The development of ultrasound in radiology in Sweden

Diagnostic ultrasound in radiology started up in Sweden in the 1970s. And, as elsewhere in the world, it was a couple of enthusiasts who found out that a new and interesting technology was used in other departments and thought it could be used in radiology as well. The main inspiration came from the departments of obstetrics and gynaecology where ultrasound had been shown to be of great use in different obstetrical problem situations. Obstetrical ultrasound was initially used only in the larger university hospitals, which is why the first attempts to use ultrasound in radiology also started there. In southern Sweden, ultrasound was used extensively both for cardiac and obstetrical diagnosis, thus its use in radiology came on early at Lund and Malmö University Hospitals. In Lund, the radiologist wilhelm Karp introduced static ultrasound scanning in radiology. He and his co-worker Lillemor Forsberg published several papers with reference to the use of ultrasound technology in various fields and he also defended the first Swedish thesis in radiology dealing with ultrasound. Their publications showed that this new technology was not just a flash in the pan but here to stay. In Malmö, static ultrasound within the radiology department was introduced by a group lead by Jan Hildell and Peter Aspelin. Simultaneously ultrasound became more and more popular in the larger Swedish hospitals such as Karolinska Hospital in Stockholm and Uppsala Academic Hospital. In Stockholm, several of the radiology departments were pioneering ultrasound in obstetrics and this became the incentive to also use the technology for abdominal and genitourinary diagnosis. Some of the most active radiologists in this work were Ingmar Fernström, who was responsible for both obstetric and radiological ultrasound at Karolinska Hospital for several years, and Anders Törngren and Gunnar westberg who had similar positions at Danderyd and Serafimer Hospitals. Commercial ultrasound equipment at that time were rather complicated to use and to calibrate. The first scanners also utilized so-called bi-stable displays, which lacking in grey-scale made it rather complicated to interpret the images. Therefore ultrasound did not have the same rapid breakthrough as other later introduced radiological imaging modalities.

The role of technology in video-mediated consensus meetings

We have studied the use of video-mediated technology to facilitate multidisciplinary meetings where consensus is reached about the diagnosis and treatment of patients. The meetings involved 2–5 sites, with 1–20 participants from each site, and concerned patients with severe diseases in the upper abdomen. During a period of about one year we conducted observations and interviews at the Karolinska hospital and some of the local hospitals. Eight video-mediated consensus meetings were video-recorded and transcribed. The audio and the radiology images presented during the meetings were considered to be most important; video was not critical for the consensus meeting itself, but contributed to a feeling of awareness and social presence. We conclude that video-mediated consensus meetings are affected by the technology used, and certain changes in the technology or environment could improve the meetings. Without the technology, such meetings would lead to more travelling for the patient and for the medical staff involved.