UTC imaging is no rocket science and depending on the knowledge about tendons and the dedication to spent time to train, it is learned easily.
With each UTC System sold an initial training is included in the purchase price. This two to three days training deals with the basics of UTC imaging, the scanning, the analysis and the interpretation.
For proper use of UTC imaging it is important to understand the underlying basics. So, the training starts with extensive explanation on the principles of UTC imaging.
Since scanning is highly automated, both for the ultrasound settings as well as the probe movement, data acquisition is learned within an hour. Most important is the positioning of the Tracker parallel to the tendon and keeping the Tracker motionless for the 45 seconds of the scan. Scanning does not need specialized personnel, just a pair of steady hands and could even be left to supporting personnel.
The analysis is also highly automated and in many cases just needs the click of a button. The training covers however the rules to apply in the analysis settings. This too is learned in an hour.
The most important part of UTC imaging is the interpretation of the color-coded images. This takes most of the time of the training.
Besides scanning, analysis and interpretation live on some patients, most training is done based on our extensive database of cases.
After the initial training, each novice-user is ready to start using UTC imaging at his own which is crucial for improving skills, especially interpretation. To guarantee a steep learning curve we are available ‘on the background’ to discuss interpretation when requested.
In our experience, it takes approximately three-month regular use to become completely confident in using UTC imaging.
UTC imaging is fully validated for the Achilles and patellar tendon. However, every straight tendon can be visualized. At the moment the tendons in the hand and wrist are being validated at the University of Umea in Sweden.
Since the rotary cuff is not a straight tendon, that is the only area where UTC imaging does not work.
Besides tendons though also muscles can be visualized and evaluated. At the moment it is more and more used on the hamstring and quadriceps.
Since UTC imaging is a new imaging technology, there are still areas that need validation for reference values and pathology but as said it works on all straight tendons.
Ultrasound scanning is known to be highly dependent on the skills of the ultrasonographer and even then, images can hardly be reproduced nor are they of any value to colleagues who did not collect the image themselves. In conventional US scanning is poorly reproducible and evaluation is subjective.
In UTC imaging however scanning and analysis is highly automated and therefor operator independent. The ‘art’ has been taken out of the scanning, rather it is pure science.
Studies both in veterinary and human applications revealed that the intra- and inter- observer reliability is excellent, both for scanning and statistical analysis (ICC is always well over 0.90).
So, data sets (50 to 60 MB) can be shared with colleagues and after analysis both the color-coded images and statistical data will be similar at both ends and can thus very well be discussed.
Of course the colleague should have a UTC System or have a UTC Analyzer license to be able to display and analyze UTC imaging data sets.
The problem with a “test drive” with UTC imaging is that is concerns a new imaging technology which needs training. And although no rocket science, an initial intensive training of three days and a period of intense use of approximately 3 months is needed to become confident in the use of UTC imaging. Hence just a test unit for a try-out period is really no option.
As an alternative, we can introduce you to UTC imaging users where possibly a demonstration of their use of the UTC System could be organized. A visit to the Netherlands and visiting a clinic here may be another option to get acquainted with UTC imaging.
UTC imaging is being used both in human and equine applications in more than 20 countries around the world. Australia and the United Kingdom top the list with the most installations.
Countries are: The Netherlands, Belgium, United Kingdom, Ireland, Sweden, Denmark, France, Germany, Spain, Switzerland, Slovenia, Israel, Canada, USA, Brasil, Australia, Hong Kong, Japan, Oman, United Arab Emirates, Qatar and South Africa
The UTC scanner makes use of a modified Terason ultrasound scanner to obtain the raw ultrasound data for analysis. The Terason scanner is however still a fully functional high quality ultrasound scanner which can accept a range of high-resolution transducers and has full Doppler options.
The probe used for UTC imaging is a regular T-probe as used in MSK in the 5 – 12 Mhz range and can be detached from the Tracker within half a minute.
Thus next to Tissue Characterisation, the UTC scanner can be used for regular ultrasonography as well.
Although the UTC imaging algorithms for Ultrasound Tissue Characterisation appeared to be robust, the best way to reach standardised analysis is to collect “original”, raw digital ultrasound information. Processing of this “original” information, as done by normal ultrasound scanners in order to come to a nice ultrasonographic image (and every manufacturer of ultrasound scanners has his own secret procedures to create that nice display!), significantly clutters ultrasound signals that are vital for high-resolution and discriminative tissue characterisation.
Another frequent problem with normal ultrasound scanners is that ultrasonographic images have to be “grabbed” from the display by means of a so-called frame-grabber. Besides the extra step of analog to digital (A/D) conversion, this procedure also suffers the disadvantage that frame-grabbers do not fit in laptop computer.
So, for multiple reasons UTC Imaging decided to use the Terason ultrasound scanner. This modified scanner is connected to the MacBook Pro and the ultrasound information is brought real-time, unprocessed into this high-capacity laptop computer. In this way, ultrasound signals early in the processing chain, thus without deformation caused by complex signal processing for displaying the nice picture, can be used directly for high-resolution and highly-discriminative tissue characterisation.