Digital Echocardiography – The Desired and the Actual

Objectives: Definition of standards on the acquisition, transfer, playing and storage echocardiographic examinations.

Background: The last recommendations regarding the acquisition and storage of the echocardiographic images in a digital format related to 2005. In this work, we sought to define new standards on digital echocardiography according to the modern computational environment.

Methods: We investigated routine echocardiographic practice in 10 major echocardiographic laboratories in Israel: transfer of echocardiographic data from echo systems to a hospital database, and displaying echocardiographic films on the workstations and storage.

Results: In all echo-labs echo examinations are performed by sonographers and then are reviewed by physicians on the workstations. In 8 of 10 hospitals, echocardiographic data are transferred from the echocardiography systems to the workstations with significant degradation of image quality. Additional degradation of echocardiographic image quality occurs at the workstations due to the inability of the workstations` monitors to support high frame rate videos. The only person who observes original high-quality echocardiographic images is the sonographer.

Conclusions: In recent years, computerized technologies have developed significantly and opened up wider opportunities for the transmission, storage, and playback of echocardiography data. The old simplified approach to echocardiography examinations using a reduced frame rate and the lossy format is deceptive, leads to a degradation of video quality, loss of useful information and is associated with the risk of misdiagnosis. In these work, we defined new standards for the transmission, storage, and reproduction of echocardiographic studies in their original quality on echocardiography workstations.