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The Technical Quality Assurance group was initiated by the EFSUMB Board in 2007 and met firstly in 2008 to discuss and evaluate methods and procedures published for performing technical quality assurance for diagnostic ultrasound devices. It is the aim of this group of experts to advise the EFSUMB Board of effective and efficacious methods for routine use and to make recommendations regarding the technical aspects of EFSUMB by-law 9, parts 11.6. & 11.7. The group's work focused on new developments and related European projects to establish a common guideline. There is a great need of a well established protocol and dedicated processing software for the performance testing of medical ultrasound equipment. The measurements should be user independent as much as physically possible. Only if these goals are achieved in an international (firstly European) context, the optimal quality of ultrasound imaging can be offered and maintained to the medical community. This guideline aims to offer and summarize suitable procedures and evaluation processes to lend support for an optimal Technical Quality Assurance (TQA) scheme. The content of this guideline was presented to the EFSUMB Board of Directors (delegates) and approved by the EFSUMB Executive Board (ExB) at the regular meeting during EUROSON 2012 in Madrid April 2012.

The purpose of this study was to develop a fully-automated segmentation algorithm, robust to various density enhancing lung abnormalities, to facilitate rapid quantitative analysis of computed tomography images. A polymorphic training approach is proposed, in which both specifically labeled left and right lungs of humans with COPD, and nonspecifically labeled lungs of animals with acute lung injury, were incorporated into training a single neural network. The resulting network is intended for predicting left and right lung regions in humans with or without diffuse opacification and consolidation. Performance of the proposed lung segmentation algorithm was extensively evaluated on CT scans of subjects with COPD, confirmed COVID-19, lung cancer, and IPF, despite no labeled training data of the latter three diseases. Lobar segmentations were obtained using the left and right lung segmentation as input to the LobeNet algorithm. Regional lobar analysis was performed using hierarchical clustering to identify radiographic subtypes of COVID-19. The proposed lung segmentation algorithm was quantitatively evaluated using semi-automated and manually-corrected segmentations in 87 COVID-19 CT images, achieving an average symmetric surface distance of $$0.495\pm 0.309$$ 0.495 ± 0.309 mm and Dice coefficient of $$0.985\pm 0.011$$ 0.985 ± 0.011 . Hierarchical clustering identified four radiographical phenotypes of COVID-19 based on lobar fractions of consolidated and poorly aerated tissue. Lower left and lower right lobes were consistently more afflicted with poor aeration and consolidation. However, the most severe cases demonstrated involvement of all lobes. The polymorphic training approach was able to accurately segment COVID-19 cases with diffuse consolidation without requiring COVID-19 cases for training.

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There is evidence from surveys carried out in the 1990s that improvements in ultrasound technology have been associated with increases in acoustic output levels. Current medical devices regulations in Europe and the USA require manufacturers to declare the acoustic output levels from their equipment. This paper analyses such declarations to identify recent trends in acoustic output levels. Comparison of declared values with the earlier surveys showed a 50% increase in mean rarefaction pressures in B-mode and colour Doppler mode and a 75% increase in pulsed Doppler mode. In B-mode, the mean temporal average intensity level has approximately doubled, but approximately halved in pulsed Doppler mode. Analysis of mechanical and thermal safety index values (MI and TI) suggested that some manufacturers are designing their ultrasound systems to be capable of using the highest MI values permitted by the Food and Drugs Administration (FDA). This results in the use of higher acoustic pressures at higher frequencies. Most maximum values of TI declared to the FDA were much lower than the normal maximum value of 6.0. Increases in acoustic pressure and intensity levels would be expected to occur as transducer efficiency and beam-forming methods are improved and new techniques introduced. It is likely that future developments will continue to push typical output levels towards the regulatory limits. Users must maintain awareness of acoustic safety issues and make use of on-screen safety indices to ensure appropriate use of imaging modes that use the highest output levels.