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Experts advise using ultrasound option first

Ultrasound should be the first type of imaging used to assess pelvic symptoms in women, a group of U.S. experts says.

Ultrasound is safer and more cost-effective than other types of imaging for these types of cases, the team of obstetricians and gynecologists wrote in an article published March 31 in the American Journal of Obstetrics & Gynecology.

They support an American Institute of Ultrasound in Medicine initiative called Ultrasound First, which urges doctors to use ultrasound when evidence shows that it is equally, if not more, effective compared with other imaging methods for the area on the patient’s body that requires examination.

“This recommendation applies particularly to obstetric and gynecologic patients. A skillfully performed and well-interpreted ultrasound usually eliminates the need to perform additional, more costly and complex cross-sectional imaging techniques,” article lead author and institute president Dr. Beryl Benacerraf said in a journal news release.

Currently, many women with pelvic pain, masses or flank pain first undergo CT scans, and sometimes MRIs, noted Benacerraf, who is also a clinical professor in obstetrics, gynecology and reproductive biology and radiology at Harvard Medical School and Brigham and Women’s Hospital in Boston.

However, CT scans and MRIs of the pelvis often result in unclear findings that require further clarification using ultrasound, she said.

Moreover, the growing use of CT raises safety concerns, added article co-author Dr. Steven Goldstein, professor of obstetrics and gynecology at NYU School of Medicine.

“The use of CT scans has tripled since 1993,” Goldstein said, noting that radiation associated with CT may pose a cancer risk.

It’s estimated that 29,000 future cancers could be related to CT done in the United States in 2007 alone, Goldstein added. And nearly half of those predicted cancers were attributed to CT of the pelvis and abdomen, he said.

“For example, patients with suspected kidney stones frequently have a CT scan first, despite the associated radiation burden. In a recent study, most of the patients evaluated first by ultrasound did not ultimately need a CT scan, sparing radiation exposure,” Goldstein noted.

Ultrasound imaging uses sound waves rather than radiation.