damon Jeetoo


Essential exercise and stretching for sonographers

Mrs Ruth Stoodley


Advanced second trimester ultrasound – How and when to extend the examination of the face and skeleton

Dr Kate Russo


Miss Katrina Dietrich

Duty of care and litigation: Protecting you and your patients


VASCULAR Popliteal entrapment syndrome

Mr Heath Edwards

PAEDIATRICS Urinary tract

Mrs Erin Geeves


Neuroanatomy in the 2nd & 3rd trimester

Dr Valeria Lanzarone


Dynamic assessment of ankle ligaments

Dr Colin Chong & Dr Joo Haw Ong

GENERAL Cirrhosis

Mr Oisin McHugh

SPECIAL CONFERENCE ISSUE 33 soundeffects news
General Cardiac Obstetrics Breast Gynaecology MSK Paediatrics





Vascular | Syndrome Sunday

9.00–9.10 AM Abdominal veins – Compression syndromes Mr Peter Sharman

9.10–9.20 AM

9.20–9.30 AM Popliteal entrapment syndrome Ms Deb Coghlan


Obstetrics | Fetal Neurosonography

1st trimester neurosonography Assoc Prof Andrew McLennan

Information is correct at time of publication; however, is subject to change without notice. Please visit our conference website for the latest details and to download and print a copy of the program.


Paediatrics | The Weird & Wonderful

Contrast imaging Dr Tom Watson


Professional Topics | Inspirational Matters

Perserverance pays off Ms Erin Laird


Cardiac | Cardiomyopathies

Dilated cardiomyopathies Dr Anita Boyd

Interesting cases Mrs Erin Geeves

Tropical sonography: The views from up here Mrs Sarah Baxter

Infiltrative cardiomyopathies Ms Felirose 9.30–9.40 AM

9.40–9.50 AM

Ultrasound in diagnosing GCA: Understanding our piece of the puzzle

What do you think? Insights into the second and third trimester fetal brain Dr Kathryn Graham

Congenital fetal infection – What sonographers need to know

Interoperative ultrasound Dr Tom Watson

Educational challenges when training sonographers in developing nations

Hypertrophic Ms Ada Lo 9.50–10.00 AM

10.00–10.10 AM

Mr Greg Curry

Eagle syndrome Miss Lucy Nicholas

Mrs Erika Cavanagh

Collaborative approach to the fetal brain Miss Joyce Chen

Advancements in cranial ultrasound technique of preterm neonates

Mrs Catherine Scott & Mr Patrick Nielson

Professional networking

Mrs Christina Farr

Live scanning scanning Ms Ada Lo 10.10–10.20 AM

Ms Glenda McLean

10.20–10.30 AM Q&A Session Q&A Session Q&A Session Q&A Session Q&A Session

10.30–11.25 AM MORNING TEA

General | Men’s Health

11.30–11.40 AM Penile ultrasound

Mr Peter Coombs

11.40–11.50 AM

11.50 AM–12.00 PM Scrotum

12.00–12.10 PM

12.10–12.20 PM

12.20–12.30 PM

Mr Andrew Grant

Male infertility

Mr Stephen Bird

12.30–12.40 PM BPH and prostate ca – What’s new?

Dr Kris Rasiah

Gynaecology | Infertility Insights

Now you see it, now you don’t – The robotic excision of rectosigmoid endometriosis

Dr Lauren Hofmann

Endometriosis/DIE/pelvic pain assessment – A collaborative approach

Dr Kate Stone

Infertility and how advanced gynaecological ultrasound supports the IVF journey

Dr Jennifer Alphonse

Fertility assessment and assisted conception –What do I need to know and what should I image?

Mrs Vanessa Pincham

Musculoskeletal | Limb – Extension

Quadriceps assessment and injury grading

Mr Aaron Fleming

Rotator cuff interval

Dr Damon Jeetoo

My MSK struggles Mr Aaron Fleming

Enhancing MSK ultrasound with shear wave elastography Miss Jacqui Roots

Obstetrics | Third Trimester Cardiac | Congenital

Fetal growth restriction and uteroplacental dysfunction

Mrs Erika Cavanagh

Unveiling the hidden lifeline: Navigating fetal umbilical cord abnormalities in U/S imaging Dr Kathryn Graham

Simplifying cervical length screening – What you need to know, do and avoid

Dr Kate Russo

Garrett’s legacy: Assessment of the placenta by ultrasound Dr Lynn Townsend

Echo assessment Mr Michael

Percutaneous Mrs Rachael

Echo assessment Miss Nina Pangilinan

Live scanning intraventricular Ms Amy Clark 12.40–12.50 PM 12.50–12.55 PM

Q&A Session Q&A Session Q&A Session Q&A Session Q&A Session
soundeffects news 34

Cardiomyopathies Philips Siemens Canon GE cardiomyopathies Boyd


Work the problem

Mr Michael Foster-Greenwood

cardiomyopathies Bartolome

Hypertrophic cardiomyopathies

scanning | Advanced cardiomyopathy



Unveiling the hidden culprit: Nonsaphenous reflux Mr Gaorui Liu


Prof Hans Peter Dietz


Ms Sarah Beadle

Ms Carolynne Cormack

Mr Chris Sykes

Ms Jane Wardle

Session Congenital Heart Disease Philips Siemens Canon GE

assessment ASD Savari


Mr James Maunder


Dr Kunal Thacker, Ms Kerry Benson

assessment VSD Pangilinan


Dr Adrian Lim


Work the problem

Mr Michael Foster-Greenwood

Room C4.4 Room C4.9 Room C4.10 Room C4.8 Room 4.3
Percutaneous shunt closure procedures Rachael Hellyer
CONFERENCE ISSUE General Cardiac Obstetrics Breast Gynaecology MSK Paediatrics Professional Topics Vascular ASA Arena
scanning | Assessing the intraventricular septum Clark Session SPECIAL
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soundeffects news

Special ASA2024 Sydney Conference Issue

soundeffects news is the biannual magazine of the Australasian Sonographers Association (ASA) Ltd.

The information in this publication is current when published and is general in nature; it does not constitute professional advice. Any views expressed are those of the author and may not reflect ASA’s views. ASA does not endorse any product or service identified in this publication. You use this information at your sole risk and ASA is not responsible for any errors or for any consequences arising from that use.

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