Role of biplane echocardiography in a large-volume clinical practice: revamping strategies for echocardiography in a limited time.
OBJECTIVE
We determined the feasibility, learning curve, time efficacy, and the quality of imaging during biplane echocardiography performed in clinical practice with a view to reduce a sonographer's time for image acquisition.


BACKGROUND
Multidimensional echocardiographic imaging has improved the assessment of cardiac geometry and function in clinical settings. However, concerns regarding ease of performance and effects on overall clinical work flow remain inadequately addressed.


METHODS
The study included 100 consecutive unselected patients referred to our echocardiography laboratory. They were randomized to conventional or biplane echocardiography performed by a sonographer without previous knowledge of biplane imaging. Image acquisition time and variables influencing the learning curve and overall image quality were analyzed.


RESULTS
Mean time required for biplane and mono-plane imaging was not different in the first 24 cases. In the remaining cases, mean image acquisition time was reduced significantly in 58 cases (76.3%): biplane, 5.6 minutes (SD 1.3); and monoplane, 6.6 minutes (SD 1.6) ( P = .0003). For both techniques, scanning time was not affected by referral pattern, body habitus, or underlying cardiac lesion. Overall, biplane scanning resulted in reduction in echocardiographic imaging time of 9.1%, maintaining an acceptable image quality in 87% of patients. In the last 20 cases, new software design and superior instrumentation technique improved the mean time gain to 15%.


CONCLUSIONS
In a high-volume echocardiography laboratory, biplane imaging effectively reduces sonographer time for imaging and improves throughput by increasing the number of comprehensive ultrasound studies that can be performed in a limited time.
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905, USA.
Partho P
PP
Sengupta
Krishnaswamy
K
Chandrasekaran
Daniel J
DJ
Prince
Rebecca A
RA
Dyke
Bijoy K
BK
Khandheria
D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D019560:Echocardiography, Three-Dimensional / Q000379:methods* / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000706:statistics & numerical data*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013997:Time Factors; D013996:Time and Motion Studies; D014481:United States / Q000453:epidemiology; D016526:Workload / Q000706:statistics & numerical data*